Intensive Seminar for New and Emerging Leaders
September 15–19, 2008
Session Descriptions
Framing the Forces of Change
Monday, September 15, 3:00 – 5:45 pm
David A. Shore, PhD
Director, Forces of Change Program
Director, Trust Initiative
Harvard School of Public Health
Health care greatly exceeds most other markets in its complexity and vulnerability. The sources, directions, and implications of change are nearly endless. For many participants in this volatile undertaking, the evolution of the health care market is an unending source of anxiety and confusion. We begin with a topographical sketch of the dominant challenges and questions, and with one clarion call: succeeding in the evolving marketplace demands that we think differently. Are you ready?
Stakeholder Conflicts and the Tragedy of the Commons:
Moving Beyond Winners and Losers (Includes Participant Reactor Panel)
Tuesday, September 16, 8:15 – 10:00 am
David A. Shore, PhD
The system of health care in the United States is anything but systematic. In contrast to other more efficient markets that feature clearly defined buyers and sellers, U.S. health care comprises a disorganized aggregate of diverse parties and groups, each of which relentlessly pursue their interests without coordination or regard for the interests of other stakeholders. Moreover, traditional market mechanisms rarely operate in this arena. Governments account for nearly half of the nation’s health care, while the interaction between purchasers and patients is mediated by payers, and hospitals and providers occasionally operate as near monopolies.
Consequently, stakeholders view health care as a competitive enterprise, where gains by one imply losses by another. Following the retreat of managed care, we have witnessed increasingly hostile interactions between providers and payers, between health plans and employers, between employees and payers, and many other conflicts. Stakeholder groups rush toward merger agreements in order to gain “leverage” over other groups. The resulting waste and market inefficiencies threaten the very limited resources available to all groups. Fortunately, alternatives to this “Tragedy of the Commons” are available. Stakeholder relations can be reconfigured to feature periodic collaborations and tacit accommodations. This transformation requires that stakeholders rethink their relations and identify areas in which their interests and expertise converge, rather than simply focusing on where they compete.
Breaking Down Silos:
Merging and Managing Diverse Stakeholder Interests in Hospitals and Health Systems
Tuesday, September 16, 10:30 – 12 Noon
Michael J. Dowling
President & CEO
North Shore-LIJ Health System
Successfully leading complex organizations involves the management of constituent politics — the bringing together of the various stakeholder groups and guiding them toward a common mission. This is of particular import in health care where many of your collaborators can also be your competitors. This session will discuss these issues and suggest some strategies on how best to resolve these inherent conflicts. Handling constituent politics is not just the province of government. It is key to organizational success.
Transformational Leadership: Is It Possible in the Complex World of Today’s Health Care? (Includes Participant Reactor Panel)
Tuesday, September 16, 1:00 – 3:00 pm
Michael J. Dowling
“Transformational leadership” has emerged as an extremely popular idea among those concerned with social and organizational change. James MacGregor Burns, the scholar who gave the phrase its currency, regarded Gandhi, Mandela, and Lincoln as archetypal transformational leaders. Today, the term is applied much more broadly. Even employing this expansive definition, however, the question remains as to whether transformational leadership is possible in the complex world of today’s health care.
Socratic Dialogue
Tuesday, September 16, 3:30 – 4:30 pm
Moderator:
Michael J. Dowling
Roberts draws upon the time-tested Socratic method in enticing participants to share their reflections on the program’s initial sessions, and the implications for the future of the health care industry. Participants will explore the central issues and debate the relative merits of available strategic options.
Who Killed Health Care? (Includes Participant Reactor Panel)
Wednesday, September 17, 8:00 – 9:45 am
Regina E. Herzlinger, DBA
Nancy R. McPherson Professor of Business Administration Chair
Harvard Business School
The largest service industry in the United States is undergoing a massive transformation that will release both providers and consumers from the strictures of managed care. How will this transformation affect you as a user, payer, or provider of health care? What can you do to help it along? Professor Herzlinger will answer these questions in her presentation.
