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.
2. “Invisible architecture, notbuildings, determines whetheryou are a good hospital, agreat hospital, or just anotherhospital.”
3. Today we’re going todesign the InvisibleArchitecture™ for ahypothetical greenfieldhealth system.
4. Self-Made Man byBobbie Carlyle
5. Let’s talk about employeeengagement and a cultureof ownership, but first let’sgo on a little rafting trip…
6. This storm willnot pass and youcannot just waitit out.
7. Equilibrium is a statewhere every force iscancelled out by another.In other words… Stagnant
8. “Disequilibrium is thenecessary condition for asystem’s growth.” Margaret Wheatley: Leadership and the New Science
9. Question #1When did thehealthcare crisisbegin?
10. Question #2When will thehealthcare crisisend?
11. Companies that study employeeengagement* consistently find: ~ 25% fully engaged ~ 60% not engaged ~ 15% aggressively disengaged* e.g. Gallup, HR Solutions, Press Ganey
12. Engaged:Spark Plugs 24
13. Not Engaged:Zombies 25
14. Disengaged:Vampires 26
15. “Whatever the engaged do, theactively disengaged seek toundo, and that includesproblemsolving, innovation, andcreating new customers...”
16. Disengagedpeople, especiallydisengaged managers, are aquality defect Jim Clifton: The Coming Jobs War
17. Disengagementnegatively effects…
18. Clinical quality
19. Patient safety
23. Job security
24. But what’s evenmore tragic...
25. It has a life-diminishingimpact on the disengaged.
26. “Disengagement [is] oneof the chief causes ofunderachievement anddepression.” Edward M. Hallowell, M.D. in HBR, 12-10
27. Dilbert Disease
28. Organizational CultureAssessment SurveyWould you be okay with3.39 on a 5.0 scale?
29. The higher you are in theorganization the morelikely it is you are wearingrose tinted glasses. U Iowa Center for Health Policy and Research 42
30. Shifting the Attitude Bell Curve
31. Is the midpoint of the curve inthe same for middle managers?
32. Or worse yet does your culturetolerate little Donalds?
33. Remind me to tell youabout Jim Kilts and theturnaround at Gillette.
34. “Going from 30 million engagedworkers to 60 million engagedworkers would change the face ofAmerica more than any leadershipinstitution, trillions of stimulusdollars, or any law or policyimaginable.” Jim Clifton: The Coming Jobs War
35. If doubling the number ofengaged workers would solveevery problem inAmerica, imagine what itwould do for yourorganization!
36. The journey from mereAccountability to a culture of Ownership
37. Ac count able
38. AccountabilityDoing what you are supposedto do because someone elseexpects it of you. It springsfrom the extrinsic motivationof reward and punishment.
39. You cannot hold people“accountable” for thethings that really matter.
40. Nobody ever changesthe oil in a rentalcar!
41. OwnershipDoing what needs to be donebecause you expect it ofyourself. Ownership springsfrom the intrinsic motivationof personal pride.
42. The Ideal Job descriptionFirst and foremost acaregiver, last but notleast a janitor, and inbetween whatever elseneeds to be done.
43. In a culture ofownership, the jobdescription is afloor, not a ceiling
44. Someone with a job is never secure.Someone with a calling is never unemployed. - McZen
45. 79,996– avg 5 stars As 2-5-13, 1:30am 18,979,525 views
46. “We have hundreds if notthousands of examples…” 796,911
48. Who Owns Left Field?Ball Girl Video
49. This ownershipis of theheart, not ofthe wallet
50. Nobody ever walked awayfrom a Habitat for Humanityproject in a pay dispute.
51. A word about theassumptions we make.
52. “The way that we pose ourquestions often illusorily limitsour responses… The way wethink our thoughts illusorilylimits us to a perspective ofeither/or.” Gary Zukav: The Dancing Wu Li Masters
