Dr. Stephen Covey recently passed away. The self-help and management guru was 79 years old. It has been years since I saw him present his "Seven Habits of Highly Effective People," but I clearly recall his charisma, sincerity and wisdom. Over the intervening years, I occasionally have reread and benefited from his simple but profound insights. The best advice, I have found, is simple: If all of us did the simple things we already know, it would change the world. My Advisory Board Company colleagues -- former CIOs themselves -- and I have attempted to relate Covey's seven habits to the work life of health care CIOs. CIOs have difficult, complicated and stressful jobs. Who could benefit more from a little simplicity?
We are going to list each of the seven habits, as Covey defined them, and then identify ways that CIOs can apply these habits, based on input from leaders in the field.
Habit 1: Be Proactive -- Take initiative in life by realizing that your decisions are the primary determining factor for effectiveness in your life.
Right or wrong, a CIO in most hospitals today has to earn his or her place at the executive table. A passive CIO is headed for trouble, quickly -- few organizations will define your role strategically or arrange effective IT governance for you -- you must continually take the initiative and take responsibility for your results. A CIO who only does what his or her users ask is not going to earn that seat at the table. Assess your organization from the CEO's perspective: look at what makes the organization work, do your own SWOT -- strengths, weaknesses, opportunities, threats -- analysis and determine how you, as a leader, can help. Use this information to avoid becoming just an "order taker" by initiating brainstorming and "what-if" exercises with your users. Ingrain proactive service into your department -- make it a priority to identify problems before the users do and encourage staff to suggest uses of technology to their users instead of waiting for requests and fending them off.
Habit 2: Begin with the End in Mind -- Self-discover and clarify your deeply important character values and life goals.
Define an IT department vision and mission statement that reflects the values and strategic goals of your organization, your staff and yourself. Develop an IT strategy to achieve your mission and vision. Strategy definition is difficult during times of major change like we are facing today, but that makes it even more important.
As part of your strategy, define ideal departmental roles and relationships, and then plan to make them a reality. Set business or clinical goals and objectives, not IT goals. The goal of your business intelligence strategy should not be to "build a data warehouse," but rather to "improve financial performance" or "improve clinical quality" or "reduce readmissions." Focus on producing value, not capability. And plan two or three years out; do not get swallowed by today's operational problems.
Habit 3: Put First Things First -- Prioritize, plan and execute your work based on importance rather than urgency.
Is what you are doing now moving you toward the vision and mission you defined in Habit 2? In order to know this, you must understand how your resources are currently allocated. Do you know how many of your full-time employees are allocated to "keeping the lights on," how many to upgrading existing applications and technologies and how many to new strategic initiatives? And do you know how this mix is changing based on the new projects in your queue? Only when you have this information can you help your fellow executives understand where you are going, what you are doing and what can and cannot be done without new resources.
Develop IT roadmaps that show how technologies and applications will evolve; use these roadmaps to communicate both inside and outside the IT department. Do not commit to more than you can deliver -- you will only disappoint yourself and others, and keep them from developing their own innovative solutions. Use Lean and other process improvement methods to increase your departmental capacity without adding staff.
Habit 4: Think Win-Win -- Genuinely strive for mutually beneficial solutions or agreements in your relationships.
Work for mutually beneficial solutions or agreements in your relationships with your bosses, peers and subordinates. Avoid short-term "wins" that benefit you or your department but are not the right long-term answer for the organization as a whole. Be open to doing what is needed for the organization even if it conflicts with your carefully crafted technical architecture: be a leader who is more concerned with the fate of the organization than with optimizing IT. When a department wants to buy a cloud-based solution, overcome your fears of losing control; if this is the best solution for the entire organization, do not be a roadblock but ask "how can I help?" In this case, the CIO should at least be involved in contract negotiations.
Start with a belief that everyone wants to do a good job and work from there. Misunderstandings about what constitutes a good job can be a major contributor to workplace issues. Focus on identifying and lowering the barriers to doing good work, including lengthy paperwork to do simple recurring tasks (e.g., provision a new employee, change a patient's address, order a new batch of printer paper), inconveniently planned down times, lengthy system logins, juggling too many priorities and inconsistent priorities.
Habit 5: Seek First to Understand, Then To Be Understood -- Use empathic listening to be genuinely influenced by people, which compels them to reciprocate the listening and take an open mind to being influenced by you.
In today's environment, skilled IT staff have many alternatives to working for you. Your willingness to understand them before being understood is part of a culture that will retain the best people. Work to make this principle a part of the culture of your department. Send your IT staff into the field. Emphasize knowledge of the organization, how it works, and its goals and objectives, not just IT. Make sure your staff know they are working in health care. Change management is a key to implementing electronic health record systems and other new technology, and we want people, especially clinicians, to "comply" for the good of the organization. However, research shows that before they comply, clinicians must know that the organization understands and values them and their needs. The physician organization should lead the development of practice standards that are codified in the EHR. Make it a practice to start by understanding the current state and what users are trying to accomplish, rather than just what demands will be put on IT. Focus the discussion on how to accomplish what is asked for, not on why you cannot do it.
Habit 6: Synergize -- Combine the strengths of people through positive teamwork, so as to achieve goals no one person could have done alone.
Use more cross-functional teams, both inside the IT department and with other functions and departments. Give and take staff to and from other departments on temporary assignments. Try "walk-a-mile" programs, cross-training, agile development techniques, joint application design and workshops to provide focus and direction, but also leverage cross-functional knowledge and skills. Invite your colleagues to join you in creating or refreshing your IT strategic plan. Make sure brainstorming sessions do not result in the "lowest common denominator," but instead identify the best ideas.
Habit 7: Sharpen the Saw -- Renew your resources, energy and health to create a sustainable, effective lifestyle.
A lot of CIOs now are forced to contain costs by giving up training and development dollars, but you do not have to give up on sharpening the saw for yourself or your staff. Find ways to encourage staff development outside of formal training. Send staff to speak at local colleges and universities, and encourage presentations of your staff's work to local chapters of professional groups like the Healthcare Information and Management Systems Society or the American Health Information Management Association. Promote continuous learning -- leverage online learning, distribute research assignments to staff and have them bring their findings back to the rest of IT. If you send staff to a conference, task them with documenting what they learned and sharing it with others in departmental training meetings. Have your IT experts develop and host "brownbag lunch" meetings for users in which they discuss technology or IT issues, or how to work more effectively with IT.
Also, make room to have a life. Even the CIO cannot always be "on." You must take vacations and get away from the technology-driven invasion of personal and family time. You may be surprised by how much your behavior influences your staff's. When they see the CIO responding to emails at night, over weekends and on holidays, they learn this is what is expected. Try standardizing your schedule and avoid emailing your staff after 6 p.m., on weekends, or during vacations or holidays unless it is a true emergency -- then watch the stress level drop in your department.
Sharpening the saw also applies to your IT infrastructure. Many organizations continue to layer more and more complex applications onto their infrastructure without an adequate plan or resources to refresh or upgrade it -- to keep it "sharp."
This is a book whose message never gets old. If you have not yet read Dr. Covey's "The Seven Habits of Highly Effective People," buy a copy and read it. If you already have read the book, skim it again and identify two or three ways you can use its principles to improve your personal life, your management skills or your department.
Senior Research Directors Meg Aranow and Ernie Hood and Executive Director Jim Adams contributed to this article.