|  Scott Regan

Does your hospital’s brand have defined values — brand attributes — that drive your brand promise? Are brand values even necessary? Do they make a difference?

The short answer to both questions: Yes and yes.

Consider two hospitals, each anchoring itself to a brand platform of customer service. The first hospital identifies its brand values as excellence, compassion, and respect. The second hospital, meanwhile, defines its customer service experience around the values of responsiveness, accountability, and accessibility.

If each hospital operationalizes a brand experience and articulates a brand promise based on their respective brand values, then each will offer a unique experience that is distinctly different from the other — even though both hospitals are building their brands around a customer service theme.

The benefits of knowing your brand values are multi-fold.

First, it richly defines your brand promise, allowing your organization to inculcate those values into the organization — from back-office processes such as recruitment and retention to front-line process such as patient care.

Second, it provides your organization with a touchstone for making decisions. By asking the question, does this decision erode our brand values or strengthen them, you are assured of charting a much truer course.

And third, it gives you something to measure against. You want to “own” your brand values in the marketplace, and if your values are clearly defined, then it is relatively easy to determine if you do. For the hospital whose brand values are excellence, compassion, and respect, questions regarding these values can be included on patient, employee, and physician satisfaction surveys. Consumer preference surveys can ask, “When I say the word compassion, what is the first hospital that comes to mind?” Through these methods, you can actually quantify the strength of your brand.

And knowing the strength of your brand allows you to make it even stronger. After all, you can’t manage what you can’t measure. Having defined brand values allows you to do both.

Recently, I was working with an organization to craft a mission statement. How long should the mission statement be, the CEO asked?

My reply: Short enough to put it on a bumper sticker.

He looked at me quizzically. The CEO had an engineering background, and I sensed that he was looking for something more specific.

Eight words, I told him. I’ll give you eight words.

Some strategists may consider my advice somewhat draconian. Eight words? What can you possibly say in eight words?

The answer: Plenty.

When it comes to mission statements, short is always better than long. It is those rambling mission statements that drone on for paragraphs that become meaningless, as the essence of the organization is buried amongst so much rhetorical garbage.

Limit yourself to eight words, however, and you have to focus on the very core of what your organization stands for. With eight words, there is no time to expound on the 17 reasons why your organization exists. There is no room for every board member, committee chair, and executive with “chief” in their title to have their own contributory sentence. There are no comprises, no literary flatulence, and no hyperbole.

With eight words, you are forced to strip off all the excess layers and define what your organization really is.

Here are two of my favorite healthcare mission statements:

• We help people feel better (Memorial Health, Savannah, Georgia)
• We enhance life (LibertyHealth, Jersey City, NJ)

Imagine … two mission statements of five and three words each that not only are memorable, but also resonate within their respective communities and define what each hospital does. Walk around those facilities, and it becomes clear that each medical center truly lives its mission and that each employee deeply understands the impact his or her individual performance has on the mission itself.

Interestingly, for each of these organizations, the mission became the brand. Memorial Health’s branding efforts were anchored by the words “feel better” from 1999 to 2007. And LibertyHealth has been branding itself on the mantra of “enhancing life” since 2008. But that’s what happens when the mission is so clear; the mission becomes the brand, and the brand becomes the mission.

All by being able to reduce the mission statement down to the size of a bumper sticker.

The Achilles heal for most hospital brands these days is the fact that they are built upon statistics. The two most common brand platforms – customer service and clinical outcomes – are often reliant on patient satisfaction scores, core measure data, Healthgrades rankings, and the like. And why not? Objective, third-party data is always better than hollow claims of superiority.

But what happens when the market shifts? What is the impact to your brand when patient satisfaction falls, or the competition’s scores surpass your own? Where do you turn when your brand – based on clinical outcomes and medical staff performance – is suddenly under attack because of a headline-raising event?

These are issues faced by every company that built its brand around celebrity endorsements. Pepsi-Cola with Michael Jackson. Hertz with OJ. Kmart with Martha Stewart. And, most recently, Accenture, Nike, Gillette, and Gatorade with Tiger.

