tom peters’ excellence. always. the art of the possible. press ganey/17 november 2009

Tom Peters’Tom Peters’

Excellence.Excellence.Always.Always.

The Art of the possible.The Art of the possible.

Press Ganey/17 November 2009Press Ganey/17 November 2009(Slides at tompeters.com)(Slides at tompeters.com)

NOTENOTE:: To appreciateTo appreciate this presentation this presentation [and ensure [and ensure

that it is not a that it is not a messmess],], you need you need Microsoft fonts:Microsoft fonts:

“Showcard Gothic,”“Showcard Gothic,” “Ravie,”“Ravie,” “Chiller”“Chiller”

andand “Verdana”“Verdana”

DVM/Lyme/2005-2008DVM/Lyme/2005-2008

**Multiple diagnoses (>5)**Multiple diagnoses (>5)**Specialist self-certainty**Specialist self-certainty**Health deterioration failed to produce urgency-**Health deterioration failed to produce urgency- communication communication**Virtually no communications between specialists**Virtually no communications between specialists**Follow-up very spotty unless bugged incessantly**Follow-up very spotty unless bugged incessantly**Lost major test results, mis-placed 3 or 4**Lost major test results, mis-placed 3 or 4 occasions occasions**Near fatal drug mistake (one nurse takes charge)**Near fatal drug mistake (one nurse takes charge)**Effectively, disinterest in chronic-care**Effectively, disinterest in chronic-care**Lack of curiosity**Lack of curiosity

The failure to The failure to pursue pursue

EXCELLENCEEXCELLENCE is is incomprehensible incomprehensible

to me.to me.

““Let us create Let us create such a building such a building

that future that future generations will generations will

take us for take us for lunatics.”lunatics.” —the church hierarchs at Seville—the church hierarchs at Seville

14,00014,00020,00020,000

14,000/14,000/eeBayBay20,000/Amazon20,000/Amazon3030/Craigslist*/Craigslist*

*Lockheed “Skunk Works,” 125 vs. 5,000(??)*Lockheed “Skunk Works,” 125 vs. 5,000(??)

1977-1977-19821982

MBWMBWAA

Excellence1982: The Bedrock “Eight Basics”Excellence1982: The Bedrock “Eight Basics”

1. A Bias for 1. A Bias for ActionAction2. Close to the 2. Close to the CustomerCustomer3. 3. AutonomAutonomyy and and EntreEntreppreneurshireneurshipp4. Productivity Through 4. Productivity Through PeoPeopplele5. 5. Hands OnHands On, , Value-DrivenValue-Driven6. 6. Stick toStick to the Knitting the Knitting7. 7. SimSimpplele Form, Form, LeanLean Staff Staff8. Simultaneous 8. Simultaneous Loose-TightLoose-Tight Properties” Properties”

Hard Is Hard Is SoftSoft (Plans, (Plans, ##ss))

Soft Is Soft Is HardHard (people, (people, customers, values, customers, values,

relationships)relationships)

““If I could have chosen not to tackle the IBM culture If I could have chosen not to tackle the IBM culture head-on, I probably wouldn’t have. My bias coming in head-on, I probably wouldn’t have. My bias coming in was toward strategy, analysis and measurement. In was toward strategy, analysis and measurement. In comparison, changing the attitude and behaviors of comparison, changing the attitude and behaviors of

hundreds of thousands of people is very, very hard.hundreds of thousands of people is very, very hard.

[Yet] I came to see in my [Yet] I came to see in my time at IBM that culture time at IBM that culture

isn’t just one aspect of the isn’t just one aspect of the

game game ——it is the it is the gamegame.”.” —Lou Gerstner,—Lou Gerstner,

Who Says Elephants Can’t DanceWho Says Elephants Can’t Dance

3030--

fold!fold!

