0
Some Things You Would Do
       Differently
        Fred Lee
3 Key Premises

We have reached the ceiling in how much
 we can improve patient satisfaction
 scores with our current appr...
Table of Contents
If Disney ran your hospital you would…
1. Focus on What Can’t be Measured
2. Make Courtesy More Importan...
If Disney
 Ran Your
Hospital You
  Would...

          1.
Focus on What Can’t Be
      Measured
On Measurement
“Not all that can be counted, counts. And not all that
counts can be counted.”              -- Albert Einst...
Measurement


     Outcomes                 Perceptions

                       Satisfied        Loyal fan
Clinical   Fina...
Impact of PI on Total Quality
                                                     Talent
                      ns
       ...
You can’t manage perceptions in the
       same way you manage outcomes.

Outcomes (left brain)          Perceptions (righ...
If Disney
 Ran Your
Hospital You
  Would...
            2.
   Make Courtesy More
     Important Than
       Efficiency
Disney’s Quality Priorities




       1. Safety
       2. Courtesy
       3. Show
       4. Efficiency
How do you make courtesy
more important than efficiency?

    PERSONAL EXAMPLES

          Personal efficiency vs.
       ...
Paradox: Customer First is More Efficient
 unit efficiency first      courtesy first

    internal focus         external ...
If Disney
 Ran Your
Hospital You
  Would...
              3.
      Consider Patient
     Satisfaction Fool’s
            G...
In Commercial Businesses
 Research on satisfaction shows…

On a scale of 1 to 5, people who mark a 4 are
  six times more ...
Why is it so hard to raise our scores?


       +2         Meeting expectations = 0
       +1
        04        Satisfied ...
Patient satisfaction is a fool’s gold.




        It’s the same as zero!
        Neither good nor bad.
Singing our praises…
Caring, Cared, Cares +32
Kind, kindness +24                             Committed
                   ...
The Three Levels of Care
                                      Patient
 Staff               Staff
                        ...
Three enemies of caring
               This is about
   Enemy                         Enemy
  is not..                    ...
If Disney
 Ran Your
Hospital You
  Would...
           6.
 Change the Concept of
  Work from Service to
        Theater
Disney is not a service and neither are we.

                             Experiences
   The progression
   of economic   ...
Theater is about life –
 comedy and tragedy.
               Disney:
                  Meeting the emotional needs of
     ...
Focus on the patient’s experience,
          not our service…
Companies stage an experience whenever they
engage customers...
At the Wilderness Lodge

   Think Disney
experience, not just
department or hotel
     service.

                 Think pa...
Our Service Or Their Experience?

                      OR       Experience paradigm
Service paradigm
   Depends on the em...
Borrowing from Theater

THE DIRECTOR:
Start by describing the experience you want the guest
   to have (see, hear, and fee...
Borrowing from Theater

THE ACTOR:

Actors learn how to be real by becoming emotionally
   engaged with their character.
A...
Acting is not pretending…
Eric Morris, No Acting,
                            To paraphrase…
Please (first sentence)

    ...
Theater changes the service paradigm…

From patient satisfaction –
                  to a fan with a story to tell

From j...
Theater changes the service paradigm…

From hiring for the skills to do a job –
                  to casting for the talen...
Knowing how is not the problem…
Like losing weight, our problem is not with
knowing how. When we want to enough,
we figure...
W. Edwards Deming might add…

              What is the value of
                  a committed
               ensemble of ...
In The Box
You can’t get different results by doing more of
  the same old things in the same old way.

             Centr...
Correlating patient and employee satisfaction.
PREMISE: Excellence is Fun

There is nothing like excellence to improve morale.

Anything done poorly is hard work and a r...
Overcoming Inertia

                                                  >   Organizational
Dissatisfaction                  ...
The Wall
              Compliance                 Commitment

                                         Loyalty
           ...
Old Paradigm to New

                       Memorable Experience
Service excellence
                       Starts anywhere...
Fallacy of asking, “How?”

