Article published by The American Hospital Association's ASHHRA in HR Pulse - December 2008

How often have we heard someone wish that they could just snap their fingers to make major changes happen? In our rapid-fix and disposable society, we often seek the "magic pill" for quick and easy ways to improve our lives. Unfortunately, many of us have learned that shortcuts like fad diets and playing the lottery typically don't yield the long-term results we desire.

Thomas Edison said, "Genius is 1 percent inspiration and 99 percent perspiration. Many hospital CEOs and HR executives say that implementing their ideas is at least three times more difficult than developing strategy. When senior executives blame others for their own mistakes rather than holding themselves accountable, it complicates matters even more.

Plotting the Course
Great results won't happen just because we want and need them. We need to move beyond wishful thinking and adopt a deliberate course of action that will support the attainment and subsequent maintenance of optimal levels of performance. Otherwise, we're exposing ourselves and our organizations to dangerous and often avoidable risks.

Dan Zuhlke, Vice President, Human Resources for Intermountain Healthcare in Salt Lake City, Utah, and current ASHHRA Vice President, believes in being less concerned about earning a seat at the table and more focused on delivering the right results by focusing on HR practices that support the strategic plan, HR executives need to connect the dots between the organization's strategy and its HR practices.

Zuhlke suggests that the HR professionals should keep presidents and CEOs informed and facilitate their success by serving as a real "human resource," a sounding board and an important business partner. It also is essential that the HR executive helps the CEO and other leaders to understand that HR's role extends beyond the traditional personnel functions and help them to drive their business metrics.

Performance Excellence Criteria
One proven way to ensure a high level of integration and support for our HR work is to apply the Malcolm Baldrige National Quality Program standards. The Baldrige criteria recognize that there must be an established culture and processes that will sustain quality outcomes, and these processes must be repeatable to consistently produce quality results. The following seven Health Care Criteria for Performance.

Excellence are applied to an organization's operations:
Category 1: Leadership
Category 2: Strategic Planning
Category 3: Focus on Patients, Other Customers, and Markets
Category 4: Measurement, Analysis, and Knowledge Management
Category 5: Workforce Focus
Category 6: Process Management
Category 7: Business Results

Measuring Up
This comprehensive, integrated and non-prescriptive approach requires that we take an honest and hard look in the mirror, diagnose our organization's strengths and weaknesses, and then develop specific action plans with timelines and measurable performance criteria to ensure that we are making progress and achieving our desired results. Once an organization's leaders have made the strategic and emotional commitment to achieving quality results, most of the subsequent decisions can be tied back to improving our structures, processes and outcomes. This gives the HR leader license to pursue those initiatives that support the strategic plan.

For example, since labor expenses constitute about 60 percent of a hospital's operating budget, measuring all aspects of HR should be a top priority for CEOs. Because effective C-level executives will never stop wanting metrics, measuring what matters gives HR executives the chance to prove our effectiveness. CEOs often do not know how best to measure the performance of their HR executive, which gives us the opportunity to offer the senior team and board members useful information regarding the most appropriate people metrics.

Demonstrate Your Value
Rick Lovering is currently the Vice President of Human Resources for AtlantiCare Health, in Egg Harbor Township, NJ. In his prior role as Vice President of Human Resources with Robert Wood Johnson University Hospital Hamilton, he helped that organization to become the fourth hospital in the country to earn the Malcolm Baldrige National Quality Program Award. Lovering contributed to significant workforce improvements in their employee satisfaction, reduced employee turnover, and implemented management development initiatives, and he created more effective processes that enabled the organization and its leaders to track the efficacy of their work.

He started his career in manufacturing and in operations, so he was accustomed to demonstrating a return on investment and being held accountable for his performance, like any COO or CFO. He said "When I originally transitioned from HR to production and back to HR while in manufacturing, I figured that I still had to document what I was doing and demonstrate my own and my department's value to the organization. You can't expect the CEO to treat HR with equal value if you are not held to the same standards as everyone else. Our specific metrics may be different than those of the CFO, but every department leader must drive results."

Lovering explained that he accomplished these results "by looking at the organization's strategic goals and key business initiatives and finding ways that I could help the organization to achieve these. I created a people scorecard that was reported up to the CEO. I also influenced those outcomes and stuck my neck out."

He advocates taking calculated risks and quickly correcting anything that doesn't work. He also suggests being conservative in business planning and when estimating earnings or savings in specific terms. "In requesting resources, explain how you will impact the organization positively in terms of savings or some other productivity measure for a defined period, and then manage that project or initiative carefully."

Lovering has found that "you need to look for ways that you can add value to the organization so that you can not only earn your seat, but keep it and improve it. Then you need to celebrate your successes with your team."

He adds "If the CEO's platform is quality, the HR executive needs to identify what are the quality issues on the "people side" that can help the organization to achieve higher quality outcomes. In brief, you want to make sure to make a connection between what you're doing and how it supports their agenda."

Get Involved
As business leaders, we must be proactive and make critical decisions. Zuhlke says, "We should not wait to be asked to get involved. Instead, we should assume that we have permission to act unless we are told otherwise. If we truly believe that we are responsible for the well-being of the organization, then we have a legitimate business interest in taking action."

Yet, some well-intentioned HR executives are their own worst enemies. In their attempts to be good team players, they are reluctant to assert themselves, do not act to protect their own self-interests and that of the organization (although they know what needs to be done), and may not acknowledge some of their own and HR's accomplishments. Then, they are surprised when they are overlooked for promotions, raises, and requests for additional resources. This is a prime example of how having the right metrics in place can help to demonstrate our value and effectiveness to the organization. We can, and should, let the facts speak for themselves and for us. Regardless of the methodology used for process improvement, our organizations structures, processes, alignment of personal incentives with strategic goals, balancing individual and group interests, all need to be considered. What are we measuring, what is most important?

Recruit the Right People
Also, to be most productive and to secure our own futures, HR executives need to implement the respected findings of Jim Collins, bestselling author Good to Great and Built to Last. Collins found that the most successful leaders are careful in their recruitment and selection initiatives; he refers to this as the process of getting the right people on the bus and assigning them to the right seats. Similarly, our own health care industry research found that direct and indirect costs of "bad hires" within the leadership ranks are at least six to 10 times more that leader's annual earnings!

These research findings clearly illustrate how using validated best practices in recruiting and selecting new leaders is 1) extremely time- and cost-efficient, 2) protects the best interests of everyone involved, and 3) can help progressive HR executives to avoid needless aggravation. In essence, providing quality services requires that we do the right things right the first time, and we cannot afford to take shortcuts. Unfortunately, too many of us have learned from experience the wisdom of the adage "Hire in haste, repent at leisure".

Another obvious, yet overlooked way to facilitate an organization's short and long term success is "results-oriented" succession planning with clear and objective processes, performance criteria, individualized developmental action plans This can protect the organization as well as overall success and longevity of the HR executive as well. Despite these proven benefits, most hospitals and health systems remain exposed to significant and preventable risks, with only 25-33 percent having implemented such programs with their senior leadership teams. It is likely that these percentages drop substantially beyond the senior team levels.

Significant and sustainable organizational transformations are difficult to accomplish. These require a great deal of hard work - from their initial conception and implementation all the way through to their ongoing measurement and maintenance. By taking control of our futures, we can and will create additional opportunities that will benefit ourselves and others we serve.

Kenneth R. Cohen, Ph.D., is the president of The Synergy Organization, a leading national metrics and Evidence-Based Healthcare Executive Search/Leadership Assessment firm he established in 1988. He can be contacted at (215) 638-9777 or (866) 447-3123 or via e-mail at ken@synergyorg.com