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Michael Carrese (Host): Explaining the why is one of the core strategies Chad Grant uses to lead change as regional CEO of the central regions for McLaren Healthcare. I'm Michael Carrese and in this addition of McLaren Leadership podcast, we’ll explore other key approaches he’s taken in his roles as CEO of McLaren Oakland and now McLaren Flint to manage constant change in a way that leads to higher quality care.

Chad Grant, FACHE ( Guest):  You know, first off healthcare overall is undergoing significant changes. Over the years and the constant pressures, the change from a fee for service model to a pay per value model, I mean there's almost a daily focus on healthcare costs, and it can sometimes be overwhelming. Bottom line, it’s an industry of extreme transformation. So with this transformation, having a change in a CEO or an executive leader is also pretty significant. It’s is impactful. The CEO is responsible for, I'm my opinion, really setting the vision, setting the direction. These changes with healthcare and the changes in leadership vision, it’s potential to be disruptive. I try to focus really on the culture. I try to focus on culture.

My main role is I play to the strengths of the organization. I have a way that I do things. We take a look at an organization—a hospital in this particular care—we play to the strengths. What works well. I try to leverage the culture focusing on results. At McLaren Oakland, we focused on our strengths. We expanded to the north. We played to the strengths of the organization from the main trauma center in Oakland County, northern Oakland County there. We improved our access and our quality for our community. It was very impactful, very beneficial. It helped drive some of the success we saw at McLaren Oakland.

At McLaren Flint, again, played to the strengths. Played to the things that we do well. We have a lot of expertise. There's a lot of experience of physicians and staff in some of the real key areas here at McLaren Flint—cardiology, cardiovascular, surgery, our cancer program. We play to those strengths. We really leverage the things that we do well to really benefit the overall community. The bottom line, really, has been that both hospitals prosper. Most important, the quality score cards improved. So the access to care improved for our patients. When you do a good job and physicians are happy, patients are happy, the community’s happy then everything’s easier. The financials get better. When the financials get better, we can invest more dollars, hire more people, and continue to improve the experience and the outcomes.

Host:  So the kind of change will change, right. Sometimes in policy reimbursement, this big shift of value based care. The underlying principles of how you managed change seems to me as a leader that what you gotta focus on. You talked about playing to strengths. Are there other sort of principles of managing change, whatever it may be, that you want to talk about?

Chad:  The most important thing is focusing on culture. I've read culture to find multiple different ways. The one I like the best is what do people do when no one’s looking, right? That’s culture. What's the culture of the organization? So playing to the strengths is really a strategic approach to take, but really focusing on the culture. Ensuring that we really explain the why. Because I think when we ask people to do things, it’s helpful to know why so that it’s not just an order. It’s not just a directive. There's a leveraging of the passion within healthcare workers to really go down that road. So I really try to focus on culture, which is really involving our people whether it’s physicians, our employees, or our community board members into some of those decisions we make as an organization. It’s a people business. I say this all the time. We’ve really got to leverage our people to accomplish the things we’re trying to accomplish.

Host:  Sure. So with any changes, you know, there’s going to be resistance or may be resistance at management level all the way down to frontline level. What are some of the tactics or concepts that you use to help move team members past resistance or uncertainty about change?

Chad:  No matter who we are, change is difficult. In an ideal world and we didn’t have the significant pressures on healthcare, we wouldn’t have to do some of the things that we do from a change perspective. I go back to really trying to leverage a couple of things. One is the explanation of the why. I try to go above and beyond to explain why we’re doing things so that my team members understand that it’s not just me making decisions in a vacuum. There’s a data driven approach or there's a reason or there's a best practice. There's something that’s driving the need for us to implement and do something different. After we explain the why and we create the basis for some of the decisions, I like to put in processes. I talk about creating a structure and then holding each other accountable. So I focus on explaining the why, creating a structure for people to be successful, and then double checking ourselves and holding ourselves accountable. That’s pretty much the secret sauce to how I go about helping manage through the resistance of change.

Host:  How do you determine how hard to push on things?

Chad:  I think it depends on the situation. I really like diversity of opinion. I think it’s good. We all look at things from different angles. I'm a very analytical data driven person. I do believe that people are inherently good. I do believe that. I think people need to have a compelling vision when we go through difficult change. So when it comes to pushing, if we all agree we’re doing the right thing and we’ve explained the vision, the reason for the change, we’ve allowed appropriate input into the decision, then it comes down to does somebody want to be on the team or do they not. I think there's some initiatives that we focus on that are the right thing to do because they're good for people. Again, we’re a business of people taking care of people. I'm going to push pretty hard on those.

When it comes down to initiatives that maybe are less impactful to the overall business, I might be a little more open, a little more reasonable with timelines. I pretty much operate all the time at a pretty fast pace. I some urgency to initiatives that, for example, improve the quality of care we provide or improve the access. So to those, I'm going to put a high sense of urgency and I'm going to push pretty hard.

Host: So in addition to leading change, you're also affected by it, of course, yourself.  McLaren Healthcare is evolving, has to, to meet all the needs in this complex industry. So how do you keep yourself open to change and being willing to lead it even when it might push you outside of your own personal or professional comfort zone?

Chad:  It’s difficult for the employees that work at the organization. We’re an employee too. CEOs are employees. I have grown a lot over the years. I've been fortunate to have good bosses and good mentors to help me out. I really try to take time. Believe it or not, I do it on my commute to and from work. I do try to think about the day. What's going on at the end of the day. I try to reflect on what occurred. I try to be thoughtful about it. I really do try to leverage the diversity of opinion from both my colleagues and some of the employees that work for me.

So I try to be open minded. If there's a major decision, it’s not that I'm going to get paralyzed by analysis, but sometimes I do want to think things over and reflect and maybe give things a 24 hour rule. I do try to read a lot. I try to see what's going on elsewhere in the healthcare industry. Not that that’s going to change what I do, but I do like to take pieces and parts from other individuals who are successful and kind of put it in my own personal portfolio. For me, it gets back to my own personal principles. I'm data driven. I try to understand the data. I do not live by anecdotes. I do not do that. When I'm open to change, I always try to think to myself, is this the right thing to do? Kind of support it with information or data, or is this just an emotional reaction to something that just is difficult, or I don’t want to do? I try to spend a lot of time reflecting on those decisions when there's change that’s even impacting me.

Host:  So when you really step back, if you had to boil it down and encapsulate all these things you’ve touched on, what would be your bottom line advice to other leaders who are having to navigate frequent change?

Chad:  As I said before, people are inherently good. I think people care what they do in most circumstances. Change is difficult. So if I boil it down, I would say number one, I like to use the phrase play to the strengths. I like to leverage internal differentiators. Change is inevitable. We all know that successful leaders are going to navigate change and find their own ways to be successful during that change. I believe in play to the strengths. Leverage relationships. Those relationships can help provide additional data. They can also help you see a different perspective on things. I believe transparency is key. Explaining the why behind why things are occurring. I constantly try to talk to employees about what's really happening in healthcare. There’s a lot going on.

So it’s important to understand that why so we can connect the passion for what they do with some of the decisions that we make as an organization. Like I said, I really like to back up a decision with data and facts. There's gotta be a reason behind the why, and data and specific examples are key. I like to try to put it in process of accountability and structure. Rules help us achieve the outcomes or achieve the benefit of the change that we’re trying to put in place. So if I had to boil it down, again I really like to play to the strengths. I like to leverage relationships. I like to be transparent and explain the why. I like to establish an accountability process and a structure.

Host:  You’ve been listening to Chad Grant. He’s regional CEO for the central region of McLaren Healthcare. Thanks very much for joining us today.