“Asking How? Is a favorite defense
against taking action.”
     Peter Block, The Answer to How ...
Knowing how is not the problem…
Like losing weight, our problem is not with
knowing how. When we want to enough,
we figure...
3 Key Premises

We have reached the ceiling in how much
 we can improve patient satisfaction
 scores with our current appr...
Baldrige Criteria
      Category: Patient Satisfaction

APPROACH: How will we talk about going
  from good to great in pat...
3 Key Premises

We have reached the ceiling in how much
 we can improve patient satisfaction
 scores with our current appr...
Baldrige Criteria
       Category: Patient Satisfaction

APPROACH: Going from good to great by using
  the experience appr...
Baldrige Criteria
       Category: Patient Satisfaction

DEPLOYMENT: Involving everyone. From just…


Committees          ...
Baldrige Criteria
          Category: Patient Satisfaction

RESULTS: Use feedback that motivates. From…
                  ...
If Disney
 Ran Your
Hospital You
  Would...
            2.
   Make Courtesy More
     Important Than
       Efficiency
Pillars are Equally Important




SERVICE • PEOPLE • QUALITY • FINANCIAL
Disney’s Quality Priorities




                1. Safety
                2. Courtesy
                3. Show
            ...
Hospitals Need To Add Compassion
1. Safety/Quality
      Evidence based medicine.
      Zero defects / Reducing variation ...
Two Biggest Barriers to Internal
          Customer Service
1. Poor communication, by which they mean,
   “Someone in anot...
Deming Principles

QUALITY: Reduce variation
EFFICIENCY: Calculate the COPQ (cost
  of poor quality) in each step of the
 ...
Paradox: Customer First is More Efficient
 unit efficiency first      courtesy first

    internal focus         external ...
What is a grand slam
                in performance?

WIN on quality (you reduced variation)
WIN on efficiency (your reduc...
Budgeting Process Questions
1. Where and how will you reduce
   expenses this year?

2. Will anything you do affect anothe...
Conversation
 What do you do for your own
 efficiency that frustrates other
 departments or patients?

 If you changed it ...
If Disney
 Ran Your
Hospital You
  Would...
           6.
 Change the Concept of
  Work from Service to
        Theater
Disney is not a service and neither are we.

                             Experiences
   The progression
   of economic   ...
Theater is about life –
 comedy and tragedy.
               Disney:
                  Meeting the emotional needs of
     ...
Our Service Or Their Experience?

                      OR       Experience paradigm
Service paradigm
   Depends on the em...
Borrowing from Theater

THE DIRECTOR
Start by describing the experience you want the guest
   to have (see, hear and feel)...
Borrowing from Theater

THE ACTOR:

Actors learn how to be real by becoming emotionally
   engaged with their character.
A...
Video clip: Connie
      1. What is Connie’s
         problem? What does her
         body language and tone
         of v...
Coaching Tips
1. Plan your coaching sessions, do not “wing it.”
2. Ask leading questions to get the other person to say
  ...
If Disney
 Ran Your
Hospital You
  Would...

            7.
 Harness the Motivating
  Power of Imagination
What determines our response to stimulus?


                                      R
                       I
     S
      ...
Four Levels of Motivation
                                             Weakest
1 Compliance
    (based on authority, rewar...
Handling an Upset Customer




    
Disney Teaches:
(Left brain approach)

    Listen
    Apologize
    Solve
    Thank
 ...
Dealing With an Irate Person

When someone goes
ballistic…




                    Empathize       Cool Off
   Ventilate  ...
If Disney
 Ran Your
Hospital You
  Would...
          9.
Stop Using Competitive
 Rewards to Motivate
         Staff
Some characteristics of high IQ types
that make for poor manager coaches.

• Don’t listen because they are used to knowing...
Some characteristics of high IQ types
that make for poor manager coaches.

• Stingy with compliments, because they don’t
 ...
Add three Requirements for Promotion
         (High IQ = To get an “A”)

1) Has this person shown an ability to inspire,
 ...
In theater it’s an ensemble, not a team.
  Describe the characteristics of an ensemble
              All are on the same p...
Which Model is More Useful
                  for Hospitals?




In sports, a team              In theater, an ensemble
is ...
Paradox of Competition
“You can’t have the fruits of cooperation from
a paradigm of competition.”
                        ...
Separating Recognition from Competition

Stories:
       • TWA attendant
       • ED compliment cards.
       • Boys and t...
According to virtually all
    the research on motivation..


Extrinsic rewards tend to
extinguish intrinsic motivation, a...
What is gained by…
Searching only to reward the “best” and not the rest?
      It makes all but one feel like losers.
    ...
Instant
Feedback
Cards
If Disney
 Ran Your
Hospital You
  Would...

