Private PowerPoint for discussion with New Mexico Hospital Association for a project to bring the Rural Values Collaborative to critical access hospitals in that state.

1. The Rural Values
Collaborative
Helping Hospitals Build a Culture of
Ownership on a Foundation of Values
Prepared for New Mexico Hospital Association
1
Values Coach Inc.
319-624-3889 Michelle@ValuesCoach.com

2. Contents
I. Guiding Insights
II. Overview, Purpose, and Assuring Ongoing Sustainability
III. Training for Certified Values Coach Trainers
IV. Expected outcomes and key success factors
V. Core Curriculum: The Twelve Core Action Values
VI. Additional Tools, Techniques, Resources, and Ongoing Support
VII. Results
VIII. Testimonials
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3. 3
I. Guiding Insights

4. Guiding insight part 1
Culture does not change
unless and until people
change.

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

6. Same job. Different attitude.

7. You will never exceed the
expectations that you set
for yourself.

8. You will never exceed the
limitations that you place
on yourself.

9. We help people
see the lion in
their mirrors

10. “I got a whole new team
and didn’t have to change
the people because they
changed themselves.”
Paul Utemark, CEO
Fillmore County Health System
Geneva, Nebraska

11. 11
Participating organizations receive a
“Proceed Until Apprehended” banner!

12. 12
II. Overview, Purpose,
and Assuring Ongoing
Sustainability

13. 13
To date, more than 500 people have
become Certified Values Coach Trainers

14. 14
Building a Culture of Ownership
on a Foundation of Values
This is the central theme of our work at Values Coach Inc.
When a critical mass of people within an organization
internalize and act upon The Twelve Core Action Values, they
will inevitably have a positive influence on the culture of their
organization. And a culture of ownership that is built on those
foundational values is essential to being a great place to work,
providing outstanding quality service, and creating a
sustainable source of competitive advantage.

15. Purpose of the Values Collaborative
The overall purpose of the Values Collaborative is to share the proprietary Values Coach
course on The Twelve Core Action Values and related content with hospital employees to
help them in their personal and professional lives – and do so in such a way that it helps
the sponsoring hospital foster a stronger culture of ownership. Specific goals include:
 Make this program accessible and affordable to every hospital regardless of size.
 Prepare Certified Values Coach Trainers (CVC-T) to teach and coach coworkers, and
eventually to reach out to a larger community.
 Help individual hospital employees learn values-based life and leadership skills they
need in order to achieve their own personal, professional, financial, and family goals.
 Helping employees make the connection between personal and organizational values.
 Support patient-centered care and operating effectiveness by teaching values-based
life and leadership skills that create personal buy-in on the part of workers.
 Help hospital leaders more effectively design their Invisible Architecture™ of core
values, organizational culture, and workplace attitude.
 Prepare individuals with mental toughness and hospitals with cultural toughness for
the challenging times ahead.
 Help hospitals build new bridges to their larger communities.
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16. Not another flavor of the month!
It is essential that your participation in the Values
Collaborative not be seen as just another program of the
month (or worse yet, be just another program of the month).
To be sure, training for The Twelve Core Action Values and
related tools and techniques should reinforce what has gone
before, but because this is an investment in people as well as
in the organization, it should be entered with a commitment
that values-based life skills will become part of the cultural
fabric of the organization.
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17. 17
III. Training for
Certified Values
Coach Trainers

