Kim Cripe builds Children’s Hospital of Orange County into a national player Featured

8:00pm EDT September 25, 2010

Kim Cripe knows how it feels to be busy.

“The demands for your time are probably double the time — at least — that you have,” says the president and CEO of Children’s Hospital of Orange County. “The demands for your time and your energy, they just seem to exponentially grow year after year.”

Lately, Cripe has been busier than ever as she repositions CHOC from a community children’s hospital to a nationally recognized children’s hospital. The new vision has brought big changes, like building a new hospital and affiliating with UC Irvine.

However, she recognizes that her 2,432 employees face the same time pressures. Her job is to keep them focused on the right things.

“The things you talk to people about are the things they pay the most attention to,” Cripe says. “If we’re focusing and talking about something, I’m certain that people are paying attention to it. And if I don’t, there are many other things to fill that time slot.”

To get everyone concentrating on the same vision, Cripe learned she had to refine the organization’s focus and communicate it relentlessly. It took a lot of effort to reach all of the employees across a 238-bed main facility in the city of Orange, a hospital-within-a-hospital in Mission Viejo and 12 other clinics. It required a clear plan laying out the steps to becoming the kind of children’s hospital CHOC aspired to be.

“If you’re trying to move your company, you need to have a plan, and then you have to have tools to deploy the plan,” Cripe says. “You need to be able to develop the plan, communicate the plan and explain to everybody that works there what their role is in achieving the plan.”

Create an involved plan

Half a dozen years into her CHOC tenure, Cripe stepped into her current position with a bigger vision for the company. She knew she couldn’t get there — or get others to follow — without a plan.

She started by evaluating what propelled other hospitals to CHOC’s desired position by benchmarking the top players in the field, as determined by top 10 criteria-ranked lists in several publications.

“We studied the key attributes of those children’s hospitals, and we came up with 11 to 13 different core attributes that they all had,” Cripe says. “For example, they all had academic affiliations with universities. They all had robust fundraising efforts and endowments.”

The critical step, then, is mapping your position in comparison to those and analyzing why gaps exist. For example, the hospitals with large endowments had been around for a hundred years in comparison to CHOC’s 45 years — which made sense, considering how endowments grow over time.

That analysis can be too much for one person, especially someone close to the organization. Cripe recommends external help.

“There’s a time and a purpose for a consultant,” she says. “Sometimes it’s really hard to hold the mirror up and be painfully honest with yourself about where you are. If you’re really serious about transforming your company, having someone from the outside that has relevant expertise coming in and helping you hold up a mirror and debating the truths that you have [is important].”

Those analyzed attributes became a pool to pull priorities and eventually evolved into CHOC’s strategic plan.

“It was clear, when we looked at all the things that were on the list, so many of them tied back to the need for an academic affiliation,” Cripe says. “So that was the strategic initiative that we pursued first. Typically, there’s either a chronology or there’s some sort of foundational piece that needs to get done, and then the different elements build upon that.

“The first ranking was: What’s the most important thing to advance this institution? And then: What is the timeline, and then, what pieces fall after that?”

Remember, when prioritizing, that you can’t do everything.

“Every company has dozens — if not hundreds or thousands — of demands for their time and resources,” Cripe says. “A word of caution is for leadership to be reasonable and set realistic expectations. … We were trying to take on too much at one time, and over the years, we’ve learned to discipline ourselves from trying to tackle 10 things at a time to two or three so that we do them and do them well.”

Keep employees informed

Because your plans don’t only affect you, don’t forget about your employees while you’re planning. Involve them in the process through constant communication.

“If people aren’t involved on the ground floor with helping to develop that plan … it certainly reduces the likelihood that they’re going to buy in and support what you’re doing,” Cripe says.

She tries to reach as many employees in as many ways as possible — from focus groups and electronic surveys to town-hall meetings.

“You truly cannot spend enough time or too much time designing communication systems,” she says. “Every channel’s important. You can’t just send out a company newsletter or give a big talk. It’s an endless job of engaging and communicating with your stakeholders.”

Like any other part of your plan, lay out a communication strategy up front.

“We try to think of every communication channel possible for a particular initiative,” says Cripe, who works closely with her public relations department to select appropriate methods. “You have to be realistic; you can’t do 15 different things every single time. We prioritize: Where do we want focus groups? Where do we want departmental meetings? Where do we want town-hall meetings? [We] think through the importance of what we’re doing and the best way to get that word out.”

Regardless of the avenue, the goal is fostering buy-in. Specifically, employees in a certain department need to understand why an initiative affecting them has been delayed.

“Most people tend to think what they’re working on is the most important thing,” Cripe says. “But it might not be, at the time, the most important thing for the organization. Helping them understand why we have to make decisions to delay or defer is also important.”

You may not get agreement from everyone — but you don’t have to. Cripe has found that when employees understand decisions, extreme dissension is rare.

