The big picture Featured

8:00pm EDT July 26, 2008

Occupying the CEO’s post in a company is supposed to have the same effect as the energy drink Red Bull: It gives you wings.

Paul Bacharach, president and CEO of the Uniontown Hospital system of health facilities — which generated 2007 revenue of about $125 million — says that as the leader, you should possess the capability to hover at the often-referenced 30,000-foot level, taking in the big picture and basing your decisions on what will help build the company as a whole. But the same cannot be expected of those under you.

Your employees have a smaller frame of reference in the work that immediately surrounds them on a daily basis. When you make a decision from high atop the company, there is a good chance that each employee will see the decision refracted only through the lens of how it immediately affects his or her job.

Bacharach says that when employees don’t understand your reasoning, it’s your job to show them why.

Smart Business spoke to Bacharach about how to get everyone on board with the bigger picture.

Show your people the way. A lot of times decisions are made on an organizational basis that might seem irrational or even arbitrary because they are not put in the broader context of the entire organization. So I think in any communication that goes on, you do need to spend time providing some kind of concise, understandable rationale of why the decision is being made.

The staff in general is very focused on their individual responsibilities and specialties, so you need to be able to inform them of what the basis is for various actions you are taking and put it in the context of the organization’s strategic direction.

You have to understand the direction of the organization and each individual’s role in making that happen. We recently developed a freestanding out-patient diagnostics center, understanding that we needed that for multiple purposes. (It) was a significant investment for us but provided some alternative locations for services.

If you looked at it on an individual basis, it might seem like more of an extravagant project, but in a broader context, it tied into a number of other activities.

Solicit feedback. We do a survey every couple of years with our staff. One of the things we learned was that we were not doing an effective job in communicating the issues and challenges that the organization faced and really made a concerted effort to try and improve upon that.

We have a number of means, apart from typical departmental meetings. We host information in every department in our hospital that gives staff a clear picture of our performance in areas like quality of care and services quality of care and services we’re delivering, the volume of activities that are going on, the human resources and people-related matters, and our financial performance.

We share the same financial data with our entire staff in the hospital as we do with our board of directors, so that they know on a quarterly basis how the organization is doing in a pretty challenging environment. Apart from that, there are a number of other opportunities.

For a number of years, I have been spending time shadowing in various departments. I block a day a month and typically go out and spend the day in the departments to see what they are doing. It is very informative in general and allows me to understand what they do on a day-to-day basis.

I have also carried over from my previous employer, 16 years ago, a patient rounding program, where on a fairly regular basis [I] go out and round with the nursing staff and visit patients. It is a good opportunity for me to develop an understanding with what the patients are experiencing.

Stay engaged and accessible.Having active, engaged leaders clearly reduces the impression of management being up in their ivory tower and not having a clear understanding of the challenges employees face in their day-to-day responsibilities.

Just being there, being able to acknowledge it, acknowledging that they have a unique set of skills that are, in most cases, valuable to an organization, it makes a very big difference.

We’re fortunate, since we are a modest-sized, independent organization with fairly long-term tenure of our staff, which means you actually get to know people here. Most people know me, and I know them at least by their first name.

In a smaller organization, you can develop the kind of personal relationships that make a difference in comparison with large organizations that might have a much greater transition going on. I’ve worked in larger organizations where, just because of the sheer size, it is more difficult to develop those types of relationships.

I kind of view my leadership style as being akin to a conductor with an orchestra, where you try and place talented people around you and get them to work in concert to produce superior results. I generally have a good idea of the direction the organization should be moving in and getting people working toward the same end. That’s typically how I approach management.

HOW TO REACH: Uniontown Hospital, (724) 430-5000 or