Grassroots Change + Personal Accountability in Healthcare

Change and personal accountability in health and care!

Standing on the shoulders of the rebels, the crazy ones, the trouble makers and the boat rockers – these are the folks that I am blessed to call my friends and my colleagues; these are the people that push the envelope for change, that embrace the hard work and the ones I love!

Here’s to Colin Hung, Linda Galindo, Helen Bevan, Tracy Granzyk, Dave Mayer, Michael Bennick, Paul Westbrook,  Paul LevyKaty SchulerSteve Farber, Jake Poore, Diana Christiansen, Jason Wolf, Coleen Sweeney, Carol Santalcuia, Jason Gottlieb, Chris McCarthy, Kip Durney, Jim Rawson, Debra Barrath, and many, many more.

Changing the culture of healthcare takes a village of the committed, personally accountable, energetic, loving and audacious. I love these change agents!

Please join us on March 24th 20:30 EST (8:30 pm) on Twitter for a tweetchat #hcldr

Grassroots Change + Personal Accountability in Healthcare.

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Culture and Love – Safety Leadership Lessons from a Supermarket Chain

Culture and Love – a story from 2014

As 2014 drew to a close last week many a news outlet spent time reflecting back on the highs and the lows of the past year. Whether framed as a “top 10 list” or presented more as the best and the worst, here in northeastern Massachusetts one particular story caught my ear.

This was the Market Basket Story, a tale of unparalleled employee unity and pride, and living proof that a small group of committed people can in fact make a difference.

If you’re unfamiliar with this particular tale, there was a real cast of characters; long-time feuding, wealthy family members, unfairly (some would argue) fired senior executives, passionate, committed employees, and deeply loyal customers.

Bottom line: local grocery-store chain CEO fired by cousin (hate each other) board member, employees (loyal is an understatement) outraged and walk off the job, stand-off ensues, employees rally for the fired CEO to be reinstated, customers stay away at the request of employees (and there are no supplies on the shelves) and eventually the fired CEO buys enough shares to take control of the company and is reinstated – celebrations all around and bonus checks for employees!

The news story that I heard a few days ago was celebrating the fact that the entire body of employees has been recognized as the Boston Globe’s “2014 Business Person of the Year”, and reflecting on the leadership of Arthur T. Demoulas, the reinstated CEO, making the statement “… he was reinstated along with his culture of generosity, kindness and caring.”

I love this statement! His Culture!

Think about the words, his culture. This is not an abstract, difficult to grasp concept – this is his, the way he leads, the way he works.

In our work to improve safety in healthcare the word ‘culture’ gets tossed around all too easily. It’s easy to blame the culture, almost as if doing so excuses the behavior. It rolls off the tongue as part of our standard vernacular, and is often the response to much of what ails us:

Q: “Why are some of your operating rooms using surgical checklists and others not?”

A: “That’s just the way we do things here, it’s our culture…”

Q: “What stopped you from speaking up when you saw your senior colleague acting in that rude, disrespectful manner?”

A: “That’s the culture on this team, keep your mouth shut and your head down…”

It strikes me that we cite or state culture as the root-cause of the problem because it creates the impression that fixing or changing it is nigh on impossible. That to tackle, change or create a new culture is a myth so complicated that we best not even try…

The Market Basket story annihilates this myth.

Health and care leaders listen up

Culture is the way we act as leaders. It is the tone we set, the expectations we communicate, and the behavior, language and performance that we tolerate.

Culture is the way we (you and I) do things. Do you want a communicative, fair, safe culture? Then communicate openly about the good, the bad and the ugly. Be fair with the people that choose to work in your organization, and with the way you make decisions (don’t interpret as treating everyone the same…), and model an environment where speaking up about your mistakes and owning them is celebrated not frowned upon.

Remember, if it is to be it is up to me.

His culture!

“His culture of generosity, caring and kindness.” The reporter goes on to interview Arthur T. (reinstated CEO) and he describes some additional tenets by which he runs his company, with fairness, justice, and connection to the human soul.

They’re running supermarkets people, and he’s talking about connecting to the human soul…

He nails it when he shares that the secret to this incredible story is to remember that they are, “… in the people business first, and the food business second.”

Health and care safety in 2015

People business first, medicine business second.