          10 .
Close the Gap Between
  Knowing and Doing
Lee Performance Evaluation Grid

                                                       Shaded zone
                5     ...
Overcoming Inertia

                                                  >   Organizational
Dissatisfaction                  ...
Organizational Change
–
                         Model (Fred Lee)
–
    Feedback
–
    Data
–
–
–
–
     “could be”
–
–
–
...
Organizational Change
–
                         Model (Fred Lee)
–
    Feedback
–
    Data
–
–
–
–
     “could be”
–
–
–
...
Organizational Change
                            Model (Fred Lee)
–
    Feedback
–
    Data
–
–
–

                      ...
Leadership Commitment

“At the moment of commitment, the
universe conspires to assist you.”
                             G...
Organizational Change
                            Model (Fred Lee)
–
    Feedback
–
    Data
–

                          ...
10 Key Ideas To Start Immediately
1. Have a daily huddle to value and encourage staff, and
    share best practices.
2. De...
Ownership
    What is the value of
        a committed
        ensemble of
   caregivers who have
          become
     co...
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Presentatie Fred Lee Part 1+2 Maart 2009

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Transcript of "Presentatie Fred Lee Part 1+2 Maart 2009"

  1. 1. Some Things You Would Do Differently Fred Lee
  2. 2. 3 Key Premises We have reached the ceiling in how much we can improve patient satisfaction scores with our current approach. We cannot go from good to great in patient perceptions by copying and deploying what they do at service companies like Ritz-Carlton or Nordstrom’s. Culture is driven by management systems, not workers or values.
  3. 3. Table of Contents If Disney ran your hospital you would… 1. Focus on What Can’t be Measured 2. Make Courtesy More Important Than Efficiency 3. Regard Patient Satisfaction as Fool’s Gold 4. Measure to Improve, not to Impress 5. Decentralize the Authority to Say “yes” 6. Change the Concept of Work from Service to Theater 7. Harness the Motivating Power of Imagination 8. Create a Climate of Dissatisfaction 9. Cease Using Competitive Rewards to Motivate People 10. Close the Gap Between Knowing and Doing
  4. 4. If Disney Ran Your Hospital You Would... 1. Focus on What Can’t Be Measured
  5. 5. On Measurement “Not all that can be counted, counts. And not all that counts can be counted.” -- Albert Einstein “The most important figures one needs for management are unknown and unknowable…(invisible also used)…What is the value, for instance, of the multiplying effect of a happy customer and the opposite effect from an unhappy customer…(or the) Loss from inhibitors to pride of workmanship?” -- W. Edwards Deming, Out of the Crisis, p. 122
  6. 6. Measurement Outcomes Perceptions Satisfied Loyal fan Clinical Financial Good to Great
  7. 7. Impact of PI on Total Quality Talent ns tio Place of choice p ce r Emotional Pe Reputation improves Skills Customers sing our praises Total Quality PERFORMANCE IMPROVES Processes improve Analytical Ou Skills Productivity improves tco m es Costs go down
  8. 8. You can’t manage perceptions in the same way you manage outcomes. Outcomes (left brain) Perceptions (right brain) Objective, Measurable Subjective, Impressions Created by teams Created by individuals Map and study process steps Take action -- just do it! Improve technical competence Inspire attitudes and behaviors “Zero defects” thinking “Best possible” thinking Based on what you do Based on what you say Eliminate avoidance Eliminate carelessness 80% of our PI scores 80% of our PS scores
  9. 9. If Disney Ran Your Hospital You Would... 2. Make Courtesy More Important Than Efficiency
  10. 10. Disney’s Quality Priorities 1. Safety 2. Courtesy 3. Show 4. Efficiency
  11. 11. How do you make courtesy more important than efficiency? PERSONAL EXAMPLES Personal efficiency vs. Accessibility Job efficiency vs. Saying “yes” Process efficiency vs. Responsiveness
  12. 12. Paradox: Customer First is More Efficient unit efficiency first courtesy first internal focus external focus unresponsive responsive compete for resources share resources Results in overall Results in overall organizational organizational inefficiency efficiency & teamwork
  13. 13. If Disney Ran Your Hospital You Would... 3. Consider Patient Satisfaction Fool’s Gold Wilderness Lodge
  14. 14. In Commercial Businesses Research on satisfaction shows… On a scale of 1 to 5, people who mark a 4 are six times more likely to defect to the competition than those who mark a 5. Harvard Business Review, Nov-Dec, 1995
  15. 15. Why is it so hard to raise our scores? +2 Meeting expectations = 0 +1 04 Satisfied = 0 -1 Satisfied patients have no story to tell -2 Hampton Inn, huddle -3
