Putting the Execute Back into Executive

Say the word “executive” to some people and it conjures up images of leather chairs and mahogany desks. In reality an executive’s job is to execute, or achieve results. At times we all get caught up in the storms that surround us- meetings, urgent issues, committees, etc. Just remember, never confuse activity with results. Like what? In healthcare we must achieve results in: service, patient safety, quality, growth, market share, service line development, cost containment, productivity, community benefit, employee/physician engagement, turnover, etc.

When executing, know where you are going. In order to execute you must have a X-Y goal in mind. For example, create a goal to grow market share from 22% to 50% in two years. If you are not clear where you want to go, how will others be clear? Relentlessly pursue your goal as that’s why we were hired- to execute and achieve results.

At the conclusion of your tenure with a given organization, know what you’ve executed. What was your X-Y in HCAHPs, profitability, turnover, market share, etc.? Clearly communicating these results to recruiters and hiring managers is the key to honing your value proposition. Remember- execution and results are the reason we get paid.

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Opportunities in Urgent Care

Healthcare expenditures in the U.S. exceed $2.9 trillion each year, representing more than 17.4% of the GNP(1). It should be noted that 80% of this expenditure is associated with chronic disease and, therefore, it is no surprise that Population Health is addressing the identification of at-risk populations and patients with early stage chronic conditions, not to mention the growth of our aging population. With Healthcare Reform driving the shift from volume to value, Urgent Care Centers (UCCs) represent a key care component of the Patient Protection and Affordable Care Act (PPACA) as well as the IHI Triple Aim that directly impacts access/convenience and reduced costs.

Between UCCs and retail medical clinics that are in stores like Walgreens, CVS and Target, convenient care is approaching 10,000 sites throughout the U.S. The Urgent Care concept originated in the late ‘70s and has proliferated in recent years, fueled by a shortage of primary care physicians and overbooked primary care offices, long emergency room wait times and the high cost of emergency room care. This leaves patients frustrated and feeling like they have no place to turn when they have an immediate need for medical attention but their condition is not an emergency. In fact the Centers for Disease Control and Prevention stated in 2012 that nearly 80% of visits to emergency departments were due to a lack of access to other healthcare providers(2). The niche market of urgent care therefore has a huge opportunity to make an impact.

To the credit of many physicians, they saw and are trying to meet the community need of access at lower cost by starting and owning a majority of the UCCs. These UCCs are designed to function for the convenience of the consumer on a walk-in, no appointment basis and be open for extended hours.

Health Plans, large Medical Groups, Hospitals and Health Systems are realizing the importance of establishing this type of convenient care model and have different strategies for providing Urgent Care such as building their own or affiliating with existing urgent care operators as strategic partners in providing quality outcomes at a lower cost with greater satisfaction.

For Hospitals and Health Systems, UCC affiliations are mutually beneficial. They can relieve excess volume in the hospitals’ overcrowded emergency departments and, by virtue of having a lower volume it will result in a reduction of the hospital write-offs. These relationships will generate downstream referrals for the hospitals when there is a need by the UCCs for a higher level of diagnostics, when specialist referrals are required and when patients with conditions requiring emergency care show up first at the UCCs and need to be directed to emergency departments. UCCs can also assist hospitals by functioning in the capacity of discharge clinics to reduce the hospitals’ readmission rates.

For Primary Care physicians and Medical Groups, there can be a delay of weeks or months for patients getting appointments. The number of aging patients with chronic diseases is increasing as well, making the timely delivery of care challenging. These physician groups can look to UCCs for arrangements to cover after-hours or for vacations as well as for more patient-convenient certified laboratory collections and testing, imaging, suturing, in-house medication dispensing and durable medical equipment.

For Health Plans, UCCs pose a more cost-effective alternative than emergency rooms. Additionally, as it pertains to population health, it is crucial that the respective electronic health records interface so that at-risk patients can be identified and treated for early stage chronic conditions. An EHR would allow a seamless connection with an ACO or a Medical Group as well.

