Becker's Hospital Review

100 THOUGHT LEADERSHIP Dr. Hovet says. "Get the most important stakeholders at the table and listen to them. Don't tell them how things are going to change. Instead, listen to how they do things and what they want to change. Once you have heard everyone's voice, you will have a much clearer picture of where and how to adopt the culture to fit your own. "Also, if you let the stakeholders be a part of the decision and planning process, you'll have champions on the ground where you need them when things get sticky or difficult. And you might find that this smaller organization has some really good ideas you could learn from. But if you don't listen first, you may never hear those good ideas," she adds. I'll add another thought here: Remember why you merged with or acquired the other organization. If you are intent on enlarging your geographic territory, remember that you have to win the patients in the new area, just like you won your current patients. That means you want to tread lightly and respect the culture and values of the organization, seeking to enhance the existing trust between the organization and its patients/customers in the community you are embracing. If you acquired an organization that had specific strengths, focus on nurturing those strengths. Too often, organizations get tunnel vision and force changes that erode the very strengths that attracted them to the smaller organization in the first place. They forget what the ultimate goals are, especially when faced with the details of merging cultures and technologies. Keep your eyes on the prize, whatever that might be for your individual situation. The same basic principles apply to helping physicians and other clinical staff adopt a new organizational culture to meet the challenge of value- based reimbursement. Chances are your organization has depended on filling beds and filling the schedule in surgery, cath lab and other procedure-based areas to succeed financially. Administrators may have courted physicians based on their ability to fill beds and schedule procedures, and physicians have been rewarded for volume. In a value-based reimbursement environment, the attitudes and behaviors that maximized revenue will become a liability. Hospital leaders will be challenged to help change the thinking and behaviors of their physicians, a group not excessively fond of being told how to do their clinical work. As a physician, I know just how hard it can be to change practice patterns, especially when the changes are forced upon me. It's going to be a difficult challenge, and patience is your best tool for meeting that challenge. Start by getting the right stakeholders at the table and talk about the challenges. Pose questions instead of presenting answers. Brainstorm with your stakeholders on ways to create the effects you are looking for. Listen first, and remember that better patient outcomes at lower cost is your ultimate goal. Don't let yourself get sidetracked into exciting new technology that isn't what your specific situation calls for, or set up complex systems that get in the way of efficient and effective patient care. And make sure the solutions you and your team propose are sustainable. If you work with all stakeholders and listen to their needs, you'll be more likely to find solutions that will be easy for the organization to embrace. Finally, remember there will be skeptics, naysayers and foot-draggers with any important changes in organizational culture. And that's a good thing. You need to listen to the grumblers as well as the cheering section if you want to get a really clear view of the situation. Those grumblers, if treated with respect and if their concerns are addressed, can ultimately be your best champions. You don't want to be The Borg, forcing your will on those less powerful. You want to discover new galaxies of good healthcare, and you'll need everyone's help to do it. Be like Guinan on Star Trek, the El-Aurian character played by Whoopi Goldberg who ran the ship's lounge, 10 Forward, and listened to everyone's troubles. She rarely gave advice. Instead, she asked questions that focused each person on solving their own problems. So, like Guinan, listen and include people. Ask questions instead of giving answers. It takes patience and thoughtfulness, but it is more effective in the long run. n Becker's 5 th Annual November 7-9, 2016 l Swissotel, Chicago CEO + CFO Roundtable

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