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The lesson from Aikido (well, one of many) is that the degree of force generated by others can be redirected or transformed. This is no different than the trials of our lives. Generally speaking, throws follow an arc. Longer arcs have less power and displace less energy. Tighter arcs are far more powerful, though more dangerous and require greater skill to control. Interestingly, the highest form of the art is practiced when the attacker feels little or no pain, perhaps only discomfort. The intent is to understand your surroundings as they are now and will soon be – employing all senses (particularly intuition) – in protecting yourself, but bringing little harm in restoring harmony.

Self Actualization Requires Mental Discipline
The point of my relating this story is that this philosophy can be applied to all facets of life. It’s been many years since sitting seiza in a dojo and I now prefer the running trails of Colorado to the strict training and hard falls upon a cold tatami mat, but the mindset stays with me. Physical exertion fuels the mind and calms the spirit – I believe this still, though harmony through self-actualization requires mental discipline in governing all aspects of one’s life.

Traditional Catholicism teaches that, “God scourges those He loves.” As you embrace new beginnings, be thankful for the challenges and the opportunity to grow. Surpassing self-imposed limitations requires that we become tomorrow what we are not today by finding harmony in confrontation – if only with ourselves.

________________________________________
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Transformation

Life is very much what you make of it. Be open to change. Be flexible in accepting new opportunities. If you consider a layoff as remarkably detrimental, it likely will be. My experience with these types of events is that they generally provide good opportunities for growth. Like most transformational events, these require pressure, heat and time. Typically unpleasant to experience, it never-the-less remains effective. Recently, someone signed off an email to me with “grace and gratitude”. We generally experience so little of this in our interactions with others. Having an abundance of each will serve you immeasurably well in whatever endeavor you next embrace.

He who lets the world, or his own portion of it, choose his plan of life for him, has no need of any other faculty than the ape-like one of imitation. He who chooses his plan for himself employs all his faculties. He must use observation to see, reasoning and judgment to foresee, activity to gather materials for decision, discrimination to decide, and when he has decided, firmness and self-control to hold to his deliberate decision (John Stuart Mill, On Liberty, 1859)

DANGER

Following is an overview on D.A.N.G.E.R. as an acronym for the cycle of coping with unexpected change. It may help others understand the process from a psychological perspective. Knowledge often creates a bridge to understanding and from there new opportunities emerge.

A search for the origination of this acronym proved fruitless, so I attribute it to the ubiquitous ‘Anonymous’ as it entered my consciousness many years ago, but without any recollection of who, when or where.

DENIAL: characterized by the failure to respect and accept the aspects of change.

ANGER: overviews the actions and conduct of an undisciplined mind during the trial.

NUMBNESS: details the evolution during a period of transition from anger to grief where recognition of the change (though not acceptance) occurs.

GRIEF: the span of emotional and mental recovery including detachment from a past that could not be recovered, the level-setting of expectations and acquiescence to transformation.

EQUILIBRUM: the stage of transition from past paradigms to new, unconsidered beginnings.

RECOVERY: final acceptance, growth and evolution exemplified by comprehension of reinvigorated realities and new horizons.

Freedom exists, as it always does, within ourselves. We must have equal measures of intelligence, wisdom and courage to embrace the paradigm that realities are self-created and limitations not coincidentally of our own choosing. The world is as we make it and transformational periods often require pressure, heat and time. Though often uncomfortable, something uniquely different and generally stronger results from it. Accepting transformation as an opportunity to become tomorrow what we are not today is an imperative for those who would walk in wisdom.

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How do you know when to lie to your Client? A period of awkward silence fell between us as a bolt from the blue would have left me no less apoplectic. His straight delivery and open body language left no doubt of his sincerity. How to respond?

Those who know me realize my being dumbstruck occurs as frequently as the Chicago Cubs hoisting NL Pennants over Wrigley Field. After gathering myself, my first thought was to answer his question with one of my own, “First, permit me to ask you a question. Do you understand the distinction between the Japanese concepts of ‘face’ and ‘honor’?” His puzzled expression and furrowed brow also left no doubt that we lost each other in the changing of paradigms from West to East. Waiting briefly for a response that would never come, I continued “Permit me to explain”.

