Slides used by Values Coach CEO Joe Tye in presentation for Indiana Organization of Nurse Executives on 10-17-2018

1. Building a
Culture of Ownership in
Healthcare
Indiana Organization of Nurse Executives
October 17, 2018
Joe Tye, CEO and Head Coach
Values Coach Inc.
Copyright © 2018, Values Coach Inc.
8:40-10:00

4. Why we do what
we do >>>>>

7. For these slides and the resources
listed on the handout :
Text 66866
Type message valuescoach

8. The Culture Sea Change

10. “Joy in work – or the lack there of – not only
impacts individual staff engagement and
satisfaction, but also patient experience,
quality of care, patient safety, and
organizational performance.”
Perlo J, Balik B, Swensen S, Kabcenell A, Landsman J, Feeley D. IHI Framework for
Improving Joy in Work. IHI White Paper. Cambridge, Massachusetts: Institute for
Healthcare Improvement; 2017.

12. The Old Criteria...
 Trust
 Pride
 Camaraderie

13.  Values
 Innovation
 Financial Growth
 Leadership Effectiveness
 Maximizing Human Potential
 Trust

14. My take...
Effective leaders maximize human potential
by...

15. My take...
Effective leaders maximize human potential
by helping people live their values...

16. My take...
Effective leaders maximize human potential
by helping people live their values, creating
a culture where trust and innovation can
flourish...

17. My take...
Effective leaders maximize human potential
by helping people live their values, creating
a culture where trust and innovation can
flourish, resulting in financial growth.

18. Guiding insight #1
Culture does not change unless
and until people change.

19. Guiding insight #2
People will not change unless
given tools and structure, and
inspired to use them.

20. Guiding insight #3
The best way to help people be
better employees is to first help
them be better parents, better
citizens, better humans.

21. “I got a whole new team and didn’t
have to change the people because
they changed themselves.”
Paul Utemark, (then) CEO
Fillmore County Hospital
Geneva, Nebraska

24. You tell him that we
love our culture and he
had better not come in
here and [mess] it up.

25. “FCH will remain committed
to The Twelve Core Values
in the years to come. These
values are visible on a daily
basis in our hallways and
observable in conversations
with patients, families, and
co-workers.”

26. Your cultural DNA should transcend
any particular individual or position
on the organization chart –
including the CEO

33. Which one
is weird?

37. Same job. Different attitude.

38. Who do you think is happier?

39. Who would you rather work with?

40. Who would you rather live with?

41. Who would you rather be like?

42. There is an invisible barrier on the
potential of your organization

43. The real
leadership
challenge

51. Companies that study employee
engagement* consistently find:
~ 25% fully engaged
~ 60% not engaged
~ 15% aggressively disengaged
* e.g. Gallup, Avatar, Press Ganey, Modern Survey, Values Coach

52. Spark
Plugs
52

53. Zombies

54. Vampires

55. No one has tell an
owner to mow the lawn

56. Renters don’t care what
the neighbors think

57. Squatters trash the place,
and get paid for doing it

58. Disengaged employees, especially
disengaged managers, are a
quality defect.
Jim Clifton: The Coming Jobs War

61. “Disengagement [is] one of the
chief causes of underachievement
and depression.”
Edward M. Hallowell, M.D. in HBR, 12-10

63. When Sally and I were in the market for a
second home in Arizona our criteria were:
 Spectacular back yard
 Low to zero maintenance
 Affordable

65. And this was our primary
residence, the house where we
lived for 20 years and raised our
two children >>>>>

67. Lesson #1
Things aren’t always
what they seem.

68. Lesson #2
What you really want
might be closer than
you think.

69. Lesson #3
You must be willing to
jettison old baggage
to move forward.

70. Lesson #4
There is almost
always a way to
create a win-win.

71. A word about the
assumptions we make.

72. What do you get when you
break the word “assume”
into its constituent parts?

75. Question #1
When did the healthcare
crisis begin?

77. Question #2
When will the
healthcare crisis end?

79. What 112* of you told me
about your perceptions of your
organizations’ cultures

80. Our people
LOVE our
culture

81. Really?

82. Vaughn, Thomas, Koepke Mark, Levey Samuel, Kroch
Eugene, Hatcher Christopher, Tompkins Christopher, Baloh
Jure: Governing Board, C-Suite, and Clinical Manager
Perceptions of Quality and Safety Structures, Processes, and
Priorities in U.S. Hospitals. Journal of Healthcare
Management. 59(2 March/April):110-128, 2014.

83. Powered by
Our people know the values of our organization.
88%
38%

84. Powered by
Our people are committed to assuring that those values are reflected in
how they do their work.
88%
29%

85. Powered by
Q5: Our people feel a genuine sense of pride in being a member of our
team.
82%
35%

86. Powered by
Our culture does not tolerate bullying, toxic negativity, or disrespectful
behavior.
76%
22%

87. Powered by
Our managers effectively deal with toxic negative attitudes/behaviors in
the workplace.
65%
12%

88. Powered by
Our people don't just complain about problems, they work to find
solutions.
62%
11%

89. Powered by
I am happy with our patient satisfaction scores.
40%
7%

90. Would we use that
7% number on a
billboard ad?

92. Next
Is it truly great
care if delivered
with just an
okay attitude?

93. Will these results
help you attract and
retain new talent?

94. Are these results
likely to generate
outstanding patient
satisfaction?

95. If all hospital employees, not just
nurse executives, had taken the
survey, would result be more
positive, or less positive?