And they will eventually be issues faced by every hospital built around market data. At some point, the market changes, and your brand has to high-tail it out of town.

So how do you prevent this likely brand demise?

Simple. Build a brand that transcends market forces.

Sounds mystical, doesn’t it? But it is relatively quite easy. If the brand is built upon the organization’s personality, values, operational philosophy, or some other organizational attribute, it can make itself immune to market conditions.

Take, for instance, a hospital brand not build on clinical superiority, but on the experience and commitment of its people. This was a strategy deployed by Avis, which built a brand on its “we try harder” mantra. It didn’t matter whether Avis was No. 1 or No. 2 in the market, nor did it matter if it was ever awarded a single J.D. Power customer satisfaction trophy. Avis was laying claim to an organizational value that was elevated to a brand position. Only Avis could sabotage its brand, and it never has. The “we try harder” brand was launched in 1962 and will soon celebrate its 50th birthday. How’s that for market transcendence?

Now, imagine your own hospital brand being wrapped around the experience and commitment of your staff. No one – and no organization – can strip you of these attributes. Commitment and experience are yours to own or give away. They do not rely on market superiority to succeed, or volume supremacy, Magnet hospital status, nationally leading patient satisfaction statistics, or any other measure that the competition might claim.

Certainly, you have to deliver on the brand. But if you do, yours will be a brand that really does elevate itself out of reach of market forces.

Hopefully, your 2010 strategic plan is completed, approved, distributed, and communicated.

However, I suspect there are many of you who are still putting the finishing touches on your organization’s strategic plan, either because you are awaiting final year-end numbers to validate your 2010 objectives, your board didn’t meet in December to approve the plan, or the executive team got sidetracked by the budget process.

Regardless of whether you have finished the planning process, resolve to build accountability into this year’s plan. Assuming you use the standard business school strategic planning model of goals, objectives, strategies, and tactics, and that your organization has quantifiable and measureable 2010 objectives, as well as strategies and tactics designed to achieve those objectives, here then is a six-point plan for driving strategic plan accountability:

1. Make sure each 2010 objective is assigned to a single senior leader in the organization. Objectives are the lifeblood of the strategic plan; they should be “owned” by your senior-most executives — not middle managers. And they should be assigned to single individuals, not a team of executives. At the end of the day, you want to know who is ultimately responsible for an objective. Individual ownership breeds accountability; team ownership does not. And if you think that because yours is an integrated delivery system with 12 hospitals, 65 physician practices, 18 outpatient centers, etc., you are forced to have shared objectives, then understand that this is just the culture of your organization talking.
2. Make sure every strategy and tactic has a very specific completion date. Second quarter is not specific. Neither is June 2010. However, June 18, 2010, is. And unless your organization’s leadership team routinely works weekends and holidays (which I doubt they do), make sure completion dates don’t fall on any of these days. In addition, the completion date for any strategy should be the latest completion date of the tactics that make up that strategy. A strategy is nothing more than the sum of the tactics that comprise it. When the tactics are completed, the strategy is completed. Period.
3. Make sure every strategy and tactic is assigned to someone in management. Like objectives, they should be assigned to single individuals, not teams of people. Even if a team is required to execute a strategy or tactic, one person will be designated the team leader. This is the person who should have strategic plan responsibility. Don’t ever assign strategies and tactics to non-management staff or to physicians who are not employed by your organization (that includes physicians who receive a medical director stipend). This is a recipe for failure.
4. Monitor due dates. Develop a system for notifying people when they have a strategic plan strategy or tactic coming due. Let them know how to report the status of their activity, and whom to report it to. And when they are late, let the executives in your organization know. Implementing strategies and tactics on time should not be optional; it should be required.
5. Create an easy-to-understand dashboard system to monitor your organization’s objectives. Any such system should include early-warning flags that alert the organization when an objective is in jeopardy. This will help your strategic planning team assess whether the strategies and tactics were ill-conceived, or just poorly executed. Devise a scoring system that shows the success of the plan. My favorite methodology is to use a 100-point system in which meeting the objectives is 75% of the score and completing the strategies and tactics on time is 25% of the score. Scoring makes communications easy, as people inherently know that a strategic plan score of 88.5 is much better than a score of 72.6. And while you’re at it, establish a score you are aiming for — for instance, 90.0 (if you ever achieve a perfect score of 100.0, I would argue that your plan was soft).
6. If possible, incentivize your management team on the success of the strategic plan. Align management bonuses to the plan, either as a team or as individuals. There are pros and cons of each. Strategic plan incentives that are based on individual contributions to the strategic plan provide your team with intense focus, but it can also create silos. On the other hand, awarding the entire team equally on strategic plan performance might create a culture of teamwork and camaraderie, but it can also breed contempt, as the bottom performers receive rewards equal to the organization’s star achievers. I’ve seen both models work, depending on the organizational culture at hand.

