Intro: The following SHSMD Podcast is a production of DoctorPodcasting.com.

Bill Klaproth (Host): On this edition of the SHSMD Podcast, we're talking about how health systems can move from complexity to clarity when it comes to service line performance. We're going to discuss the role of a service line management office and how standardized processes can help align priorities across departments and the tools and frameworks and skills needed to support stronger service line strategy and growth.

Joining me are Michael Parsons, Senior Administrator, Service Line Strategic Operations; and Stephanie Jackson, Vice President of Service Lines, both from Tampa General Hospital. Michael and Stephanie are participating in a new SHSMD course called Driving Service Line Growth: Strategy, Structure, and Activation. More on that coming up and how to sign up. But let's get to Michael and Stephanie right now.

This is the SHSMD Podcast, Rapid Insights for Healthcare Strategy Professionals in Planning, Business Development, Marketing, Communications, and Public Relations. I'm your host, Bill Klaproth. Stephanie and Michael, welcome.

Stephanie Jackson: Thanks, Bill. We're excited to be here.

Michael Parsons: Yes, Bill. Thank you so much

Host: Yeah, this is so great. Happy to talk to you both. So, let's jump into this. Stephanie, let's start with you. So, your session is called From Complexity to Clarity: The Service Line Management Office's Role in Optimizing Service Line Performance. So many organizations have service lines, but not all have a formal service line management office.

What problem does an—we're going to call it an SLMO, service line management office—solve, and why are more health systems moving in that direction?

Stephanie Jackson: That's a really great question, Bill. And I think in order for the audience to understand the problem that SLMO, service line management office, solves, I think they need to understand how Tampa General has evolved over the last several years.

So, if you go back 10 years, Tampa General was primarily a single hospital on an island supported by a very limited ambulatory footprint. Today, we're a health system. We have community hospitals to our north. We have specialty hospitals inclusive of rehabilitation and behavioral health. We also have a growing imaging and urgent care footprint, as well as an extensive physician enterprise aligned to our hospital. At the same time, our clinical programs have become significantly more sophisticated.

In 2019, we had eight service lines, and today we've expanded to nearly 30 institutes, service lines, and specialized programs. Each one of them has been intentionally designed with the authority and autonomy to drive their own growth, to improve quality, and manage the success of their business. Quite frankly, that autonomy has been the reason why service lines have been so successful at Tampa General.

But as we've grown, it's brought on a new challenge for us. When you have dozens of high-performing teams moving very quickly and independently, there still has to be that mechanism to ensure everyone is moving in the same direction. There has to be alignment around strategic priorities, performance expectations, and objectives across the health system.

So, that's the problem that Service Line Management Office was created to solve. It doesn't exist to remove that authority from service lines, it exists to connect them. It provides the structure, the operating framework that allows independent service lines to work together towards a common set of organizational goals.

It helps ensure that the growth within one area or service line supports that broader system strategy. It also enables best practices to be shared and ensures that resources are prioritized appropriately. The management office creates alignment across our growing and increasingly complex health system. And this is very, very unique to Tampa General, and I hope that health systems listening in can model after our success.

Host: This is really interesting. You went from eight service lines to 30 institute service lines. That's a lot of growth. And I could see where you would need to have consistency along all of the service lines. As you said, the slo-mo, as you call it, provides structure and framework and support the broader system strategies. And you said each service line has the autonomy to drive their own growth. Does that mean they each have their own marketing budgets too? Is that how that works?

Stephanie Jackson: Oh, yeah. So in essence, each service line has their own strategic plan, their own business plans to support that strategic plan. And a lot of the work that Michael Parsons and his team in the service line management office are going to do will help drive and further align all of the components across those 30 institutes.

Host: So, speaking of Michael, thank you, Stephanie. Michael, let's bring you in on this. So, service line leaders often juggle competing priorities across departments, as you know. So, what are some of the biggest operational challenges that you see, and how can standardized processes help reduce that complexity?

Michael Parsons: Well, service line leaders are expected to deliver results across quality initiatives, smart growth, strategic growth, access, meaning access to care, finance, looking at our operating expenses, physician alignments, ensuring that our physicians and the rest of our providers within our health systems are aligned, and then shared services. These are all of the partners that function within a health system. We all are collectively working together, and the service line leaders are expected to deliver results.

But of course, this complexity increases when ownership and decision rights are unclear. And what I mean by that is I'll use Tampa General Hospital as an example TGH multi-hospital health system, we continue to evolve, we continue to become more complex. But with these service line leaders, they have to balance all of these areas while maintaining that ownership and accountability and those decision rights.

