The Exec: How a CMO Can Succeed in Conflict Management
By Christopher Cheney
Conflict management is part of the skillset of an effective CMO, according to the new CMO of Cleveland Clinic Martin Health.
Chirag Choudhary, MD, MBA, became vice president and CMO of Cleveland Clinic Martin Health in early January. Cleveland Clinic Martin Health is part of Cleveland Clinic‘s Florida market, and it features Martin North Hospital, Martin South Hospital, and Tradition Hospital. Choudhary’s prior leadership experience includes serving as vice president and CMO of Tradition Hospital.
For a CMO, fact-finding is at the heart of conflict management, according to Choudhary.
“In conflict management, a CMO should start with separating the facts from the stories that people have told themselves, which can be subjective and different from the actual facts,” Choudhary says. “When there is a conflict, a CMO should have conversations with all of the parties involved, with the goal of getting down to the core issue.”
Choudhary says the core issues of conflicts at healthcare organizations generally include resources, workflow changes, and perceived inequities in the way things are working.
When there is a conflict over resources, a CMO must understand the business case that defines what resources are needed and how quickly more resources are needed, Choudhary explains.
“Then it becomes the organization’s responsibility to come up with a plan, articulate the plan, and deliver on the plan,” Choudhary says. “A plan to address resource shortages could include hiring more staff or buying a new piece of equipment. You need to be honest and transparent about the process for implementing a plan.”
When there are conflicts over workflow changes, Choudhary says a CMO should understand factors such as what patients need and what patients are saying.
“For example, if patients want extended hours at a clinic, a CMO should be able to articulate why extending hours is important and back up the need for change with data,” Choudhary says. “This approach helps staff members make the leap from the current state to the new state.”
It is crucial for a CMO to have consistency in conflict management, according to Choudhary.
“When a conflict arises, it should not matter who is involved, and the CMO should approach the impacted parties in the same standard manner,” Choudhary says.
To be successful in conflict management, a CMO must establish trust with staff members, Choudhary explains.
“To build trust when there are conflicts, CMOs and other leaders need to be consistent, fair, and transparent, which resonates with people,” Choudhary says.
Expanding medical services
Cleveland Clinic Martin Health has been experiencing population growth in its region, and Choudhary says managing expansion of medical services to accommodate population growth starts with data.
“You need to try to figure out the areas of greatest need and the services that people are looking for,” Choudhary says. “Once you have data on population growth and the service lines that face the most growth, you need to build capacity in the areas that are growing.”
An effective approach to growth includes focusing on specific communities, according to Choudhary.
“If you want to increase access to primary care services, you want to make sure you are growing services in communities that need more access to primary care,” Choudhary says. “You want people to be able to have easy access to new facilities or practices, so they do not have to drive long distances to access care.”
Once the need to expand services has been identified, Choudhary says CMOs and other leaders should focus on three areas: space, people, and optimization.
In terms of space, there is the necessity of identifying facilities where services are going to be expanded or acquiring new facilities, Choudhary says.
In terms of people, a CMO needs to hire the right physicians and the right team members to support those physicians when expanding services. Choudhary explains that this effort will look different for different specialties.
“If you hire a new surgeon, you will need advanced practice providers and nurses to support that surgeon,” Choudhary says. “When you hire new physicians and teams to work with them, you want people to feel supported and to hit the ground running.”
“You want to limit variability from one physician to another, and you want to limit variability from one site of care to another,” Choudhary says. “One optimization strategy in service growth is establishing virtual visits, so patients do not always need to come to an office or hospital.”
Promoting continuous improvement
Choudhary says a CMO can play a pivotal role in promoting continuous improvement.
“Fostering a culture of continuous improvement starts with the caregivers in your organization and whether they feel safe and supported as well as feel they have the resources they need to do their work,” Choudhary says. “In addition, you need caregivers to feel open to suggestions and new ideas, which is something we constantly encourage.”
Choudhary says he has been involved in ongoing efforts to collect suggestions from staff members on improving efficiency.
“We want to know whether we can improve a process from a time perspective, resource perspective, or waste perspective,” Choudhary says.
A CMO should help establish a continuous improvement mindset among staff members, according to Choudhary.
“You need staff members to view continuous improvement as a constant journey,” Choudhary says. “Continuous improvement is rarely about overnight success. You need to make little steps forward that add up to big leaps forward over time.”
Cleveland Clinic encourages continuous improvement throughout the organization with the health system’s Catalyst Grants program.
“Under this program, staff members can get money to support ideas that are good for our patients and good for the organization,” Choudhary says. “These ideas include improving patient safety, improving efficiency, and reducing waste.”
Christopher Cheney is the CMO editor at HealthLeaders.