Follow this six-point plan, and you will find that strategic plan accountability in your organization will become second-nature, and that your likelihood of success will be achieved.

With the beginning of a new year upon us, many hospitals are in the throes of developing new marketing communications campaigns. After all, it’s a new decade, so why not a new brand? But launching a brand initiative begs the question, just how strong is our brand today?

The truth is, very few hospitals can quantify the strength of their brand. Over the years, we have used consumer preference surveys, market share reports, patient satisfaction studies, and communications audits to extrapolate our respective brand positions. But even collectively, these tools only tell a part of the story.

If you believe, as we do, that branding is an inside-out process, beginning with the hospital’s mission, vision, and values, being parented and raised by the hospital’s leadership, and extending through every operational touch-point (we call these touch points “moments of truth”) in the organization, then any brand study that ignores the internal workings of the hospital will provide you with incomplete information at best, and a false reality at worst.

Is there a way around this issue?

Yes. And as our gift to you as we enter a new decade, we give it to you free.

Anderson Healthcare has developed the Hospital Brand Assessment, the only brand study of its kind that evaluates both your brand position and the impact that internal operations has on your brand. Through this online survey of your board of trustees, senior management, middle management, front-line staff, and medical staff, you will be able to identify the brand strengths and weaknesses in your organizational strategy, organizational structure, and organizational execution. And you will be able to pinpoint exactly those operational processes that are keeping your brand from reaching its full potential.

What’s more, you will also identify which of the eight most common hospital brand platforms your organization is commonly associated with and whether this is the most appropriate brand platform for your marketplace.

All pretty heady stuff — especially if you are about to embark on an entirely new brand campaign.

And did I mention that we are giving you this assessment for free?

For complete information on the Hospital Brand Assessment, download our electronic brochure by clicking here. Then, call us at 888-950-3555, and we’ll walk you through the details.

Until then, happy New Year.

I struggled with whether I wanted to venture into these waters, but there are so many brand lessons in the Tiger Woods saga that I finally decided to jump in feet first.

Tiger Woods is, arguably, the world’s biggest brand. On any level. In any country. In any industry. Period. Even if you want to debate that point, it’s hard not to agree with the premise that his brand is sizeable and robust.

And infallible. Or so we thought.

As the first athlete to earn $1 billion, his brand was once sterling. He was a Golden Boy. And now, his brand is fast approaching rubbish. Accenture has already severed ties with Woods. As the scandal continues to unfold, there will certainly be others. So what can you learn from this debacle that might save your own brand? Plenty. Here’s five lessons that will serve you well.

