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Shop Talk with John Gering of HCA Management Services

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John GeringJohn GeringJohn GeringThe challenges of modern healthcare can prove daunting. No less challenging are the talent management needs of large, complex healthcare organizations. HCA Management Services' John Gering knows well the enormity of these challenges. In this conversation, he discusses how HCA Management Services has implemented talent reviews and gained traction with development.

Headquartered in Nashville, Tenn., HCA's Management Services Group is a leading provider of healthcare business and operational services to more than 1,400 hospitals and 11,000 non-acute care providers. The company offers healthcare providers a complete range of industry-leading business solutions, which include group purchasing through HealthTrust Purchasing Group®, supply chain operations, workforce management, revenue cycle operations, and project management. HCA Management Services operates with 30,000 of HCA's 235,000 employees.

Can you describe the major talent challenge you faced in HCA Management Services?

It became obvious that given the significant growth expectations, along with an aging leadership team, a leadership succession and development strategy was essential. HCA had begun the process of using HR analytics to forecast leadership turnover, through retirement, by analyzing tenure and age. They were able to forecast highly predictable outcomes. So, with that as a backdrop, we needed a process.

Our talent management model started with performance management. We undertook performance planning with position-specific performance goals and competencies (technical and behavioral). Then, we engaged in a performance review that specified daily coaching, quarterly assessments, and annual evaluations. Our evaluations start with subordinate self-evaluation, then manager evaluation, followed by face-to-face reconciliation of differences. Both the performance plans and progress reviews are documented in our talent management system (TMS). The TMS produces a nine-box placement based on the managers' overall performance rating and potential assessment. With this data, talent reviews are conducted with the respective peer leadership group to validate and/or change the nine-box placement. Line supervisors through corporate executives are reviewed using this process. As we go forward, we will now be able to slate candidates for advancement positions.

What does the development strategy entail?

We worked with DDI as a partner to develop the strategy. With the lines of business (LOB) champions and under the guidance of DDI consultants we started with understanding the individual LOB strategies and from that we produced the essential business drivers. From the business drivers we were able to determine the critical competencies. With this, our development design could start to be formed. Each competency was assessed with regard to skill gap (small, medium, or large). Then, each competency was given a desired learning level (1-awareness, 2-perform with assistance, 3-perform without assistance, 4-able to teach).

To address the development needs, we now have the HCA Management Services Leadership Institute, which launched in 2014 with the mission to "Develop skilled, competent leaders, at all levels, as measured by their ability to prove direct business impact in terms of Service, People, Finance, Growth, and Quality." The high potentials are determined from their positions in the nine-box and are selected to be part of a special cohort group.

What do those high potentials experience when they enter into the HCA Management Services Leadership Institute?

We want it to be viewed as recognition of their ability to become future LOB leaders. It's a noteworthy "club." You should feel honored to be a part of it, so we publicize it that way. And we make it a valuable experience for them.

The institute received very high marks. Nashville is a city people look forward to visiting. We conduct our sessions in desirable hotels. But most important is the content of the learning. We have two tracks, strategic and operational, pairing DDI senior consultants with senior leaders from the individual LOBs. This provides the participants with exposure to the learning concepts, through the DDI consultant, and the HCA leader there takes the learning to practical application.

When learners understand the process we go through to get to this particular point they're very impressed that we're not just randomly picking courses. We're not into making courses and development synonymous. We're in the business of competency development and this is how we're going to do it.

I look at the leadership institute for high potentials, and other development programs under the leadership institute umbrella as corporate development or group development, while at the same time every one of our leaders has an individual development plan. When we look at individual development at all of our locations it takes many different forms. It could be job-shadowing or cross-functional experiences. It also could be mentorship or executive coaching. All options are in play.

How successful have you been at identifying those high potentials to be developed?

Our first year, we selected 90 for the high-potential cohort group, and we can say that 95 percent of them proved to be high-caliber candidates, and many are already advancing in their careers. This year we have selected 60 and we feel very confident about our ability to produce our next generation of high-quality leaders.

When they enter the institute, how long does that journey last?

We are now thinking in terms of three-year plans. I was struck by data I saw in a DDI consultant presentation that showed participants recall only 21 percent of the learning in the first 31 days following a course. To combat that forgetting curve we intend to continue with refreshers of learned content, while adding additional content along the way. We will perform a number of measurement actions along the way, too, such as measuring their satisfaction at the time of learning, measuring the applicability 90 days out from the learning, and surveying their managers regarding their view of direct business impact as a result of the learning.

What advice would you give an organization looking to implement a talent management and development initiative like you've put in place at HCA Management Services?

First of all, it can't be a human resources initiative, or an organizational development initiative, or an organizational effectiveness initiative. It has to be presented as an operational necessity. It must be bought into by, launched by, and "owned" by business operations. That's also where the accountability must lie, not in the human resources department or the talent function. We're not doing this because HR thinks it's a good idea. We're not doing this because organizational effectiveness people say it's a good idea. We're doing this because you, as an operational entity, need to understand that this is for your benefit. There's no benefit to us, the benefit is all yours so you have to own it. So that operational partnership is critical.

One of the things that helped us is that we had high-level leaders involved, including LOB regional CEOs and COOs. We facilitated all of their input into a process that had meaning to them and that they could understand. As I mentioned earlier, we also involved them as co-facilitators in the institute along with the DDI consultants. And as we go along, making decisions, they're the ones that are requiring the talent reviews, they're the ones who will choose the high potentials, and they're the ones that are going to advance these people. So we want to keep them heavily engaged.

Any other advice?

I would say that the net you cast to capture buy-in can never be too narrow or too small. You really have to keep that net expanded and make sure to continue to revalidate, maintain buy-in, make sure you're continuing to hit the mark and prove your value every day. That's why analytics are so important. Don't assume that you're still connected. You need to demonstrate back to those leaders that you are creating value and here's the data that says we're on the right track. Don't ever take anything for granted. You've got to manage that part of the business all the time.


Talk to an Expert: Shop Talk with John Gering of HCA Management Services

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