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Annotated presentation for the independent hospital network, 1 13-12

Annotated presentation for the independent hospital network, 1 13-12



Annotated and expanded version of slides used by Values Coach CEO Joe Tye in a presentation for the Independent Hospital Network at the Aultman Health Foundation, January 13, 2012

Annotated and expanded version of slides used by Values Coach CEO Joe Tye in a presentation for the Independent Hospital Network at the Aultman Health Foundation, January 13, 2012



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  • When FN walked into the Scutari Barrack Hospital: There was no clean water, the floors were filthy and the air was foul, rats ran wild and the place was infested with vermin.Soldiers were bedded on blood-soiled straw, most still wearing what they wore on the battlefield.There was no nutritious food and virtually no medicines or supplies, and no money to get any.Orderlies cared only for officers, refused to empty chamber pots, and spent more time chasing nurses than caring for patients.Amputations were performed out in the open in full view of other patients. Surgeons refused to wash their hands and most of their victims died of infection.The first thing the medical director said to her was that he wanted nothing to do with Florence and her do-gooder ladies.He relented only when several boatloads of casualties appeared on the horizon and the hospital was already beyond a state of crisis.

Annotated presentation for the independent hospital network, 1 13-12 Annotated presentation for the independent hospital network, 1 13-12 Presentation Transcript

  • Annotated EditionThe Florence Prescription Building a Culture of Ownership on a Foundation of ValuesIndependent Hospital Network Leadership Summit January 13, 2012 Joe Tye, CEO and Head Coach Values Coach Inc. Copyright © 2012, Values Coach Inc.
  • If your raft is in class 5whitewater and the guidehollers out for everyoneto grab a paddle…
  • What do you do to theperson who says…
  • In the stormy seas of healthcarereform, it is everyone’s job tograb an oar and paddle!
  • Question #1When did thehealthcare crisisbegin?
  • Question #2When will thehealthcare crisisend?
  • This story… 14
  • Has a happyending! 15
  • The Chinese symbol for crisismeans danger + opportunity
  • “Brick walls are notthere to stop you, theyare there to make youprove how much youwant something.” Randy Pausch: The Last Lecture
  • Whether it’s the best of times orthe worst of times depends uponwhat we choose to see
  • 19
  • What would you think of this ship and itsleadership if 25 of the 100 rowers did mostof the work while 60 of them coasted byand 15 of them were actually rowingbackward?
  • Companies that study employeeengagement* consistently find: ~ 25% fully engaged ~ 60% not engaged ~ 15% aggressively disengaged* e.g. Gallup, HR Solutions, Press Ganey
  • Engaged:Spark Plugs 22
  • Not Engaged:Zombies 23
  • Disengaged:Vampires 24
  • Shift Your Bell Curve
  • Employee disengagementnegatively effects clinicalquality, productivity, patient satisfaction, andmarketing image.
  • But what’s evenmore tragic...
  • It has a life-diminishingimpact on the disengaged.
  • “Disengagement [is] oneof the chief causes ofunderachievement anddepression.” Edward M. Hallowell, M.D. in HBR, 12-10
  • The journey from mereAccountability to a culture of Ownership
  • AccountabilityDoing what you are supposedto do because someone elseexpects it of you. It springsfrom the extrinsic motivationof reward and punishment.
  • Do you know people whoseem to think that this isthe official uniform wherethey work?
  • Or that this is the officialjob description?
  • You cannot hold people“accountable” for thethings that really matter.
  • What’s wrongwith thispicture?
  • Nobody ever changesthe oil in a rentalcar!
  • OwnershipDoing what needs to be donebecause you expect it ofyourself. Ownership springsfrom the intrinsic motivationof pride.
  • In a culture ofownership, every jobdescription includes first andforemost being acaregiver, last but not leastbeing a janitor, and in betweenbeing willing to do whateverelse needs to be done.
  • Cultural ownership is of the heart, not ofthe wallet… No one ever walked off the jobof a Habitat project in a pay dispute! 42
  • When baggage handlers at Unitedbroke Dave Carrolls’s Taylorguitar, they refused to reimburse himfor the damage. When he said that hewas going to write a song aboutit, they told him to go ahead. He did –to date, more than 16 million peoplehave viewed “United Breaks Guitars.”
  • 78,545– avg 5 stars As of 01-13-11, 12:15am 18,339,829 views
  • “We have hundreds if notthousands of examples…” 787,839
  • The Taylor Guitar Company made theirown video: how to pack up your Taylorguitar so United won’t break it!
  • How do you spell publicrelations black eye?
  • All it would havetaken to preventthis PR black eyeis one persontaking ownershipfor the problem. 48
  • Unfortunately, becausethat did nothappen, every Unitedemployee has beenpainted with that brush. 49
  • The real losers inthis picture are thegood people whowork at United.