The Concepts of Face and Honor
“The Japanese view personal honor or integrity quite differently than Westerners. Subtleties of ancient customs, rituals, and rites imbued in professional expectations in the Far East fill volumes. Oversimplifying the matter greatly for purposes of this discussion, I would ask that you consider two concepts unique to the Japanese – face and honor. Vastly different, though inter-related, I argue these as germane to our current business practices in the United States and pay rich dividends to those that pay heed. Bear with me on this; I promise to bring it full circle.

“Many Japanese consider honor (an amalgam of what Westerners would consider personal integrity, honesty, competence and moral courage) as ‘what is’; more specifically, that which a man possesses internally whereas face is how others perceive honor within that man. Honor requires a lifetime to develop and a momentary lapse of judgment to forever compromise. Losing face from a disrespectful act or slanderous remark by another draws conflict even today. Integrity matters. It remains something worth fighting for. Honor extends through the individual to his family and certainly the organization represented. The idea of acting shamefully is abhorrent. Consider the story of the 47 Ronin and how these men avenged the murder of their Lord, the loss of face within the community and eventually proved honorable when surprising all in avenging their Master. Now, while you may never storm a castle to avenge the loss of your Region Manager, a fundamental truth exists in all of this that I believe lost in our Western world. It encompasses many words; Integrity, Honesty, Character, Courage, Humility, Grace and Gratitude. These signposts mark the path of a professional life worth leading. More likely to be mocked than adopted in any of the curriculum of the major business schools, consider the significance of how friends, family and – particularly for this discussion – clients, perceive those traits.

“Western thought devolved over time to the point where we now consider every experience through a prism of personal beliefs. We reject God for truths thought self-evident. For some, this latitude permits a freedom of thought excusing anything while condoning most reprehensible behavior as a result of differing perspectives – just another hue amongst many shades of gray. These shifting sands of moral relativism compel many otherwise good men and women to marginalize their integrity in justification of vain pursuits, placing personal gain ahead of the Client or organization.

Simplicity and Transparency
“Things change. The pendulum swings back and hope exists as it always does in the wellspring of our youth and new thinking. Though somewhat occluded by the distractions in our lives, we often find ourselves (and others) by remaining true to our calling to serve others while persevering in faith, hope and charity. Simplicity. Transparency. Enduring Transformation. These are more than words. Consider what these should mean to you in all interactions.

“The question you posed, “how do you know when to lie”, struck me as unusual. You knew the answer before you asked. You know now. You’ll know when arriving at a crossroads in your life years hence. It will call to you as clearly as the tolling of a bell. The dilemma faced quite frankly is whether you possess the moral courage to bear the consequences of a just decision. My advice? Take the high road and educate your Client on the appropriate course of action regardless of the professional ramifications. Offer to help an existing Client sign a competitive proposal if that firm provides greater demonstrated value than yours given the same circumstances. Will that change perception? Yes. Clients invariably respect this. Why? Because integrity matters – always.”

This young man will undoubtedly go on to perform brilliantly in whatever role he next assumes. I had plenty of windshield time to think through this conversation and as of this message, I remain unsettled in knowing something deeper may have been lurking in his question. Selling ‘Solutions’ requires deep and broad knowledge to permit Advisors to consult appropriately on Strategic, Operational and Tactical considerations. It mandates constant education, networking and stoking a passion for unlocking latent organizational potential. It involves developing deep and lasting relationships founded on trust. Some fake it and get by. Most perform adequately and earn a reward for the effort. Those few true believers make all the difference.

________________________________________
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You undoubtedly remember the phrase, “this too shall pass”. Are you aware of its origin?

