Drafting a Bright Future
Date: June 15, 2012
From the first meeting in March, otolaryngologist Lisa Ishii knew that serving on the new team of “subject matter experts” would be a different kind of Hopkins experience. The assistant professor and president of the medical school council found herself working with a group that included a financial officer for a community hospital, a director of nursing, a human relations director and an attorney/lobbyist.
Their assignment: join forces across the enterprise to determine how Johns Hopkins Medicine can attract and retain the best employees at every level of its organization. The task required the group to craft a vision statement as well as suggest initiatives that could help realize that goal. Ways to measure Hopkins’ progress were also on the table.
“I’m guilty of looking at things through my school of medicine/faculty lens,” says Ishii, who, with Hopkins professor and internist John Flynn, guided the team’s discussion. “This process is bringing together a broad base of people who otherwise would not have the opportunity to interact.”
It’s all part of a carefully constructed plan to build common goals and a unified vision of the future for an institution which has grown into a complex, $6.5 billion enterprise.
Led by John Colmers, Johns Hopkins Medicine’s vice president for health care transformation and strategic planning, this initiative also responds to a watershed time of market change and health care reform. Faculty, staff and administration from entities and departments across the enterprise have helped determine ways to guarantee the sustainability of Hopkins’ missions of research, education and patient care while responding to new federal laws aimed at transforming the nation’s health care delivery
“Johns Hopkins Medicine’s mission hasn’t changed, but the world around us is being significantly altered by, among other things, reduced private and public funding for all parts of the tripartite mission,” Colmers says. “Although we have the luxury—and the challenge—of being looked to as a leader in all of our mission areas, that also means we may not have felt the need to change how we do things. Part of this process is getting people to understand the risks of not changing in the face of external challenges.”
The planning effort serves JHM 3.0, the broad reconfiguration of Hopkins’ systems of internal management. In addition to the work group seeking to establish Hopkins as the “employer of choice,” six other teams have created plans to address these mission imperatives:
• Develop new and expanded sources of revenue.
• Implement a seamless system of health care delivery that is focused on patients and their families.
• Develop and implement financial and performance incentives across the enterprise.
• Develop and implement a sustainable, open, balanced and transparent financial model that adequately supports JHM’s clinical, research and education missions.
• Create and maintain an innovative learning environment throughout the enterprise.
• Invest, develop and apply scientific discoveries to improve patient and population health.
Each team, composed of roughly a dozen members, was led by two “emerging leaders,” professionals who broadly represent the organization and possess expertise in the targeted areas.
“Part of this process is taking what we already know we need to do and harnessing it into something coherent and cohesive,” Colmers says.
The notion of assembling teams skilled in certain subjects grew out of last winter’s leadership retreat during which the seven mission imperatives considered vital to sustaining the mission were presented. (These priority areas were decided through an earlier enterprise-wide process.)
In May, the subject matter expert teams completed “white page” documents. Each is a one-page summary with a description of the team’s vision of success, specific ways to measure progress toward it, and suggestions for two to four initiatives that can begin the desired transformation during the next three years.
These recommendations were presented to JHM’s 34-member Joint Operating Committee as well as to all school of medicine department chairs at a planning retreat this month.
Colmers describes the undertaking as “great and important work.”
“We’re trying to answer such questions as What would it be like at Hopkins Medicine if we were to have a truly transparent and balanced financial model? Or What if we treated those who are teaching with an even higher degree of respect in accordance to what they are providing in the mission?”
Defining work, choosing themes
In order to grasp Hopkins’ current status as an employer of choice, the Ishii-Flynn work group began by reviewing existing data from the system-wide employee engagement survey, the faculty satisfaction survey, and a survey concerning disruptive behavior by clinicians.
That work produced a list that combines areas that Hopkins must cultivate enterprise-wide for employee satisfaction. They include creating a workplace culture where employees can thrive through leadership training and other development courses; encouraging civility; promoting diversity; creating an environment where individual opinions count, and improving how information is shared.
A work group guided by two clinician-scientists—faculty oncologist Steve Leach and cardiologist Ted Abraham—considered ways to advance Hopkins’ scientific discoveries and technologies. One priority is finding ways to promote interaction between basic lab-based scientists and their more clinically oriented colleagues.
“At first, it was easy to imagine cultural barriers between scientists, administrators and leadership in our group that might impair communication,” Leach says. “But it’s been very rewarding to understand that everyone shares very strong devotion to science and to the principle that all of Hopkins Medicine should be involved in creating important biomedical knowledge.”
Ishii believes the most exciting aspect of such work is the novel, empowering way in which it draws strength from such a broad spectrum of perspectives. She also admires its tactical approach.
“People are more likely to participate and follow guidelines if they were part of developing them,” she points out. “They will take ownership and want to live by them.”
That’s exactly what Colmers and his team have in mind. Hopkins has become so large and complex, he says, that a majority of people throughout the organization need to pull in the same direction to make it shift its course even slightly.
“Organizations like ours tend to be decentralized, entrepreneurial and opportunistic about making decisions,” he says. “Defining mission imperatives is an attempt to put some degree of intentionality into our collective work. We’re trying to get people to be mindful of the changes we’re all facing—and to find a common sense of direction.”