As we reflect on our journey since launching Frontier Strategy Partners, LLC on September 28th, we are filled with immense gratitude for the overwhelming support and engagement from our growing community. Today marks a significant milestone as we've reached 5,000 visitors to our site, and we wanted to take a moment to express our heartfelt thanks to each of you who has been part of this journey.

The implementation of Lean Process Improvement methodologies in healthcare organizations has become increasingly critical as institutions seek to enhance both patient experience and employee satisfaction. This article examines the eight fundamental forms of waste identified through Lean methodology and their specific manifestations in healthcare settings, with particular emphasis on their impact on patient care quality and staff efficiency.

As a follow-up to Tuesday’s (Dec 10) post, we presented an opportunity many hospitals have available through a strategic approach to managing the balance sheet financial assets. Hospitals continually search for ways to strengthen their financial foundation. To recap, a recent analysis of 37 Minnesota hospitals has uncovered a significant opportunity many institutions overlook: again - through a more strategic utilization of their investment portfolios.

These 37 hospitals collectively manage nearly $1 billion ($933.5M) in investable assets, yet currently generate only $13.9 million in annual investment income—a return of just 1.49%. With current treasury rates between 4-5%, even a conservative treasury strategy could generate between $37.3 million and $46.7 million annually—an additional $23.4M to $32.8M over current returns. This represents an additional $632,000 to $886,000 per hospital, achievable through low-risk treasury management. To put this in perspective, even at the conservative 4% return level, the additional $23.4M in annual income could fund 195 new nursing positions across these institutions. Moving to a balanced portfolio approach targeting 7% returns would generate $65.3 million annually, providing an additional $51.4M system-wide or $1.4M per hospital through a thoughtfully diversified investment strategy.

Evidence-based research demonstrates that systematic competency development serves as the cornerstone of healthcare organizational success. The ACHE Healthcare Executive Competencies Assessment Tool (available here) provides the essential framework for this development process.

At the foundation of executive competency lies effective communication. Organizations that implement structured leadership rounds with documented learning systems consistently report significant improvements in staff engagement within six months. Beyond basic rounds, leading healthcare institutions have found success through communication laboratories that focus on real-world scenarios. These programs have demonstrated marked improvements in leader confidence, conflict resolution, and overall staff-leader communication effectiveness.

Leadership development builds naturally upon this communication foundation. The most successful healthcare organizations emphasize cross-departmental project management as a key development tool. By managing initiatives outside their primary expertise, leaders develop broader organizational understanding and enhanced collaborative capabilities. This approach pairs effectively with systematic case review programs, where actual organizational challenges become learning opportunities. Regular crisis simulation exercises round out this aspect of development, consistently improving emergency response capabilities and team coordination.

Hospitals have traditionally focused on operational revenue for much of their ability to reinvest in the resources needed to care for a community—the day-to-day revenue (and income) from patient care, procedures, and reimbursements. But beneath these obvious revenue streams lies a potentially transformative opportunity that many healthcare institutions overlook: the strategic management of their investable assets.

A recent study of 37 Minnesota hospitals reveals a striking picture of this untapped potential. These institutions collectively manage nearly $1 billion in investable assets. Yet, their cautious investment approaches may leave significant value on the table—value that could be reinvested in patient care, staff development, and crucial infrastructure improvements.

The landscape of healthcare employee engagement presents a complex intersection of workforce satisfaction, patient care quality, and organizational success. At its foundation lies trust - between colleagues, between staff and leadership, and between healthcare providers and patients. Employee engagement surveys serve as crucial diagnostic tools within healthcare institutions, providing measurable insights into workforce health, organizational culture, and the strength of these trust relationships.

These surveys' significance extends beyond basic job satisfaction metrics. In healthcare environments, where patient outcomes directly correlate with staff performance, engagement surveys reveal critical patterns in care delivery quality. Evidence consistently shows that engaged healthcare workers, operating in environments of mutual trust, deliver superior patient care, maintain higher safety standards, and contribute to improved patient satisfaction scores.