  16. 16. Patient satisfaction is a fool’s gold. It’s the same as zero! Neither good nor bad.
  17. 17. Singing our praises… Caring, Cared, Cares +32 Kind, kindness +24 Committed Understanding +2 Compassionate +15 Warm Thoughtful +2 Help, helpfulness +15 Upbeat Knowledgeable +2 Comfort, comforting +13 Generous Smiling +2 Softness Bedside manner +2 Friendly +8 Pleasant Empathy +2 Professional +9 Supportive Attention, attentive +7 Tender +1 Concerned +6 Cheerful Takes time +1 Listens +4 Informative Competent Sensitive Loving +3 Efficient Reassuring Sweet +3 Proficient Selfless Respect +3 Prompt Gentle Quick +3 Hardworking Nice Polite +3 Courteous Conscientious Patient +3
  18. 18. The Three Levels of Care Patient Staff Staff Evaluation Motivation Performance Inspire 5 Compassion Require 4 Courtesy Hire 3 Competence 1&2 Fire Judy
  19. 19. Three enemies of caring This is about Enemy Enemy is not.. Is… Compassion Indifference Judging What I Feel Courtesy Rudeness Avoidance What I Say Incompetence Competence Carelessness What I Do
  20. 20. If Disney Ran Your Hospital You Would... 6. Change the Concept of Work from Service to Theater
  21. 21. Disney is not a service and neither are we. Experiences The progression of economic Stage value Services 00 19 e Deliver nc Si Goods E IM Entertainment? T Make R E Commodities V O Joe Pine, The Experience Economy Extract
  22. 22. Theater is about life – comedy and tragedy. Disney: Meeting the emotional needs of a family to have fun together. Hospital: Meeting the emotional needs of a family suffering a tragedy together. A hospital without compassion is like Disney without fun.
  23. 23. Focus on the patient’s experience, not our service… Companies stage an experience whenever they engage customers, connecting with them in a personal, memorable way.” “They actually occur with any individual who has been engaged on an emotional, physical, intellectual, or even spiritual level. The result? No two people can have the same experience – period.” B. Joseph Pine II, The Experience Economy
  24. 24. At the Wilderness Lodge Think Disney experience, not just department or hotel service. Think patient Or… experience, not just department or hospital service.
  25. 25. Our Service Or Their Experience? OR Experience paradigm Service paradigm Depends on the emotional needs of the patient. High anxiety No Pain Pain Low anxiety Compassion Courtesy What you feel What you say Clinical effect No clinical effect
  26. 26. Borrowing from Theater THE DIRECTOR: Start by describing the experience you want the guest to have (see, hear, and feel) and how to make each scene memorable. Cast for the talent to play the role called for in the guest experience, rather than just the skills to do a job. Clarify each person’s role in creating a memorable experience and get their commitment to their role.
  27. 27. Borrowing from Theater THE ACTOR: Actors learn how to be real by becoming emotionally engaged with their character. Actors rely on sense memory and imagination to become real in their role.
  28. 28. Acting is not pretending… Eric Morris, No Acting, To paraphrase… Please (first sentence) Care giving is the art of Acting is the art of creating genuine creating genuine realities realities on the stage. on the hospital stage. No No matter what the matter what the event, the material, the actor’s caregiver’s fundamental fundamental question is: question is: “What is the “What is the reality and reality of this patient’s how can I make it real to experience, and how can I me?” make it real to me?” Acting must “come from Compassion also must a real place.” “come from a real place.”
  29. 29. Theater changes the service paradigm… From patient satisfaction – to a fan with a story to tell From just being courteous – to engaging the guest From our service excellence – to their memorable experience
  30. 30. Theater changes the service paradigm… From hiring for the skills to do a job – to casting for the talent to play a caring role in the guest experience From teaching body language – to teaching acting principles (being real through imagination)
  31. 31. Knowing how is not the problem… Like losing weight, our problem is not with knowing how. When we want to enough, we figure out how and learn by doing. Our problem is with being committed enough to do what it takes every day, and do it permanently, not just in short bursts of inspired energy.
  32. 32. W. Edwards Deming might add… What is the value of a committed ensemble of care givers who have become compassionately engaged in the patient’s experience?
