The volume-to-value journey: Guidelines for the new C-Suite

Healthcare leaders are under pressure to improve performance as rapidly as possible in an environment of great ambiguity.

The colossal shifts taking place in the industry require urgent action and more new ways of approaching complex issues that may affect quality, safety and reimbursement.

Forward-thinking executives appreciate that success requires fundamental transformation of delivery systems and disruption of unproductive, legacy practices. The challenge for the C-Suite today is optimizing revenue by filling beds while simultaneously envisioning and executing strategies that push care out of the hospital and into a broad spectrum of ambulatory, retail and home-based settings.

As is true with any large-scale change, ultimate success cannot be achieved without the full alignment and commitment of the executive team. In the new world of healthcare, it is ever more critical to build a team at the top that thinks broadly and innovatively while acting collaboratively to continuously improve performance.

Regardless of the size or complexity of a delivery system, the following five guidelines can help a hospital C-Suite lead a successful, sustainable organization.

1. Hire the right skills and develop the team. Most healthcare administrators have a demonstrated track record as successful operators with deep industry experience. While this is important, in a post-reform context it is critical to balance healthcare and administrative competencies with expertise from other consumer-oriented, innovative and entrepreneurial sectors. Thinking through the eyes of the customer, building creative partnerships and affiliations, extending care across vast geographies, redefining populations and importing technology supportive of a value-based model are examples of "must do" priorities for the C-Suite. These and a plethora of other strategic initiatives are fully optimized only if the team is able to embrace diversity of thinking, authentically challenge longstanding beliefs and practices, dismantle organizational insularity and welcome the views of outsiders who may try to upend the status quo.

While many CEOs and executives acknowledge the unique importance of the C-Suite, building a team that can operate at maximum capacity starts by assessing the most critical competencies for an organization undergoing rapid and massive change, accompanied by a commitment to put the right people around the table and invest resources to coach and/or develop the team's capabilities.

2. Learn creative thinking. Creativity is most often associated with industries such as entertainment, technology and fashion. However, creativity is now a critical competency for successful executive teams striving to achieve the goals of the ACA and Triple Aim. Meeting the diverse needs of consumers with services that are accessible, effective and possibly even revenue-generating is the new mandate.

Too frequently, addressing the need for innovation and creativity is considered the domain of product development, i.e., information technology. In fact, research shows simply investing in products produces the lowest ROI. Innovation is a systemic capability influencing organizational vision, brand, customer engagement, organizational structure and many more facets of the entity. And all of this begins with the executive team and its ability to think and act creatively. Fortunately, through training on creative processes, such as mind mapping and design thinking, the team can practice and then embed tools that will help the entire system to assimilate these capabilities.

3. Integrate "outside-in" thinking. "This is the way we do things here," remains an unfortunate refrain in many healthcare organizations. Despite proclamations from the top that legacy practices are no longer the standard, organizational DNA has a strong pull and can prevail unless the C-Suite consistently demonstrates learning from outsiders and thinking from an "outside-in" point of view. It is therefore incumbent upon the C-Suite to adopt behavioral expectations that force them to think through the lenses of consumers, the community and key stakeholders, as well as to proactively seek ideas from other industries and outside resources. In addition, by being transparent with the organization about how it approaches problems, the team will reinforce the importance of listening to the "voice of the consumer" and ideas from people and industries that are dissimilar but from whom valuable lessons may be gleaned.

There are other ways of training an organization to break through insularity as well. A short list includes exposing the board to thought leaders from the healthcare and other industries that have undergone transformative change; coaching the executive team on how to broaden organizational perspectives; and, recognizing people at all levels who pose solutions to consumer needs that may improve access, quality, safety and/or the patient experience.

There are many tactics that can break down silos, opening the organization to broad thinking. Ultimate success lies with a C-Suite that "walks the talk" and consistently demonstrates a bias toward solutions that support a customer-centric, performance-focused organization.

4. Push decision-making close to the customer. Look to travel and retail for two industries that understand the direct link between front-line decision-making, consumer satisfaction and financial performance. Healthcare organizations' traditionally hierarchical structure and top-down management style are barriers to engaging front-line employees. The move toward patient-centric care implies that every touch point with the consumer is an opportunity to either strengthen or diminish the organization's reputation and value proposition. This places a new responsibility on those who interact with the patient and family to create memorable experiences, indirectly leading to improved financial performance.

Flipping the hierarchy upside down with the consumer at the top is a possible first step toward achieving a new approach to care delivery. However, the executive team must first decide that building a consumer-centric organization is the strategic intent, then clarify the array of implications at the strategy and operational levels. If the system is not ready to make this fundamental shift, then the C-Suite can support initiatives to restructure decision-making at the front line, and train managers and employees on new tools and processes that support patient-centered care.

5. Team coaching to improve C-Suite performance. Building an effective team at the top is likely the most important priority for any CEO. An organization's vision, mission, values and strategy are contingent on having the right talent collaborating as a team in a coherent, engaged and aligned manner. Given each team member's unique attributes, a successful team must synergistically unite an array of strengths and overcome individual weaknesses. This requires a high level of trust and appreciation for diverse and divergent thinking among the team members.

Group coaching is an effective solution to enable executive team members to develop the necessary deep understanding of one another, enhancing group dynamics and collective performance. By investing in their performance, the organization demonstrates its commitment to excellence and sustainable success.

For those hospitals that choose an unaggressive approach to repositioning themselves for a post-reform environment, the focus remains mostly on short-run objectives and incremental changes. Regardless of the pace of change, the most important characteristic driving long-term success is that the CEO and executive team are honest about their intended strategic objectives. If optimum performance for the future is the goal, then now is the time to build a C-Suite equipped with the talent, tools and perspectives needed for the new value-based era.

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.

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