Good Leaders Drive Results!

Leaders are expected to be creative problem solvers, challenge the status quo and visualize problems before they occur. Your success as a leader is largely dependent upon how quickly you seek improvement in broken processes, develop new procedures and maximize efficiency and effectiveness.

Below are three tips to help you stay in front of the curve when managing your people and organization through change and drive results: Read Full Article.

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A True Understanding of Beauty Can Make Us Better Leaders

While in college, I agreed to meet someone at our church. No one else was at the building. It was 1:30 in the afternoon. I was able to let myself in, because I had a calling that required me to have a key. As I think back on it, I cannot remember who I was meeting or why; I just remember that this person stood me up. I sat for an hour in the foyer. Staring out at a gray, rainy sky, I thought, “What a miserable day!” I lived in Monroe, Louisiana where we would get a lot of rain. If every rainy day was a miserable day, I was going to have a lot of miserable days. I chose then to look for the beauty in that day. Everything looked clean and shiny from the standing water. I appreciated the different shades of gray. I saw bright sunlight peeking out through the clouds. I beheld that it really was a beautiful day, and my mood lightened considerably.

Frederick Longbridge said, “Two men look out through the same bars. One sees the mud and the other the stars.” Both are incarcerated. Both are in a bad place, yet one sees hope, and the other sees despair. One sees beauty and the other ugliness. Many people feel trapped in their lives, their work and their circumstances. They see so much of what is wrong and so little of the beauty that surrounds them.

The lens of seeing the good can be a powerful tool for anyone and especially for a leader. When we look for the good in people, we will find it. When those we lead know that we see good in them, they feel valued and respected. They want to prove that our faith in them is well-placed. They will often rise to meet our expectations. If we find concerns in their performance, we are able to weigh those concerns against all they bring to the table. We would not so blind our eyes to tolerate any kind of bad behavior. There must be accountability. Yet a strong tendency to look for the good is more likely to be right and to be effective in leadership than a strong tendency to look for the bad.

When we face great challenges in our organizations, we may see them as an opportunity to survive or perish. We should remember that the great men of history are made or revealed by the great challenges that have been thrust upon them or they have imposed upon themselves. Winston Churchill found his place in history because he was prime minister in England’s darkest hour and rose to meet the challenge.

In the movie, The Fellowship of the Ring, Frodo says: “I wish the Ring had never come to me. I wish none of this had happened.” Gandalf answers him saying, “So do all who live to see such times, but that is not for them to decide. All we have to decide is what to do with the time that is given to us. There are other forces at work in this world, Frodo, besides the will of evil.” Most organizations are faced with serious threats. We must not see these as our doom. These are beautiful opportunities to rise to greatness as leaders.

My own Christian faith is the source of my next thought on beauty. It occurs to me that Jesus Christ must see each of us as beautiful. I am certain that there are some expressions that He is not pleased to see, but I do not believe that He sees any of us is ugly. So, what makes us beautiful to Him? To answer that question, I want to take you to an assisted living facility in Rochester, New York.

It was the Christmas season. We had gone as a family to visit a beautiful, octogenarian couple we knew from church. We had with us three-year-old Abigail and infant Michael. Small children get a lot of attention in assisted living facilities. As we were leaving, we were invited into a public room that had the feel of a living room. In this exchange of laughter and joy, I captured with my camera a remarkable image of Abigail standing in front of a very old woman holding her chin with the tips of the fingers of her upturned hand. Each gazed on the other with a look of pure love. As I have studied the picture, it occurred to me that Abigail only saw beauty. I thought about all the grandparents and great-grandparents all over the world, many of whom are quite weathered and withered with age who are adored and are seen as beautiful by their perfect grand and great-grandchildren.

I am sure that you have known where I was going with this. We are seen as beautiful by Jesus Christ, because he loves us. This has caused me to realize that if I ever see someone as ugly, it tells me far more about where my heart is and should not be than it does about the other person. When we love people, they are beautiful to us.

