Wednesday, August 20, 2008

The Value of Relationships

Having completed visits to six of the CHRISTUS Health regions as part of our plan to spend time in every region, site and business unit both in the U.S. and internationally as we move toward our 10th anniversary, I have been reflecting on the value of relationships in creating a culture of excellence in an organization.

In these last 10 years, before each trip to a facility or program the senior team has asked the question, “Are we doing the right thing by taking the time of the local leaders to facilitate our visits?”

We questioned whether they had more important things to do than planning an agenda for our visit, which obviously involves the time and efforts of members of their teams. And as much as we would hope they would not make special preparations, we always know that they will be made, and we will be fed well during our visits. Obviously, this is not only a time but an expense issue as well. So is it really worthwhile?

During these visits--as we have done in the past--we instruct the local teams to utilize our time as effectively as possible, making sure they know we are available as early as 6 a.m. and want to fill our day completely until 9 or 10 at night. We ask them to make sure that as we come to give our updates, they create forums for us to reach as many Associates, board members (both governance and foundation), physicians (including medical leadership) and volunteers as possible. For our visits over the last two months, they have done just that. In our most recent regional visit, I had the opportunity to interact with over 2,500 Associates, 12 governance board members, 20 foundation board members, 30 members of their medical staff and over 200 volunteers. I was amazed at the attendance at the various forums, the attentiveness during my presentations, the thoughtfulness of the questions posed during the dialogues and the constant comments by many of how beneficial these interactions were.

These comments included:
* “I can’t believe you spent the time to come and visit us.”
* “I cannot believe that you know our journey so well that you can speak to it without looking at notes.”
* “We are truly appreciative of having a better knowledge of what the entire CHRISTUS system is doing.”
* “It is great to understand how we as a department, business unit or clinical service fit into the regional strategies and how that strategy then fits into CHRISTUS Health system strategy.”
* “We are so proud of being part of the CHRISTUS family because we now know better what other family members are doing, particularly as you shared the stories of Santa Rosa and Spohn as being at the top of the mountain and in the valley in the last several weeks as well as the work occurring in the CHRISTUS Stehlin Foundation in Houston.”
* “We are pleased to see your passion and enthusiasm, which gives us the energy and the focus we need to continue the Journey to Excellence in our specific areas.”

In the past, if you asked many CEOs in health care what their major role in their organization was, they would tell you it was to be the external face of the health care system. That would mean that they thought most of their time should be spent in Washington, at the state government, attending national and state association meetings and addressing local groups such as Rotary and Lions clubs regarding the status of the health care system they were leading.

Although these external activities are still important today, with the challenges we are facing in health care, it is my belief that much more attention must be placed on creating the internal face of the leadership team for all the Associates, physicians and volunteers who are part of the CHRISTUS family. It is clear to me that the Journey to Excellence is only attained if the people believe and work in a culture of excellence. And it is more clear to me than ever after six of these regional meetings that the culture of excellence can only be created, energized and sustained if the CEO and the leadership team are there to speak to it and to demonstrate by behavior that it is a way of life in CHRISTUS Health and not a mission, vision and value statement framed on a wall or embedded in a series of policies in a book that is rarely read by anyone.

We all know at CHRISTUS that these trips take an enormous amount of time and effort on the part of the leadership team, the communications team who plans the agenda and the local leadership team who carries out the implementation. But at the end of each trip, the value of these efforts are reinforced and remind us that although we might believe that our greatest asset in health care and particularly in CHRISTUS Health may be the $4.7 billion we have on our balance sheet which represents the amount of buildings and technologies that we own and operate, in reality our greatest asset is our people. And people are motivated by people who have developed relationships with them and who demonstrate by the way they walk and talk that they are committed to excellence. This can only be transmitted by face-to-face forums through these regional visits, and must be seen as one of the most important things we do. So often we attempt to resolve crises in health care quickly and efficiently and fail because we have not established the appropriate culture or relationships prior to the occurrence of the crisis.

The challenges in health care are great and the changes we must make to address these challenges are even greater, but at the end of the day, if we expect to make the progress necessary to provide excellence for every person who comes through our doors, we must believe that relationships and the culture of excellence that comes from them is the essential ingredient to be sure that our people create an excellent environment in both clinical and quality services so that the care that is rendered is worthy of the CHRISTUS brand.

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