CIO Unplugged – 6/1/09

The views and opinions expressed in this blog are mine personally, and are not necessarily representative of Texas Health Resources or its subsidiaries.

It’s Not About You
By Ed Marx

I dreaded visits from Battalion HQ. Bravo Company operated fine without big brother coming down and creating more work. As a twenty-year-old platoon leader, I had to gauge what level of involvement was beneficial versus what was busywork. I understood the need and benefit of our association with well-intentioned HQ, but at times, enough was enough before they only caused agitation. I made every effort to keep standard operation policies from becoming the frontlines. HQ existed to help my troops complete their mission, not create diversion and roadblocks.

I then recall with trepidation my promotion to Captain with orders to HQ. As the Battalion Motor and Movement Officer, I was responsible for the readiness and mobility of the 40M dollars worth of vehicles in our five line companies. Operating my unit and making sure our companies were prepared to deploy at a moment’s notice while contending with the inherent HQ bureaucracy of my position was tough.

Over time, I became…one of them. I found myself so focused on my HQ efforts that I lost site of the reason for my position. I was building a world-class organization and process but inadvertently choking our line companies agility required for mission execution.

Those Army leadership experiences shaped my belief that corporate exists to serve those who did frontline work.

As our country emerged out of the American Revolution, similar conflicts took place. Our young republic was deeply concerned about the national government growing too large and powerful to the point of snuffing out state rights. Conversely, federalists were worried that too much state independence and freedom would unravel the fragile democracy. Perhaps the greatest balance was brought forth not by the constitution itself, but in the principles espoused in the Federalist Papers. Two hundred years later, these papers still carry important lessons and ideas for corporate America. They help bring perspective and balance to the relationship of corporate HQ versus line company relationships.

It’s easy for those of us who hold HQ positions to forget that we exist to serve line companies. In healthcare, the frontline is anywhere care is delivered. In a single hospital, clinics and departments see patients. In multi-hospital systems, the hospitals themselves interface with patients. I continually struggle with this reality. In and of themselves, the strategies, structure, and process I create are important. At the same time, they become hurdles too high for frontlines to jump, therefore impeding progress. When HQ is physically separated from the frontline, the challenge is exasperated. In such cases, be extra vigilant.

Here are some actionable ideas to help us remember our appropriate HQ role:

· Frontlines is where care is delivered and what drives revenue:

Beyond government/accreditation/safety mandates, are your requirements perversely impacting clinical care?

Beyond government/accreditation/safety mandates, are your requirements perversely impacting revenue?

· HQ by definition is overhead, a “tax” burden on the frontline:

Keep costs low as possible

Keep demands on frontlines to a minimum

Regularly question your own demands and those of your peers

· Seek to understand before striving to be understood:

Leaders, spend equal amounts of time on the frontlines as you do in your safe, remote office

Send staff routinely to the frontlines to gain customer perspective and understanding

· Engage frontlines in all aspects of your area and avoid mandates:

Include them in strategic planning

Be extremely transparent with costs

Provide options with well thought out pros and cons

Discuss and gain perspective before making mandates

Ask them the tough question “am I helpful?” and then listen

· Policy & procedures:

Eliminate as many policies as possible

Stop creating new policies unless absolutely necessary

Develop common operating principles

Say “yes” more than you say “no”

Many governments, armies, and companies grow the complexity of HQ at the expense of frontlines and eventually lose their sense of purpose. Their pride turns into arrogance as HQ shines brightly, yet the dull of the frontlines quickly tarnishes any fleeting glory. I plead guilty on all counts! Balance is a must. Once you become more concerned with your area performance than with frontline success, you have lost your reason for existence.

Ed Marx is senior vice president and CIO at Texas Health Resources in Dallas-Fort Worth, TX. Ed encourages your interaction through this blog. (Use the “add a comment” function at the bottom of each post.) You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook, and you can follow him via Twitter – User Name “marxists.”