So, a true understanding of beauty has brought us to love. The kind of love that I am speaking of is philia or brotherly (or sisterly) love. When we truly love, we cannot abuse. We seek the interests of others. We are as merciful as circumstances can allow. If hard choices must be made, we implement them as softly as possible. Love is one of the great and essential leadership qualities. Our ability to see beauty is a powerful indicator of our mastery of that love.

someone in their 80s

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A Winning Car for Leadership

The first time that I ever gave much thought to linking my choice of car to my career was in my medical legal class at Louisiana State University School of Medicine in Shreveport. We were warned that a disgruntled patient might see our expensive new Mercedes-Benz in the doctors’ parking lot and decide that we deserve to be sued. I cannot tell you exactly which car you should buy as a leader. That will vary according to your community, your personal needs, your personality and your important stakeholders. In this article I will illustrate how your choice of automobile might strengthen or weaken your position as a leader.

For two years a man that I know had the contract to do all of the electrical work in a large manufacturing plant. He bought a four-year-old, $40,000 Porsche and drove it over to the plant. The engineers in the plant took one look at the car and said, “He is making way too much money off of us,” and canceled his contract. He could have spent the same amount of money on a new pickup truck and they would have been fine with it. The problem was not the amount of money that he spent, but the brand image of the car he chose. One man told about owning an old Audi. He said the car was in rough condition, and he had not paid much money for it, but every time someone got in the car they would say, “Oooh, an Audi!” The brand image had overpowered the age, poor condition and low resale value of the actual car.

We often covet automobiles with high brand images that project the message that we are wealthy, successful and of a high socioeconomic class. There are situations where that message may serve our purposes well. A friend of mine was a senior executive at a Fortune 500 company. He drove an old, red Ford Ranger pickup truck. Functionally, it served his needs quite well, but one evening he valet parked it at an expensive restaurant where he was having dinner with other senior executives including his boss. After the dinner the valet brought his beat-up pickup truck around for him. His boss began to speculate over what clown would have driven that piece of junk to the restaurant. Since the valet was waiting for my friend to get into the truck, he had to confess to his boss that it was his. His boss told him, “You need to buy yourself some class.” And he did. He bought a beautiful, brand-new luxury car. Perhaps that was necessary to dig himself out of the hole. If he had not been in the hole to begin with, he would’ve done just fine with a clean, late-model Toyota Camry, Toyota Avalon or Honda Accord. My friend’s stakeholders were all other well-paid senior executives who drove expensive cars.

Sam Walton had a different set of stakeholders - his employees and his customers. These are all working-class people. He drove a 1979 Ford F150 single cab pickup truck. He said, “I just don’t believe a big showy lifestyle is appropriate. Why do I drive a pickup truck? What am I supposed to haul my dogs around in, a Rolls Royce?” Sam Walton was like the self-made millionaires described by Thomas Stanley in his book, The Millionaire Next Door, only he was the billionaire next door. He used his truck to great effect to project the image that he wanted his employees and customers to see. It was powerful because, in spite of all his acquired wealth, he was still that man.

He reminds me of my late friend, Bert “Nevada” Smith, from Ogden, Utah. He had only an 8th grade education and was one of the smartest men I have ever known. He grew very wealthy buying and selling military surplus, farm supplies and land. He offered to partner with me on business deals. I declined because my path was set on medicine. I have never been sure I made the right decision. One day he was taking me over to look at a surplus pickup truck. We walked out to his truck. It was an older Chevrolet single cab four-wheel-drive pickup truck. I made a point of looking at the odometer. It had over 70,000 miles on it. It was clearly a work truck. Bert dressed nice, but not above his customers. Everyone knew that he was wealthy, yet he was one of them.

My internal medicine residency program took me to Kijabi, Kenya, in October 2002 for a tropical medicine rotation. Kijabi Station is a ministry which includes a church, a hospital, a boarding school for ex-patriot children and a school for the local children. The wife and mother of one of the families ministering there shared with us that it was not their hiring several local people to be nanny, housekeeper and landscaper that caused distance between them and the local people, but the fact that they owned any car at all. In America, hiring “servants” to help you around the house is considered pretentious and selfish. In their local culture, you would be considered selfish if you did any work that you could afford to pay someone else to do. But since so few people owned cars in that area, there was no escaping that you were of a different class if you owned one.