““When a plane crashes, When a plane crashes, they ask, ‘What they ask, ‘What

happened?’ In medicine happened?’ In medicine they ask: ‘Whose fault they ask: ‘Whose fault

was it?’ ”was it?’ ” ——James Bagian, M.D. & former James Bagian, M.D. & former

astronaut, now working with the VHAastronaut, now working with the VHA

Acute Respiratory Distress Syndrome, 1Acute Respiratory Distress Syndrome, 1stst test of variation analysis and reduction; test of variation analysis and reduction;

various ventilator settings; 50-page docvarious ventilator settings; 50-page doc;; deviate as desired; re-write deviate as desired; re-write weekly.weekly. ARDS survival rate, 40% vs national average of 10%ARDS survival rate, 40% vs national average of 10%

per MGH study. Committees (docs, nurses, administrators) forper MGH study. Committees (docs, nurses, administrators) for 50 clinical 50 clinical conditionsconditions; ; protocols computerized if possible. Concept:protocols computerized if possible. Concept: ID variationID variation.. 35 35 imitators. (“Don’t argue philosophy. Show me your morality rate, and I’ll believe imitators. (“Don’t argue philosophy. Show me your morality rate, and I’ll believe

you.”—James.) Operational systemyou.”—James.) Operational system plusplus culture change. 700-hospital study/culture change. 700-hospital study/Journal Journal

of Health Affairsof Health Affairs:: “many hospitals are not even aware of what they do well and what they don’t.” “People are very often willing to make intuitive diagnoses even when “People are very often willing to make intuitive diagnoses even when

they’re very likely to be wrong.”—Daniel Kahneman. “The human mind can sometimes they’re very likely to be wrong.”—Daniel Kahneman. “The human mind can sometimes do a better job of piecing together amorphous bits of information … On the other do a better job of piecing together amorphous bits of information … On the other hand, human beings can be unduly influenced by just a few experiences, like the hand, human beings can be unduly influenced by just a few experiences, like the

treatment of an especially memorable patient.”—James.treatment of an especially memorable patient.”—James. Psychological Psychological AssessmentAssessment: “clinical” vs. “data-driven”—DD clear winner : “clinical” vs. “data-driven”—DD clear winner

across numerous studies. Pronovost’s checklist/s: 108 across numerous studies. Pronovost’s checklist/s: 108 Michigan hospitals, line-infection rate approx. ZEROMichigan hospitals, line-infection rate approx. ZERO ((New New

England Journal of MedicineEngland Journal of Medicine, 2006—most still not use), 2006—most still not use) “[Intermountain] is “[Intermountain] is the best model in the country of how you can actually the best model in the country of how you can actually

change healthcare.”—Jack Wennbergchange healthcare.”—Jack Wennberg “Brent is the future.”—Lucian “Brent is the future.”—Lucian Leape Leape

Primary source: “Dr. James Will Make It Better,” Primary source: “Dr. James Will Make It Better,” NYTNYT/11-08-09/11-08-09

“Most people think that quality of care is defined by medical

interventions, such as a hip replacement, lens implant, or

coronary bypass operation, but genuine quality of care is defined

by action based on good information. Definitions of quality are often counterintuitive. Definitions of quality are often counterintuitive.

Multiple lab tests do not constitute quality medicine. … Entrepreneurial Multiple lab tests do not constitute quality medicine. … Entrepreneurial physicians have a greater stake in doing more than in doing good. Medicare, physicians have a greater stake in doing more than in doing good. Medicare, for example, provides funding for autopsies of every hospitalized beneficiary, for example, provides funding for autopsies of every hospitalized beneficiary,

and good science suggests that at least 30 percent of deaths should be and good science suggests that at least 30 percent of deaths should be autopsied. Very few are.. … In fact, lack of autopsy is the ultimate cover-up in autopsied. Very few are.. … In fact, lack of autopsy is the ultimate cover-up in

medicine, and the signature of poor quality care. … The whole issue of medicine, and the signature of poor quality care. … The whole issue of patient safety is based on honesty, and the autopsy is central in a system patient safety is based on honesty, and the autopsy is central in a system that finds truth, deals with it honestly, and tries to improve patient care.”that finds truth, deals with it honestly, and tries to improve patient care.”

