creating a cultural blueprint for your invisible architecture - the hospital cooperative
TRANSCRIPT
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Creating a Cultural
Blueprint for Your
Invisible ArchitectureThe Hospital Cooperative
August 10, 2015
Joe Tye, CEO and Head CoachValues Coach Inc.
Copyright © 2015, Values Coach
Inc.
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There is an invisible barrier on
the potential of your
organization
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leadership
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From the Pulitzer Prize winning book
Leadership by James MacGregor Burns
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Managemen
t is a job
description
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Leadership
is a
life
decision
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In today’s complex,
turbulent, and
uncertain world we
need leadership in
every corner, not just in
the corner office.
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When Sally and I were in the
market for a second home in
Arizona our criteria were:
Spectacular back yard
Low to zero maintenance
Affordable
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And this is our primary
residence, the house
where we lived for 20
years and raised our two
children – photo taken
April 2013…
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Lesson #1
Things aren’t
always what
they seem.
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Lesson #2
What you really
want might be
closer than you
think.
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Lesson #3
You must be
willing to
jettison old
baggage to
move forward.
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Lesson #4
There is almost
always a way to
create a win-win.
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A word about the
assumptions we
make.
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What do you get
when you break the
word “assume” into
its constituent
parts?
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Question #1
When did the
healthcare
crisis begin?
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Florence Nightingale firsts include:• Medical records
• Laundry and housekeeping
• Infection control
• Nutrition service
• Pharmacy
• Materials management
• Patient library
• Medical triage
• Nursing uniforms
• Chaplain service
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Question #2
When will the
healthcare
crisis end?
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Healthcare Crisis
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YOU
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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 Plugs
35
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Not Engaged: Zombies
36
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Disengaged: Vampires
aka Pickle Suckers
37
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Dilbert Disease
Hates boss, despises
coworkers, avoids being given
real work to do; biggest fear is
losing the job.
If that’s not neurotic,
what is?
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Source: Curt Coffman and Kathy Sorensen: Culture Eats Strategy for Lunch
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Disengagement Entitlement
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Disengagement effects…
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Clinical
quality
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Patient safety
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Patient
satisfaction
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Productivity
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Marketing
image
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Turnover (good and bad)
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Job security
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Disengaged people,
especially disengaged
managers, are a
defect
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What is the lost
productivity – or put
another way what is the
dollar value of the
opportunity cost – of all
those wasted hours?
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$500,000,000,000
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The real tragedy of disengagement >>>
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It has a life-diminishing
impact on the
disengaged.
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“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
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Mina Ubbing
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CeCe Peters
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We can do better than this.
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We can BE better than this.
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The journey from mere
Accountabilit
y to a culture of
Ownership
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From the Information Age to the Conceptual
Age “The ability to encapsulate,
contextualize, and emotionalize
has become vastly more
important in the Conceptual
Age.”
Daniel Pink: A Whole New Mind: Moving from the Information Age to the Conceptual Age
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Bean
Cou
nte
rPo
et
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Left Brain Counts
Right
Brain
Creates
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Linear
Relational
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Rules
Values
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Plans
Inspires
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Measured
Seen
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A Given
A Choic
e
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Inert
Contagious
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Process
Attitude
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systems
Culture
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What you do
Who you are
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Boring!
Chaos!
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Please turn to page 20
of the Cultural
Blueprinting Toolkit
workbook
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Ac
count
able
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Joe’s word association game
What other words do
you associate with
the word
accountability?
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Not trusted
Rules
ConsequencesBlame
April 15More stick than carrot
Looking over your
shoulder
Punitive Feet to the fire
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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.
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The
Accountabilit
y Continuum
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Hierarchical
accountability…
Someone else looking over
your shoulder.
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It is the accountability of
a parent over a child
A boss over a
subordinate
It’s the accountability of
command and control
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Hierarchical flows downhill!!!
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The metaphors
we use for
hierarchical
accountability :-o
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Cultural accountability
is when a group of
peers hold each other
accountable.
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Cultural accountability
is what prevents
people from lighting a
cigarette in a public
place.
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Cultural accountability
is far more powerful
than hierarchical
accountability – for
better and for worse.
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At its best, cultural
accountability creates
positive peer pressure to
treat others with
respect…
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Refrain from toxic
emotional negativity
and to perform at the
highest professional
level.
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At its worst, cultural
accountability creates
negative peer pressure to
not be an overachiever...
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And to participate in
chronic complaining,
bullying, gossiping, and
other forms of toxic
emotional negativity.
