Edge Talk: The key ingredient to organisational transformation
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Edge Talk: The key ingredient to organisational transformation, Dr Irv Rubin and Matt Stone of Temenos with Dr Maxine Craig. Friday 6 May
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Edge Talk: The key ingredient to organisational transformation
- 1. @theEdgeNHS | #EdgeTalks The Key Ingredient To Organisational Transformation Dr Irv Rubin and Matt Stone, Temenos Dr Maxine Craig Friday 6 May 2016 at 9.30am BST
- 2. Joining in today and beyond • Please use the chat box to contribute continuously during the web seminar • Please tweet using hashtag #EdgeTalks and the handle @School4Radicals @theEdgeNHS • Send a request to join our Facebook group School for Health and Care Radicals and The Edge NHS
- 3. The team today Chat room monitor Dom Cushnan @DomCushnan Twitter monitor Kate Pound @KateSlater2 Session chair Olly Benson @ollybenson
- 4. Our presenters Irv Rubin, Ph.D. CEO, Temenos, Inc. @temenosinc Matt Stone, J.D. COO, Temenos, Inc. @MattStone048 Dr Maxine Craig @maxine_craig
- 5. Key Ingredient to Organisational Transformation -Edge Talk- 6 May 2016
- 6. Copyright © 2016 Overview 1 The Organisation as Patient 2 Key to Better Engagement 3 Feedback Technique 4 Behavioural Diagnostic Tool
- 7. Copyright © 2016 THE TRUTH HAS BEEN TOLD... AND IT IS OLD REVANS' RESEARCH [1964] SALMOND'S RESEARCH [1972] •LENGTH OF PATIENT STAY...UNRELATED TO SIZE •THE RICH WERE NOT GETTING RICHER! •HIGH-TOUCH NOT HIGH TECH WAS THE EXPLANATION •NURSING TURNOVER AND LoS HIGHLY CORRELATED
- 8. Copyright © 2016 Houston, we Have A Problem: Healthcare Is In Trouble Malpractice is destroying health care Tens of thousands are dying from treatment unrelated to their admitting condition Untold numbers of near misses go unreported Good nurses are hard to find and hard to keep
- 9. Copyright © 2016 Zooming in on the Nurses: The Point of ‘TLC’ Disruptive Behaviors Witnessed or Experienced by Nurses (N=2562) Condescension 69% Disrespect 80% Abusive anger 43% Abusive language 69% Berating patients 26% Physical abuse 22%
- 10. Copyright © 2016 How Often Does It Happen? 38% up to 10 times per year 29% 1 - 2 times per month 24% weekly 7% daily 2% never
- 11. Copyright © 2016 Who Are The ‘Perpetrators’? 6 - 9 % exhibit over 70% of the disruptive behaviors Majority of staff exhibit 28% of the disruptive behaviors 2% of the staff were seen as exhibiting 0% of the behaviors
- 12. Copyright © 2016 Not Just An American ‘Dis-ease!” 2 District Hospitals; 4 Community Hospitals; 9 Practices; 3 PCT Headquarters Frequency of verbal abuse UK Data 2003 (N=334) 29% 37% 10% 15% 8% 0% 5% 10% 15% 20% 25% 30% 35% 40% 1 2 3 4 5 Good Bad 33% = Weekly or More Often 8% = Daily 37% = Once/Twice in Last Month 29% = Not Once in Last Month
- 13. Copyright © 2016 BQA: CQI At The Individual Level Technical Effectiveness BQA Managerial Efficiency Three-legged Stool
- 14. Copyright © 2016 Behavioral Quality Assurance (BQA) 1. CURING F (Science of Medicine) Focus of traditional Q.A. “Having the hard technologies and science of medicine been appropriately and skillfully applied in service of curing?” 2. HEALING F (Art of Medicine) Focus of BQA “Have ALL the hands laid on patients been appropriately and skillfully applied in the service of healing?”
- 15. Copyright © 2016 A Spiritual Sister in Chiba, Japan: St. Marguerite Hospital To heal sometimes. To support often. To comfort always.
