Wednesday, October 20, 2010

Burning Questions, Part III

We continue again this week with my answers to the questions posed by leaders from across CHRISTUS Health at our recent leadership retreat.

Q. How would you succinctly define quality care?

A. In concise terms, I think a quality outcome has four metrics:
1. Morbidity and mortality
2. Functional status
3. Patient satisfaction
4. Adherence to best practices and evidenced –based clinical protocols

Q. I know you said if you had it to do over, you would do it all over again. But is there one thing that you might change?

A. Yes.I would have been a pediatric specialist instead of a general surgeon. When I was training they did not have pediatric specialty residencies, and I did not think I would be challenged enough as a general pediatrician. As a general surgeon in the early years, before there were pediatric surgeons, I operated also on children. I love all patients, but have a special place in my heart for children.

Q. What is the one thing that can minimize the toxic side-effects of change you talk about?

A. Besides identifying the potential toxic sides effects, I would say there are two keys to implementing long-term change:
1. Providing clear rationale of why the change is necessary
2. Breaking the change down into doable chunks. Sudden and overwhelming change can, as we have experienced, trigger fundamental survival instincts and build strong resistance. Effective leaders recognize this and move quickly to help followers regain a sense of balance and equilibrium.

Q. You are saying on your recent visits to the regions and business units that if CHRISTUS Health is going to reach excellence, the leaders need to feel “called” and then be able to do transformational work. What is your definition of transformational leadership?

A. When describing transformational leadership, I use the 8 steps outlined in the January 2007 edition of the Harvard Business Review. They are:
l. Establish a sense of urgency
2. Form a powerful guiding coalition
3. Create a clear vision
4. Communicate the vision
5. Empowers others to act on the vision
6. Plan and create short-term wins
7. Consolidate the improvements, often creating more change
8. Institutionalize the new approaches

Q. What is the one major obstacle standing in the way of obtaining excellence?

A. Not dealing with the people who are satisfied with “good.”

Burning Questions, Part II

As I mentioned in my last post, we recently gathered leaders from across CHRISTUS Health for a leadership retreat. In my opening presentation to these leaders, I asked them to submit questions for me, one of which was, “If this was your last chance to meet with me, what burning questions would you like to ask?”

Our leaders submitted over 90 different inquiries, of which I answered about 50 at a later session. Here are some additional submitted questions along with my answers.

Q. You described the characteristics of a successful health system in your opening presentation. As we move forward, what do you think needs to stay constant in CHRISTUS Health, and what do you think can change in the future?

A. Certainly our brand needs to remain as constant as possible, with each component being enhanced and strengthened in the next decade. Also, our 5 Strategic Directions and our 8 Strategic Enablers must remain. In addition, I would list 5 other behaviors that must remain constant:
l. We must put our patients’, families’, and residents’ needs and interest first and foremost.
2. We must always give caring and responsive service.
3. We must treat each other with courtesy and respect to maintain the excellent team focus that a successful heath system must have.
4. We must be stewards of the resources that our communities and CHRISTUS have entrusted to us.
5. We must devote significant organizational and personal resources to not only replenish our knowledge base, but also to reflect in small groups and in one-to-one encounters on how we might further improve. Successful organizations grow both in individual and organizational wisdom.

With that said, I think everything else is malleable. However, I believe the prerequisite for each change--and we know many will be required in the future--must be a serious attempt to improve our ability to do our work in meeting the needs of our patients, residents, families, and customers, and well as to structure our education and research mission to ensure high quality and low cost services in our present, and to predict the future and change its magnetic north to better health.

Q. What energizes you when you are tired or facing tough challenges?

A. I always pause and reflect on the successes we have accomplished as a family or a ministry. You have heard me say many times that you must celebrate the incremental victories to get the energy to overcome the obstacles you see ahead. And I always remember Babe Ruth’s hitting history……..He struck out 1,330 times in between his 714 home runs.

Q. What do you pray for most often?

A. For peace…personally, professionally, and in the world.

Q. What in CHRISTUS do you love most, and what will you miss the most?

A. The answer to both parts of the questions is the same……..YOU!

Q. What is your biggest achievement?

A. Personally…having a family. Professionally….becoming a physician and helping to heal many people along the way.

Q. What is the most important lesson that every leader should learn?

A. You must always be humble!

Wednesday, October 13, 2010

Burning Questions, Part I

Last week, we gathered leaders from across CHRISTUS Health for a leadership retreat. In my opening presentation to these leaders, I asked them to submit questions for me, one of which was, “If this was your last chance to meet with me, what burning questions would you like to ask?”

Our leaders submitted over 90 different inquiries, of which I answered about 50 at a later session. Over the next few weeks, I will be answering many more via email with these leaders.

One question that was asked by many had to do with accountability, what it really means, how it is seen in action, and how it can be measured. Because this is such an important question and its answer is a critical success factor for the future of CHRISTUS, I shared with these leaders the 10 accountability items that I have looked for in my daily work for the last 44 years. They are:
l. Follow disciplined processes in getting work done
2. Feel ownership for the goals of the organization, region, business unit or program
3. Work to remove unnecessary bureaucracy
4. Drive out costs at every level
5. Eliminate redundancies
6. Meet commitments
7. Commit to quality and safety in all work activities
8. Accept responsibility for getting the work done
9. Provide and receive rewards, verbal as well as monetary, tied to meeting goals on time and within budget
10. Create and experience clear expectations for who has to do what to get the work done in an excellent manner

It is my hope that these 10 Accountability Items will be helpful for our leaders in reflecting on accountability and sharing their thoughts and expectations with their team members.