He keeps goals big in scope but few in number. For instance, he and his group agreed to meet one performance objective for the group around readmissions.
"All 11 agreed and all would be responsible for some piece, which forced them to have conversations among each other."
He argues that senior leaders need to create "stretch" metrics that subordinates don't hit every year. When they don't hit them, they also need to know you're not planning on firing them. He says while clinical people have some transformation of work practices, to deal with that can be quite challenging; it's the administrative staff that has the toughest bridge to cross as healthcare incorporates vast changes.
"The leaders under the most pressure are traditional C-suite people because they cannot achieve anymore without their clinical people being at the table," he says, adding that 70%–80% of what physician senior leaders have to deal with are not necessarily tied to the organization—that is, the independent medical staff. As CMO, Priest tries to bridge that gap and own a goal, but it's his responsibility to make sure his team members can help him achieve it.
"I'm going to be the owner of the goal. If they don't get it right, maybe you can laugh about it and find ways to improve. It's not perceived as an organizational failure, but you have to hold people accountable. I might have a conversation that goes like, ‘We've been at this 18 months. Tell me what you need to do different.' If they're blaming someone else and they don't bring solutions, that's a red flag."
For what it's worth, Priest also doesn't buy into prescriptive culling of the leadership ranks for the
"You have to deal with the fact that at times people are ill-suited for their job." Leadership skills or their lack are quickly evident in an industry that is undergoing such constant change. But Priest is convinced that his hands-on style means that people are rarely surprised when he has to arrange for them to exit the company, as he puts it.
"If they're surprised," Priest says, "either I didn't do my job, or they have self-deception. I have to feel comfortable in both a verbal and written manner that I have been very clear about my expectations. They're often happy you've helped arrange for them to exit the company because it's miserable for them, too. People don't like to fail."
This article appears in the November 2012 issue of HealthLeaders magazine.