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The Florence Prescription Building a Culture of Ownership on a Foundation of Values Presentation for Illinois Critical Access  Hospital Network March 1, 2011 Fran Finley, DHA, FACHE Copyright © 2010, Values Coach Inc.
William Howard Russell
“For surely this is the Kingdom of Hell.”
“A vast field of suffering and misery” Rev. Sydney Osborne
And we think WE have a healthcare crisis!
“By the end of the war, the Scutari hospitals had been transformed into efficiently-organized, smooth-running operations.” Mark Bostridge: Florence Nightingale: The Making of an Icon
After the war
Florence Nightingale was the first nurse, the first hospital administrator, and the first effective advocate for the healthcare rights of soldiers and veterans and…
WWFD – Today?
“Nightingale’s enduring legacy is socially relevant because the profession of nursing shows signs of losing its soul; it is in crisis.” Barbara Montgomery Dossey et al:  Florence Nightingale Today:  Healing, Leadership, Global Action
And it’s not just nursing!
Companies that study employee engagement* consistently find: ~ 25% fully engaged ~ 60% not engaged ~ 15% aggressively disengaged * e.g. Gallup, HR Solutions, Press Ganey
And it’s getting worse :-o “Disengagement, one of the chief causes of underachievement and depression, is on the rise.” Edward M. Hallowell, M.D. in HBR, December 2010
The essential question for creating a patient-centered care culture…
The “Empowerment” Conundrum
“How do we empower caregivers to empower patients?” Patrick CharmelPresident and CEOGriffin Hospital
The only real empowerment is self-empowerment.  No one can empower you but you, and once you have given yourself that power, no one can take it away.
We need to reconnect with the core values that make the healing professions so special, and that made this nation so great.
The journey from mere  Accountability  to a culture of Ownership
Accountability Doing what you are supposed to do because someone else expects it of you.  Accountability springs from the extrinsic motivation of reward and punishment.
Nobody ever checks the oil in a rental car!
Ownership Doing what needs to be done because you expect it of yourself.  Ownership springs from the intrinsic motivation of pride.
In a culture of ownership, every job description includes first and foremost being a caregiver, last but not least being a janitor, and in between being willing to do whatever else needs to be done.
Click for video 65,493– avg 5 stars  14,436,765 views  As of 1-28-11, 12:45am
The “United Breaks Guitars” videos that went viral on You Tube are a great example of why you must have a culture of ownership – they illustrate the downside of failing to foster such a culture, and the upside of having one.
“We have hundreds if not thousands of examples…”  546,403
How do you spell “Public Relations Black Eye”
United Airlines has great people – the problem that created the “United Breaks Guitars” PR disaster was a broken culture.
Who Owns Left Field? Click here for “Ball Girl” video
What attitude do you want to be reflected in the care patients receive at your hospital – Jake or the ball girl?
The first impression that patients, visitors, and new employees have of your hospital is the physical facility, and you would not so much as remodel a bathroom without a detailed blueprint.
But no one ever recommends your hospital to others because of the beautiful fountain in the lobby; the primary influence on their experience is the culture of your organization.
Shouldn’t we put as much thought and imagination into the cultural blueprint as we do the blueprints we create for our physical plant?
What do you get when you break the word “assume” into its constituent parts?
Faulty Assumption #1 You can’t teach people values – if they didn’t learn in kindergarten, it’s too late.
Faulty Assumption #2 Culture is a given – especially in the short term you cannot transform it.
Faulty Assumption #3 You can “empower” people without them having doing the work of self-empowerment.
The “Invisible Architecture” of an organization “Invisible Architecture” is a trademark of Values Coach Inc.
Invisible architecture is to the soul of your organization what physical architecture is to its body.
Core Values are the Foundation
Built to Last
Core values define what you stand for and what you won’t stand for
“The only assets we have as a company [are] our values, our culture and guiding principles, and the reservoir of trust with our people.” Starbucks CEO Howard Schultz in Harvard Business Review, July-August 2010
And as the country song says, if you don’t stand for something, you’ll fall for anything,
Auto-Owners Insurance Company has ten core values, and every one of its 3,600 associates is expected to know what those values are, and what they mean in terms of attitude and behavior expectations.  As a result, the company has…
[object Object]
  Double the productivity
  Highest  customer satisfaction,[object Object]
What are the core values of your hospital?
