Most every organization wants to grow!! But not all organization do (or are not willing to do) what is necessary to grow!! Where does your organization stand?? Do you know what the “signs and symptoms” are in your organization that lead to a culture that does not support growth?? Every organization has them. In this post we will focus on hospice companies but the solutions suggested here apply to all.

When most hospice organizations stop growing or even loss market share, the first thing they contribute it to are to external forces such as competition, a regulatory or compliance change, or a referral source change of loyalty. While these may contribute to lack of growth, there are a number of internal issues that impact growth that are more organizational culture driven.

Here are a few example:

1. A high Not Taken Under Care (NTUC) rate. And for those referrals being NTUC, weak reasoning for the NTUC.
2. A low 90-day rolling conversion rate. Any referral inquiry to admission 90-day rolling conversion rate below 70% is a BIG sign something is wrong. The same would be true of the conversion rate that was 90% or above as that is just highly unlikely and is a sign the referral inquiry to admission process is being “Gamed”
3. A high revocation rate. This is a sign there may be significant service issues occurring; especially within the first 24-hours of service.
4. Not enough admission staff to complete the needed number of admissions per month to grow! If your program is budgeted for 25 admissions in a month, you need to have the admissions staff available to meet this to complete these admissions.
5. A sales and marketing team that does not provide a pre-call report weekly, an End-of-Day report and a quarterly sales plan. If your sales team is not doing these things, how do you know what is occurring with your referral development efforts?

These are five examples of what I refer to as the “Invisible Velvet Glove On The Spigot of Growth” phenomena! There are many other factors that are invisible that can negatively impact growth.

The first order of business is to identify as many as possible “invisible gloves” and quantify what is occurring; such as with the conversion rate or number of NTUC, etc. This is basically doing a diagnostic assessment on the culture of your organization involving growth.

It is not enough to state, “We need to Grow” or to implement processes that you want your team to follow to achieve growth. Nor is it enough to simply task the individuals and departments responsible for driving growth. It is the behavior, belief, and the establishment of a growth-focused culture that leads to successful growth. By establishing a culture of growth, you will ensure that all members of the organization understand and participate in driving the organization to be on the forefront of innovation and leadership.

Following are some suggestion that can start to change your culture of growth and break-through any barriers.

Top line support. A recent survey of CEOs found that 81% of those surveyed felt that their management team did not fully support or understand the growth strategy their company was implementing. This is an obstacle that organizations from every industry, every company size, and every region are facing. It is a paramount roadblock to sustainable top-line growth.

Plan-Do-Study-Act. All culture change is rooted in continuous process improvement. The PDSA is a fundamental organizational process to follow to work on growth improvement and start a culture change. Once you have identified your “invisible gloves” you rank them in order of importance and go to work. For example, put in place a small group to improve the referral inquiry to admission conversion rate using a PDSA would be a mean and method to start change. Here is a nice link to help you get going.

101 Change Management. For those who remember their change management class, here are 10 key points to create change to build a culture of growth.

• Address the “human side” systematically. Any significant transformation creates “people issues.” New leaders will be asked to step up, jobs will be changed, new skills and capabilities must be developed, and employees will be uncertain and resistant. Dealing with these issues on a reactive, case-by-case basis puts speed, morale, and results at risk. A formal approach for managing change — beginning with the leadership team and then engaging key stakeholders and leaders — should be developed early, and adapted often as change moves through the organization.
• Start at the top. This point was called out above in #1. Because change is inherently unsettling for people at all levels of an organization, when it is on the horizon, all eyes will turn to the CEO and the leadership team for strength, support, and direction. The leaders themselves must embrace the new approaches first, both to challenge and to motivate the rest of the institution.
• Involve every layer. As transformation programs progress from defining strategy and setting targets to design and implementation, they affect different levels of the organization. Change efforts must include plans for identifying leaders within the company and pushing responsibility for design and implementation down, so that change “cascades” through the organization.
• Make the formal case. Individuals are inherently rational and will question to what extent change is needed, whether the company is headed in the right direction, and whether they want to commit personally to making change happen. They will look to the leadership for answers. The articulation of a formal case for change and the creation of a written vision statement are invaluable opportunities to create or compel leadership-team alignment.
• Create ownership. Leaders of large change programs must over perform during the transformation and be the zealots who create a critical mass among the work force in favor of change. This requires more than mere buy-in or passive agreement that the direction of change is acceptable. It demands ownership by leaders willing to accept responsibility for making change happen in all of the areas they influence or control.
• Communicate the message. Too often, change leaders make the mistake of believing that others understand the issues, feel the need to change, and see the new direction as clearly as they do. The best change programs reinforce core messages through regular, timely advice that is both inspirational and practicable.
• Assess the cultural landscape. Successful change programs pick up speed and intensity as they cascade down, making it critically important that leaders understand and account for culture and behaviors at each level of the organization.
• Address culture explicitly. Once the culture is understood, it should be addressed as thoroughly as any other area in a change program. Leaders should be explicit about the culture and underlying behaviors that will best support the new way of doing business, and find opportunities to model and reward those behaviors.
• Prepare for the unexpected. No change program goes completely according to plan. People react in unexpected ways; areas of anticipated resistance fall away, and the external environment shifts. Effectively managing change requires continual reassessment of its impact and the organization’s willingness and ability to adopt the next wave of transformation.
• Speak to the individual. Change is both an institutional journey and a very personal one. People spend many hours each week at work; many think of their colleagues as a second family. Individuals (or teams of individuals) need to know how their work will change, what is expected of them during and after the change program, how they will be measured, and what success or failure will mean for them and those around them.

The Best!!