In this time of widespread financial distress in the healthcare industry, many organizations are turning to the use of consultants to help them define and deploy strategies to restore sustainable financial stability. In multi-entity health systems, the consultants are often engaged by System level leadership and deployed across the organization’s entities and markets in an effort to generate large scale cost savings. This experience is often extremely challenging for local leaders who struggle with their perceived loss of control. They fear that the changes wrought by the consultants will not fully appreciate the complex implications of those changes resulting in adverse impact on long-term performance and material damage to the organization’s culture. Triggered by those fears, many local leaders approach these consulting relationships defensively. In so doing, they diminish their influence in the process and damage their “brand” at the System level.
As an executive coach who works with healthcare leaders navigating this dynamic, I want to be clear about the distinction: a consultant is typically brought in to diagnose a problem and help you formulate a prescriptive answer, while a coach’s job is to build your capacity to navigate moments like this one well, whether or not a consultant is in the room. With that in mind, here are a few suggestions on how to make the most of the experience when engaging consultants to assist in performance improvement efforts:
Start with a positive mindset.
Instead of approaching the consultant as an intruder who is going to tell you how to run your business, consider the positive opportunity to take advantage of the capabilities and capacity they bring to assist your team in driving improvement efforts.
Here are just a few possibilities:
- While they may lack specific knowledge of your organization and its challenges, they typically come with the benefit of having broad exposure to ideas and strategies other organizations have used to address similar challenges in their markets. That breadth of experience can help your team see familiar things in a new way and can serve as a spark to a new level of creativity. It can be a challenge for those inside an organization who have become accustomed to doing things one way to envision how it might be done differently. Those who come with a different perspective can help open up possibilities which might otherwise be overlooked.
- Approach the engagement with a learning mindset, open to what your team can gain from the experience of working with others who have unique expertise or experience. Capture and retain the insights gathered by the consultants in the course of their work, rather than letting it “walk out the door” when the engagement comes to an end.
- Sometimes consultants bring specialized expertise, systems, proven processes, or tools which are beyond the depth that exists inside of the organization. It may make sense to “buy” that specialized expertise rather than investing in developing internal depth, and it may allow you to accelerate the timeframe in which you can bring that expertise to bear in your efforts to drive improvement.
- If nothing else, consultants bring capacity giving you more resources to put to the task of developing improvement initiatives. Take advantage of the ability to put those resources to use, strategically blending them with your internal leaders in issue focused “partnerships.” The combination of the unencumbered outside perspective with the depth of internal knowledge can be a powerful combination in finding new approaches to address old challenges.
Strive to retain “ownership” of decisions.
Ultimately, you will own the consequences of decisions which emerge from the deployment of consultants. It makes sense, then, that you work to position the consultants as a resource to help inform your decisions rather than simply deferring to the consultants’ expertise.
- This requires you and your leadership team to probe deeply enough to understand the rationale behind the consultants’ recommendation in order to form your own point of view as to its feasibility and appropriateness. Drive the consultant deeper than their conclusions. If they propose changes based on high level ratio analyses, require them to go deeper and work as a thought partner to define the “how” those results can be achieved.
- A simple 3 step approach can help assure this rigor:
- Identify the proposed change;
- Define the impact of the change if nothing else is done to address that impact. If the consultant has identified true non-value-added waste, then it may be that nothing needs to be done. More often, absent some compensatory adjustment to address the implications of the change, there is an adverse impact on performance.
- Define the steps to be taken (e.g., process redesign, change in operating model, etc.) to prevent the impact or, if that is not possible, make an intentional decision as to your willingness to absorbing the impact for a time in order to help stabilize short-term financial performance.
- In seeking to retain ownership of the decisions, be mindful to check yourself on any bias which may prevent your consideration of a change from the status quo. Avoid defensiveness. Be open to challenges to your assumptions and perspective. Recognize the value of the creative spark that can come from those who see familiar things with fresh eyes.
Build trust with the consultant by working in partnership on key initiatives.
By engaging in collaborative problem solving around key decisions and being open to consideration of new and disruptive ideas, you avoid the risk of being perceived as defiantly resistant to change. The key is to engage in thorough and thoughtful discussion of ideas, especially when you and the consultant have a different perspective on its impact and feasibility.
- As with anyone new to your team, take time to build a relationship with the consulting team. Gain an understanding of the experience and expertise of the team members so that you are able to position them as an extension of you and your leadership team. Share with them your aspirations for the engagement addressing the desired character of the effort as well as the desired outcome.
- When your point of view is at odds with the consulting team, explore the different perspectives in depth. Seek to understand the underlying logic, assumptions or experiences that lead to the consultant’s position. Share your perspective with that same depth, describing the thought process which is the basis for your position. Identify where your perspectives diverge. Seek ways to resolve those differences through additional research, pilot programs or other means if possible. Focus on “yes, if…” thinking not “yes or no.”
- Engaging in collaborative problem solving at this depth refutes the perception of defiant resistance to change and fosters trust in your openness to appropriate risk and disruptive change.
- By developing trusted, collaborative relationships with the consultant, you will strengthen your credibility and influence at the System level.
- Speak always from the perspective of commitment to the what’s best for the System overall and the goals of the improvement initiative in a manner that is sustainable and faithful to the organization’s culture and values.
Ensure the work with the consultant reflects the principles of effective change leadership.
Under financial stress, with pressure to move fast and implement significant change, organizations often fail to take the necessary time to design and deploy the change in a manner which will help assure its effectiveness and sustainability. The tradeoff in taking the time for change leadership is the avoidance of managing the backlash and doing the rework of poorly implemented initiatives. Avoid the temptation to look at this as a false choice between going slow or going fast. It is a matter of choosing to move “thoughtfully fast” vs. “frantically fast.” The more skillful the organization and its consulting partner are in the elements of change leadership, the greater the trust in the process. The deeper the level of trust, the faster the process can move.
The introduction of a consultant into an organization can be seen as a threat to be resisted or an asset to be leveraged. By choosing the latter approach, leaders have a greater chance of assuring the experience is a positive, value added one. If you would like to explore these concepts in greater depth, please contact us and let us explore how we might help you navigate in the turbulence of this challenging environment.
