With three hospitals and multiple affiliates throughout Connecticut, the Yale-New Haven Health System serves more than a million patients each year. This private nonprofit company has grown significantly in the past few years: It had about 12,000 employees and revenues of around $1.5 billion last year, compared with less than 10,000 workers and $1 billion in profits in 2001, which constituted increases of 20 percent and 50 percent in those respective categories. Michael Pepe, Ph.D., vice president of education and executive director of the Yale-New Haven Health System’s Institute for Excellence, has to make sure that the organization’s learning and development initiatives can keep up with the swift expansion of its operations.
“I coordinate and develop, and ensure consistency and set standards for all of the education and training that occurs across the system,” he said of his role as vice president of education. As the head of the Institute for Excellence, his main objectives are to build an infrastructure and drive initiatives to develop key attributes—innovation, teamwork and continuous change—in current and future leaders at all levels of the Yale-New Haven Health System. “We are taking both a short-term and a long-term approach to delivering leadership development resources,” he said of the Institute’s strategy. “I take a systemic approach to development, primarily leadership development, which is to say that I think continuity is critical.”
One of the challenges Pepe faces is getting individuals who are about to assume a leadership or management role to see how their decisions have upstream, downstream and cross-functional impact. “If you look at a person’s career, there are predictable challenges that a person has to address or overcome through the course of their career,” he said. “When one makes the transition from a clinician to a leadership role, where he does the clinical work half of the time and the other half of the time he manages other physicians, that’s a huge transition.”
Another complication is the structure of the organization, which can make delivery of content a Byzantine affair. “I’m driving this philosophy and these concepts from a central point—that’s this Institute—but our delivery is very decentralized. One huge difference I see in health care delivery is access to development resources. In health care delivery, it’s a 24×7 world. People have a difficult time leaving their specific workspace, unlike other organizations where it’s expected and doable to leave your office for a couple of days and go to a training center.
“What I’m trying to do is create a delivery model that takes the training and development resources to the site, which means we really have to capitalize on technology where we can,” he added. “There are computer terminals at every nurses’ station in just about any unit in a hospital. What we’re trying to do is deliver resources to those terminals, so that when people do have time in their work area, they can engage in some kind of skill development electronically. That only works for a portion of things, though. You don’t develop interpersonal competence by working at a computer terminal. You’ve got to have dialogue and interface with people.”
Part of the impetus behind the founding of the Institute for Excellence was the need to establish a uniform culture of leadership across the enterprise as it grew, particularly through a series of acquisitions. “Over the past seven years, the system has brought in three major hospitals and several health care delivery networks, clinics and other community physicians offices,” Pepe said. “Historically, the system has not paid a great deal of attention to merging and aligning cultures. What has grown up over the past seven years in this system is that we’ve got the system as a rubric or umbrella way up on top, but as soon as you look below that, you have a lot of independently operating organizations.”
Now the Yale-New Haven Health System is looking to strike while the iron is hot by disseminating its objectives and values in the early stages of these corporate moves. “That is perhaps one of the greatest opportunities an organization has to introduce values, cultural considerations, expectations and basic tools to people who are joining the organization,” Pepe said. “We’re investing significant resources in doing that from a system standpoint. Part of my role and part of this emphasis on a systemic approach to leadership development is to try to find synergies across the system to capture best practices where we can and then use them across the system. Operating in silos up and down the coast of Connecticut is OK, but it’s by no means the most effective way to do business. We’re trying to address that through this leadership development center. The Institute for Excellence is a major culture-change lever.”
–Brian Summerfield, firstname.lastname@example.org
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