  33. 33. In The Box You can’t get different results by doing more of the same old things in the same old way. Centralized Control Unit Efficiency Focus Silo mentality Percentile ranking Compliance culture Just to Outsourced coaching mention a Competitive rewards few…
  34. 34. Correlating patient and employee satisfaction.
  35. 35. PREMISE: Excellence is Fun There is nothing like excellence to improve morale. Anything done poorly is hard work and a real drag. Persistent mediocrity is discouraging, depressing and saps all our energy. Anything done at the level of excellence or in the pursuit of excellence with a great coach is FUN and energizing.
  36. 36. Overcoming Inertia > Organizational Dissatisfaction Knowing Vision of + + Inertia with “as is” “how to” “could be” Must be greater than Comfort zone Force of habit
  37. 37. The Wall Compliance Commitment Loyalty Satisfaction Improvement Ownership Autonomy Excellence Enthusiasm Teamwork Program Inoculation Time
  38. 38. Old Paradigm to New Memorable Experience Service excellence Starts anywhere Starts at the top Citizenship Leadership Ownership Empowerment Responsibility Accountability Commitment Compliance Learn by doing Do by learning
  39. 39. Fallacy of asking, “How?” “Asking How? Is a favorite defense against taking action.” Peter Block, The Answer to How is Yes
  40. 40. Knowing how is not the problem… Like losing weight, our problem is not with knowing how. When we want to enough, we figure out how and learn by doing. Our problem is with being committed enough to do what it takes every day, and do it permanently, not just in short bursts of energy.
  41. 41. 3 Key Premises We have reached the ceiling in how much we can improve patient satisfaction scores with our current approach. We cannot go from good to great in patient perceptions by copying and deploying what they do at service companies like Ritz-Carlton or Nordstrom’s. Culture is driven by management systems, not workers or values.
  42. 42. Baldrige Criteria Category: Patient Satisfaction APPROACH: How will we talk about going from good to great in patient perceptions that is inspiring and motivating for our staff? DEPLOYMENT: Who will lead out, and how will we generate commitment throughout the organization at every level? RESULTS: How will we get, track, and use feedback?
  43. 43. 3 Key Premises We have reached the ceiling in how much we can improve patient satisfaction scores with our current approach. We cannot go from good to great in patient perceptions by copying and deploying what they do at service companies like Ritz-Carlton or Nordstrom’s. Culture is driven by management systems, not workers or values.
  44. 44. Baldrige Criteria Category: Patient Satisfaction APPROACH: Going from good to great by using the experience approach rather than a service approach. Moving from the good of… Patient’s experience Our service to Dept Courtesy first Dept Efficiency first to Hardwired courtesy Emotional support to
  45. 45. Baldrige Criteria Category: Patient Satisfaction DEPLOYMENT: Involving everyone. From just… Committees Departmental ownership to Managers coaching Educators training to Inspiring compassion Hardwiring service to
  46. 46. Baldrige Criteria Category: Patient Satisfaction RESULTS: Use feedback that motivates. From… Loyalty (% top box) Satisfaction (avg.) to Courtesy / service Compassion / healing to Quantitative (data) Qualitative (stories) to
  47. 47. If Disney Ran Your Hospital You Would... 2. Make Courtesy More Important Than Efficiency
  48. 48. Pillars are Equally Important SERVICE • PEOPLE • QUALITY • FINANCIAL
  49. 49. Disney’s Quality Priorities 1. Safety 2. Courtesy 3. Show 4. Efficiency What’s missing for patients? Internal customers?
  50. 50. Hospitals Need To Add Compassion 1. Safety/Quality Evidence based medicine. Zero defects / Reducing variation (Deming) 2. Compassion Emotional support as best clinical practice, affecting stress, anxiety, pain, and the immune system. 3. Courtesy Constantly seeking out guest contact. (Disney) 4. Presentation We are always on stage. What will the audience see, hear, and feel? 5. Efficiency Unit efficiency vs. courtesy and overall efficiency. Reducing the cost of poor quality (Deming)
  51. 51. Two Biggest Barriers to Internal Customer Service 1. Poor communication, by which they mean, “Someone in another department makes a decision that affects us without consulting with us first.” 2. Poor teamwork, by which they mean: • competing for resources • unresponsive, unhelpful processes • silo mentality, workarounds
  52. 52. Deming Principles QUALITY: Reduce variation EFFICIENCY: Calculate the COPQ (cost of poor quality) in each step of the process. When the process breaks down Workarounds Redundancy Unclear responsibilities