18. Certified Values Coach Trainers (CVC-T)
CVC-Ts will be trained and equipped to teach The Twelve Core Action Values and related
topics to coworkers and (at the option of the hospital) reaching out to the larger
community. They will also learn how to facilitate group discussion on such topics as
building a culture of ownership, and to organize book clubs, community service events,
and other activities.
CVC-T candidates do not need to be professional trainers (some of the best aren’t), they
just need to be committed to living The Twelve Core Action Values to the best of their
ability themselves and enthusiastically sharing what they’ve learned with others.
CVC-Ts will go through a 4-day course that will cover the content of The Twelve Core
Action Values and other topics in depth, including hands-on practice with presenting,
facilitating, and coaching skills.
They will be provided an extensive instructor toolkit.
CVC-Ts are authorized to teach classes within the context of their organizations and, if
appropriate, community outreach (e.g. schools), but they are not allowed to charge for
these services (the exception being for hospital-sponsored programs where proceeds are
donated to a charitable cause).
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19. CVC-Ts: Catalysts for Change
We call Certified Values Coach Trainers Spark Plugs because that’s what we hope (and
expect) they’ll do with what they learn: spark positive changes in their own lives and
then share that spark with others. The following is excerpted from the Spark Plug
“job description,” which participants are asked to sign upon entering the course.
 Become more creative, productive, and enthusiastic at work and in their
own personal and professional development.
 Reflect a positive attitude and refrain from the negativity of complaining,
finger-pointing, and rumor-mongering.
 Assume informal leadership roles by setting an example of positive team-
building and motivation for others.
 Help co-workers, friends, and family members deal with frustration and
adversity in a more positive and constructive manner.
 Be a role model of positive leadership in representing our organization in a
positive light for the community at large.
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20. Certified Values Coach Trainers
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CVC-T Group in Kearney, Nebraska CVC-T Group in Lincoln, Nebraska
CVC-T Group in Kaufman, Texas CVC-T Group in Sidney, Nebraska

21. CVC-T Group in Ord, Nebraska
Passing out The Florence Prescription
in McCook, Nebraska
CVC-T Group in Omaha, Nebraska
Master CVC-T Group in VISN 20 of the
Veterans Health Administration

22. Teaching The Twelve Core Action Values
The course on The Twelve Core Action Values is structured so that it can be taught in
several different formats.
First, it can be taught in a single 2-day class. This is ideal for a management retreat and
for launching a Values Initiative in a way that maximizes initial momentum. The CVC-T
tools most appropriate for this approach will be the PowerPoint presentation (the
template can be tailored for the instructor and the organization) and the note-taking
workbook. This approach is by far the most effective for achieving a sustained impact
on culture.
Second, it can be taught in twelve 60-minute sessions. This works best for people who
are not able to get away from the work unit for an uninterrupted two-day period, and has
the added advantage of allowing time for assimilation between classes. The CVC-T tools
most appropriate for this approach will be the twelve 10-minute icebreaker videos and
the note-taking workbook.
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23. 23
IV. Expected outcomes
and key success factors

24. Expected outcomes for participating hospitals
The most important outcomes of participating in the Values Collaborative will be
difficult to measure except indirectly: how does one measure pride, enthusiasm, self-
confidence, or other such intangibles that result from people connecting with and
acting upon values? However, when a critical mass of workers make that transition,
the hospital should see:
 Enhanced employee engagement (Core Action Value #7 is Purpose and Core
Action Value #10 is Enthusiasm).
 Enhanced patient satisfaction (Core Action Value #3 is Awareness and Core
Action Value #11 is Service).
 Increased productivity (Core Action Value #9 is Focus).
 Higher levels of creativity (Core Action Value #8 is Vision).
 Greater resilience and “cultural toughness” for dealing with the inevitable
challenges of the years to come (Core Action Value #4 is Courage and Core Action
Value #5 is Perseverance).
 A more positive workplace environment, including a significant reduction in the
incidence of gossip, rumor-mongering, and finger-pointing (Core Action Value #2
is Integrity).
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25. Key success factors
Over the past 20+ years, Values Coach has been privileged to work with many
organizations across North America, including many in industries other than healthcare.
We have seen several consistent themes in the most successful undertakings, including:
 The CEO is willing to make this investment in people as “a gift” to help them be more
effective in their own personal and professional lives – as parents, as time and money
managers, as goal-setters and achievers – without explicitly tying the initiative to
specific financial or service outcomes.
 The middle management team is supportive of their Spark Plugs and the work that
they are trying to do (having a department head ridicule “Sparky” can deflate
enthusiasm throughout that department and beyond).
 Structure and process are used to reinforce the commitment to values, including such
things as making The Twelve Core Action Values part of new employee orientation,
visibly posting The Self-Empowerment Pledge and “Pickle-Free Zone” signs in
manager’s offices, announcing each day’s Pledge promise on the overhead, etc.
 Spark Plugs making a commitment to community service.
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26. Evaluation
We begin by acknowledging that the most important outcomes cannot be measured (how
do you measure the impact of one person making a profoundly positive life-transformation
because they began to act upon their values?).
The Culture Assessment Survey does give us a solid baseline assessment of how employees
rate values, culture and attitude within their organization that allows us to compare with
our data base and to monitor changes within the organization.
Given that, we can look at operating factors such as employee satisfaction and
engagement, patient satisfaction, productivity, and turnover (keeping in mind that Values
Training will be but one of a number of factors influencing these variables).
Hospitals seeking the Values Coach INSPIRED Award for Values and Culture Excellence
must have an institution-specific plan for evaluating the ongoing impact of their
commitment to Values Training.
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We also have an instant assessment tool that
can be accessed by laptop or smart phone at:
www.Culture-IQ.com