In conclusion, UCCs that are appropriately integrated in the healthcare delivery system will effectively meet the intent of the ACA and Triple Aim by providing greater convenience, satisfaction, reducing cost and be integral in achieving Population Health.

(1) https://www.washingtonpost.com/news/wonk/wp/2014/12/03/heres-exactly-how-the-united-states-spends-2-9-trillion-on-health-care
(2) http://www.cdc.gov/nchs/data/nhis/earlyrelease/emergency_room_use_january-june_2011.pdf

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Your Career is a Journey

Plan Ahead and Manage Effectively

From my experience working with executives over the past 27 years I have learned a great deal about how executives tend to do a poor job in managing and planning for advancing their own career.

Before I share my observations with you on advancing your career, let's define manage and plan:

Manage: Be in charge of, administer, run
Plan: Decide on and arrange in advance

Though desiring to advance, many healthcare professionals have plateaued in their career and are unsure how to regain momentum. Obviously, they had an idea of where they were going when they started, but never took the time to actively and consistently plan and manage their careers which have resulted in advancement delays.

Gaining the Right Focus

It is also not uncommon for well-meaning professionals to overlook particular skills that create the opportunity for advancement. Even if they were lucky enough to have a mentor, most of that effort and time was focused on expertise rather than the soft skills necessary to become an excellent leader. Aiming at the right target will yield the best results.

How much more successful would you be if you knew
how to plan effectively and manage your career?

Please join us for our upcoming webinar on May 25, at 2:00PM ET, where I will be sharing key ideas that will help you put momentum back into your career journey.

Learn More

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The Nursing Leadership Challenge

Everyone recognizes nursing plays a huge and vital role in our hospitals and healthcare systems today. Nursing, like any other area of healthcare, needs experienced coaches and mentors.

Please remember the optimum word here is experienced.

Here are some of my observations from my 27 years of healthcare experience:

  • The aging of America will create more need for nurses and nursing leadership.
  • Nurses don't seem to be very well represented in the CEO role.
  • Because of their training, they seem to struggle with their assimilation into that role.
  • Nurses move up into management roles within the nursing department because they were good nurses which doesn't always guarantee they'll be good managers.
  • Like many others who are promoted into management roles, nurses are generally not offered a great deal of assistance as they move into these new and challenging positions.
  • The chief nursing officer role is not attractive to younger nurses developing their careers.

Wiederhold & Associates believes that Nurse Leadership is an important area to invest in. We know that the very skills that make effective nurses (great communicators, creative problem-solving abilities and leadership acumen) are also the skills that make great leaders. With proper guidance, the transition into a senior leadership role can be very successful.

To maximize the success of our nursing clients, we have partnered with Nursing Leadership Coach Diane Scott. With her strong clinical background, Diane has a deep understanding of the nurse executive role.

Diane explains, "Senior nursing leaders usually are in charge of the majority of theworkforce of any healthcare organization. They are often promoted through the ranks and experience challenges with increasing their ability to critically think at their new leadership level. However, once they reach that level, the new challenge is the overwhelming desire to meet the mission of patient care and balance a seemingly polar opposite of managing the numbers, especially financials. They also struggle with developing a self-strategy for their career, finding it too self-serving and not patient driven.

The most successful senior nursing leaders learn that by increasing their own abilities, they can achieve their own potential, develop their managers as well as provide excellent patient care. In this way, everyone benefits under leadership that understands needs from the ground up."

At Wiederhold & Associates, we know an organization can optimally increase a nursing leaders’ capacity for successful outcomes through professional Nursing Leadership Coaching. It is the single most powerful way for a leader to achieve their potential for superior leadership, strategic thinking, and measurable results.

If you would like to learn more about our Nursing Leadership Program, download a tri-fold brochure here

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Elements of a Successful Turnaround Strategy

Hospitals/Health systems across the country are faced with increasing financial pressure including slow economic recovery, decreases in reimbursement, increases in uninsured or underinsured leading to increased bad debt write offs, and increased operating expenses.

