Tom Peters’ Leading for Excellence: Surpassing “Unrealistic” Expectations AHCA/NCAL 55 th...

Tom Peters’

Leading for Excellence: Surpassing “Unrealistic”

Expectations

AHCA/NCAL 55th Annual Convention & ExpoMiami Beach/10.04.2004

Slides at …

tompeters.com

Goals.

Tom’s Healthcare9: Goals2004

1. Stop killing people in acute-care settings through negligence/lousy management/craft mores. (THIS IS ABOUT ATTITUDE & WILL … NOT $$$$.)2. Adopt Patient-centric acute-care models (a la Planetree).3. Embrace the Boomer Tsunami.4. Prepare for consumer-driven healthcare.5. Revise-Revolutionize the entire system (K-90) to revolve around Wellness-Prevention.6. Erase the disgrace of uninsured Americans … in Planet’s Wealthiest Economy.7. Re-orient Boomer-driven Eldercare toward Optimism (“The time of your life!”) (60 – 30 = 90 – 60).8. Re-imagine! What an Opportunity!9. Excellence = State of Mind.

Musings …

This is the most important speech I’ve given since

NAESP!

Never felt it so keenly …

Problem-focused?Opportunity-focused?

RegulationsSky-high (“Unrealistic”) Expectations

Inadequate FundingStaffing Woes

Etc.Etc.Etc.

“Growth market” or … Magical Opportunity to Lead this Demographic Revolution … and Re-

imagine Aging?

Biases.

95/Ginger Cove/Life Care Services

T = SS – 34D

Cool? Oh Bleep?

60 – 30 = 90 - 60

TP/61/CR: Diet … Eating Habits/Philosophy … Nutrition Supplements … Breathing …

Stretching … Meditation (Short, Long) … Exercise … Mini-walks … Sound … Flowers …

Aromatherapy … Baths … Labyrinthine … Massage … Acupuncture … Chiropractic … Big CR/“CR Pauses” … Water (Japanese bath) … “Stop. Look. Listen.” ... Monitor & Measure &

Record. New World Order = Reverse 5 decades

of abuse (With damn little help from my M.D. friends)

Revolution.Period.

It is the foremost task—and responsibility—of our generation to

re-imagine our enterprises, private

and public. —from the back cover, Re-imagine!

“Beware of the tyranny of making

Small Changes to Small Things. Rather, make Big Changes to Big

Things.” —Roger Enrico, former Chairman, PepsiCo

The greatest dangerfor most of us

is not that our aim istoo high

and we miss it,but that it is

too lowand we reach it.

Michelangelo

IS/IT. Go for the Gold. (Or: At Least

Try and Get Off the Bench.)

“Some grocery stores have better

technology than our hospitals and

clinics.” —Tommy Thompson, HHS

Secretary

Source: Special Report on technology in healthcare, U.S. News & World Report (07.04)

“Our entire facility is digital. No paper, no film, no medical records. Nothing. And it’s all integrated—from the lab to X-ray to records to physician order entry. Patients don’t have to wait for anything. The information from the physician’s office is

in registration and vice versa. The referring physician is immediately sent an email telling him his patient has shown up. … It’s wireless in-house. We have 800 notebook computers that are wireless. Physicians can walk around with a computer that’s

pre-programmed. If the physician wants, we’ll go out and wire their house so they can sit on the couch and connect to the

network. They can review a chart from 100 miles away.” —David Veillette, CEO, Indiana Heart Hospital (HealthLeaders/12.2002)

Consumerism.

“We expect consumers to move into a position of dominance in the early

years of the new century.”

Dean Coddington, Elizabeth Fischer, Keith Moore & Richard Clarke, Beyond Managed Care

Amen!

“The Age of the

Never Satisfied Customer”

Regis McKenna

Quality.Whoops.

Ouch.Yikes.

“Without being disrespectful, I consider the U.S. healthcare delivery system the largest cottage industry in

the world. There are virtually no performance measurements

and no standards. Trying to measure performance … is the next

revolution in healthcare.”Richard Huber, former CEO, Aetna

“As unsettling as the prevalence of inappropriate care is the enormous amount of

what can only be called ignorant care. A surprising 85% of everyday medical

treatments have never been scientifically validated. … For instance, when family

practitioners in Washington were queried about treating a simple urinary tract infection, 82

physicians came up with an extraordinary 137 strategies.”