- 16. Copyright © 2016 One Example of Failure To Embrace This Truth and The Consequences QUESTION: Does It Make a Difference Which E.R. You’re Taken to? [Over 5000 Patients] ANSWER: Only a Matter of Life or Death! [60% survival versus 58% Deaths “Differences Appear to relate to the quality of the interaction and communication between physicians and nurses…” [Knauss, et.al., Annals of Internal Medicine, Vol. 104]
- 17. Copyright © 2016 True or False? __ We have one common Behavioral code of conduct for everyone. __ Our Behavioral Code of conduct is enforced without ‘favoritism.’ __ Everyone gets a performance review at least yearly. __ Both technical and interpersonal competencies impact performance rating. __ Feedback is direct and face-to-face versus anonymous and averaged. Potential Managerial Malpractice Liability Quiz
- 18. Copyright © 2016 True or False? __ We have “dead messengers” in some of our closets. __ We have big “undiscussed elephants” on some of our meeting room tables. __ We know that ‘staff infections’ are as potentially lethal as ‘staph infections.’ __ We know that the culture in the Boardroom filters into the treatment room. __ We view our organisation as a human entity, a “Patient in need of care.” -Cont-
- 19. Copyright © 2016 It Starts With What We Believe • Identity must be “either or” • Treatment of people become a “yes and”
- 20. Copyright © 2016 Do We Have the Courage and Integrity? And Be Have It Of The To Will You
- 21. Copyright © 2016 BQA: CQI At The Individual Level Technical Effectiveness BQA Managerial Efficiency Three-legged Stool Awareness = Seek and Provide Feedback on Consequences of Behavior Behavior = Strive to Learn and Exhibit Win-Win Behaviors Regularly Consequences = Monitor Impact of Behavior Regularly so As to Increase Awareness
- 22. Copyright © 2016 Dr. Maxine Craig
- 24. 2015
- 25. 2003
- 26. Some of the biggest challenges we face are not far far away … but in my opinion are the ones we encounter in our every day work
- 28. What we worked out : •People had not known how to give feedback in a way that was impactful and might have stopped things developing •We had no process of assuring the behaviour of our leaders and our staff
- 29. Technical CLINICAL Effectiveness BQA Managerial Efficiency Three-legged Stool © 2003 Temenos ®, Inc., USA. All rights reserved.
- 31. The information needed to prevent the disaster was known
- 34. Copyright © 2016 2 Key to Better Engagement
- 35. Copyright © 2016 Engagement is a quality of a relationship, not a person… taking place from the inside-out, not the outside-in. and… It’s all personal.
- 36. Copyright © 2016 The New Executive Listening Tour “We want your input!” Summer Picnic/BBQ Remodeled Breakroom Christmas/Holiday Party Retreat New “Values” Statement
- 37. Copyright © 2016 Connectivity ≠ Connectedness
- 38. Copyright © 2016 Self-Assessment Personality Profiling
- 39. Copyright © 2016 Google Research on Building Great Teams (http://nyti.ms/20Vn3sz) Good vs. Dysfunctional Teams Hinged on: “how teammates treated one another.” Putting the “best people” or similar people into groups does not correlate to good team performance. MOST IMPORTANT FACOR: PSYCHOLOGICAL SAFETY
- 41. Copyright © 2016 BEHAVIORAL FEEDBACK The key to all Learning and Development In a Relationship
- 42. Copyright © 2016 We need to rehabilitate this word.
- 44. Copyright © 2016
- 45. Copyright © 2016 Anonymous 360s The Cure that Worsens the Illness. Annual Performance Reviews A Compliance Task “Whew, glad we could check that box!”
- 46. Copyright © 2016
- 48. “Culture is built through shared learning and mutual experience.” –Ed Schein, Ph.D. Feedback Organisational Transformation??? Feedback is the key to developing and sustaining a shared experience.
- 49. 4 Keys to Successful Feedback Regularity Skill Honesty Compassion
- 50. –Dr. Rose N. Franzblau “Honesty without compassion and understanding is not honesty, but subtle hostility.”
