Tearing down silos

Vince McCorkle, CEO, Akron General Health System

As he sat in a meeting to discuss the future of his organization, Vince McCorkle had another one of his aha moments. However, he soon realized the revelation was something his team had noticed for a while.
“I had been in one meeting — it was part of the strategic planning process — and said, ‘You know, we behave too silo-like within our health system,’ and I’ll never forget someone said, ‘That’s because we’re structured like silos.’ says McCorkle, CEO of Akron General Health System. “And that person was right.”
When McCorkle join AGHS in April 2010, the organization had recently completed a revitalization process following several tough years. While it had accomplished great strides since, as the dust settled, employees realized it was time to take another look at a developing a plan to move forward.
“The improvements they made were operational improvements, refining the systems, some of the basic blocking and tackling that needed to be done had happened, but everyone was really looking and saying, ‘We want to know where we are going,’” McCorkle says.
Though Akron General hadn’t had a strategic plan in years, the problem with getting anywhere wasn’t just with the lack of a strategic plan, it was the way the organizations itself was set up. McCorkle knew well that if your structure isn’t driving function, then culture can eat strategy. So AGHS was going to develop a new strategic plan, and it needed the combined, united support of his 5,700 employees and a participative culture that could enable one.
“So we’re saying, we want a common mission, common vision, common value systems,” he says. “Certain things are going to make sense to be done at the system level, but we have to respect the uniqueness and the different gifts we have in different parts of the system. It’s not centralization; it’s system thinking.
“If you say we want to behave like a system, then structure will drive function. We have to structure ourselves or restructure ourselves so we don’t behave like silos. For me the ‘aha’ was the structure was forcing us to behave like silos. It wasn’t the behavior. It was the structure.”
Encourage participation
Before you can unite people in a vision, you have to first recognize what is keeping them fragmented in the first place. McCorkle knew he needed to understand why and how his employees operated within their own constraints and rules to see where there was opportunity to connect them.
“The great challenge was having the discipline not to just come in and intuitively start doing things but to really go through a defined process involving both internal and external stakeholders to really architect the future of the organization, reaffirm its mission and redefine its vision for the future,” he says.
If your organization is made up of silos, you can’t just write a new rulebook that applies to everyone. As a new leader, you won’t know about all the various cause-and-effect relationships that exist within your organization unless you dig a little, which is why McCorkle decided to spend his first months as CEO seeking input from people who knew the ropes at AGHS, including employees, patients, community members and the board of directors.
“My goal for my first three months was really to listen and learn, to speak with as many people as possible and get their insights,” McCorkle says. “I believe that everyone is 100 percent in their point of view, but that point of view was shaped by where they sit in the organization. So I felt like I had all of these mosaic pieces and I needed to really carefully assemble them together to get an accurate snapshot of current reality as well as the aspirations, these different individuals, clinical leaders, management, trustees had for the future not only of our organization but the greater Akron community.”
To find out what his people think, McCorkle’s strategy has been simple: Ask them and they’ll tell you. And as a new leader, he says if you see something you don’t understand, ask why. There’s probably a good reason why it is the way it is.
Also, in order to get accurate information at the management level, it’s important to eliminate any feeling of organizational or management hierarchy that could inhibit or isolate some people from offering their input or giving honest information.
“I think every one of us in the organization has an important job to do,” McCorkle says. “We are privileged to be able to care for people at some of the most vulnerable times in their lives. Because we have different titles or a nerve chart, it doesn’t mean what I do is any more important than what you do. We’re a community of inspired people wanting to make a difference, and so I don’t believe that we should use the hierarchy of titles.
“I was convinced that our plan would have much more applicability and sustainability if we had that genuine involvement versus someone like myself who comes to work in a business suit saying, ‘This is the direction I think we should go in.’”
Give feedback
It’s important to encourage your employees to share their opinion, but if you want your culture to enable strategy, you also have to make sure employees and stakeholders feel like that contribution makes a difference. This means showing them that their ideas for improving the organization aren’t just heard, but considered and appreciated.
“If you go through a process where individuals can have input and you honor that input — you are upfront and say, ‘We may not be able to do or we may not think what you are suggesting is one of the critical things we need to concentrate on this year or the next three years, but we want your input’— then people generally will feel that they have ownership in the direction of the organization and they can buy into it,” McCorkle says.
His goal at AGHS has been to help every person feel connected to the larger goal of helping patients. He often tells people the story of a group of people who were touring Cape Kennedy at an off time. When they noticed someone sweeping the floor, one visitor asked, ‘But what are you doing here?’ The man sweeping replied, ‘I’m helping to put a man on the moon.’
“It’s that sense of greater purpose; you’re not being a bricklayer but building a cathedral, not being a technician but being a healer,” McCorkle says.
To show people they are part of the vision, you have to make that vision participative. Whether or not a team member’s idea seems actionable or actually pans out, it’s important to show that person that you aren’t just blowing it off. It’s better to tell someone, ‘This idea won’t work,’ then give no feedback at all or worse, say something negative. Just as respecting input is the key to promoting ideas, criticism is the quickest way to kill them.
One way McCorkle ensures he gets a reliable picture of where AGHS stands, positive and negative, is having guidelines for handling feedback. These guidelines ensure his people embrace even the most unpopular ideas with kindness and equitable consideration.
“I didn’t use this language, but essentially, here are the rules of engagement,” McCorkle says. “We want to assume that people always have good intentions, and even if they do something that you say, ‘Well, that was a wackadoodle move,’ you have to say, ‘I’m assuming they have good intentions.’ You do not attack or criticize the person, but you work to better understand their ideas or their behavior.
“I’ve asked many people I’ve met with, ‘If you see me doing something that makes you pause or I’m not doing something that you think I should be doing, would you please tell me, because that’s the only way that I can learn. I have had occasions where people have come in and said, ‘I don’t know if you’re going to want to hear this or not,’ but then they tell me and I thank them. There’s amnesty in that, and that builds trust, I think, when I’m open to that feedback and they are mutually open to that feedback.”
Still, even though a participative management style can help you motivate and unite your team, at the end of the day, you have to remember a collaborative culture is not a democracy.
“I really like a lot of participation,” McCorkle says. “I think it’s healthy for people to be able to disagree, but you can never abdicate your role and responsibilities as CEO of the organization. So you listen. You try to incorporate the best thinking, but then as Howard Sherman said, ‘The buck stops here.’ You have to make that decision. Hopefully, it’s always a well-informed decision and I would say directionally correct. Generally there is more than one way to do something, and when you have the clarity in terms of values, purpose and goals, those decisions usually will be directionally correct.”
Share as you go
Despite working in health care, McCorkle doesn’t believe in the saying “no news is good news.” Rather than being confined to his office as a CEO, he knows it’s important that the engagement and participation of his people is matched by his own willingness to share what he knows.
“I’m convinced that people love to handle good news, they can handle bad news, but it’s really hard to handle no news,” he says. “So [it was] giving feedback on my learnings as I was going, or maybe even saying, ‘This is what I sense. Could you please help me understand it from your perspective?’ There were many ‘ahas’ in that process.
“You might go into one group and you have a position leader and you might have someone that’s a secretary in the same group pulling oars in the same direction. I also believe it’s important not to hunker down in the CEO’s office, but to get out in the organization — talk to people. I try to allow time in my schedule when I do that rounding that I can stop and engage in discussion, see how people are doing, because it’s those personal relationships that I know are critical to forming the culture of the organization.”
As the head of the organization, you have a bird’s eye view of how different areas and teams operate. So the more you learn about what makes each these areas unique, the more you can find ways to bring out their commonalties. Building a two-way dialogue between you and your team can help you identify commonalities and partnership opportunities together that you wouldn’t see just sitting behind a desk. Armed with that knowledge, you’ll be able to connect people in a plan that suits the organization’s best interests.
“I think every day you can look back and say, ‘What did I learn from that?’” McCorkle says. “And it brings fruit to bear. So if I’m working with a group of talented people I might say, ‘Let me share some scar tissue with you. This is something I’ve learned and you may want to consider it as you are forging and architecting this plan.’ That’s maybe something I can bring to the table given my tenure in health care. But there are many ways to accomplish the goal. It’s not Vince’s way that’s important.
“I believe that it is through relationships that we all reach our fullest potential. I am committed to lifelong learning. You can’t have an attitude that because you have a title and a role, you know everything. It’s really valuing people and walking the talk in terms of authentically letting them see you value them and value their insights. It tends to be very, very energizing for me and I think very energizing for the people serving in the organization.”
How to reach: Akron General Health System, (330) 344-6000 or www.akrongeneral.org

