3 questions on motivating teams, overcoming failures, vendor dealbreakers with St. Vincent's Health Partners' Dr. Michael Hunt

In this special Speaker Series, Becker's Healthcare caught up with Michael Hunt, DO, chief population health officer at St. Vincent's Health Partners in Bridgeport, Conn.

Dr. Hunt will speak on a panel during the Becker's Hospital Review 4th Annual Health IT + Revenue Cycle Conference titled "Population Health, Data Analysis and the Impact on Services," at 1:15 p.m. Thursday, Sept. 20. Learn more about the event and register to attend in Chicago.

Question: Can you share your best advice for motivating your teams?

Dr. Michael Hunt: Staff at St. Vincent's Health Partners make it a practice to go outside of the healthcare domain to learn from other industries and published literature about the best processes and measurements of strategies and successful execution of those strategy. Reading from resources such as the Harvard Business Review, Fast Company and the transparent experience of leaders from Google and General Electric helps us to challenge preexisting notions about motivating teams and to be more comfortable with taking risk, learning from our mistakes and moving from strength to strength.

Our admittedly lofty goal is to be able to demonstrate the link — or lack thereof — between our practices for motivating the team and successful outcomes of our mission. More and more patients within the prevue of this organization must get the right care at the right time, in the right place, and be able to manage the associated cost of service. Objective measures include outcomes-related organizational contractual goals and internal retention and turnover rates. Like the quadruple aim, it is the value of the organization that staff themselves as a group that is also a stakeholder and must experience satisfaction and productivity.

We believe that being able to build and sustain motivation is only possible by paying close attention to the concept of both 'soft' and 'hard' practices and metrics. In our experience, soft practices and metrics must infuse the hard practices and metrics. For example, the organization must have the hard skills in place for the work that needs to be done, and it recruits and trains talent accordingly. However, employees also need to continually grow their skills to mitigate miscommunication, to effectively manage the inevitable friction that arises within teams when team members work together, and to be able to build resilience in the face of obstacles. These soft skills make it possible for people to use their hard skills to accomplish their full potential while minimizing negative experiences, time-consuming distractions and interactions, which so often demotivate people and result in less success than is possible in meeting goals.

Clearly identified goals and metrics are 'hard' stuff. How goals are selected, communicated and kept visibly connected to daily work is the 'soft' component. Both aspects impact motivation. Visibility of the goals is maintained through socialization at all meetings and through a software platform like ONStrategyTM. Monitoring and evaluation of the progress against goals, and creating regular opportunities to brainstorm solutions to barriers, are high priorities. Most recently, a short group exercise involving the creation of an acronym to remember key performance indicators and then posting the acronym visibly around the office brought levity and clarity to motivate the team in their work.

Our values are intentionally articulated and are foundational for motivating the team. The team annually reviews its values to evaluate them for authenticity. From pre-hire and throughout the work of the organization, having values that are lived — not just paid lip service to — empowers teams in function and enables individual team members to feel connected to the organization's work as a whole.

SVHP has invested in its leaders by having them complete the Birkman Occupational and Behavioral Assessment. The Birkman Method allows the leaders to be challenged and accountable to incorporate a high level of social intelligence with accuracy into their work. It is also a tangible way to access a rigorous level of insight into the motivations, perceptions and behaviors of each person on the leadership team. Having a powerful tool to better understand what makes an effective match or mismatch between skills, roles, expectations, teams and goals is empowering and challenging. It brings wisdom to the day-to-day interactions among team leaders and to ensure that each person is supported in what keeps them motivated. In turn, developing a meaningful continuous performance review process based on these insights makes more sense, both for individual motivation and organizational performance.

Q: Describe your biggest failure. What did you learn from it?

MH: Our biggest failure occurred during the startup phase of our company, but what we learned from it has made us stronger for the long run. Why? Because its applicability was much broader than the point of failure. It taught us the necessity of two cross-cutting areas, both critical to the sustainability and growth of the organization: 1) transparence with staff about contractual arrangements, and 2) the necessity of a living, breathing strategic plan.

The failure was a delay in the successful deployment of the health informatics technology capability of the company. Key staff were not involved in the selection and terms of the technology. It took several iterations, as well as the active participation of a cross section of staff for the current innovative framework to be in place. That framework comprises of not one but three complementary and interacting platforms reflect the innovation necessary in the rapidly changing healthcare environment.

Other contractual arrangements within the organization also lacked visibility to key programmatic staff. In the past, the lack of transparence led to weaker contract design and a vague understanding about our obligations by contract as well as unnecessary budget confusion. If we hadn't embraced transparence, we wouldn't have reached our current status in which frontline staff contribute to the design of the programs with which they will be intimately involved, bringing a variety of needed skills and innovative approaches to the unique situations of the customer.

Related to this confusion was a lack of understanding about priorities and an inability to effectively align resources strategically with goals. Together with a lack of transparency, this factor contributed to delays in understanding the value of the initial health IT solution and its intended future. Ultimately, the organization was unable to support the solution because it was not meeting the needs and cost more than was sustainable. Change was necessary, but the road map needed to make sense to everyone involved.

During the organization's fourth year, a strategic framework was introduced to capture the entire process of goal setting and execution of those goals. Aligning the activities and resources of the organization to the strategic plan and being able to use a common language enabled the leadership working together with the staff to identify a timeline for goal achievement and create a budget process that aligned with the goals — one that extends far beyond the situation that arose with the health IT experience.

Q: What is your No. 1 dealbreaker when it comes to evaluating vendor partnerships?

MH: SVHP, the first nationally-recognized Utilization Review Accreditation Commission-accredited Clinically Integrated Network, evolved our membership in our provider network several years ago to include post-acute partners such as skilled nursing facilities, home health, hospice, rehabilitation and pharmacy. To add post-acute providers, the network required moving beyond a traditional vendor relationship to ensuring that the organizations participate as active members of our high-value network. Our partners are not owned by the CIN. When joining as a network member, they agree to fully participate in the necessary transformative work individually by organization and collectively for the network; this requires cooperation and collaboration among competing organizations looking elsewhere in the marketplace.

Therefore, while initial admission to our network required evidence of strong quality and processes, the primary focus was on a demonstrated commitment to continual transformation and active participation in network initiatives to achieve goals. Going forward, ongoing activities were driven — and continue to be driven by — purposeful attention to goals and intentional communication practices that have to be respected by all members.

Our success is striking. The CIN can clearly demonstrate how differently our members perform compared to non-network entities. Our SNFs' length of stay decreased by 10 days and lowered readmission rates over a three-year period. They are also adapting new technologies, like telemedicine for example, to improve patient care and handle higher acuity patients. Our network home health agencies have reduced readmissions to about 7 percent, significantly beating national Medicare trends.

Our experience has revealed the 'deal breaker' in evaluating the value of partnerships is the level of maturity that any given organization demonstrates to leverage its unique and complementary strengths in skills and culture for the initiatives of their network. The result is a limited number of organizations working synergistically to allow the group to compete more aggressively in the marketplace.

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