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Building a team Featured

8:00pm EDT July 26, 2009

Marsha Powers saw the passion and the energy right from the start. Her new employees at Tenet HealthSystem Medical Inc. cared about their work and were willing to go above and beyond the call of duty to provide the best care they possibly could.

“I just remember one of the hospitals I went into when I first came to Florida, I had no idea where I was going,” says Powers, who heads up the health care provider’s 10-hospital Florida region. “I had two or three people saying, ‘Let me help you.’ There was an energy level, a commitment to doing the right thing. You walk in and everyone knows what their role is.”

Passion for one’s work is something Powers loves to see, especially in the area of health care.

“I’ve been in hospital management for 30 years,” Powers says. “The only thing I know how to do is run hospitals. We’re in the business of taking care of people. If our people don’t understand that, if they think we are making widgets, then they are in the wrong business.”

But it wasn’t a lack of understanding job duties and responsibilities that concerned Powers. Instead, she felt like the hospitals were each trying to go it alone and lacked a true sense of identity under the Tenet brand and with other hospitals in the region.

“I think every hospital had their own vision, but I didn’t see that there was a vision for all the hospitals of Tenet in total,” Powers says. “Everyone needs to know where we are, where we’re going, how we did and where we’re headed.”

Powers wanted to change that and bring them together. She believed that as one powerful organization, Tenet Florida and its 11,175 employees would better be able to grow the business and improve market share. The company would be able to communicate in one clear voice to those who came in contact with the organization and share what Tenet is all about.

“Every hospital has been awarded numerous honors and has numerous things that they do very well,” Powers says. “How do you get that information out to the public? How do you work in a collaborative manner with your physicians and employees and with each other to build market share? We’ve got great hospitals and they were doing great, but they could be greater.”

The trick was to take those good things, that high level of energy and willingness to go above and beyond on the job and harness them for delivery as a cohesive and concise message to the community.

“Every hospital has their strengths and their core services,” Powers says. “It’s working together to not only identify those strengths but to have all the hospitals work together so that they know each other’s strengths.”

Here is how Powers worked with her people to create a sense of both team and common purpose at Tenet.

Engage in dialogue

If you want to know what your people are thinking and what would bring them together, you can’t expect to have a complete understanding after just one individual encounter or even after a single all-hands meeting.

“It happens one interaction at a time,” Powers says. “The easiest way is to sit down with them and ask them, ‘What are we doing well? What are we not doing well? To improve our market share and performance, what are the levers you would pull?’”

Powers began her dialogue about these key issues at the top, meeting with the CEOs of each hospital in her region. She needed to get to know each of these leaders to find out what they felt was good and maybe not so good about the Tenet organization.

“To get honest dialogue established, you have to want honest dialogue,” Powers says. “If you ask someone, what can we do to make things better and they help you, that suggestion is a gift to you. It’s up to you to take that gift and utilize it. If you constantly ask the question, but you don’t do anything about it, the result of any organization is going to be the same. People are no longer going to be willing to speak up.”

When you get feedback that contains concern about a problem, it helps if you don’t try to deflect ownership of the problem.

“What’s keeping us from getting the job done?” Powers says. “What do we need to do to improve? It’s not something you ask just once. It’s something all hospitals ask on an ongoing basis. What are we doing? How are we doing it? How can we do it better? It starts at the top.”

As you and your key leaders begin to formulate the concept of a common vision for your organization, you need to involve others in the process.

“If I look at our hospital management team, they are out and about in our hospital all day long,” Powers says. “They know our staff; they know the business.”

Powers says you need to attend meetings at each of your locations to get everyone involved in the process.

“With everybody sitting down and talking about issues and talking about ways we can improve what we’re doing, everybody has a seat at the table and checks their egos at the door,” Powers says. “They talk about what they’re doing and how they can improve.”

She says she’s definitely a participant in the meetings but not to dictate terms or issue edicts as to how she thinks things should be done.