Years ago, I spoke to a wealthy man who had been called to a high-level, unpaid ministry position in my church. He told me that when he was first called to this position that he owned a Mercedes-Benz. He discovered that the brand image of that car caused a division between him and the people he was called to serve so he sold the car and bought a brand-new, fully-loaded Suburban. He paid almost as much for the Suburban as he got for the Mercedes-Benz, but the brand image of the Suburban was a fit for the people he served, and the Mercedes-Benz was not.

I attended a physician leadership conference at a beautiful, high-rise hotel on the beach in Miami. I was in a shuttle van on my way back to the airport. As we moved through the parking lot of the hotel, two other physician leaders zeroed in on a beautiful, exotic sportscar. They both really wanted that car. I tried to caution them of the baggage that the brand image could bring to their leadership roles. I invited them to consider how difficult it would be to negotiate effectively against a union asking for pay raises for employees that their organization could not afford if it were known that they were driving that car. Their response seemed to be, “To heck with the consequences. We just want that car.”

It is possible that you may serve your entire tenure in an important leadership position without anyone taking any special notice of the car you drive. This is more likely to occur if you choose an automobile in the middle of the spectrum, neither too low-end nor too high-end. Remember, especially on the high-end, that the actual value of the automobile may not be what drives people’s impressions, but the brand image of car you choose. Instead, select an automobile that will not distract, but complement and strengthen your position as a leader.

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Sustainable Population Health:

Part B – Catcher or Pitcher?

Part B of this article addresses how growth plans of healthcare systems distinguish population health management from community and public health.

Part A of this article clarified the terminology and implications of Community, Public and Population Health. So what does all this this mean for healthcare system leaders’ growth plans?

Healthcare providers have historically played catcher, “receiving” patients who sought care. Access meant being available when and where patients sought them. The transition from volume-based care to population health management requires a role change of providers from catcher/receiver to pitcher/initiator. The transfer of utilization and intensity (and possibly actuarial) risk to providers requires providers to be economically accountable for care and the health of a population. The good news is that this is a better alignment with the societal view of healthcare as a service (in economics, a ‘good’ with a cost) that is necessary but not a value-add. The bad news for providers is that this is contrary to traditional culture and payment incentives. This change is not a transition, but a transformation that involves many transitions.

Is Less Healthcare Better?

From a community and public health perspective, success involves preventing disease and reducing the demand for healthcare services. Success for providers often means growth in healthcare services. Traditional revenue growth for providers involved price and quantity (P & Q). Providers feel conflicted: more P and Q meant economic success, but now, with increasing “value-based” care (more-risk, if not full risk), less P and Q means success.

Studies have called out pricing as the primary reason why costs in the U.S. are significantly higher than in other developed countries (Uwe Reinhart, ‘It’s the Prices Stupid’). Increasingly transparent societal forces are serving to limit growth in P. And the ascendance of population health management is serving to put downward pressure on Q – the quantity of health services provided. Read Full Article.

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Success or Failure: Healthcare Can Not NOT Change

One can not, not change – especially in business. And, though not always a popular perspective, healthcare is not only a business, it is big business. With many rural communities, the local healthcare system is the primary economic driver. It may sound harsh, but in business, it has been said that we are either growing, adjusting or dying.

As an avid fitness enthusiast, I can personally attest that I must either work to improve, or I will lose the progress I have made - requiring almost constant re-assessment and modifications to my programs. Especially as I age. What I was able to do 10, much less 20 or 30 years ago will no longer render the same results today. Very much like rural health.

Change and growth can be intimidating. It requires making choices on probability weighted outcomes. There must be a willingness to make additional investments, or cutting budget of one area to expand another. And, perhaps the scariest issue is leaving the known (what has been done), to embrace the unknown.

With any business, we must continuously evaluate our market to make effective strategic adjustments. Our communities’ needs, demographics, reimbursement, regulations and staffing – the only constant within healthcare is change. Read Full Article.

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Eating Live Frogs and Other Strategies to Organize Your Work

Mark Twain said, “Eat a live frog first thing in the morning and nothing worse will happen to you the rest of the day.” When I first read this quote, I thought it was just a bit of silliness and good fun, but I read once that it meant that you should tackle your most dreaded task first. This is good advice for often dreaded tasks are not as difficult as we feared. We just need to get started.