1. Brands are often tied to people, as organizations take great strides to personify their brands. Your hospital’s brand is inexplicably intertwined with the CEO, the physicians on your medical staff, and your employees. Woods only needed to manage himself. You have to manage 500 to 50,000 individuals, depending on the size of your brand. And any one of them can destroy your brand as quickly as Woods destroyed his. If you are going to manage your hospital’s brand, you have to also manage the reputation of your team — because they are a critical component of your brand.
2. Hubris almost always sinks a brand. It certainly sunk Woods. Because of his own arrogance and overbearing presumptions, he believed that he could behave badly without retribution. When hospital CEOs begin believing their own press releases, trouble is on the horizon. And when those same CEOs believe they are bigger than the organizations they serve, trouble is just around the corner. Hubris has killed many an executive — as well as the brands they were charged to protect and oversee.
3. It takes five to 10 years to build a brand. It takes five to 10 minutes to destroy it. We need brands. They serve as a trust mark, a sorting device. We make conscious and subconscious decisions all day long based on brand trust. Ever purchase Advil for $9.99, when the generic next to it sold for $3.49 and had identical ingredients? Maybe it wasn’t Advil. Perhaps it was Philadelphia Cream Cheese versus the generic. Or maybe it was the physician who was the recent subject of a Medicare fraud investigation that you passed by in favor of a doctor a mile further away. My point is this: The next time Tiger Woods talks about the values that was inculcated in him as a child (although I can’t believe this will happen anytime in the near future), how much of his rhetoric will you actually believe? Now take your answer and apply it to your collective community next time your hospital is trying to defend its brand and the values associated with it.
4. Even in times of utter and total brand turmoil, brands can survive. However, pulling this off takes skill. And speed. Tiger Woods displayed neither as he cocooned in his home, forgoing an appearance at his own charity golf tournament and hiding behind the “private matters should stay private” comment. Had Woods stepped forward into the white hot spot light and bared his soul, showing remorse for what he had done, and pledging to take steps to rectify his sins, many would have raised his pedestal even higher. We all fall at some point. Individuals and institutions. It’s not the fall that is unforgiveable. It is not rising up after the fall and soaring even higher.
5. It’s better to take all of your medicine in one dose, that have it administered to you over several weeks or several months. Woods is learning this lesson the hard way, as new stories emerge nearly every day. With each new story, the Woods brand continually erodes, and Woods has more to answer for. When your brand is in trouble, it is better to assume that the things you are hiding will eventually emerge, rather than hope they are never uncovered. Step forward, put it all on the table, and be done with it. Not only is this brave, it shows that you have taken responsibility for your actions — even those that have yet to be disclosed. It’s easy to forgive someone who tells the whole truth, shows remorse, and pledges to do better. It’ hard to forgive someone who does otherwise.

You’ve worked hard to develop a strong hospital brand. Take a minute to think about how fast it can come tumbling down, should your hospital accidentally kill a patient, the Justice Department launches an investigation into billing fraud, your purchasing manager is accused of taking bribes, or your CEO is charged with sexual harassment. Now think about what you will do to save your brand from ruin. The time you spend planning now could save your brand in the future.

Last week, we conducted a poll on the eight most common brand platforms for hospitals, and 135 of you responded. The results: 60% of respondents listed “customer service” as their hospital’s primary brand platform, followed by medical staff reputation (13%), clinical outcomes (13%), teaching and research (7%), and facilities (7%).

Those categories without a single mention: Technology (surprise!), physician relationships, and financial stewardship. So maybe the Big Eight is really the Big Five, although every category with the exception of teaching and research was considered to be a secondary brand platform by at least six hospitals.

Quite a few hospitals also provided their own secondary brand platforms that were not on the list of eight. Among those that were included were compassion, affordability, accessibility, trust, and world-class. The question is, are these really brand platforms? Or are they brand values?

Dictionary.com lists the sociological definition of values as is “the ideals, customs, institutions, etc., of a society toward which the people of the group have an affective regard. These values may be positive, as cleanliness, freedom, or education, or negative, as cruelty, crime, or blasphemy.”

If you are searching for a home, the home itself has a certain brand platform: wealthy, poor, urban, rural, etc., depending on where the home is. And depending on the location of the home and how it is constructed, it can also carry specific values: clean, cost-efficient, warm, drafty, and secure, to name just a few. But these are attributes of the home that help convey the home’s brand. They are not the brand platform itself.

You can purchase a home in a down-trodden neighborhood whose brand platform is under-class by virtue of the neighborhood that surrounds it, and elevate the brand platform by adding a Florida room, re-landscaping the yard, and adding exterior lights. By focusing on the brand’s values, you can strengthen, weaken, or even change the brand platform.