- 51. Copyright © 2016 Beware the shortcut answers. “Empower your People” “Support Enthusiasm” “Encourage Learning” “Invite Input” “Create Fun Environment” “Be Flexible”
- 52. Copyright © 2016 3 Feedback Technique
- 53. Copyright © 2016 “DAP”Feedback Technique
- 54. Copyright © 2016 [D] The report was due at 2:00 and it’s 3:30. [A] It’s hard to trust your word when you don’t keep a commitment. [P] In the future I need you to call me before-the-fact if you need to re-negotiate a change in the schedule. Describe: The Facts Appreciate: Your Feelings Prescribe: Your Suggestion/Need Be Specific D A P
- 55. Copyright © 2016 [D] "My kids are still sick and you’ve bailed me out twice now." [A] "I really value your support." [P] "Let me know if you ever need any help from me."
- 56. Copyright © 2016 4 Behavioural Diagnostic Tool
- 57. Relationships Thrive on Behavioral Feedback
- 58. Easy to Use Fast Non-Judgmental Proven Model Specific, Actionable Behaviors
- 60. Invitee “Kim” Desire for More/Less/Same Five Priority Behaviors Frequency Perception
- 61. Inviter “Richard” Inviter’s Survey Limited to His/Her Frequency Perception For Comparison with Invitee’s Perception
- 62. 1 See how another person sees you behaving when you are dealing with them—their impression of you. The Behavior Minder® Enables you to do three things:
- 63. 2 Compare this with how you see yourself behaving with this person—your impression of yourself.
- 64. 3 Identify specific actions to further strengthen the relationship—to extend its win-win range and potential.
- 67. Join us Facebook.com/temenosinc Follow us Twitter.com/temenosinc Visit us www.temenosinc.com Thank You!
- 68. We are witnessing the emergence of a new phenomenon in healthcare: self-organising, online communities, all focused on a particular disease area. We know from other digital platforms just how quickly these platforms can evolve, disrupt old business models and create entirely new businesses. JUNE EDGE TALK: EXPLORING ONLINE HEALTH COMMUNITIES, WITH PAUL HODGKIN AND BEN METZ FRIDAY 3 JUNE, 09.30 – 11.00 (GMT +1) Find out more at http://theedge.nhsiq.nh s.uk/june-edge-talk- exploring-online-health- communities.
Editor's Notes
- Four discrete parts. -We’ll touch on recent studies that point to shifting attitudes about legacy solutions related to employee engagement and performance management. -Then well introduce what we believe is the single most important ingredient to transforming organizations into healthy, high-functioning teams. -We’ll also introduce a simple and highly effective behavioral technique for growing and strengthening human relationships. -And finally, we’ll introduce a powerful behavior tool that improves trust, understanding, and cooperation between people. It’s the Ultimate Engagement Tool. No more training and then forget. And of course we’ll do our best to get to your questions. But if we don’t, please don’t hesitate to reach out. We’ll also publish this webinar as a podcast and the slides will be available for download.
- If you don’t understand the nature of engagement, it’s impossible to improve. It’s a reflection of a PROCESS between two people. We’ve heard many stories about approaches to engagement that are centered on picnics, employee parties, employee rewards programs, etc. This is a total and complete misfire. Organizational engagement requires individual engagement between people. IT’S ABOUT RELATIONSHIPS.
- Imagine a workplace where there’s a high level of fear and distrust…and of course very low engagement scores. New Executive comes in and decidedes to initiate some better “Engagement Activities” The quality of these activities is more a reflection of the health of the relationship-building potential and process – the health of the ”relational fabric” of the organization. Are these events environments where people who have the tools, trust, and willingness to further their relationships develop, or are they opportunities to avoid being authentic...to “get through it,” or politic. Saying it doesn’t make it so. Conspiracies of Codependencies. People find allies Once that happens, the Trap of ignorance takes hold.
