On a mission Featured

7:00pm EDT February 24, 2008

Steven Altschuler believes the most successful organizations are mission-driven organizations.

He says mission-driven organizations are easy to distinguish from organizations motivated by something else if you know where to look. They are able to unite everyone, regardless of the role he or she performs, around a uniform set of goals and objectives.

It’s the type of organization Altschuler has built and maintained at The Children’s Hospital of Philadelphia, where he serves as president and CEO.

Throughout The Children’s Hospital of Philadelphia (commonly referred to as CHOP) system, Altschuler has strived to rally doctors, nurses, administrators and support staff around the systemwide goal of remaining on the cutting edge of pediatric medical care.

It’s much easier said than done. For any business to climb to the summit of its industry and stay there, ambitious mission statements are a starting point. To get there, Altschuler says you need persistence and an unquenchable thirst for improvement — both self-improvement and the improvement of your company.

At CHOP — which has 7,000 employees and an estimated $1 billion in 2007 revenue according to Hoovers.com — it means Altschuler must tirelessly communicate with many different groups of people, keeping messages consistent and easily understood. He must foster teamwork among departments that perform completely different tasks, and he must run a hospital enterprise like a business while accomplishing a health-care-oriented mission.

“In order for us to be successful and meet our goals, we have to operate like a business,” Altschuler says. “We have to have the same principles, we have to operate within the margins so we have the money to invest to take care of kids.

“In your business, you have to maximize profit. That’s your obligation. Our obligation is to the kids we take care of and their families, to maximize their health and development.”

Altschuler says it’s a juggling act that requires both skill and stamina. You will never totally perfect it, but over time, you can get better at it.

Becoming goal-oriented

If you want to have a goal-oriented organization, you first have to define what your goals are. For Altschuler, that process begins with a well-defined strategic plan.

“We are very disciplined in terms of strategic planning,” he says. “We recently began a new strategic planning process for the next seven years. The elements of the strategic plan really determine our yearly operating plan, which is developed in conjunction with the budget. So the operating plan is really built from the ground up.”

Altschuler says you have to get the people on your company’s ground levels involved in the process. During the planning process, Altschuler both actively and passively seeks input from his employees, both by engaging them through various communication channels and by letting everyone in the organization know that his office door is open as often as possible.

“We solicit every level of the organization for what should be our goals for the next year,” he says. “I have an open-door policy where anybody in the hospital can come and see me all the time and about any issue. Our senior executives, our medical leadership, act in a very similar way.”

He says that face-to-face communication is the most effective form when trying to disseminate a message and get instant feedback from many people at once. But since your opportunities to communicate with many employees at once might be limited, you have to make each chance count.

When seeking input and feedback from employees on issues that affect the entire organization, Altschuler says you must know your audience. That’s easy if someone stops by your office to chat or ask a question, but it gets exponentially more difficult when you are trying to speak to dozens in a particular department or hundreds throughout your organization.

“An open-door policy typically involves a one-to-one interaction with an employee,” he says. “But when you get out and talk to people, typically you might be speaking to a larger audience, many different constituencies throughout the organization. You can say the same message, but you have to tailor it in a way that fits the constituency.”

However, Altschuler says you shouldn’t try to outsmart yourself. Remember that everyone in your organization is probably interested in producing a good product. What you have to do when communicating with members of a specific group or department is show them how they relate to the topic on the table.

“Everyone wants to attain the same results, but the issue might look different to the nursing staff than it does to our physician staff or our resident doctor staff or to our researchers,” he says. “Getting out really allows me to talk to a group in detail, to try and tailor a conversation that would be most appropriate and most effective in communicating what I want to get across.”

A case for change

Achieving buy-in is enough of a challenge when your goal is maintaining the status quo. When your goal is change, it becomes that much more difficult.

CHOP is currently in the midst of a $2 billion infrastructure expansion to deal with increased demand for the hospital’s services, due to a drop in the number of pediatric care facilities in the Philadelphia area. It has forced Altschuler to become something of a salesman to his people, attempting to sell everyone from doctors to nurses to office staffers on the benefits of growth and change.