Why were those specific values chosen and what does that tell employees and patients about the character of the hospital?
Two examples of how failure to clarify values leads to counterproductive attitudes and behaviors…
Example #1: Which value do direct caregivers feel is more important to executive  leadership?
Compassion
OR
Productivity
OR We need to do what Jim Collins talked about.  We need to move from the tyranny of “or”, compassion or productivity, to the genius of “and”.  AND
Failure to clarify core values can lead to a false dichotomy, such as a presumed tradeoff between compassion and productivity.  Florence Nightingale calculated cost per patient day because she knew that inefficient hospitals will not be optimally compassionate hospitals.
Example #2: Every hospital, explicitly or implicitly, considers integrity to be a core value.  But there is…
An Integrity Gap
Because there is not a hospital in the world that does not have a hyperactive rumor mill.
And what does it say about your hospital’s commitment to integrity if the culturetolerates two peopletalking about a thirdperson who is notin the room?
ValuesareSkills
Nobody learns everything they need to know in kindergarten!  When you assume that values cannot be taught, you are selling short your employees, your patients, and your organization.
The Values Coach course is a 60-module, two day training session on universal personal values.
The deepest human values transcend political and religious beliefs, ethnic heritage, social class, and every other superficiality.
After all, who wants to be a phony?   Core Action Value #1 is Authenticity
Don’t we all need to live with integrity, awareness, courage, perseverance, and faith?   The first six Core Action Values lay a solid foundation of character strength
Don’t we all need the power of purpose, vision, focus, enthusiasm, and service?   The second six Core Action Values help us do our work and make a difference
Don’t people who live their values inspire and influence others? Core Action Value #12 is Leadership
87 “We know from our research that the people who are clearest about their [personal] vision and values are significantly more committed to their organizations than are those who are not clear about their vision and values.” James Kouzes and Barry Posner: A Leader's Legacy
When a critical mass of people connect with and act upon these core values, they will have a positive impact upon…
Corporate culture is the superstructure
Culture is to the organization what personality and character are to the individual.
Culture eats strategy for lunch!
“Culture influences how we deliver care, how we interrelate with our colleagues, and how we treat our patients.”
Who has the power to change the culture of your organization?
“Don’t try to fix cultural problems with structural solutions.” Jamie Orlikoff
As people begin to change the ways that they think and act under the influence of culture, they effect…
Emotional attitude is the interior décor
99 “It is a leadership responsibility to create a workplace environment where toxic emotional negativity is not tolerated.” The Florence Prescription, page 142
Emotional attitude is determined by what you expect and by what you tolerate…
And over time, what you tolerate will dominate what you say you expect.
102 “One toxically negative person can drag down morale and productivity of an entire work unit.” The Florence Prescription, page 142
Toxic emotional negativity (T.E.N.) is the emotional and spiritual equivalent of cigarette smoke.
Building a culture of ownership
You can’t always choose who you have on the bus
You can’t just throw all the “wrong” people off the bus
You can create a bus that everyone wants to ride
What does a culture of ownership look like?
“One does not have to look far today to see that many of Florence Nightingale’s greatest concerns remain ours too.” Mark Bostridge: Florence Nightingale:  The Making of an Icon
Essential qualities in a culture of ownership
1. Commitment To the values, vision, and mission of the organization
“We need to see opportunities where others see barriers.  We need to be cheerleaders when others are moaning doom-and-gloom.”   From The Florence Prescription
“We need to face problems with contrarian toughness because it’s in how we solve those problems that we differentiate ourselves from everyone else.”    From The Florence Prescription
2. Engagement With patients, coworkers, and with the work itself
“Committable core values that are truly integrated into a company’s operations can align an entire organization and serve as a guide for employees to make their own decisions.”
