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

1. Lessons for Building a
Culture of Ownership
Genesis Health System
November 15, 2012
Joe Tye, CEO and Head Coach
Values Coach Inc.
Copyright © 2012, Values Coach Inc.

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Joe@JoeTye.com 2

5. Self-Made Man by
Bobbie Carlyle

12. This storm will
not pass and you
cannot just wait
it out.

13. Question #1
When did the
healthcare crisis
begin?

15. Question #2
When will the
healthcare crisis
end?

17. This story…
17

18. Has a happy
ending!
18

21. Companies that study employee
engagement* consistently find:
~ 25% fully engaged
~ 60% not engaged
~ 15% aggressively disengaged
* e.g. Gallup, HR Solutions, Press Ganey

22. Engaged:
Spark Plugs
22

23. Not Engaged:
Zombies
23

24. Disengaged:
Vampires
24

25. What Gallup sees…

26. What patients see…

27. Memo to Doug…
With all due respect, I
would like to clarify two
key numbers: 36 and 10.

28. Shifting the Attitude Bell Curve

29. Genesis is generally 10-15
points below best-in-class
healthcare scores for
employee engagement.
What will it take to close
that gap?

30. The significant outlier – at
a 23 point gap – is “Senior
management is concerned
about employees.”
What’s this all about?

31. Is the midpoint of the curve in
the same for middle managers?

32. Remind me to tell you
about Jim Kilts and the
turnaround at Gillette.

33. Disengagement
negatively effects…

34. Clinical quality

35. Patient
satisfaction

36. Patient safety

37. Productivity

38. Marketing
image

39. Turnover (good
and bad)

40. Job security

41. But what’s even
more tragic...

42. It has a life-diminishing
impact on the disengaged.

43. “Disengagement [is] one
of the chief causes of
underachievement and
depression.”
Edward M. Hallowell, M.D. in HBR, 12-10

45. The neurobiology of
corporate culture

46. 46

47. Bean Counter
Poet

48. Management is of the
left brain.
Leadership is of the
right brain.
48

49. And in today’s
world we need
leaders in every
corner – not just in
the corner office

50. transactional
Transformational

51. Rules
Values

52. Process
Attitude

53. Plans
Inspires

54. Measured
Seen

55. A Given
A Choice

56. Inert
Contagious

57. What you do
Who you are

58. Boring!
Chaos!

59. Left Brain
Counts beans

60. Right brain
creates

62. RecruitingandRetention
… is not just one word!
62

64. You recruit with the “honey”
of left-brain features such as
pay and benefits…
64

65. You retain with the “glue”
of right-brain qualities
reflected in values, culture,
and attitude.
65

66. One more thing – if
“lean” is all left brain,
you are just speeding
up the assembly line.

67. It’s not accountability
(left brain) OR
ownership (right
brain).

68. It’s how we interrelate
the two to create a
whole brain culture.

69. The journey from mere
Accountability
to a culture of
Ownership

70. Ac
count
able

71. Accountability
Doing what you are supposed
to do because someone else
expects it of you. It springs
from the extrinsic motivation
of reward and punishment.

75. You cannot hold people
“accountable” for the
things that really matter.

76. Nobody ever changes
the oil in a rental
car!

77. Ownership
Doing what needs to be done
because you expect it of
yourself. Ownership springs
from the intrinsic motivation
of personal pride.

