1. Solutions
Single
Source physicians
capability
Integrating…
community
staff
promise

2. New Challenges- Bringing Entities Together
 Integration  Changing healthcare
 Cultures economics
 Employees  More (and/or different services) while
 Physicians receiving less revenue
 Services  Strategic shift while maintaining
core mission, vision and values
 Capabilities
 Facilities
promise & capability
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3. Integrating – Establishing the “New We”
 For a successful integration:
 Clarify rationale of affiliation
 Create value
 Blend Cultures
 Communicate (Over communicate)
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4. The Core of Every Entity …
• Assessment
Culture • Integration
Communit • Assessment
• Communication
y
Leadershi • Assessment
• Integration
p • Development
Operation • Assessment
• Innovation
s • Integration
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5. Bringing Entities Together-General Considerations
 Assessment of impact
 Evaluate potential enhancements We need to know
 Identify similarities/differences where we are
 Establish the operating structure
 Determine communications
strategy
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6. Proposed Focus
 Operations Integration
 Innovation and Leadership
Development
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7. Operations Integration
Establishing the New “We”
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8. Operations Integration
 For a successful integration:
 Clarify rationale of affiliation
 Create value
 Blend Cultures
 Communicate (Over communicate)
First we need to
know where we
are
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9. Assessment Offerings (Short Term Impact Analysis)
 Clinical services
 Information technology
 Communications
 Logistics
 Sourcing
 Community expectations
 Leadership
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10. Clinical Services Assessment
 Processes, procedures, protocols and metrics
 Unique services
 Replicate services
 Implication
 Potential redundancy
 Leverage strengths
 IT specifications:
 Communications
 Reporting
 Coding
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11. Information technology Assessment
 Respective site requirements
 Connectivity/compatibility
 Cross communication between entities
 Outpatient expectations and requirements
 Capabilities:
 Strengths/Weaknesses
 Compatibility
 Cross-communication requirements
 Pending enhancements
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12. Communications Assessment
 Strategy and plan
 Content
 Frequency
 Focal Point
 Target audience and mode(s) for:
 Employees
 Physicians and physician leadership
 Community
You can’t over communicate!
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13. Logistics and Sourcing Assessments
 Logistics
 Patient transport
 Employee assignment
 Employee transport
 Supplies and equipment
 Sourcing and materials
 Vendor agreements
 Contract services
 Pricing advantages
 Order approvals and processes
 Systems
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14. Leadership Assessment
 Leadership focus
 Clinical services and Service Lines
 Clinical and Academic Chairs
 Physician Leaders
 Administrative Leaders
 Nursing Leadership
 Leadership Structure
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15. Integration Cornerstones: Post Assessment Steps
 Clarify rationale of affiliation
 Create value
 Blend Cultures
 Communicate (Over communicate)
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16. Innovation and Leadership Development
Adapting to New Challenges
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17. New Challenges
 Integration
 Cultures
 Employees
 Physicians
 Services
 Capabilities promise & capability
 Facilities
 Changing healthcare economics
 More (and/or different services) while receiving less revenue
 Strategic shift while maintaining core mission, vision and
values
Copyright 2010 Six Sigma Solutions, Inc. All rights reserved 17

18. Focus Areas for Getting to the “New We”
Culture
Communit
y
Leadershi
p
Operation
s
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19. Leadership Development and Organization Culture
According to a 2010 Harvard Business Review
article, most leaders facing a failing business
situation will :
• Tighten the purse strings
• Take strict control over the organization
• Put strategy first
In the famous words of Peter Drucker:
“Culture eats strategy for breakfast.”
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20. Culture
Given the importance of Culture
Strategy
What is Culture?
CULTURE
Employees/
Leaders /
Processes
Tradition/ Past
Practices
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21. Culture
Culture
Community Service
Employee
s
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22. Culture
 Current state assessments
 Facilitate compiling a current state cultural assessment
for:
 Allied health and support employees
 Nursing and Nursing leaders
 Physicians and Physician leaders
 Administration and Administrative leaders
 Communities served and local government
Copyright 2010 Six Sigma Solutions, Inc. All rights reserved 22

23. Culture
 Given the importance of culture:
 What drives culture?
 How do you sustain culture?
 How do you change or redirect culture?
A significant responsibility of a
leader is to foster and develop
the organization culture
We need to give them the tools
Copyright 2010 Six Sigma Solutions, Inc. All rights reserved 23

24. “Culture Eats Strategy for Breakfast”
 Culture is the “performance” cornerstone – but …
 Strategy needs to adapt to changes in the market
 How do you align/realign culture with changing
strategies necessary to adapt to changing demands?
Copyright 2010 Six Sigma Solutions, Inc. All rights reserved 24

