Tom Peters slides

1. Tom Peters’ X25* Toward Health ( care ) Excellence ! Inova Leadership Institute/13 March 2007 * In Search of Excellence 1982-2007

2. Slides* at … tompeters.com *also “long”

3. Part 1

4. EXCELLENCE. ALWAYS.

5. “ Why in the world did you go to S iberia ?”

6. S y non y ms Purity Transcendence Virtue Elegance Majesty Anton y ms Mediocrity

7. The Peters Princi p les : Enthusiasm. Emotion. Excellence. Energy. Excitement. Service. Growth. Creativity. Imagination. Vitality. Joy. Surprise. Independence. Spirit. Community. Limitless human potential. Diversity. Profit. Innovation. Design. Quality. Entrepreneurialism. Wow.

8. Part 2

9. EXCELLENCE. HEALTH(CARE).

10. “ When I climb Mount Rainier I face less risk of death than I’ll face on the operating table.” — Don Berwick

11. TP’s Health(care) Rants & Passions

12. Quality! DSS! Prevention! Wellness! Chronic care! Elder care! Convenient care! Childhood obesity! H5N1!

13. “ Quality”: COULD IT TRULY BE THIS AWFUL ?

14. CDC 1998 : 90,000 killed and 2,000,000 injured from hospital-caused drug errors & infections

15. 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

16. 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

17. YE GADS! New England Journal of Medicine/ Harvard Medical Practice Study: 4% error rate (1 of 4 negligence). “Subsequent investigations around the country have confirmed the ubiquity of error.” “In one small study of how clinicians perform when patients have a sudden cardiac arrest, 27 of 30 clinicians made an error in using the defibrillator.” Mistakes in administering drugs (1995 study) “average once every hospital admission.” “Lucian Leape, medicine’s leading expert on error, points out that many other industries—whether the task is manufacturing semiconductors or serving customers at the Ritz Carlton—simply wouldn’t countenance error rates like those in hospitals .” — Complications, Atul Gawande

18. “ 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 State 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

19. “ Most physicians believe that diagnosis can’t be reduced to a set of generalizations—to a ‘cookbook.’… How often does my intuition lead me astray? The radical implication of the Swedish study is that the individualized, intuitive approach that lies at the center of modern medicine is flawed—it causes more mistakes than it prevents .” —Atul Gawande, Complications

20. “ Some grocery stores have better technology than our hospitals and clinics.” —Tommy Thompson, former HHS Secretary Source: Special Report on technology in healthcare, U.S. News & World Report

21. Part 2A

22. Planetree : A Radical Model for New Healthcare/Healing/ Wellness Excellence Tom Peters/17 September 2006

23. The 9 Planetree Practices 1. The Importance of Human Interaction 2. Informing and Empowering Diverse Populations: Consumer Health Libraries and Patient Information 3. Healing Partnerships: The importance of Including Friends and Family 4. Nutrition: The Nurturing Aspect of Food 5. Spirituality: Inner Resources for Healing 6. Human Touch: The Essentials of Communicating Caring Through Massage 7. Healing Arts: Nutrition for the Soul 8. Integrating Complementary and Alternative Practices into Conventional Care 9. Healing Environments: Architecture and Design Conducive to Health Source: Putting Patients First , Susan Frampton, Laura Gilpin, Patrick Charmel

24. 1. The Importance of Human Interaction

25. Press Ganey Assoc : 139,380 former patients from 225 hospitals: none of THE top 15 factors determining P atient S atisfaction referred to patient’s health outcome PS directl y related to Staff Interaction PS directl y correlated with Employee Satisfaction Source: Putting Patients First , Susan Frampton, Laura Gilpin, Patrick Charmel

26. “ 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

27. 2. Informing and Empowering Diverse Populations: Consumer Health Libraries and Patient Information

28. Planetree Health Resources Center/1981 Planetree Classification System Consumer Health Librarians Volunteers Classes, lectures Health Fairs Griffin’s Mobile Health Resource Center Open Chart Policy Patient Progress Notes Care Coordination Conferences (Est goals, timetable, etc.) Source: Putting Patients First , Susan Frampton, Laura Gilpin, Patrick Charmel

29. 3. Healing Partnerships: The Importance of Including Friends and Family

30. The Patient-Famil y Experience “ Patients are stripped of control, their clothes are taken away, they have little say over their schedule, and they are deliberately separated from their family and friends. Healthcare professionals control all of the information about their patients’ bodies and access to the people who can answer questions and connect them with helpful resources. Families are treated more as intruders than loved ones.” — Putting Patients First , Susan Frampton, Laura Gilpin, Patrick Charmel