78. 79,973– avg 5 stars As 11-15-12, 1:30am 18,975,125 views

79. “We have hundreds if not
thousands of examples…” 795,929

81. 81

83. Who Owns Left Field?

84. A word about the
assumptions we make.

85. What do you get when
you break the word
“assume” into its
constituent parts?

87. Let’s watch as the
word “assumption”
gets deconstructed
(along with those who
made the assumption)

89. Invisible
Architecture™
“Invisible Architecture” is a
trademark of Values Coach Inc.

91. Invisible Architecture™
is to the soul of your
organization what
physical architecture
is to its body.

92. We use a construction
metaphor to design
Invisible Architecture.

93. 3 stages

94. You don’t need to have
an architectural degree
to design the Invisible
Architecture of your
hospital!

95. Shawneen Buckley at St. Francis Hospital and
Health Center of Poughkeepsie, New York

96. Core Values are
the Foundation

97. Core values
define what you
stand for and
what you won’t
stand for

98. TMC Values …
Honor Tradition, Nourish Dreams

99. What are the
Genesis Health
Core Values?

101. The Values  Behaviors
 Outcomes Continuum

102. Genesis Health Core Values
Integrity
Compassion
Safety
Accountability
Values?
Respect
Behaviors?
Excellence Outcomes?

103. The 3-minute
values drill

104. Current version
Compassion
Advocacy
Respect
Excellence
Values statement of
a Values Coach client

105. Old version New version
Compassion Integrity
Advocacy Enthusiasm
Respect Loyalty
Excellence Stewardship
Ownership
Fun

106. Nobody does it
better than...

107. 107

108. Zappos Family Core Values
1. Deliver WOW Through Service
2. Embrace and Drive Change
3. Create Fun and A Little Weirdness
4. Be Adventurous, Creative, and Open-Minded
5. Pursue Growth and Learning
6. Build Open and Honest Relationships With
Communication
7. Build a Positive Team and Family Spirit
8. Do More With Less
9. Be Passionate and Determined
10. Be Humble
Source: Zappos website

109. 1. Deliver Wow Through Service
Core Values Frog thinks anything worth doing is worth
doing with WOW. To WOW, CVF differentiates himself by
doing things in an unconventional and innovative way.
He goes above and beyond the average level of service to
create an emotional impact on the
receiver and give them a positive
story they can take with them the
rest of their lives.
Source: Zappos website

110. When’s the last time you called
a 1-800 call center number and
months later remembered the
name of the person you talked
to – and told anyone who
would listen your story?

111. The guiding insights behind
our work at Values Coach…
111

112. Values
are
Personal

113. Values
are
Skills

114. Skills
can be
Learned

115. Skills
must be
Practiced

116. 7 reasons why you
should care about the
personal values (skills)
of your people…
116

117. Reason #1
The invisible
ceiling on
performance 117

123. Reason #2
Commitment
123

124. “People who are clearest
about their personal vision
and values are significantly
more committed to their
organizations.”
James Kouzes and Barry Posner:
A Leader's Legacy 124

125. Reason #3
Loyalty
125

126. People are loyal to
values and culture, not
to business strategies.
126

127. Source: Roger Herman, et al: Impending Crisis:
Too Many Jobs, Too Few People (page 139)

128. Reason #4
Behavioral
Expectations
128

129. Core Action Value #4 is Courage
You can teach
people the Courage
skills needed to…

130. Call a time-out during
a procedure even
though the delay
annoys everyone else

131. Confront disrespectful
and bullying behavior

132. Walk out on gossip,
backbiting, and toxic
emotional negativity

133. Reason #5
Employee health
and wellbeing
133

134. 134

135. Reason #6
Risk
management
135

136. Wal-Mart's Mexican Bribery
Scandal Will Sink It Like an
Iceberg Sank the Titanic
Adam Hartung column heading in Forbes, 4/26/12
136

137. This values violation
cheated Wal-Mart
shareholders out of
$12.5 BILLION dollars
in a single day!

138. In case you think that
such things couldn’t
happen in hospitals…

139. One in eight U.S. patients who
have non-emergency stenting
procedures to clear blocked
arteries in the heart are likely
to see more harm than good
from the procedure,
researchers said last year.

141. Reason #7
It’s the right
thing to do
141

142. Nobody learns
everything
they need to
know in
kindergarten!

144. When a critical mass of
people connect with
and act upon their core
values, they will have a
positive impact on…

145. Corporate culture is
the superstructure

146. Culture is to the
organization what
personality and
character are to the
individual.

147. Same
business
Different
cultures

148. “Culture influences how
we deliver care, how we
interrelate with our
colleagues, and how
we treat our patients.”

