Healthcare IT Team
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Healthcare CIO: Imagine Alignment

Demonstrating a team’s interdependence was one of the greatest challenges I had as a leader. Let me walk you through one specific experience I had — I’m curious as to whether you can relate.

So, I’m entering year two of my tenure as Healthcare CIO, and I am handed a document with a list of all active IT projects. For reference, the IT staff was comprised of about 450 individuals across operations and capital projects. We had an IT budget in the lower percentile for a $5.5BN health system and I’m looking at a list of 120 active projects.

That’s one project for every four people that are on the IT staff. I had two immediate thoughts: First: if all of these projects were high-value strategic initiatives, I was going to have to talk to the executive team about either focus or money… neither of which is ever fun. My second thought was that perhaps there were some projects on the list that were no longer of value. You know, the projects that are part of the inertia that is inherent in any organization.

Either way, it was time to find out.

The Experiment

We created a one-day meeting where every IT project owner was to present their project to the IT leadership team. That meant 120 project presentations, with 5 minutes for each project. Lunch would be brought in. It was a little bit like Shark Tank, in that the IT leadership team sat at the conference table and PMs with key SMEs came in to present their project.

The result? Epic failure. We got through less than half the projects and I was more confused after the meeting than I was going into it. It was a good concept, but poor implementation.

The challenge was simple, at the end of the day. How does the leadership team get all the information we needed and give the project teams what they needed (which was the ability to raise concerns and ask for help in five minutes)?

The new answer – which finally solved our problem — was “project cadence” and the advent of the four slide project presentation.

Slide #1 – The “Why” for the project. What is it? What was the business driver? Does the need still exist? Who is the business owner?
Slide #2 – Where are we at? (A one-page PM slide that showed the status)
Slide #3 – What are the risks to the project?
Slide #4 – What do you need from leadership in order to be successful?

The result of the meeting exceeded my expectations. We found four projects that were at odds with one another and many projects with dependencies of which the project teams were unaware. There were several projects with no business owner and about 15 projects that simply had no reason for being — we couldn’t answer the question of “Why are we doing this project?”

We heard of many projects that were at risk. Oh, and one out of three projects needed money, resources, or more time.

I have to admit that I didn’t like having to do this, as it appeared to be a micromanager’s move. Sometimes, though, you have to teach people how to recognize their interdependence and the value of functioning as part of the whole.

The cadence meeting became an exercise on seeing the big picture for my team and how all the pieces interrelate. Let me talk a bit more about some of the benefits of this exercise.

Teach them how to communicate with leadership

The first attempt at this meeting was painful. There wasn’t a team present who had less than a 10 slide deck for a five-minute presentation. For some, they wanted to show us all the great work they had done, for others it was a justification for why great work hadn’t been done.

Some were seeking affirmation and some justification. Neither was helpful, except it was telling as to what the staff thought that leadership wanted from them.

With the four slides and subsequent communication, we taught them to think about any presentation from the audience’s perspective. What does your audience want to know? Also, what do they need to know and understand in order to deliver on the promise of the presentation?

The goal of this meeting wasn’t to evaluate them but to evaluate their project in the mass of projects. In this case, less was more… much more.

Teach interdependence

Needless to say, my leadership team was shocked when we were done with the first cadence meeting. We decided beforehand that the meeting would be more about uncovering challenges, rather than solving them. Each of them had five or six pages of notes and more action items than they could handle.

Most of the action items centered around talking with one another. This was the most gratifying thing for me as a leader.  I knew this situation existed prior to the meeting, but was failing to communicate with them their interdependence as a team. One meeting later, they saw it clearly.

Isolated project success in IT is lifted high. We celebrate our own wins. However, so much of our current and future success will be loosely-related projects that form the foundation for larger capabilities within the organization as a whole.

As an example, video visits will require a good network, security, data sharing, integration, analytics, VDI, mobility, engagement, and adoption programs. The I&O team’s success is tightly linked to the business applications and customer service team. This meeting demonstrated that.

Uncover the value of shared purpose on culture

To hear about projects that were in conflict with each other was almost breathtaking. You could visibly see the lack of a unifying mission, the inefficiencies of being at odds with one another, and the impact on morale that comes with not knowing the place of one’s work in the larger whole.

The role of the healthcare leader is to create alignment, link the work to the purpose of the organization, and create a culture that celebrates the success of the whole over the individual.

A few months after we kicked off the cadence meeting, we had one of the most powerful meetings we’d ever had as a team. My own team sat in amazement as each team came in and presented the four slides. We spent more time talking with them about their interconnectedness with other projects and the value of their project in the mission of the organization.

The meeting went from a micromanaging event to a vision-casting and mission-affirming event. My leadership team was learning their interdependence, and the IT organization was more focused on fewer projects and demonstrated more purpose.

It only took me two years to launch this. I can’t even fathom how we functioned over the first two years.  The next four years would be spent turning a meeting into a part of our operating culture.

Drop me a note if you would like a copy of the four slide outline. [email protected].  As always, you can follow me on Twitter @ThePatientsCIO.  You can also check out a closely-related post on project success.