Demanding Medical Excellence: Doctors and Accountability in the Information Age, Michael Millenson

CDC 1998: 90,000 killed

and 2,000,000 injured from nosocomial

[hospital-caused] drug errors & infections

HealthGrades/Denver: 195,000 hospital deaths per year in the U.S., 2000-2002 =

390 full jumbos/747s in the drink per year. Comments: “This should give you pause when you go to the hospital.” —Dr. Kenneth Kizer, National Quality

Forum. “There is little evidence that patient safety has improved in the

last five years.” —Dr. Samantha Collier

Source: Boston Globe/07.27.04

1,000,000 “serious

medication errors per year” … “illegible handwriting, misplaced decimal points, and missed drug

interactions and allergies.”

Source: Wall Street Journal / Institute of Medicine

It’s the “Experience”!

“Experiences are as distinct from services as services are from

goods.”Joseph Pine & James Gilmore, The Experience Economy:

Work Is Theatre & Every Business a Stage

“The [Starbucks] Fix” Is on …

“We have identified a ‘third place.’ And I really believe that sets us apart. The third place is

that place that’s not work or home. It’s the place our

customers come for refuge.”Nancy Orsolini, District Manager

Experience: “Rebel Lifestyle!”

“What we sell is the ability for a 43-year-old accountant to dress in black leather, ride

through small towns and have people be afraid of him.”

Harley exec, quoted in Results-Based Leadership

A Certain Sort of Experience:

Women.

1. Men and women are different.2. Very different.3. VERY, VERY DIFFERENT.4. Women & Men have a-b-s-o-l-u-t-e-l-y nothing in common.5. Women buy lotsa stuff.6. WOMEN BUY A-L-L THE STUFF.7. Women’s Market = Opportunity No. 1.8. Men are (STILL) in charge.9. MEN ARE … TOTALLY, HOPELESSLY CLUELESS ABOUT WOMEN.10. Women’s Market = Opportunity No. 1.

Experience Plus:

Planetree.

“If one didn’t know better, one might think that hospitals set out to design

systems that provide the most sophisticated technical care but

deliver the worst possible experience to sick people.” —Putting Patients First, Susan

Frampton, Laura Gilpin, Patrick Charmel

“It was the goal of the Planetree Unit to help

patients not only get well faster but also to stay well longer.” —Putting Patients First, Susan Frampton,

Laura Gilpin, Patrick Charmel

The 9 Planetree Practices

1. The Importance of Human Interaction2. Informing and Empowering Diverse Populations: Consumer Health Libraries and Patient Information3. Healing Partnerships: The importance of Including Friends and Family4. Nutrition: The Nurturing Aspect of Food5. Spirituality: Inner Resources for Healing6. Human Touch: The Essentials of Communicating Caring Through Massage7. Healing Arts: Nutrition for the Soul8. Integrating Complementary and Alternative Practices into Conventional Care9. Healing Environments: Architecture and Design Conducive to Health

Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

1. The Importance of Human Interaction

“There is a misconception that supportive interactions require more staff or more time and are therefore more costly. Although labor costs are a substantial part of any hospital budget, the interactions themselves add nothing to the budget. Kindness is free. Listening to

patients or answering their questions costs nothing. It can be argued that negative interactions—alienating

patients, being non-responsive to their needs or limiting their sense of control—can be very costly. …

Angry, frustrated or frightened patients may be combative, withdrawn and less cooperative—requiring far more time than it would have taken to interact with them initially in a positive way.” —Putting Patients First,

Susan Frampton, Laura Gilpin, Patrick Charmel

Press Ganey Assoc/1999: 139,380 former patients from 225 hospitals

0 of top 15 factors determining Patient Satisfaction referred to patient’s health outcome

PS directly related to Staff Interaction

PS directly correlated with ES (Employee Satisfaction)


Mgrs re staff: wages, security, promotion opportunities

Staff re staff: interesting work (M: 5 of 10), appreciation (8 of 10), sense of being “in” about

what’s going on (10 of 10)


The Customer Comes Second: Put your People First and Watch ’Em Kick Butt —Hal Rosenbluth (and Diane McFerrin Peters)

“Planetree is about human beings caring

for other human beings.” —Putting Patients First, Susan

Frampton, Laura Gilpin, Patrick Charmel (“Ladies and gentlemen serving ladies and gentlemen”—4S credo)