One day Solomon decided to humble Benaiah; his most trusted minister. He said to him, “There is a certain ring that I want you to bring to me. I wish to wear it for Sukkot (a Jewish religious holiday typically falling in late September) which gives you six months to find it.” The minister accepted Solomon’s request and stated simply, “If it exists anywhere on earth, your majesty, I will find it and bring it to you. What can you tell me of the ring and its origin?” The king replied that it possessed magic powers and added, “If a happy man looks at it, he becomes sad, and if a sad man looks at it, he becomes happy.” Solomon knew that no such ring existed, but desired only to lead his minister to a greater degree of humility. Spring passed and then summer, and still Benaiah had no idea where to obtain the ring. On the night before Sukkot and with all hope of obtaining the ring lost, Benaiah decided to walk in one of the poorest quarters of Jerusalem framing the words of failure to his King. Passing by a merchant who had begun to lay out the day’s wares on a shabby carpet, he asked “By chance, have you heard of a magic ring that makes the happy wearer forget his joy and the broken-hearted forget his sorrows?” He watched as the elderly merchant took a plain gold ring from his carpet and engraved an inscription. When Benaiah read the words on the ring, he smiled. That night, the holiday of Sukkot was met with great festivity. “Well, my friend,” said Solomon, “have you found what I sent you to obtain?” All the ministers laughed and Solomon himself smiled warmly. To everyone’s surprise, Benaiah held up a small gold ring and declared, “Here it is, your majesty!” Amusement and incredulity alighted the face of the King as Benaiah handed to him the ring. As Solomon read the inscription, the smile and all color ran from his face.

The jeweler had inscribed three Hebrew letters on the gold band: which began with the words “Gam zeh ya’avor” — “This too shall pass.” At that moment Solomon realized that all his wisdom, wealth and unsurpassed power were but fleeting possessions as all things will one day return to dust.

Remember, always, that life can only bring you pain, it can not bring you harm – unless you permit it. We face dark times, but we need not travel without faith, hope and charity.

Be cheerful in all weathers.

Gam zeh ya’avor!

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Enabling a Revenue Driver
A significant portion of a hospital’s admissions enter through its Emergency Department (ED). Unfortunately, many hospitals exhibit broken processes, long wait times and fundamentally poor coordination of care. As a result, most hospital organizations view their EDs as cost centers and a necessary, though frustrating, component to delivering quality care to its community.

Ironically, in high-performing hospitals, EDs are drivers of profitability, adding tremendous value to patients and providers alike. Properly addressed, it becomes a high-value marketing medium to the community providing the hospital a significant competitive advantage.

A significant issue facing EDs today is the rapid increase in under-insured or indigent care seeking “last resort” healthcare. The current economic malaise will only intensify the strains as this trend exponentially increases.

With unemployment rates surpassing 20 year highs, hospital EDs will need to be properly prepared – operationally and financially – to address the influx of these patients and still be able to operate profitably. None of the indicators are positive. Once insured consumers present with health concerns, they will turn to hospitals for primary or urgent care. Many patients will delay treatment due to worsening financial condition, only exacerbating the severity of their condition. The delay could worsen; consequently requiring immediate, urgent and likely more expensive care when considering what might have been treated at the onset of symptoms.

Faced with shrinking contribution margins and steeper losses, EDs are faced with constant prioritization of patient care, payor status and the burgeoning bureaucratic procedures to ensure some measure of compensation for services provided are obtained. The unfortunate, perhaps counter-intuitive, result is that ED staffing is being curtailed particularly when it is most needed. This is a potential “death spiral” if not addressed effectively.

Addressing Under-insured and Indigent Care
That EDs have become a stop-gap treatment source for many under-insured and given the reluctance of consumers to seek medical treatment from primary care clinics do to their seeming lack of financial resources to obtain it, may are seeking urgent care services from a hospital’s ED which significantly constrains capacity and marginalizes those patients in true need. Hospitals must find a way to capture premium or self-pay patients without their leaving. Long wait times or poor service will drive these consumers to seek alternatives. It is worth noting that, on average, admitting 4 premium or self-pay patients per week can provide additional revenue opportunities of $2,000,000 in inpatient, $500,000 in outpatient and 2-3x that amount in supporting or ancillary services revenue. This amount of revenue is significant and lends credence to the design of many leading hospitals to improve capacity, throughput and the patient experience within their EDs.

