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
We come with (some) good news

Cutting budgets can be an opportunity . . . .
to reinvent your work in a new&better way
Really. Glass half-full and all that!

We are here with PRACTICAL counsel on
how to do it
And what’s the alternative? Just say NO?
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 . . . . .

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
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
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 . . . . .
Is it mean to be lean
OR
keen to be lean??
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 . . .
Time to remember . . . .
It’s not personal. It’s business.

That’s how the CEO sees it, so if you react
personally . . . . .
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?
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
“I said we are in bad shape,
and my PR VP said but I still
need this budget”
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.”
SO . . . . . where do you
start and what do you do?
A practical 5-step
analytic approach
Our 5-Step Approach
1.
Lock in the essentials that must stay (but may be
revamped).
Then look at what’s left and:
2. Ruthlessly assess the high cost items
3. Analyze and evaluate remaining programs and
prioritize the keepers
4. Identify NEW best practice efforts that you want
to add
5. Finally – go back over what’s left on the table and
ask “How can we do this more cost effectively”
Step One: Identify, justify
and recommit to the
ESSENTIALS
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
Essential #1 Customer Satisfaction
PR plays a leading role
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
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
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
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
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
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
Essential #2 Internal Comms
Creating a motivated workforce
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
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
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
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
Do you rely on huddles
for information?
Patient loyalty scores:
cause and effect?
Other major gains
Pre
Post
Change
Consumer Top-of-mind
Awareness
36.3%
44.2%
 7.9
Consumer Preference
31.2%
41.6%
 10.4
Market Share
35.3%
38.9%
 3.6
-2%
1%
3pts
Profitability
Chain of success starts
with satisfied employees
Essential #3 Web Presence
It’s the foundation
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
Now that we know
what’s staying . . . .
. . . . .How to sort out the rest
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
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
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
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? Have
we maximized what we can communicate “for free”? Can we
do more face-to-face communication?
Step Three: Assess and prioritize
(How to retain your sanity, your
employment status and your peers)
Hint: use a PROCESS,
not a dart board
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?
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
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
Marketing and Communications Prioritization Methodology
Program
Priority
Decision
Publicity
Marketing
Key Client –
Business as
Usual
Included in
Strategic
Plan
IN (8)
IN (1)
Not Included in
Strategic Plan
Low
Marketing
Impact
Marketing can
Impact
High ROI
Low ROI
Potential
No Potential
IN (7)
OUT (3)
OUT (3)
KEY:
High Backing
1 = Will do: major program
Low Backing
2 = Planning support & may do
3 = Won’t do
Resources
Available
No Resources
Identified
Resources
Available
No Resources
Identified
7 = Publicity effort only
8 = Key client: business as usual
IN (1)
IN (2)
IN (2)
OUT (3)
For example:
Product Selection Guide for Marketing & Communications
Completed by:_______________________________________________
Date_____________________
Step 1 Step 2 -
Score each product /service line applying the following scale:
4 = strongly agree, 3 = agree, 2 = disagree, 1 = strongly disagree
Mult iply score times weight.
Insert product/service line Š
such as Cardiac, OB, Oncology,
Sports Medicine, ER
1. Market Share Growth Potential.
There is opport unity for increased
market share
2. Profi tabi lity. The product/service
line contributes significant ly t o
profitability.
3. Product De velopment. The
product Is in place, not smoke and
mirrors. This is a truly int egrated
product line, not a loose collection of
services.
4. Im pact on Managed C are. This
Service will be a significant factor in
obtaining and/or negot iat ing managed
care contracts.
Total Score for each service line
Times weight (3)
Total for factors with a weight of (3)
X3
X3
X3
X3
X3
X3
X3
X3
X3
X3
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
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
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)
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 . . . .
Having completed
the five steps . . . .
Now you have a PLAN





Begins with the Essentials
Omits high ticket items that don’t deliver real
value
Rank orders programs and projects,
eliminating the low rankers to make more
time for . . . . .
New programs
AND everything has been scrutinized for
cost efficiency and effectiveness
So sell it . . . . .
It meets needs within budget constraints
 It’s based on best practices, proven effective
 You’ve built in metrics and research dollars to ID
results!
 Have an expert or expert opinion available to tee up
or back up your plan
 Pre-sell it to key peers so they “get it” and will
speak up in support
You’ve created a better program, with more content
and results, for the same or less money . . . AND
you’re free from the things that never worked!

Stay in touch

We welcome phone or email questions and
dialogue
Klewton@LSTLLC.com 917 734 5376
Sseekins@LSTLLC.com 818 378 6664
Ktrester@LSTLLC.com 313-515-0321
www.lstllc.com