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Personal accountability
is holding yourself
accountable.
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No one has to hold your
feet to the fire when
you are willing to walk
across hot coals
on your own.
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You cannot hold people
“accountable” for the
things that really
matter.
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Nobody ever
changes the oil in a
rental car!
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Ownership
Doing what needs to be
done because you expect it
of yourself. Ownership
springs from the intrinsic
motivation of personal
pride.
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22,844,690 views 86,976– avg 5 stars
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108
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Invisible
Architectur
e“Invisible Architecture” is a trademark of Values Coach Inc.
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Invisible Architecture™
is more important
than bricks & mortar
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The Blueprint
Behind the
Blueprint™
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Invisible architecture
is to the soul of your
organization what
physical architecture
is to its body.
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3 stages
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Th
e F
ou
nd
ati
on
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Core values define who
you are, what you stand
for, and what you won’t
stand for
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A great statement of organizational
values:
Defines expectations
Taps into emotions
Inspires action
Aligns with personal
values
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Integrated DNA Technologies Inc. values (excerpt)
Be yourself,
Unless you’re a jerk
118
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From the statement of values
“These values, which guide
Mayo Clinic’s mission to this
day, are an expression of the
vision and intent of our
founders, the original Mayo
physicians and the Sisters of
Saint Francis.”
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From the statement of values
“Staying true to our core values
during thirty-plus years in
business has helped us create a
company we’re proud to run
and work for.”
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Have you ever been to a Texas Roadhouse?Passion, Partnership, Integrity and Fun
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From the Cypress Semiconductor values
(excerpt):
CYPRESS IS ABOUT WINNING
We do not tolerate losing.
We thrive on competing against the world's best.
WE MAKE OUR NUMBERS
We make 20% profit.
We each set goals and achieve them.
We ship 100% on time and get zero returns.
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Values Behaviors Outcomes
Continuum
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The desired
Outcome is
Trust
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The required
Behaviors are
Honesty and
Reliability
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The motivating
Value is Integrity
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The 3-minute
values clarification
drill…
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Memorial Hospital of Converse CountyDouglas, Wyoming
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Posted version
Compassio
n
Advocacy
Respect
Excellence
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Posted version
Compassio
n
Advocacy
Respect
Excellence
Group version
Integrity
Enthusiasm
Loyalty
Stewardshi
p
Ownership
Fun
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From…
Compassion
Advocacy
Respect
Excellence
To…
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What values would
you come up with?
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A statement of values does
not have to be a boring
brass plaque
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A tough love message
By not expecting people to
know your core values by
you are implicitly making an
assumption that they either
don’t care or are not smart
enough to learn them.
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Besides, if 5 year old kids
can learn the Pledge of
Allegiance by why can’t
you expect adults to learn
core values?
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140
“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
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Organizational values define
strategies while personal
values define culture.
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Nobody learns
everything they
need to know in
kindergarten!
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When a critical mass
of people connect
with and act upon
their core values,
they will have a
positive impact on…
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Th
e S
up
ers
tru
ctu
re
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Culture is to the
organization what
personality and
character are to the
individual.
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Which diner is most
likely to earn your
repeat business and
have you recommending
the place to friends and
neighbors?
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or…
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This is not a trick
question…
It’s the reality of
competing today.
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Same business
Different cultures
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People pay to
shop at
Costco…Ecstatic employees
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People shop at Wal-
Mart because they
don’t have to dress up
like they do for the
Dollar Store.
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Same business
Different cultures
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Nap
Rap
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Same business
Different cultures
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“No single
person owned
any decision.”Valukas report on the
GM safety scandal
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Same business
Different cultures
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Those who think culture can’t change will be demolished by those who are doing it!
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Culture is to recruiting
and retention what
marketing is to gaining
and earning customer
loyalty
>>>>>>>>>>>>>>
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Modern Healthcare cover story 1/19/2015
“Nurse shortage
looms”
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10 Reasons Culture
Eats Strategy for
Lunch
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Reason #1
People are
attracted by
and loyal to
culture, not
strategy
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Southwest
Airlines didn’t
earn the highest
loyalty in the
industry with its
bags fly free and
fuel price
hedging
strategies
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Reason #2
Culture
provides
resilience in
tough times
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“The only assets we have
as a company [are] our
values, our culture and
guiding principles, and
the reservoir of trust with
our people.”Starbucks CEO Howard Schultz in
Harvard Business Review, July-August
2010
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Reason #3
Culture is more
efficient than
strategy
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Nordstrom people don’t go
above and beyond the call
of duty because it’s in a
policy…
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Nordstrom has only one rule…
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Reason #4
Culture creates
competitive
differentiation
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Les Schwab sells the same tires
you can buy anywhere else – but no
one can compete with their culture
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“Advertising is a tax
you pay on having an
unremarkable culture.”
