MORE WITH less (Oh not again!)

1. MORE WITH less(Oh not again!) Kathleen L. Lewton, MHA, Fellow PRSA Steven V. Seekins, MPA, Fellow PRSA Kenneth G. Trester, Fellow PRSA Lewton,Seekins&Trester PRSA International Conference October 17, 2010

2. We come with (some) good news • Cutting budgets can be an opportunity . . . . to reinvent your work in a new&better wayReally. Glass half-full and all that! • We are here with PRACTICAL counsel on how to do itAnd what’s the alternative? Just say NO?

3. Overview: We’ve heard it all before • Tighten belts • Cut out the fat • Across the board reductions • Support areas (staff functions, aka “fluff”) take the first hits And there’s only one difference today . . . . .

4. This economic downturn is even impacting healthcare • Provider organizations are desperately seeking to “mitigate the effect of the financial crisis” says HealthLeaders national exec survey • And they are walkin’ the walk • Cost reduction one of top 3 priorities of CEOs • They see hospitals really ARE closing • If NYC is a bellweather . . . . . small and large alike are going down • Rx companies are looking at less-than-robust pipelines, patents expiring, ever lurking threat of (more) government regulations • Docs ready to sell practices to best bidder

5. And even organizations that are doing “OK” . . . . . • Are looking three or four years out and (if they’re paying attention), they’re worried • The cost slashing consulting firms are doing a lot of business • And they love to look at the expense side of the ledger first • Even IF you may avoid budget or staff cuts, you are surely being asked to do more, more, more

6. We could (and would) go on and on . . . . • The CEOs we’re hearing from are battening down the proverbial hatches • SO when the phone rings or the email arrives saying“Tell me what you’ll do to cut 30% out of your budget . . . . .” OR “Here are six more things we need your team to handle . . . . .

7. Is it mean to be leanORkeen to be lean??

8. More with less IS an opportunity! • We’ve all been through this in the past • First reaction – oh my, but not US? • Is it something I’ve done? Or said? • But we’re doing SUCH great work! • I’ve tried SO HARD . . .

9. Time to remember . . . . It’s not personal. It’s business. • That’s how the CEO sees it, so if you react personally . . . . .

10. Yes, we CAN fight the fight • Make a great, and 100% accurate, case for the value of the work we do • Explain and explain why we’re different, should be exempt, are better than the others, help the others, etc. But really – do we want to be perceived as DIFFERENT than the rest of our management peers? Is that the way to the CEO’s heart?

11. Because even IF it’s true . . . • What you’re really asking for with that line of attack is: • Take less from my division and MORE from somewhere else • Nursing? • And what we sound like is: • Tone deaf, self-centered or truly clueless

12. “I said we are in bad shape, and my PR VP said but I still need this budget”

13. The other scenario . . . • “OK, I’ll get a plan together. • And do you also want us to start working on a communications plan so we can be ready to present this to the organization?” THAT is music to the CEO’s ears PS You have to really mean it. You can’t go back in two weeks with “Here’s why we really can’t cut OUR budget.”

14. SO . . . . . where do you start and what do you do? A practical 5-step analytic approach

15. Our 5-Step Approach • Lock in the essentials that must stay (but may be revamped). Then look at what’s left and: • Ruthlessly assess the high cost items • Analyze and evaluate remaining programs and prioritize the keepers • Identify NEW best practice efforts that you want to add • Finally – go back over what’s left on the table and ask “How can we do this more cost effectively”

16. Step One: Identify, justify and recommit to the ESSENTIALS

17. LST Short List of Essentials: • Customer satisfaction (and the culture change to get there, if needed) • Employee communications • Online/website: core channel, front door These have to stay -- but that doesn’t mean as is – all can be revised and revamped with an eye toward leaner, keener

18. Essential #1 Customer SatisfactionPR plays a leading role

19. The core of any organization: Customer care&caring • Reputation is built on reality -- how we perform, how we take care of and build relationships with our core stakeholders, • Promotion builds awareness and supports perception – but the foundation is performance • So marketing/PR must be integrally involved in this key arena of organizational performance, not just relegated to promotion or communications

20. Up Close: Customer satisfaction • Customers are “expert endorsers” – their opinions based on experiences and their satisfaction drives word-of-mouth endorsements • Today’s picture isn’t pretty • Banks, airlines, pharmacies, hotels, Netflix, Pampers – the blogosphere is rife with UNHAPPY CUSTOMERS • As prices increase, crankiness and expectations increase and poor service results in REALLY MAD people

21. Culture change may be required • Customer satisfaction often requires true culture change, and PR/marketing staff are the culture change warriors • McKinsey study of execs in companies that successfully implemented change: • Clear, comprehensive and compelling communication • Define and share clear goals • Communicate a compelling story • Acknowledge success regularly and publicly

22. PR = Culture Changers • CEOs of top performers in the quality and customer satisfaction arena say it has to start at the top • Ideal place for PR/marketing to step up and help CEO make it happen • If you have a crisis, leverage it • If you don’t have a crisis, lead by inspiration, persuasion, threats . . . . . • Use communications, research and planning skills to ensure that data is translated into action

23. The public relations role also includes: • Culture management • Keep the platform burning • Provide measurement tools • Manage the customer research • Shoppers • Other feedback mechanisms (Web, callbacks) • Spread the message • Successes AND failures/challenges • Metrics outcomes and benchmarks • Keep it on top management’s agenda

24. Make it stick - even if you’re big, complex & decentralized • Can’t be “Change Initiative du Jour” • New processes to support new cultures • HR policies and practices critical • Reliable tracking systems • Accountability mechanisms • Disciplined, methodical rollout plan with standardized communications • Benchmark against national peers, AND your own market competition

