Silo Mentality- Difficult to Work With, Difficult to Remove
Silos do not exist just on farms.
Yes, we have that. I am sad to say that we have silo mentality. Actually, silo mentality has existed for so long, I believe it is part of our corporate culture. Not a culture that you want to continue to foster, of course. We have talked about this mindset for years, yet it still exists. It has outlasted initiatives to eradicate it. It has outlasted senior leadership. It has outlasted major enterprise change. Silo mentality has a strong hold on us…..
Leaders, management, individual employees are all in its sickening grip. What lives inside our walls that continues to allow this harmful bacteria to flourish? I don’t want to be too dramatic, not everyone in our organization has the disease. There are enough folks that do have it, however, to make this a real concern for us.
Meetings can be tense because of the silo mentality of some. Projects are more difficult than then need to be. Timelines are blown because needed information was not shared in a timely fashion. Needless competition is created between departments. Workflows are negatively impacted.
Aside from these adverse work/task situations, it takes a toll on people. I believe that staff morale is bruised along the way. People take it personal that they are denied information or access. Feelings are hurt. Destructive relationships are created.
Thankfully, our organization continues to succeed even with this condition. Our successes could be greater and/or a lot easier without it of course. Can better communication save us? Can inter-department collaborations help us? Are new incentives the answer? Do we lack a singular vision? Your suggestions are most welcome.
Participant comments on Silo Mentality- Difficult to Work With, Difficult to Remove
I think it should be part of vision and consequently mission of the institution.Leaders should foster the collaborative mentality and implement it.
Incentives are good but temporary band aids, if people do not buy into the idea.
Leadership needs to launch a cultural campaign.
Breaking down barriers and silos is a very difficult thing. These silos create a sense of mistrust within any organization, and it is extremely difficult to change that mistrust. The only way we have been successful is to foster better communication and transparency. It has been a difficult road for my organization and there is still some mistrust, but we continue to build back the trust by communicating regularly about the decisions that are being made by senior leadership. To change things you must begin somewhere and know that it is a long road. Celebrate the small wins and keep it going.
Sounds like a very familiar challenge to me, too! One important thing in my mind is to set joint goals and KPIs for different silos. Patients’ processes tend to cross may silos in the organization. Making people see that is important. Taking a few patient processes and working together to describe them, look at them from the patient’s point of view, aiming at improving them in a patient-oriented fashion, and then setting joint goals and KPIs sometimes help. It is also important that the incentives of leaders and the staff are aligned with creating collaboration, not supporting silo thinking.
One important component in breaking down the silo is through co-location i.e. facilitating collaboration through the seating/room layout and physical arrangement in which these healthcare workers work together on a day to day basis. Similar to the concept of relationship based healthcare, it is also important to build the trust and camaraderie amongst team mates for them to work seamlessly and effectively.
You can break silos only by changing the structure of the organisation. That would make a drift for silos to disappear.
However, especially physicians are specialty-based and naturally have silo mentality from their upbringing.
This is a difficult job, but it can be done. You have to have the hospital leadership with you. Everything should be openly patient-oriented, which shows that silos are enemies of good care.
Our 8 hospital system has experienced this. Each hospital had it’s own president and CMO. Although our incentives were 60% system and 40% site, it still didn’t break down the barriers.
In February we had a massive reorg. 8 presidents were reduced to 4, so presidents have multi site responsibility. A president of ambulatory was added to develop new “big box” sites that would not be tied to any of the existing silos (so planning would be objective based on strategy of system, not a particular site) and a president of “shared services” for clinical services was added, so that one person has the responsibility, authority and accountability to drive service line strategy (that happens to be my new role…. I was previously a single site hospital president). The change in behavior in the past two months has been remarkable.
We experienced this a lot and still today it definitively remains a big challenge. The first thing we put in place 3 years ago with the arrival of our new CEO was to build a ‘tactical plan’ aligned with our new strategy. He asked me to build such a plan… I didn’t had really a clear way to proceed, so I follow this different steps:
1) I started with interviews and sessions with every person at the C-level based on some key questions: based on our new strategy where do you wanna be with your departement within the next 5 years? Based on this what actions/projects/initiatives do we need to work on next year ? Who is accountable and responsible for each action? Which team will work on that? Which ressources do you need (budget, people, material, machines, hardware, …) ? What is the timeframe ? Are there some prerequisites ? Are there some interdependencies with other projects or teams?
Remark: the first time I did this, it was more top down from C-level. Now we do this every year and it’s much more bottom up since a lot of people know the approach much more better and understand where we wanna go.
2) I collected all this input and put this in a excel spreadsheet. I made a kind of Template we now use every year.
3) I did several workshops with the executive committee to review all together all the list of projects. Big discussion around all those projects: are those strategic ones, or more departemental ones ? Do we really need this? Is this really a priority next year? And we came to kind of commitment on what we wanna do all together. Also the link with budget was criticial and helped to do a kind of cross check if we foresee all resources needed to be able to realize our ambitions.
4) We presented this detailed plan to our managers (physicians and non physicians) to get them on board and still adapt the plan where needed. It was key to have also their support in this exercice and to move forward
5) We get this tactical plan validated by our Audit Committee and our Board.
The key thing here is that we know all projects we all are working on, we know the priorities and so we make much more links. This helped us a lot to avoid that kind of silo working method. The key challenge remains when a new Director arrive, or a new staff member which don’t know this method, of way of working. But here again communication and coaching remains crucial.