Not surprisingly the result is more and more organizations that were financially sound find themselves either in financial distress or at least moving financially in the “wrong direction.” Turning around a hospital where finances are in decline requires extremely strong leadership from the top, ideally a CEO with prior experience leading a turnaround. This initiative needs to be supported by the hospital senior leadership team and board, and reinforced by engaged employees, physicians, and even members of the communities served by the organization.

Hospital turnarounds are not just about cutting costs. You can’t cut your way to long-term growth and profitability. You need to build programs that will financially support the hospital and meet the community’s needs through physician recruitment and capital investment. Cutting costs are a short term sometimes necessary endeavor, but long term success will only come from program volume and revenue growth.

It’s now essential in the current evolving environment to negotiate favorable contracts with insurers and other networks who control patient access and also consider the development of Accountable Care Organizations and other population health strategies. Finally developing key affiliations and networks with other hospital and healthcare providers are essential to strengthen your gaps in services and geographic coverage.

While no two turnaround situations are ever the same, just as no two sick patients are ever exactly the same, there are some common elements that all successful turnaround situations will have.

These elements includes the following:

  • A strong visionary CEO with proven experience in leading a successful turnaround.
  • A strong committed board that will support the CEO and put what is good for the long term survival of the hospital ahead of long-standing personal friendships and relationships and agendas and the short term pain and changes that may have to occur.
  • A good comprehensive and realistic turnaround action plan based on an in-depth assessment of the hospitals financial, operational, cost structure, market position and also physician and community perception and support. The plan should identify specific goals and objectives and actionable plans with quantifiable metrics and assignment of ownership.

Implementing the turnaround plan:

  • Implement plan with sense of urgency.
  • Monitor results and modify tactics where necessary.
  • CEO stays engaged / leads from “the front.”
  • Divides resources/removes obstacles/drive changes forward.
  • CEO and leadership team “walks the walk” and “talks the talk.”
  • Communication -- CEO establishes robust communication process so that employees & physicians are kept fully informed of changes occurring and why they need to occur and to gain their support for the long term benefit to the organization.
  • Publicize and celebrate the successes. Nothing breeds success, like success.

Going through a “turnaround” situation is one of the most stressful events for any healthcare organization to go through. With great visionary leadership and a good “plan” the organization will emerge not only more financially sound but with a “high performance” culture ready to move on new challenges.

You can see Davide Carbone's LinkedIn profile here

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Executive Skill: Reading the Tea Leaves

How often in my conversation with executives do I hear the statement, "he/she is good at reading the tea leaves" or "he/she is not so good at reading the tea leaves"?

What does it mean?

To me, it indicates a sense of external awareness of what's being said around you. When the action and the talk don’t align – you’d better take notice. Unfortunately, a lot of executives get so caught up in their own internal world that they are unaware of what's going on around them.

There's lots of evidence to support this lack of external awareness. In working with executives in transition, I often hear the statement “I never saw it coming.” As I review the details of their last 60 to 90 days of employment and then we review it together, the next statement I often hear is –“I should've seen it coming. Obviously, that executive didn't do a good job of "reading the tea leaves."

Now most of us are aware of the concepts emotional intelligence and political intelligence.

  • Emotional intelligence is the capacity to be aware of, control, and express one's emotions, and to handle interpersonal relationships judiciously and empathetically.
  • Political intelligence is a thorough understanding of the interpersonal and political dynamics that organizational structures create and to know how to make things happen within this context.

We define these concepts in terms of both nouns and verbs. As you know, a verb implies action, and both forms of intelligence must have an action to be of any benefit.

Both terms suggest a strong emphasis on the external environment as well as the internal environment. As mentioned, too many executives become overly focused on the internal environment. By practicing the art of emotional intelligence and political intelligence you will learn to pay attention to the external as well as the internal and increase your ability to read the tea leaves.

