Being aware of the signs of failure

Recognizing the reality and concerns expressed in last week’s blog post related to the volatility of the market and the global economic crisis that has ensued, it is undoubtedly important for all health care institutions, including CHRISTUS Health, to be more cognizant of the signs of failure than ever before. I would suggest that there are six clear signs of failure which, if seen early, can hopefully be minimized and also serve as energizers to make sure that incremental successes are cancelling out the failures as quickly as possible.

1. How is your performance measurement, and therefore, your performance credibility? As I believe I have shared before, one of my greatest mistakes in my early leadership years was not having metrics for everything that I was doing or leading in the organization where I worked. You have undoubtedly heard me discuss many times our Journey to Excellence and the metrics associated with our Four Directions, hallmarks of all of our regions and programs both in the U.S. and internationally. Hence, by monitoring these metrics on a daily, weekly or monthly basis, it is very easy to determine if the measurements are being met. If not, then we can reaffirm that there are clear action plans in place to ensure that these metrics are going to be reached in as timely a fashion as possible.

2. Are you focused on the basics of execution? Leadership teams must always demonstrate the ability to do good strategic planning and to articulate the tactics to bring these plans to reality. However, where teams most often fail is the ability to execute these tactics and, more importantly, to hold people in the organization accountable to bringing these plans to fruition. Again, by monitoring metrics as outlined above, one can determine if the execution is successful or not. If the latter is the case, one can quickly reaffirm the need to improve them to the responsible party, or remove the responsible party and replace them with someone who understands the urgency of the day and is willing to take not only the responsibility, but the accountability to fully implement the tactical plans for improvement.

3. Is bad news coming to you regularly? Is each day filled with an array of emails, written communications, telephone calls or personal interactions which indicate that something unexpected--and more importantly, negative--has been occurring more frequently than would normally be the case? In addition, are people presenting these reports without quickly articulating the action plan which they have already put in place to assure you that the problem will quickly be ameliorated? Bad news is expected in the complex health care environment in which we function today. But good leaders in good times never present the bad news without the action plan to turn it around.

4. Is your own team disconnected? In bad times, weak teams become weaker. Finger-pointing is accentuated and excuses run rampant. The resolution of problems in challenging times can rarely be carried out by a single individual in a single department, program, or region, and therefore the cohesiveness of the team and the ability to act in a collaborative and connected way is essential. If this is not happening, then it is most appropriate to pause and do some basic team building exercises, for the solutions that are reached will parallel the effectiveness of the team.

5. Are you unable to confidently predict your outcomes daily, monthly or quarterly? It is imperative that during challenging times, an increase effort be placed on processes to predict at mid-month what the month-end operational margins will be. Likewise, it is important to monitor labor and supply costs on a daily basis and create as much variable budgeting in these two areas as possible to parallel the predicted revenue that they are generating. The degree to which these predictions can be made accurately will be the degree to which the proposed solutions will be successful in addressing the reality of the market volatility.

6. Are the things that you were doing well becoming now the things at which you are failing? Perhaps more important than a snapshot of today’s metrics is the trend of these metrics over the last several months or year. Recognizing, as we have stated before in prior posts, that health care change is never linear, we expect some ups and downs as normal variability as we climb from the valley to the top of the mountain. However, if the trends are showing that the peaks we’ve reached on our climb are no longer in view and we are standing at a much lower level on the mountain for a prolonged period of time, we should be honest with ourselves and understanding that what we thought was hard-wired into our improvement plans was in fact extremely transient, therefore new performance plans must be devised and implemented to replace those that are not working.

Yes, it is imperative that we accept the volatility of the market as what will probably be a longer-term reality for us. But we also must accept that our mission, vision and values cannot be altered during this period of time, and that in fact we must continue to energize ourselves to maintain our Journey to Excellence as our highest priority. These times may require different approaches, different tactics and innovative methodologies to create change, and if we are successful by clearly monitoring the signs of failure and correcting them as quickly as possible, it seems reasonable to expect that reaching the top of the mountain is still extremely important and very possible.