The ED as the front door of the hospital and primary interaction point for many within its community needs improvement. Approaching the problem from an enterprise perspective and understanding the inherent financial and operational relationships to other departments within the hospital yields transparency to operations. It permits the opportunity to effectively integrate and optimize the services rendered to the community using the hospital serves.

Operational Benchmarks (Recommended Ceilings for Performance)
* % Patients left w/o being seen: <= 3% of Total Visits
* ALOS Door to Triage: <= 15 Minutes
* ALOS Triage to Bay: <= 15 minutes
* ALOS Bay to Physician Visit: <= 30 Minutes
* ALOS Physician to Discharge: <= 30 Minutes
* ALOS Physician to Admit: <= 60 Minutes

Matching the right care to the criticality of the condition sufficiently improves the utilization of assets and resources permitting proper flow and throughput of patients into hospital programs that result in great physician, staff and patient satisfaction.

The unusual confluence of current social and economic conditions has yielded a healthcare paradigm of “episodic care”. What this means to healthcare is that many patients now seek care after falling into illness, often leading to increased acuity, escalating costs and increasing length of treatment. It also suggests that patients will not schedule preventative tests and examinations, such as wellness visits.

Optimization through Process Improvement & Improved Transparency
Fundamental changes in the delivery of preventative care require intelligent choices be made by Hospital executives to reduce the consequential financial and operational burden the organization. Improving the operational integrity and capacity of the EDs is an imperative for survival of many hospitals. Providing preventative programs of various natures have shown excellent results in addressing consequential healthcare costs. The fulcrum for change resides in the ED and identifying and delivering these services should begin there.

Today, most EDs have a single administrative methodology to process all patients. Altering this process to create a more efficient flow of patients to a level appropriate to both immediate and preventative care is essential in developing efficient integration, flow and throughput as well to reducing the incidence of un-necessary (and unpaid), critical patient flow.

Building operational excellence in an ED begins with understanding the Triage methods used to streamline the use of hospital assets and staff translates quite easily to this process. Application of lean transformation methodologies can result in vastly improved use of hospital assets and resources. Individuals who are actually in need of clinical rather than emergency services would be routed to more appropriate resources aligned to better address those conditions. This permits additional payor issues to be addressed upfront, diverting unnecessary administrative, clinical and infrastructure assets from this patient flow process.

The ED and other departments will continue to receive indigent or under-insured patients. The constraining issues will persist and worsen if not remedied. Unfortunately, few programs are incented to address the most at-risk population or the pending collapse of many EDs and the virtual lack of preventative resources are creating a “perfect storm” of conditions that may paralyze many of our nation’s hospitals.

Gratefully, this situation presents tremendous opportunity to reduce costs of care and capture data to improve a myriad of foundational healthcare issues. Access to the patient population, effective capture and interchange of information and healthcare dollars spent on prevention to reduce treatment costs are the key to optimization.

However, Things Must Change
However, things must change. Today’s healthcare approach to this population is inherently confrontational, whereas overall patient satisfaction is improving. The care giver, at the time of presenting to the ED, is powerless to ‘teach’ their patient of the inherent dangers of lifestyle and dietary habits. They are frequently obligated to point out these shortcomings of personal care in a brief clinical encounter, resulting in an experience neither pleasant nor effective. A more appropriate approach would be to integrate incentives for holistic preventative care with ED treatment. The primary barrier is the compensation for these services. Consequently, low utilization results and the cost of care rises. Fundamentally, the question is how to resolve this “death spiral” of preventative neglect and resulting increased cost, erosion of quality care, and strained infrastructure?

Resolution lies in lean transformation of the ED through proven methodologies, enabling the tactical mission of immediate treatment and also working strategically to connect preventative treatment to at-risk populations. Triaging at the ‘front door’ to appropriately route those in need of clinical (rather than emergency) services, streamlining administrative processes to capture information and compensation, and ultimately direct the underserved patients to resources focused on wellness and primary care.

