Edge Talk: The key ingredient to organisational transformation

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The Key Ingredient To Organisational TransformationDr Irv Rubin and Matt Stone, TemenosDr Maxine CraigFriday 6 May 2016 at 9.30am BST

@theEdgeNHS | #EdgeTalks

Joining in today and beyondPlease use the chat box to contribute continuously during the web seminar

Please tweet using hashtag #EdgeTalks and the handle @School4Radicals @theEdgeNHS

Send a request to join our Facebook group School for Health and Care Radicals and The Edge NHS

The team todayChat room monitorDom Cushnan @DomCushnan

Twitter monitorKate Pound@KateSlater2Session chairOlly Benson@ollybenson

Our presenters

Irv Rubin, Ph.D.CEO, Temenos, Inc.@temenosinc

Matt Stone, J.D.COO, Temenos, Inc.@MattStone048

Dr Maxine Craig@maxine_craig

Key Ingredient to Organisational Transformation

-Edge Talk-6 May 2016

Overview1The Organisation as Patient

2 Key to Better Engagement

3Feedback Technique

4Behavioural Diagnostic Tool

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Four discrete parts.

-Well touch on recent studies that point to shifting attitudes about legacy solutions related to employee engagement and performance management. -Then well introduce what we believe is the single most important ingredient to transforming organizations into healthy, high-functioning teams. -Well also introduce a simple and highly effective behavioral technique for growing and strengthening human relationships. -And finally, well introduce a powerful behavior tool that improves trust, understanding, and cooperation between people. Its the Ultimate Engagement Tool. No more training and then forget.

And of course well do our best to get to your questions. But if we dont, please dont hesitate to reach out. Well also publish this webinar as a podcast and the slides will be available for download.







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Houston, we Have A Problem:Healthcare Is In TroubleMalpractice is destroying health care

Tens of thousands are dying from treatment unrelated to their admitting condition

Untold numbers of near misses go unreported

Good nurses are hard to find and hard to keep

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Zooming in on the Nurses:The Point of TLCDisruptive Behaviors Witnessed orExperienced by Nurses (N=2562)

Condescension69%Disrespect80%Abusive anger43%Abusive language69%Berating patients26%Physical abuse22%

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How Often Does It Happen?

38% up to 10 times per year 29% 1 - 2 times per month 24% weekly 7% daily 2% never

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Who Are The Perpetrators?6 - 9 % exhibit over 70% of the disruptive behaviorsMajority of staff exhibit 28% of the disruptive behaviors2% of the staff were seen as exhibiting 0% of the behaviors

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Not Just An American Dis-ease!2 District Hospitals; 4 Community Hospitals; 9 Practices; 3 PCT Headquarters

33% = Weekly or More Often8% = Daily37% = Once/Twice in Last Month29% = Not Once in Last Month

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BQA: CQI At The Individual Level

TechnicalEffectivenessBQAManagerialEfficiencyThree-legged Stool

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Behavioral Quality Assurance (BQA)

CURING F (Science of Medicine)Focus of traditional Q.A.

Having the hard technologies and science of medicine been appropriately and skillfully applied in service of curing?

HEALING F (Art of Medicine)Focus of BQA

Have ALL the hands laid on patients been appropriately and skillfully applied in the service of healing?

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A Spiritual Sister in Chiba, Japan:St. Marguerite Hospital

To heal sometimes.To support often.To comfort always.

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One Example of Failure To Embrace This Truth and The Consequences

QUESTION: Does It Make a Difference Which E.R. Youre Taken to? [Over 5000 Patients]ANSWER: Only a Matter of Life or Death! [60% survival versus 58% Deaths

Differences Appear to relate to the quality of the interaction and communication between physicians and nurses[Knauss, et.al., Annals of Internal Medicine, Vol. 104]

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True or False?__ We have one common Behavioral code of conduct for everyone.__ Our Behavioral Code of conduct is enforced without favoritism.__ Everyone gets a performance review at least yearly.__ Both technical and interpersonal competencies impact performance rating.__ Feedback is direct and face-to-face versus anonymous and averaged.

Potential Managerial Malpractice Liability Quiz

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True or False?

__ We have dead messengers in some of our closets.

__ We have big undiscussed elephants on some of our meeting room tables.

__ We know that staff infections are as potentially lethal as staph infections.

__ We know that the culture in the Boardroom filters into the treatment room.

__ We view our organisation as a human entity, a Patient in need of care.-Cont-

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It Starts With What We BelieveIdentity must be either or

Treatment of people become a yes and

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Do We Have the Courageand Integrity?


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BQA: CQI At The Individual Level

TechnicalEffectivenessBQAManagerialEfficiencyThree-legged StoolAwareness = Seek and Provide Feedback on Consequences of Behavior

Behavior = Strive to Learn and Exhibit Win-Win Behaviors Regularly

Consequences = Monitor Impact of Behavior Regularly so As to Increase Awareness

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Dr. Maxine Craig

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2015PAST - 2003& The here and now


Some of the biggest challenges we face are not far far away but in my opinion are the ones we encounter in our every day work

What we worked out :People had not known how to give feedback in a way that was impactful and might have stopped things developingWe had no process of assuring the behaviour of our leaders and our staff

Technical CLINICAL EffectivenessBQAManagerialEfficiencyThree-legged Stool 2003 Temenos , Inc., USA. All rights reserved.

The information needed to prevent thedisaster was known

PUSH PULL Describe PrescribeUnderstandAskAppreciateInspireEmpathiseAttend

2 Key to Better Engagement

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Engagement is a quality of a relationship, not a person

taking place from the inside-out,not the outside-in.


Its all personal.

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If you dont understand the nature of engagement, its impossible to improve.

Its a reflection of a PROCESS between two people.

Weve heard many stories about approaches to engagement that are centered on picnics, employee parties, employee rewards programs, etc. This is a total and complete misfire.

Organizational engagement requires individual engagement between people. ITS ABOUT RELATIONSHIPS.

The New Executive Listening TourWe want your input!

Summer Picnic/BBQ

Remodeled Breakroom

Christmas/Holiday Party


New Values Statement

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Imagine a workplace where theres a high level of fear and distrustand of course very low engagement scores.

New Executive comes in and decidedes to initiate some better Engagement Activities

The quality of these activities is more a reflection of the health of the relationship-building potential and process the health of the relational fabric of the organization.

Are these events environments where people who have the tools, trust, and willingness to further their relationships develop, or are they opportunities to avoid being authentic...to get through it, or politic.

Saying it doesnt make it so.

Conspiracies of Codependencies. People find allies

Once that happens, the Trap of ignorance takes hold.

Connectivity Connectedness

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We are using technology as a poor substitute for face to face communication.

People are dying at record numbers because of texting and driving. But they are also wrecking relationships due to the same lack of presence and attention to what is going on around them.

Need to be present to pick up on the nonverbal and tone of voice.

If engagement is all about relationships, then we need to be more careful what technologies we use, and how and when. How many times have you experience a total miscommunication because of an email or instant message?

Theres a reason emojis are so popular. But they dont ultimately solve the problem. We need face to face communication between people who have the attention, presence, skills, and interest to learn and grow.

Self-Assessment Personality Profiling

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There are no short cuts to achieving meaningful relationship development.

Self Assessment Profiling may be self-affirming, but it doesnt do the trick.

Google Research on Building Great Teams(http://nyti.ms/20Vn3sz)Good vs. Dysfunctional Teams Hinged on: how teammates treated one another.Putting the best people or similar people into groups does not correlate to good team performance.MOST IMPORTANT FACOR:PSYCHOLOGICAL SAFETY

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The key to all Learning and Devel