The second Tuesday of each month, practice managers and healthcare industry service providers gather at KraftCPAs headquarters for the monthly Nashville Medical Group Management Association (NMGMA) meeting.

April's program, "Swimming with the Hippos," utilized an interactive case study to spark discussion on the process to create and sustain meaningful change. Mark Kenny, president of Franklin-based Hippo Solutions, founded the company in 2012 using an evidence-based problem-solving program to address business change, patient experience, employee retention and engagement, ownership transitions, and project implementation.

The interactive case study presented at the NMGMA gathering focused on a meeting between a quality management officer and a practice improvement manager to discuss process change in the aftermath of an adverse patient event. The audience was broken into smaller groups to answer a number of open-ended questions after watching short video clips of interactions between the actors. The larger audience also participated in facilitated discussions led by Kenny.

He asked, "How can we make great organizational change happen?" The answer: "We can't."

Too often, he continued, leaders believe they have to put change on their shoulders and carry it through. However, he noted, it is exceedingly rare to find a person able to get others aligned around values and create a culture shift that is not only great but sustainable all on their own. With the most effective leaders, Kenny continued, "They don't think about getting people behind them. They think about getting behind their people."

Kenny noted with any project or change movement, an organization needs to consider structure, tools, processes and people ... with people being the key element to change that is real and enduring.

Discovery is the first step in the process continuum, which he stressed is iterative ... rather than linear ... in nature. On the front end, Kenny said it is important to collect quantitative and qualitative data. Creating a baseline allows organizations to track improvement and sustainability over time.

It's also important to identify your 'hippos' at this stage. The hippos represent both obstacles to change and opportunities. Attacking hippos are the overt issues in an organization that take time and attention. Territorial hippos hold tight to a belief or process and won't budge out of fear of change. "The third type of hippo is the most dangerous one of all, and that's the lurking hippo," he said. The lurking hippo hides under the water and represents what is not being said.

Create is step two as an organization comes together to craft a different future. It's the part of the process where the lurking hippos must come to light through honest dialogue. Kenny noted the interactive case studies and videos help facilitate those types of conversations.

The third step is to sustain what has been created. "Whatever your performance challenges, we want outcomes," Kenny said, noting outcomes are driven by behaviors. "Sometimes we try to modify behaviors, and it works for awhile, but it's often not sustainable because behaviors are driven by mindsets."

Mindsets have to shift in order to get sustainable results. "If we can transform mindsets, then we can get great organizational change."

For information on upcoming NMGMA events or to learn more about the association, go online to nmgma.com.

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