53. What do you get whenyou break the word“assume” into itsconstituent parts?
54. Let’s watch as theword “assumption”gets deconstructed(along with those whomade the assumption)
55. Assumptions video link
56. What are some ofthe self-limitingassumptions we mightbe making in ourorganizations?
57. The neurobiology ofcorporate culture
58. Rewiring theorganizationalbrain 79
59. Bean Counter Poet
60. Management is of theleft brain.Leadership is of theright brain. 81
61. And in today’sworld we needleaders in everycorner – not just inthe corner office
62. transactional Transformational
63. Rules Values
64. Process Attitude
65. Plans Inspires
66. Measured Seen
67. A Given A Choice
68. Inert Contagious
69. What you do Who you are
70. Boring! Chaos!
71. Left BrainCounts beans
72. Right brain creates
73. The old paradigm 95
74. The new paradigm 96
75. RecruitingandRetention … is not just one word! 98
76. You recruit with the “honey”of left-brain features such aspay and benefits… 100
77. You retain with the “glue”of right-brain qualitiesreflected invalues, culture, andattitude. 101
78. One more thing – if“lean” is all left brain,you are just speedingup the assembly line.
79. It’s not accountability(left brain) ORownership (rightbrain).
80. It’s how we interrelatethe two to create awhole brain culture.
81. InvisibleArchitecture™ “Invisible Architecture” is a trademark of Values Coach Inc.
83. Invisible Architecture™is to the soul of yourorganization whatphysical architectureis to its body.
84. We use a constructionmetaphor to designInvisible Architecture.
85. But you don’t need tohave an architecturaldegree to design yourInvisible Architecture!
86. Shawneen Buckley at St. Francis Hospital andHealth Center of Poughkeepsie, New York
87. TMC Values …Honor Tradition, Nourish Dreams
88. 3 stages
89. In our constructionmetaphor, the foundation iscore values, the superstructureis corporate culture, and theinterior is emotional attitude.
90. “The only assets we have asa company [are] ourvalues, our culture andguiding principles, and thereservoir of trust with ourpeople.” Starbucks CEO Howard Schultz in Harvard
91. Core Values arethe Foundation
92. Core valuesdefine what youstand for andwhat you won’tstand for
93. When people buy into acommon set ofvalues, you don’t needto have a lot of rules
94. Auto-Owners Insurance expectseach of its 3,600 associates toknow by heart its ten core values.
95. Auto-Owners Insurance has… One half the turnover of the industry average. Double the productivity of the industry average. Highest customer satisfaction in the industry 122
96. Make that 4!
97. “These values have made ourcompany successful, and they arethe foundation of a successfulcareer within our company. Theyguide every decision we make,and direct every action we take.” Roger Looyenga (with Joe Tye): Take the Stairs
98. Nobody does itbetter than...
100. 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
101. 1. Deliver Wow Through ServiceCore Values Frog thinks anything worth doing is worthdoing with WOW. To WOW, CVF differentiates himself bydoing things in an unconventional and innovative way.He goes above and beyond the average level of service tocreate an emotional impact on thereceiver and give them a positivestory they can take with them therest of their lives. Source: Zappos website
102. When’s the last time you calleda 1-800 call center number andmonths later remembered thename of the person you talkedto – and told anyone whowould listen your story?
103. The Values Behaviors Outcomes Continuum
104. The desiredOutcome isTrust
105. The requiredBehaviors areHonesty andReliability
106. The motivatingValue is Integrity
107. Do your valuesinspire trust,passion, and prideamong your people?
108. Do they evenknow whatthey are?
109. Which value do nursesfeel is more important toexecutive leadership? 136
110. Compassion 137
111. OR… 138
112. Productivity 139
113. The 3-minutevalues drill
114. Current versionCompassionAdvocacyRespectExcellence Values statement of a Values Coach client
115. Old version New versionCompassion IntegrityAdvocacy EnthusiasmRespect LoyaltyExcellence Stewardship Ownership Fun
116. What are the corevalues of ourgreenfieldhospital?
117. The guiding insights behindthe Values Collaborative… 144
118. Values arePersonal
119. Values areSkills
120. Skills can beLearned
121. Skills must bePracticed
122. It’s not that you do ordon’t practice values –it’s where you fall on thecontinuum. 149
123. And if you are not movingforward, then you aresliding backward. 150
124. 7 reasons why youshould care about thepersonal values (skills)of your people… 151