My long-range calendar is kept in Outlook, but I do not use Outlook to keep track of what I need to do today. I have often found myself ranging over the hospital so I would not have immediate access to my desktop computer. I also want to be able to talk on my phone and look at my schedule at the same time. So, to prepare for tomorrow, I pull out an unlined 3 x 5 index file card. Orienting it in a portrait layout, I write the day of the week and the date at the top. Below this I write in my known schedule for the day. If meetings are back to back, I write them with no space in between. If I have time between meetings, I leave space to write in commitments that will be made that day.

If you have a job with clear and regular boundaries between work and personal time, it may be practical to keep two separate calendars. But those of us in leadership, especially hospital leadership, find the boundary between work and personal time to be very fluid. We may have to come in early one day to meet with the surgeons and the next day stay a couple of hours into the evening for hospital committee meetings. Under these circumstances, it is critical that there only be one calendar on which is kept all work and personal commitments. One of Steve Jobs’ daughters understood this principle well. When her father would commit to spend time with her, she would call his secretary and have her add the event to his calendar.

If someone helps you with your schedule, it may be necessary to give them access to your Outlook calendar so that they can schedule meetings for you. If you feel you need privacy, it is possible to add things to your Outlook calendar such that others can see that the time is blocked but cannot see how you labeled the event.

On the backside of the 3 x 5 index file card, I write my “to do” list. These are things that I want to get done in my open time between meetings. As things are completed, I cross them off. Anything uncompleted by the end of the day, can be added to the next day’s “to do” list. For me there is always something to carry over on my “to do” list to the next day for I am a very ambitious “to do” list writer.

So how do we prioritize our “to do” list? We can begin by looking at our list in terms of a Johari window. Tasks can be divided into urgent & important, not urgent & important, urgent & not important and not urgent & not important. We must be careful about how we characterize our tasks. We may think that something is not important, but we can make a serious mistake if we decide that a task in unimportant while our boss thinks it is extremely important. We can lighten our load and focus our energies by removing things that are truly not important from our “to do” list. In the short term we must tackle urgent and important tasks, but in the long run we want to complete our tasks that are important while they are still not urgent.

There is merit in quickly knocking out easy tasks that are important, but we must not allow our sense of accomplishment to excuse us from tackling difficult tasks that we need to get done.

No is a word that I do not like to say to my superiors. I was hired to make things happen and to get things done. I was hired to be a solution to problems. When given a problem, I want to serve, I want to help. This can result in overloading my schedule. After starting a job as a physician leader, I was invited to sit on several committees. Early on I was given advice by one of my bosses that I should limit the number of committees that I sat on. So, I asked him to give me a number of how many committees he thought I should be on. As I accepted these committee assignments, I let them know that I had a limited number of committees that I could be on and that I might have to step down from their committee if the hospital needed me somewhere else. I had the advantage that I oversaw 22 physicians and four nurse practitioners who each needed to sit on at least two hospital committees. With so many providers needing committees, I struggled to find places for them all. When I needed to step down from one committee to take on a more important assignment, I was always able to replace myself with one of these providers.

Stephen Covey listed “sharpen your saw” as one the seven habits of highly successful people. A carpenter who only saws and never takes the time to sharpen his blade will be very unproductive sawing with a dull blade. We must take time to plan, prioritize and organize our work. This gives our work focus and power. We feel more effective, because we are more effective, and that sense of accomplishment brings joy and meaning to our work.

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Sustainable Population Health -- Who's on First?

Part A of this article clarifies the blurring terminology that can inadvertently stunt health improvement understanding and action.

Post-truth, Fake news, Misinformation (Dictionary.com words of the year for 2016, 2017 and 2018, respectively). Let’s be clear: How is population health different from community and public health? How does it relate to health disparities? A senior leader discussion on these topics can begin to sound like a rendition of Abbott and Costello’s “Who’s On First?”

The terms Community Health, Public Health and Population Health are often used with the same broad brush. But advancement in our thinking and action start with clarity of our language and terminology. Clearly there is much common ground with these terms. To start 2019 off with clarity, below is a summary delineation of these terms. Read Full Article

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In Praise of Corporate Tension

“Corporate will be here next week to help…”

“Corporate is sending out a team in person to review the project.”

