Comprehensive Leadership for Senior Executives. Files/ACHE Face to Face Friday.pdf · • What are your organization’s most important ... Positive Workplace Environment ... Good

Comprehensive Leadership for Senior Executives

ACHE Professional Development Session

Little Rock, AROctober 11, 2013

Presented by Tom Atchison

This session will be valuable to me if I learn, solve, understand, create….

Tangibles Personal Intangibles

Organizational Intangibles

INPUTS • Cash• People• Policy/Procedures• Strategy• Plant• Information Systems• Communications

• Meaning• Caring• Giving

• Mission• Values• Vision• Inspiration• Leadership • Recognition• Motivation

OUTPUTS • Profit• Market Share• Products• Customer Satisfaction• Growth• Productivity

• Quality

• Inner Peace of Purpose

• Joy• Pride

• Culture• Followers• Commitment• Job Satisfaction• Team Spirit• Trust

• Quality

REMEMBER

BALANCENo Balance—No BusinessNo People—No Profits

4

Financial Performers

Patient Safety

Clinical Quality

Joy

Pride

Respect

Trust

SYNERGYThe Bridge Betweenthe Tangibles and the Intangibles

The “X” FactorThe “Spirit” of

the organization

TANGIBLES:Clinical and businessprocesses account for

35% oforganizationalperformance

These 3 elementsresult from living the:

• Strategic Plan•Departmental Plans

•The Budget

INTANGIBLES:Human relationsaccount for 65% oforganizationalperformance

THE DEEPERDIMENSIONS

These 4 elementsare the source of asense of purpose

and meaningful work asa result of living themission, values and

vision.

Titled Executives (CTOs)Begin Here

Leaders (CLOs)Begin Here

REMEMBER:DEVELOPMENTAL

Trust + Respect

Then Pride and Joy

Leadership/Management

8

Leadership Management

Titles‐Leadership‐Followership

Titles e.g., Executive, Manager, Director, Trustee, Chief of Staff are received upon employment or appointment and last as long as the person is in the position.

Leadership is not a title given, but a status earned through the display of: Competence, Integrity, Consistency, Courage, and Humility.

Followership is the defining characteristic of leadership and result from aligned values, shared vision and trust.

Leadership‐‐Management

Inspires PredictableInfluence ControlListens TalksVision/Strategy Focus Tactics/IPFocusManages change Reacts

Minutes 1440 MoneyRelationships PlansPeople Policies

Leaders lay the track.

Managers make sure the trains run on time.

Leaders are thermostats.

Managers are thermometers.

Leaders are gyroscopes.

Managers are compasses.

Farmer – Soil – Seed

Leadership—ManagementInspires PredictableInfluence ControlListens TalksVision Focus Tactics FocusManages change Reacts

Minutes (1440) MoneyRelationships PlansPeople Policies

CONTROL‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐INFLUENCE

Technical Management Leadership

Review

1. A mirror that reflects the way others see us(Note: Emotional Intelligence‐Daniel

Goleman, 1995)

2. Ruthless control of your calendar

Leadership ‐ Definition

“Leaders have trusting followerswith aligned values who commit

to achieving a visionwithin a culture of performance.”

‐Tom Atchison

Learnings I want to remember….

Application to my current role/responsibilities….

Questions????

What is Culture? Corporate Culture? Hospital Culture?

Culture‐‐Basics• Evolved from Anthropology to mean all human phenomena that are not genetically determined. It is the way humans represent their lives in symbols, values and behaviors—language, dress, food, religion, commerce‐‐the totality of our “way of life.”

•How tradition, values and social practices affect our psyche in ways that unify peoples.

• Culture is everything!• Culture is what we do when no one is looking!

USA Culture

•Some of the cultural symbols, values and behaviors that define USA’s culture are….Subcultures??

Corporate Culture‐‐Definition• Corporate Culture is the organization’s personality.

• It is the behavioral manifestation of an agreed upon set of core values

•Makes it possible for trustees, physicians, executives, managers and employees to share the same set of values, and work toward the same goal.

• Corporate culture allows a company to capitalize on individuality and create a synergy for the benefit of the customers.

Corporate Culture

• Some retail and service organizations that have strong corporate cultures include Starbucks, Zappos, Nordstrom, Ritz, Disney….

•Other USA companies….

•What values and behaviors make them unique?

•What would a company look like if they had a weak corporate culture or multiple subcultures?

Culture creation/strengthening is the process of converting Value words to behaviors. It is personalityDevelopment—3‐5 years

Behavior* is the Culture MetricBehaviors are different from emotions, feelings and impressions. Behaviors have these characteristics:1. Observable2. Repeatable3. Measureable

The two metrics for behavior are:1. Frequency, and2. Duration

*Words lie—Behaviors never lie!!

