1. Creating a Cultural
Blueprint for a Highly-
Engaged Healthcare
Organization
AONE 46th Annual Meeting & Exposition
Joe Tye, Values Coach Inc.
Carol Wahl, Good Samaritan Hospital
Copyright © 2013, Values Coach Inc. 1

2. 2
If we don’t answer your
questions or to request
follow-up information, give
me a card or email:
Joe@JoeTye.com

3. Question #1
When did the
healthcare crisis
begin?
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4. 4

5. Question #2
When will the
healthcare crisis
end?
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6. 6

7. Before we begin
let’s go on a little
rafting trip…
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14. Companies that study employee
engagement* consistently find:
~ 25% fully engaged
~ 60% not engaged
~ 15% aggressively disengaged
* e.g. Gallup, HR Solutions, Press Ganey
14

15. Disengaged
people, especially
disengaged managers, are a
quality defect
Jim Clifton: The Coming Jobs War
15

16. Disengagement
negatively effects…
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17. Clinical quality
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18. Patient safety
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19. Patient
satisfaction
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20. Productivity
20

21. Marketing
image
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22. Job security
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23. But what’s even
more tragic...
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24. It has a life-diminishing
impact on the disengaged.
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25. “Disengagement [is] one
of the chief causes of
underachievement and
depression.”
Edward M. Hallowell, M.D. in HBR, 12-10
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26. 26

27. The journey from mere
Accountability
to a culture of
Ownership
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28. Ac
count
able
28

29. Accountability
Doing what you are supposed
to do because someone else
expects it of you. It springs
from the extrinsic motivation
of reward and punishment.
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30. You cannot hold people
“accountable” for the
things that really matter.
30

31. Nobody ever changes
the oil in a rental
car!
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32. Ownership
Doing what needs to be done
because you expect it of
yourself. Ownership springs
from the intrinsic motivation
of personal pride.
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33. Who Owns Left Field?
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34. Invisible
Architecture
“Invisible Architecture” is a
trademark of Values Coach Inc. 34

35. The Blueprint
Behind
the Blueprint

36. “Invisible architecture, not
buildings, determines whether
you are a good hospital, a
great hospital, or just another
hospital.”
36

37. Invisible architecture
is to the soul of your
organization what
physical architecture
is to its body.

38. Core Values are
the Foundation
38

39. Core values
define what you
stand for and
what you won’t
stand for
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40. 40
“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

41. When a critical mass of
people connect with
and act upon their core
values, they will have a
positive impact on…

42. Corporate culture is
the superstructure

43. Culture is to the
organization what
personality and
character are to the
individual.

44. Same
business
Different
cultures

45. Culture eats strategy
for lunch!
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47. If culture eats strategy
for lunch, shouldn’t you
have a culture plan to
complement your
strategic plan?
47

48. Culture doesn’t change
unless people
change, and that is
emotional
work!
48

49. Emotional attitude
is the interior décor

50. 50

51. How would you
calculate the
ROI on a smile
like this?
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52. 52
A positive workplace
culture begins with
intolerance for toxic
emotional negativity.

53. 53
“One toxically negative
person can drag down
morale and productivity
of an entire work
unit.”

54. 54
“It is a leadership
responsibility to create a
workplace environment
where toxic emotional
negativity is not
tolerated.”

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58. 58
Harlan County
Hospital
Brodstone
Memorial
Hospital

59. Alverno Clinical Laboratories 59

60. White River
Health System 60

61. Star Valley Medical Center
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62. Battle Creek VA Medical Center
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63. Building a
culture of
ownership
63

64. Do you have to start with the
right people on the bus?
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65. You can’t always
choose who you have
on the bus!
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67. You can’t just throw
all the “wrong”
people off the bus!
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68. 68

69. You can create a bus that
everyone wants to ride
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70. That is the sort of
culture Carol Wahl
and her team are
working toward at…
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71. Good Samaritan Hospital
Kearney,
Nebraska
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72. CHI/GSH Core Values
• Core Values (RICE)
– Respect
– Integrity
– Compassion
– Excellence
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73. GSH Culture Connection
“. . .making the
story of the Good
Samaritan a living
reality.”
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74. “Living the Story”
Create
Alignment
Create
Connections
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75. Our Priorities
Personal
Care Delivery
Service Standards
CHI/GSH Core Values
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76. Triple Aim + One
A sustainable health care system
needs to be:
Good for patients (the
experience of care)
Source: Blue Shield California
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77. Triple Aim + One
A sustainable health care system
needs to be:
→ Good for the community
(population health)
Source: Blue Shield California
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78. Triple Aim + One
A sustainable health care system
needs to be:
→ Good for the economy
(affordable)
Source: Blue Shield California
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79. Triple Aim + One
A sustainable health care system
needs to be:
→ good for providers
(business model, career)
Source: Blue Shield California
79

80. Our Timeline:
Core Action Values Training
Senior Team support (April 2009)
Leadership retreat (July 2009)
Open staff presentations (May &
August 2010)
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81. Our Timeline:
Core Action Values Training
Spark Plug training (Jan 2011)
“Distributor Cap” leadership to
departments
DSER maintain the momentum
(2012)
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83. From Authenticity to
Leadership, these values
reflect who we want to
be as an organization
and as individuals

84. Hospital Activities
Culture Council
The things that can be counted don’t
always count and the things that count
can’t always be counted.
Einstein
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85. Hospital Activities
Rural Health Values
Collaborative
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87. Hospital Activities
Community
Education through
the Chamber of
Commerce 87

88. Hospital Activities
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Daily overhead
reading of promises
from The Self-
Empowerment Pledge

89. Hospital Activities
Patient and
employee stories
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90. Department Activities
Unit-based councils
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91. Department Activities
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92. Department Activities
DSER group
“Bottom-up innovation tends to
be chaotic but smart. Top-down
innovation tends to be orderly but
dumb.” -- Rich Carlson, SRI
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93. The 6 Es of Employee Engagement
1. Expect
2. Educate
3. Enable
4. Energize
5. Evaluate
6. Elevate
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94. Key lessons we’ve
learned through our
work on cultural
transformation…
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95. Lesson #1a
Launching a movement is a
lot harder than starting a
program – it is also much
more likely to achieve a
lasting positive impact
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Lesson #1b
Achieving critical mass
requires approximately 30%
population commitment

97. Lesson #1c
You need enough people
moving fast enough to
escape negativity,
pessimism, cynicism, and
inertia of the past
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98. Lesson #2a
Top down direction and
support
AND
Bottom up passion and
innovation
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99. Lesson #2b
People must believe
senior leadership
believes in and is
committed to the
cultural vision

100. Lesson #2c
Middle management’s mere
support is not enough –
they must be gung ho
champions for change

101. Lesson #3
You need a blueprint for
your Invisible Architecture
and a culture plan to
complement your strategic
plan…

102. The Culture Blueprint
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103. The Culture Plan
Use the Culture Mapping
Schematic to map out plans
for actions you can take to
promote a stronger culture of
ownership.
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105. Lesson #4a
Start from where your
culture is and align and
evolve

106. Lesson #4b
Avoid identification of the
change process with any
single individual or
“program.”

107. Lesson #4c
Create initiative
coherence by being clear
about how various
projects reinforce one
another

108. Lesson #4d
Celebrate successes
through stories

109. Lesson #5
Proceed until
apprehended!

110. WWFD?
Build a Culture of Ownership
on a
Foundation of Values
Transforming People through the Power of Values
Transforming Organizations through the Power of People