Issue link: https://beckershealthcare.uberflip.com/i/351959
54 Leadership & Management T he playbook for hospital and healthcare leadership has fundamen- tally changed. Integrated hospital systems, academic medical centers, freestanding hospitals — no provider is immune from the need to transform its delivery model to align with the Patient Protection and Afford- able Care Act and broader industry reforms. CEOs and their executive teams are tasked with reinventing their organizations to meet the call for a more patient-centric, value-based approach while simultaneously managing tradi- tional, volume-based models. What's the score? Are CEOs and other C-suite leaders successfully adapting to this unprecedented paradigm shift, or is it too early to judge? Are there accepted paths to successful enterprise-wide transformation? What new play- book "plays" or strategies are proving most effective? To find answers to these and other questions, we recently held candid conver- sations with 20 CEOs across the U.S. from a diverse cross-section of health- care delivery systems. We heard first-hand about changes they are making to transform their organizations, along with the myriad challenges they and their teams are facing along the way. The new world order Unilaterally, the CEOs' sentiments echoed what we hear during our daily work with healthcare executives: The healthcare world with which they are accustomed has turned upside down. The primary purpose of hospitals has changed from providing care within their four walls to keeping patients healthy in and out of the hospital. CEOs must define new strategies for their organizations to succeed. They must establish a cohesive system of care by engaging physicians and improv- ing efficiencies, quality, safety and the patient experience. These demands are forcing them to address their senior talent, as each member must be invested in the process and capable of leading an integrated system. 5 strategies for successful change Considering the CEOs' perspectives and our insights gained from working directly with C-level executives, we posit the following five strategies as the core of the healthcare industry's new playbook. 1. Horizontal and vertical integration must co-exist. Regardless of a healthcare system's size or complexity, breaking through legacy silos and diminishing traditional fragmentation of care are key to creating a successful integrated and patient- centered delivery model. An initial step is defining "integration," with the leadership team identifying the hurdles a system needs to overcome and defining an iterative change process. Traditionally, senior leaders have been tasked with oversight of their respec- tive business units and some system-wide decisions. Today's playbook calls for a "team- at-the-top" demonstrating true integration, across vertical and horizontal boundaries of care, both within and well outside of the hospital structure. Moving in this direction calls for the team to develop a shared and clear strategic direction around provision of care. Wrestling with an array of complex issues, including infrastructure requirements, organizational struc- ture, partnerships, efficiencies and culture is central to the job of architecting a delivery system positioned for long-term viability. 2. The CEO is the primary agent of change. In the past, a CEO was laud- ed for being an excellent hospital administrator with strong financial and opera- tional acumen. Today, expectations of the CEO are undergoing a material shift. Contemporary CEOs must be change agents who can win the "hearts and minds" of employees, physicians, the community and a diverse array of stakeholders. A CEO in the new world order must have sufficient vision to fully understand the complex, strategic and practical implications of re- form in order to lead the team, transform the organization and achieve new metrics of success. Building delivery systems focused on access, quality and the patient experi- ence requires alliances previously unimagined or impossible, often extending care across vast geographical regions. The CEO and his or her team must think broadly, entertain unfamiliar and often uncomfortable frameworks, operate well in ambiguity, set a high bar for performance and demonstrate the core values that underlie action. Those CEOs who remain a step ahead will flourish, while those who lag behind will become obsolete. 3. Culture is a business imperative. Culture no longer is about the soft side of business. Without the "right" culture, the best-laid operational plans will stagnate in the vertical hierarchy or fail from poor execution. Forward- thinking CEOs are quickly realizing that command and control leadership ultimately breeds mediocrity. Influence is the name of the game in today's era in which patients, staff, physicians and diverse stakeholders must all be engaged to achieve results. To further complicate matters, as hospitals swiftly merge or acquire to remain relevant, conflicting cultures and values may lead to stunted growth and performance. While wizened CEOs and executive teams are champions of culture transforma- tion initiatives, they also acknowledge that the process is lengthy and difficult. Accordingly, culture has become one of their top priorities. An increas- ing number of hospital CEOs are hiring outside expertise to guide them through a multi-year process of culture change, starting with aligning the C-suite around goals, values, process and commitment. Those experienc- ing success understand that changing the culture requires ownership by the CEO and full support from all members of the executive team and physician leadership. 4. A new world calls for new executive skills. CEOs across the country acknowledge that building a care-centric delivery system calls for executives who have a unique combination of both analytical and relational skills. They must be team players, think strategically and operationally, wear multiple hats, and effectively lead and inspire others toward enterprise-wide change. Reinventing Healthcare: By Carol J. Geffner, PhD, Newpoint Healthcare Advisors and Chris Corwin, Witt/Kieffer 5 Strategies for Successfully Leading Change The healthcare world to which CEOs were accustomed has turned upside down. These five strategies are the core of the industry's new playbook.