97. First the good news
There were not very many
“strongly disagree” responses
to any of the questions.

98. The bad news
There also were not very many
“strongly agree” responses to
any of the questions.

99. Powered by
What percent of total paid hours in your organization are wasted on toxic
emotional negativity (e.g. disrespect, bullying, spreading rumors)?
~17%

100. Actual result for a critical
access hospital:
$3,280,000 per year

101. $13,930,910 per year
Actual result for a large
community hospital:

102. $119,000,000 per year
Actual result for a multi-
hospital health system:

103. Will these results
support your
reputation for
being a great place
to work?

104. Will these results
help you attract and
retain new talent?

105. Are these results
likely to generate
outstanding patient
satisfaction?

106. Tough
Love,
Baby

107. The journey from
Accountability
to a culture of
Ownership

108. 35,472,692 views142,966 – avg 5 stars

110. Just when you thought United’s PR
catastrophe couldn’t get any worse

117. Who Owns
Left Field?

119. Ac
count
able

123. The
Accountability
Continuum

128. Son, you’ll be proud
of your old Dad...
Today the boss held
me accountable.

129. No one ever won
a DAISY Award
by being held
accountable!

130. “In the long run... accountability
encourages a culture of evasion,
denial, and finger pointing.”
Richard Farson and Ralph Keyes:
The Innovation Paradox

135. Cultural accountability is
essential for fostering a
just culture

136. We don’t talk
about colleagues
behind their
backs.

139. Invisible
Architecture
“Invisible Architecture” is a
trademark of Values Coach Inc.

141. Invisible Architecture™
is more important than
bricks & mortar

142. Invisible architecture is the
soul of your organization the
way physical architecture is
its body.

143. The Blueprint
Behind the
Blueprint™

147. Core values define who
you are, what you stand
for, and what you won’t
stand for.

152. Organizational values determine strategies
but personal values shape culture.

153. 153
“People who are clearest about
their personal vision and values
are significantly more committed
to their organizations.”
James Kouzes and Barry Posner:
A Leader's Legacy

154. “If people could understand their core
values, they would save years of doubt,
confusion, and misplaced energy as they
try to find direction for their lives.”
Laurie Beth Jones: Jesus CEO

155. What are
your values?

158. We acknowledge that gossip and rumor-
mongering is a serious violation of our
integrity and is profoundly disrespectful to
the target of those rumors.
It takes courage for us to hold ourselves
and each other to a higher standard and
to challenge inappropriate attitudes and
behaviors.
The surest way to promote a centered
culture is with a spirit of mutuality where
we serve without judging – look beyond
the nametag and see the human.
We are determined to persist at every
task and overcome every obstacle and to
never slack off or make excuses for
anything less than excellence.

161. Culture is the personality
and the character of the
organization.

162. Same
business
Different
cultures

164. People pay to
shop at Costco!

165. People shop at Wal-Mart
because they don’t have
to dress up like they do
for the Dollar Store.

166. Same
business
Different
cultures

169. Describe your culture
in just 6 words.

170. Southwest Airlines Core Values
Servant’s Heart, Warrior
Spirit, Fun-Loving Attitude

171. Netflix Culture Code
We employ only fully
formed adults

172. Cypress Semiconductor Motto
The Marine Corps
of Silicon Valley

173. 173
From managers sitting in
the same room at one
large medical center’s
leadership retreat

174. 174
We love patients and
each other

175. 175
We are ALWAYS
here for you

176. 176
Multiple priorities,
limited resources,
great expectations

177. 177
We’re entitled,
hating it,
and staying

178. 178
Disjointed departments
working against each
other

179. 179
Negativity reigns
while circling the
drain

180. 180
I’ve been here
longer – you
leave

181. 181
Beatings will
continue until
morale improves

183. The Florence Challenge
Emotionally Positive
Self Empowered
Fully Engaged

191. The Culture Mapping
Schematic Wheel
Pick up a copy
at my table in
the exhibit hall

193. There is no right-or-wrong pathway
through the Culture Mapping
Schematic...
All 693 potential pathways
will yield great ideas!

198. 198
Workplace attitude is
determined by what
you expect and what
you tolerate...

199. 199
And what you tolerate
will dominate over
what you expect!