“If you bring people along and they have knowledge of what you’re trying to do and what the circumstances are and the limitations, while they might not completely agree … they’ll at least understand why you’re pursuing the different strategic initiates in a particular order,” she says. “Understand that people don’t have the same information that senior leadership has. They don’t have access to the broad band of what the company is facing. If you help them get some insight into what all the demands are and the strategic direction, they understand, and they want to do their part to help you.”

Make messages relevant

Just as a single communication method doesn’t reach everyone, one message doesn’t fit all, either.

“One of the biggest challenges for a chief executive officer is to translate that vision into something that every employee can relate to personally,” Cripe says. “I tend to get very excited about our vision and can talk about it and it’s crystal clear to me, but then I need to think about, if I were a nurse, what’s that vision mean to me personally and how do I contribute to it?”

To some extent, you can tailor your message by putting yourself in employees’ shoes.

“You need to think about the person receiving the message, how you make it meaningful to them,” she says. “Think about, for the gentleman cleaning the room, what does that mean to him? Then craft the message specific to, ‘OK, to be a great children’s hospital, one of the things is that we want really clean patient rooms,’ and get it down to a clear picture.

“People need clarity: Exactly what does that mean to me and what do you want me to do? Develop a communication plan to help that individual understand their role. It can’t just be broad and generic. You need to think about the audience and what you need them to do.”

But it’s rare you’ll have specific knowledge of each department. Even if you did, it’s difficult to step back from your own understanding of the vision. Recognize those limitations — and the importance of delegation.

“Our job is to be clear about the vision and then to get the right people in the room to start to translate that down throughout the organization,” Cripe says. “I long ago realized that there’s no way that one person, no matter how good a CEO might be, can do all of that himself or herself and do it well.”

Cripe requires other leaders in the organization — from senior leaders to front-line supervisors — to develop their own offshoot of the vision for their teams, complete with specific goals, objectives, metrics, timelines and communication strategies.

“You literally need to get down to the individual level, and one of the best ways to do that is to involve all of your management,” Cripe says. “Ask your departmental managers to develop their own little strategic plan for their department (that) ties into the company’s vision and how they’re going to contribute.”

Department heads have several resources available for assistance, like access to CHOC’s strategic planning department.

CHOC even set up management training on setting and measuring realistic goals. For example, the program covered the balance between ambition and achievement.

“(Goals) shouldn’t be so ambitious that there’s no chance that they’re going to be achieved, because that’s demoralizing in the end,” Cripe says. “You need to work with your management team on, realistically, given everything a department’s working on, ‘What rate of improvement should we be aspiring to achieve?’”

The program also trained them to set reasonable timelines.

“You can set a really aggressive timeline, but that might sacrifice buy-in,” Cripe says. “The manager has to weigh the pros and cons of the timeline versus the depth and penetration of a particular goal.”

Offering those tools enables consistency, but checks and balances ensure it. The vice presidents of each department review the mini-visions so no one veers from the ultimate company mission to “nurture, advance and protect the health and well-being of children,” or the vision to “achieve national recognition as a premier children’s hospital.”

Hold employees accountable

Once you’ve established the companywide plan, as well as departmental contributions, hold people accountable to it.

“Starting with management, you’ve really got to link the accountability piece to performance evaluation and compensation,” says Cripe, explaining that part of managers’ compensation is base pay and part depends on achieving the strategic plan. “There’s just complete integrity and continuity in clearly articulating … what their job is and what they need to do to be successful.”

In addition to compensation, reporting results to everyone is crucial for maintaining alignment to the vision. Department managers at CHOC regularly address employees about where they’re meeting goals and where they’re not.

If a department falls off track, involve its employees in designing the correction. To do that, they need visibility.

“You’ve got to have a structure so that people can see clearly their progress and identify when they’re not meeting their targets,” Cripe says. “We’ll ask a manager, ‘OK, you’re not on target. What is your plan to mitigate?’ Sometimes they need different resources; sometimes it’s just a timing issue. But look specifically [at] why and what can we do to get back on track.

“If people are tracking their goals, they’re aware that they’re not hitting them. [If] they think through why, you can get back on track. What’s difficult is if you wait till the end of the year and you go, ‘Oh my gosh, we didn’t make it.’”

On the other hand, if they are meeting goals, don’t let it go unnoticed.

“The human touch and engagement is, honestly, the single most important thing we can do — stopping and thanking people and being specific, not just, ‘Hey, thanks for doing such a great job,’ but, ‘Thank you, John. I heard yesterday that you were working with a family and they needed (something) and you were able to provide it.’ People really want to know that you know what they’re doing and how they’re helping.”

By creating, clearly communicating and following up on her plan to vault CHOC to national status, Cripe has kept employees focused on the vision. Over the past decade, it has become one of the fastest-growing freestanding children’s hospitals in California. It has also been ranked the 17th-busiest children’s hospital in the nation, with admissions increasing 130 percent since 1998.

“I think people genuinely want to do a good job,” Cripe says. “If you’re clear on what you need them to do and everything is linked back so there isn’t any mixed messaging or lack of clarification, it works well.”

How to reach: Children’s Hospital of Orange County, (714) 997-3000 or