A hospital I worked with a few years back focused on clinical outcomes as its primary brand platform and customer service as its secondary brand platform. It had a single brand value it wanted to own in the marketplace, that value being “trust.” The hospital felt that unless the community really trusted the hospital, it would never fully develop their brand platforms.

That single value of “trust” was imbedded in every internal and external communication. Hospital executives obsessed on this value. The external marketing communications conveyed images of trust and had the word unobstrusively included in every message that was released into the marketplace. Within five years, the percent of people who mentioned this hospital by name when asked what hospital they trusted the most went from 32% to 74%.

And market share went from from 37% to 51% during this same time.

All by understanding their brand platforms, brand values, and interweaving them together.

Take our three-question survey on brand platforms by clicking here.

When was the last time you gave any thought to the platform your hospital’s brand was anchored to? Was the brand platform a deliberate choice, or did it “just happen”? Even more important, do you know what your brand platform is and whether that platform is effective?

After conducting extensive research over the past 10 years, I have found that 95% of all hospitals anchor themselves to one or more of the following eight brand platforms.

1. Customer Service
2. Clinical Outcomes
3. Teaching and Research
4. Technology
5. Medical Staff Reputation
6. Physician Relationships
7. Financial Stewardship
8. Facilities

The two that dominate hospital marketing is customer service and clinical outcomes. Hospitals usually make up their minds to win the war for patients either by providing excellent personalized attention and creature comforts or by leading the marketplace in clinical indicators. It’s a fight between “we’ll love you” and “we’ll save you.”

The second tier of brand platforms includes teaching and research, technology, and medical staff reputation. Often, two of these are naturally coupled together. Teaching and research hospitals tend to migrate toward their strength, laying claim to the belief that because of their status, they are simply better and more sophisticated. But it’s not uncommon in markets where there is a major teaching institution to see a community hospital build a brand around technology and medical staff reputation. Consistent messaging is the key.

Finally, the third tier consists of physician relationships, financial stewardship, and facilities. While not as likely brand platforms as the first five on the list, they are still common, and are often a secondary brand platform for hospitals. The difference between medical staff reputation and physician relationships is that the latter is grounded in the collective pedigree of the medical staff (board certifications, fellowships, specialized training, awards and recognition, etc.) while the latter uses the medical staff to provide professional references for the hospital (physician testimonials, physician practice patterns, where physicians receive their own care, etc).

Financial stewardship is — and will probably always be — a stronghold of sorts for safety net hospitals, which must maintain a public dialogue about the need foir public funding. Integrated delivery systems, on the other hand, have given rise to the facilities brand platform, as they try to win market share by having a hospital, physician’s office, urgent care center, and/or imaging facility on every corner in town.

Any one of these brand platforms can be successful, if executed correctly. Where hospitals get into trouble is moving from platform to platform, creating diffusion as well as confusion. To create a strong, sustainable brand, define your platform — whether it’s on the above list or not — and use it to create a strong foundation for everything that you do, from operations to communications.

Years ago, when I first went to work at Memorial Health in Savannah, Georgia, I was stunned when I was handed the strategic plan to review. The document was about 50 pages long and nothing more than a collection of Word tables that listed the activities of the organization’s leadership team.

As I was to learn, strategic planning there was a rhetorical exercise in which everyone filled out a form at the beginning of each year listing the things they were going to accomplish. The forms were assembled into a tidy document and updated quarterly. It was all very task-oriented.

Yes, strategic plans contain tasks, but not in a vacuum. Without goals, objectives, and strategies to provide context, the tasks are meaningless. In this case, they were.

The lack of measureable objectives stunned me. No wonder the organization was losing $17 million a year. Theirs was a series of yes-no items that had no meaning or purpose. For instance, one of the tactics was to develop a business plan for a new mammography unit. The only thing in question was whether the business plan was completed. Yes-No. There was nothing in the plan about actually increasing mammography volume. Another item read, “Meet with referring physicians throughout the region.” Again, Yes-No. Not a single mention of how many physicians the exec was to meet with, which would have been slightly better, but still insignificant. If the purpose was to drive physician referrals to the hospital’s specialists (which it was), then the executive should have been held accountable to achieving a target (e.g. increase Bryan County inpatient admissions from 56 to 92).

