Bren Manaugh, MSW, LCSW, CPHQ VP, Adult Behavioral Health Center for Health Care Services

Leveraging Opportunities with Organizational Change

Bren Manaugh, MSW, LCSW, CPHQVP, Adult Behavioral HealthCenter for Health Care Services

Change is Always a Challenge…

And not usually welcomed; Nobody really looks forward to change except a wet baby…

But Change is Full of Opportunities!

…if we think about change as a means to reach our goals rather than as a burden or barrier;

It’s all about attitudeChange is possible if we have the desire and

commitment to make it happenM. Gandhi

and willJust do it.

Nike

Roadrunner vs. Coyote

Health Care Reform and other shifts in the environment of health care delivery present a radical paradigm shift for community mental health care.

Is your organization the Roadrunner or the Coyote?

Strategic Direction and Framework

“Hope” is not a plan

“Soon” is not a timeline

Triple Aim Framework

IOM Report Dimensions for Improvement: Safe – as safe in health care as in our homes Effective – matching care to science; avoiding

overuse of ineffective care and underuse of effective care

Patient-centered – honoring the individual, and respecting choice

Timely – less waiting for both patients and those who give care

Efficient – reducing waste Equitable – closing racial and ethnic gaps in health

status

CMS’ Triple Aim

better care for individuals, The Patient Experience

better health for populations, Effectiveness

and lower growth in expenditures for Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) beneficiaries Efficiency

CHCS Adult Behavioral Health Division Empowerment and Accountability

CHCS Reorganization: Flattened organization structure

Culture Change – Impact of, and on, Systems and People

“Strengths-based” Empathy, Empowerment and

Accountability Transformational Leadership CQI Environment

Empowerment and Accountability

“Flat” Organization Very few, or no, layers of management

between direct line staff and CEO Managers empowered to set goals and make

decisions, in alignment with agency goals CEO provides feedback and direction as needed Managers acknowledged for both successes

and misfires “Safe” environment for executing decisions and

learning from mistakes

Surround yourself with the best people you can find, delegate authority, and don't interfere. Ronald Reagan

Empowerment and Accountability

Applying therapeutic and recovery strengths and skills to management: Emotional intelligence “Strengths-based” and treating staff and

colleagues with empathy while holding them accountable for high levels of performance

Collaborative leadership (Transformational)

The Southwest Airlines Way: Relational Coordination

Relational Coordination

Frequent, timely problem-solving communication carried out through relationships of: Shared Goals Shared Knowledge Mutual Respect

Both increased quality AND increased efficiency

Key to High Performance: Build and sustain relationships among the organization’s key participants

Transformational Leadership Manager ≠ Leader Position = Title ≠ Respect Leadership is a process through which

one individual influences a group of individuals to achieve a common goal

Transformational leadership achieves this while changing and transforming individuals (Northouse, 2001).

“A good leader inspires others with confidence in him; a great leader inspires them with confidence in themselves.” Unknown

Transformational Leadership

Transformational Leaders Start with vision and build up with trust, passion,

integrity and commitment; model personal accountability and ideals

Inspire others to change expectations, perceptions and motivations to work toward common goals

People-oriented: balanced focus between actions and impact on people

Are positive change agents Build other leaders!

If your actions inspire others to dream more, learn more, do more and become more, you are a leader. John Quincy Adams

Transformational Leadership

The “4 I’s” of Transformational Leadership Idealized Influence: role model; “walks the talk”; can be

relied on to do the right thing; persistent; doesn’t play it safe

Inspirational Motivation: inspires and motivates; provides meaning to work; creates an atmosphere of commitment to goals and shared vision; enthusiastic and optimistic

Individualized Consideration: demonstrates genuine concern for the needs and feelings of people; mentors and coaches; constantly challenge people to higher levels of performance; authentic listening – 2 way communication

Intellectual Stimulation: challenges people to be innovative and creative; creates a safe forum and climate for exploration and contributions

Empowerment and Accountability

Personal Accountability:

A personal choice to rise above one’s circumstances and demonstrate the ownership necessary for achieving desired results – to See It, Own It,

Solve It and Do It.

Connors, Smith and Hickman, The Oz Principle

Empowerment and Accountability

4 Steps to Accountability See It – Acknowledge the Problem

Own It – Take Responsibility for It Solve It – Determine What I Can Do

Do It – Take Action

Empowerment and Accountability

Above the Line: See It, Own It, Solve It, Do It

Below the Line: The Blame Game

Accountability and Empowerment

Holding People Accountable the Oz Principle Way Define the Result Determine time to report on progress Deliver praise or coaching

Build and Operate in a CQI Culture

I haven't failed. I've found 10,000 ways that don't work.

Thomas Edison

Even if you’re on the right track, you’ll get run over if you just sit there.

Will Rogers