The Changing Health Care Marketplace
Wednesday, September 17, 9:45 – 10:45 am
Marc J. Roberts, PhD
The American health care system is beset by many challenges. Some of these are universal around the world: aging of the population, rising expectations, increasing costs due to new technology, etc. Others are unique to the United States: high administrative costs; a significant fraction of the population without coverage; and an intense competitive environment. How have various players in the system, hospitals, doctors, government, insurance companies, employers, and pharmaceutical companies, responded to these pressures? What sorts of strategic opportunities do these developments create? How can various participants in the system defend their legitimate interests and yet also act in a way that will contribute constructively to the development of national policy?
Transparency and Consumerism Make Patient-Centered Care the Standard
Wednesday, September 17, 11:00 – 12 :15 pm
Melvin F. Hall, PhD
In today’s health care landscape, many factors are converging that put more control in the hands of consumers. Increasing costs to consumers, more transparency in the quality of care, and growing demands by patients all point to the need for a greater emphasis on patient-centered care. Hospitals that have realized this trend and acted on it are seeing the results, not only in patient satisfaction, but also in employee morale, physician relations, and clinical and financial outcomes.
Dr. Hall will speak to the trends in the industry, drawing on input from millions of patients receiving care in the U.S. He will note areas of success and areas of opportunity based on facility and patient demographics, as well as which aspects are most critical to driving satisfaction. He will also speak to the emerging “data-hungry” health care consumer, and how government programs like HCAHPS are increasing transparency and promoting a consumer-driven model that increases the significance of patient satisfaction even more.
An executive at a leading health care organization will highlight their successful approach to creating an organization-wide patient-centered care model. This co-presenter will discuss specific programs and practices put into place, challenges faced along the way (staff buy-in, accountability), and how these challenges were overcome.
Making Health Care Safer and More Humane
Wednesday, September 17, 1:00 – 2:30 pm
Lucian L. Leape, MD
Adjunct Professor of Health Policy
Harvard School of Public Health
Despite the publicity garnered by the patient safety movement following the Institute of Medicine’s reports in 2000 and 2001, progress in the nation’s hospitals and other health care institutions has been agonizingly slow. Apologists note that moving to safe health care demands a change in culture comparable to that undergone by the aviation industry several decades ago. According to this view, effective change will take time. Others note that there are structural impediments that need to be resolved before significant change can take place. We will examine several of these structural barriers.
Pay for Performance, at the Tipping Point.
Will It Get Us Where We Want to Go?
Wednesday, September 17, 2:45 – 4:15 pm
Arnold M. Epstein, MD, MA
John H. Foster Professor and Chairman,
Department of Health Policy and Management
Harvard School of Public Health
Quality of health care in the United States remains far from ideal. The expectation that efforts by health care providers in quality improvement would transform the delivery system has not been realized. In response, we have growing efforts in both the private and public sectors to better align payment with quality of care. It seems likely that use of financial incentives to improve quality will continue in coming years and become even more widespread. This session describes the developments in the delivery system that gave rise to “pay-for-performance,” the nature of prototype payment systems to encourage greater quality of care, the evolution of these systems as they have matured, the response by providers to date in terms of improving quality and the challenges that confront us as we look to these approaches. The session concludes with a discussion of the policies most likely to improve the quality of care.
Headaches and Sleepless Nights: Emerging Market Threats
(and How to Thrive in Spite of Them) (Panel Discussion)
Thursday, September 18, 8:30 – 9:45 am
Marc J. Roberts, PhD
The best-laid plans of health care leaders often go awry due to factors outside of their own organization and beyond their control. Some institutions strain to accommodate workforce shortages, while other sectors grapple with unfunded government mandates. Our panel of diverse experts will identify and appraise the dominant market threats, including concerns over reimbursement levels; provider and payer consolidation trends; strained hospital-employee relations; and malpractice litigation. They will also draw upon their own experiences to outline methods for anticipating future threats and for adjusting organizational tactics in an appropriate manner.