Altschuler says a period of rapid growth can become a confusing time in a business. You are trying to keep the people in your company focused on the same mission and goals while everything is changing around them.

That’s why, if change is in your organization’s future, he says you need to start communicating the need for it as soon as possible or you run the risk of allowing your employees to lose sight of the bigger picture.

Regardless of the business, he says there is a need for employees to develop something of an entrepreneurial, risk-taking spirit.

“In many ways, people here have to have a competitive, entrepreneurial spirit, so if you can show them what the outcome is going to be by embracing change, you can get them to where they need to be,” Altschuler says. “Part of change in an organization is that when you want to perform change and see it through, you have to see it through to the success of the change. Once your people see success, they are more likely to embrace it.”

As a leader, Altschuler says you will sooner or later be forced to put a stake in the ground when making a major change to your company. You will have to make the statement that change is inevitable, and in the end, your employees are either coming on board or they’re not.

However, he says the best way to minimize the difficult personnel-related decisions you’ll have to make goes back to enabling employees to take ownership in the decision-making process.

Even if you’re the one drawing the line in the sand, Altschuler says it’s always better if the employees who accept change feel like they’ve reached that conclusion themselves.

When the time came to sell CHOP’s employees on the need for expansion, he once again led his senior managers out among the people, meeting with them, proposing ideas, soliciting feedback and refining the vision.

“What I and my senior leadership do is really try to engage people in the decision-making process,” he says. “You can get to a strategy, but if you can’t implement the strategy, it does you no good. So it’s really critical for individuals in leadership positions to really be able to engage the work force and make the part of the process to induce the change.”

Altschuler has implemented some formalized methods of soliciting feedback from staff members within the CHOP organization. Aside from frequent electronic communication, such as e-mail, he holds large organizational meetings four or five times a year where he’ll lay out the current state of the hospital and the direction in which he wants to take the hospital in the near future.

Altschuler also tries to place what is going on in his organization within the larger context of the industry. He says any larger perspective you can give your employees will give them a better understanding about where they and the company stands.

“I’ll always try to give people an update on what is happening out there, how could the presidential election affect health care, things like that,” he says. “It’s always good to get out there and catch up with people and tell them what is going on. I think that develops trust in the leadership, which is critically important. There has to be trust in the vision and the ability to manage through difficult situations.”

The right kind of communication

Even if the concept of keeping your organization goal-focused might seem obvious to you, Altschuler says that’s only half the battle. Whether you want to keep everyone steadfast on consistent objectives or whether you’re trying to change course and take your company in a new direction, it’s not just what you say, but it’s how you say it.

At CHOP, Altschuler underscores the importance of a multifaceted communication approach. General messages are mass-distributed through e-mail or the Internet. If an issue requires more specific attention, he will make time in his schedule to meet with a person or group.

“A good communication strategy has many different facets,” he says. “If I’m trying to get out to the entire organization with a good message, we will typically do an e-mail message to everyone. We have a very robust Internet site for our organization, and our (chief operating officer) does a monthly blog. So it’s really multifaceted, and as companies grow, the ability to communicate through electronic media becomes more and more important.”

At CHOP, Altschuler shares a challenge with the leaders of many publicly traded companies: the need to communicate frequently and clearly with a board of directors. Altschuler needs to relay health-care-related concepts to board members who don’t have a medical background.

If you have to translate industry jargon for a board filled with members who come from diverse professional backgrounds, Altschuler says the only thing you can really do is streamline the language and prepare yourself to answer a lot of questions.

“We have to make sure that our board understands what we’re going to be doing because they are typically community and business leaders who don’t necessarily appreciate the nuances of health care,” he says. “They’re good, smart businesspeople, but health care is a bit of a peculiar business.

“My style with the board is to talk with as many people as possible on a personal basis. That’s not the most efficient style, but the board is so important, and the ability for them to understand what is going on is so important to our success; I really have believed over the years that it’s worth the time.”

HOW TO REACH: The Children’s Hospital of Philadelphia, www.chop.edu