The lack of measurable objectives is a strategic planning fatal flaw. Without them, you might be working hard and staying busy, but the work is meaningless. If the executives meets with every physician in Bryan County, but admissions actually decline, has the executive accomplished his task? Of course, but to the detriment of the hospital. The exec has not met the objective, which means the strategy was flawed and the organization needs to rethink its approach.

Measurable objectives provide us with a yardstick to determine the efficacy of strategies and tactics.

I thought Memorial Health was alone in its flawed methodology. But over the years, I have seen hospital after hospital develop strategic plans using the “turn-in-your-action-plan” approach. And now, I am working with a mid-sized hospital in the midwest to correct the same deficiency: A jumble of to-do lists that are not coordinated and have no stated objectives.

In more than a decade of working with hospitals on strategic planning issues, I have come to the conclusion that plans are constructed this way because the leadership team does not want to be held accountable for measurable objectives, especially when bonuses are tied to the outcomes. Sure, everyone wants to have patient satisfaction scores in the 90th percentile. But tell the CNO that her bonus is tied to hitting that mark, and she will likely argue why she should be awarded on what she does and not on what she achieves.

A strategic plan without measureable objectives is no strategic plan at all. It is junk and will mislead the organization into believing it is blazing a path to the future, when, in all likelihood, it is setting up their own demise.

This blog may generate a lot of criticism. I know it going in.

So, which are the most powerful hospital brands in America?

Mayo? Cleveland Clinic?

No and no.

If a measure of a brand is volume and market share, then neither of these brands — or any other hospital brand, for that matter — makes the cut.

Of the two brands mentioned above, neither of them are even among the 20 largest hospitals in America.

If volume is a measure of brand strength, then the Big Two would be Florida Hospital and New York-Presbyterian Hospital, which have national market shares of 0.29% and 0.25%, respectively.* So, you say, it isn’t fair that I measure brand performance at a national level. Okay, then, let’s look at it regionally. In Orlando, which is essentially a two-hospital town, Florida Hospital is battling Orlando Regional with 53.2% market share. And in New York City, New York-Presbyterian — the largest hospital in America with 2,207 staffed beds — has but 19.8% market share.

I know what many of you are thinking right now. A brand cannot be measured solely on market share.

And I agree with you.

But my point is this: Whatever market you are in, you are not trying to position your brand against Mayo or the Cleveland Clinic (unless, of course, you happen to be in Rochester or Cleveland). Hospitals are local in nature and, for the most part, the vast majority of patients travel less than 50 miles to seek a hospital provider. This is not Nike vs. Reebok for world domination. This is Community Hospital vs. Memorial Medical Center for local market position.

The fact is, there are no powerful hospital brands in the U.S. (This is where the criticism begins.)

Even in Cleveland, the renowned Cleveland Clinic has but 33.8% market share and is battling Fairview Hospital, MetroHealth Medical Center, and University Hospitals for quality bragging rights, as all four have been named a top 100 hospital in recent years. (Check out the CMS Hospital Compare website and see which of these hospitals is the leader in core measure performance. Hint: It isn’t the Cleveland Clinic.)

Which is why branding is becoming increasingly important — not at the national level, but at the local level. More and more hospitals are figuring out they can create a brand that can be more dominant in their market than Mayo or the Cleveland Clinic is in theirs. The smart ones are even tearing a page from the Mayo/Cleveland Clinic playbooks by creating a customer experience built around quality and service.

After all, there is a reason that Mayo and the Cleveland Clinic are held in such high regard, even if their brands don’t translate into king-of-the-hill kind of market share numbers. They are both intensely focused on what their brands mean and work hard to deliver on their reputations. And they have been doing it for years.

The lesson here is that brands are not built overnight, and healthcare brands are not even built nationally. Which means that the most powerful hospital brand in America is, in actuality, the most powerful hospital brand in your own market.

The question is, is it yours?

*Market share is based on 2007 data