Patrick Lencioni’s The Advantage emphasizes that organizational health is essential for achieving sustainable success. He suggests that strong internal cohesion and clarity guide an organization more effectively than any single strategic decision or technological advancement. The approach presented focuses on building a leadership environment defined by trust and honest dialogue, ensuring that decisions are made with a full understanding of differing perspectives and potential pitfalls.

Leadership in the modern workplace requires more than just strategic thinking and technical expertise. At its core, effective leadership demands a quality that cannot be learned from textbooks or acquired through experience alone: empathy. The ability to understand, share, and respond to the feelings of others has become the cornerstone of building trust within organizations, and its absence can create irreparable rifts between leaders and their teams.

Trust forms the foundation of all meaningful workplace relationships. It's the invisible thread that weaves teams together, enables innovation, and drives organizational success. Yet trust itself is built upon something even more fundamental: the capacity for empathy. When leaders demonstrate genuine empathy, they create an environment where trust can flourish naturally. This connection between empathy and trust isn't coincidental—it's essential to human psychology and social dynamics.

The story of physician recruitment is fundamentally a human one. It's a story about professionals who have dedicated their lives to healing, seeking not just a place to practice, but a place to belong. It's about organizations learning to create environments where these healers can thrive, contribute, and find fulfillment in their calling.

The journey of physician recruitment begins long before the first interview. It starts with the understanding that physicians seek more than competitive compensation and state-of-the-art facilities. They seek a voice in their practice environment, a seat at the decision-making table, and a culture that values their expertise beyond clinical skills.

Many physicians can recall moments when they felt like mere cogs in a healthcare machine – their insights overlooked, their concerns dismissed, their professional growth stagnated. These experiences shape what they seek in their next role: an environment where their voice matters, where their contributions are valued, and where they can shape the future of patient care.

Picture this: For every tax dollar you send to Washington in 2024 (soon to be 2025), a growing portion isn't going to provide healthcare, build highways, support veterans, or fund education. Instead, it's being used to pay interest on our national debt. According to recent Congressional Budget Office projections, this year alone, the federal government will spend an astounding $892 billion just on interest payments. That's not paying down the debt itself – that's merely the cost of borrowing.

To grasp the magnitude of this financial burden, consider that we're now spending more on interest payments than on Medicaid, all federal programs for children, veterans' benefits, and critical income security programs combined. These interest payments, which essentially amount to the cost of past spending, are beginning to overshadow investments in our nation's future.

When it comes to healthcare facility expansion, Minnesota and Wisconsin represent two distinct regulatory philosophies. Minnesota's Certificate of Need (CON) requirements create what many healthcare analysts describe as a protective "moat" around existing healthcare facilities, while Wisconsin's free-market approach since 2000 has opened the doors to unrestricted expansion. Both approaches carry significant implications for healthcare providers, patients, and market dynamics.

Many believe leadership assumes or means leaders have all the answers. Like many executives, I thought showing vulnerability would undermine my authority and effectiveness as a leader. However, a powerful insight from Brené Brown's research shows an entirely different perspective: connection—the very thing we seek as leaders—requires vulnerability.

Think about the leaders who've most influenced your life. Chances are, they weren't the ones who maintained a perfect facade. They were the ones who showed up authentically, who admitted when they didn't have all the answers, and who shared their challenges alongside their victories. These leaders understood something fundamental about human nature: we connect through our shared humanity, not our pretense of perfection.

Hospital halls hum quietly on Thanksgiving morning. While most families wake to the aroma of roasting turkey and warming ovens, healthcare workers begin their rounds. For many, holiday shifts have become a familiar rhythm, woven into the fabric of their calling.

The truth is, healthcare never sleeps. As families across the country gather around their tables today, medical professionals continue their essential work. They monitor vital signs, process urgent labs, make critical decisions, and provide comfort to those who find themselves in hospital beds instead of at home this holiday.