Robert Stephens, Founder of Geek
Squad
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Your culture is
your brand!- Tony Hsieh
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Reason #5
A brittle culture
can doom even a
great
organization (or
product)
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As witnessed by one
of the most highly
publicized funerals
of our time…
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The fingers are all
pointing in the
wrong direction
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What really killed
Hostess was a culture
of labor-management
hostility.
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Reason #6
When strategy
and culture
collide, culture
will win
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Nardelli’s hard-fisted GE
strategies increased
sales, profits, and stock
price…
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At the cost of violating its
people-centric values and
ability to compete for the
best talent.
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Home Depot’s board
wanted so badly to get
rid of Nardelli that they
paid him a quarter of a
billion dollars just to
make him go away!
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Reason #7
Cultural miscues
are more
damaging than
strategic ones
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Not fixing Dave Carroll’s
guitar cost United $millions
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Reason #8
Culture
provides
greater
discipline than
disciplinary
action does
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Reason #9
Culture provides a
level of risk prevention
that cannot be
attained with strategy
alone.
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Wal-Mart’s culture of
low price at any cost
has come at a huge
cost to the company.
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Wal-Mart has spent
nearly $500 million
on the investigation
of bribery and other
ethics scandals.
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Sam Walton would
be rolling over in his
grave!
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Reason #10
Culture will have a
significant impact on
your future bottom
line.
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Describe your culture
(current and ideal) in
just 6 words.
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This is a lot harder than
you’d think – especially if
you avoid boilerplate
slogans and make in real
and authentic.
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202
From managers
sitting in the same
room at one large
medical center’s
leadership retreat
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We love patients
and each other
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We are ALWAYS
here for you
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Multiple
priorities, limited
resources, great
expectations
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We’re entitled,
hating it,
and staying
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Beatings will
continue until
morale improves
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Southwest Airlines Motto
Servant’s Heart, Warrior
Spirit, Fun-Loving
Attitude
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Cypress Semiconductor Motto
The Marine Corps of
Silicon Valley
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Entrepreneurial small business
We’re tough
We’re focused
We win
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The Florence Challenge
Emotionally
Positive
Self Empowered
Fully Engaged
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What 6 words would
you use to describe
the culture of your
hospital?
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Please turn to page 103
of the Cultural
Blueprinting Toolkit
workbook
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Exercise #4-2 in the Cultural
Blueprinting Toolkit Workbook, pages
103-106
Use the Culture
Mapping Schematic
to define culture
change strategies
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This tool will help you
create a tactical
roadmap for specific
activities to achieve
desired culture
change.
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Desired
out
com
es
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Esse
ntia
l
char
acte
rist
ics
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Prove
n
stra
tegi
es
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There is no right-or-
wrong, cookie cutter
answer to how you
navigate the Culture
Mapping Schematic…
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It’s like the tumblers in a
bank vault – the idea is to
align the why, what, and
how of a particular
strategy.
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One final point:
Cultural work can’t be
just a “flavor of the
month”
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Culture doesn’t change
unless and until people
change
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Th
e
Inte
rior
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An enthusiastic
workforce gives you an
incredible source of
competitive advantage
in a world where 75% of
workers, on average,
are disengaged!!!
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234
A positive workplace
culture begins with
intolerance for toxic
emotional negativity.
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235
Emotional climate is
determined by what
you expect and what
you tolerate…
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236
And over time, what
you tolerate will
dominate over what
you say you expect!
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Have you defined
your ZTBs?
Do you have the
courage to enforce
them?
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238
“One toxically negative
person can drag down
morale and productivity
of an entire work
unit.”
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239
“It is a leadership
responsibility to create a
workplace environment
where toxic emotional
negativity is not
tolerated.”
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240
Unfortunately, we
are swimming
against a strong
current that’s going
the wrong way…
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241
The simple promise
that will change your
life…
And change your
organization…
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Work sucks
then you
die
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The Pickle Challenge
has taken on a life of
its own!
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245
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Grinnell Regional Medical Center
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The Pickle Challenge
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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.
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The Florence Challenge
Emotionally
Positive
Self Empowered
Fully Engaged
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Therapy pets can even
sign!
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Building a
culture of
ownership
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Do you have to start with the
right people on the bus?