31. Care Partner Programs (IDs, discount meals, etc.) Unrestricted visits (“Most Planetree hospitals have eliminated visiting restrictions altogether.”) (ER at one hospital “has a policy of never separating the patient from the family, and there is no limitation on how many family members may be present.”) Collaborative Care Conferences Clinical Guidelines Discussions Family Spaces Pet Visits (POP: Patients’ Own Pets) Source: Putting Patients First , Susan Frampton, Laura Gilpin, Patrick Charmel

32. 4. Nutrition: The Nurturing Aspect of Food

33. Kitchen Beautiful cutlery, plates, etc Chef reputation Source: Putting Patients First , Susan Frampton, Laura Gilpin, Patrick Charmel

34. 5. Spirituality: Inner Resources for Healing

35. Griffin : redesign chapel (waterfall, quiet music, open prayer book) Other : music, flowers, portable labyrinth Source: Putting Patients First , Susan Frampton, Laura Gilpin, Patrick Charmel

36. 6. Human Touch: The Essentials of Communicating Caring Through Massage

37. Mid-Columbia Medical Center/Center for Mind and Bod y Massage for every patient scheduled for ambulatory surgery (“Go into surgery with a good attitude”) Infant massage Staff massage (“caring for the caregivers”) Source: Putting Patients First , Susan Frampton, Laura Gilpin, Patrick Charmel

38. 7. Healing Arts: Nutrition for the Soul

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

40. 8. Integrating Complementary and Alternative Practices into Conventional Care

41. Griffin IMC/Integrative Medicine Center Massage Acupuncture Meditation Chiropractic Nutritional supplements Aroma therapy Source: Putting Patients First , Susan Frampton, Laura Gilpin, Patrick Charmel

42. 9. Healing Environments: Architecture and Design Conducive to Health

43. “ Planetree Look” Woods and natural materials Indirect 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 Source: Putting Patients First , Susan Frampton, Laura Gilpin, Patrick Charmel

44. Access to nurses station: “Happen to” vs “Happen with” Source: Putting Patients First , Susan Frampton, Laura Gilpin, Patrick Charmel

45. Conclusion: Caring/Growth “Experience ”

46. F.Y.I.

47. Griffin Hos p ital/Derb y CT (Planetree Alliance “HQ”) Results : Financially successful. Expanding programs-physically. Growing market share. Only hospital in “100 Best Cos to Work for”— 7 consecutive years, currently #6. —“Five-Star Hospitals,” Joe Flower, strategy+business (#42)

48. Learn more about Planetree/ The Planetree Alliance: www.planetree.org

49. Part 3

50. “ Little Stuff”: The True “Basics”

51. Thank You!

52. F L O W E R P O W E R

53. “ Courtesies of a small and trivial character are the ones which strike deepest in the grateful and appreciating heart.” —Henry Clay

54. The … Jim Jeffords oversight!

55. The Manager’s Book of Decencies: How Small gestures Build Great Companies. —Steve Harrison, Adecco Servant Leadership —Robert Greenleaf One: The Art and Practice of Conscious Leadership —Lance Secretan, founder of Manpower, Inc.

56. “ Leaders ‘ SERVE ’ people. Period.” —Anon.

57. Servant Leadership /Robert Greenleaf 1. Do those served grow as persons? 2. Do they, while being served, become healthier wiser, freer, more autonomous, more likely themselves to become servants?

58. THE PROBLEM IS RARELY THE PROBLEM.

59. THE PROBLEM IS RARELY/NEVER THE PROBLEM. THE RESPONSE TO THE PROBLEM INVARIABLY ENDS UP BEING THE REAL PROBLEM . * *RMN, M Stewart, WJC, “Scooter” Libby

60. OFTEN AS NOT/MORE OFTEN THAN NOT THE UNDERLYING PROBLEM IS NOT MUCH OF A PROBLEM.

61. PERCEPTION IS ALL THERE IS. PERIOD .* *From Whole Foods to IBM to the corner deli

62. Relationships (of all varieties) : THERE ONCE WAS A TIME WHEN A THREE - MINUTE PHONE CALL WOULD HAVE AVOIDED SETTING OFF THE DOWNWARD SPIRAL THAT RESULTED IN A COMPLETE RUPTURE.