Organizations frequently encounter periods of leadership transition that demand immediate attention and specialized expertise. From unexpected C-suite departures to strategic reorganizations, the need for skilled interim leaders has become increasingly vital to maintaining organizational stability and fostering continued growth. Understanding the nuanced role these temporary leaders play can help healthcare organizations better navigate periods of change while ensuring uninterrupted quality of care.

Across rural America, a critical healthcare crisis is unfolding in plain sight. In thousands of communities far from major cities, millions of Americans face a troubling paradox: their areas have some of the highest needs for mental health support yet the fewest resources to address these challenges. The impact touches every segment of rural society, from working adults to seniors, teenagers to young children., where mental health services are critically underrepresented despite growing needs. In the vast expanses between major cities, millions of Americans face a troubling paradox: their communities often have the highest need for mental health support yet the fewest resources to address these challenges.

The scope of this rural mental health crisis is staggering. More than 60% of rural Americans live in areas designated as Mental Health Professional Shortage Areas. This shortage translates into real human impact – rural residents experience higher rates of depression, substance abuse, and suicide than their urban counterparts. The suicide rate in rural areas is one and a half times higher than in urban communities, a statistic that reflects the urgent need for better mental health resources.

In hospitals today, administrators and board members face a unique challenge: balancing the noble mission of healthcare delivery with the pragmatic needs of financial sustainability. This intersection of purpose and practicality finds a compelling solution in an investment philosophy that dates back to the Great Depression – value investing.

Benjamin Graham, often called the father of value investing, developed his investment principles during one of America's most challenging economic periods. His approach, first detailed in "Security Analysis" (1934), emphasized finding the true worth of investments beyond their market prices. This focus on intrinsic value mirrors how hospitals must evaluate both their clinical and financial decisions – with careful analysis, patient consideration, and a long-term perspective.

Howard Marks, a modern torchbearer of value investing principles, wrote in "The Most Important Thing" (2011) that "successful investing requires thoughtful attention to many separate aspects, all at the same time." This multifaceted approach resonates deeply with hospital operations, where success depends on simultaneously managing patient care, financial stability, and community health.

Where lives hang in the balance and split-second decisions can make all the difference, creating a safe environment isn't just about rules and regulations—it's about culture. Specifically, it's about fostering what healthcare experts call a "Just Culture," a framework revolutionizing how healthcare organizations approach patient safety and staff accountability.

At its heart, Just Culture represents a fundamental shift in our thinking about mistakes and accountability in healthcare settings. Rather than defaulting to blame when things go wrong, this approach encourages organizations to take a deeper look at both individual and systemic factors that contribute to errors. It's about finding the delicate balance between personal responsibility and organizational support—understanding that while healthcare professionals must be accountable for their choices, they also deserve support when systems fail them.

Many organizations still struggle with one of the most powerful catalysts for growth: productive disagreement. The instinct to avoid conflict, while natural, often leads to missed opportunities and stagnant thinking. But when handled skillfully, disagreement becomes a driving force for better products, services, and organizational outcomes.

Research from Harvard Business School professor Amy Edmondson reveals a counterintuitive truth: teams that perform at the highest levels often experience the most constructive disagreement. This finding challenges the common belief that harmony equals productivity. Instead, it suggests that our ability to disagree respectfully and productively may be the key to unlocking innovation and excellence.

Standing out and creating a competitive advantage in the marketplace while delivering exceptional patient care has become more challenging than ever. Healthcare organizations continually search for ways to differentiate themselves meaningfully in their markets. One powerful approach that is gaining traction is pursuing Center of Excellence certification through leading accrediting bodies such as DNV GL Healthcare and The Joint Commission (TJC). While each accrediting organization has its unique approach, the strategic value of these certifications extends far beyond the credential itself.

When viewed through the lens of Michael Porter's competitive strategy framework, an orthopedic center of excellence certification emerges as a powerful tool for creating sustainable competitive advantage. Whether through DNV GL Healthcare's innovative ISO 9001-based approach, The Joint Commission's disease-specific care certification, or other recognized programs, the certification process doesn't just validate clinical excellence – it serves as a catalyst for comprehensive organizational transformation that can reshape market positioning and operational effectiveness.