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A growing number of healthcare organizations are hiring executives with unconventional, non-healthcare backgrounds in a bid to increase efficiency and boost financial performance. But attempts to introduce a new leadership perspective into an organization can turn disastrous when the executive flounders.

When such “outsiders” fail, the problem often lies in their approach to their new industry, says Eric Hanson, PhD, executive consultant for Development Dimensions International, a consultancy based in Bridgeville, PA. Many leaders with non-healthcare backgrounds struggle to gain staff buy-in for their ideas because of a philosophy that doesn’t account for the intricacies of a hospital or healthcare in general, says Hanson. Instead, executives new to the industry should concentrate on a soft approach—building coalitions of support and speaking with stakeholders face-to-face—to gain an understanding of the organizational dynamics at play.

Matthew Furlan took such an approach in 2004 when he was brought in to be the resident expert on Toyota lean thinking as chief operating officer of the 160-staffed-bed Appleton and 160-staffed-bed Theda Clark medical centers, two acute-care hospitals that are part of the ThedaCare health system based in Appleton, WI. Furlan was previously the director of global operations for the manufacturing firm Parker Hannifin and director of lean initiatives for the Parker Aerospace division in Irvine, CA.

Furlan first sought to understand the organization, then found ways to apply lean rigor, says Kathryn Correia, the person who hired Furlan and senior vice president of the two hospitals. Like many candidates from a manufacturing background, he faced a steep learning curve. To overcome the knowledge gap, Furlan spoke with key staff members, physicians and other stakeholders to identify what they thought were the top three problems within the health system. “There are experts in all areas of the business, so it’s fairly easy to learn as long as you focus on the vital few and don’t get overwhelmed by the whole,” says Furlan.

Even after a leader grasps the finer points of an organization’s politics, however, he or she must secure buy-in before change can happen—which means developing a convincing case for changing a system that people have come to take for granted, says Hanson.

One of Furlan’s first initiatives at ThedaCare was to improve the patient flow of inpatient care. To show staff members the waste involved in the process, Furlan mapped out the steps required to admit a patient and noted the time each step entailed. Soon the staff recognized multiple opportunities for improvement.

By taking small steps and organizing small groups of staff members in different operational areas, Furlan gained support for his ideas. Hanson points out four ways an organization can improve the rate of success for external candidates like Furlan:

1. Conduct due diligence during the hiring process. Just as you would for an acquisition, make a thorough evaluation of the candidate before you bring him or her aboard. You want to gain an understanding of the candidate’s capabilities and personal attributes, as well as get a strong sense of whether he or she will be a sound cultural fit with your organization.

2. Institute an effective on-boarding plan. This includes making sure new leaders are building the right networks with people and have a strong sense of the culture that they are joining. “Make sure that person is accumulating that organizational wisdom, sooner rather than later,” says Hanson.

3. Open the lines of communication. Success may come down to feedback from stakeholders and the responsiveness to the feedback. Observe and assess new executives to make sure they are a good fit; this also allows a candidate to refocus his or her approach if needed.

4. Accept the risk and be patient. Recognize that you’re taking a risk by hiring someone whose background is not in healthcare and who demonstrates a different skill set. The executive will require a longer orientation process, says Correia—and initial success may be slow going.

—Corey Christman