Happy Reading,

Jim

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"Manage Up" for Success

A big piece of onboarding is the ability to manage up- how you effectively work with your immediate Manager. My experience in this area indicates that we don't give this enough attention. The conflict that begins here usually ends up in one being asked to leave the organization or perhaps exiting too soon on their own.

Often, different styles, as well as egos, get in the way. Change the way you look at this relationship, and you will be more successful in building it. I haven't come across many people who “manage up” t extremely well, and it's such a necessary skill to one's future success. Embracing the employee/manager relationship is a critical skill to hone and managing up helps you master it.

Managing up means that you go above and beyond the tasks outlined on your job description. You continuously go the extra mile. Your job is to make your immediate manager’s life easier.

Ways to effectively manage up:

  • Listen well
  • Learn his/her style
  • Jump in when needed
  • Project a positive attitude
  • Deliver quality work
  • Keep him/her well-informed
  • Build key relationships
  • Sell/negotiate when appropriate
  • Recognize what he/she respects and honors
  • Create early wins
  • Execute great follow up
  • Establish a comfortable level of transparency
  • Establish the rules of effective pushback
  • When you have a challenge, always offer a solution
  • Communicate, communicate, communicate
  • Close information gaps
  • Have a voice beyond your boss
  • Keep commitments
  • Apologize when you are wrong
  • Don’t make excuses

Learning to effectively "manage up" can put you in a great position to align with your immediate supervisor, integrate effectively with the organizational culture, receive great recommendations, and ultimately help you on board effectively.

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Enhanced Leadership Tools to Light the Way

Coaching comes in many forms but the goal is to help you become the very best version of yourself as a leader, executive, and whole person.

As you know, I have been coaching executives for years to help them become their best. Through the power of technology, my coaching capabilities have been extended into a new dimension. I am excited to present the 2016 Webinar & Telebridge Series.

Webinars:

Once a month, Wiederhold & Associates will be inviting renowned speakers to address leadership topics in healthcare in this interactive online series. The next scheduled webinar is in April and will be free to ALL registrants. Beginning in May, we will continue to offer these webinars free to only our Premium Active Network Group members and current clients. There will be a nominal registration fee for everyone else. There are limited spots for each session so make sure you register early and take advantage of this opportunity to learn from national experts! Email us to request topics and dates.

Telebridge Calls:

As a new benefit of our Premium Active Network membership in 2016, Wiederhold & Associates will implement the following program each month. I am hosting a Telebridge (conference call) meeting with any of our premium active network members who want to participate. In that meeting, I will answer questions you may have related to your career, whether you are gainfully employed, in transition, or thinking of looking for a new position. This is sure to be a time of enrichment that will aid you in developing a lifetime of success.

Before each TeleBridge meeting, we will announce the initial topic of discussion. Once we conclude that topic, we will move on to other subjects relevant to the group. Our first meeting was an excellent discussion of interim work in the healthcare Industry from both sides of the equation. This will be the initial subject of our next TeleBridge Premium Active Network meeting. After the initial topic is addressed, any subject that the group wants to talk about is fair game.

I will facilitate these meetings as well as disseminate a summary to the participants from these sessions. The Telebridge calls are an excellent opportunity to learn and engage with relevant healthcare subjects.

Through these programs, you are sure to make valuable connections & gain critical industry insights throughout the year. I look forward to connecting with you.

Here's to your success,

Jim

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10 Steps to Ace Your Next Interview

As one wise recruiter once told me, "You can have a B resume which may open the door but you must have an A interview to walk through it."