People is where our focus needs to be. Caring and healing our patients and their families, absolutely, it’s the calling that many of us responded to that finds us doing the work we do. But it needs to be more than this…

I propose that in 2015 we need our focus to be more on the people that provide this care – as leaders we need to make these people ‘the business that we are in.’ They will take care of their patients.

Commit to being in the people business first. The care givers; the nurses, the technicians, the physicians, the patient care attendants, the unit secretaries, the managers, the supervisors, the housekeepers, the pharmacists, the social workers and each other.

Provide the generosity, kindness, love, fairness and justice that connects them to their purpose, reminds them of their calling, and creates a safe environment for them to deliver the best care possible.

 

The reporter for the piece on Market Basket closed out the segment by suggesting that the Market Basket employee’s actions have presented other companies throughout the Commonwealth and around the world with a challenge of sorts – loyalty is one thing, these folks though clearly love where they work, and who they work for…

From loyalty to love!

Perhaps for 2016…

 


Personal Accountability

A conversation with Chuck Lauer

Last year I had the wonderful opportunity to be introduced to Chuck Lauer, the former publisher of Modern Healthcare, by my good friend and colleague Kristi Peterson. Chuck and I spent considerable time talking and emailing about a subject of mutual interest and something we are both passionate about, accountability, specifically about the idea and concept of ‘personal accountability’.

This concept of personal accountability, and the choice to change the words I use when I think about accountability, are in part lessons from the leadership, writings, and friendship of Linda Galindo.

Chuck went on to pen a piece that appeared in Beckers Hospital Review on August 17th 2013. I just re-read it, and thought I’d share it here again. Enjoy…

We hear a lot about “accountability” in healthcare — from the boardroom, to the workplace, to new payment methodologies like “accountable care organizations” — but most people don’t have a clue about what the word really means.

Everyone knows the basic definition: Accountability is a kind of answerability. The word derives from having to give an account — to clearly explain what you are doing. But the actual definition goes much deeper than that.

Richard Corder, assistant vice president of CRICO, a Harvard-affiliated malpractice and patient safety organization, has thought a lot about what accountability is — including what it is not. It is not, he told me recently in an email, about saying “yes” whenever your approval is sought. “In healthcare, we have fallen for the belief that good service means saying yes to everything,” he said to me. “Saying no — and being clear about why, and when you may be able to meet, chat, review, discuss — is a liberating, time-saving, accountable action.”

One of the things often missing in today’s workplace, he said, is a lack of clarity about what accountability really means. “Treating everyone the same is disrespectful to our high performers and excuses (rewards) our middle and low performers,” he said. Fairness is not about treating everyone the same. As leaders, we understand that we have to treat, manage, coach and lead people differently — based upon performance and needs.

“In healthcare, we are currently spending a lot of time (and money) talking about and pondering the ‘accountable entity,'” he told me. “We wax and wane poetically about the who, what, why, when and where, when all the time it’s staring back from the mirror. We are the accountable entities.”

That gets us to the heart of the matter: Accountability has to start with you! If you are ever going to be successful and fulfilled in your life, you have to be accountable to yourself. Sure, you can kid yourself about how good you are, and you can even fool other people by what you say and how you behave. But do not forget that the hardest person to satisfy is you! You have to judge yourself and live with it every day!

Each of us is an accountable entity. That’s why, when leaders lead with clarity and conviction, honesty and transparency, they bring with them inspiration and determination. They have become accountable to themselves! It’s a contagious enthusiasm that permeates their organizations. Talented people are attracted to institutions where leaders are dedicated to innovation, creativity and risk-taking. They fully accept that answering to oneself is the key to success.

I have had the honor of meeting a lot of great people — people who have made a difference and achieved unparalleled success in sports, business and other pursuits. None of them really caught fire until they took stock of themselves and became accountable. Some did this when they were young. Others didn’t face up to themselves until they were older. But in all cases they look back and say that being accountable to themselves is what changed their lives.

Richard Corder said personal accountability means always trying to be clear. When confronted with a problem, you can say, “I tried, but they wouldn’t let me,” he said, or you can say, “Can you help me figure this out? I need to get some clarity.”