  53. 53. Paradox: Customer First is More Efficient unit efficiency first courtesy first internal focus external focus unresponsive responsive compete for resources share resources Results in overall Results in overall organizational organizational inefficiency efficiency & teamwork
  54. 54. What is a grand slam in performance? WIN on quality (you reduced variation) WIN on efficiency (your reduced overall costs) WIN on customer satisfaction WIN on staff job satisfaction
  55. 55. Budgeting Process Questions 1. Where and how will you reduce expenses this year? 2. Will anything you do affect another department? If so, explain. 3. Have you discussed your plans with them and gotten their agreement that this way is the most efficient overall?
  56. 56. Conversation What do you do for your own efficiency that frustrates other departments or patients? If you changed it to be more customer friendly, estimate the cost to your department, then estimate the cost benefit (value added) to those you serve. How would your people like the change?
  57. 57. If Disney Ran Your Hospital You Would... 6. Change the Concept of Work from Service to Theater
  58. 58. Disney is not a service and neither are we. Experiences The progression of economic Stage value Services 00 19 e Deliver nc Si Goods E IM T Make R E Commodities V O Joe Pine, The Experience Economy Extract
  59. 59. Theater is about life – comedy and tragedy. Disney: Meeting the emotional needs of a family to have fun together. Hospital: Meeting the emotional needs of a family suffering a tragedy together. A hospital without compassion is like Disney without fun.
  60. 60. Our Service Or Their Experience? OR Experience paradigm Service paradigm Depends on the emotional needs of the patient. High anxiety No Pain Pain Low anxiety Compassion Courtesy What you feel What you say Clinical effect No clinical effect
  61. 61. Borrowing from Theater THE DIRECTOR Start by describing the experience you want the guest to have (see, hear and feel) and how to make each scene memorable. Cast for the talent to play the role called for in the guest experience, rather than just the skills to do a job. Clarify each person’s role in creating a memorable experience and get their commitment to their role.
  62. 62. Borrowing from Theater THE ACTOR: Actors learn how to be real by becoming emotionally engaged with their character. Actors rely on sense memory and imagination to become real in their role.
  63. 63. Video clip: Connie 1. What is Connie’s problem? What does her body language and tone of voice tell you? 2. Make a list of behaviors you wish Connie would follow.
  64. 64. Coaching Tips 1. Plan your coaching sessions, do not “wing it.” 2. Ask leading questions to get the other person to say to you what you wanted to say to them. Remember the mind instinctively “reacts” to statements. 3. Use imagination to get them to put themselves in other peoples’ shoes, or your shoes. 4. Listen and reflect back all important points before responding. 5. Say, “I need a person in your position who will________” not, “I need you to__________” 6. Add, “…and I wish it could be you.”
  65. 65. If Disney Ran Your Hospital You Would... 7. Harness the Motivating Power of Imagination
  66. 66. What determines our response to stimulus? R I S Imagination Response Stimulus (pain & fear) (empathy) Emotions Fight or Flight All growth Empathy happens here Body language Tone of voice Freeway
  67. 67. Four Levels of Motivation Weakest 1 Compliance (based on authority, rewards, threats) 2 Will Power (based on values and beliefs) 3 Imagination (based on feelings) Habit 4 Strongest (based on character)
  68. 68. Handling an Upset Customer  Disney Teaches: (Left brain approach) Listen Apologize Solve Thank There’s a better way…
  69. 69. Dealing With an Irate Person When someone goes ballistic… Empathize Cool Off Ventilate Listen Explain Listen Thank Stay Calm
  70. 70. If Disney Ran Your Hospital You Would... 9. Stop Using Competitive Rewards to Motivate Staff
  71. 71. Some characteristics of high IQ types that make for poor manager coaches. • Don’t listen because they are used to knowing more than others, and love to prove it. • Underdeveloped EQ (emotional intelligence), not needed for academic success. • Success built on critical analysis, therefore tend to critique ideas, rather than consider or try them, which tends to kill creativity and “thinking outside the box.”
  72. 72. Some characteristics of high IQ types that make for poor manager coaches. • Stingy with compliments, because they don’t need them. For the exceptional one only. • Have a greater need to be “right” than “liked.” • Highly judgmental, so tend to lack the empathy & tact needed in a collaborative world. • Succeeded in an independent, competitive environment (school), so think individual competition succeeds everywhere.
