1. Creating a CulturalBlueprint for a Highly-Engaged HealthcareOrganizationAONE 46th Annual Meeting & ExpositionJoe Tye, Values Coach Inc.Carol Wahl, Good Samaritan HospitalCopyright 2013, Values Coach Inc. 1

2. 2If we dont answer yourquestions or to requestfollow-up information, giveme a card or email:Joe@JoeTye.com

3. Question #1When did thehealthcare crisisbegin?3

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5. Question #2When will thehealthcare crisisend?5

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7. Before we beginlets go on a littlerafting trip7

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14. Companies that study employeeengagement* consistently find:~ 25% fully engaged~ 60% not engaged~ 15% aggressively disengaged* e.g. Gallup, HR Solutions, Press Ganey14

15. Disengagedpeople, especiallydisengaged managers, are aquality defectJim Clifton: The Coming Jobs War15

16. Disengagementnegatively effects16

17. Clinical quality17

18. Patient safety18

19. Patientsatisfaction19

20. Productivity20

21. Marketingimage21

22. Job security22

23. But whats evenmore tragic...23

24. It has a life-diminishingimpact on the disengaged.24

25. Disengagement [is] oneof the chief causes ofunderachievement anddepression.Edward M. Hallowell, M.D. in HBR, 12-1025

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27. The journey from mereAccountabilityto a culture ofOwnership27

28. Accountable28

29. AccountabilityDoing what you are supposedto do because someone elseexpects it of you. It springsfrom the extrinsic motivationof reward and punishment.29

30. You cannot hold peopleaccountable for thethings that really matter.30

31. Nobody ever changesthe oil in a rentalcar!31

32. OwnershipDoing what needs to be donebecause you expect it ofyourself. Ownership springsfrom the intrinsic motivationof personal pride.32

33. Who Owns Left Field?33

34. InvisibleArchitectureInvisible Architecture is atrademark of Values Coach Inc. 34

35. The BlueprintBehindthe Blueprint

36. Invisible architecture, notbuildings, determines whetheryou are a good hospital, agreat hospital, or just anotherhospital.36

37. Invisible architectureis to the soul of yourorganization whatphysical architectureis to its body.

38. Core Values arethe Foundation38

39. Core valuesdefine what youstand for andwhat you wontstand for39

40. 40People who are clearestabout their personal visionand values are significantlymore committed to theirorganizations.James Kouzes and Barry Posner:A Leaders Legacy

41. When a critical mass ofpeople connect withand act upon their corevalues, they will have apositive impact on

42. Corporate culture isthe superstructure

43. Culture is to theorganization whatpersonality andcharacter are to theindividual.

44. SamebusinessDifferentcultures

45. Culture eats strategyfor lunch!45

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47. If culture eats strategyfor lunch, shouldnt youhave a culture plan tocomplement yourstrategic plan?47

48. Culture doesnt changeunless peoplechange, and that isemotionalwork!48

49. Emotional attitudeis the interior dcor

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51. How would youcalculate theROI on a smilelike this?51

52. 52A positive workplaceculture begins withintolerance for toxicemotional negativity.

53. 53One toxically negativeperson can drag downmorale and productivityof an entire workunit.

54. 54It is a leadershipresponsibility to create aworkplace environmentwhere toxic emotionalnegativity is nottolerated.

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58. 58Harlan CountyHospitalBrodstoneMemorialHospital

59. Alverno Clinical Laboratories 59

60. White RiverHealth System 60

61. Star Valley Medical Center61

62. Battle Creek VA Medical Center62

63. Building aculture ofownership63

64. Do you have to start with theright people on the bus?64

65. You cant alwayschoose who you haveon the bus!65

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67. You cant just throwall the wrongpeople off the bus!67

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69. You can create a bus thateveryone wants to ride69

70. That is the sort ofculture Carol Wahland her team areworking toward at70

71. Good Samaritan HospitalKearney,Nebraska71

72. CHI/GSH Core Values Core Values (RICE) Respect Integrity Compassion Excellence72

73. GSH Culture Connection. . .making thestory of the GoodSamaritan a livingreality.73

74. Living the StoryCreateAlignmentCreateConnections74

75. Our PrioritiesPersonalCare DeliveryService StandardsCHI/GSH Core Values75

76. Triple Aim + OneA sustainable health care systemneeds to be:Good for patients (theexperience of care)Source: Blue Shield California76

77. Triple Aim + OneA sustainable health care systemneeds to be: Good for the community(population health)Source: Blue Shield California77

78. Triple Aim + OneA sustainable health care systemneeds to be: Good for the economy(affordable)Source: Blue Shield California78

79. Triple Aim + OneA sustainable health care systemneeds to be: good for providers(business model, career)Source: Blue Shield California79

80. Our Timeline:Core Action Values TrainingSenior Team support (April 2009)Leadership retreat (July 2009)Open staff presentations (May &August 2010)80

81. Our Timeline:Core Action Values TrainingSpark Plug training (Jan 2011)Distributor Cap leadership todepartmentsDSER maintain the momentum(2012)81

82. From Authenticity toLeadership, these valuesreflect who we want tobe as an organizationand as individuals

83. Hospital ActivitiesCulture CouncilThe things that can be counted dontalways count and the things that countcant always be counted.Einstein84

84. Hospital ActivitiesRural Health ValuesCollaborative85

85. Hospital ActivitiesCommunityEducation throughthe Chamber ofCommerce 87

86. Hospital Activities88Daily overheadreading of promisesfrom The Self-Empowerment Pledge

87. Hospital ActivitiesPatient andemployee stories89

88. Department ActivitiesUnit-based councils90

89. Department Activities91

90. Department ActivitiesDSER groupBottom-up innovation tends tobe chaotic but smart. Top-downinnovation tends to be orderly butdumb. -- Rich Carlson, SRI92

91. The 6 Es of Employee Engagement1. Expect2. Educate3. Enable4. Energize5. Evaluate6. Elevate93

92. Key lessons wevelearned through ourwork on culturaltransformation94

93. Lesson #1aLaunching a movement is alot harder than starting aprogram it is also muchmore likely to achieve alasting positive impact95

94. 96Lesson #1bAchieving critical massrequires approximately 30%population commitment

95. Lesson #1cYou need enough peoplemoving fast enough toescape negativity,pessimism, cynicism, andinertia of the past97

96. Lesson #2aTop down direction andsupportANDBottom up passion andinnovation98

97. Lesson #2bPeople must believesenior leadershipbelieves in and iscommitted to thecultural vision

98. Lesson #2cMiddle managements meresupport is not enough they must be gung hochampions for change

99. Lesson #3You need a blueprint foryour Invisible Architectureand a culture plan tocomplement your strategicplan

100. The Culture Blueprint102

101. The Culture PlanUse the Culture MappingSchematic to map out plansfor actions you can take topromote a stronger culture ofownership.103

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103. Lesson #4aStart from where yourculture is and align andevolve

104. Lesson #4bAvoid identification of thechange process with anysingle individual orprogram.

105. Lesson #4cCreate initiativecoherence by being clearabout how variousprojects reinforce oneanother

106. Lesson #4dCelebrate successesthrough stories

107. Lesson #5Proceed untilapprehended!

108. WWFD?Build a Culture of Ownershipon aFoundation of ValuesTransforming People through the Power of ValuesTransforming Organizations through the Power of People