27. V. Core Curriculum:
The Twelve Core
Action Values
27

28. 28
“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

29. Most people intuitively have good solid values, but it
is very rare that they have specifically defined those
values, much less that they conscientiously apply
those intuitive values to how they spend their time
and money, how they manage relationships, or even
to what they put into (or let come out of) their
mouths. The Values Coach course on The Twelve
Core Action Values is a 60-module curriculum for
values-based life and leadership skills.
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30. The interaction of personal and organizational values
There is an intimate and powerful interaction
between the values of an organization and the values
of the people who work there, though this is rarely
expressed in explicit terms. One of the exercises
CVC-Ts will do with Spark Plugs is create a matrix
showing this relationship.
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31. Organizational values define
strategies while personal
values define culture.

32. Core Curriculum: The Twelve Core Action Values
In recent years, dozens of books and articles have been written emphasizing the
importance of values clarity for organizational success. The Values Coach course on
The Twelve Core Action Values is a comprehensive and systematic guide for values-
based life and leadership.
 These values are universal – they transcend particular religious or political beliefs,
job titles, ethnic background, or other factors. From Authenticity to Leadership,
this is who we want to be.
 These personal values reinforce the organizational values of the hospital.
 There are four cornerstones that put action into each of the twelve values.
 This course recognizes the often misunderstood truth that values are skills that
must be learned – not high-minded philosophical pronouncements; the course is
packed with practical skills to help people achieve their goals by living their
values.
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34. Core Action Value #1
Authenticity
The Cornerstones
1. Self-awareness
2. Self-mastery
3. Self-belief
4. Self-truth