Over the River (Case Study)
Thursday, September 18, 10:00 – 11:15 am
Marc J. Roberts, PhD
This case explores the complex leadership challenges faced by a manager who has to respond to a variety of pressures, concerns, and constituencies. TeeTee Stevens, the founder and CEO of a small biotech company, has to make a decision about how to price a new cancer drug. His parents, investors, employees, and various activists all have different views. What sort of process, if any, should he create to help him make this decision? Once the decision is made, what steps should he take to bring along the key constituencies? As a tool for analyzing this case we will also explore a brief analytical note on “A Metaphoric Framework for Analyzing Leadership Challenges.”
Turning Soft Assets into Hard Power:
Leveraging the Tangible Power of Your Most Enduring Intangible Assets
Thursday, September 18, 1:00 – 3:00 pm
David A. Shore, PhD
Of the many factors contributing to individual and organizational success, none is more important than reputation. A highly valued reputation allows a brand to stand out from the crowd, comprising what Warren Buffet, deems a “competitive moat” in your market. In the health care field, there is compelling data to suggest that the organization that owns a reputation for trust owns its marketplace. A trusted reputation for high quality programs, products, and services is good medicine, good business, and great leadership — it is both a mission-driver and a margin-driver. This practical workshop moves beyond simply documenting the value of brand, reputation, and trust-building. We will focus on how to build your organization’s capacity for trust and trustworthiness, and how your organization can translate that capacity into a trusted reputation and brand.
Reframing the Human Capital Debate:
Aligning Business, People, and Engagement Strategies to Sustain High Performance
Thursday, September 18, 3:30 – 5:00 pm
Roselyn Feinsod, F.S.A.
Principal
Towers Perrin
Employee engagement “powers” the employee-customer-performance chain. Organizations have far more ability and control to raise engagement levels than they typically assume. For hospital leadership, the message is clear: You have enormous untapped potential to engage your workforce in behavior that adds value and delivers on your strategic goals.
Using insights, analytic tools, and real-world experiences, we will examine how to tap into this potential, taking into account how the unique aspects of each organization’s strategy and culture need to come together to create a truly differentiated high-performance work environment.
We will also explore a rigorous method to translate business strategies into specific drivers of performance at the organizational and individual level and to use those drivers as the foundation for developing business, people, and reward practices and programs that yield the right kind of performance from all segments of today’s diverse workforce.
Capstone Workshop The Activation Process:
From Ideas to Implementation (with refreshment break)
Friday, September 19, 8:15 – 11:15 am
David A. Shore, PhD
There is nothing more elemental to the work of leaders than producing results. Leaders are the force that ignite change. All too often, however, the desired results are not achieved and a new initiative falls flat. Walt Disney said, “If you can dream it, you can do it.” Not so fast, Walt. Many brilliant ideas have floundered or even died due to the lack of an activation-implementation strategy. Moreover, leaders get little credit for their brilliant ideas unless they can also bring them to market.
The Forces of Change model demonstrates the dominant market dynamics driving the future of health care. This interactive workshop will present the fourth phase of the Forces model, the Corporate Activation & Management Program (CAMP). CAMP offers a set of activation mechanisms for stakeholder groups to use both internally and externally. These mechanisms increase the likelihood of success for new initiatives. We will spotlight four prerequisites necessary to overcome pervasive inertia, resulting in greater organizational effectiveness and efficiency.
We conclude this workshop with an ending well exercise, prompting participants to draft a plan of action for bringing the lessons and strategies of the program to bear on their particular organization. We explore mechanisms for translating ideas into specific actions. We also draw upon our collective experiences to evaluate available techniques for enlisting the support and advice of colleagues.
We look forward to your active participation in CAMP.
For fees, payment policies, and registration, click HERE.