Now, the standardization is truly meant to reduce that friction and improve execution. So, standardization is not about creating more processes. I'll be the first to admit I, love to over-engineer. I love to create more frameworks just because I can create more frameworks, if you will. But standardization is not about creating more and more and more processes or frameworks. They're intended to ensure that everyone is moving in the same direction toward that vision and strategic priorities. So again, these operational challenges that we face and what we have to deliver, ultimately, that standardization helps bring everyone together, reduce any type of nuance, or I should say reduce quite a few nuances, and improve that execution across the health system.

Host: So, it's there just to help, again, provide a framework or guidelines for the different service lines to make it easier for them to achieve what they want to achieve under the full brand umbrella of TGH. Would that be right?

Michael Parsons: Yes. That is right. Yeah, you got it.

Host: Yeah, yeah. Wow, I'm loving this. So, Michael, I know you're the framework guy. You said it. You love frameworks. I love it. That's fantastic. So, I know that you've developed, practical tools and frameworks to support service line performance. I'm wondering if you could give us maybe an example of a change or a resource that made a meaningful difference for the organization.

Michael Parsons: I'd like to say it's our service partnership agreements. This is the first example that comes to mind. Now, what is a service partnership agreement? It is kind of an internal document that the service lines together collectively. So, that's a huge differentiator. It's not one service line, it's all of them collectively have an agreement with a partner in the health system. It could be the division of advanced practice. It could be the hospital system foundation. It could be business intelligence. It could be the Office of Clinical Research. Again, all of these different partners we collectively rely on and partner with to advance our health system, to advance healthcare, to provide care to our patients, and to work together.

So, the service partnership agreement clarifies expectations, accountability, and ownership. And it's not service lines to the partner. It is a collaborative approach between service lines and that partner. And the way that I've approached it, if you will, as a third party between service lines and that partner, is this is meant to be a partnership, not a one-way street. This is mutual, and we come to the table together to identify mutual key performance indicators, mutual actions that we can together achieve and move our mission and our shared purpose forward. So, the service partnership agreement is that primary example.

One of the most valuable things an organization can create is clarity, and the most valuable tools are not meant to complicate that clarity. They are the ones that create the clarity and help the teams move in the same direction. So, this service partnership agreement is not meant to complicate an already complex system. It's meant to create that clarity.

Host: So even though each service line has their own autonomy, it sounds like you're in there working with each service line. So, they're certainly not on an island, but there's somebody with them like you helping them with what they need to do within the frameworks that have been created.

Michael Parsons: Yes, 100%. I feel like I am a mediator, if you will, the frameworks guy, the one who goes in the front and says, "Okay, everybody, let's dance together. Let's do this dance. We may all have our own dance moves, but we're all going to dance to the same song. So, let's do this together."

Host: That's great. The service partnership agreement you call it.

Michael Parsons: Yes.

Host: Yeah, that's good. So, Stephanie, when organizations try to improve service line performance, and we know this is true, sometimes they get stuck. There's a lot of landmines and hoops and objections and things. What advice would you give someone who's just getting started and maybe wanting to adopt what you're doing at TGH?

Stephanie Jackson: So, I've presented the service line management office concept and Tampa General service line model at several national forums. And the question that we get most often after we've presented is: How do you get that buy-in and alignment in your institution around the service line model? And I feel like that's where a lot of organizations get stuck.

I'm going to use an analogy. Michael and I are big on analogies, you already heard one from him, but I'm going to compare it to captaining a ship. So if you're standing at the helm and you're simultaneously trying to convince the crew that where you're going is the right destination to head towards, you're not going to move very fast because every decision requires debate. Every course correction requires buy-in from the team. It slows down progress. At Tampa General, we've largely solved that challenge because our leadership team is completely bought into the service line concept. Whether you're frontline management or you're C-suite, we all believe and are bought into that service line model, and that commitment starts from the very top.

So, our CEO has established very clear expectations around accountability, ownership, and decision-making, all be through the service lines. In fact, physicians frequently will approach our executive team requesting service line status because they see that value and success that the model has created. As a result, we're not spending time debating where we're going. We all understand the destination. So the role of SLMO, or the service line management office, is to make sure that as that organization grows, all of the boats are rowing in the same direction. That's important because it allows us to move faster, stay aligned, and execute more effectively as a health system. If you can get that buy-in out of the gate, it will make that journey much less complicated.

Host: So kind of stay in your own lane, but row as fast as you can.