35. Core Action Value #2
Integrity
The Cornerstones
1. Honesty
2. Reliability
3. Humility
4. Stewardship

36. Core Action Value #3
Awareness
The Cornerstones
1. Mindfulness
2. Objectivity
3. Empathy
4. Reflection

37. Core Action Value #4
Courage
The Cornerstones
1. Confrontation
2. Transformation
3. Action
4. Connection

38. Core Action Value #5
Perseverance
The Cornerstones
1. Preparation
2. Perspective
3. Toughness
4. Learning

39. Core Action Value #6
Faith
The Cornerstones
1. Gratitude
2. Forgiveness
3. Love
4. Spirituality

41. Core Action Value #7
Purpose
The Cornerstones
1. Aspiration
2. Intentionality
3. Selflessness
4. Balance

42. Core Action Value #8
Vision
The Cornerstones
1. Attention
2. Imagination
3. Articulation
4. Belief

43. Core Action Value #9
Focus
The Cornerstones
1. Target
2. Concentration
3. Speed
4. Momentum

44. Core Action Value #10
Enthusiasm
The Cornerstones
1. Attitude
2. Energy
3. Curiosity
4. Humor

45. Core Action Value #11
Service
The Cornerstones
1. Helpfulness
2. Charity
3. Compassion
4. Renewal

46. Core Action Value #12
Leadership
The Cornerstones
1. Expectations
2. Example
3. Encouragement
4. Celebration

47. Every employee
evaluation at
Grinnell Regional
Medical Center
includes a rating
on The Twelve
Core Action Values

48. VI. Additional Tools,
Techniques, Resources,
and Ongoing Support
48

49. The CVC-T Toolkit
Most resources will be available online at the Values Trainer website at no charge for
participating organizations, and can be purchased in hard copy for a substantial
discount. Available resources include:
 The workbook on The Twelve Core Action Values.
 The Self-Empowerment Pledge including a set of promise wristbands and the
Pickle Pledge including a Pickle-Free Zone door hanger.
 Leader’s guide with study questions, suggested exercises, and other resources.
 A mini-library of Joe’s books The Florence Prescription, Pickle Pledge, Winning
the War with Yourself, and The Healing Tree.
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50. Values Trainer Resource Website
Every employee of a participating organization will have access to the Values Coach
members-only resource website, which contains a wealth of eBook, workbook, audio,
and video resources. These include
 Twelve one-hour audio recordings on The Twelve Core Action Values that can be
burned to a CD or downloaded to an iPod.
 Twelve 10-minute icebreaker videos recorded by Joe Tye before a live audience.
 Icebreaker videos and customizable PowerPoint presentations, handout masters,
and other resources to facilitate training.
 A growing archive of webinars, teleconferences, video seminars, and other
resources for personal and professional achievement and fulfillment.
 Audio recordings of The Janitor in Your Attic – Morning Motivation and Evening
Meditation programs.
 Personal Daily Journal for setting goals and monitoring progress.
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51. We begin with a Culture Assessment
Survey of all participating hospitals; each
organization can compare its results with
the group average and with our overall
data base.
51
From the
data base

52. We can produce a custom edition of
The Florence Prescription with a
special foreword by the New Mexico
Hospital Association and print copies
for every employee of participating
organizations

53. The Pickle Challenge for Charity is a fun yet
powerful starting point for any culture
change initiative – and it creates possibilities
for a friendly competition between hospitals.

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

55. Turning Complaints into
Contributions!
More than $60,000 has been raised for
charities by the first 30 participating
organizations – more than 200,000
complaints turned into donations!!!

57. The Self
Empowerment
Pledge

59. The Advanced Course
21 video lessons – 3 for each day’s promise

61. Midland Memorial Hospital
PledgePower web page
Participating hospitals
can share the entire
PledgePower course with
all employees on their
website or intranet (see
example from Midland
Memorial Hospital below)

63. 63

64. Mary Lanning Memorial HealthCare
Hastings, Nebraska
Gallup Engagement Score improved
from 23rd to 72nd percentile.
Productivity improved by 55 FTEs.
HCAHPS scores topped the 95th
percentile in six categories.

65. Fillmore County Hospital
Geneva, Nebraska
Patient satisfaction increased in 27
of 30 categories.
CEO Paul Utemark said he got a
whole new team and didn’t have to
change any of the people.

66. Community Hospital (employees)
McCook, Nebraska
Rating hospital as excellent place to work
increased by 26% to the 74th percentile.
Rating training & development as
“excellent” increased by 51% to 91st
percentile.
Likelihood of recommending hospital as
excellent place to work increased by 45%
to 84th percentile.

67. Community Hospital (patients)
McCook, Nebraska
HCAHPS scores went from meeting just
12.5% of benchmarks to currently
meeting 87.5%.
Overall quality of care rated “excellent” in
patient surveys increased from 60.9% to
87% in current quarter.