Zappos Family Core Values Deliver WOW Through Service  Embrace and Drive Change  Create Fun and A Little Weirdness  Be Adventurous, Creative, and Open-Minded  Pursue Growth and Learning  Build Open and Honest Relationships With   Communication  Build a Positive Team and Family Spirit  Do More With Less  Be Passionate and Determined  Be Humble Source: Zappos website
At Best Buy, a 0.1% increase in employee engagement generates a $100,000 increase in gross store revenue* * Harvard Business Review, October 2010
3. Passion Enthusiasm, positive attitude, and joy reflected in everyday actions
4. Initiative Don’t wait around to be “empowered” – Proceed Until Apprehended!
5. Stewardship Because we don’t own the earth – we are borrowing it from our grandchildren
6. Belonging Bringing down the silo walls that separate us from one another
7. Fellowship Because (as Mother Teresa reminded us) we are all children of the same God
8. Pride In your organization, in your profession, in your work, and in yourself
Pride is reflected in your answer to the universal icebreaker question What do you do?
Does your answer convey: I’m good at what I do. I love what I do. I’m proud of what I do. What I do is important.
There is no cost to join The Florence Challenge and access a growing library of resources for building a culture of ownership in your organization.
Here’s what we’re asking people to do:
Read the Book And use the online study guide to Spark discussion within the organization
eBook edition is a free download at The Florence Challenge website. Books are just $5 for Challenge hospitals.
What’s wrong with this picture?
Download Pledge mini-posters, slide shows, and screen savers at: www.TheFlorenceChallenge.com

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Icahn florence prescription march 1.2011 share

  • 1. The Florence Prescription Building a Culture of Ownership on a Foundation of Values Presentation for Illinois Critical Access Hospital Network March 1, 2011 Fran Finley, DHA, FACHE Copyright © 2010, Values Coach Inc.
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.
  • 9.
  • 10.
  • 11. “For surely this is the Kingdom of Hell.”
  • 12. “A vast field of suffering and misery” Rev. Sydney Osborne
  • 13. And we think WE have a healthcare crisis!
  • 14.
  • 15. “By the end of the war, the Scutari hospitals had been transformed into efficiently-organized, smooth-running operations.” Mark Bostridge: Florence Nightingale: The Making of an Icon
  • 17.
  • 18.
  • 19. Florence Nightingale was the first nurse, the first hospital administrator, and the first effective advocate for the healthcare rights of soldiers and veterans and…
  • 21. “Nightingale’s enduring legacy is socially relevant because the profession of nursing shows signs of losing its soul; it is in crisis.” Barbara Montgomery Dossey et al: Florence Nightingale Today: Healing, Leadership, Global Action
  • 22. And it’s not just nursing!
  • 23.
  • 24. Companies that study employee engagement* consistently find: ~ 25% fully engaged ~ 60% not engaged ~ 15% aggressively disengaged * e.g. Gallup, HR Solutions, Press Ganey
  • 25. And it’s getting worse :-o “Disengagement, one of the chief causes of underachievement and depression, is on the rise.” Edward M. Hallowell, M.D. in HBR, December 2010
  • 26. The essential question for creating a patient-centered care culture…
  • 28. “How do we empower caregivers to empower patients?” Patrick CharmelPresident and CEOGriffin Hospital
  • 29. The only real empowerment is self-empowerment. No one can empower you but you, and once you have given yourself that power, no one can take it away.
  • 30. We need to reconnect with the core values that make the healing professions so special, and that made this nation so great.
  • 31. The journey from mere Accountability to a culture of Ownership
  • 32. Accountability Doing what you are supposed to do because someone else expects it of you. Accountability springs from the extrinsic motivation of reward and punishment.
  • 33.
  • 34.
  • 35. Nobody ever checks the oil in a rental car!
  • 36. Ownership Doing what needs to be done because you expect it of yourself. Ownership springs from the intrinsic motivation of pride.
  • 37. In a culture of ownership, every job description includes first and foremost being a caregiver, last but not least being a janitor, and in between being willing to do whatever else needs to be done.
  • 38. Click for video 65,493– avg 5 stars 14,436,765 views As of 1-28-11, 12:45am
  • 39. The “United Breaks Guitars” videos that went viral on You Tube are a great example of why you must have a culture of ownership – they illustrate the downside of failing to foster such a culture, and the upside of having one.
  • 40. “We have hundreds if not thousands of examples…” 546,403
  • 41. How do you spell “Public Relations Black Eye”
  • 42. United Airlines has great people – the problem that created the “United Breaks Guitars” PR disaster was a broken culture.