“Corporate is coming out for a visit.”

These words can immobilize the most courageous of hearts. Many at the clinical sites believe corporate exists to disrupt and provide self-enhancement for the corporate individual making the demand. The incoming request often appears as a consistent disruptor to the local individual who is focused on the hospital, clinic or community issues. As a non-corporate individual, you are at the site addressing immediate and multiple priorities. The demands can range from concerns for improving patient care, addressing colleague concerns or responding to the corporate enhanced financial issues to name just a few of the more common daily agenda items. In fact, you may even be reacting to a situation affecting the greater importance (?) of your immediate supervisory interacting environment (i.e. keeping your local boss happy). Whatever the corporate demand at the time, it can seem to distract from the work necessary to be successful at the site. Furthermore, from the limited view in field, the request can sometimes make no sense as to its timing or priority except “Home Office needs it now.”

The tension between the entities in the field and the corporate power is real. The euphemism of “Corporate,” with all of its priority setting, sweeping powers, and down-flowing time demands can cause untold tension and disruption at the sites. However, corporate has its own demands and in the final measure is often made up of people just attempting to survive and succeed. Good leaders are conscientious individuals balancing competing demands, shifting priorities, and seemingly continuously adjusting metrics driven by someone else’s “higher-up” tinkering. Both sections of the organization contain people searching for a positive impact. Same organization. Different pressures. Competing language. How does that language sound as a result of differing views? Let’s take a look and listen in: Read Full Article.

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The Empowered Physician Leader

Today’s healthcare environment is shifting at an ever-increasing pace. The transition to community health focused care is both daunting and challenging for most organizations. Now, more than ever physician leadership can play a crucial and important role.

Setup Your Physician Leaders for Success

Before we begin, it’s foundational to understand how physicians view leadership. Physicians are trained to work independently, they value their autonomy and can be reluctant to delegate authority. All good qualities if you’re the patient. My colleague once said me, “these trauma surgeons are sure difficult to work with.” My response, “Of course they are. They are trained to take charge, assess situations quickly and be right, every single time. And If I’m critically injured, that’s who I want taking care of me.” But yes, when we ask them to take on the mantle of administrative leaders, they need our help.

Read Full Article.

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The Obstacle is the Path

“The obstacle is the path” is a Zen proverb that tells us that obstacles are the key to success.

Sometimes the only way out is through. The key to overcoming adversity is at times simple perseverance. Winston Churchill said, “If you’re going through hell, keep going.” Churchill was surrounded by people who, early in World War II, wanted him to give in to Hitler. He would not surrender. If he had, the world would be a very different place today.

Adversity gives us strength. Great athletes must challenge their bodies to develop the strength, skill and agility needed to excel. My mother is fond of quoting Ralph Waldo Emerson who said, “That which we persist in doing becomes easier, not that the nature of the task has changed, but our ability to do has increased.” The Russians are the masters of extended times in space. These cosmonauts were able to spend many months in the apparent weightlessness of space free of the constraints of gravity, but when they landed on the steppes of Kazakhstan, they had to be carried away on stretchers. They had lost so much bone and muscle mass that they could no longer stand.

In entrepreneurship, we are taught that the key to innovation is the “pain”. The pain is the problem that your innovation solves. If there is no pain, no problem, then there is no need for your innovation. Many entrepreneurs developed innovations that made them very successful when they found that the marketplace did not offer a solution to their own problem. They knew that others would value their solution if available so they offered a product or service to solve the same problem for others. Read Full Article.

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Mitigating Decision-making Errors Along a Transformation Journey

In Part A of this two-part article on decision-making errors, the main categories and types of decision and judgement errors were reviewed along with some associated logic fallacies.

So What?

Two practical questions emerge. First, what can we do to improve our judgement? A combination of antidotes is often recommended to mitigate the untoward effects of these decision traps: being humble and aware, knowing yourself and knowing others, and following a process are the top three. The first, being aware, is like telling a pitcher to “throw strikes” (well-intended, but not of great practical help – this is what the pitcher is trying to do but it does not help him/her do it!). The second, to know oneself, is harder than diamonds and steel, according to Benjamin Franklin. The third, following a process, offers the most tangible promise for something we can actually do that can consistently make a difference.