Creating an efficient ED process is insufficient if it only results in higher patient throughput at a lower cost. The real challenge is improving the wellness of the community the hospital serves and establishing a preventative foundation yielding a higher rate of compensation, thus ensuring the improved ED has a reduced patient population and can sustain the community load at optimal resource and infrastructure costs.

First, consider incentives for those in most need of wellness and primary care services. Many of these patients are presenting in the ED today, within insufficient resources to pay for emergency care and burdening the community with the ‘toll’ for their care. This care should require participation in programs that treat the systemic aspects of their healthcare issues. Incentives would ideally include creation of a means of remaining connected to this resource. Cell phone service, whose minutes are recharged as a reward for continued involvement, discounted prescriptions granted at a rate to match follow up interviews, are just two ideas that hospitals are now using to incent this continued connection.

Compensation is a far more complex issue, though, anecdotally the resolution is simple. The net present value of program preventative care is less than critical care rendered in the ED, yet the flow of funding for such programs creates significant barriers to ownership of the resolution and promotion of a lower cost solution.

Many of the conversations on this issue are oversimplified, but ultimately the answer lies in data, information and transparency. Only through the development of an adequate business case can the barriers for appropriate redress be made. Whether the programs are sponsored by government, non-governmental agencies (NGOs) or private entities is immaterial. The objective result is to deliver the best possible care at the lowest cost while improving the wellness of the community a hospital serves.

________________________________________
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Black Diamond Transformation, LLC ©2009. ALL RIGHTS RESERVED. Any use of materials on this site, including reproduction, modification, distribution or republication, without the prior written consent of BDT, is strictly prohibited.

• Lack of adequately trained personnel
• Fundamental devaluation of basic supply management practices and processes due to the need to concentrate on patient care
• Lack of organization as it relates to the design of supply processes
• Lack of awareness of inefficient operations
• Broken or antiquated supply management processes
• Budget shortfalls not permitting hospitals to perform proper analysis of needs and inability to implement corrections to identified issues in the supply chain

Perhaps the most notable area of inefficiency lies in supply management. Considering that supplies account for 25% of the overall costs in most profit and non-for-profit hospitals, it is easy to understand how impediments within the supply chain process of a hospital could lead to significant financial consequences. It has been estimated by the American Association of Hospitals that a gain of 10-25% on gross margins could be realized through basic investment in redevelopment or redesign of the supply chain. Much of the savings derived is from a leaning of labor costs (particularly in overtime and part-time labor cost), supply expense management and increased operational efficiencies.

Another major concern experienced by hospitals lies in a fundamental breakdown within the hierarchy of personnel. While Clinical staff is generally responsible for department supply management, they generally place a lower priority on the activities supporting effective supply management than other, more important, activities.

While organizations are clearly able to recognize and communicate the benefits of effective supply management, they have not yet bridged the gap to action. Fully 60% of organizations currently rely upon manual tools to collect and analyze supply spend data, resulting in limited visibility to expense and an inability to effectively implement cost savings opportunities.

An effective Cost Containment program, of which Supply Chain Management is a key component, will employ the following:

• Data Integrity & Integration
• Actionable Reporting & Executive Dashboards
• Process Improvement & Rapid Response Teams
• Physician & Clinician Advocacy

High Performance begins with Proper Fundamentals
Stephen Covey stated that we should “begin with the end in mind” and we should each remember that high-performance organizations did not transform overnight. Each evolved over time, yet addressed basic issues before tackling larger organizational problems. A good manager is compelled to take a situational inventory before making any major decisions when assuming control of a new Team, Department or Client. This truth extends to Supply Chain Optimization efforts. A high-integrity physical inventory of all medical supplies in core departments, mapped against hospital Materials MIS and department MIS, e.g. ORIS, will provide the Executive Management Team with a valuable tool in understanding what efforts to undertake in fixing the primary problems with sourcing, replenishment and availability.

Physical Inventory: this is best sourced to an external firm that can provide more than a summary report of inventoried items against an average cost. Consider using a reputable firm that can offer services such as Data Management, Opportunity Assessment, Inventory Rationalization, and Process Improvement efforts such as Right Sizing. A firm unwilling or unable to implement their recommendations suggests corrupt business practices.