  • United does nothave broken people;United has a brokenculture.
  • A word about theassumptions we make.
  • What do you get whenyou break the word“assume” into itsconstituent parts?
  • Faulty Assumption #1You can’t teach peoplevalues – if they didn’tlearn in kindergarten,it’s too late.
  • Faulty Assumption #2Culture is a given –especially in the shortterm you cannottransform it.
  • Faulty Assumption #3You can “empower”people without themhaving doing the workof self-empowerment.
  • Faulty Assumption #4If you can’t measureit, it’s not worth doing.* * The left brain counts but the right brain matters.
  • InvisibleArchitecture “Invisible Architecture” is a trademark of Values Coach Inc.
  • When it comes to employee andpatient satisfaction, the blueprintthat can’t be seen is moreimportant than bricks andmortar.
  • Invisible architectureis to the soul of yourorganization whatphysical architectureis to its body.
  • Core Values arethe Foundation
  • 65
  • Zappos Family Core Values1. Deliver WOW Through Service2. Embrace and Drive Change3. Create Fun and A Little Weirdness4. Be Adventurous, Creative, and Open-Minded5. Pursue Growth and Learning6. Build Open and Honest Relationships With Communication7. Build a Positive Team and Family Spirit8. Do More With Less9. Be Passionate and Determined10. Be Humble Source: Zappos website
  • 1. Deliver Wow Through ServiceHe goes above and beyond the average level of service tocreate an emotional impacton the receiver and givethem a positive story theycan take with them the restof their lives. Source: Zappos website
  • 68
  • Trust is an outcome that is earned…By the behaviors ofhonesty, reliability, humility, andstewardship, which are founded on…The value of integrity. 69
  • What are the corevalues of yourorganization? 70
  • Why were those specificvalues chosen and whatdo they say about whoyou are and how you doyour business? 71
  • Which value do nursesfeel is more important toexecutive leadership? 72
  • Compassion 73
  • OR… 74
  • Productivity 75
  • This is a false dichotomy. Noorganization can be optimallycompassionate if it is not alsooptimally productive.The first person ever to calculatecost per patient day was… 76
  • OR AND 77
  • Most organizations, no matterwhat industry they are in, claimintegrity as a value, eitherexplicitly or implicitly.But in almost all of them (mostlikely including yours) there is… 78
  • An Integrity Gap 79
  • Because almost every organizationhas a rumor mill… And what does itsay about your commitment tointegrity, respect,and dignity if yourculture toleratespeople spreadingrumors? 80
  • The root of the wordintegrity is “integer” –one unified whole 81
  • The guiding insights behindour work at Values Coach… 82
  • Nobody learnseverything theyneed to know inkindergarten!
  • Why should you careabout the personalvalues of yourpeople? 88
  • “People who are clearestabout their personal visionand values are significantlymore committed to theirorganizations.” James Kouzes and Barry Posner: A Leaders Legacy 89
  • 90
  • Participants say it’s like graduateschool for life (or like graduateschool for the seven habits). 92
  • These universal valuestranscend politicalopinion, religious belief (ornon-belief), ethnic heritage,and social class. 93
  • After all, who wantsto be a phony?Core Action Value #1is Authenticity 94
  • Don’t we all need to livewithintegrity, awareness, courage, perseverance, and faith?The first six Core Action Values lay asolid foundation of character strength 95
  • Don’t we all need the powerofpurpose, vision, focus, enthusiasm, and service?The second six Core Action Values helpus do our work and make a difference 96
  • Don’t people who livetheir values inspire andinfluence others?Core Action Value#12 is Leadership 97
  • The business casefor values training…
  • Is not really aboutbusiness
  • The individual wins:“If people could understand theircore values, they would saveyears of doubt, confusion, andmisplaced energy as they try tofind direction for their lives.” Laurie Beth Jones: Jesus CEO 101
  • The organization wins:“People who are clearest abouttheir personal vision and valuesare significantly more committedto their organizations.” James Kouzes and Barry Posner: A Leaders Legacy 102
  • It’s not that you do ordon’t practice values –it’s where you fall on thecontinuum. 103
  • And if you are not movingforward, then you aresliding backward. 104
  • In Stage 4 decline “peoplecannot easily articulatewhat the company standsfor; core values have erodedto the point of irrelevance.” Jim Collins: How the Mighty Fall 105
  • Why it mattersnow more thanever before… 106
  • Values andvalue-basedpurchasing. 107
  • People will sustainpersonal change only tothe extent that they aremotivated by deeply heldcore values. 108
  • 109
  • Recruitingandretentionis not one word.Use the “Honey andGlue” formula to findand keep great people. 110
  • You recruit with the “honey”of left-brain features such aspay and benefits… 111
  • You retain with the “glue” ofright-brain qualities reflectedin values and culture. 112
  • Source: Roger Herman, et al: Impending Crisis:Too Many Jobs, Too Few People (page 139) 113
  • When a critical mass ofpeople connect withand act upon their corevalues, they will have apositive impact on…
  • Corporate culture isthe superstructure
  • Culture is morally neutral.Enron had a powerful culture.
