The old cliché says steering a large organization is like steering a ship. But steering an ocean liner on the open water might actually be a simpler task than what Laurence Merlis needs to accomplish.
As the president and CEO of Abington Health, Merlis is charged with steering a medical system comprised of 6,000 employees spread across two hospitals, two major outpatient campuses and 57 physician sites.
Merlis has to promote and enforce a uniform set of standards and values for everyone, regardless of where they work in the Abington system. To do it, he needs a vision, and he needs the vision to be clearly defined and communicated to managers and employees who understand their role and how it helps the system accomplish its overarching goals.
“Everybody has a part to play, leaning forward and recognizing day in and day out that we can move toward our vision if we’re clearly aligned,” Merlis says. “We need to recognize that there is a connection between the parts people play in their daily tasks and the work we do to ensure the very best outcome for patient safety and service, while at the same time ensuring that we are efficient and effective.”
Merlis wants everyone at Abington to visualize what the medical system can be when it realizes its full potential. In the highly competitive Philadelphia market, in which patients have numerous options when seeking medical care, Merlis wants Abington to be the go-to system for area residents, known for high standards regarding service, technology and safety.
Visualizing that outcome starts with Merlis, and must cascade down from there. That’s where a great deal of the work occurs. Merlis realizes that he needs to be a visionary, but even more than that, he needs to be a unifier.
“You do need to be able to visualize the concept of what you can be as an organization,” he says. “You start really thinking about tomorrow and how has to be inspiring for everyone. But it has to be understandable, we have to stretch for it, and we have to make sure that the messages are crisp and simple and something that becomes compelling in terms of what our purpose is and how we can rally support to achieve that vision.”
Start with leadership
Two of the most critical things a leader can do when formulating and promoting a vision is to listen and measure. It’s something that Merlis has made a top priority at Abington. He wants his leadership team to get input on the future direction of the organization from all involved stakeholders — the board of directors, physicians, medical staff, office staff and support staff. Then, once the vision and strategy are formed, he manages by what he can measure and communicates that data back to employees to facilitate an ongoing dialogue.
“You need to make sure that you can measure and manage work, and that you are not setting strategy or policy by anecdote, but that you are setting it by fact,” Merlis says. “You need to be sure that you are measuring yourself by what you said you would do.”
When a strategic initiative is set, Merlis and his leadership team keep tabs on metrics within that initiative, and disclose the results to the employee population. He wants to keep the entire work force engaged in the process and also empower employees to hold management accountable for their leadership decisions.
“We have metrics within each of our major strategic intents,” he says. “We share that in an effort to stay as transparent as possible. Since one of our core values here is patient safety, we’re very public with where we are day to day against what we call ‘serious safety events,’ because that is a critical metric for us. We have other patient safety initiatives around the effort to reduce infections. It might be something as simple as the number of our staff who received a flu vaccine.”
Merlis wants the staff involved in measuring progress against the vision because they are the people at ground level each day. They have a front and center seat for what is going on in the facility corridors, and can offer real-time advice on improvements that can be made.
“Our philosophy here is the staff are experts in how to get things done,” Merlis says. “We look to them for advice and recommendations on how to make things better when it comes to making ourselves a place for patients to receive care. We need to constantly look at all of our processes, work on them and continually find ways to make them work better. It all gets back to execution. You need to get the results needed to achieve your vision. You can’t confuse effort with results.”
Stay on message
Rolling out a vision is great. Receiving input from your staff on the vision is even better. But what about after the initial push is over? You need to keep the momentum going and keep your people interested in continuing to achieve the goals you originally set.
At Abington, Merlis has learned that keeping a vision fresh within a large organization takes a combination of front-and-center communication and subtle reminders in the day-to-day details.
The details can be as small as a pocket-sized card.
“We have what we call an ‘E3’ card, which stands for ‘engaging every employee,’” Merlis says. “Every employee has a card, and on that card are the three things they can do to help us move our mission and vision forward.”
The more direct reinforcement comes in the form of, among other things, patient feedback. Like many health systems, Abington uses the stories of successful patient treatment to inspire, and any negative patient feedback is analyzed for ways to improve policies and processes.