It’s important to put some effort into establishing clarity, he said, offering me a quote from the inspirational speaker, Mark Victor Hansen: “By recording your dreams and goals on paper, you set in motion the process of becoming the person you most want to be.”

Listening to yourself can help you put your plan into action. I don’t know about you, but I have conversations with myself all the time, and from what I can gather from colleagues and friends, they do the same thing. This enables us to begin to develop a sense of our own accountability.

With accountability comes additional responsibility. For instance, in your job, do you speak up when you feel something could be improved? Or are you so concerned about the risk of falling out of favor that you don’t say anything?

In healthcare, we too often delude ourselves into accepting the status quo and are unwilling to try new things that just may be more efficient and guarantee a better experience for the patient. Accountability has to start with people who are willing to hold themselves to a higher standard and be answerable to themselves at all times. The goal is to never deviate from your dedication to excellence.

The road ahead is paved with uncertainty, and you will probably have to drive over many potholes along the way. The whole industry needs leaders who have the courage to look into the future with clear eyes and to inspire their people to do the same. We need to be willing to bring about the changes that healthcare so critically needs. It isn’t going to be easy. Those who hold themselves personally accountable to mission and vision and to themselves will be the stars that inspire all of us with their courage.

Richard Corder gave me a kind of motto for personal accountability. It’s all simple, two-letter words that go like this: “If it is to be, it is up to me.”

I have already put them up on my office wall.

 

Thanks again Chuck for the friendship, mentorship, interest, and support.


Press Conference Leadership

Leadership lessons from the New England Patriots

On the way home tonight I listened to a recording of last week’s post-game press conference with Tom Brady, Quarterback for the New England Patriots football team. In the spirit of full disclosure; I am a Patriots fan, and Brady and colleagues had just come off a victory that many a pundit predicted they had no hope of pulling off, a win against the favored Denver Bronco’s…

PatsI am a happy fan of the winning team, feeling additionally buoyed by the fact that my team had just beat the team that denied us a berth in last year’s Super Bowl, a good result by anyone’s measure. All this aside, what I heard in the press conference from the captain leader of this team, made me realize that what made this football team successful last Sunday afternoon are the same tenets that make any team successful, regardless of the game being played…

A clear vision

During the comments made about the winning game, it became obvious that the vision for this team was broader and longer term than the afternoon’s victory. The vision of the organization (New England Patriots), is to ultimately win the Super Bowl each year. They are competing every week to win enough games to get to the post season, and ultimately get to the final game of the season, and win. Clarity and single-minded committment to a vision is critical.

Clear, executable goals

Tom Brady reiterated that winning football games is the reason the team goes out on the field every week. There are clear goals related to the execution of everyone’s job, there is clarity about each and everyone’s role, the expectations of each player, and their purpose when they’re out on the field. Role and goal clarity is often glossed over as a nice to have, not for this team, not for the Patriots.

Brady

Relationships built on trust

When asked about several remarkable plays, from a one-handed catch, to a stunning interception resulting in a touch-down; Brady spoke to the fact that he and his team mates take time to get to know each other, developing deeply rooted bonds of friendship and building trust with each and every one. Over time they learn how to build on and support each other’s strengths, accommodate each others shortcomings, and provide honest (for anyone who has been naked in a locker room with another team mate you know what this feels like), timely, and candid feedback.

A dose of reality

Bill BellichickIn the locker room, following the win, the Patriots’ coach Bill Belichick congratulated the team for a well-played game, allowing those that had worked hard for the victory a moment of celebration and appreciation. He then reminded the team that seven wins does not make for a winning season and does not guarantee entry into the post season and will certainly not win a Super Bowl. I was struck by this gracious dose of reality; a little time to enjoy the moment, to savor the win, and then remember why you are here. To achieve the goals and reach the vision. Do not stop working toward your goal.

Hire and retain the right people

It was clear listening to Brady during the press conference that this team was made up of people that really love the game of football. They enjoy working hard to get better through practice every single day of the season. He also spoke to the fact that if this wasn’t how a player was “wired”, then they wouldn’t last very long in the program.

 

Clear vision, communicated expectations and goals, the trust of those you work with, against a back-drop of reality, and a culture of “player fit”, are tenets of any high performing organization and successful team.

How does your organization or team perform? What would your “post-game press conference” sound like?