William “Biff” Comte would rather be the tortoise than the hare. He knew the path to profitability at AccentCare Inc. wouldn’t be quick or easy, especially if he was going to involve employees in the process. But he thought steady consensus-building would be the surest route to success.
“This isn’t a race,” he says. “We’d rather be the turtle and get there than be the rabbit and run out of energy after a couple of months. You’ve got to play for the long term.”
When he stepped to the starting line, taking over as chairman, president and CEO in 2003, Comte saw a $40 million in-home health care company losing money fast. By the time he got there, the corporate office had seen significant turnover. And metrics were almost unheard of to the point that he wasn’t sure what the remaining employees were doing every day.
The venture-backed start-up began in private-paid personal care but hadn’t decided exactly what it wanted to be when it grew up. As a health care veteran, Comte knew the company would need to broaden its approach by getting involved with government payers to enter the skilled nursing arena for programs like Medicare.
So he began the process of weaving feedback from more than 10,000 employees into his own observations so he could form a clear picture of what he was working with and how he could use that to get where he wanted to go.
“We knew that we needed to go in that direction, but it’s one step at a time and until we knew where we were, we couldn’t figure out where to go,” Comte says. “So we spent a lot of time talking to the employees.”Get up to speed
Before you can think about the finish line, you have to figure out where you’re starting. Comte didn’t have the luxury of data to get him up to speed, so instead he started investigating.
“It’s what I would think to be Business 101,” he says. “When you go into a new organization, you take a look at your people, you take a look at your product, and you take a look what we are doing.”
Whether you’re taking over or just staying up-to-date, the key to assessing the state of your business is meshing your observations with feedback from others.
Comte’s first step to do that was shadowing some caregivers to learn how his employees spent their days.
“I just wanted to get a feel for what it is they do so when we make decisions here, we understand how it’s going to affect the folks in the field,” says Comte, who now requires all office employees to spend time observing caregivers to understand what goes on in the field.
Remember, you’re not just assessing the company for the sake of a snapshot. Look for better ways of doing what you’re doing or even additional things you could be doing, too. Some of that can come from your past experience, so think about what you’ve seen at other companies what works and what doesn’t.
“Based on the fact that I had been in the health care business for a long time, I could see things that were possibilities for us that we weren’t doing,” Comte says. “I could also see things that we were doing that didn’t make a lot of sense.”
Comte complemented his observations with feedback from employees and clients. He continues to poll patients about the service they receive and employees about what they think of their company and where they see room for improvement.
The key is to be frank about what you see and hear, which will encourage employees to take on the same bluntness.
“The first thing you have to do is be straightforward and honest with everybody. Tell everybody what they’re doing right, what they’re doing wrong,” he says. “Listen to what they have to say as to where they thought the company should be, what they thought they were doing right and wrong, how they have interacted with management in the past, what they think could be better.
“It was honesty: ‘Here’s where I see things. Here’s what I think we need to improve on, and here’s where I think we’re doing a great job.’ And if they disagree with me, that was the time to stand up and say, ‘You might be right here, but we think you’re missing the point here.’ I tell them what I think and I respect the fact that they’ll do the same back with me.”
As long as he kept his door and, therefore, the communication circuit open, Comte found that feedback flowed.Establish structure
Comte describes the structure of the AccentCare he first encountered as loose and scattered. People were getting work done but more out of habit than as progress toward any ultimate goal. There was no accountability and no metrics, which meant progress was tough to track.
“We needed to establish direction and goals and then hold them to those goals and make them accountable for what they did, reward them when they did it, and let them know when they didn’t do it,” he says.
If your company is going to do anything more than merely scrape by, you need to establish some structure that includes both abstract operating philosophies and concrete metrics.
For the first piece creating a mission statement and guiding principles Comte relied on his employees, who had the best insight into the company’s core.
“Management shouldn’t be developing these, in my opinion,” he says. “These are things the employees have to buy in to and have to agree to and have to live. I can’t tell people how do to that.”
So he asked each manager to round up a few willing volunteers sans management, of course to participate on a committee. He gave them a general direction and asked them to fill in gaps by defining what the company was all about.
“We don’t put a lot of structure in when and how they should do it,” Comte says. “We just put the emphasis on the results.”
