Form a plan
Duggan has three basic rules for executing a turnaround.
One, talk to your people and involve them in formulating the
go-forward strategy. Two, find a major win early in the process
to build confidence in the plan throughout the organization.
Three, get everyone focused on the go-forward strategy — and
as part of that, do not tolerate bickering among your employees.
“If you do those three things, good things will happen,”
Duggan says.
Involving your employees from the beginning is crucial.
Employees who are left in the dark during a time of transition
will begin to form their own conclusions, which is how rumors
start. Above all else, you need to make sure you are crystal clear
on where your employees stand with regard to job security. In a
time of change, that is likely the first concern that will cross
every employee’s mind.
Duggan met with groups of employees more than 100 times
in the first year of DMC’s turnaround. In those meetings, he
consistently relayed the same message.
“When you’re in a turnaround, all you’re going to get asked all
day is, ‘Are you going to save my job?’” Duggan says. “I’d tell
every employee the same thing: ‘I can’t save your job; nobody
can save your job except satisfied patients. If satisfied patients
come here and tell their friends and family, we’ll be hiring a lot of employees. If people have bad experiences, there is nothing
I can do to help you.’
“‘The turnaround starts with you.’ That’s the message I delivered
day and night for the first year.”
Duggan heightened the entire organization’s awareness of
patient service in the first year, and used that renewed focus to
help roll out a plan designed to create a market differentiator for
DMC — and in the process, gain the all-too-critical first comeback
win around which he could rally the organization.
“In May of 2004, we launched a 29-minute emergency room guarantee,” he says. “One of our competitors had done a 30-minute
guarantee, and I was trying to instill an ethic that we’re not going
to be as good as the other guys, we’re going to be better.”
The plan involved streamlining the emergency room process,
reducing the time between when a patient arrived at a DMC emergency room and when the patient saw a doctor to 29 minutes or
less.
Duggan says it was a matter of identifying one of the primary
areas in which his business receives customers and formulating a
plan to improve customer service and, by extension, customer loyalty.
“An emergency room isn’t necessarily where a hospital makes its
profits, but there are two ways we get patients,” he says. “Nobody
comes to the hospital and says, ‘Hey, I need gallbladder surgery
today.’ Patients either come in through the emergency room or
they are referred by a doctor.
“When I looked at it, it was clear to me that the doctor referral
path takes some time. I needed to turn the cash situation around
immediately. If you cut your hand open, you decide which emergency room you’re going to that day. So it seemed clear to me that
the fastest way for us to conduct a turnaround was in the emergency room.”
From there, Duggan continued to focus on communicating the
idea to his employees and selling the idea of the 29-minute guarantee as a path to follow, along with removing roadblocks to the
plan’s ultimate success.
“I’m pretty good at laying out a case, but I did have one hospital
vice president who disagreed with me on the 29-minute campaign,” Duggan says. “He did not think it was a worthwhile exercise, and I fired him. I did it in a friendly way, but I told him that
this is the direction we’re going and you’re either with the program
or you’re not.
“He was the only one I had to fire. When we made it clear that
you were going to follow central strategy or go somewhere else,
and the central strategy worked, you put those two pieces together and most people are going to follow because they believe in it.
But you also have to be willing to remove roadblocks, otherwise
you’re not going to get to where you want to go. And by roadblocks, I mean people.”