  73. 73. Add three Requirements for Promotion (High IQ = To get an “A”) 1) Has this person shown an ability to inspire, coach, and motivate others without resorting to threats and bribes? 2) Has this person demonstrated a commitment to customer service that is verified by measurable results or feedback? 3) Does this person understand and talk about our focus on the patient’s emotional experience, not just courtesy standards?
  74. 74. In theater it’s an ensemble, not a team. Describe the characteristics of an ensemble All are on the same page, take turns being the soloist, and support each other. Can improvise but must know the tune and the rhythm to stay in sync. Joy is in the playing, and making a memorable experience for the audience, not in competing with each other. Success is in the overall performance, not in winning or losing. Do not need a “leader” to become great.
  75. 75. Which Model is More Useful for Hospitals? In sports, a team In theater, an ensemble is motivated by… is motivated by… • The joy of performing • The thrill of winning • In concert with others • In competition with others • To engage an audience • To defeat another team • And win their applause • And win their trophy What does the applause of a patient sound like?
  76. 76. Paradox of Competition “You can’t have the fruits of cooperation from a paradigm of competition.” Steven Covey A basic drive in some personalities…especially males. A healthy source of motivation between organizations, dysfunctional within.
  77. 77. Separating Recognition from Competition Stories: • TWA attendant • ED compliment cards. • Boys and the old man Employees want recognition for good work, not competing with other members of their team. Employees are hungry for appreciation, not contests. They want more individual, spontaneous praise, not more trophies or coffee mugs at special events.
  78. 78. According to virtually all the research on motivation.. Extrinsic rewards tend to extinguish intrinsic motivation, and with it the values the rewards were intended to encourage! See Punished by Rewards by Alfie Kohn
  79. 79. What is gained by… Searching only to reward the “best” and not the rest? It makes all but one feel like losers. Hampers teamwork. Fosters jealousy and sabotage. Rewarding only those who do something unusual that goes above and beyond? How about those who are… Always cheerful? Always responsible? Always dependable?
  80. 80. Instant Feedback Cards
  81. 81. If Disney Ran Your Hospital You Would... 10 . Close the Gap Between Knowing and Doing
  82. 82. Lee Performance Evaluation Grid Shaded zone 5 must change or AR d en ST leave. i Fr PEOPLE 4 Focus on and Compassionate praise relating 3 e Courteous ag ert er and doing Helpful p Av Ex strengths. 2 ATTITUDE Work around 1 weaknesses. 2 3 4 5 1 TASK Accuracy / Speed / Consistency DELIVERABLES
  83. 83. Overcoming Inertia > Organizational Dissatisfaction Knowing Vision of + + Inertia with “as is” “how to” “could be” Must be greater than Comfort zone Force of habit
  84. 84. Organizational Change – Model (Fred Lee) – Feedback – Data – – – – “could be” – – – – – – – – – – – – “as is” – performance – – – – – –
  85. 85. Organizational Change – Model (Fred Lee) – Feedback – Data – – – – “could be” – – – – INERTIA – – – – – – – – “as is” – performance – – – – – –
  86. 86. Organizational Change Model (Fred Lee) – Feedback – Data – – – er – g – na – a M – – INERTIA – – – – – – – – – performance service – – standards – – – communication –
  87. 87. Leadership Commitment “At the moment of commitment, the universe conspires to assist you.” Goethe
  88. 88. Organizational Change Model (Fred Lee) – Feedback – Data – nt – e itm – – m om – c – er – g na – a INERTIA – M – Modeling – – – Relating – – – Coaching – performance service – Learn by doing – standards – – – communication –
  89. 89. 10 Key Ideas To Start Immediately 1. Have a daily huddle to value and encourage staff, and share best practices. 2. Determine how to seek out and use feedback on frustrations (rounding). 3. Do discharge phone calls to patients within 48 hrs. 4. Do the avoidance exercise (the enemy of courtesy). 5. Focus on the patient experience, not our service. 6. Use patient letters and comments instead of numbers to motivate and generate specific ideas for improvement. 7. Talk to each about “your role in the patient experience.” 8. Make courtesy more important than efficiency, especially in the support services. 9. Ask, “Why is it easy to feel compassion for some patients and not others?” (Judging) 10. Teach the ballistic curve in dealing with anger.
  90. 90. Ownership What is the value of a committed ensemble of caregivers who have become compassionately engaged in the patient’s experience?
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