Source: Source: “The Search for Quality: “The Search for Quality: It All Begins on the Autopsy Table,” chapter chapter title, title, Severed Trust: Why American Medicine Hasn’t Been FixedSevered Trust: Why American Medicine Hasn’t Been Fixed, George Lundberg, George Lundberg

“stunning lack of scientific knowledge

about which treatments and

procedures actually work”

Source:Source: Best Care Anywhere: Why VA Healthcare Is Better Than YoursBest Care Anywhere: Why VA Healthcare Is Better Than Yours/Phillip Longman/Phillip Longman

400,000400,000 heart bypass surgeries, heart bypass surgeries,

1,000,000 1,000,000 angioplasties per year:angioplasties per year: “Yet recent studies show that only “Yet recent studies show that only

about about three percent of the of the

patients who receive such operations patients who receive such operations benefit from them; most would be benefit from them; most would be better served better served jjust takinust takingg as asppirin or irin or

low-cost beta blockerslow-cost beta blockers.”.”Source:Source: Best Care Anywhere: Why VA Healthcare Is Better Than YoursBest Care Anywhere: Why VA Healthcare Is Better Than Yours/Phillip Longman/Phillip Longman

““The The moremore doctors and specialists around, the doctors and specialists around, the moremore tests tests and procedures performed. And the results of all these and procedures performed. And the results of all these

tests and procedures? Lots more medical bills, exposure tests and procedures? Lots more medical bills, exposure

to medical errors, and ato medical errors, and a loss of loss of life life

expectancy.”expectancy.”

Source:Source: Best Care Anywhere: Why VA Healthcare Is Better Than Yours Best Care Anywhere: Why VA Healthcare Is Better Than Yours/Phillip Longman /Phillip Longman

20072007SiberiaSiberia

Why in Why in the the World did World did youyou go to go to SiberiaSiberia??

EnterpriseEnterprise* ** (*at its best):* ** (*at its best): An An emotionalemotional, , vitalvital, , innovativeinnovative, , joyfuljoyful, , creativecreative, , entrepreneurialentrepreneurial endeavor that endeavor that elicits maximum elicits maximum

concerted human concerted human potential potential in the in the wholeheartedwholehearted serviceservice of othersof others.****Employees, Customers, Suppliers, Communities, Owners, Temporary **Employees, Customers, Suppliers, Communities, Owners, Temporary partnerspartners

20072007SydneSydne

yy

… … no less than no less than CathedralsCathedrals

in which the full and in which the full and awesome power of the awesome power of the

Imagination and Spirit and Imagination and Spirit and native Entrepreneurial flairnative Entrepreneurial flair

of diverse individualsof diverse individuals is is unleashed in passionate unleashed in passionate pursuit of … pursuit of … ExcellenceExcellence..

Thank you Peter Drucker/AIMThank you Peter Drucker/AIM

Our goal is to serve our customers brilliantly Our goal is to serve our customers brilliantly and profitably over the long haul.and profitably over the long haul.

Serving our customers brilliantly and profitably Serving our customers brilliantly and profitably over the long haul is a product of brilliantly over the long haul is a product of brilliantly serving, over the long haul, the people who serving, over the long haul, the people who

serve the customer.serve the customer.Hence, our job as leaders—the alpha and the Hence, our job as leaders—the alpha and the

omega and everything in between—is abetting omega and everything in between—is abetting the sustained growth and success and the sustained growth and success and

engagement and enthusiasm and commitment engagement and enthusiasm and commitment to Excellence of those, one at a time, who to Excellence of those, one at a time, who

directly or indirectly serve the ultimate directly or indirectly serve the ultimate customer.customer.

