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Accidental Adversaries
Accidental Adversaries
Accidental Adversaries
Accidental Adversaries
Accidental Adversaries
Accidental Adversaries
Accidental Adversaries
Accidental Adversaries
Accidental Adversaries
Accidental Adversaries
Accidental Adversaries
Accidental Adversaries
Accidental Adversaries
Accidental Adversaries
Accidental Adversaries
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Accidental Adversaries


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For hospitals and physicians to thrive in evolving healthcare environment they must put aside their historic adversarial relationships in favor of defining and leverageing areas of common interest.

For hospitals and physicians to thrive in evolving healthcare environment they must put aside their historic adversarial relationships in favor of defining and leverageing areas of common interest.

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  • 1. Overcoming the barriers to
    Hospital – physician collaborations in creating healthcare innovation
    Accidental Adversaries
    © 2011 Karen Wade, Ph.D.
  • 2. Accidental Adversaries*
    When groups of people who ought to be in partnership with one another and have much to gain by partnering, end up bitterly opposed.
    Potential partners strengthen understanding of one another’s needs, how they unintentionally undermine one another, and how they can support each other, instead.
    Classic Example:
    Procter & Gamble and Wal-Mart
    *Senge et al (1994), The Fifth Discipline Fieldbook
    © 2011 Karen Wade, Ph.D.
  • 3. Adversarial Dynamics
    Hospital Executives and Physicians
    Exceptionally different professional cultures and development pathways create values collisions
    Each group controls the other’s vital resources
    Transactional vs. Authentic Relationships
    Task focus on business plan/financial structures
    Lack of trust = cautious transactions that suppress creativity
    Lack of trust = impaired conflict resolution skills
    Ineffective conflict resolution = suboptimal/failed ventures
    © 2011 Karen Wade, Ph.D.
  • 4. The Innovation Imperative
    Lessons from the Auto Industry Meltdown
    ….The combination of very un-innovative business plans, visionless management, and overly generous labor contracts….instead of focusing on making money around innovating on fuel efficiency, productivity, and design, GM threw way too much energy into lobbying and maneuvering to protect its gas guzzlers.
    Thomas Friedman, NY Times
    November 11, 2008
    It is incumbent upon hospitals and physicians to cease protecting the status quo, and to envision and implement new ways of making money by delivering value to their customers in re-imagined and responsive services, professional relationships, and revenue models …OR FACE A SIMILAR FATE!
    Nate Kaufman (paraphrase)
    Kaufman Strategic Advisors
    Article, January 2009
    © 2011 Karen Wade, Ph.D.
  • 5. From Adversaries to Allies: The Context
    Environment is ripe as never before
    Mutual survival needs are strong motivators
    Proposed new reimbursement models threaten viability of many hospitals and medical practices
    EHR/technology mandates are too expensive for many physicians
    Individual portfolio losses creating unprecedented financial and emotional stress among physicians
    Largest proportion on record of physicians who want to leave medicine; hospitals need the revenue they produce; must retain
    Some predict a flood of physicians newly interested in employment
    Movement toward ‘clinical integration’ of business/clinical outcomes
    Must move beyond historic mistrust to creative shared action – or PERISH
    © 2011 Karen Wade, Ph.D.
  • 6. ‘Simple’ Rules for Making New Alliances Work
    Focus more on the ‘how’ of working together vs. the ‘what’
    Monitor alliance progress via process & outcome metrics
    Leverage differences to create value
    Encourage relationships beyond formal structures
    Conscientiously manage internal stakeholders
    J. Hughes and J. Weiss, November 2007
    Harvard Business Review
    © 2011 Karen Wade, Ph.D.
  • 7. © 2011 Karen Wade, Ph.D.
    Simple ≠ Easy
  • 8. Prototype ‘Intensive Care’ for New Alliances
    Process to overcome historic lack of collaboration and/or adversarial dynamics:
    Assess Collaborative Potential & Innovation “Readiness”
    Design “Treatment” Recommendations to Enhance Success
    Apply “Treatment” and Support Alliance Development
    Assess Effectiveness of “Treatment”
    © 2011 Karen Wade, Ph.D.
  • 9. Phase 1a: Assess Collaborative Potential
    Design/execute triangulated methodology, involving broad base of stakeholders, to determine:
    Is there, and what is, the ‘burning platform’ that is motivating the collaboration at this time?
    Do the key players view the burning platform the same way, and with the same degree of ‘heat’?
    What potential drivers vs. obstacles exist to a productive alliance and/or its outcomes? What prior experiences have we learned from?
    Leadership: who has the ‘right stuff’, on both sides, to engage over the long-term, through the challenges?
    © 2011 Karen Wade, Ph.D.
  • 10. Phase1b: Share Findings and Recommendations
    Key Finding
    Is there sufficient readiness and motivation to collaborate for innovation at this time with a high likelihood of success?
    Key Recommendations
    If yes, who is most likely to gel into the core ‘alliance team’ and what processes and considerations would facilitate their success?
    If no, what needs to happen within the system of stakeholders to arrive at readiness?
    © 2011 Karen Wade, Ph.D.
  • 11. Phase 2: Design Adversaries to Allies ‘Treatment”
    Based on assessment findings, customized program components build:
    Positive leadership impact, individually and collectively
    Team identity, interpersonal trust, effective communication
    Alignment around ‘rules of the road’ going forward
    What does success look like 2 to 3 years from now, 5 years out?
    Success regarding services, revenue, and relationships
    Innovation and change management knowledge
    © 2011 Karen Wade, Ph.D.
  • 12. Phase 3: Implement the Alliance (and Treatment)
    • Formation Event/Process (Months 1 to 3)
    • 13. Early Stage (Months 3 to 12)
    • 14. Assist in preparation of meeting agendas and prepare leadership for managing meeting dynamics
    • 15. Monitor process benchmarks as indicators of alliance success
    • 16. Be present at and provide group coaching during first several meetings, especially in conflict resolution
    • 17. Graduate to the background with increasing group competence
    • 18. Ongoing Support (Months 13 to 24)
    • 19. Based on consensus, continue to support the alliance as needed with periodic observations as a ‘reality check’
    © 2011 Karen Wade, Ph.D.
  • 20. Phase 4: Evaluate Alliance Progress
    This phase co-occurs with the launch of the alliance.
    Periodic metrics provide feedback for continuosly improving:
    Leadership Effectiveness
    Productivity (achieving innovation goals)
    Other, as identified
    © 2011 Karen Wade, Ph.D.
  • 21. Expected Outcomes of Strong Alliances
    Innovation that is responsive to customer/community need
    High quality/efficiency (streamlined processes)
    Increases in clients to hospitals and to medical practices
    Increases in revenue/profitability for hospitals and medical practices
    Alignment of clinical and business outcomes
    Enhanced quality of life for physicians
    Strengthened institutional capital and communities
    A team that will want to ‘do it again’
    © 2011 Karen Wade, Ph.D.
  • 22. Why Use Management Psychologists?
    Uniquely qualified to assess the feasibility of and to provide ‘intensive care’ to early stage alliances:
    Doctoral training in human/systems behavior with real-world applications
    Part of professional/scientific culture
    Expert advisors to business leaders
    Experts at harmonizing between ‘business’ minds and ‘clinical/technical/scientific’ minds.
    © 2011 Karen Wade, Ph.D.