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Surgical precision Featured

7:00pm EDT December 26, 2009

Crystal Haynes is proud of Saint Louis University Hospital. It’s a level-one trauma center, meaning it’s capable of handling the worst of the worst when it comes to illness and injury.

It’s a 356-bed academic teaching hospital that has provided health care to the St. Louis region for more than 70 years. But as Haynes looked at the hospital’s range of service offerings a few years ago, she felt like maybe her staff was trying to do too much.

“This was a facility that wanted to do every aspect of the health care business and be involved and engaged in it and wanted to do that at an exceptional level,” says Haynes, CEO at the hospital, which is part of Tenet HealthCare Corp. “The lack of real adherence to specialization and narrowing the choices to what you want to do, and doing those really well and selling those services appropriately, was a bit of a departure from where this organization had been.”

Another problem was Barnes-Jewish Hospital, located right across the street from SLU Hospital.

“We don’t have the size and scope or depth to be a Barnes, nor do we want to be one,” Haynes says. “We were literally duplicating the services that were being offered over at Barnes and competing against them.”

Haynes decided it was time to stop trying to be everything to everybody and start focusing on what her 1,800 employees do best. SLU needed to find its own niche. It needed to sell a more targeted vision to the community of what it could do instead of trying to compete with everything that Barnes was doing.

“This goes way beyond just the health care industry,” Haynes says. “It’s all about defining your product and understanding what it is you do well. It’s figuring out what are the best aspects of your product or service and being able to enhance that. Instead of offering a very broad or generic service or product, we became much more precise about what it was we were going to market and where we were going to place our resources and how we were going to deliver that.”

Haynes succeeded by focusing on what could be gained rather than dwelling on what would be lost. She sold her employees on the opportunity to take their most valuable skills and put them to use for the betterment of the organization.

“Our success has been moving forward the things we have in place, not going out and inventing new things to do,” Haynes says.

Here’s how Haynes got her employees to focus on their core talents, improve performance and raise their organization’s standing in the community.

Take an honest look

If you don’t know what you’re really good at, the chances are pretty good that your clients and customers don’t know either. Haynes felt this was one of the biggest obstacles holding SLU Hospital back from reaching its full potential.

The hospital was known for doing a lot of things well. But if it could put itself in a position to be lauded for doing a few things exceptionally well, that would be even better.

“You need to be honest with yourself about truly what it is you do well,” Haynes says. “Sometimes you can have one piece of your whole business doing really well, but it could do a lot better if you were willing to change and either add to or subtract from other services you’re providing in the organization. It’s understanding the bits and pieces. If you turn the dial to the right or the left, you might be able to even enhance the opportunities for the service you want to provide. You don’t have to be everything for everybody.”

For too long, Haynes says employees would wistfully dream of what they could do, if they only had this money or that equipment to do it.

“The first piece is kind of emotional and just a little bit hard,” Haynes says of launching the identification process. “We stopped wishing for things, like, ‘Gee, I wish we did better in this particular service line.’ We really looked at what we had at that moment. Instead of just saying, ‘If we added this person or brought this surgeon on,’ and how we would do this, we were very critical of ourselves. What do we have in place that we can do now without having to expend a huge amount of money, buy a bunch of capital or hire a bunch of people? What is it we have that we can enhance?

“Someone would come to you and say, ‘I’ve got this ability to do these things, and it’s not going to cost an arm and a leg.’ That would be a very strong indication of opportunity. People that would come and say, ‘If you give us this new type of technology or this new piece of equipment or you completely rebuild something, this is going to cost you millions and billions of dollars,’ generally that was not something indicative of a good investment. They were suggesting the reason they hadn’t moved forward was related to equipment or technology or money.”

So how do you get to that point to know what it is you really do best? How do you convince employees who have been doing something a certain way and feel a certain level of pride at how they do it that you’re going to go in a new direction and not do it that way anymore?

