A Culture of Ownership at Genesis Health System

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Slides used by Values Coach CEO Joe Tye for leadership retreat program with Genesis Health System.

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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.
  • A Culture of Ownership at Genesis Health System

    1. 1. Lessons for Building aCulture of Ownership Genesis Health System November 15, 2012 Joe Tye, CEO and Head Coach Values Coach Inc. Copyright © 2012, Values Coach Inc.
    2. 2. If you’d like special reports,workbooks, and otherresources to build ontoday’s session, fill out theform or send me an email: Joe@JoeTye.com 2
    3. 3. Self-Made Man byBobbie Carlyle
    4. 4. This storm willnot pass and youcannot just waitit out.
    5. 5. Question #1When did thehealthcare crisisbegin?
    6. 6. Question #2When will thehealthcare crisisend?
    7. 7. This story… 17
    8. 8. Has a happyending! 18
    9. 9. Companies that study employeeengagement* consistently find: ~ 25% fully engaged ~ 60% not engaged ~ 15% aggressively disengaged* e.g. Gallup, HR Solutions, Press Ganey
    10. 10. Engaged:Spark Plugs 22
    11. 11. Not Engaged:Zombies 23
    12. 12. Disengaged:Vampires 24
    13. 13. What Gallup sees…
    14. 14. What patients see…
    15. 15. Memo to Doug…With all due respect, Iwould like to clarify twokey numbers: 36 and 10.
    16. 16. Shifting the Attitude Bell Curve
    17. 17. Genesis is generally 10-15points below best-in-classhealthcare scores foremployee engagement.What will it take to closethat gap?
    18. 18. The significant outlier – ata 23 point gap – is “Seniormanagement is concernedabout employees.”What’s this all about?
    19. 19. Is the midpoint of the curve inthe same for middle managers?
    20. 20. Remind me to tell youabout Jim Kilts and theturnaround at Gillette.
    21. 21. Disengagementnegatively effects…
    22. 22. Clinical quality
    23. 23. Patientsatisfaction
    24. 24. Patient safety
    25. 25. Productivity
    26. 26. Marketingimage
    27. 27. Turnover (goodand bad)
    28. 28. Job security
    29. 29. But what’s evenmore tragic...
    30. 30. It has a life-diminishingimpact on the disengaged.
    31. 31. “Disengagement [is] oneof the chief causes ofunderachievement anddepression.” Edward M. Hallowell, M.D. in HBR, 12-10
    32. 32. The neurobiology ofcorporate culture
    33. 33. 46
    34. 34. Bean Counter Poet
    35. 35. Management is of theleft brain.Leadership is of theright brain. 48
    36. 36. And in today’sworld we needleaders in everycorner – not just inthe corner office
    37. 37. transactional Transformational
    38. 38. Rules Values
    39. 39. Process Attitude
    40. 40. Plans Inspires
    41. 41. Measured Seen
    42. 42. A Given A Choice
    43. 43. Inert Contagious
    44. 44. What you do Who you are
    45. 45. Boring! Chaos!
    46. 46. Left BrainCounts beans
    47. 47. Right brain creates
    48. 48. RecruitingandRetention … is not just one word! 62
    49. 49. You recruit with the “honey”of left-brain features such aspay and benefits… 64
    50. 50. You retain with the “glue”of right-brain qualitiesreflected in values, culture,and attitude. 65
    51. 51. One more thing – if“lean” is all left brain,you are just speedingup the assembly line.
    52. 52. It’s not accountability(left brain) ORownership (rightbrain).
    53. 53. It’s how we interrelatethe two to create awhole brain culture.
    54. 54. The journey from mereAccountability to a culture of Ownership
    55. 55. Ac count able
    56. 56. AccountabilityDoing what you are supposedto do because someone elseexpects it of you. It springsfrom the extrinsic motivationof reward and punishment.
    57. 57. You cannot hold people“accountable” for thethings that really matter.
    58. 58. Nobody ever changesthe oil in a rentalcar!
    59. 59. OwnershipDoing what needs to be donebecause you expect it ofyourself. Ownership springsfrom the intrinsic motivationof personal pride.
