Meeting Challenges Head On: Simplifying the Complicated — In Conversation with Sherie Hickman

Image from Unsplash by Olav Ahrens Røtne

For business executives and board members, unanticipated challenges often go with the territory of leadership. What is the best approach to navigating the changing currents — and getting through troubled waters successfully?

We’re in conversation with Sherie Hickman, a highly experienced thought partner, sustainable change steward, and results-driven, inclusive leader who consistently takes a structured approach to overcoming complex challenges.

Sherie, you’re known for your ability to pilot through the unexpected and implement huge changes with ease. What is your approach?

It begins with understanding why unexpected events, and even planned changes, can wreak so much havoc. Typically, they bring with them the need for a shift in people, processes, and culture, all of which have been programmed to go a certain way but — in the face of disruption — will need to be reassessed and redirected.

What’s important from my experience is to listen to and integrate all voices before implementing a significant change. If people understand the organization’s mission and purpose, and you line up, in simple terms, why a complex change is needed to achieve mission and fulfill purpose, you can move everyone forward, synthesize their varied perspectives, and focus on the collective solution — one issue at a time.

Can you offer us an example of how you’ve successfully used this approach in your work?

Several years ago, I was faced with a major challenge. Younger surgeons were complaining about inefficiencies in our hospital’s operating room (OR). They were unable to use block scheduling — a process by which surgeons are given predictable time blocks, usually half days or full days, so they can manage their schedules more efficiently.

The younger surgeons felt the process for obtaining blocks wasn’t transparent. We had a few ‘old-guard’ doctors who’d had block time for many years. Whether they were using the system 10 percent or 100 percent, they didn’t want any changes to it.

To meet this issue head on, I brought together a problem-solving group, including the OR director and a number of surgeons, some older, some younger; some longstanding and some new to our hospital. I said, ‘Let’s just talk about what’s working and what’s not working.’ As a group, we identified what everyone could agree on as being significant issues, for example, block utilization was inefficient and the process for getting blocks was unclear.

From there, we formed what we called an ‘OR governance committee.’ We pulled together surgeons from all the disciplines, as well as anesthesia. I co-led the committee with a surgeon who was considered not only an informal leader but also highly objective. After some difficult conversations, bringing in best-practice literature and talking through how other hospitals handle OR scheduling, we put in place block utilization criteria that everyone agreed were objective and fair.

When we started discussions, we were at 40 percent block utilization efficiency. Most ORs define efficiency at 75 percent or better; we set 65 percent as our goal and agreed on a three-month timeframe to meet that target.

Then, after three months, if we did not see a change, we had objective data to move through iterative conversations and set individual and collective goals for improved efficiency. At the end of the process, we improved block utilization significantly and had a strong, objective governance group to oversee not only block allocations but also new service lines and equipment purchases.

How did the surgeons react to these changes? Were they skeptical? Were they welcoming?

Some initially were skeptical, believing that this new committee would change their lives and not in a good way.

A transparent process helped allay those doubts. Every month I met with the medical executive committee and updated these leaders on our work. I made sure they were informed also about best practices in the community and how our OR was performing in comparison.

We continued to have an open dialogue with the surgeons. Those who were distrustful came to see that our intentions were well meaning: we wanted to create a better operating room, a better process for our surgeons and staff, and ultimately, a better experience for our patients. Together, we achieved those goals.

Thank you, Sherie, for sharing your perspective with us.

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Sherie Hickman is a positive change agent, strategic thinker, and devoted community leader. Throughout her 25-year career as a health care industry executive, she has taken a structured approach to dealing with challenges and disruption — and designing and executing concrete action steps for enduring improvements.

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