“It needs to be data-driven and not based on motives,” Haynes says. “You really have to look at things with a jaundiced eye and ask critical questions. When you hear specific pieces of information that don’t jive with what you know from an experience base to be true, you stop. The data may be right, and it may be showing you something that you haven’t experienced before or find hard to believe. But at least you can go through the process of understanding it more deeply.”

You also have to remove as much bias as you can from your analysis of the data to make a truly honest assessment.

“We have a tendency to delegate responsibility for determining what data should be and what metrics should be to the people that are actually being measured,” Haynes says. “There’s a bit of a bias attached to that. There is good merit in having people kind of extraneous to that be able to look at that data and use that data. … It’s all part of that honesty and trying to divorce yourself from wishing and trying to create an environment where you’re really looking at the stuff that is tangible.”

In the end, what’s often most important in developing a niche is asking yourself what your customers would want and what you can give them.

“It doesn’t matter whether you’re selling shoes or working in a telecommunications company,” Haynes says. “If you embrace the same kind of concept we embrace in health care, which is to look to the patient, as you are going through your decision-making and testing your ideas and questioning whether you made the right decision, that will give you the answer you are looking for.

“As these things merit themselves out, you’re able to deploy your resources and your money in a way that supports the effort of people that are changing process or redeveloping or retooling their product based on what is a much stronger set of business principles than just saying, ‘If you build it, they will come.’ You have to step away from that. … That was one of the key decision factors in deciding what it was we would spend our energy and efforts on.”

Create energy

It’s much easier to implement change when people are asking you for it. That philosophy served Haynes well in getting employees to buy in to the transformation at SLU Hospital.

ȁ C;You’re in the position of saying, ‘Oh, you want to change? How can we help you do that?’” Haynes says. “It really is motivating. I think the trick for us was finding one particular area with the right people that wanted to move things forward and rethink what they were doing. Either they had experience at other hospitals or they just had a grander sense of what was possible. Being able to do that one time was really all that was necessary.”

Try to stay away from making huge announcements or convening meetings that make it seem like nothing will ever be the same after the meeting is over.

“If you’re going to effect change, it needs to be organic and feel like it’s coming from within,” Haynes says. “This doesn’t mean you have to be like a sloth making change. A lot of times, you have to say, ‘Guys, we’re going to try this for six weeks. We’re going to stick with it if it works. We’ll retool it if it doesn’t, but we are going to make this change today.’ Sometimes you have to do that.”

But the goal is to implement change in a way that attracts rather than repels other employees.

“When we would go in and work effectively on a particular service line, others would see the success that would breed,” Haynes says. “We had others come to us and say, ‘We want to do this, too.’ It’s a wonderful position to be in when you have people that can see individual opportunities in these service lines and exploit them.

“That’s when other people come forward and say, ‘We want to do that, too.’ Instead of having people gnash teeth over huge change, it does take you to another level. You’re able to see these people not only embrace it, but they are excited about it.”

It’s usually easier to build this kind of energy if you focus on smaller areas rather than attempting to convert everyone at the same time.

“Deal with individual operating units or departments and make sure they are functioning as optimally as possible,” Haynes says. “Then worry about the connectivity with the other departments. Make sure the individual little bits of pieces of that larger equation all function well, and then you work on creating that collegiality between all the different services.”

As Haynes looks at her organization today, she feels like her mission has been accomplished. The hospital was named one of the nation’s best in both 2007 and 2008 by U.S. News & World Report.

It also has begun to fulfill its mission of more specialized excellence by developing the Mid-America Stroke Network.

“We draw from hospitals and patients from a 500-mile radius because we’re an accredited stroke center,” Haynes says. “The quality of patient care has improved. We were already great but became even better. And the ability to both attract physicians and clinicians in their areas of specialty improved. Also, the number of patients we had went up. We never want people to get sick, but if they are sick, we want them to choose the best place for them to receive their care. It really isn’t any different when you think of it at that level than a business.”

How to reach: Saint Louis University Hospital, (314) 577-8000 or www.sluhospital.com