231. Seven Simple PromisesThat Will Change Your Life* * One for each day of the week.
232. If you’ve been waitingfor someone else toempower you, youshould know that…
233. No one can empower youbut – YOU – and once youhave empowered yourself…No one cantake thatpower away.
234. The Self-EmpowermentPledge can give you thatpower – but first you needto invest in yourself…
235. If you knew it wouldchange your life for thebetter – profoundly andpermanently – would youinvest …
236. A minute a day forthe next 365 days
237. Would you give up onetelevision commerciala day for a year tochange your life?
238. If your answeris yes, here’swhat you needto do.
239. Every morning startyour day by making thatday’s promise – whichwill take you about15 seconds.
240. Repeat the promiseagain in in the middleof your work day.
241. Once more before youleave for home.
242. And one more time rightbefore you go to bed.
243. 4 x 15 seconds= 1 minute
244. Repeat these promises likeyou really mean them!
246. Let’s take a lookat the sevenpromises…
247. Monday’s Promise:Responsibility
248. Tuesday’s Promise:Accountability
249. Wednesday’s Promise:Determination
250. Thursday’s Promise:Contribution
251. Friday’s Promise:Resilience
252. Saturday’s Promise: Perspective
253. Sunday’s Promise: Faith
254. Here’s WHYit works…
255. You keep promising yourself that youwill be responsible, accountable, anddetermined; make a contribution, beresilient in the face of adversity, have apositive perspective,and that your faithwill shine through.
256. Then you catch yourself whining andcomplaining, procrastinating,gossiping, blaming others for yourproblems, taking when you should begiving, and pretendingthat you have no power.
257. You end up with whatpsychologists call…Cognitive Dissonance
258. Which is trying to simultaneouslyhold two incompatible beliefs
259. At that point, one of twothings MUST happen.Either you take the easyway and stop makingthe promises…
260. Or you keep making thepromises until you beginto change your attitudesand yourbehaviors.
261. And as you do that, youwill begin to achievebetter results in everydimension of your life.
262. When you get home, readthese seven promises onemore time…
263. Now ask yourself thesetwo questions…
264. Question #1:If you personally were to takethese seven promises toheart, would you be better offthan where you are headed now–personally, professionally, finan
265. Question #2:If everyone where you work madea good faith effort to live theseseven promises, would you do abetter job of serving customersand of supporting each other?
266. If your answer to these two questions is…And if you’re beinghonest, that’s whatyour answer will be.
267. Then why wouldn’t youinvest those 365 minutesin yourself? Do it,because no one canempower youbut you.
268. Will you do it? Willyou give up one TVcommercial a day…To changeyour life?
269. The Pledge is a greatway to foster a moreempowering culture!
271. Building aculture ofownership
272. Do you have to start with theright people on the bus?
273. You can’t alwayschoose who you haveon the bus!
274. You can’t just throwall the “wrong”people off the bus!
275. You can create a bus thateveryone wants to ride
276. It starts with ashared vision
277. The Vision Statement of Columbus Regional HospitalTo be the best in the worldat everything we do. 342
279. The differencebetween wishfulthinking andpositive thinking… 345
280. Wishful thinking ishoping for something andwaiting for someone elseto make it happen. 346
281. The new American Dream 347
282. Positive thinking isexpecting something andworking to make ithappen. 348
284. Wear your Dream next toyour heart 352
285. Five times every morningand two things every day. 353
286. A Memory of the Futurecreates healthy cognitivedissonance 354
288. The 6-As forcreating Memoriesof the Future 356
289. 1. AspirationYou gotta want it –without ambition wewould all still be huntingand gathering. 357
290. 3. ArticulationYou need to describeyour dream in a way thatothers can see it. 358
291. 3. AffirmationBecause we dream inpictures but we worry inwords. 359
292. 4. AskingThe Aladdin Factor isasking the right questionof the right personat the right time. 360
309. Can one personwho takes initiativechange yourorganization? 387
311. Are people afraid ofchange?
312. StewardshipManagingpersonal, organizational, and global resources for thegreat grandchildren
313. BelongingTreating employees asthough they really werepartners and owners
314. The root of the wordintegrity is “integer” –one unified whole
315. FellowshipFostering a “supportgroup” culture ofrespect and caring
317. Committeeof the Ring 405
318. The Ring Team 406
319. Fellowship ofthe Ring 407
321. PrideIn the organization,in the profession, inthe work, and in youyourself
322. Pride is reflected in the answer tothat universal icebreaker question: What do you do?
323. What do you do?Thanks for asking!I’m good at what I do.I love what I do.I’m proud of what I do. WhatI do is important.
324. What could be more boring thanindustrial ventilation systems?
325. bigasshospital.comThis page is parked free, courtesy of GoDaddy.com. 414
326. 15 Strategies for building a culture of ownership on afoundation of values
327. Purpose of the Values CollaborativeShare The Twelve Core ActionValues and related content withpeople to help them in theirpersonal and professional lives –in such a way that it helps theorganization foster a strongerculture of ownership.
328. Nebraska Values Trainers:
329. Nebraska Values Trainers:
330. Mary Lanning Memorial HealthCareGallup Engagement Score improvedfrom 23rd to 72nd percentile (achievingin 18 months what Gallup said wouldordinarily have taken five years).