- We are using technology as a poor substitute for face to face communication. People are dying at record numbers because of texting and driving. But they are also wrecking relationships due to the same lack of presence and attention to what is going on around them. Need to be present to pick up on the nonverbal and tone of voice. If engagement is all about relationships, then we need to be more careful what technologies we use, and how and when. How many times have you experience a total miscommunication because of an email or instant message? There’s a reason emojis are so popular. But they don’t ultimately solve the problem. We need face to face communication between people who have the attention, presence, skills, and interest to learn and grow.
- There are no short cuts to achieving meaningful relationship development. Self – Assessment Profiling may be self-affirming, but it doesn’t do the trick.
- Ergo, the link to Performancen Management Gotta be 2-way in order to build trust: People need to feel like they matter, their viewpoint exists Toxic people thrive in Feedback-free zones. (Political campaign where dissenters are excluded from events. Strongmen control.) So Fundamental that Species die without it.
- What does this word make you think of? We’ve lost touch with the true meaning, and potential of this word. It doesn’t necessarily mean criticism. It doesn’t mean terror. And yet that is what the word means to most people these days. The words “feedback” and “praise” are often used to mean separate things. “Feedback” is presumed to be negative. The true nature of feedback is similar to the function of a thermostat. WE determine the value of the temperature, not the device.
- Accusations, hiding, protection, defenses, blame, attack, pain, threat, shame… We know from neuroscience that things that cause fear shut down our abilities to problem solve. Fear closes us down. And we all know about the defensive postures that people take when they feel threatened.
- Imagine you are Mark. Good luck on having a happy, restful, serene weekend!
- There’s little wonder why the majority of organization are rethinking their Performance Management Processes. The legacy solutions have failed us. Many organizations are dropping annual performance reviews. Other failures include personality profiling, forced stacked rankings (see Microsoft), ”Brutal Honesty”
- Behavioral Feedback is borne out in our daily interactions. This is where the opportunity lies. The catalyst for building/strengthen the relational fabric/infrastructure is regular constructive conversations. It’s the regular business conversations, the difficulties, clashes, etc. that provide the real opportunities Having more parties doesn’t facilitate this kind of dialogue. In fact, parties are often environments where people avoid ”talking business.” It’s like setting up the stage, and not giving the actors any parts to play. We need to equip people with a common language, tools and techniques that allow them to be themselves while connecting with each other. When people are disengaged they can use the common language and tools to re-engage, learn, develop, grow, build, share, transfer knowledge, etc.
- One hole in the fiber, becomes bigger, faster. And people looking to cause harm go to it first and often.
- Whether or not we have a culture is not a choice. The word “culture” gets thrown around, and many executives roll their eyes. Talking about changing a culture is too ethereal for many, yet every organization has one. So the challenge for the executives and other leaders charged with changing the culture is to help team members build and strengthen relationships that form a different shared experience. It’s hard to have a good shared experience when we are talking past each other, or avoiding the elephant in the room, or don’t feel safe. Cultures of excessive cordiality/politeness/avoidance are no less toxic (in many cases) as overtly nasty ones.
- By “regular,” we mean that it is something done as part of the regular course of interaction. And it is not overly-formalized to the point of avoidance. Skill makes it work much better, more efficiently, but honesty and compassion determine success or failure. If people do not trust your honesty and cannot feel your compassion, they will be very judgmental of your skill in delivery. There is a trend (recently published in the Wall Street Journal) related to creating workplace cultures of “brutal honesty.” This is a dangerous and ineffective solution to the equally debilitating effect of overly-cordial workplaces.
- Saw a list of strategies for better engagement recently. Feedback was number 14 on the list, with things like “Encourage Learning” and “Empower you Employees” and “Support Enthusiasm” also on the list. How is this possible without exchanging behavioral feedback, to have the kind of relational info needed to make someone feel inspired, encouraged, or empowered.
- The WAY its done really matters. Having a common behavioral model, or “operating system” helps to tune the currencies.
- Note on how our system and tool helps bridge diverse teams. Age, Gender, Culture, Personalities, etc.