Pillar Talk

Molly Rowe, for HealthLeaders Media, April 11, 2008

Nothing makes my eyes glaze and my pulse slow like the ubiquitous “pillars” of healthcare. Usually comprising some variation of “people, community, finance, quality, and growth,” pillars are the focus of staff retreats, mission statements, and annual reports.

When done right, pillars give organizations a consistent focus and a foundation on which to base goals, employee evaluations, and strategic planning. But at too many hospitals, “pillars” are nothing more than the rhetoric of media interviews and filler for web sites and marketing.

How can organizations ensure that their pillars are more than words? I recommend you start by asking three key questions.

Did you spend more time last year coming up with pillars or actually using them to plan your short- and long-term goals? It astounds me how much time some organizations spend working on the pillars themselves. Should the pillar be named “community” or “service”? Is “growth” a pillar on its own or can we combine it under “finance”? Some organizations spend so much time coming up with pillars and crafting mission statements that they forget to actually implement them.

Do you measure your effectiveness in each pillar? A pillar list is all well and good but how do you evaluate how you’re doing in each? A story I wrote about executive compensation in this month’s HealthLeaders magazine highlights two organizations that put their money where their pillars are. These hospitals use organizational pillars as the basis for compensation, ensuring that their pillars are more than just a list of overused words. Sarasota Memorial Health Care System in Florida uses a report card that judges leaders on the system’s seven pillars. It’s updated yearly, reviewed monthly, and annual raises are awarded based on performance in each pillar.

How do you prioritize your pillars?
Many organizations list “people” first among their pillars, presumably to symbolize that people are the organizational priority. If you’re telling me that people come first, your annual investments should reflect that (over and above salary). Great, you built a $4-million Women’s Health Center, increased capacity by 25 beds, and increased revenues, but what are your people-related investments? If you list people first, make sure you put them first in real life.

I’m all for strategic focus and consistency, but before you go around pillar-thumping, take a close look at them. If you and your staff can’t see beyond the words to the implement them, you may want to knock your pillars down and start over.

Molly Rowe is leadership editor with HealthLeaders magazine. She can be reached at mrowe@healthleadersmedia.com.


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