(Read Full Article)

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Impostor Syndrome...Me??

Have you ever questioned your competency or skills in a situation or role? Impostor Syndrome is defined as “a psychological pattern in which an individual doubts their accomplishments and has a persistent internalized fear of being exposed as a "fraud". While most people that experience this professionally do not to such a great extreme, it is common especially in women. Some of it could stem from the social pressures of trying to downplay your successes or not to self-promote that becomes so inherent that you start doubting your accomplishments and attributing them to external factors. Many men seem to display these characteristics too from time to time.

I have experienced impostor syndrome several times in my career. Every time I land that next great career opportunity, I victimize myself! The fear of failure or a new challenge, the fear of venturing into the unknown and overextending your skills, the fear of being discovered for what you don’t know. It can be intimidating or overwhelming and for some paralyzing, where it may limit them from taking on new ventures. Fortunately for me, being a risk-taker, I thrive in chaos. So, despite the impostor syndrome I have experienced, it has never thwarted my career. It only pushes me to learn and master the new role or niche so I can become a subject matter expert as soon as possible. It drives me to excel.

But if you are one of those that constantly battles this and it is indeed holding you back or sabotaging your career, here are some strategies that can help:

  • List your career accomplishments and celebrate them often
  • Review the challenges you have overcome in your personal and professional life
  • Do not minimize your wins. Next time you feel the urge to say “I was just lucky”, “I just happened to be at the right place”...remind yourself of the effort, strategy and planning that went into that achievement
  • Reach out to your professional network and tap into other’s experiences in the area that you feel uncomfortable in
  • Build a support network of individuals that uplift your confidence (your personal cheerleading squad) and indulge in activities that boost your confidence
  • Be authentic. No one expects you to know it all and it is perfectly fine to say, “I don’t know but I will find out”. People will respect you for your honesty and showing vulnerability is a trait of a confident leader
  • Challenge that inner negative voice, channel your positive thoughts and reframe the situation that is causing you anxiety
  • Drive yourself to become a subject matter expert in the area

You would not have made it so far, if you were an impostor, so get over it!

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The Cultural Leadership effect -- it starts with you

The leadership team is responsible for strategy. It is a major portion of our many meeting agendas. We have all seen or created the list of items and our strategy focus may vary from how to enhance our service line growth, to retaining and recruiting more nurses, or focusing on the improvement necessary to boost the patient scores and much, much more: however, as leaders we all know what must always be forefront on our strategic agenda, taking care of our employees.

How many times have you seen where the Administrative Team gets together, decides they are all going to Round together, and their assistants (with repetitive internal mirth) agonizingly make the schedule, coordinating whereby everyone can Round together. It lasts for a few months, weeks or even never gets completely off the ground despite the many studies showing its benefit. It is not out of leadership neglect, but the daily re-prioritization battle that necessitates our lives. Nevertheless, the focus on your employees must always take precedence.

The questions must then be asked: How is this precedence displayed? How do you show you care about your employees? Read Full Article.

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Understanding that Other’s May Think Differently

Photo Credit: Jeff Widener, Associated Press

Years ago, my sister taught a Sunday School class of 5-year old boys. At 11 p.m. one Saturday she suddenly remembered that she had a schedule conflict and needed me to teach her class. I got up early the next morning to study the lesson and to cut out and color smiley faces. As the time for church neared, I gathered all my materials and headed for the door. I suddenly remembered that my sister had told me to take them a snack, but a quick glance at the clock told me I was out of time. If I did not leave then, I would be late for church.

About halfway through the hour-long lesson Daniel suddenly became concerned. He looked and sounded like a little man dressed in his navy-blue business suit with white shirt and tie, “Do you have a snack for us?”

“No, Daniel, I ran out of time while preparing the lesson. I am sorry. There will not be a snack today.”

Daniel folded his arms and crossed one leg over the other. He gave me a look of stern disapproval and in an even, authoritarian tone stated, “Our teacher ALWAYS has a snack for us.”

“Daniel, I am sorry, but I do not have a snack. I did not have time.”

Daniel looked at me like a boss who was not going to accept excuses. “You are not a very good teacher.” Another little boy sounding very much like “a little boy” said, “Yeah, you’re not a very good teacher.”