25. Essential #2 Internal CommsCreating a motivated workforce

26. Employee Communications: A core sustainable strategy • Employee behavior drives QUALITY,customer satisfaction, market share, efficiency and more • Employees can support or undercut all messages to other stakeholders

27. Workforce communications • Require multiple channels • Education/literacy variations • Employee preferences • Repetition important • AND Face to face with supervisor remains #1 preferred channel • Publications, e-mail, videos, etc., can be used to reinforce, explain details

28. Case in Point: The Huddle • Organizational problem: • Low employee satisfaction with intradepartmental communications • Low employee satisfaction with trust • Bottom quartile patient satisfaction • Serious financial losses

29. Solution: The Huddle Breakthrough communications tool • Systematic process for assuring group discussions every day • Simplicity: 5 to 10 minute meeting • Consistency: everyone, everyday, every shift • Interactivity: discuss customer service standards • Motivational: reinforce personal values • Fun: engender team spirit

30. Do you rely on huddles for information?

31. Patient loyalty scores:cause and effect?

32. Other major gains

33. Chain of success starts with satisfied employees

34. Essential #3 Web PresenceIt’s the foundation

35. We really don’t need a slide here • We all know we live in a www. World • But how many sites are truly best in class? • Easily, easily navigable • Eye-catching and easy to READ • Great copy that’s exciting • CURRENT and instantly updated • If not, why not? • Facebook friends and tweets don’t make up for a HOME page that’s not top notch

36. Now that we know what’s staying . . . . . . . . .How to sort out the rest

37. Once the essentials are nailed . . . • The hard part starts • What stays as is • What stays but is downsized or restructured • What goes on the auction block (back to the departments who should be doing it) • What goes in the dark of night • What’s given a decent public burial • And what’s added

38. There IS an upside– opportunity to lose dead wood, streamline, enhance • Yes, some of this will be painful (we all love our four color glossy magazines) • BUT this is also an opportunity to get rid of things you have hated for years • If you’ve always done it for TEN years • And to ADD best practices you’ve wanted to add but couldn’t get extra budget for • Slash enough and there’s suddenly money available

39. Recap: Steps 2-5 • Step 2: Assess the high ticket items • Step 3: Rank order the rest of the list using a defined, rigorous process • Step 4: Determine what you’d like to add • Step 5: Go back and look at every program with your “Is there a better, cheaper way to do THIS” radar

40. Step Two: Look at the high cost programs • CRM: Highly expensive not always effectively used. Can you do just as well buying segmented mailing lists? • Ratings services (pay2play): Expensive, seldom worth the investment. Consumers don’t use them, and everyone can get some sort of high rating, thus leveling the playing field. • Consultants: Often they’re “first to go,” but carefully evaluate their value in resetting strategy or outsourcing project work. • Sponsorships: Rigorously assess ROI. If a sponsorship has no purpose but to gratify someone, assign the cost to that someone’s budget. • Publications: Do they really have a purpose anymore? Havewe maximized what we can communicate “for free”? Can we do more face-to-face communication?

41. Step Three: Assess and prioritize (How to retain your sanity, your employment status and your peers) Hint: use a PROCESS, not a dart board

42. Look at your “to do” list strategically • Assessment and analysis • Know your audiences and how to best reach them • Identify how each project you do ties specifically to key business objectives • Ask around –interview the key players and find out what they need, want and expect from PR • Clues to what you can broom away • Also fodder if they end up saying don’t cut anything (because no one is willing to give up anything) • Do THEY agree on corporate business objectives?

43. By going through this process: • You build and maintain credibility and support from the rest of the management team, • You’re seen as a canny innovator who’s clearly trying to craft win-win solutions in lean times

44. Then start sorting • Create a set of criteria to assess each program or project your department now handles • Adds a level of objectivity to the process and helps you sort through it all

45. Program Priority Decision Publicity Marketing Marketing and Communications Prioritization Methodology Key Client – Business as Usual Included in Strategic Plan Not Included in Strategic Plan Potential No Potential IN (7) OUT (3) IN (8) IN (1) Marketing can Impact Low Marketing Impact High ROI Low ROI OUT (3) KEY: 1 = Will do: major program 2 = Planning support & may do 3 = Won’t do 7 = Publicity effort only 8 = Key client: business as usual High Backing Low Backing Resources Available No Resources Identified Resources Available No Resources Identified IN (1) IN (2) IN (2) OUT (3)

46. For example:

47. Criteria to consider • Does this program/project: • Have a champion (CEO, Board?) • Support market growth (raise funds, recruit students, etc.) • Enhance our reputation • Build relationships with a key audience • Highlight a niche that’s “unique” to our organization • Contribute to employee morale • Have a measurable impact

48. This process gets you to: • The point where you have looked at everything you are doing with a rigorous eye, using facts and data • And you have numbers to help you rank order the list • That helps when someone says we MUST keep doing #18, because you can say OK, then #4 has to go

49. Step Four: What’s shall we add? • What new channels/tactics can you create/enhance to deliver their message to the right audience • Social media • Blogs • Thought leader programs – cost almost nothing, and if you make 200 key opinion leaders “insiders” you’re reaching 20,000 people • Community-based events • Affinity groups • AND . . . . . . (y’all share your ideas now)

50. Step 5: One last look:Can we do it cheaper? • Take your final list – the essentials, the keepers in priority order, and the new additions, and look at each tactic, asking“Is there a way to do this less expensively?” • Online vs.printed • Market to docs vs consumers or consumers VIA docs • Face to face, the cheapest channel of all . . . .