  • 43. Who Owns Left Field? Click here for “Ball Girl” video
  • 44. What attitude do you want to be reflected in the care patients receive at your hospital – Jake or the ball girl?
  • 45. The first impression that patients, visitors, and new employees have of your hospital is the physical facility, and you would not so much as remodel a bathroom without a detailed blueprint.
  • 46. But no one ever recommends your hospital to others because of the beautiful fountain in the lobby; the primary influence on their experience is the culture of your organization.
  • 47. Shouldn’t we put as much thought and imagination into the cultural blueprint as we do the blueprints we create for our physical plant?
  • 48. What do you get when you break the word “assume” into its constituent parts?
  • 49.
  • 50. Faulty Assumption #1 You can’t teach people values – if they didn’t learn in kindergarten, it’s too late.
  • 51. Faulty Assumption #2 Culture is a given – especially in the short term you cannot transform it.
  • 52. Faulty Assumption #3 You can “empower” people without them having doing the work of self-empowerment.
  • 53. The “Invisible Architecture” of an organization “Invisible Architecture” is a trademark of Values Coach Inc.
  • 54. Invisible architecture is to the soul of your organization what physical architecture is to its body.
  • 55.
  • 56. Core Values are the Foundation
  • 58. Core values define what you stand for and what you won’t stand for
  • 59. “The only assets we have as a company [are] our values, our culture and guiding principles, and the reservoir of trust with our people.” Starbucks CEO Howard Schultz in Harvard Business Review, July-August 2010
  • 60. And as the country song says, if you don’t stand for something, you’ll fall for anything,
  • 61. Auto-Owners Insurance Company has ten core values, and every one of its 3,600 associates is expected to know what those values are, and what they mean in terms of attitude and behavior expectations. As a result, the company has…
  • 62.
  • 63. Double the productivity
  • 64.
  • 65. What are the core values of your hospital?
  • 66. Why were those specific values chosen and what does that tell employees and patients about the character of the hospital?
  • 67. Two examples of how failure to clarify values leads to counterproductive attitudes and behaviors…
  • 68. Example #1: Which value do direct caregivers feel is more important to executive leadership?
  • 70. OR
  • 72. OR We need to do what Jim Collins talked about. We need to move from the tyranny of “or”, compassion or productivity, to the genius of “and”. AND
  • 73. Failure to clarify core values can lead to a false dichotomy, such as a presumed tradeoff between compassion and productivity. Florence Nightingale calculated cost per patient day because she knew that inefficient hospitals will not be optimally compassionate hospitals.
  • 74. Example #2: Every hospital, explicitly or implicitly, considers integrity to be a core value. But there is…
  • 76. Because there is not a hospital in the world that does not have a hyperactive rumor mill.
  • 77. And what does it say about your hospital’s commitment to integrity if the culturetolerates two peopletalking about a thirdperson who is notin the room?
  • 79. Nobody learns everything they need to know in kindergarten! When you assume that values cannot be taught, you are selling short your employees, your patients, and your organization.
  • 80. The Values Coach course is a 60-module, two day training session on universal personal values.
  • 81.
  • 82. The deepest human values transcend political and religious beliefs, ethnic heritage, social class, and every other superficiality.
  • 83. After all, who wants to be a phony? Core Action Value #1 is Authenticity
  • 84. Don’t we all need to live with integrity, awareness, courage, perseverance, and faith? The first six Core Action Values lay a solid foundation of character strength
  • 85. Don’t we all need the power of purpose, vision, focus, enthusiasm, and service? The second six Core Action Values help us do our work and make a difference
  • 86. Don’t people who live their values inspire and influence others? Core Action Value #12 is Leadership
  • 87.
  • 88. 87 “We know from our research that the people who are clearest about their [personal] vision and values are significantly more committed to their organizations than are those who are not clear about their vision and values.” James Kouzes and Barry Posner: A Leader's Legacy
  • 89. When a critical mass of people connect with and act upon these core values, they will have a positive impact upon…
  • 90. Corporate culture is the superstructure
  • 91. Culture is to the organization what personality and character are to the individual.
  • 92. Culture eats strategy for lunch!
  • 93. “Culture influences how we deliver care, how we interrelate with our colleagues, and how we treat our patients.”
  • 94. Who has the power to change the culture of your organization?