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You can’t always
choose who you
have on the bus!
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You can’t just
throw all the
“wrong” people off
the bus!
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You can create a bus that
everyone wants to ride
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It begins with a
shared vision…
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270
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Essential
qualities for
promoting a
culture of
ownership
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Commitment
To the values,
vision,
and mission of the
organization
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Commitment is
most important
when the going
gets tough...
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“We need to see
opportunities where others
see barriers. We need to
be cheerleaders when
others are moaning doom-
and-gloom.”
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“We need to face problems
with contrarian toughness
because it’s in how we
solve those problems that
we differentiate ourselves
from everyone else.”
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“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
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Engagement
With patients,
coworkers, and
with the work itself
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At Best Buy, a 0.1%
increase in employee
engagement generates
a $100,000 increase in
gross store revenue*
* Harvard Business Review, October 2010
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Initiative
A “Proceed Until
Apprehended”
mindset
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283
Can one person
who takes
initiative change
your
organization?
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287
MMFI!
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Belonging
Making everyone
feel like a partner
and not just a
hired hand
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The root of the word
integrity is “integer”
– one unified whole
The incredible
invisible man
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Fellowship
Fostering a
“support group”
culture of respect
and caring
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293
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Pride
In the organization,
in the profession,
in the work, and in
you yourself
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Pride is reflected in the answer
to that universal icebreaker
question:
What do you do?
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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.
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What could be more boring than
industrial ventilation systems?
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299
BigAssHospital.com
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Passion
Enthusiasm,
positive attitude,
and joy reflected in
everyday actions
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Remember CeCe?
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If you think such
a profound
change is
impossible, let
me remind you
>>>>>>
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And where is your
smoking section
today?
>>>>>>>
308
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Across the highway!
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If we could do it
with toxic cigarette
smoke, why can’t we
do it with toxic
emotional
negativity?310
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“I got a whole new team
and didn’t have to
change any of the people
because they changed
themselves.”
Paul Utemark, CEO
Fillmore County Hospital
Geneva, Nebraska
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10 key lessons we’ve
learned through our
work on cultural
transformation…
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Lesson #1
Launching a movement is
a lot harder than starting
a program – it is also
much more likely to
achieve a lasting positive
impact.
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Lesson #2a
Achieving critical mass
requires approximately
30% population
commitment.
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Lesson #2b
You need enough people
moving fast enough to
escape negativity,
pessimism, cynicism, and
inertia of the past.
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Lesson #3a
Top down direction and
support
AND
Bottom up passion and
innovation
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Lesson #3b
People must believe
senior leadership
believes in and is
committed to the
cultural vision.
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Lesson #3c
Middle management’s
mere support is not
enough – they must be
gung ho champions for
change.
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A tough love message…
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Lesson #3d
The privileges of being a
manager also entail
certain foregone
freedoms
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Lesson #4d
Engage the medical staff
in a meaningful and
proactive manner
>>>>>>>>>>>>>>>>>
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The Twelve Core Action Values
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The Twelve Core Action Values
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Lesson #4a
Embrace the skeptics,
marginalize the cynics,
and plow through
resistance
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Lesson #4b
Engage potential critics
in a constructive
manner – encourage
them to think like
partners in the change
process
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Lesson #5a
Sustainability requires a
growing core of
passionate “Spark
Plugs” who have a
personal stake in
cultural transformation.
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Lesson #5b
Personal stories
resonate better than
scripted lectures.
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Lesson #6a
Avoid identification of
the change process with
any single individual or
“program.”
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Lesson #6b
Create initiative
coherence by being
clear about how various
projects reinforce one
another.
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Lesson #7
Keep it visible: posters,
banners, screensavers,
newsletter articles, web
pages; include it at the
start of every meeting.
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Lesson #8
Remember that
everyone listens to the
same radio station:
WIIFM.
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Lesson #9
Balance urgency and
patience to sustain
momentum; be in it for
the long haul.
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Lesson #10
In order to be
sustainable over the
long-term, the culture of
an organization must
rest on a solid
foundation of values.
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A Key Point!
You cannot allow
people to opt-out of
positive culture
change!
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“If we each do our
part, we will
change our lives for
the better.”
335
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Wes Barnt Bob Dent Kyle Graham Katy Longbotham
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“If we all do our
parts, we will
change our
organizations for
the better.”337
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Midland Memorial Hospital Values and Culture
Initiative
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“And in changing our
organizations, we can
change our world for the
better.”
340
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The Triple Win
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