“I’ll ask questions, and they’ll ask questions,” Powers says. “It’s just the establishment of a dialogue and the development of that relationship with our hospital teams and with our physicians.”

The key is to level the playing field in the meeting room. When you take the role of asking questions and being someone who wants to learn, you increase the sense of a collaborative spirit.

“Not one of us is more important than the other,” Powers says. “How can we do things together? How can we do things collaboratively? How can we better meet the needs of our patients? We’re not building widgets; we’re taking care of people. Everything has to be done by what’s best for our patients.”

The final piece of your effort to ensure good feedback from your people is the follow-up.

“We don’t just meet once and then come back six months later and talk again,” Powers says. “We have a very structured formal process where we meet monthly and we talk about what we are doing. We listen to ideas and we execute.”

It is that execution that will convince employees that their efforts are worthwhile. It’s that execution that Powers now sees in her CEOs.

“I see a vibrant organization,” Powers says. “I see a group of CEOs that are CEOs that want to run a successful business and do run a successful business. They have excellent communication plans with their employees and physicians. All of them are committed to putting the ‘community’ back in ‘community hospital.’ They are not just inwardly focused. They want to be a good corporate citizen.”

Track your progress

The enactment of organizational change is something that needs to be tracked. If you don’t know where you’ve been, it’s hard to tell if you’ve made any progress toward where you want to go.

In the case of Tenet, Powers’ employees needed to know what steps to take in order to better align the hospitals in the Tenet region and what needed to be done in order to create a true sense of team across t he 10 hospitals.

“You have to communicate it,” Powers says. “Let people know what their job is and why it’s important. If they’re making just one little part, why is that important to the whole business? Everybody is important. I can’t overemphasize how important the communication aspect is in any business.

“We need to constantly tell people what we’re doing, how we’re doing it and where we’re headed. It puts people at ease so they know what to expect.”

Tenet generated a written scorecard system that is available on a shared drive within the company.

“We have the same indicators for every hospital, and it’s on a shared drive so you can see everybody’s,” Powers says. “It’s not something that’s kept in a binder in my office. That wouldn’t do anyone any good.”

Powers says the scorecards are updated monthly on such things as patient satisfaction, patient outcomes and other key benchmarks that need to be met.

“Every business needs to establish what are the key levers for their business and then communicate that and measure it, then recommunicate it and remeasure it,” Powers says. “It has to be something that’s not just done once. It can’t be something that is just the flavor of the month. These are key things that are important to how we operate. They are important now, and they are important in the future.”

The key to making a benchmark system work is the ability to select things that both can be tracked and should be tracked.

“We look at what’s important to the overall business,” Powers says. “We look at quality, our people, service, cost and growth. We establish what the key results are that we need. We benchmark against our other hospitals, not just in Florida but we have quite a number of hospitals throughout the country.”

One of the things you have to be careful not to do is get too wrapped up in what a single metric might tell you.

“You can’t look at one metric and have an understanding of that organization,” Powers says. “Nothing is the end-all, be-all. But what it does is it gives you the indication to then get to the next step and focus further on that one area. If you have a 50 percent turnover rate, I would think that’s probably not too good. That in itself doesn’t tell you anything about the organization. It just tells you what the turnover is. Maybe I need to look further and see what the issues are. It’s just an indicator, and it gives you the opportunity or direction of where you need to start looking.”

Powers can see the fruits of her labor when she hears her direct reports talk about where Tenet still needs to go.

“Each of our hospitals and each of our leaders are able to very succinctly talk about what their plan is, where they stand and where we’re doing well and not well, and what the two or three things are that matter in each area,” Powers says.

“It’s just making sure that everyone is on the same page and establishing goals, not just for the hospital but overall. I think if you look at the overall vision, it’s to surround yourself with good people and set reasonable expectations and allow them to exceed expectations.”

How to reach: Tenet HealthSystem Medical Inc., (954) 509-3600 or www.tenethealth.com