Regardless of who is receiving the message, Merlis and his leadership team don’t do a great deal of tailoring the message to a given audience. Whether the message is meant for physicians, nurses or food prep staff in the kitchen, everyone receives it in similar fashion. Though some large organizations believe in crafting the message to meet the needs of a certain audience, Merlis says it’s more important to keep everyone on the same page and eliminate any chance of a message getting muddled or completely lost in translation.
“We don’t shape the message,” he says. “We share with everybody what the issue is, what the strategy is, what the goals are moving forward. We want to make sure that we clearly articulate the behaviors we want, the behaviors we need to exhibit, so that it can resonate with every single person and show them the part they do have within the system. The size of our organization, with 6,000 people and multiple facilities, is why we need consistency. It creates different challenges in terms of making people feel connected.”
Build your team
With a well-defined vision comes the need to continually look for people who can help promote the vision at all levels of the organization. At Abington, much of the interview process for many positions focuses on whether a job candidate has the competencies needed to support the system’s mission and goals.
Merlis calls it “behavioral-based interviewing.” He says the essential skills needed for a job are going to be present on a resume, or they aren’t. The technical requirements are a mere means to getting in the door for an interview. Once in the door, it’s up to Merlis and his team, as well as the interviewee, to figure out whether there is a cultural match.
“What we’re looking for are people whose behaviors will exhibit and support our values,” Merlis says. “To get to that stage, we’re already looking for people who have the right skills and competencies. The skills are the hurdle to get into the interview. The knowledge and the background, their experience, those are all things you can pick up in their CV and references. But you really want to be interviewing for the level past that. You want to know if they can be the right fit based on those leadership competencies and behaviors, what you know you need to have in order for a person in that position to be successful.”
The way to drill down and find the best possible match is to ask specific questions in the interview process. Merlis says you want examples of ways in which the job candidate has exhibited the cultural qualities you want in an employee.
“You’re asking specific questions to elicit examples of where their behavior and prior experiences support the values that you think you need for this particular position in the organization,” he says. “It’s a given set of competencies for each position. But you’re always looking for people who can manage a vision and a purpose, people who manage ethically in terms of honesty and integrity, people who manage by engaging their staff. You want people who have great interpersonal skills and are focused on results.”
And once you’ve found the right match for the position, you need to let the person do his or her job. As long as the employee is doing it well, you should be able to trust that he or she is on the same page with regard to the vision, will live it and help promote it.
“When I got here back in 2009, we already had a team that was excellent,” Merlis says. “If you have that, you want to give people the freedom to do their jobs. You want somebody who recognizes that they’re going to be a part of a team. We define success as the success of the team. And you want people to be self-aware so they learn.”
Ultimately, you are defining the roles and the rules of engagement. Beyond that, you want to see your best and brightest show their stuff, which means letting them do their jobs and promote the vision, mission and values in a way that plays to their strengths.
“Everyone has to be committed to the goals of the team,” Merlis says. “You have to have the right mix of skills, and you really have to have a sense of holding each other responsible. We want the team to understand, based on the project or issue, who is responsible, who is accountable and who they need to contact for support.
“Another big key is continuing to create a safe environment, meaning an environment where people feel safe to raise issues and follow up. You’re going to need to have crucial conversations or confrontations at some point, but you promote the culture by doing that in a positive and respectful way. You want your people to be able to handle conflict yet move on, a team that has a sense of spirit and can support each other.”
How to reach: Abington Health, (215) 481-2000 or www.amh.org
The Merlis file
Born: Bay Shore, N.Y.
Education: Bachelor’s degree in biology and psychology, Union College, Schenectady, N.Y.; MBA, George Washington University
First job: I taught waterskiing for a summer after my freshman year in college.
What is the best business lesson you’ve learned?
What is critical for anyone to be successful is to not act outside yourself. Be true to who you are. Be genuine and sincere.
What traits or skills are essential for a business leader?
First and foremost, ethical behavior. You absolutely must lead with honesty and integrity. You need to be approachable. You need to be willing to lead and make difficult decisions and be self-aware of what you can do better. Just constantly look to improve.
What is your definition of success?
Success could be defined as making sure you make a positive difference in the lives of others, while achieving goals to bring the organization closer to its vision. You want people to be moving forward with you and, ultimately, leave the organization in a better position than when you first arrived.