201. 80% yes 70% no

202. “The average worker
spends 2.5 hours per
day in drama.”
Cy Wakeman: No Ego

205. Burnout
Disengagement
Compassion fatigue
Bullying
Incivility
Disrespect
Dropout
Suicide

206. “Roughly 60 percent of new RNs quit
their first job within 6 months of being
bullied, and one in three new graduate
nurses considers quitting nursing
altogether because of abusive or
humiliating encounters”
Terri Townsend: “Breaking the Bullying
Cycle” American Nurse Today, January 2012

207. In one survey of more than 4,500
healthcare professionals, 71 percent
tied... abusive, condescending or
insulting personal conduct to medical
errors, and 27 percent tied such
behavior to patient deaths.
Christine Porath: “No Time to be Nice at
Work” New York Times, June 19, 2015

209. Toxic Emotional Negativity
The healthcare
crisis within

210. You cannot be a negative,
bitter, sarcastic pickle
sucker in the break
room…
This place
sucks

211. May I help you? I
have the time.
NOT!

212. You cannot be a negative,
bitter, sarcastic pickle
sucker at work…
My job sucks

213. I wish she
would stay
at work!

214. 214
“It is a leadership responsibility to
create a workplace environment
where toxic emotional negativity is
not tolerated.”

215. 215
The simple promise that
will change your life...

216. 216
And transform your
organization…

218. The Pickle Challenge
has taken on a life
of its own!

219. 219

227. You’re being a Pickle,
Doc... Please put a
quarter in the jar.

233. Lighten up, baby –
this is supposed to
be fun!
#Bonus

234. Why this matters
more now than ever
>>>>>>>>>

235. BREAKING NEWS
The Healthcare News Channel
LIVE
This just in…
There will not be enough
nurses and other staff to
care for the 75 million
baby boomers heading
for our doors.

236. “Hospitals face unprecedented
turnover and attrition rates.”
Study by Leaders for Today

237. “A large majority of CNOs say the nurse shortage at
their organizations is moderate to severe, and most
say this problem will become increasingly worse
over the next five years.
CNOs see shortages negatively affecting some of
the most important aspects of healthcare: patient
satisfaction, quality care, and staff morale.”
Worsening Shortages and Growing Consequences: CNO Survey on Nurse
Supply and Demand, a white paper by the Center for Advancement of
Healthcare Professionals, B.E. Smith, and AMN Healthcare

238. And it’s not just nursing!

239. As if the challenges we know
about now weren’t sufficiently
daunting >>>>>

241. A mini case study
on positive culture
change>>>

245. Culture of Ownership Classroom

251. MISD Superintendent Midland Health CEO

253. Almost
doubled
Cut in
half

254. Patient satisfaction
Patient satisfaction from
record low to record high
Emergency Department from
bottom 10% to top 10%

255. RN Turnover
32% reduction overall
43% reduction for new nurses
in first 2 years of employment

256. Other staffing expense
Significant reductions in overtime
and $2.5 million annual reduction
in contract labor expenses

257. Quality measures
22% reduction in CLABSI
38% reduction in ventilator
related events
64% reduction in CAUTI

258. More than one
million dollars in
annual energy
cost savings

259. Annual Cultural
Productivity Benefit
>$12,000,000

260. First hospital to earn the
INSPIRED Award for Values
and Culture Excellence

261. Email received 10-04-2018
“Our new employees in Culture
of Ownership this week are
AMAZING and ONNNN FIRE!!!
I love it.”

262. But remember...
Culture changes one person,
one attitude, one leadership
example at a time

266. Building a Culture
of Ownership

268. You can’t always
choose who you
have on the bus!

270. You can’t just throw
all the “wrong” people
off the bus!

273. It begins with a
shared vision...

275. 275

276. A leader is someone who
takes you to a place to
which you didn’t know
you wanted to go.
– Joel Barker

277. A leader is someone
who helps you become
the person you didn’t
realize you could be.
– Joe Tye

278. 12 Key
Success Factors

279. Key Success Factor #1
Early engagement of leaders from
appropriate constituencies including
board of directors, medical staff,
and if appropriate unions

280. Key Success Factor #2
Commitment of the executive team
is the primary difference between
real culture change and just
another “program of the month”

281. Key Success Factor #3
Enthusiastic engagement of
middle management creates
expectations within each unit
and department

282. Key Success Factor #4
Assess don’t assume – ask your
people about their perceptions of the
culture, not just whether they are
satisfied or engaged

283. Key Success Factor #5
Have a blueprint and/or a manifesto
that creates a shared vision of the
culture you aspire to build

284. Key Success Factor #6
Establish initiative coherence and
avoid identification of the change
process with any single individual
or program

285. Key Success Factor #7
Keep it visible and tangible with
refresher courses, buttons and
wristbands, physical displays, daily
huddles and the like

286. Key Success Factor #8
Start with a core group of your
most passionate and enthusiastic
“Spark Plugs” then keep growing
the community

287. Key Success Factor #8 (contd.)
Embrace the skeptics,
marginalize the cynics, and
plow through resistance

288. Key Success Factor #9
Collect and share stories from
patients, visitors, and staff

289. Key Success Factor #10
Reach out to the micro-communities
of employee families and the macro-
communities of local schools,
business, and government

290. Key Success Factor #11
Remember that the best way to
motivate people to be better employees
is to inspire them to be better people
by living their personal values...

291. Key Success Factor #11 (contd.)
And that organizational values
determine strategy while personal
values shape culture

292. Key Success Factor #12
Opting out is
not an option!

293. The real
leadership
challenge