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Leading with patience Featured

8:00pm EDT June 25, 2009

Marcia Manker had to make this change work.

After years of being owned by a for-profit insurance company, Orange Coast Memorial Medical Center had become part of the not-for-profit Memorial Health Services.

“Because we were a closed system, we didn’t have to work to create our volume,” says Manker, who was named CEO at the 1,100-employee hospital in 1998. “It was a huge change to have to be service-oriented toward those community physicians and those patients coming in. We had to do a lot of training and changing out staff that couldn’t adjust.”

One of the most important lessons Manker learned was that you can’t change everything overnight.

“You just stay after it,” Manker says. “You have to be relentless and understand that not everyone is going to get on board. You have to be visible and dogged in your pursuit of the vision and you have to be able to communicate in a manner they can understand and connect with.”

The hospital has found its way, reaching $197 million in 2008 revenue.

Smart Business spoke with Manker about how to put yourself in the right position to get your organization to where it needs to be.

Develop a plan. Put your goals down on paper and set specific time frames for when you’re going to accomplish it. Identify who needs to participate in that effort and keep measuring it.

We had goals and deadlines and people responsible for that, and we measured it monthly. We had people out questioning our key constituents constantly for feedback, and we’d bring those brutal truths back to our folks to say, ‘This is where we’re not hitting it. This is what they are saying.’

Show your confidence. Give employees the confidence that they are going to survive the change and that we are all going to be better off for it. A lot of people, they may lose something in the process, and you have to help them with change resilience. It’s constant communication and coaching, reinforcement and encouragement. Sometimes it’s a kick.

But we’re all human beings and you just can’t be pounded on all the time. You need to reward behavior in addition to looking for opportunities for improvement.

Don’t just go out and give a speech. You’re walking the floors and you are communicating it in every venue. You’re always on, and you never let down your energy level. Even if you are in the cafeteria purchasing a bagel, you have to have your game face on. That cashier wants to know that you are positive and you believe this is going to happen. It doesn’t matter if you haven’t slept all night [or] you don’t have any energy. You are on stage. Show you are the one that has the energy and vision to carry everyone through the tough times.

Make time for yourself. You don’t do your best thinking when you’re constantly bombarded with work issues. You have to replenish. With me, I just got a dog and I have to get out there and walk him.

That sounds so selfish that I spend that time with him but, frankly, that’s when I can plan and sort out what I need to get done. Plan it into your schedule and make it a key aspect of your day. It depends on the individual. There isn’t one approach for everybody.

Learn how to communicate. I ask employees, ‘How do you like to receive communication?’ Some are visual, some are auditory and some are tactical. There isn’t one form that works well for everybody, so I don’t think we could ever rely on just one form.

You just have to recognize that everyone is looking through a different set of lenses or hearing things differently. Be cognizant of how they are receiving you, whether it be your nonverbal or your verbal.

I just ask so many questions. I do less talking and more questioning and listening. Maybe a key point in how to communicate is to be a good listener.

Learn how to listen. You’re never very good at it. You may think you are, but even when you think you are listening, you are formulating a plan or response and you can be missing key points. You have to develop that skill of listening.

Ask the person, ‘This is what I heard from you; did I get it all? What did I miss?’ They believe they have been heard and haven’t just been sitting there.

It takes an amazing bit of self-control and discipline to control that. Count to 10 inside your head. Take notes while you’re listening.

Be humble. You are supposed to be strong and they are paying you to be the leader. But you also have to be secure enough with yourself to know you are not perfect. You probably have huge areas for improvement and you have to be very careful in who you select to trust.

You’ll have a lot of people managing upward, and they’ll tell you what they think you want to hear and maybe withhold some of the hard issues. The insecure leaders are probably the ones that you have to worry about the most. They think they have to appear strong and all-knowing and all things to all people when that’s not how it works anymore. It’s more of a participatory situation.

Show a united front. You argue like mad behind closed doors. You flesh out all the differences, and you set the ground rules: ‘Within this conference room, we want all the disagreements to come out. But once we leave the room, we have our talking points and our message.’

How to reach: Orange Coast Memorial Medical Center, (714) 378-7000 or www.memorialcare.com/orange_coast