  • 95. “Don’t try to fix cultural problems with structural solutions.” Jamie Orlikoff
  • 96. As people begin to change the ways that they think and act under the influence of culture, they effect…
  • 97. Emotional attitude is the interior décor
  • 98.
  • 99.
  • 100. 99 “It is a leadership responsibility to create a workplace environment where toxic emotional negativity is not tolerated.” The Florence Prescription, page 142
  • 101. Emotional attitude is determined by what you expect and by what you tolerate…
  • 102. And over time, what you tolerate will dominate what you say you expect.
  • 103. 102 “One toxically negative person can drag down morale and productivity of an entire work unit.” The Florence Prescription, page 142
  • 104. Toxic emotional negativity (T.E.N.) is the emotional and spiritual equivalent of cigarette smoke.
  • 105.
  • 106.
  • 107.
  • 108. Building a culture of ownership
  • 109.
  • 110. You can’t always choose who you have on the bus
  • 111. You can’t just throw all the “wrong” people off the bus
  • 112. You can create a bus that everyone wants to ride
  • 113. What does a culture of ownership look like?
  • 114. “One does not have to look far today to see that many of Florence Nightingale’s greatest concerns remain ours too.” Mark Bostridge: Florence Nightingale: The Making of an Icon
  • 115.
  • 116. Essential qualities in a culture of ownership
  • 117. 1. Commitment To the values, vision, and mission of the organization
  • 118.
  • 119. “We need to see opportunities where others see barriers. We need to be cheerleaders when others are moaning doom-and-gloom.” From The Florence Prescription
  • 120. “We need to face problems with contrarian toughness because it’s in how we solve those problems that we differentiate ourselves from everyone else.” From The Florence Prescription
  • 121.
  • 122. 2. Engagement With patients, coworkers, and with the work itself
  • 123. “Committable core values that are truly integrated into a company’s operations can align an entire organization and serve as a guide for employees to make their own decisions.”
  • 124. Zappos Family Core Values Deliver WOW Through Service Embrace and Drive Change Create Fun and A Little Weirdness Be Adventurous, Creative, and Open-Minded Pursue Growth and Learning Build Open and Honest Relationships With Communication Build a Positive Team and Family Spirit Do More With Less Be Passionate and Determined Be Humble Source: Zappos website
  • 125. At Best Buy, a 0.1% increase in employee engagement generates a $100,000 increase in gross store revenue* * Harvard Business Review, October 2010
  • 126. 3. Passion Enthusiasm, positive attitude, and joy reflected in everyday actions
  • 127.
  • 128.
  • 129.
  • 130. 4. Initiative Don’t wait around to be “empowered” – Proceed Until Apprehended!
  • 131.
  • 132.
  • 133. 5. Stewardship Because we don’t own the earth – we are borrowing it from our grandchildren
  • 134.
  • 135. 6. Belonging Bringing down the silo walls that separate us from one another
  • 136.
  • 137. 7. Fellowship Because (as Mother Teresa reminded us) we are all children of the same God
  • 138.
  • 139. 8. Pride In your organization, in your profession, in your work, and in yourself
  • 140. Pride is reflected in your answer to the universal icebreaker question What do you do?
  • 141. Does your answer convey: I’m good at what I do. I love what I do. I’m proud of what I do. What I do is important.
  • 142.
  • 143. There is no cost to join The Florence Challenge and access a growing library of resources for building a culture of ownership in your organization.
  • 144. Here’s what we’re asking people to do:
  • 145. Read the Book And use the online study guide to Spark discussion within the organization
  • 146. eBook edition is a free download at The Florence Challenge website. Books are just $5 for Challenge hospitals.
  • 147.
  • 148.
  • 149.
  • 150.
  • 151. What’s wrong with this picture?
  • 152. Download Pledge mini-posters, slide shows, and screen savers at: www.TheFlorenceChallenge.com
  • 153.
  • 154. Thanks to Joe Tye for writing such an inspiring book!

Notas del editor

  1. Almost 15 million people have watched United Breaks Guitars version 1, 2, 3,. It would take another 24 hours to read all of the other United Stories that have been posted.
  2. The Taylor Guitar Company did their own – How To Pack Your Guitar So United Wont’ Break It.