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2008 Top Leadership Teams

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Winner: Bangkok Hospital Medical Center, Bangkok, Thailand: Global Hospitals

Teamwork Tips

  1. Create a sense of urgency.
  2. Hold executive team accountable for fostering leadership talent.

For Bangkok Hospital Medical Center, being good isn't enough. The four-hospital system wants to be excellent—by international standards, says CEO Chatree Duangnet, MD. "To bring people who only know local things to accept and work within an international standard is a huge thing for us to do," he says. "My own people right now are proud of running an international standard."

After a completing a successful Joint Commission International survey in 2007, one of the challenges senior leaders faced was instilling a sense of urgency in their staff members to continue to improve. The executive team presented the staff with their next set of goals aptly named, "BMC after JCIA."

The vision includes gaining disease-specific certification in primary stroke care, breast cancer, heart failure, and acute coronary syndrome; ensuring the staff was properly trained and credentialed; having up-to-date equipment and technology; and having healthcare products that could compete with U.S. products. To achieve these goals, the executive team focused on developing future leaders, strategic planning, and teamwork. "Working well together is one of the core competencies," says Duangnet. "We feel it is the most important. If we cannot work well together, then we cannot serve 3,000 outpatients a day and 340 inpatients."

Knowing that BMC's goals depend heavily on the leadership talent within its organization, the executive team focused on leadership development, recruitment, and retainment. Employees complete an individual development plan, and the executive team is held accountable for fostering leadership talent. The executive team meets monthly with managers to discuss key performance indicators and quality improvement initiatives. These monthly audits not only give senior leaders the chance to interact with the staff members who are delivering patient care, but the employees appreciate the opportunity to communicate with the administration, as well.

To recruit and retain employees, BMC constructed a new 283-room dormitory complete with swimming pool and fitness center, which brings the number of subsidized living quarters to 700. It promotes work-life balance through activities like intramural games, yoga classes, and special interest clubs in photography and art.

—Carrie Vaughan

Winner: HealthTexas Provider Network, Dallas, TX: Medical Group Practices

Teamwork Tips

  1. Establish common culture across locations.
  2. Send monthly dashboards to all physicians on satisfaction, finance, and quality.

For the past 15 years, the senior leadership team at HealthTexas Provider Network has successfully navigated the murky waters of healthcare—from the front of the pack. The executive team anticipated the trend toward patient-centered care, so they adopted solutions for better patient satisfaction reporting, created a department focused on patient relationship management, and adopted an ambulatory electronic health record that will play a big role in their disease management effort going forward. "The commitment to quality and service is embodied in their patient-focused and patient-friendly initiatives," says Top Leadership Teams judge Marshal Baker.

One of the key challenges for HealthTexas has been establishing a common culture across 106 locations and communicating effectively with nearly 500 physicians. "We like governance to be as close to the local practice and that exam room as we can possibly get it," says President Bill Roberts.

To that end, each location has an executive committee that meets weekly, and the information is broadcast to the whole group. Leveraging leadership from this diverse group is crucial, says board chairman David Winter, MD. "We depend on them to coalesce the ideas, refine them, and report them upstream. And also to take the leadership ideas from the board when we come up with mandates that we think are important for the culture of HealthTexas. We use them as a communicator."

HealthTexas also established a physician newsletter that provides pertinent information about the organization. Each new physician is also required to attend a two-day session to learn about HealthTexas' culture in addition to issues like coding and malpractice during their first year, says Winter. "We have monitored this through surveys, and it is remarkable that almost every physician thinks this is extremely important," he says. "We teach them how to be a team player."

HealthTexas provides its physicians a profile every month—a dashboard that is sent via the Web. For example, they can see patient satisfaction scores, preventive health service scores, and the company's financial information. "Everything we do is as transparent as we can get it," says Roberts, adding that physicians can see how other doctors are performing and "that peer pressure has driven a lot of the good behavior that we benefit from."

—Carrie Vaughan

Winner: CareSource Management Group, Dayton, OH: Health Plans

Teamwork Tips

  1. Partner with broad base of government, social service agencies, and providers.
  2. Educate employees on member population's needs.

CareSource Management Group's mission is centered on making decisions based on what is best for the consumer. That philosophy is what ties the organization's executive team and employees together—and it helped Pamela Morris, president and CEO, lure her chief operating officer and chief medical officer away from top positions at larger commercial managed care organizations. "It has taken me back to why I went into medicine in the first place," says CMO Craig Thiele, MD. "The culture of our company is to serve the underserved, and that goes from the very top down to the frontline people."

The ongoing challenges for CareSource, the largest Medicaid HMO in Ohio and the nation's fourth largest, are meeting the needs of public-sector consumers and the regulatory and legislative demands that drive the healthcare industry. "We are relying on state regulators and legislators to determine our entire revenue stream. It can be pretty scary," says Morris.

CareSource, which has grown from about 245,000 members in 2002 to roughly 600,000 members today, has partnered with government regulators, social service agencies, and providers to meet its members' needs. The result of these alliances is the development of preferred option programs, the expansion of Medicaid coverage for covered families and children, and the addition of the aged, blind, and disabled population to the Ohio Medicaid managed care program.

The executive team believes in leading by example and open communication, which is why they joined other employees who were calling to welcome the nearly 10,000 new members to CareSource. Senior leaders also established the CareSource University in 2003 to help align employees under its key initiatives, unify the various departments, and increase cultural awareness. For instance, all employees were required to attend sessions that educated them on the new segments of the Medicaid population and the challenges of serving these members. Every quarter employees attend "all staff" meetings to delve into the financials and strategic initiatives.

Initiatives designed to improve benefits for its members and yield cost savings include CareSource 24, a 24-hour, seven-day in-house nurse-advice line, and a program to promote preferred medications.

—Carrie Vaughan

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