    60. 60. 79,973– avg 5 stars As 11-15-12, 1:30am 18,975,125 views
    61. 61. “We have hundreds if notthousands of examples…” 795,929
    62. 62. 81
    63. 63. Who Owns Left Field?
    64. 64. A word about theassumptions we make.
    65. 65. What do you get whenyou break the word“assume” into itsconstituent parts?
    66. 66. Let’s watch as theword “assumption”gets deconstructed(along with those whomade the assumption)
    67. 67. InvisibleArchitecture™ “Invisible Architecture” is a trademark of Values Coach Inc.
    68. 68. Invisible Architecture™is to the soul of yourorganization whatphysical architectureis to its body.
    69. 69. We use a constructionmetaphor to designInvisible Architecture.
    70. 70. 3 stages
    71. 71. You don’t need to havean architectural degreeto design the InvisibleArchitecture of yourhospital!
    72. 72. Shawneen Buckley at St. Francis Hospital andHealth Center of Poughkeepsie, New York
    73. 73. Core Values arethe Foundation
    74. 74. Core valuesdefine what youstand for andwhat you won’tstand for
    75. 75. TMC Values …Honor Tradition, Nourish Dreams
    76. 76. What are theGenesis HealthCore Values?
    77. 77. The Values  Behaviors Outcomes Continuum
    78. 78. Genesis Health Core ValuesIntegrityCompassionSafetyAccountability Values?Respect Behaviors?Excellence Outcomes?
    79. 79. The 3-minutevalues drill
    80. 80. Current versionCompassionAdvocacyRespectExcellence Values statement of a Values Coach client
    81. 81. Old version New versionCompassion IntegrityAdvocacy EnthusiasmRespect LoyaltyExcellence Stewardship Ownership Fun
    82. 82. Nobody does itbetter than...
    83. 83. 107
    84. 84. 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
    85. 85. 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
    86. 86. 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?
    87. 87. The guiding insights behindour work at Values Coach… 111
    88. 88. Values arePersonal
    89. 89. Values areSkills
    90. 90. Skills can beLearned
    91. 91. Skills must bePracticed
    92. 92. 7 reasons why youshould care about thepersonal values (skills)of your people… 116
    93. 93. Reason #1The invisible ceiling onperformance 117
    94. 94. Reason #2Commitment 123
    95. 95. “People who are clearestabout their personal visionand values are significantlymore committed to theirorganizations.” James Kouzes and Barry Posner: A Leaders Legacy 124
    96. 96. Reason #3Loyalty 125
    97. 97. People are loyal tovalues and culture, notto business strategies. 126
    98. 98. Source: Roger Herman, et al: Impending Crisis:Too Many Jobs, Too Few People (page 139)
    99. 99. Reason #4 BehavioralExpectations 128
    100. 100. Core Action Value #4 is CourageYou can teachpeople the Courageskills needed to…
    101. 101. Call a time-out duringa procedure eventhough the delayannoys everyone else
    102. 102. Confront disrespectfuland bullying behavior
    103. 103. Walk out on gossip,backbiting, and toxicemotional negativity
    104. 104. Reason #5Employee health and wellbeing 133
    105. 105. 134
    106. 106. Reason #6 Riskmanagement 135
    107. 107. Wal-Marts Mexican BriberyScandal Will Sink It Like anIceberg Sank the Titanic Adam Hartung column heading in Forbes, 4/26/12 136
    108. 108. This values violationcheated Wal-Martshareholders out of$12.5 BILLION dollarsin a single day!
    109. 109. In case you think thatsuch things couldn’thappen in hospitals…
    110. 110. One in eight U.S. patients whohave non-emergency stentingprocedures to clear blockedarteries in the heart are likelyto see more harm than goodfrom the procedure,researchers said last year.
    111. 111. Reason #7It’s the rightthing to do 141
    112. 112. Nobody learnseverythingthey need toknow inkindergarten!
    113. 113. When a critical mass ofpeople connect withand act upon their corevalues, they will have apositive impact on…
    114. 114. Corporate culture isthe superstructure
    115. 115. Culture is to theorganization whatpersonality andcharacter are to theindividual.
    116. 116. Same businessDifferentcultures
    117. 117. “Culture influences howwe deliver care, how weinterrelate with ourcolleagues, and howwe treat our patients.”