Source:Source: The Little BIG Things: 163 Ways to Pursue EXCELLENCE The Little BIG Things: 163 Ways to Pursue EXCELLENCE

We—leaders of every stripe—are in the “Human We—leaders of every stripe—are in the “Human Growth and Development and Success and Growth and Development and Success and

Aspiration to Excellence business.”Aspiration to Excellence business.”““We” [leaders] only grow when “they” [each and We” [leaders] only grow when “they” [each and

every one of our colleagues] are growing.every one of our colleagues] are growing.““We” [leaders] only succeed when “they” [each We” [leaders] only succeed when “they” [each and every one of our colleagues] are succeeding.and every one of our colleagues] are succeeding.

““We” [leaders] only energeticallyWe” [leaders] only energetically march toward Excellence when “they” [each and march toward Excellence when “they” [each and

every one of our colleagues] are energetically every one of our colleagues] are energetically marching toward Excellence.marching toward Excellence.

Period.Period.

Source:Source: The Little BIG Things: 163 Ways to Pursue EXCELLENCE The Little BIG Things: 163 Ways to Pursue EXCELLENCE

““You have to You have to treat your treat your

employees like employees like customers.”customers.” —Herb Kelleher, —Herb Kelleher,

complete answer, upon being asked his “secrets to success”complete answer, upon being asked his “secrets to success”

Source: Joe Nocera, Source: Joe Nocera, NYTNYT, “Parting Words of an Airline Pioneer,” on the occasion , “Parting Words of an Airline Pioneer,” on the occasion of Herb Kelleher’s retirement after 37 years at Southwest Airlines (SWA’s pilots of Herb Kelleher’s retirement after 37 years at Southwest Airlines (SWA’s pilots

union took out a full-page ad in USA Today thanking HK for all he had done; union took out a full-page ad in USA Today thanking HK for all he had done; across theacross the

way in Dallas American Airlines’ pilots were picketing the Annual Meeting)way in Dallas American Airlines’ pilots were picketing the Annual Meeting)

““The doctor The doctor interruptsinterrupts after …*after …*

*Source: Jerome Groopman, *Source: Jerome Groopman, How Doctors ThinkHow Doctors Think

1818 secondsseconds

[An obsession with] Listening is ... the ultimate mark[An obsession with] Listening is ... the ultimate mark of of RespectRespect..Listening is ... the heart and soul of Listening is ... the heart and soul of EngagementEngagement..Listening is ... the heart and soul of Listening is ... the heart and soul of KindnessKindness..Listening is ... the heart and soul of Listening is ... the heart and soul of ThoughtfulnessThoughtfulness..Listening is ... the basis for true Listening is ... the basis for true Collaboration.Collaboration.Listening is ... the basis for true Listening is ... the basis for true PartnershipPartnership..Listening is ... a Listening is ... a Team SportTeam Sport..Listening is ... a Listening is ... a Developable Individual SkillDevelopable Individual Skill.* .* (*Though women (*Though women are are farfar better at it than men.) better at it than men.)

Listening is ... the basis for Listening is ... the basis for CommunityCommunity..Listening is ... the bedrock of Listening is ... the bedrock of Joint Ventures that workJoint Ventures that work..Listening is ... the bedrock of Listening is ... the bedrock of Joint Ventures thatJoint Ventures that lastlast..Listening is ... the core of Listening is ... the core of effective Cross-functional effective Cross-functional Communication* Communication* (*Which is in turn Attribute #1 of (*Which is in turn Attribute #1 of organizational effectiveness.)organizational effectiveness.)

[cont.][cont.]