  • Culture is to theorganization whatpersonality andcharacter are to theindividual.
  • “I came to see, in mydecade at IBM, thatculture isn’t just oneaspect of the game –it is the game.”
  • Culture eats strategyfor lunch!
  • Corporate culture didn’t evenmake the top ten list of CEOconcerns in the 2010 ACHEsurvey on issues facing theindustry.
  • Who has the powerto change theculture of yourorganization? 124
  • Anyone can have an influence on theculture of the organization simply byraising expectations of how we treatour patients and howwe treat each other. 125
  • You do not need an architecturaldegree to design the InvisibleArchitecture of your organization! Shawneen Buckley of Saint Francis Hospital and Health Center in Poughkeepsie, New York 126
  • Culture doesn’t changeunless peoplechange, and that isemotionalwork!
  • Emotional attitudeis the interior décor
  • As with finishing off abuilding, the outwardreflection of corporateculture is…
  • If I were to becomea hospital CEOtoday…
  • This would be myresponse!
  • Seriously, in that rolethe first thing I wouldgive my attention towould be…
  • The invisible ceilingon your hospital’sperformance
  • Every child has superpowers, but we tend to forgetthem as we grow up – especiallyif subjected to an emotionallytoxic workplace.
  • In The Florence Prescription:From Accountability toOwnership, Sarah Rutledge is anurse with great clinical skillsbut a toxic negative attitude.
  • Our challenge as healthcareleaders is to move people fromthe “Rutledge Quadrant” intothe high-passion and high-performance quadrant of thismatrix…
  • I would help peopleconfront the malignantecho of negative self-talk
  • By showing them howto have “The Janitor inYour Attic” erase suchtoxic mental graffiti
  • And help them setaside debilitatingemotional baggage
  • By showing them howto leave it behind on acairn in the desert
  • 146
  • A positive workplaceculture begins withintolerance for toxicemotional negativity. 147
  • “One toxically negativeperson can drag downmorale and productivityof an entire workunit.” 148
  • “It is a leadershipresponsibility to create aworkplace environmentwhere toxic emotionalnegativity is nottolerated.” 149
  • The Pickle Challenge is asimple and light-heartedapproach for people to holdeach other accountable forthe attitudesthey bring towork.
  • A real “Sarah Rutledge” story 153
  • Remember these days? What wouldhappen to someone who lit a cigaretteon a plane today? 154
  • Building aculture ofownership
  • Do you have to start with theright people on the bus?
  • You can’t alwayschoose who you haveon the bus!
  • You can’t just throwall the “wrong”people off the bus!
  • You can create a bus thateveryone wants to ride
  • 163
  • The Florence Challenge website“resources” section includes awealth of additional resources forbuilding a culture of ownership. www.TheFlorenceChallenge.com
  • More than 400 hospitals and healthcareorganizations and nearly 80,000 books. 165
  • Only $5per book: 166
  • Call Michelle:800-644-3889 167
  • 1. CommitmentTo the values, vision, andmission of the organization
  • The Vision Statement of Columbus Regional HospitalTo be the best in the world at everything we do. 170
  • “We need to see opportunitieswhere others see barriers. Weneed to be cheerleaders whenothers are moaning doom-and-gloom.”
  • “We need to face problemswith contrarian toughnessbecause it’s in how we solvethose problems that wedifferentiate ourselvesfrom everyone else.”
  • When the goinggets tough...
  • Cultural toughness is theultimate competitive advantage
  • 2. EngagementWithpatients, coworkers, andwith the work itself
  • “Having a highly engagedworkforce is the firstthing required to winon the global stage.” Jim Owens, retired CEO, Caterpillar Inc.
  • At Best Buy, a 0.1%increase in employeeengagement generatesa $100,000 increase ingross store revenue* * Harvard Business Review, October 2010
  • I went into the Apple storeto look at an iPhone andwalked out with a $4,000iMac computer – sold to meby another customer! 179
  • Apple does nothave employees…Apple does nothave customers… 180
  • Apple is a cult! 181
  • Books like In Search ofExcellence and Built to Lastremind us that greatcompanies have “cult-likecorporate cultures.
  • And in organizations withsuch cultures, people areinspired to be engaged –with customers, withcoworkers, and with thework itself.
  • 3. PassionEnthusiasm, positiveattitude, and joy reflectedin everyday actions
  • What’s wrong with this picture?There is an undeniable element of cheerleading inthe most effective leadership, according to JamesO’Toole in the book Leadership A to Z.
