Building an electronic health record (EHR) seems to have little in common with creating a collaborative culture. Decreasing denials involves different steps than reducing unnecessary readmissions. Yet all the collaborative initiatives in this Leadership report used similar strategies to foster collegiality and encourage results-oriented teamwork.


This is the Last Word section of the Leadership report Collaborating for Results.

Return to the full report.


Prioritize around the patient. Begin with what everyone can agree on: We are here to serve the patient. Citizen's Memorial Healthcare prioritized EHR decisions around improving quality. Adverse drug events immediately declined. Cash flow also improved.

Build momentum. Virtua CEO Richard Miller ignited a cultural transformation by saying: "Do we want to be average, or do we want to be a great organization?"

Engage all stakeholders. The involvement of various stakeholders will vary. Gundersen Lutheran's IT team met with physicians before going live with CPOE-and simply listened. "We couldn't implement a system that was going to slow the physicians down," says CIO Deb Rislow, RN.

Lay ground rules. Rules and social norms will vary from "no finger-pointing" to "data transparency." Another example: Gundersen Lutheran has summed up expected behaviors of physician leaders in a formal compact.

Create necessary structures. St. John Providence Health System has eight teams actively working to decrease readmissions. Oversight is provided by a system-level leader who holds weekly meetings with each team, coordinates data collection, and shares successes.

Use proven tools and approaches. Cross-discipline teams may benefit from training in Six Sigma or other quality improvement approaches. Sometimes a simple tool is all that is needed. Finance leaders at CHRISTUS St. John used a matrix to show clinical leaders how managed care contracts impact the hospital revenue stream.

Instill accountability and reward successes. As part of a balanced scorecard initiative, all units across CHRISTUS Health are continually measured in four key areas. In addition, a special award recognizes best practices in each quadrant of the balanced scorecard.

Provide education and support. Gundersen Lutheran has developed a comprehensive training program for physician leaders. All physician vice presidents and department chairs are also paired with administrative partners.

Determine the business model. Maintaining financial stability requires an ROI-or at least a break-even strategy. Months after opening a medical home clinic, Swedish Medical Center saw a rapid increase in no-pay patient volume. The clinic must now cap the number of no-pay patients.

Embrace collaborative technologies. CHRISTUS Health CEO, Tom Royer, MD, uses his blog Wireside Chat with Dr. Tom to continually emphasize the health system's shared mission and objectives.

Return to the Leadership report, Collaborating for Results.

Publication Date: Wednesday, April 21, 2010