Listening is ... the engine of Listening is ... the engine of superior EXECUTION.superior EXECUTION.Listening is ... the key to Listening is ... the key to making the Sale.making the Sale.Listening is ... the key to Listening is ... the key to Keeping the Customer’s BusinessKeeping the Customer’s Business..Listening is ... the engine of Listening is ... the engine of Network development.Network development.Listening is ... the engine of Listening is ... the engine of Network maintenanceNetwork maintenance..Listening is ... the engine of Listening is ... the engine of Network expansionNetwork expansion..Listening is ... Social Networking’s Listening is ... Social Networking’s “secret weapon.”“secret weapon.”Listening is ... Listening is ... Learning.Learning.Listening is ... the Listening is ... the sine qua non of Renewalsine qua non of Renewal..Listening is ... the Listening is ... the sine qua non of Creativitysine qua non of Creativity..Listening is ... the Listening is ... the sine qua non of Innovationsine qua non of Innovation..Listening is ... the core of Listening is ... the core of taking Diverse opinions aboardtaking Diverse opinions aboard..Listening is ... Listening is ... StrategyStrategy..Listening is ... Listening is ... Source #1 of “Value-added.”Source #1 of “Value-added.”Listening is ... Listening is ... Differentiator #1.Differentiator #1.Listening is ... Listening is ... Profitable.*Profitable.* (*The “R.O.I.” from listening is higher than(*The “R.O.I.” from listening is higher than from any other single activity.)from any other single activity.)

Listening is … the bedrock which underpins a Listening is … the bedrock which underpins a Commitment toCommitment to EXCELLENCEEXCELLENCE

*Listening is of the*Listening is of the

utmost … utmost … strategicstrategic importance! importance!

*Listening is a proper … *Listening is a proper …

core core valuevalue ! !

*Listening is … *Listening is … trainabletrainable !!

*Listening is a … *Listening is a … professionprofession ! !

ListenListen = Profession = Study = practice = evaluation = = Profession = Study = practice = evaluation = Enterprise value:

"We listen "We listen intently to and intently to and fully engagefully engage

all with whom all with whom we work."we work."

““The The fourfour most most importantimportant wordswords in in any organization any organization

are …are …

The four most important words in any organizationThe four most important words in any organization

are …are … “What do “What do youyou

think?”think?”

Source: courtesy Dave Wheeler, posted at tompeters.comSource: courtesy Dave Wheeler, posted at tompeters.com

““The deepest human The deepest human

need is the …need is the … need to be need to be

appreciated.”appreciated.”—William James—William James

*appreciation is of the*appreciation is of the

utmost … utmost … strategicstrategic importance! importance!

*appreciation is a proper … *appreciation is a proper …

core core valuevalue ! !

*appreciation is … *appreciation is … trainabletrainable !!

*appreciation is a … *appreciation is a … professionprofession ! !

And the answer is ….And the answer is ….

otisotis

““There is a misconception that supportive interactions require There is a misconception that supportive interactions require more staff or more time and are therefore more costly. Although more staff or more time and are therefore more costly. Although

labor costs are a substantial part of any hospital budget, the labor costs are a substantial part of any hospital budget, the interactions themselves add nothing to the budget. interactions themselves add nothing to the budget.

Kindness is Kindness is freefree.. Listening to patients or answering their Listening to patients or answering their

questions costs nothing. It can be argued that negative questions costs nothing. It can be argued that negative interactions—alienating patients, being non-responsive to their interactions—alienating patients, being non-responsive to their needs or limiting their sense of control—can be very costly. … needs or limiting their sense of control—can be very costly. …

Angry, frustrated or frightened patients may be combative, Angry, frustrated or frightened patients may be combative, withdrawn and less cooperative—requiring far more time withdrawn and less cooperative—requiring far more time than it would have taken to interact with them initially in a than it would have taken to interact with them initially in a

positive way.”positive way.” ——Putting Patients FirstPutting Patients First, Susan Frampton, , Susan Frampton, Laura Gilpin, Patrick CharmelLaura Gilpin, Patrick Charmel

““Courtesies of a small Courtesies of a small and trivial character are and trivial character are

the ones which strike the ones which strike deepest in the grateful deepest in the grateful

and appreciating heart.”and appreciating heart.”