149. Culture eats strategy
for lunch!

150. Static culture can doom
an organization

151. When strategy and
culture collide, culture
will win

152. Genesis Health has a
strategic plan – but do
you have a culture plan?

153. Can you describe
the Genesis Health
culture in just six
words?

154. Hemingway wrote a
short story in just 6
words
154

155. And this guy made a
fortune with just 6
words

156. From a large
medical products
company
156

157. Version 1
Global company driven
by motivated individuals
157

158. Version 2
Great company, often
own worst enemy
158

159. Version 3
Process driven crisis
management creating
dysfunction
159

160. From a large
academic
medical center
160

161. Version 1
Heartfelt commitment
unifies a dynamic
culture
161

162. Version 2
Sailing in turbulent
waters rudders aligned
162

163. Version 3
Dedicated employees
deflated by overwhelming
obstacles
163

164. Culture doesn’t change
unless people change,
and that is
emotional
work!

165. Emotional attitude
is the interior décor

166. 166

171. A positive workplace
culture begins with
intolerance for toxic
emotional negativity.
171

172. Emotional climate is
determined by what
you expect and what
you tolerate…
172

173. And over time, what
you tolerate will
dominate over what
you say you expect!
173

174. Genesis values include
integrity, compassion,
and respect. But does
your culture tolerate…
174

175. 175

176. “One toxically negative
person can drag down
morale and productivity
of an entire work
unit.”
176

180. 180

184. What do people say when
a manager finally finds
the resolve to deal with a
toxic negative employee?

187. What took
you so long?

188. Building a
culture of
ownership

190. Do you have to start with the
right people on the bus?

191. You can’t always
choose who you have
on the bus!

193. You can’t just throw
all the “wrong”
people off the bus!

195. You can create a bus that
everyone wants to ride

197. Fairfield Medical Center Adapts Florence to
their Recruiting and Retention Brand

198. Shared Vision
Transform wishes and
dreams into Memories of
the Future

199. 199

201. 201

202. Commitment
To the values, vision, and
mission of the organization

203. Do you remember what Flo
said about the first days of
the culture change process
at Bon Secours?

204. Commitment is
most important
when the going
gets tough...

205. “We need to see opportunities
where others see barriers. We
need to be cheerleaders when
others are moaning doom-
and-gloom.”

206. “We need to face problems
with contrarian toughness
because it’s in how we solve
those problems that we
differentiate ourselves
from everyone else.”

209. “Brick walls are not
there to stop you, they
are there to make you
prove how much you
want something.”
Randy Pausch: The Last Lecture

210. Engagement
With patients, coworkers,
and with the work itself

211. At Best Buy, a 0.1%
increase in employee
engagement generates
a $100,000 increase in
gross store revenue*
* Harvard Business Review, October 2010

213. Passion
Enthusiasm, positive
attitude, and joy reflected
in everyday actions

219. Initiative
Don’t wait around to be
“empowered” – Proceed
Until Apprehended!

220. Can one person
who takes initiative
change your
organization?
220

223. 223

224. Fellowship
Because (as Mother Teresa
reminded us) we are all
children of the same God

227. 227

228. Pride
In your organization, in
your profession, in your
work, and in yourself

229. Pride is reflected in the answer to
that universal icebreaker question:
What do
you do?

230. 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. What
I do is important.

231. What could be more boring than
industrial ventilation systems?

233. BigAssHospital.com
233

234. 15 Strategies for
building a culture
of ownership on a
foundation of values

236. Mary Lanning Memorial HealthCare
Gallup Engagement Score improved
from 23rd to 72nd percentile (achieving
in 18 months what Gallup said would
ordinarily have taken five years).

237. Fillmore County Hospital
Patient satisfaction increased in 27
of 30 categories.
CEO Paul Utemark said he got a
whole new team and didn’t have to
change any of the people.