331. Fillmore County HospitalPatient satisfaction increased in 27of 30 categories.CEO Paul Utemark said he got awhole new team and didn’t have tochange any of the people.
332. Community Hospital (employees)Rating hospital as excellent place to workincreased by 26% to the 74th percentile.Rating training & development as“excellent” increased by 51% to 91stpercentile.Likelihood of recommending hospital asexcellent place to work increased by 45%to 84th percentile.
333. Strategy #1Launching a movement is alot harder than starting aprogram – it is also muchmore likely to achieve alasting positive impact.
334. How to Start a Movement
335. Strategy #1 AppliedHow can you position yourdesired culture change as amovement, e.g. creating agossip-free workplace topromote integrity.
336. Strategy #2Achieving critical massrequires approximately 30%population commitment. 427
337. Strategy #2 AppliedWho are your “lone nuts”and how can you help themidentify those crucial firstfollowers? 428
338. Strategy #3You need enough peoplemoving fast enough toescapenegativity, pessimism, cynicism, and inertia of thepast.
339. Strategy #3 AppliedWhat immediate and short-term goals can help youquickly gain traction andbuild momentum?
340. Strategy #4People must believeleadership is committedto the cultural vision.
341. Strategy #4 AppliedWhat actions will leaderscommit to on a sustainedbasis to demonstratesupport, e.g. daily readingof The S-E Pledge.
342. Strategy #5Middle management’s meresupport is not enough –they must be gung hochampions for change.
343. You are here
344. Corollary to Strategy #5The privileges of being amanager also entail certainforegone freedoms
345. Strategy #5 AppliedWhat message will you giveto middle management thatobstruction and second-guessing will not betolerated: get on or get off.
346. Strategy #6Sustainability requires agrowing core of passionate“Spark Plugs” who have apersonal stake in culturaltransformation.
347. Strategy #6 AppliedWhat actions will you taketo nurture (and protectfrom cynics) the peoplehuddled in the middle ofthe Attitude Bell Curve?
348. Strategy #7Personal stories resonatebetter than scriptedlectures.
349. You simply cannot buyadvertising like this!
350. The most effective safetylecture I ever heard.
351. And now, a motivational wordfrom your manager…
352. Strategy #7 Applied – AWhat mechanisms can youuse to collect, edit, andpublish stories from yourLone Nuts, First Followers,and Spark Plugs?
353. Strategy #7 Applied – BWhat steps can you take toprepare your managers tobe better public speakersand storytellers?
354. Strategy #8Embrace theskeptics, marginalize thecynics, and plow throughresistance.
355. Strategy #8 AppliedCome to a consensus onwhen skeptical questionsbecome cynical obstructionand an agreed upon waymanagement will respond
356. Strategy #9Engage potential critics ina constructive manner –encourage them to thinklike partners in thechange process.
357. Strategy #9 AppliedBegin by identifying thepeople who could derailyour effort (medicalstaff, union, etc.) andapproach them early inthe process.
358. Strategy #10You cannot allow peopleto opt-out of culturechange!
359. Strategy #10 AppliedDefine which actions aremandatory (e.g. valuestraining) and which arevoluntary (e.g. The PickleChallenge or The Pledge).
360. Strategy #11Avoid identification of thechange process with anysingle individual or“program.”
361. Strategy #11 AppliedDescribe every “program”in the context ofvalues, purpose, and visionof the organization – andshow how it reinforcesthese.
362. Strategy #12Create “initiativecoherence” by being clearabout how variousprojects and programsreinforce one another.
363. Strategy #12 AppliedBe creative in showinglinkages – e.g. a graphic withan umbrella arching oversymbols representing theseprojects and programs.
364. Strategy #13Keep it visible: posters,banners, screensavers,newsletter articles, webpages; include it at thestart of every meeting.
365. Strategy #13 AppliedSee illustration.
366. Strategy #14Remember that everyonelistens to the same radiostation: WIIFM.
367. Strategy #14 AppliedBefore asking people to“do more with less,” helpthem do it at home, e.g.by offering a low-costDave Ramsey course.
368. Strategy #15Balance urgency andpatience; be in it for thelong haul.
369. “If we each do ourpart, we will changeour lives for thebetter.” 463
370. “If we all do ourparts, we will changeour organizations forthe better.” 464
371. “And in changing ourorganizations, we canchange our world for thebetter.” 465