  • The official uniform at TexasRoadhouse Restaurants
  • Colonel Jennifer is founding director of theCenter for the Intrepid, which cares for themost horribly wounded soldiers. Despitetheir grim task, CFI is a place that shineswith passion!
  • 4. InitiativeDon’t wait around to be“empowered” – ProceedUntil Apprehended!
  • Leadership in everycorner, not just inthe corner office.
  • No one gave Cool Hand Lukepermission to become a leader onthe chain gang, and to transformdrudge work into a game.
  • His attitude was…
  • Courage is thecatalyst forinitiative 192
  • It did not take Randall Patrick McMurphylong to realize that the men in “the cuckoo’snest” were not crazy – they were frightenedinto paralysis.
  • People and organizations can bothbe paralyzed by irrational fears
  • Are people afraid ofchange?
  • 5. StewardshipBecause we don’t own theearth – we are borrowing itfrom our grandchildren
  • Operation Wipeout – Spark Plugs at theAlaska VA Healthcare System adoptlocal homeless shelter
  • Last year, the nonprofit SuppliesOver Seas organization sent 60tons of discarded medical suppliesand equipment to third worldcountries
  • 6. BelongingIn a culture ofownership, people aretreated like partners, notjust hired hands
  • “You would think they’d give meas much information about ourhospital finances as I get at myonce-a-month school boardmeeting.” 202
  • Would you expect to see someof America’s most financiallyliterate employees working onan assembly line rebuilding olddiesel truck engines? 203
  • But you would at SpringfieldRemanufacturing, where JackStack invented open bookmanagement
  • 7. FellowshipBecause (as Mother Teresareminded us) we are allchildren of the same God
  • The need for fellowship is soprofound that in the absence ofother people…
  • We can find it in avolleyball
  • The most memorable Coke adsdon’t even talk about fizzybrown sugar water, do they?
  • 209
  • Committeeof the Ring 210
  • The Ring Team 211
  • Fellowship ofthe Ring 212
  • 213
  • 8. PrideIn your organization, inyour profession, in yourwork, and in yourself
  • Pride is reflected in the answer tothat universal icebreaker question: What do you do?
  • Does the answer convey: I’m good at what I do. I love what I do. I’m proud of what I do. What I do is important.
  • The most powerful andcost-effective marketingcampaign your hospitalcould ever launch! Thanks for asking…
  • What could be more boring thanindustrial ventilation systems?
  • Big Ass Hospital.comThis page is parked free, courtesy of GoDaddy.com. 220
  • Key Lessons Learned(thus far) fromImplementation of theValues Collaborative
  • Lesson #1Launching a movement is alot harder than starting aprogram – it is also muchmore likely to achieve alasting positive impact.
  • Lesson #2Achieving critical massrequires approximately 30%population commitment. 223
  • You need enough peoplemoving fast enough toescapenegativity, pessimism, cynicism, and inertia of thepast.
  • Lesson #3Senior leadership musthave a highly visiblelevel of engagementand commitment.
  • Lesson #4Middle management’s meresupport is not enough –they must be gung hochampions for change.
  • The privileges of being amanager also entail certainforegone freedoms
  • Lesson #5Sustainability requires agrowing core of passionate“Spark Plugs” who have apersonal stake in culturaltransformation.
  • Personal stories resonatefar better than scriptedlectures – culturaltransformation is moreabout sharing than it isabout teaching.
  • Lesson #6Embrace theskeptics, marginalize thecynics, and plow throughresistance.
  • Lesson #7Engage potential critics ina constructive manner –encourage them to thinklike partners in thechange process.
  • Lesson #8Avoid identification of thechange process with anysingle individual or“program.”
  • Lesson #10Create initiativecoherence by being clearabout how variousprojects reinforce oneanother.
  • Lesson #11Keep it visible:posters, banners, screensavers, newsletterarticles, web pages;include it at the start ofevery meeting.
  • Lesson #12Remember that everyonelistens to the same radiostation: WIIFM
  • Lesson #13Balance urgency andpatience; be in it for thelong haul.
  • Lesson #14Sometimes it’s more magicthan it is science!
  • “If we each do ourpart, we will changeour lives for thebetter.” 240
  • The work of changing an organizationbegins with helping the people whowork there make positive changes intheir own livesResponses fromMaster Values CoachTrainers in VISN 20of the Veterans HealthAdministration
  • “If we all do ourparts, we will changeour organizations forthe better.” 242
  • In a growing number oforganizations across thecountry, groups of peoplegather daily to read thatday’s promise from TheSelf-Empowerment Pledge 243
  • 244
  • “And in changing ourorganizations, we canchange our world for thebetter.” 245
  • Building a Culture of Ownership is theUltimate Win-Win-Win
  • The Patient Wins
  • The Hospital Wins
  • The Caregiver Wins