    118. 118. Culture eats strategyfor lunch!
    119. 119. Static culture can dooman organization
    120. 120. When strategy andculture collide, culturewill win
    121. 121. Genesis Health has astrategic plan – but doyou have a culture plan?
    122. 122. Can you describethe Genesis Healthculture in just sixwords?
    123. 123. Hemingway wrote ashort story in just 6words 154
    124. 124. And this guy made afortune with just 6words
    125. 125. From a largemedical productscompany 156
    126. 126. Version 1Global company drivenby motivated individuals 157
    127. 127. Version 2Great company, oftenown worst enemy 158
    128. 128. Version 3Process driven crisismanagement creatingdysfunction 159
    129. 129. From a largeacademicmedical center 160
    130. 130. Version 1Heartfelt commitmentunifies a dynamicculture 161
    131. 131. Version 2Sailing in turbulentwaters rudders aligned 162
    132. 132. Version 3Dedicated employeesdeflated by overwhelmingobstacles 163
    133. 133. Culture doesn’t changeunless people change,and that isemotionalwork!
    134. 134. Emotional attitudeis the interior décor
    135. 135. 166
    136. 136. A positive workplaceculture begins withintolerance for toxicemotional negativity. 171
    137. 137. Emotional climate isdetermined by whatyou expect and whatyou tolerate… 172
    138. 138. And over time, whatyou tolerate willdominate over whatyou say you expect! 173
    139. 139. Genesis values includeintegrity, compassion,and respect. But doesyour culture tolerate… 174
    140. 140. 175
    141. 141. “One toxically negativeperson can drag downmorale and productivityof an entire workunit.” 176
    142. 142. 180
    143. 143. What do people say whena manager finally findsthe resolve to deal with atoxic negative employee?
    144. 144. What tookyou so long?
    145. 145. Building aculture ofownership
    146. 146. Do you have to start with theright people on the bus?
    147. 147. You can’t alwayschoose who you haveon the bus!
    148. 148. You can’t just throwall the “wrong”people off the bus!
    149. 149. You can create a bus thateveryone wants to ride
    150. 150. Fairfield Medical Center Adapts Florence totheir Recruiting and Retention Brand
    151. 151. Shared VisionTransform wishes anddreams into Memories ofthe Future
    152. 152. 199
    153. 153. 201
    154. 154. CommitmentTo the values, vision, andmission of the organization
    155. 155. Do you remember what Flosaid about the first days ofthe culture change processat Bon Secours?
    156. 156. Commitment ismost importantwhen the goinggets tough...
    157. 157. “We need to see opportunitieswhere others see barriers. Weneed to be cheerleaders whenothers are moaning doom-and-gloom.”
    158. 158. “We need to face problemswith contrarian toughnessbecause it’s in how we solvethose problems that wedifferentiate ourselvesfrom everyone else.”
    159. 159. “Brick walls are notthere to stop you, theyare there to make youprove how much youwant something.” Randy Pausch: The Last Lecture
    160. 160. EngagementWith patients, coworkers,and with the work itself
    161. 161. At Best Buy, a 0.1%increase in employeeengagement generatesa $100,000 increase ingross store revenue* * Harvard Business Review, October 2010
    162. 162. PassionEnthusiasm, positiveattitude, and joy reflectedin everyday actions
    163. 163. InitiativeDon’t wait around to be“empowered” – ProceedUntil Apprehended!
    164. 164. Can one personwho takes initiativechange yourorganization? 220
    165. 165. 223
    166. 166. FellowshipBecause (as Mother Teresareminded us) we are allchildren of the same God
    167. 167. 227
    168. 168. PrideIn your organization, inyour profession, in yourwork, and in yourself
    169. 169. Pride is reflected in the answer tothat universal icebreaker question: What do you do?
    170. 170. 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.
    171. 171. What could be more boring thanindustrial ventilation systems?
    172. 172. BigAssHospital.com 233
    173. 173. 15 Strategies for building a culture of ownership on afoundation of values
    174. 174. Mary Lanning Memorial HealthCareGallup Engagement Score improvedfrom 23rd to 72nd percentile (achievingin 18 months what Gallup said wouldordinarily have taken five years).
