In Praise of Corporate Tension

By Rodney Reider

“Corporate will be here next week to help…”
“Corporate is sending out a team in person to review the project.” 
“Corporate is coming out for a visit.” 

These words can immobilize the most courageous of hearts.  Many at the clinical sites believe corporate exists to disrupt and provide self-enhancement for the corporate individual making the demand.  The incoming request often appears as a consistent disruptor to the local individual who is focused on the hospital, clinic or community issues.  As a non-corporate individual, you are at the site addressing immediate and multiple priorities.  The demands can range from concerns for improving patient care, addressing colleague concerns or responding to the corporate enhanced financial issues to name just a few of the more common daily agenda items.  In fact, you may even be reacting to a situation affecting the greater importance (?) of your immediate supervisory interacting environment (i.e. keeping your local boss happy).  Whatever the corporate demand at the time, it can seem to distract from the work necessary to be successful at the site.  Furthermore, from the limited view in field, the request can sometimes make no sense as to its timing or priority except “Home Office needs it now.” 

The tension between the entities in the field and the corporate power is real.  The euphemism of “Corporate,” with all of its priority setting, sweeping powers, and down-flowing time demands can cause untold tension and disruption at the sites. However, corporate has its own demands and in the final measure is often made up of people just attempting to survive and succeed.  Good leaders are conscientious individuals balancing competing demands, shifting priorities, and seemingly continuously adjusting metrics driven by someone else’s “higher-up” tinkering.  Both sections of the organization contain people searching for a positive impact.  Same organization. Different pressures. Competing language.  How does that language sound as a result of differing views?  Let’s take a look and listen in:

The Perception from the Field:

— “A lot of times it seems they don’t listen or don’t care.” 
— “I know they have a lot to do too but sometimes their expectations are unrealistic.”
— “It’s never enough no matter how much we do, they always want more.”
— “It can seem there are too many priorities - Everything.”
— “Sometimes their arrival and questions make me think they believe they think they know more of what is going on at our site/in our community then we who live and work here.”
— “I wish they would just communicate better or even sooner.”
— “Corporate demands and does what it wants when it wants. They don’t seem to realize how hard we work. They wait to the last minute, make their demands late in the week and expect us to drop everything despite our own workload and timelines or local bosses expectations.”

View from Corporate:

— “The individuals in the field are often eager, but not always adequately informed regarding all the important things going on in the company.”
— “Why does it often take so long to get back the simple information we request, don’t they know how important this is?”
— “Sometimes when we come out for a friendly visit some of the individuals seem so territorial, suspicious or rude to us from corporate.  It’s not like we are Joint Commission or anything.”
— “We really do want to just help them.”
— “It is often believed by those at corporate that the field does not realize “how hard we work.”

What is really going on? 

Corporate Executives, Directors, and Managers ultimately, have to leave the corporate office.  These individuals are aware they must perform the geographical hospital and clinical circuit.  It makes them better leaders.  It is where the real action of care occurs.  Each corporate executive must wear the badge of knowledge that they are not too far removed from understanding, experiencing, and acknowledging what the front-line care people undergo everyday.  The great leaders know graphs, metrics, and conference calls are not enough.  They also want to be part of something successful and pursue the opportunity to help address issues in the field.  It not only gets them out and allows them to contribute but also reinforces their feeling of value as they reconnect with the reason why we exist. 

Furthermore, corporate survival requires the ability to gather information to show the strength of one’s position and to pronounce an air of authority that one knows what is going and the depth of awareness, understanding and, knowledge of how the business truly works.

Finally, there is always an inherent fear in the back of the corporate mind –

long-term survival.  Will anybody become aware of what I am lacking?  Will there be an effect if I am gone?  Does the corporate hierarchy see me as valuable enough to warrant staying in my role or am I a possible cost-cutting measure moving to the forefront?

The benefits of bridging the Perception/Language/Relationship/Information gap:

Corporate has a roving eye.  It is a major contributing factor to the field of tension; nevertheless, Home Office is consistently looking to where it can direct its resources to focus on the most pertinent issues throughout the company.  Corporate is prompted by a sense of urgency and will align its assets for the necessary site action.

The tension will continue to exist.  A great site leader will harness the resources of corporate to improve their local organization before the roving eye lands them on the “watch-list” and bringing them untimely attention and strain.  If corporate arrives due to metric issues alone (i.e. missing your numbers, a major quality concern, etc.) the voice of site leadership is greatly diminished; however, keeping corporate engaged and providing plenty of credit upward provides the perfect forum for expertise and communication to be enriched and an ability to address the issues before they become urgent. 

For corporate, a connected site team provides continuous cognizance opportunities by engaging with local caregivers and hearing leadership concerns.  Site knowledge and awareness is key to good decision-making for corporate and often provides the correlating support for the site.  Corporate must encourage and leadership in the field must foster this desire for site learning and take advantage to continuously serve as a resource for corporate colleagues. 

Remember we all have the same overarching goal.  To help and be part of an organization providing the opportunity, stability and growth for the company and its contributing colleagues in the prospect towards success.  The essential balancing act lies in aligning differing priorities and enhanced communication.

Many advantages flow from an ideal dual beneficial relationship.  One can gain additional resources and an enhanced focus including pilot programs not always readily available to others.  The cross-fertilization of ideas, especially knowledge the field doesn’t have or information contained within the field of which corporate is unaware delivers benefit to the entire organization.

For those who work outside the corporate headquarters at our hospitals, clinics, nursing homes, long-term care facilities, home health, and even in the EMS transport hubs, etc., most likely the realization has already occurred that no matter how far you are physically from corporate, you still remain within the confines of corporate reach.  Speak positive in all avenues of communication.  Resentment does not provide either party any benefit.  If we study the language of corporate success, good and talented people who wish to be helpful and associated with progress are the key contributors in competitive ascendancy. 

In the final analysis, we need each other to succeed.  Accept the existing tension and use it to harness a heightened level of communication, an understanding of the multiple priorities and an allowance that both parties wish to excel for the betterment of the overall corporation - together.  We have all benefited from partnering with incredible people in corporate roles and experienced the many brilliant colleagues at our clinical sites.  Many of our partners are intelligent, driven and kind.  Be this type of partner.  You will gain ideal achievement for the entire organization and for you.