John Graham Featured

7:00pm EDT December 26, 2007

To show employees he is really listening to them, John Graham makes himself available so they can talk to him and meet with him on an informal basis. Then, the president and CEO of North Oakland Medical Centers acknowledges what the person suggested and demonstrates where changes are being made, explains why it isn’t realistic to do something right now or explains why the suggestion is inconsistent with the goals of the $115 million organization. Smart Business spoke with Graham about how to communicate change and why it’s important to balance work and play.

Set a vision. A great deal of it is active listening at the level of the board, at the level of the medical staff leadership, to define, very clearly, what the primary role is for the hospital. Then, taking that broad vision and defining the specific actions that are required of a multitude of players inside a hospital setting to then accomplish the vision.

There is a nursing component of the type of care we’re going to provide in a given setting and ancillary services and everything up to and including the way that housekeeping is interacting with those patients and families and nutritional services. So, it’s breaking it into the component parts to make sure that everybody on the team understands how their role interconnects with other team members and how it takes everybody providing all of those activities at just the right time to be able to do it well.

So, everybody on the top executive team is involved in the process in following up on implementation of that vision. It’s a great deal of personal communication as well as in a variety of forums — written communications, internal newsletters, town-hall meetings that we routinely run with all the employees to make sure that they’ve heard personally what the vision is that we’re trying to accomplish.

Then, follow up between the executive team and the department managers to make sure they understand and are trying to explain to the staff where the linkage occurred to bring the pieces together.

Balance your professional and personal lives. We encourage everyone on the team that you need to have a balance between what you are doing at work and what you are doing in your personal life. Family is paramount, and you need to make sure you are leaving time so you can gain the value out of having family interaction that you need to be a fulfilled person, and you can passionately pursue activity here at the hospital.

But when you leave, you have to be able to contain it so it doesn’t become all-consuming.

That’s an ongoing exercise. We have a very dedicated set of employees, solid management team, where we have probably spent more time encouraging them to focus on continuous learning and, again, making sure they take the time off to meet family obligations to recharge their battery.

A very concrete example: This is an organization that banked earned time off and would routinely have it paid out. Well, we changed some of that policy and procedure to encourage people to take the time off because it is very valuable to the retention of that balance.

Communicate change. As you go through a change process, it is very important to repeat the message several times in several different formats in slightly different ways because people don’t always hear what you are trying to communicate in that process of change. It’s very important that, to the extent they can, they understand what change is occurring and why it needs to occur.

Once we’ve identified an objective, we may very routinely write it up as part of an internal or external written communication, and then have a slightly different perspective on that same goal as part of verbal communication that would take place in department-head meetings or in town-hall meetings with groups of employees. Then, very basic follow up during tours of the facility, touching base with individual staff members to try to make the linkage back to what that bigger goal or objective was.

So it’s, ‘How is it that you, as a nursing assistant, directly affect the communication with the patient to assure that they feel like they are getting the proper respect? So, did you introduce yourself? Did you let them know what you are going to be doing?’

That’s a program that has been communicated in writing. It’s a program that has been communicated through the management chain of command, but then we try to reinforce it when we are out just making rounds, as well.

Follow up and review potential hires. (There is a) fairly elaborate interview process that we try to use to make sure there is some type of confirmation of the actual activity. Then, a great deal of it is behavior-based interviewing, where you are attempting to get the candidate to explain very specific situations and what their behaviors were in those situations so you can identify that because past behavior is probably the best predictor of future behavior.

You are targeting specific behaviors that are needed for their role, and then trying to get into enough detail in the interview to ascertain how they specifically acted in that situation. I’m not saying that people can’t still fake it, but it becomes more difficult.

Identify employees’ passions. It is identifying where their passions are and how we can harness those passions into specific projects, activities that move the organization forward based upon the energy that they bring to the task.

It gets back to very active listening and then identifying their strengths, identifying the major needs of the organization and how to bring those together to gain the most benefit for the organization.

HOW TO REACH: North Oakland Medical Centers, (248) 857-7200 or