Let me share ten basic elements that consistently come up in our interview reviews that if addressed would make a world of improvement in your ability to interview and drive the right message:

  1. Preparation: Know the five top critical elements of the opportunity and be able to address them with current experience and success. The five top criteria is the top five things they're looking for in their next candidate. Next understand the three other critical elements which are organization, position and location. Have specific information in each one as to your interest. The more specific the higher the impact.
  2. Mirroring: A good interview is like a dance, both partners are in sync with each other. Mirror to match tempo, breathing, rate-of-speech, directness, etc. This makes each one comfortable with each other and sets the correct filter.
  3. Listening to understand: We test this in every interview we do and the majority of people fail. We are so caught up in the world of listening to respond that we miss a vital part of the question.
  4. Introduce yourself with confidence.
  5. Take the lead: As you enter the interview, know exactly the statement you will make or the open-ended question you'll ask. Demonstrate your interpersonal skills and give yourself the greatest opportunity to connect with and engage your audience.
  6. Put together an effective two-minute presentation which includes three key components to drive your message as well as connect with your audience. Those components are humanization, elevator, and differentiation/value statement.
  7. Understand what a real achievement is and present that way.
  8. Answer questions concisely, close information gaps and enhance the answer when it adds value to the original thought.
  9. Always tell the truth but word it in a win-win presentation. This will provide consistency throughout the interview.
  10. Brand yourself so that your message is consistent.

I've done a lot of interview coaching over the last 22 years. Historically, most people have a starting grade in their ability to interview probably somewhere around a B- to a C+ through no fault of their own. We just don't do well on things we don't practice consistently. But imagine if you took the time to develop a well-executed interview. What a significant way to separate yourself from the crowd in a very competitive market!

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The Power of Gratitude

I constantly hear the statement that nothing happens between Thanksgiving and New Year's day. That idea becomes a self-fulfilling prophecy that can prevent you from moving forward in the new year.

The time between Thanksgiving and New Year's day is what I referred to as Relationship/Gratitude month.

It is the perfect time to build and solidify relationships by giving thanks to those that have helped you in the past year as well as those that will help you in the new year. This show of gratitude, when done without an agenda and with great sincerity, will strengthen business partnerships that can carry you into the new year and beyond.

As you all know, the opposite of gratitude is ingratitude. When you don't express gratitude and you assume the other person understands your perspective, what you really are expressing and certainly not intending to, is ingratitude.

Call up those people that have given you so much over the past six months to a year and just say thank you. Use the holiday season to send out cards to those you don't call. Individualize each card with a note and your own signature. Make your audience feel special. Remember, this is about quality not quantity.

If done correctly, these efforts in December will pay rich dividends in the first quarter of 2016.

Here's to a prosperous new year!

Jim

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Investing in Nursing Leadership

As the health care system confronts the need to change and adapt in the new era, leadership is required throughout the entire organization.

Nursing Leaders are the centerpiece of care delivery and are extraordinarily vital and influential in carrying out the mission and vision of any healthcare organization. As a result, their leadership has a direct effect on the quality and fiscal outcomes that are of vital importance to an organization.

At Wiederhold & Associates, we know an organization can optimally increase a nursing leaders’ capacity for successful outcomes through professional Nursing Leadership Coaching. It is the single most powerful way for a leader to achieve their potential for superior leadership, strategic thinking, and measurable results.

Coaching is customized to every situation and organization, with outcomes driven models implemented to ensure success.

Who can benefit?

  • Senior Nursing Executives
  • Nursing Directors and Managers
  • Newly hired Nursing Executives who wish to position themselves out of the gate for great success
  • High potential Nurse Executives who can benefit from expanding their strategic thinking
  • Nurse Executives who want to continue to provide optimal leadership for the patients and the people who care for them

Nursing Leadership Teams

Team Coaching is different from training in that it specifically targets the needs of a group, while providing direction to challenge them to meet a targeted outcome. Teams that can benefit from our approach include:

  • High functioning teams wishing to expand their capacities
  • Teams experiencing significant changes or challenges
  • Newly formed Nursing Leadership Teams

Want to move your organization forward?

Invest in your core: Nursing Leadership.

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Leaders Plan to Win

The majority of us plan for our children’s college education, or to get married or stay single but unfortunately very few executives plan their careers. Many potentially successful executives fail to climb the executive ladder because they don’t plan where they want their career to advance to.

Healthcare professionals can progress in their careers, but only if they position themselves for success.