238. Community Hospital (employees)
Rating hospital as excellent place to work
increased by 26% to the 74th percentile.
Rating training & development as
“excellent” increased by 51% to 91st
percentile.
Likelihood of recommending hospital as
excellent place to work increased by 45%
to 84th percentile.

239. Strategy #1
Launching a movement is a
lot harder than starting a
program – it is also much
more likely to achieve a
lasting positive impact.

241. Strategy #1 Applied
How can you position your
desired culture change as a
movement, e.g. creating a
gossip-free workplace to
promote integrity.

242. Strategy #2
Achieving critical mass
requires approximately 30%
population commitment.
242

243. Strategy #2 Applied
Who are your “lone nuts”
and how can you help them
identify those crucial first
followers?
243

244. Strategy #3
You need enough people
moving fast enough to
escape negativity,
pessimism, cynicism, and
inertia of the past.

245. Strategy #3 Applied
What immediate and short-
term goals can help you
quickly gain traction and
build momentum?

246. Strategy #4
People must believe
leadership is committed
to the cultural vision.

247. Strategy #4 Applied
What actions will leaders
commit to on a sustained
basis to demonstrate
support, e.g. daily reading
of The S-E Pledge.

248. Strategy #5
Middle management’s mere
support is not enough –
they must be gung ho
champions for change.

249. You are here

250. Corollary to Strategy #5
The privileges of being a
manager also entail certain
foregone freedoms

251. Strategy #5 Applied
What message will you give
to middle management that
obstruction and second-
guessing will not be
tolerated: get on or get off.

252. Strategy #6
Sustainability requires a
growing core of passionate
“Spark Plugs” who have a
personal stake in cultural
transformation.

254. Strategy #6 Applied
What actions will you take
to nurture (and protect
from cynics) the people
huddled in the middle of
the Attitude Bell Curve?

255. Strategy #7
Personal stories resonate
better than scripted
lectures.

259. You simply cannot buy
advertising like this!

260. The most effective safety
lecture I ever heard.

261. And now, a motivational word
from your manager…

262. Strategy #7 Applied
What mechanisms can you
use to collect, edit, and
publish stories from your
Lone Nuts, First Followers,
and Spark Plugs?

263. Strategy #8
Embrace the skeptics,
marginalize the cynics,
and plow through
resistance.

264. Strategy #8 Applied
Come to a consensus on
when skeptical questions
become cynical obstruction
and an agreed upon way
management will respond

265. Strategy #9
Engage potential critics in
a constructive manner –
encourage them to think
like partners in the
change process.

266. Strategy #9 Applied
Begin by identifying the
people who could derail
your effort (medical staff,
union, etc.) and approach
them early in the process.

267. Strategy #10
You cannot allow people
to opt-out of culture
change!

268. Strategy #10 Applied
Define which actions are
mandatory (e.g. values
training) and which are
voluntary (e.g. The Pickle
Challenge or The Pledge).

269. Strategy #11
Avoid identification of the
change process with any
single individual or
“program.”

270. Strategy #11 Applied
Describe every “program”
in the context of values,
purpose, and vision of the
organization – and show
how it reinforces these.

271. Strategy #12
Create “initiative
coherence” by being clear
about how various
projects and programs
reinforce one another.

272. Strategy #12 Applied
Be creative in showing
linkages – e.g. a graphic with
an umbrella arching over
symbols representing these
projects and programs.

273. Strategy #13
Keep it visible: posters,
banners, screensavers,
newsletter articles, web
pages; include it at the
start of every meeting.

274. Strategy #13 Applied
See illustration.

275. Strategy #14
Remember that everyone
listens to the same radio
station: WIIFM.

276. Strategy #14 Applied
Before asking people to
“do more with less,” help
them do it at home, e.g.
by offering a low-cost
Dave Ramsey course.

277. Strategy #15
Balance urgency and
patience; be in it for the
long haul.

278. “If we each do our
part, we will change
our lives for the
better.”
278

279. “If we all do our
parts, we will change
our organizations for
the better.”
279

280. “And in changing our
organizations, we can
change our world for the
better.”
280