And in that moment, I knew that Daniel had taught me a very important lesson.[i] I thought to be a good teacher I needed to know my lesson and color and cut out smiley faces, but Daniel knew that the most important key to being a good teacher was to bring snacks, and if Daniel was my boss, and I did not bring snacks, I was not going to get a good performance review. Read Full Article.

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Impacting Change Through Challenge

While talking with volunteers at the information desk, in walks the sweetest elderly couple. Both were in their mid to late 80s. The wife is using a cane with one hand and holding onto her husband for support with the other.

An early August day, outside temperatures were in the upper 90s. It was my first week working within a $40M health system as interim CEO and consultant. The facility offered a vast array of both general and specialized services. Without counting the licensed beds, one would never know it was not an urban health system, but rather a Critical Access Hospital.

As they approach, I greet them with a smile and ask if there’s anything I can do to help. The husband said they were here for some laboratory work.

The long walk from the parking lot during the heat of the day had clearly taken its toll on them both, but thankfully, the Laboratory/Radiology department was nearby. The lab tech quickly came out, offering the husband a seat in the hallway and taking the wife back into the offices for her blood work.

I looked around and noticed the “waiting area” consisted of a few hard-plastic chairs sitting in a major traffic area right off the main lobby.

Little did I know what awaited me, as I told the husband I would get him some ice water and be right back. That is when the adventure began … Read Full Article

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Decision Making Traps: Decider Beware

Leadership Transformation Series

This is Part 4A in this Four-part Leadership Transformation Series (LTS); 4B will follow.

Transformation in healthcare is personal: it requires the transformation of health system leaders. The LTS begins to speak to key differences in some of the fundamentals of transformational vs traditional leadership in healthcare.

This article focuses on how we make decisions: 4A Reviews decision-making errors.

4B Addresses how to mitigate decision-making errors

Leaders – and their organizations - succeed or fail based on their decisions. Yet the evidence is clear that our decision making is perilously fraught with biases and irrational behaviors of which we are not even aware. These biases are so ingrained in our psyche that, like water to fish, we cannot imagine that they are even there, much less clouding our view – regardless of how “well-intended and objective” we believe we are. In short, bad decision-making is largely hard-wired.’ Just as many medical errors are associated with unexplained variation in medical decision-making (How Doctors Think), so too are many leadership errors are associated with unexplained variation in management decision making.

Traditional change is oriented in the past; it involves more, faster, better, but not different (Daniel Prosser). Transformation is future-oriented; it requires the creation of something from nothing, i.e., letting go and giving up something in the past to create something new. This means that, to do transformation well, it is even more important that our hidden decision biases be flushed out and made explicit. Leaders on a transformation journey are at higher risk for decision making traps and consequences than in traditional change. Said differently, leadership decision making in transformation is less forgiving.

A brief review of categories and types of decision and judgement errors include the following: (Read Full Article)

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What Southwest Airlines can teach us about running our own organizations

In an industry where its competitors have frequently gotten into serious financial difficulty, Southwest Airlines has maintained profitability every year for the previous 45 years. This is an amazing accomplishment. We will explore some of the strategies that Southwest Airlines has used to drive that success.

Southwest Airlines has only ever flown one type of airplane, Boeing 737’s. All its pilots, flight attendants, ground crews and mechanics are trained to work with every plane Southwest owns. Southwest must maintain a parts inventory for only one type of plane. I see two lessons to be learned from the strategy. The first is the value of simplicity. The second is the importance of sticking to your strategy. I am sure that over the years they were tempted at times to buy smaller planes to service smaller markets and to buy bigger planes to service foreign markets. Southwest did not yield to the siren call of chasing every potential customer. They would only pursue those customers who fit within their business model.

Southwest Airlines does not believe that the customer is always right. The late Herb Kelleher, former CEO of Southwest Airlines, said that the customer is not always right. “And I think that’s one of the biggest betrayals of employees a boss can possibly commit. The customer is sometimes wrong. We don’t carry those sorts of customers. We write to them and say, ‘Fly somebody else. Don’t abuse our people.’” So, what does this approach do for Southwest’s customer service? My own experience is that Southwest employees have always been warm and gracious to my family and me. But for more objective evidence we will look at the Temkin Experience Ratings. Southwest has rated number one for customer experience among US airlines every year since 2011 except for 2015. Read Full Article.