Inventory Rationalization & Reorganization: Following a comprehensive physical inventory that your Team has validated, the next step is to obtain Clinical Validation of the results. Provided your Team has attributed 12-24 month usage history against the items inventoried, the appropriate next step is work with Clinicians to understand whether the recommendations for right-sizing are appropriate. This will also build trust between the Teams and promote collaboration in Assessment, Implementation and Continuous Improvement of future initiatives.

Data Integrity & Transparency: Another benefit to a high-integrity Physical Inventory is that it provides the Materials Management Team with a clean file of what is NOT maintained in the Materials MIS. Typically, only 72% of all items within a Perioperative Department are cataloged properly within a Materials MIS. Does that seem low? I assure you, for under-performing hospitals, it is accurate. Properly managed, updating the item catalogs, attributing usage to consolidated items and undertaking process improvement initiatives will deliver integrity to the Supply Chain process and deliver a ROI in excess of 800% for cost of the Physical Inventory.

Process Improvement & Performance Management: If the focus of these efforts is to address excess inventory, but not improve the processes governing Supply Chain Management, spare your organization the expense and your Management Team the embarrassment of having to explain why benefits were not sustainable. Process Improvement and Performance Management are key components of sustaining change.

The Value of Transparency in Hospital Cost Containment Efforts
It is estimated that a typical 300 bed hospital with an annual $40M supply spend has a 3.6% opportunity for improvement by effectively leveraging information gleaned from previously disintegrated data. This translates to a $1.4M hospital opportunity through appropriate focus implementing high-value opportunities . Furthermore, it is estimated that Consulting organizations utilizing existing vendor capabilities for implementation of Distribution, Supply Consolidation and/or Supply Automation realize 4-15% savings on annual Supply Cost by leveraging information obtained from Hospital data .

High-integrity data supports efforts well beyond Cost Containment. Without this, other opportunities identified will have marginal value and improvements will likely be unsustainable. Consider as well that highly-touted Supply Automation cabinetry and software is a considerable expense, footprint and disruption for the organization. Delivering integrity to data, inventory and inventory management processes on the front end of a Supply Automation installation could reduce the footprint and cost by more than 1/3. As the cost of these installations are often in excess of $500,000, the savings are significant and improved inventory management practices have a direct correlation to high compliance and adoption rates for Supply Automation programs.

Statistics and Ancillary Benefits
The primary concern articulated by most Hospital organizations is that vendors and manufacturers are not a credible source of expertise in this market due to conflicts of interest. Finding a firm that is independent of (though capable of collaborating with) these firms is imperative.

A well-used example of opportunity afforded through effective supply management supported by an effective Supply Chain Management strategy is commonly referred to as spend under management. Though one of many possible metrics, research has shown that Hospitals have been able to achieve a 5-20% cost savings for each dollar of expense brought under management.

Supply Data Statistics
• $40 billion or 3.5% of sales are lost each year due to supply chain information inefficiencies.
• 30% of item data in catalogs used by retailers and manufacturers for replenishment of stock is in error.
• Each of those errors costs $60-$80 to address.
• Companies invest an average of 25 minutes per SKU (stock keeping unit) per year manually cleansing out-of-sync item information.
• 60% of all invoices generated have errors. And, each invoice error costs $40-$400 to reconcile.
• 43% of all invoices result in deductions.
• On average, a new product rollout requires four weeks due in large part to inefficient and error-prone approaches for the exchange and updating of new item information in various MIS.

_________________________________________________________________
1: Hospital Material Management Quarterly, Aspen Systems Corporation, June 2005
2: “Fixing the Healthcare Supply Chain”, Jonathan Byrnes, Harvard School of Business, April 2004
3: HCAB Financial Leadership Council Interviews (2006)
4: Nick Sears, CMO, MedAssets (AHRMM 2007)
5: “Data Synchronization in Healthcare: A Solvable Problem”, Rosenfeld & Stelzer, 2006

________________________________________
For additional information contact:

Black Diamond Transformation, LLC
http://blackdiamondtransformation.com
info@blackdiamondtransformation.com
+1.303.431.4781

Black Diamond Transformation, LLC ©2009. ALL RIGHTS RESERVED. Any use of materials on this site, including reproduction, modification, distribution or republication, without the prior written consent of BDT, is strictly prohibited.

