Change Management

Rx for change

By Brian Horn

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The Fencel file

Growth has been a constant companion in the 10 years Mike Fencel has led Brandon Regional Hospital.

And that’s just fine with him.

He realizes that in order to succeed, you have to constantly stay ahead of the competition.

When Fencel became CEO of the hospital in late 1997, it had 255 beds. Now it has 367, and there are plans to add 40 more by the fourth quarter of 2008.

The growth has been a steady but crucial necessity at the hospital, which posted about $300 million in revenue last year.

“If we didn’t grow, that could encourage other competitors to want to seek a location somewhere in my primary service area,” he says. “I think the fact that we have been able to expand so much and commit so much in resources over those 10 years makes it a harder argument for others to say we aren’t meeting community needs. It would have opened the door for others to come in. That, we feel, is not necessary because we are doing a fine job of addressing those needs.”

In order to lead the hospital through growth, Fencel needed to deal with the challenges that came along with it. He had to form the right management team, delegate authority and get buy-in from his more than 1,600 employees.

Form a strong team

When Fencel became CEO, there was already a senior management team in place, but within several years, many of them would be retiring. That meant he would have to make sure the transition was smooth while finding members who would fit in to the culture.

Fencel also noticed there was beginning to be some resistance to change from the employees. Having been in existence since 1977, the hospital grew to a point where not all the employees knew each other, and some were uncomfortable with the growth. Because of that, Fencel needed a management team that could generate excitement about growth and help everyone understand that it was for the best.

“You lost that sense of family that once existed, but that is just the nature of the organization as it’s grown,” he says. “I had to have people who could help me articulate and carry out reasons why continued change needed to take place. As we have evolved and grown, the dynamics and the need to have a really well-organized, well-structured senior team have come to the forefront to me.”

When first sitting down with a candidate for his team, Fencel looked at the interviewee’s past work history. More importantly, he looked for concrete examples of change-related situations, why there was need for change, what they did about it and how he or she succeeded in executing it.

He also wanted someone who did his or her homework before the interview, and wasn’t going to sit there and let him do all the talking.

“I like to see people who have gone to the Web site, have done their part to try to evaluate and understand the organization the best they can, and they are prepared to ask me as many questions as I ask them, so they are fully aware of what those opportunities and challenges for that position will be,” he says. “If you come in, look great and have a nice resume but don’t know anything about our organization, that doesn’t show me a whole lot.”

After other members of the management team also interviewed the candidate, the group got together, discussed all the information and made a decision.

None of the senior management team, which is composed of six members including Fencel, was promoted from within the hospital, but each member came from HCA Inc., the parent organization of Brandon Regional Hospital.

“One other thing that is critical is having the right fit,” Fencel says. “Someone may be extremely successful in a certain role in another organization within HCA or outside, but their culture is different from mine. That was another lesson learned. We’ve had to make some changes because it wasn’t the right fit for the individual, the team or the organization. It actually turned out that some of the people on their own recognized that and sought other opportunities, and got those in HCA, where it was a better fit for them.

“If I feel the leadership team understands my approach and philosophy and will support me and are committed to do the things I need done, then I want to keep them here.”

Though he wants people who will follow his lead, Fencel also realizes it’s important to have diversity on a team.

“I’ve got a wide variety of years of experience from different members, attitudes, enthusiasm, personalities, and you blend them all together,” he says.

Delegate authority

After Fencel’s team was in place, he knew he needed to delegate authority because the growth of the hospital meant he could not operate it by himself.

Fencel says his primary role is to develop, maintain and modify the strategic plan and growth initiative and to be a liaison with the parties that will help move the organization forward.

He and his team developed their delegation process by reading books and looking at the ways different organizations handle delegation. They identified areas or activities that certain team members were more comfortable at doing than others were and came up with certain types of philosophies they were comfortable with and could lead by.

When the senior team began to take more responsibility, Fencel intentionally stayed out of the spotlight, which led some to believe he no longer cared about the organization. If he could do it all over again, he wishes he would have communicated the change better to employees and let them know he would still be in contact with his management team and be kept in the loop.