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Five things every CEO needs to do

It is a truth. As CEOs, we are pulled in many directions. The incessant priorities, though seemingly always valuable, will consistently distract us from our most meaningful impact. How does a CEO maintain their focus and discipline on what is important when everything is significant? They must focus on what is central to the organization’s success. The following five imperatives will aid in this journey:

1) Visible Listener:

The CEO must be a good listener who spends time greeting, listening and positively interacting with the individuals on the floors and in the clinics. Ninety-Five percent of your time should be spent listening. Hearing from the people doing the work who can keep you informed of the issues they are solving through the work-around of their own ingenuity. You have an opportunity to develop relationships, listen for trends, solve problems and gain credibility as a CEO who cares about the people enough to make them a priority in your busy day. Read Full Article.https://www.rodneyreider.com/blog/2019/2/7/five-things-every-ceo-needs-to-do

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Dealing with Narcissism at Work?

Have you experienced any of these characteristics with a coworker or a boss?

  • The need to be “right” all the time
  • Quick to take credit for everything but be the first to assign blame on others
  • Minimize people and their emotions
  • Pit employees against each other
  • Desire to be appreciated and attended to all the time
  • Show no consideration for others or display empathy or compassion
  • Inconsistent behavior – you may be their best colleague/employee one minute and they may be threatening to fire you the next
  • Insistence on compliance with their demands regardless of how unreasonable they might be
  • Complete disregard of ethics, standards and morals, like they are above the law

If any or all these behaviors seem familiar to you, then run as far as you can from this individual, especially if they are your boss! Since that may not always be an option, below are some strategies that will help you deal with narcissists.

  1. Make them look good. Praise and acknowledgement make them tick
  2. Give them the attention they need, within reason. They feel threatened when you do not comply with their own self worth and aggrandization
  3. Do not try to reason or argue with them, it will just aggravate them. Let them talk while you listen
  4. Learn their pet peeves and avoid those. Similarly, learn what is important to them and cater to that
  5. Build a wall – you cannot take anything these individuals say personally. They can be manipulative and abusive, damaging your self-esteem. Disengage with them
  6. Find your drivers – do not expect them to motivate you and do not let them take you down. Keep the fire burning by focusing on what’s important for you
  7. Be proactive. While this is a good management mantra all the time, learn the triggers to narcissistic behaviors and control their occurrence as much as you can
  8. Enhance your emotional intelligence and learn tactics to cope with the behaviors professionally
  9. Let them micromanage or make decisions. They want their way and will get it. If you don’t agree with it voice your concerns but don’t expect to have the final say

Narcissists may be very successful entrepreneurs or professionals owing to their ability to turn on the charm and risk-taking skills, but they make ineffective leaders. Learning how to cope with narcissists in the workplace can be a great lesson in managing up or around!

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The Operating Model: Closing the Strategy-Execution Gap

Leadership Transformation Series

The Operating Model: Closing the Strategy-Execution Gap

This is Part 3 of a Four-Part Leadership Transformation Series (LTS).

Read Part 1 and Part 2.

Transformation in healthcare is personal: it requires the transformation of health system leaders. This LTS begins to speak to key differences in some of the fundamentals of transformational vs traditional leadership in healthcare.

This article focuses on how leaders operate.

You have a strategy. How do you rate your organization’s execution of that strategy on a 1-10 scale? For most, it is not high – or as high as they would like. Closing the strategy-implementation (aka, the knowing-doing or what-how) gap is the leadership Achilles heel of any business, but especially for hospitals, a business recognized by Drucker as the most complex organization to lead. Given that his observation pre-dated some of today’s larger and more evolved and blended academic-community healthcare systems, the complexity he referred to then has only increased. Across industries, the results of studies consistently identify unsuccessful execution for the vast majority of strategies; and the results of CEO surveys cite execution as the biggest current challenge, but reasons for such failure and concern vary widely. A sampling of HBR articles on the topic cite too much of an internal focus, poor CEO preparation in both strategy AND execution, “a people problem.” (Read Full Article)

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