25. Integrating – Establishing the “New We”
 For a successful integration:
 Clarify rationale of affiliation
 Create value
 Blend Cultures
 Communicate (Over communicate)
Copyright 2010 Six Sigma Solutions, Inc. All rights reserved 25

26. Innovation and Leadership Development Center
 Value of an Innovation and Leadership Development
Center
 How it would be developed at NBI
 Possible configurations
 Address possible barriers
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27. Innovation and Development Center
 Provide an ARCHITECTURE of PARTICIPATION and
ATTENTION (O’Reilly; Nielsen)
 Create a collaborative atmosphere and a platform for
collaborative leadership training
 Real-time/real-work issues addressed, measured and
improved
 Showcase dynamic and engaged leadership
 Enhance enterprise wide engagement
Copyright 2010 Six Sigma Solutions, Inc. All rights reserved 27

28. Innovation and Development Center
 Start by identifying leader candidates
 Identify core groups
 Identify leaders in an intentional way
 Physician
 Nursing
 Administration
 Define individual and group
expectations
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29. Innovation and Development Center
 Identify key objectives and improvement
areas as possible first stage targets
 Present target list to leader candidate group
for consolidation and finalization with
leadership
 Establish goals, metrics, and end points for
the targets with the leader candidate group
 Establish clear expectations for the group
and define incentives and goals
 Manage and monitor progress
Stay Engaged
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30. Innovation Center Possible Impediments
 Possible Physician (or anyone's)
reaction:
 “Why will this work and what makes
this different?”
 “We have participated in these
activities hundreds of times and
nothing changes – No one really
seems to care.”
 “This is the same old song-and-dance
from administration because they
want us to do something their way.”
 “I don’t have time for this.”
 “How will this help my Patients,
practice or revenue?” (WIIFM)
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31. Program Model
 Physician driven
 Targeted site approach with “end-to-end” perspective
 Targeted individual approach for maximum impact
 Blended learning-maximum impact-minimal time “Off the
floor”
 Experiential training
 Cultural assessment included
 Gap analysis incorporated
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32. Program Focus
 Training delivered as required by individual
assessment including but not limited to:
 Analytics
 Finance
 Strategic planning
 Acquiring meaningful data and data analysis
 Format and delivery of meaningful and succinct management
reports
 Leadership
 Team work
 Self-awareness
 Interpersonal interaction
 Conflict management
 Change management
Copyright 2010 Six Sigma Solutions, Inc. All rights reserved 32

33. Program Features
 Clear messages delivered:
 Expectations and accountability of participants
 Technologies/tools to efficiently lead groups/teams
 Modern/current education and development
programs
 Performance management system
Copyright 2010 Six Sigma Solutions, Inc. All rights reserved 33

34. What Makes this different?
 Clear messages delivered:
 Mission, vision and value reinforcement
 Strategic adaptations required
 Expectations and accountability of participants
 Priorities clearly established
 Model Requirement
 Organizational philosophy supporting physician alignment
 Clear position descriptions
 Orientation to new physician responsibilities
 Staff support
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35. Leadership Development Center Value
 Engaged and cohesive workforce
 Engaged Physicians
 Clear and consistent message
 Provides structure for required improvements
Paid for by
achieving the
targeted strategic
improvements
Copyright 2010 Six Sigma Solutions, Inc. All rights reserved 35

36. What we will provide (as required)
 Program is Enterprise driven/  Financial impact of impending marketplace
Enterprise specific. changes:
 Healthcare economics
 The recommended approach is  ACA, VBP, ACO Impact
blended-learning  Communications
 On-line/Class room/workplace  Presentations
 Real world/real time enterprise  Providing team feedback effectively
opportunities  Leading change and change management
 Training will be supplemented with case  Team building and group processes
study to encourage and fuel innovative  How to be an Internal Consultant
thinking  Diversity and Change Management
 Managing strategic transformations
 Program will include:
 Process and change management
 Culture Assessment
 360 Evaluations -Self-assessments
 Bench-strength opinions with gap analysis
 Executive Management
 Managing innovation and technology
 Cross-functional collaboration -Managing
other professionals
 Negotiation
 Management and Financial Reporting
(format options-by audience):
 Data analysis and interpretation
Copyright 2010 Six Sigma Solutions, Inc. All rights reserved 36

37. Another way to look at Culture
• Assessment
Culture • Integration
Communit • Assessment
• Communication
y
Leadershi • Assessment
• Integration
p • Development
Operation • Assessment
• Innovation
s • Integration
Copyright 2010 Six Sigma Solutions, Inc. All rights reserved 37

38. Physician Integration
Allied Physicians Employed Physicians
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39. Physician Integration
Clinical Chairs/
Employed Physicians
Physician Leadership
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40. Employee Integration
Copyright 2010 Six Sigma Solutions, Inc. All rights reserved 40