The art and science of implementing essential healthcare change
By Lawrence Levin, Ph.D., for HealthLeaders.com, July 18, 2001
Executive healthcare teams are tasked with crafting strategic direction and deciding upon major initiatives their organization needs to implement to maintain strategic advantage in the healthcare marketplace. These initiatives run the gamut from continuing to improve existing corporate goals to initiating new projects, plans, and goals. The issue for every healthcare organization is the same - how do you successfully implement those essential strategies critical to business survival?
The connection between the creation of good strategy and the effective execution of this strategy is implementation. And the two essentials for good implementation are:
Speed (absolutely critical for competitive advantage)
Obtaining maximum buy-in from the people within your organization
Ask yourself these questions regarding major changes and implementations your organization has undertaken in the past:
Track record - What has been your track record of successfully implementing major change within your company? Did projects come in on time, on budget, and achieve the desired results? What examples do you have of successes or failures?
Cost of failure - What has partial success or outright failure cost your company? Include both short-term direct costs and the larger, indirect costs, such as staff turnover, morale and credibility issues.
Readiness - What is the mindset within your organization about taking on and implementing another major (and needed) change? Will you have a strong population of "believers" who will make the change happen or will you hear cynicism and disbelief from a sizable part of your workforce?
Your organization's history of implementation success or failure is a key predictor of how well it is likely to do on its next major initiative. Most of us earn mixed reviews in our implementation history, but every failure is extremely expensive! Competitive advantage is a moving target in today's healthcare marketplace. All companies, regardless of size or industry, must constantly implement new strategies or fall behind. The "readiness" of your company to implement change successfully and at speed depends largely on whether you and your team have a clear and coherent methodology for implementation, what your track record has been to date, and how many other "No. 1" issues you have competing for resources and time.
The costs of implementation failure are legendary and very frightening (did we mention very expensive?) Some examples include:
Mergers & Acquisitions - Studies indicate that most healthcare M&A initiatives fail to achieve their desired results between 70% and 85% of the time. Two likely points of failure: They do not implement needed change within the first critical 90 days, and they never fully resolve issues of "culture." Whether we are talking about a merger of two systems or of two practices, the variables for success are largely the same.
Restructuring, downsizing, re-engineering efforts - The majority of these big-ticket efforts have poor long-term prognoses and tend to leave workforces cynical and demoralized, which only makes the next change harder to accomplish. A recent Wall Street Journal story indicated that over 40% of companies that downsized or re-engineered had not recovered two years later.
Major technology insertions - Rarely achieve budget and schedule goals or receive full acceptance from user groups (how expensive is that?)
While we could continue to expand on the bad news, we're more interested in finding the good news for your company. The real question is this: How can you ensure that your critical strategic goals will get implemented on-time, on-budget, achieve "buy-in" from your organization, and leave your organization with high readiness for the next strategic initiative?
In order to raise your "batting average" of successful healthcare implementation, your action steps must embody three major principles:
Make a conscious and deliberate plan for implementation - utilizing a clear and consistent methodology will raise your batting average.
Acknowledge the impact of change(s) - understanding the psychology and impact of changes on your workforce will allow you to tailor an approach that is more likely to enlist the hearts and minds of those within your company behind critical initiatives. (This is where the "soft stuff drives the hard stuff.")
Understand the need for speed - Implementation success translates directly into your competitive advantage. Speed of execution is critical in determining whether a new strategy actually becomes competitive advantage. Studies demonstrate that following a clear implementation methodology can increase your speed of execution by up to 30%.
Give some thought to your implementation history - how well have you executed critical strategies on time, on budget, while achieving desired results and obtaining the support and buy-in of your workforce? Are there initiatives you would take if you thought you could implement them? Is your company ready and willing to take on the next series of challenges needed to maintain or obtain competitive advantage in today's complex healthcare environment?