Bren Manaugh, MSW, LCSW, CPHQ VP, Adult Behavioral Health Center for Health Care Services

 And not usually welcomed; Nobody really looks forward to change except a wet baby…

 …if we think about change as a means to reach our goals rather than as a burden or barrier; It’s all about attitude Change is possible if we have the desire and commitment to make it happen M. Gandhi and will Just do it. Nike

Health Care Reform and other shifts in the environment of health care delivery present a radical paradigm shift for community mental health care. Is your organization the Roadrunner or the Coyote?

“Hope” is not a plan “Soon” is not a timeline

 IOM Report Dimensions for Improvement:  Safe – as safe in health care as in our homes  Effective – matching care to science; avoiding overuse of ineffective care and underuse of effective care  Patient-centered – honoring the individual, and respecting choice  Timely – less waiting for both patients and those who give care  Efficient – reducing waste  Equitable – closing racial and ethnic gaps in health status

 better care for individuals,  The Patient Experience  better health for populations,  Effectiveness  and lower growth in expenditures for Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) beneficiaries  Efficiency

 CHCS Reorganization: Flattened organization structure  Culture Change – Impact of, and on, Systems and People  “Strengths-based”  Empathy, Empowerment and Accountability  Transformational Leadership  CQI Environment

“Flat” Organization  Very few, or no, layers of management between direct line staff and CEO  Managers empowered to set goals and make decisions, in alignment with agency goals  CEO provides feedback and direction as needed  Managers acknowledged for both successes and misfires  “Safe” environment for executing decisions and learning from mistakes Surround yourself with the best people you can find, delegate authority, and don't interfere. Ronald Reagan

 Applying therapeutic and recovery strengths and skills to management:  Emotional intelligence  “Strengths-based” and treating staff and colleagues with empathy while holding them accountable for high levels of performance  Collaborative leadership (Transformational)  The Southwest Airlines Way: Relational Coordination

 Frequent, timely problem-solving communication carried out through relationships of:  Shared Goals  Shared Knowledge  Mutual Respect  Both increased quality AND increased efficiency  Key to High Performance: Build and sustain relationships among the organization’s key participants

 Manager ≠ Leader  Position = Title ≠ Respect  Leadership is a process through which one individual influences a group of individuals to achieve a common goal  Transformational leadership achieves this while changing and transforming individuals (Northouse, 2001). “A good leader inspires others with confidence in him; a great leader inspires them with confidence in themselves.” Unknown

Transformational Leaders  Start with vision and build up with trust, passion, integrity and commitment; model personal accountability and ideals  Inspire others to change expectations, perceptions and motivations to work toward common goals  People-oriented: balanced focus between actions and impact on people  Are positive change agents  Build other leaders! If your actions inspire others to dream more, learn more, do more and become more, you are a leader. John Quincy Adams

The “4 I’s” of Transformational Leadership  Idealized Influence: role model; “walks the talk”; can be relied on to do the right thing; persistent; doesn’t play it safe  Inspirational Motivation: inspires and motivates; provides meaning to work; creates an atmosphere of commitment to goals and shared vision; enthusiastic and optimistic  Individualized Consideration: demonstrates genuine concern for the needs and feelings of people; mentors and coaches; constantly challenge people to higher levels of performance; authentic listening – 2 way communication  Intellectual Stimulation: challenges people to be innovative and creative; creates a safe forum and climate for exploration and contributions

 Personal Accountability: A personal choice to rise above one’s circumstances and demonstrate the ownership necessary for achieving desired results – to See It, Own It, Solve It and Do It. Connors, Smith and Hickman, The Oz Principle

 4 Steps to Accountability  See It – Acknowledge the Problem  Own It – Take Responsibility for It  Solve It – Determine What I Can Do  Do It – Take Action

 Above the Line:  See It, Own It, Solve It, Do It  Below the Line: The Blame Game

 Holding People Accountable the Oz Principle Way  Define the Result  Determine time to report on progress  Deliver praise or coaching

Build and Operate in a CQI Culture I haven't failed. I've found 10,000 ways that don't work. Thomas Edison

Even if you’re on the right track, you’ll get run over if you just sit there. Will Rogers