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Cultural Blueprinting for a Culture of Ownership

The Carilion ClinicMarch 22-23, 2016

Joe Tye, CEO and Head CoachValues Coach Inc.Copyright 2016, Values Coach Inc.

There is an invisible barrier on the potential of your organization

I got a whole new team and didnt have to change the people because they changed themselves.Paul Utemark, CEOFillmore County Health SystemGeneva, Nebraska

Including this very special organization

leadership

From the Pulitzer Prize winning book Leadership by James MacGregor Burns

When Sally and I were in the market for a second home in Arizona our criteria were:Spectacular back yardLow to zero maintenanceAffordable

And this is our primary residence, the house where we lived for 20 years and raised our two children photo taken April 2013

Lesson #1Things arent always what they seem.

Lesson #2What you really want might be closer than you think.

Lesson #3You must be willing to jettison old baggage to move forward.

Lesson #4There is almost always a way to create a win-win.

A word about the assumptions we make.

What do you get when you break the word assume into its constituent parts?

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Question #1When did the healthcare crisis begin?

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Florence Nightingale firsts include:Medical recordsLaundry and housekeepingInfection controlNutrition servicePharmacy Materials managementPatient libraryMedical triageNursing uniformsChaplain service

We need to respark the spirit that Florence first sparked at the Scutari Barrack Hospital!

Question #2When will the healthcare crisis end?

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Healthcare Crisis

Carilion Clinic

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

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Engaged: Spark Plugs43

43Spark Plug job description included in one of the special reports.

Not Engaged: Zombies44

44These are the people who are going through the motions, living up to the terms of their job descriptions but no more.

Unfortunately, they are more likely to be influenced by Vampires than they are by Spark Plugs because Spark Plug people are usually too busy to stand around the coffee pot gossiping and in any event they shy away from confrontation because they are positive people, whereas

Disengaged: Vampires45

45Vampires love nothing better than waiting at the coffee pot for their next victim to come along. They tend to have very domineering personalities, and once they have their fangs sunk into their victims, they are very hard to shake loose.

We can do better than this.

We can BE better than this.

The Healthcare Crisis Within

Disengaged people, especially disengaged managers, are a quality defect

Disengagement effects

The real tragedy of disengagement >>>

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It has a life-diminishing impact on the disengaged.

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

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Cynthia Pearsall

Mina Ubbing

CeCe Peters

From Sarah Sighting to Poster Child for Passion

The journey from mere Accountability to a culture ofOwnership

Accountable

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

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No one ever earned a DAISY Award by being held accountable!

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

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22,899,796 views 91,968 avg 5 stars

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Who Owns Left Field?

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What 648 of you told me about the culture of The Carilion Clinic

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Speaking on behalf of the 352 who did not participate

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87%

80%

78%

77%

75%

74%

68%

55%

52%

42%

17%

39%44%

~14%

$850,000,000 annual SWBX14%=>>>>>>>>>>>>>>>>>>>>>>>>>

$119,000,000

And that is just the direct cost of subsidizing your BMW Club it does not account for the deleterious impact on HCAHPS, productivity, retention etc.

Lets some more mathOut of 6,480 possibilities (648 people x 10 questions) there were only 759 (12%) strongly agree responses.

How much more effective would Carilion Clinic be in every dimension if you had 92% strongly agree responses?

Several additional questions

Were you surprised by any of these results?

Who is responsible for changing these results?

Invisible ArchitectureInvisible Architecture is a trademark of Values Coach Inc.

Invisible Architecture is more important than bricks & mortar

The Blueprint Behind the Blueprint

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

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It begins with a shared vision

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3 stages

The Foundation

Core values define who you are, what you stand for, and what you wont stand for

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Integrated DNA Technologies Inc. values (excerpt) Be yourselfUnless youre a jerk113

From the Cypress Semiconductor values (excerpt):CYPRESS IS ABOUT WINNINGWe do not tolerate losing.We thrive on competing against the world's best.WE MAKE OUR NUMBERSWe make 20% profit.We each set goals and achieve them.We ship 100% on time and get zero returns.

116People 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

The Superstructure

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

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Where will I take you for lunch?

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or

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This is not a trick questionIts the reality of competing today.

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Same businessDifferent cultures

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People pay to shop at Costco

Ecstatic employees

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People shop at Wal-Mart because they dont have to dress up like they do for the Dollar Store.

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Same businessDifferent cultures

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NapRap

Describe your culture (current and ideal) in just 6 words.

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130From managers sitting in the same room at one large medical centers leadership retreat

131We love patients and each other

132We are ALWAYS here for you

133Multiple priorities, limited resources, great expectations

134Disjointed departments working against each other

135Were entitled, hating it, and staying

136Negativity reigns while circling the drain

137Beatings will continue until morale improves

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Southwest Airlines MottoServants Heart, Warrior Spirit, Fun-Loving Attitude

Cypress Semiconductor MottoThe Marine Corps of Silicon Valley

The Florence ChallengeEmotionally PositiveSelf EmpoweredFully Engaged

Therapy pets can even sign!

Culture is to recruiting and retention what advertising and promotion are to marketing >>>>>>>>>>>

Modern Healthcare cover story 1/19/2016Nurse shortage looms

A Key Point!You cannot allow people to opt-out of positive culture change!

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Another key point:Cultural work cant be just a flavor of the month

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Culture doesnt change unless and until people change

The Interior

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158A positive workplace culture begins with intolerance for toxic emotional negativity.

159Emotional climate is determined by what you expect and what you tolerate

160And over time, what you tolerate will dominate over what you say you expect!

162One toxically negative person can drag down morale and productivity of an entire work unit.

163It is a leadership responsibility to create a workplace environment where toxic emotional negativity is not tolerated.

164The simple promise that will change your lifeAnd change your organization

Work sucks then you die

YouIdiot!

The Pickle Challenge has taken on a life of its own!

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Midland Memorial Hospital

Caveat: You will get resistance to The Pickle Challenge.It will be most vociferous from people who could most benefit from taking it to heart.

The Pickle Challenge for Charity

For one week will you turn complaints into contributions for the Carilion Foundation Lend a Hand Fund?>>>>>>>>>>

48,000 times

Are you up for the challenge?

Does this stuff really work? Can you really change the culture? >>>>>

Midland Memorial Hospital Values and Culture Initiative

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Daily Leadership HuddleMidland Memorial Hospital

Keeping the Pickle Pledge in the leadership huddle keeps the culture of ownership front and center.-Bob Dent

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MMH Values Trainers #1

MMH Values Trainers #1

63%

87%

36%61%

Refrain from toxic negativity and treat others with respectFebruary August

Hours wasted on toxic emotional negativity

February August

Annual Cultural Productivity Enhancement:$7,200,000

Employee Incentive Bonuses for Patient Satisfaction:$2,000,000

HCAHPS Overall

Arrow marks beginning of Values and Culture Initiative

Patient satisfaction has gone from record lows to all-time highs since launch of the values and culture initiative198

Emergency Department

Wes Barnt Bob Dent Kyle Graham Katy Longbotham

If we each do our part, we will change our lives for the better.201

If we all do our parts, we will change our organizations for the better.202

And in changing our organizations, we can change our world for the better.203

And one last thingLet me introduce you to the person you once were

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Wouldnt it be nice to become that you again?

Remember this Culture does not change unless and until people change

Are you ready for that challenge?