“The way we’ve grown no longer allows me to have as much time as I’d like to be available and in contact with all the employees, but I am still going to be in touch,” he says. “I know what is going to go on, and I am counting on these individuals to be my point people on a day-in, day-out basis. If and when the time requires me to be back out there, then I will. But, to try to continue and meet the employees’ expectations and visibility is hard.”

By the time Fencel realized the impact the change had, it was too late to try to go back and communicate it.

“But that’s one of those lessons learned,” he says. “If someone has been in their role for a long time in a high-growth organization and decided to make some fairly significant changes in their structure of management style, then I would certainly encourage them to try to communicate those things so people know that upfront.

“If someone has been in their leadership role for a long time and tries to change approaches, you really have to make sure you understand the impact that change will have on the organization and be able to communicate if those changes are taking place and why they are taking place. In retrospect, I could have done a better job in that regard with the employees as a whole.”

While he could have communicated the change better, Fencel says delegation is necessary to keep yourself fresh and on top of your game.

“It’s improved my quality of life,” he says. “If you have a better, happy, well-rounded, quality of life, professionally and personally, that just makes you more effective in your role as a leader. Over time, (work) just absorbs you. It’s all-consuming. You’re not able to separate and think strategically like you need to do.

“If you don’t have a way to break away from that, I don’t see how you can possibly continue to be fresh with your ideas, objective in your viewpoint and energized to help drive the organization forward.”

Build buy-in

While building the right management team and delegating authority to them was important, he also needed to get buy-in from the employees on the many growth-related changes the hospital was going through.

One example was the move to create a cardiac surgery program. Before getting started on the project, Fencel needed to make sure everyone understood why the hospital needed the service and why going through the process was worth it. Even if it was communicating the message through something as simple as e-mail or in meetings, the results would outweigh the simplicity of the method.

In addition, because previous attempts to start the program failed prior to Fencel’s tenure, it was important from the start he showed conviction in making the program become a reality, no matter what hurdles got in his way.

“Some of the people who had been here at the time those first efforts were made probably had some doubts it could be done,” he says. “It took us three attempts. I think if I had given up after that first effort or second effort, I would have validated for some that it wasn’t beneficial for our hospital to go through all that. But, I wasn’t going to give up and a lot of other people weren’t either. Those people that doubted, we proved them wrong. That wasn’t our intent, but it helped validate that if you put your mind to it, work hard and work together, there is a lot that can be accomplished. Here is an example where we went to a great degree to bring a much-needed service into this community for the benefit of everyone.”

Fencel says leaders need to get buy-in to make a change happen because everyone in the organization will eventually have a part in it.

“What I have to do in my role is to provide a vision and communicate the vision and what our strategic initiatives are and why,” he says. “At the end of the day, I’m not the one making that happen. It’s my staff nurse, it’s our environmental service worker, and it’s the plumber or electrician in our plant operations department. All of them have a role directly or indirectly in making things occur. If they don’t buy in and believe it, then we are less likely to be able to achieve the goals and vision that I think are so critical to our success. Communicating the vision, communicating the reason why we are doing it, communicating the challenges, allowing them an opportunity to ask questions in different forms, whether it’s with me or through their immediate leadership, we try to do it. Are we completely successful 100 percent of the time? No. That’s a process you never stop working on.”

Keeping employees informed not only creates buy-in, but it also serves as a great marketing tool for your company.

“At the end of the day, I have over 1,600 employees, and they can be my best form of advertising,” he says. “You have newspapers, you have direct e-mail pieces and TV spots, and you can do all sorts of things. But, the amount of people employees come into contact with at the ball field, in their church or a civic organization, and being able to speak intelligently and with pride in what we are doing, that goes a lot of further than any other type of advertising.”

HOW TO REACH: Brandon Regional Hospital, (813) 681-5551 or www.brandonregionalhospital.com