68. Midland Memorial Hospital
Values and Culture Initiative

69. MMH Values Trainers

70. Daily Leadership Huddle
Midland Memorial Hospital

71. Culture of Ownership Classroom
Midland Memorial Hospital

72. Personal development
and team building!

73. 63%

74. 87%

75. Reduced cost of turnover
Nursing turnover has decreased
32% overall…
And 43% for nurses in their
first two years on the job

76. Enhanced awareness 
safer patients…
- 66% reduction in c-dif
- 64% reduction in CAUTI
- 38% reduction in ventilator
related events.
- 166 days since last event

77. HCAHPS Overall
65.4 64.6 63.9 55.5 67.9 67.8 81.4 67.5 66.9
82.9
71.1
75.0
83.3
26.4 32.6 33.3 33.3 21.9 17.7
15.8
29.7 30.3
11.4
26.7
22.8 7.2
4.3
5.6
7.3
8.7
2.2 2.3
7.2
2.8 2.9
2.4
64.3
61.5
63.2 64.0
66.9 67.0 67.0 68.7
69.9
70.9
77.1
40
50
60
70
80
90
100
10-9 8-6 5-3 2-0 National Top Box VBP Achievement VBP Benchmark Accumulative Score (TB%)
Arrow marks beginning of
Values and Culture Initiative

78. Emergency Department

79. 79

80. Annual Cultural
Productivity Benefit
$7,200,000

81. Midland Memorial Hospital proudly
displays their INSPIRED Award for
Values and Culture Excellence

82. VIII. Testimonials
82

83. “Working with Values Coach to foster a stronger
culture of ownership at Grinnell Regional Medical
Center has been a great investment in our people,
our organization, and our community. The Twelve
Core Action Values has become part of GRMC’s
cultural DNA and our Values Trainers have helped
employees at every level be more productive in
their work and more positive in their personal
lives. This has been reflected in higher patient
satisfaction, quality metrics, safety initiatives and
other important measures.”
Todd Linden, President and CEO
Grinnell Regional Medical Center
Grinnell, Iowa

84. “When we shared The Twelve Core Action
Values with our employees and medical staff,
the response was unanimous: ‘We need more
of this!’ That’s why we [trained] a core group
of Spark Plugs to promote values-based
leadership in our hospital and in our
community. From Authenticity to
Leadership, this is who we want to be.”
Sandy Haryasz, (then) CEO
Page Hospital
Page, Arizona
84

85. “There are amazing testimonials from participants as
to how The Twelve Core Action Values has affected
their personal lives. Graduates of the program have
related stories of lifestyle changes that include
weight loss, smoking cessation, career goal setting
(including additional formal education), and personal-
life priority setting.”
Bill Powanda, Vice President, Griffin Hospital
(from Griffin’s 2006 application for the Fortune
100 Best Places to Work For (Griffin was 4th
overall)
85

86. “Our initiative on The Twelve Core Action Values has
definitely been worth the investment... Graduates of
the values course are genuinely interested and
engaged, and are now working together as a group
helping us develop a roadmap for the cultural
enhancements we wish to bring about in the years to
come. This training in values-based life and
leadership skills is an excellent complement to the
more traditional technical subject matter that’s
often the focus of hospital training.”
Jeff Hill, (then) President and CEO
Midwest Medical Center
Galena, Illinois
86

87. 87
“I have seen very few alternatives that can have a
greater impact on the culture of an organization.
Our Certified Values Coach Trainer group is
incredibly fired up, and we are already hearing
about amazing life changes people are making as a
result of participating in the class. It’s one of the
best investments we’ve made in our people and in
our organization.”
Bradley D. Neet, (then) President/CEO
Mary Lanning Memorial HealthCare
Hastings, Nebraska

88. 88
“This training – which 100% of our staff have now
completed – helps all of us connect with our core
values and answer the questions of ‘Who am I and
why was I placed on this earth?’ When we know the
answers to these questions, we are better able to
connect with the values of the organization and
better meet the needs of our patients.”
Marty Fattig, President and CEO
Nemaha County Hospital
Auburn, Nebraska

89. 89
“Over the past 3 months our patient satisfaction
has improved steadily from the 19th to the 96th
percentile in outpatient services based on Press
Ganey surveys, and we’re seeing significant
improvement in other areas. Our commitment to
Spark Plug training on The Twelve Core Action
Values and to The Florence Challenge has been the
single-most important factor causing this
improvement. This work is having a far-reaching
and positive impact on the culture of our hospital.”
Patsy Youngs, President
Texas Health Presbyterian Hospital Kaufman
Kaufman, Texas