63. “ WHY NOT JUST TELL THE TRUTH?” —Raymond Carver

64. POWER WORDS! “ I’m sorry.”

65. Respect

66. “ It was much later that I realized Dad’s secret. He gained respect by giving it. He talked and listened to the fourth-grade kids in Spring Valley who shined shoes the same way he talked and listened to a bishop or a college president. He was seriously interested in who you were and what you had to say.” Sara Lawrence-Lightfoot, Respect

67. “ The deepest human need is the need to beappreciated.” William James

68. “ Don’t belittle!” —OD Consultant

69. Marcus Buckingham: The One Thing You Need to Know

70. “ The key difference between checkers and chess is that in checkers the pieces all move the same way, whereas in chess all the pieces move differently. … Discover what is unique about each person and capitalize on it .” —Marcus Buckingham, The One Thing You Need to Know

71. “ The mediocre manager believes that most things are learnable and therefore that the essence of management is to identify ach person’s weaker areas and eradicate them. The great manager believes the opposite. He believes that the most influential qualities of a person are innate and therefore that the essence of management is to deploy these innate qualities as effectively as possible and so drive performance.” —Marcus Buckingham, The One Thing You Need to Know

72. SWEET SPOT: THE DISCOMFORT ZONE.

73. “ Do one thing every day that scares you.” —Eleanor Roosevelt

74. EXCELLENCE. BEDROCK. LEADERSHIP. 9Ps.

75. PURPOSE . PASSION . Potential . Presence . Personal . PERSISTENCE . PEOPLE . Potent . Positive .

76. PURPOSE . PASSION . Potential . Presence . Personal . PERSISTENCE . PEOPLE . Potent . Positive .

77. “ 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 i ntend to be ?’ Not ‘What are we going to do?’ but ‘Who do we intend to be?’” —Max De Pree, Herman Miller

78. PURPOSE . PASSION . Potential . Presence . Personal . PERSISTENCE . PEOPLE . Potent . Positive .

79. “ Nothing is so contagious as enthusiasm.” —Samuel Taylor Coleridge

80. PURPOSE . PASSION . Potential . Presence . Personal . PERSISTENCE . PEOPLE . Potent . Positive .

81. “ In the end, management doesn’t change culture. Management invites the workforce itself to change the culture.” —Lou Gerstner

82. “ The role of the Director is to create a space where the actors and actresses can become more than they’ve ever been before, more than they’ve dreamed of being .” —Robert Altman, Oscar acceptance speech

83. PURPOSE . PASSION . Potential . Presence . Personal . PERSISTENCE . PEOPLE . Potent . Positive .

84. 25

85. PURPOSE . PASSION . Potential . Presence . Personal . PERSISTENCE . PEOPLE . Potent . Positive .

86. “ You must be the change you wish to see in the world.” Gandhi

87. PURPOSE . PASSION . Potential . Presence . Personal . PERSISTENCE . PEOPLE . Potent . Positive .

88. Relentless : “One of my superstitions had always been when I started to go anywhere or to do anything, not to turn back , or stop, until the thing intended was accomplished.” —Grant

89. “ Success seems to be largely a matter of hanging on after others have let go.” —William Feather, author

90. PURPOSE . PASSION . Potential . Presence . Personal . PERSISTENCE . PEOPLE . Potent . Positive .

91. “ Leaders ‘ do ’ people. Period.” —Anon.

92. PARC’s Bob Taylor: “Connoisseur of Talent”

93. A review of Jack and Suzy Welch’s Winning claims there are but two key differentiators that set GE “culture” apart from the herd: First : Separating financial forecasting and performance measurement. Performance measurement based, as it usually is, on budgeting leads to an epidemic of gaming the system. GE’s performance measurement is divorced from budgeting—and instead reflects how you do relative to your past performance and relative to competitors’ performance; i.e., it’s about how you actually do in the context of what happened in the real world, not as compared to a gamed-abstract plan developed last year. Second : Putting HR on a par with finance and marketing.

94. < CAPEX > People!

95. PURPOSE . PASSION . Potential . Presence . Personal . PERSISTENCE . PEOPLE . Potent . Positive .

96. &quot; The reasonable man adapts himself to the world. The unreasonable one persists in trying to adapt the world to himself. Therefore, all progress depends upon the unreasonable man.” —GB Shaw, Man and Superman: The Revolutionists' Handbook.

97. PURPOSE . PASSION . Potential . Presence . Personal . PERSISTENCE . PEOPLE . Potent . Positive .

98. The greatest danger for most of us is not that our aim is too high and we miss it, but that it is too low and we reach it. Michelangelo

99. PURPOSE . PASSION . Potential . Presence . Personal . PERSISTENCE . PEOPLE . Potent . Positive .

100. “ Excellence can be obtained if you: ... care more than others think is wise; ... risk more than others think is safe; ... dream more than others think is practical; ... expect more than others think is possible.” Source: Anon. (Posted @ tompeters.com by K.Sriram, November 27, 2006 1:17 AM)

101. &quot;Life is not a journey to the grave with the intention of arriving safely in one pretty and well preserved piece, but to skid across the line broadside, thoroughly used up, worn out, leaking oil, shouting ‘ GERONIMO!’ ” — Bill McKenna, professional motorcycle racer ( Cycle magazine 02.1982)

102. EX CELLE ALW AYS .