VALUES

EMOTIONS

FEELINGS

BEHAVIORS

Hard Easy

Healthcare Culture• A combination of the healthcare organization’s Mission, Values and Vision—held together by trust.

• Unique because of the patient and family needs/wants.

• Unique because no other industry has physicians, nurses and other clinician working collaboratively for the patient.

• Remember: Hospitals are not Hotels or amusement parks!!

Organizational DynamicsExecutives‐‐‐Physicians

Decision ProcessInfluence‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐Control

Perception of TimeLong Range‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐Now

Sense of SelfPart of a Team‐‐‐Protection of Individual Prerogative

Locus of ControlCorporate Strategy‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐Practice Needs

First LoyaltyTo the Corporation‐‐‐‐‐‐‐‐‐‐‐Patient

Strength of Culture

Mission ‐ Definition

•A mission statement is the “invisible hand,” which guides employees.

•A mission statement must be seen as market‐oriented, feasible, motivating and specific.

•The ideal mission statement, however, should be clear and direct—the standard for making decisions.

Values ‐ Definition

• Decision Rules• Motivational Influences• Behavioral Drivers

Sample Values

1. Friendship2. Being Liked3. Risk Avoidance4. Quality of Care5. Patient Satisfaction

Vision ‐ Definition

•Visions are statements of destination, so, they are forward‐looking.

•Visions are conceptualizations of hopes for the future.

•Visions express a sense of the possible (not the probable).

•Visions are unique, they set you apart from everyone else.

•Visions always begin with THE

Transcendent Purpose

Measurable

Directional

Inspirational

INDIVIDUAL PERFORMANCE

TACTICS

STRATEGY

VISION

TRUSTIS THE

CRITICAL SUCCESS FACTOR

Trust

• The perception of honesty, openness and reliability• Increases as a function of active listening• Takes a long time to develop• Can be weakened/broken easily • Is the glue and lubricant for sustainable success• There is NO relationship between being trusted and being liked!!

• The benefit of the doubt!!• Controls “Pre‐emptive Behavioral Responses”



Questions????

CHANGE

Change Quotes

“Change before you have to.”“If the environment changes faster than you do, you will be out of business”

‐J. Welch

“Manage change or react to change.”‐T. Atchison

“All organizations are perfectly aligned to get the results they are getting.”‐D. Berwick, MD

“If you change nothing—nothing changes.”‐T. Atchison

“Hope is not an effective strategy for change.”‐T. Atchison

“Remember, the stone age didn’t end because they ran out of stones.”‐Rick

“We cannot solve today’s problems working from mindsets that created them.”‐paraphrase from Albert Einstein

The Easy to Hard Continuum

I want, I understandI control

I don’t want, I don’t understand

andI don’t control

Midpoint

Dynamics of Change

The Anxiety/Behavior Continuum

Happy ‐individualsresist change

Angry ‐individuals

resist change

Window of Opportunityfor Change

Dynamics of Change

“Contrary to popular belief, happiness doesn’t result from relaxation or

completely stress‐free living, but from meeting challenges with intense

activity and interest.”

‐Mihaly Csikszentmihalyi

Pride Indicators*1 – Strongly

Disagree 2 – Disagree 3 – Uncertain 4 – Agree5 – Strongly

Agree

I have a sense of loyalty to this company. I identify with this company. I think about the future of this company. I’ve regretted that I chose to work for this company. I do extra work here because I want this company to succeed. I feel that I share in the success and failure of this company. I feel a sense of ownership in this company. It would take very little for me to move to another company. I take pride in being part of this company.

© MetriTech*Any indicator less than 4.0 needs to be addressed.

• Slumber• Pajamas• Pillow•Nap• Bed

•Quiet• Snore•Dream• Blanket•Night

REMEMBER

1. Each person is correct from their point of view;

2. Collect all points of view;3. Find points of greatest agreement; and4. Focus of the future.*

*You can’t un‐ring a bell!!

Remember

1.Always agree on the end game,

2.Always agree on metrics, and,

3. Specificity is the key.



Questions????

Talent Management

1. Knowledge Academic EducationCredentials/Tests

2. Skills Competencies Training

3. Attitude Climate/Opinion RecognitionSurveys Practices

4. Motivation Culture OrganizationalAssessment Development

5. Values Culture OrganizationalAssessment Development

6. Capacity Interview/WorkPerformance Selection

7. Personality API, Myers‐Briggs Therapy/Drugs

DOMAIN DX RX

“Hiring/Credentialing Grid”

Human Capital Elements*1. Capacity

2. Capability

3. Motivation*Targeted Selection and Values‐based Interviewing

Values Agree=Compromise*

Values Conflict=Consensus**

*think chicken and pig farmers**think cattle rancher and vegan

Margaret Thatcher (b. 1925)British Conservative politician, prime minister.Quoted in: Denis Healey, The Time of My Life, pt. 4, ch. 23 (1989).