It’s not magic. We had a Team comprised of from Administration, Operations and Clinical – each tasked with helping member hospitals address deficiencies in their programs. The trick was getting department heads or even Administrators to permit us to help them. The hurdle we need to get over is ego. Ego was a killer masquerading as self-sufficiency.

She was part of a Rapid Response Team which could quickly be deployed to locations to assess current situations, identify under-utilized talent and efficiently re-task those resources to create internal implementation Teams. This permitted much quicker acceptance of the Team and its objectives by capitalizing on existing relationships. These folks understood better than anyone external the history, needs, culture and politics of the organization. They knew where the bodies were buried. They knew where the levers of power existed. What was missing was the Project Champion – someone external that had the “permission” to change things.

Here it meant the unwillingness to acknowledge the existence of problems and a resistance to accepting the help from external resources in dealing with them. While Corporate Headquarters had access to information and resources to improve revenue, contain cost and improve outcomes, many of their members refused it. The COO would not force an unwilling hospital to embrace the offer for assistance. He would, however, hold the Executive Management Team accountable for hitting their numbers.

Eventually, a member hospital accepted and performance rapidly improved in several areas. Within a short-period of time, other members requested assistance. It’s worth remembering the old adage that success has no orphans. This program ultimately became a very effective vehicle for change.

My immediate question was scale. How was a small Team of consultants going to drive performance improvement across many hospitals? Her answer surprised me. It required no more than five people. Think on that. I did – and for days afterward. It fascinated me then. It motivates me now.

Your Teams are Deep in Underutilized Talent
Transformation occurs under similar principles of alchemy, typically heat, pressure, time and a catalyst. Within any organization change seems impossible as no need exists to embark on a new path. Under current economic conditions, heat and pressure are certainly applied. The catalyst is often clients or suppliers pushing for greater service or reduced cost. If an organization does not change under those conditions, it will suffer harm.

Organizations embracing and exploiting the changing conditions can emerge from business transformation in a far greater state of viability than their competitors. Lean does not necessarily apply only to processes, but also to thinking. How does a company or Team change itself to deliver upon its commitments as a large organization, but behave with the agility of something far smaller? That’s the key. That’s the discipline.

Hire a Coach, but Consider Leave the Team of Consultants on the Bench
Executives of Management Teams often believe that they must rely upon external consultants to help shepherd their organizations through the shock to culture and process change. I would agree to the hiring of a Coach or Mentor, but leave it there. Spare yourself the cost and inherent waste of a large Team of external consultants parading through your halls as messiahs. They will never live up to the hype and will only reinforce that the Management Team does not have faith in its people. This is not only wasteful, but insulting to your Teams. Your people know far more than any Consultant does about what does and does not work. These men and women possess greater capability then most Executives fathom, so consider the option of re-tasking for the necessary work and reap the benefits of heralding latent talent resident within your organization. You create future leaders by doing so and open lines of communication across the enterprise.

Having spoken to four large healthcare organizations about their change efforts, the rationale and the struggles to attain it, I was amazed at one immutable truth in each story – their people made the difference.

Though this oversimplified for the purpose of brevity, the keys to change are getting the right people “on the bus”, defining an organization’s core competency, aligning all efforts to it, and getting on with evolving for superior results.

It’s that easy. It’s that difficult. But always rely upon your Teams. Your latent talent is deeper than you realize.

________________________________________
For additional information contact:

Black Diamond Transformation, LLC
http://blackdiamondtransformation.com
info@blackdiamondtransformation.com
+1.303.431.4781

Black Diamond Transformation, LLC ©2009. ALL RIGHTS RESERVED. Any use of materials on this site, including reproduction, modification, distribution or republication, without the prior written consent of BDT, is strictly prohibited.

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