A roadmap to organizational excellence

Chris Van Gorder is one of the finest CEOs in healthcare today. Since becoming president and CEO of Scripps Health in 2000, he has taken it to the highest tier ofhealthcare institutions in the country, a massive turnaround for an organization that had been mired in red ink, with physician and employee morale at rock bottom.
By streamlining business operations, cultivating a new relationship with physicians and creating a workplace culture of shared responsibility, Van Gorder rewrote the Scripps story. Now with five acute-care hospital campuses, dozens of outpatient centers throughout San Diego County, and more than 13,500 employees and 2,600 affiliated physicians, Scripps is ranked as one of the top 15 integrated health systems in the country by Truven Health Analytics. The system has made Fortune's "100 Best Hospitals to Work For" list for six consecutive years.
Now Van Gorder is sharing the story in a riveting new book, "The Front-Line Leader: Building a High-Performance Organization From the Ground Up." (The book is being released this fall by Jossey-Bass.) To me it is a roadmap to creating organizational excellence without turmoil. The book is filled with basic wisdom and practical solutions to working with people and breaking down silos within a healthcare organization to enable it to provide quality healthcare to its customers. It's about leadership, risk, perseverance and courage, a remarkable story of how changing corporate culture leads to better outcomes for patients, physicians, staff and the bottom line.
Van Gorder took an unusual route to healthcareleadership. On Oct. 17, 1978, he was working as a street cop in Monterey Park, Calif., when a call came in to respond to a domestic dispute. A distraught woman had seized her infant child from her estranged husband, barricaded herself in her car and refused to give the child back. The woman warned her husband not to call the police, claiming she would "ram" any police car that showed up. When Chris spotted the woman and her husband, he stepped out of his patrol car and approached. The woman fled the scene, her crying baby strapped in the car seat.
"I ran back to my vehicle and ordered the other officer to pursue the woman," he writes. "Jamming my car into gear, I turned onto a nearby cross street, hoping to intercept the woman at the next block. I took a right onto the street parallel to the one I'd been on, only to find the woman's car heading straight for me, now with two police cars in hot pursuit. That's the last thing I remember." Witnesses saw the suspect accelerate and crash head-on into Van Gorder's patrol car. "The impact sent my car bucking into the air and careening backward 10 to 15 feet. My body first slammed against the steering wheel, my bulletproof vest cushioning the blow. Then, despite the seatbelt I was wearing, I flew briefly into the air and my skull banged against the roof."
As a result of the massive injuries Chris suffered, he spent more than a year rehabbing, in constant pain. Eventually he had to leave law enforcement and seek a new career. His choice was healthcare, and he went back to school and got a graduate degree in healthcare management. He had learned enough about pain and suffering to make it a logical decision.
To Van Gorder, the first order of business for any leader is to get to know his or her people. He tells a story from early in his healthcare career when he was named a vice president of Anaheim (Calif.) Memorial Hospital. He was in charge of a number of departments, including housekeeping, food services, engineering and construction. To really understand his people he spent time working alongside them, cleaning floors and serving meals in the cafeteria. As a result of his efforts, one day he was presented with an Indian headdress by his colleagues, who told him that he was now "one of them" and “Our Chief." Van Gorder refers to that moment as an "incredible honor."
This is about stepping out of the hierarchy, where title and rank only serve to distance leaders from front-line employees. For Van Gorder, credibility is something that every leader can foster with their employees by getting personally involved on the front lines when there is a crisis. He believes that there is no substitute for actually being there and for genuinely caring.
Van Gorder has learned that storytelling is essential to the work of the fully engaged leader. It allows leaders to forge emotional connections with people by capturing their attention. Invigorated and inspired employees easily understand new ideas. The most powerful stories to tell are about the organization itself, he believes. There is no better way to help people care about an organization than by evoking the impact the it has had on real-life people, especially patients.
He also writes about creating a culture of advocacy, of holding people accountable and bringing people together so they can work as a team. He urges the reader to "put employee ideas into action" and "give employees a key role in driving change."
One chapter, entitled "Take Care of the Me," summarizes these themes. In it he writes: "We owe frontline staff care and protection, and it's in our own interests to provide it. As I've said all along, frontline workers are the people who are taking care of customers. But let's get real here. Employees — and leaders too — aren't thinking primarily about customers. They are thinking about 'me.' And that's precisely as it should be. Our most important responsibilities in daily life aren't to organizations; they are to our families and ourselves. We have to provide for our kids, spouses, aging parents; work is ultimately a means to that end. If workers don't feel they have what they need to take care of their families — they don't get paid enough or have sufficient benefits or have opportunities to advance in their careers — then they're going to leave the organization, if they can. And if they can't, they will contribute the bare minimum until they can leave. We've succeeded at Scripps because we've done our best to take the 'me' out of the equation."
Van Gorder's book has certainly inspired me, and I hope you will make the effort to read this book and pass it along to your fellow leaders.

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