Lawson & Associates ‐ 5/17/98

Ah, Consensus…

To me, consensus seems to be the process abandoning all beliefs, principles, values and policies.

So it is something in which no one believes and to which no one objects.



Questions????

Communication

Communication #1• Language of the receiver• Log‐in•New/Old Team

Communication #2

•Mouth Management•Active listening‐‐Trust

Remember

• We are very much controlled by our historical relationships with symbols.

• Understand “Pre‐emptive behavior response clusters.”

• What do you symbolize‐to various people, groups?

• What are your organization’s most important cultural symbols?



Questions????

Motivation

Remember

“Motivation is simple. You eliminate those who are not motivated!”

Lou Holtz

Time Spent in Each Cell3

CynicsWho is a low performer, feels undervalued and always complains?

2

SKEPTICSWho is very hard-working,

creative, critical and annoying?

4

SLUGSWho is a low performer, but

reluctantly does just enough to stay?

1 STARSWho currently behaves the way

you wished everyone behaved?

Contribution to Performance

Noise Level

N/600

Stabilizers

Note

Common People Metric“Turnover rate less than 12% per year”

Maybe turnover should be 100% for cynics and slugs, and 0% for stars and skeptics?!

“People don’t come to work to be No.1or 2 or to get a 20 percent return

on assets….

REMEMBER

They come to work to get meaning from their lives.”

Christopher Bartlett, Professor, Harvard



Questions????

Teamwork/Spirit

Team‐‐Description•Gathering•Group•Team

Team Components

Shared purposeClear RolesClear Role InterdependencyDynamic Tension

Summary

ComprehensiveLeadership Characteristic

Successful healthcare leaders have followers because they alignvalues first, then create and communicate their vision—within a context of trust and respect.

High/Low Performance Organization

Factor Traits

CLOChief Leadership

Officer

Competency Integrity Consistency Courage Humility

Positive Workplace Environment

Meaningful work Professional

development Respect Clear direction Reasonable expectations

Followers

Pride Joy Engaged Innovative Rewarded

Factor Traits

CTOChief Titled

Officer

Economic focus Egocentric behavior Over controlling Unpredictable Autocratic

Toxic Workplace Environment

Productivity measures rule High stress Expectations change often Employees are viewed as

economic units No/limited opportunity for

professional development

Survivors

Minimum behavior Blame transfer Avoidance Uncertainty Anger (passive aggressive

behavior)

High Performance Organization Low Performance Organization

Leadership‐Quick Test

1. I am aware of the way I am perceived by various groups.

2. I have complete control over my calendar.3. I invest two‐thirds of my time to relationship

improvement.

Leadership‐Test, con’t

4. I invest more time in the future than the present or the past.

5. I know the capabilities and capacity of the talent needed to be successful.

6. I am trusted throughout the organization.7. Coaching and professional development are a big part of my daily work.

Leadership‐Test, con’t

8. I am a servant leader.9. I routinely use active listening techniques.10. I deal with difficult behaviors, problems and conflicts quickly and effectively.

Mean score:___



Questions????

I, ________________________________________________________(Name)

Promise to ________________________________________________

__________________________________________________________

__________________________________________________________

These changes will begin in the next 3 days, and measured by:__________________________________________________________

(Date)

I need to work with the following people if I am to fulfill this contract:__________________________________________________________

__________________________________________________________

__________________________________________________________

Personal Contract for Change

ReferencesBasicGood to Great, Jim CollinsExceptional Leadership…, Carson DyeInside the Physician’s Mind, Joe Bujak, MDThe Checklist Manifesto, Atul Gawande, MD

IntermediateHow the Mighty Fall, Jim Collins Active Listening, Michael HoppeOnward, Howard SchultzLeadership’s Deeper Dimensions, T. Atchison

AdvancedGreat by Choice, Jim CollinsThe Speed of Trust, Steve Covey, Jr.Let My People Go Surfing, Yvon ChouinardEmotional Intelligence, Daniel GoldmanThe Zappos Miracle, Shinobu Ishizuka

*Escape Fire

Documents

Comprehensive Leadership for Senior Executives. Files/ACHE Face to Face Friday.pdf · • What are your organization’s most important ... Positive Workplace Environment ... Good