Stephanie Jackson: Right. Exactly. What are our priorities? We're in this together. Let's row towards the same institutional goals, and make those institutional goals very clear so that everyone can execute on them.

Host: Okay. So, let's move to this then. For someone who wants to strengthen service line strategy over the next year, what skills or capabilities do you think will be most important to develop? Stephanie, let's start with you

Stephanie Jackson: So, I'm going to start from the service line management office lens. I want to talk about how we kind of evolved and how our focus has shifted. So when we started this journey two years ago, our focus was around alignment, education, and resourcing. We were building that foundation and helping leaders understand the model, creating that consistency across service lines that we were trying to achieve, and also providing support for success.

As we look into the next phase of that management office, what we're going to strengthen in the coming year and the capabilities that we're going to focus on, it's going to be accountability and execution. Service line management office is evolving from more of a supportive function into a performance enablement function.

Our role will be to create the framework, data, and tools which Michael Parsons already gave you all one great tool to achieve institutional goals. Success will be measured on how well and effective we are at executing those goals. And that means providing leaders with clear performance expectations, actionable data, that's a really important one, and a repeatable framework, which is Michael Parsons' speciality that can be scaled across the system.

Rather than solving challenges at the service line level, we're going to create system-level capabilities that will allow every institute, program, and service line to execute at a higher level. And I encourage teams listening in to solidify those systems upfront so you can focus on the things that matter in the coming year.

Michael Parsons: Nail on the head right there, Stephanie. Thank you so much. What comes to mind for me for this next year is to continue to work towards, if not an understanding of the finances, but having a full grasp of the service line finances or finances that influence it. She mentioned data. She mentioned we function in our service line management office. We have a very brilliant team member. His name is Andrew Garrett, and he's helping us with our analytics and artificial intelligence. I'm sure everyone who's listening to this podcast right now is, "Oh, no, here comes another speech about analytics and artificial intelligence." If anything, all I would say is making the data actionable and leveraging artificial intelligence to make those informed decisions.

Next is change management. I live and eat and breathe through the grace that's been given to me, change management. I'm always influencing all of our service lines, not the eight from the very beginning, but the 30 that exist to make some changes. If they're not big, they're small, but they're incremental changes that ultimately lead to some pretty vast progression.

And then, lastly, translating strategy into execution. I mean, prior to my current role right now, my role was to help turn strategy into execution for the two service lines that I helped support, which were our Women's Institute and our Muma Children's Hospital. And what a wild ride in the best way. It was a phenomenal experience to be the person to move strategy to execution. So now, in the service line management office, through all of the tools, through all the resources, through the function of the service line management office, we're able to influence translating strategy and execution.

And I'll leave you with this. The role of the service line management office does not exist to create more process. It exists to help the health system turn purpose into action and vision into results.

Host: I like that. Everybody should grab their phone and tweet that out. That's really good. Really great thoughts. And the great part about this is you two are part of a new course, a SHSMD course called Driving Service Line Growth: Strategy, Structure, and Activation.

So if you want to learn more about this, all the great things that Michael and Stephanie talked about, please make sure you sign up for that course. I like what you both had to say here. You were striving for consistency, obviously success, but moving to accountability and execution. So, that execution part is really a big thing, as Michael was saying. You're trying to translate strategy into execution.

Michael also talked about everybody really having a full grasp of the service line, data, analytics, and AI, and of course, change management, which Michael, we know you're passionate about. That's very clear.

Michael Parsons: Yes, Bill.

Host: I you said you live and breathe change management. I love it.

Michael Parsons: That's my world. Yes, sir. I'm here if anybody needs me.

Host: Good stuff. Well, again, this is going to be a great course. We're so happy that you two are part of it, and I know you're going to really deliver a lot of great information and education for people. Michael and Stephanie, thank you so much for your time today. This has been great.

Stephanie Jackson: Thanks, Bill.

Michael Parsons: Thank you, Bill. It's been a pleasure.

Host: Absolutely. Once again, that is Michael Parsons and Stephanie Jackson from Tampa General Hospital. And if you liked what Michael and Stephanie had to say, and how could you not? If you want to dive deeper into this topic, as I was mentioning, just go to shsmd.org/education and look for the new course, Driving Service Line Growth: Strategy, Structure, and Activation. Make sure you sign up for it. You're definitely going to learn a lot.

And please make sure you share this podcast on your social channels, and please hit the subscribe or follow button to get every episode. And to access our full podcast library for other topics of interest to you, visit shsmd.org/podcasts. This has been a production of Doctor Podcasting. I'm Bill Klaproth. See ya!