2. Informing and Empowering Diverse

Populations: Consumer Health Libraries and

Patient Information

3. Healing Partnerships: The

importance of Including Friends

and Family

“When hospital staff members are asked to list the attributes of the ‘perfect patient and family,’ their

response is usually a passive patient with no family.” —Putting Patients First,

Susan Frampton, Laura Gilpin, Patrick Charmel

“Family members, close friends and ‘significant others’ can have a gar

greater impact on patients’ experience of illness, and on their

long-term health and happiness, than any healthcare professional.” —Through

the Patient’s Eyes


4. Nutrition: The Nurturing Aspect

of Food

Meals are central events

vs

“There, you’re fed.”*

*Irony: Focus on “nutrition” has reduced focus on “food” and “service”


5. Spirituality: Inner Resources for Healing

Spirituality: Meaning and Connectedness in Life

1. Connected to supportive and caring group2. Sense of mastery and control3. Make meaning out of disease/find meaning in suffering


6. Human Touch: The Essentials of Communicating

Caring Through Massage

“Massage is a powerful way to communicate caring.” —Putting Patients

First, Susan Frampton, Laura Gilpin, Patrick Charmel

7. Healing Arts: Nutrition for the Soul

Griffin: Music in the parking lot; professional musicians in the lobby

(7/week, 3-4hrs/day); 5 pianos; volunteers (120-140 hrs arts & entertainment

per month).


8. Integrating Complementary and

Alternative Practices into Conventional Care

Griffin IMC/Integrative Medicine Center

MassageAcupuncture

MeditationChiropractic

Nutritional supplementsAroma therapy


9. Healing Environments: Architecture and

Design Conducive to Health

“Planetree Look”

Woods and natural materialsIndirect lighting

Homelike settings

Goals: Welcome patients, friends and family … Value humans over technology … Enable patients to participate in their care … Provide flexibility to

personalize the care of each patient … Encourage caregivers to be responsive to patients … Foster a

connection to nature and beauty


Access to nurses station:

“Happen to”vs

“Happen with”Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

The Eden Alternative

The Ten Principals of the Eden Alternative

1. The three plagues of loneliness, helplessness, and boredom account for the bulk of suffering among Elders.2. Life in an Elder-centered community revolves around close and continuing contact with children, plants, and animals. These ancient relationships provide young and old alike with a pathway to a life worth living.3. Companionship is the antidote to loneliness. In an Elder-centered community we must provide easy access to human and animal companionship.4. A healthy Elder-centered community seeks to balance the care that is being given with the care that is being received. Elders need opportunity to give care and caregivers need opportunities need opportunities to receive care.



5. Variety and Spontaneity are the antidotes to boredom. The Elder-centered community is rich is rich in opportunities to sample these ancient pleasures.6. An Elder-centered community understands that passive entertainment cannot fill a human life.7. The Elder-centered community takes medical treatment down from its pedestal and places it into the service of genuine human caring.



8. In an Elder-centered community, decisions should be made by the Elders or those as close to the Elders as possible.9. An Elder-centered community understands human growth cannot be separated from human life.10. Wise leadership is the lifeblood of any struggle against the Three Plagues. For it, there can be no substitute.


Conclusion: Caring/Growth “Experience”

“The most basic question we need to

pose in caring for others is this: Is this a loving act?” —Leland Kaiser, “Holistic

Hospitals”


Talent I.

“The leaders of Great Groups love talent and know where to find it. They revel in

the talent of others.”Warren Bennis & Patricia Ward Biederman,

Organizing Genius

EVP = Challenge, professional growth, respect, satisfaction, opportunity, reward

Source: Ed Michaels et al., The War for Talent

High T/O Is Not Inevitable!

CostCo

vs.

Wal*Mart

Talent II.

“AS LEADERS, WOMEN RULE: New Studies find that female managers

outshine their male counterparts in almost

every measure”Title, Special Report, BusinessWeek, 11.20.00

“Ninety percent of what we call ‘management’ consists of making it

difficult for people to get things done.” – P.D.

G.H.: “Create a ‘cause,’ not a ‘business.’ ”

“Management has a lot to do with answers. Leadership is a function of questions. And the

first question for a leader always is: ‘Who do we

intend to be?’ Not ‘What are we going to do?’ but ‘Who do

we intend to be?’” —Max De Pree, Herman Miller

BZ: “I am a … Dispenser of Enthusiasm!”

“You must be the change you

wish to see in the world.”

Gandhi

“The single best way to predict the future is to create it.” —anon

Tom Peters’ Leading for Excellence: Surpassing “Unrealistic” Expectations AHCA/NCAL 55 th...

Documents

Transcript of Tom Peters’ Leading for Excellence: Surpassing “Unrealistic” Expectations AHCA/NCAL 55 th...