—Henry Clay

#10#10

““I regard I regard aappoloologgizinizing as the g as the most magical, healing, most magical, healing,

restorative gesture human restorative gesture human beings can make. It is the beings can make. It is the

centerpiece of my work with centerpiece of my work with executives who want to get executives who want to get better.”better.” —Marshall Goldsmith—Marshall Goldsmith, What Got You , What Got You

Here Won’t Get You There: How Successful People BecomeHere Won’t Get You There: How Successful People Become Even More SuccessfulEven More Successful

THE PROBLEM IS THE PROBLEM IS RARELY/NEVER THE RARELY/NEVER THE

PROBLEM. THE PROBLEM. THE RESPONSERESPONSE TO THE TO THE

PROBLEM INVARIABLY PROBLEM INVARIABLY ENDS UP BEING THE ENDS UP BEING THE

REAL PROBLEMREAL PROBLEM.**PERCEPTION IS ALL THERE IS!*PERCEPTION IS ALL THERE IS!

Relationships (of all varieties): THERE THERE ONCE WAS A TIME WHEN A ONCE WAS A TIME WHEN A

THREETHREE--MINUTEMINUTE PHONEPHONE CALLCALL WOULD HAVE AVOIDED WOULD HAVE AVOIDED

SETTING OFF THE DOWNWARD SETTING OFF THE DOWNWARD SPIRAL THAT RESULTED IN A SPIRAL THAT RESULTED IN A

COMPLETE RUPTURE.COMPLETE RUPTURE.

#11#11

Little =Little =

BIBIGG

Big carts =Big carts =

1.5X1.5XSource: Wal*MartSource: Wal*Mart

Socks Socks (DVT)(DVT) = = 10K/UK10K/UK

Compression hose would mostly fix the problem:Compression hose would mostly fix the problem: “According to the American Heart Association, up to two “According to the American Heart Association, up to two

million Americans are affected annually by deep vein million Americans are affected annually by deep vein thrombosis. Of those who develop pulmonary embolism, thrombosis. Of those who develop pulmonary embolism, up to 300,000 will die each year. ... Deep vein thrombosis up to 300,000 will die each year. ... Deep vein thrombosis also is among the leading causes of preventable hospital also is among the leading causes of preventable hospital death. Even more disturbing is the fact that, according to death. Even more disturbing is the fact that, according to a U.S. multi-center study published by two of ClotCare's a U.S. multi-center study published by two of ClotCare's

editorial board members,editorial board members, 58% of patients who developed a DVT while in the hospital received no preventive

treatment despite the presence of multiple risk factors and overwhelming

data that prophylaxis is very effective at reducing these events.” —Marie B. Walker, —Marie B. Walker,

clotcare.com, March 2008clotcare.com, March 2008

Wash Your Hands!Wash Your Hands!

*14 different traces in a bowl of peanuts at a pub*14 different traces in a bowl of peanuts at a pub*Dispensers with handwashing solution all*Dispensers with handwashing solution all

over the place, over the place, 20%20% less illness, less illness,

43%43% fewer absences from class fewer absences from class

*Moist 500X dry*Moist 500X dry*Warm-air dryer (110-206) >> No wash (117-47) *Warm-air dryer (110-206) >> No wash (117-47) *45% “forgot”/alone vs. 9% peers present*45% “forgot”/alone vs. 9% peers present

Source: Source: Wash Your HandsWash Your Hands, Dr Frederic Saldmann, Dr Frederic Saldmann

““The simplest treatments often The simplest treatments often

fall through the cracks fall through the cracks ——making sure a patient making sure a patient knows how to use an knows how to use an

asthma inhalerasthma inhaler, for instance. , for instance. And when doctors and hospitals And when doctors and hospitals try to deliver the right kind of try to deliver the right kind of

care, such as keeping track of a care, such as keeping track of a heart patient’s weight gain … , heart patient’s weight gain … ,

they lose money.” they lose money.” Overtreated: Why Too Much Medicine Is MakingOvertreated: Why Too Much Medicine Is Making

Us Sicker and PoorerUs Sicker and Poorer, Shannon Brownlee, Shannon Brownlee

90K in U.S.A. 90K in U.S.A. ICUsICUs on any on any given day; given day; 178178 steps/day steps/day

in ICU. in ICU.