In my experience, less than 5% of healthcare executives plan their career. Most, as I would say, “wing it”; taking advantage of opportunities as they present.

I describe career planning like building a straight fence. You define where you want to go and then identify the points and steps it takes to get there.

Successful executives complete a gap analysis: what are they missing for experience and skills. Skills fall in two categories: hard skills and soft skills. Executives often focus on the hard skills areas and miss the needs for developing soft skills: communications, conflict management, effective messaging, emotional intelligence, relationship building etc.

Through my work with executives in transition, 95% of people in transition lost their job due to a lack of emphasis and engagement in the soft skills.

Preparing to climb the ladder requires a plan that includes the skills both hard and soft to be successful. Successful executives must master emotional intelligence and navigating the political landscape to stay at the top of that ladder.

Here’s to your success!

Jim

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A Quality Every Great Leader Must Have

When you think of an --Effective Leader-- what comes to mind?

You might picture someone who never lets their temper get out of control, no matter what problems they are facing. Or you might think of someone who has the complete trust of their staff, listens to their team, is easy to talk tThese are qualities of someone with a high degree of emotional intelligence (EQ). Research shows that EQ scores climb with titles from the bottom of the corporate ladder upward toward middle management. Middle managers stand out with the highest EQ scores in the workplace because companies tend to promote people into these positions who are level-headed and good with people. The assumption here is that a manager with a high EQ is someone for whom people will want to work, and always makes careful, informed decisions.

These are qualities of someone with a high degree of emotional intelligence (EQ). Research shows that EQ scores climb with titles from the bottom of the corporate ladder upward toward middle management. Middle managers stand out with the highest EQ scores in the workplace because companies tend to promote people into these positions who are level-headed and good with people. The assumption here is that a manager with a high EQ is someone for whom people will want to work.

But things change drastically as you move beyond middle management. For the titles of director and above, scores descend with CEOs, on average, having the lowest EQ scores in the workplace.

The truth is that for every title the top performers are those with the highest EQ scores. Even though CEOs have the lowest EQ scores in the workplace, the best-performing CEOs are those with the highest EQs. You might get promoted with a low EQ, but you won't outshine your high-EQ competition in your new role.

Your emotional intelligence is completely under your control. Work on your EQ and it will boost your performance. Your effort can also ensure that you don't experience declines as you climb the corporate ladder. Even if your employer promotes you for the wrong reasons, you'll still outperform your contemporaries.

To help you get started, here are some EQ-boosting strategies for leaders:

  • Acknowledge Other People's Feelings
  • When You Care, Show it
  • Keep Your Emotions in Check
  • Sleep
  • Remove Negative Self-Talk

Focus on your EQ and your executive performance will soar!

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Become the Leader You Were Meant to Be

After 21 + years in the career development business, I have seen the unique skill sets required for effective healthcare leaders. One key I have discovered is that effective leaders are continuous learners who never stop growing and developing their skills and talents.

I have found important learning traits that effective leaders require:

  • New levels of perception and insight into the realities of the world and also into themselves
  • Extraordinary levels of motivation to go through the inevitable pain of learning and change
  • The emotional strength to manage their own and others' anxiety as learning and change become more and more a way of life
  • New skills in analyzing and changing cultural assumptions
  • The willingness and ability to involve others and elicit their participation
  • The ability to learn the assumptions of a whole new organizational culture

An essential part of effective leadership and growth is networking. Wiederhold & Associates has developed the most in-depth premium network of senior healthcare professionals in the country. The Premium Active Network program was developed for individuals who see the value of networking, gaining visibility in the industry and building mutually beneficial relationships.

At Wiederhold & Associates, we are a leading provider of career development, transition services and executive coaching to the healthcare industry. We help individuals and organizations with the tools and resources to develop and sustain exceptional leadership performance. Through networking and coaching, we are always focused on relationship building with a personal touch.

Throughout the year, I will be sending periodic communications through email and social media that will keep you informed of topics on leadership effectiveness and managing your career for a lifetime.

Here’s to your success!

Jim

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