The ultimate test of their proposed mission is to put it in front of everyone else. Now, for example, new employees get a printout of the mission and guiding philosophies and Comte encourages them to disagree or edit. Additionally, an employee committee gets together annually to ask the rest of the staff for revision suggestions. But for seven years, the mission has remained unchanged.
Once you have the outline of what the company is and how it acts, you can drill down into specific goals that will propel the company toward its mission. If you want to see progress, you need to be able to measure it.
“Make it look, feel and act like a business,” Comte says. “Bring in the appropriate metrics. Make sure they look at the financial information the right way.”
But, especially if you’re starting from scratch, what exactly are the appropriate metrics?
“There are certainly your financial goals. The first thing you want to do is get the company profitable,” Comte says. “And then we determined after we got profitable, what should our margins be? What should our bottom line look like? And then you drive for that.”
After you set the first goal of profitability, then you have to think ahead to what success will look like in the future.
“You just start putting together the picture using input from the field. You start mapping out what this company should look like,” Comte says. “Once you figure out what it should look like today, then you start working out what should it look l ike tomorrow, and then how do we get there. That’s an ongoing process.”
It will take several other metrics to build your future picture of success. Once you’re familiar with the company, it should be fairly obvious which statistics define the business in terms of productivity.
Basically, measure what your employees spend their time doing and what your clients expect, then try to reduce the gap. Comte, for example, looked at how many home visits caregivers conducted on various time scales and how many visits particular clients needed.
“You determine … what are the people, what are the metrics, what do we need to look at every day, every week, every month to make sure that we’re heading in the direction that we all laid out that we could get to,” he says.
Just as you should revisit your mission statement, determining metrics is similarly ongoing.
“Each business has its own set of metrics and they’re constantly evolving,” he says. “I don’t think there’s a month when we don’t say, ‘How about if we look at it like this, and chop up the data and see what it means if we do this?’ It’s never complete. You’re always looking at better ways of doing things.”Pull together
Of course, when you’re giving employees a voice in setting your direction, you’re asking for a chorus that may not always converge. But by relying on a disciplined process and common goals, Comte seldom had to make decisions that weren’t backed by his team.
Obviously, different managers will want different things for their departments. But by asking them to prioritize their needs, you can start to get alignment. Comte does that with a three-pronged question.
“Tell me what it is that you need what is critical to your operations to keep going?” he asks his executives. “What would be nice to have in order to grow your business? And if everything was just perfect, what would you like to have?”
Then you can divide their requests for people, equipment and other resources into necessities and nice-to-haves. Because you only have so many resources, the next step is deciding which ones to grant first.
“Let’s figure out whose project we’re going to move forward the fastest,” Comte tells his team. “What makes the most sense for the company, not only financially but for who we are and what we do?”
He sets the expectation up front that, at the end of the day, everybody has to agree on a direction. To establish that unity, he reminds his employees that despite divisions and departments they are one company pushing toward a single goal by illustrating how success in one part of the company translates into success for everyone.
“Ultimately, what’s best for the company is what’s best for everybody,” he says. “Although everybody, for example, may be bonused in how their division does, there’s also a big piece of the bonus that’s how the company does. So they’re going to want the other divisions to do well because it helps them.
“If we’re hitting our budget and they’re getting bonuses, that means that we’ll have additional money to do other things that will help them. They know that if they say, ‘Well, I’ll put my thing on the side burner; we’ll help you guys get there,’ those people are going to help them next time.”
After all, it’s not like one department gets something while everyone else gets nothing. It’s more like someone gets something now so others can get theirs later. Putting priorities in perspective like that can bring employees together to support each other’s initiatives. Comte also checks up on goals several times a year to see if priorities should be reorganized.
Now, the road ahead of Comte looks a little brighter. AccentCare has paid down debts significantly, and it’s now profitable enough that the venture capital company hasn’t fed it money for several years. By 2009, the company had grown to about $200 million in revenue and to a seven-state service area from a two-state area all thanks to the collaborative efforts of employees.
“Employees are our business,” Comte says. “Without listening to them and understanding what their needs are to make their jobs easier, we wouldn’t have a business. You just communicate over and over and over again and you consistently listen and try to solve their problems.”
How to reach: AccentCare Inc., (800) 834-3059 or www.accentcare.com