50%50% stays result stays result

in “serious complication”in “serious complication”

Source: Atul Gawande, “The Checklist” (Source: Atul Gawande, “The Checklist” (New YorkerNew Yorker, 1210.07), 1210.07)

****Peter PronovostPeter Pronovost, Johns Hopkins, , Johns Hopkins, 20012001**Checklist, line infections**Checklist, line infections**1/3**1/3rdrd at least one error when he started at least one error when he started**Nurses/permission to stop procedure **Nurses/permission to stop procedure if doc, other not following checklistif doc, other not following checklist**In 1 year, 10-day line-infection rate:**In 1 year, 10-day line-infection rate:

11% to … 11% to … 0%0%

Source: Atul Gawande, “The Checklist” (Source: Atul Gawande, “The Checklist” (New YorkerNew Yorker, 1210.07), 1210.07)

(1)(1) Amenable to rapid Amenable to rapid experimentation/failure experimentation/failure

“free” “free” (No bad “PR,” No $$)(No bad “PR,” No $$)(2)(2) Quick to implement/Quick to Quick to implement/Quick to Roll outRoll out(3)(3) Inexpensive to implement/ Inexpensive to implement/ Roll outRoll out(4)(4) Huge multiplier Huge multiplier(5)(5) An “Attitude” An “Attitude”(6) (6) Does not by and large require aDoes not by and large require a “ “power position” from which power position” from which

toto launch experiments.launch experiments.

#12#12

<TG<TGWWand …and …

>TG>TGRR[Things Gone [Things Gone WRONGWRONG-Things Gone -Things Gone RIGHTRIGHT]]

““May I clean May I clean your your

glasses, glasses, sir?”sir?”

““Perception Perception is allis all

there is”there is”

M.M.M.T. =M.M.M.T. = Manage to Manage to Memorable Memorable

“Moments of “Moments of Truth”*Truth”*

*with thanks to Jan Carlzon, SAS*with thanks to Jan Carlzon, SAS

CCXXOO**Chief e*Chief eXXperience Officerperience Officer

GriffinGriffin:: Music in the parking Music in the parking lot; professional musicians in lot; professional musicians in

the lobby the lobby (7/week, 3-4hrs/day)(7/week, 3-4hrs/day) ; ;

5 5 pianospianos ; ;

volunteers volunteers (120-140 hrs arts & (120-140 hrs arts &

entertainment per month).entertainment per month).

Source: Source: Putting Patients FirstPutting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel, Susan Frampton, Laura Gilpin, Patrick Charmel

The 9 Planetree Practices

1.1. The Importance of Human InteractionThe Importance of Human Interaction2. Informing and Empowering Diverse Populations: Consumer Informing and Empowering Diverse Populations: Consumer Health Libraries and Patient Information Health Libraries and Patient Information3. Healing Partnerships: The importance of Including Friends Healing Partnerships: The importance of Including Friends and Family and Family4. Nutrition: The Nurturing Aspect of Food Nutrition: The Nurturing Aspect of Food5. Spirituality: Inner Resources for Healing Spirituality: Inner Resources for Healing6.6. Human Touch: The Essentials of Communicating Human Touch: The Essentials of Communicating Caring Through Massage Caring Through Massage7.7. Healing Arts: Nutrition for the Soul Healing Arts: Nutrition for the Soul8.8. Integrating Complementary and Alternative Practices Integrating Complementary and Alternative Practices into Conventional Care into Conventional Care9.9. Healing Environments: Architecture and Design Conducive Healing Environments: Architecture and Design Conducive to Health to Health

Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

#13#13

1/401/40

““We made mistakes, of course. Most of them were We made mistakes, of course. Most of them were omissions we didn’t think of when we initially wrote the omissions we didn’t think of when we initially wrote the

software. software. We fixed them by doing it over and over, We fixed them by doing it over and over, again and again.again and again. We do the same today. While our We do the same today. While our competitors are still sucking their thumbs trying to competitors are still sucking their thumbs trying to

make the design perfect, we’re already on prototype make the design perfect, we’re already on prototype

versionversion ##55.. By the time our rivals areBy the time our rivals are

ready with wires and screws, we are on versionready with wires and screws, we are on version

##1010.. It gets back to It gets back to

planning versus actingplanning versus acting: : We act We act from day onefrom day one; ; others plan how others plan how toto planplan——for monthsfor months.”.” —Bloomberg by —Bloomberg by

BloombergBloomberg

““We ground up We ground up more pig more pig

brains”: 100% brains”: 100% “Mad “Mad

Scientists!”Scientists!”

TP’s “1/40”/“We ground up more pig brains”TP’s “1/40”/“We ground up more pig brains”

““Experiment fearlessly”Experiment fearlessly”It’s all about attitude!It’s all about attitude!

One Big Innovation Lab!One Big Innovation Lab!““Let 1,000 flowers bloom” Let 1,000 flowers bloom”

(Chief Gardener?)(Chief Gardener?)Micro-experiment budgetMicro-experiment budget

Hyper-quick approval processHyper-quick approval processHyper-quick prototypingHyper-quick prototyping

(Measure “mean time to prototype”) (Measure “mean time to prototype”) Mini-project teams born in a flashMini-project teams born in a flash

Do everything at onceDo everything at onceNo “bad ideas” except inactionNo “bad ideas” except inaction

Transparency/Publish everythingTransparency/Publish everything


““Get it right the 79th time”Get it right the 79th time”Reward clever/excellent failuresReward clever/excellent failures

Celebrate constantly/Celebrate constantly/Wee rewards/Recognition/ Wee rewards/Recognition/

““Mad scientist club”Mad scientist club”Master “nudgery”Master “nudgery”

Encourage/Reward cross-functional Encourage/Reward cross-functional excellenceexcellence (A special category!)(A special category!)

Take the lid off the “best practices” Take the lid off the “best practices” travel budget/“Visit Excellence”travel budget/“Visit Excellence”

Steal excellence everywhere!Steal excellence everywhere!LEARN from best practices/LEARN from best practices/

Allow 100% variationAllow 100% variation


Coalition of Fearless ExperimentersCoalition of Fearless Experimenters Ask for help in WikiworldAsk for help in Wikiworld

Social networking with peersSocial networking with peers(Board game?)(Board game?)

““What do you think?”What do you think?”Listen!!!!Listen!!!!

100% participation100% participation100% leaders100% leaders

Patient participationPatient participationProcess ideas from allProcess ideas from all

Map everythingMap everythingMeasure but don’t stifle! Measure but don’t stifle!

TrainingTraining in process improvement for in process improvement for 100%100%

TrainingTraining in prototyping/100% in prototyping/100%

#14#14

““Let us create Let us create such a building such a building

that future that future generations will generations will

take us for take us for lunatics.”lunatics.” —the church hierarchs at Seville—the church hierarchs at Seville

““Excellence can be obtained if you:Excellence can be obtained if you: ... care more than others think is wise; ... care more than others think is wise; ... risk more than others think is safe; ... risk more than others think is safe; ... dream more than others think ... dream more than others think is practical;is practical; ... expect more than others think ... expect more than others think is possible.”is possible.”

Source: Anon. (Posted @ tompeters.com by K.Sriram, November 27, 2006 1:17 AM)

tom peters’ excellence. always. the art of the possible. press ganey/17 november 2009

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