The McCorkle File

Vince McCorkle
CEO
Akron General Health System

Born: Wilmington, Del.
Education: Bachelor of arts degree, St. Joseph’s University in Philadelphia; MBA and master of health and medical service administration, Widener University in Chester, Pa.
McCorkle on making mistakes: If I make a mistake, I think it’s inherently important that I say, ‘I made that decision, and if I had to do it over again, I would make a different decision because X, Y or Z. They always say hindsight’s 20/20 and maybe my rationale for making that decision then was because of X, Y or Z, and either we couldn’t foresee this or I should have done more homework.’ People will respond to that … because we’re human, and we’re not perfect and we’re going to make mistakes. Try to minimize them and move forward. I had a meeting just yesterday with a major consulting firm, and they were coming in and they had made a mistake, and they were there to apologize and, quite frankly, hopefully not lose the account. I had to stop and say, ‘OK, thank you, but let’s not look backward. Time is too important. We’re going to concentrate on the future.’ And they said thank you, and they were immediately energized. I think rather than play defense, they are going to move rapidly forward and help us.
On setting goals: You have to set bodacious goals to say this is where we aspire to be. If we don’t set those bodacious goals, we have no chance of getting to them. If we make a step backward or we make a mistake, it’s not to finger point and assign blame, but to say, ‘What can we glean from this as learnings and how can we minimize the chance that this is going to happen again?’ It’s in that spirit, we’re all in this together. We’re a team and we’re looking to improve having personal mastery but also mastery in terms of the clinical and total system of care that we provide to patients and their families.