    175. 175. 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.
    176. 176. 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.
    177. 177. Strategy #1Launching a movement is alot harder than starting aprogram – it is also muchmore likely to achieve alasting positive impact.
    178. 178. Strategy #1 AppliedHow can you position yourdesired culture change as amovement, e.g. creating agossip-free workplace topromote integrity.
    179. 179. Strategy #2Achieving critical massrequires approximately 30%population commitment. 242
    180. 180. Strategy #2 AppliedWho are your “lone nuts”and how can you help themidentify those crucial firstfollowers? 243
    181. 181. Strategy #3You need enough peoplemoving fast enough toescape negativity,pessimism, cynicism, andinertia of the past.
    182. 182. Strategy #3 AppliedWhat immediate and short-term goals can help youquickly gain traction andbuild momentum?
    183. 183. Strategy #4People must believeleadership is committedto the cultural vision.
    184. 184. Strategy #4 AppliedWhat actions will leaderscommit to on a sustainedbasis to demonstratesupport, e.g. daily readingof The S-E Pledge.
    185. 185. Strategy #5Middle management’s meresupport is not enough –they must be gung hochampions for change.
    186. 186. You are here
    187. 187. Corollary to Strategy #5The privileges of being amanager also entail certainforegone freedoms
    188. 188. Strategy #5 AppliedWhat message will you giveto middle management thatobstruction and second-guessing will not betolerated: get on or get off.
    189. 189. Strategy #6Sustainability requires agrowing core of passionate“Spark Plugs” who have apersonal stake in culturaltransformation.
    190. 190. Strategy #6 AppliedWhat actions will you taketo nurture (and protectfrom cynics) the peoplehuddled in the middle ofthe Attitude Bell Curve?
    191. 191. Strategy #7Personal stories resonatebetter than scriptedlectures.
    192. 192. You simply cannot buyadvertising like this!
    193. 193. The most effective safetylecture I ever heard.
    194. 194. And now, a motivational wordfrom your manager…
    195. 195. Strategy #7 AppliedWhat mechanisms can youuse to collect, edit, andpublish stories from yourLone Nuts, First Followers,and Spark Plugs?
    196. 196. Strategy #8Embrace the skeptics,marginalize the cynics,and plow throughresistance.
    197. 197. Strategy #8 AppliedCome to a consensus onwhen skeptical questionsbecome cynical obstructionand an agreed upon waymanagement will respond
    198. 198. Strategy #9Engage potential critics ina constructive manner –encourage them to thinklike partners in thechange process.
    199. 199. Strategy #9 AppliedBegin by identifying thepeople who could derailyour effort (medical staff,union, etc.) and approachthem early in the process.
    200. 200. Strategy #10You cannot allow peopleto opt-out of culturechange!
    201. 201. Strategy #10 AppliedDefine which actions aremandatory (e.g. valuestraining) and which arevoluntary (e.g. The PickleChallenge or The Pledge).
    202. 202. Strategy #11Avoid identification of thechange process with anysingle individual or“program.”
    203. 203. Strategy #11 AppliedDescribe every “program”in the context of values,purpose, and vision of theorganization – and showhow it reinforces these.
    204. 204. Strategy #12Create “initiativecoherence” by being clearabout how variousprojects and programsreinforce one another.
    205. 205. Strategy #12 AppliedBe creative in showinglinkages – e.g. a graphic withan umbrella arching oversymbols representing theseprojects and programs.
    206. 206. Strategy #13Keep it visible: posters,banners, screensavers,newsletter articles, webpages; include it at thestart of every meeting.
    207. 207. Strategy #13 AppliedSee illustration.
    208. 208. Strategy #14Remember that everyonelistens to the same radiostation: WIIFM.
    209. 209. Strategy #14 AppliedBefore asking people to“do more with less,” helpthem do it at home, e.g.by offering a low-costDave Ramsey course.
    210. 210. Strategy #15Balance urgency andpatience; be in it for thelong haul.
    211. 211. “If we each do ourpart, we will changeour lives for thebetter.” 278
    212. 212. “If we all do ourparts, we will changeour organizations forthe better.” 279
    213. 213. “And in changing ourorganizations, we canchange our world for thebetter.” 280

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