David Jarrard- The Naked Hospital
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David Jarrard of Jarrard Phillips Cate & Hancock presentation at Naked Hospital 2010.
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David Jarrard- The Naked Hospital
- 1. The Naked Hospital August 26, 2010
- 9. The “new normal” of information transparency has changed…. The way we live What we expect from each other What we expect from the companies we do business with
- 11. “Social media is changing the foundation of the ways we relate….it is changing our interpersonal psychology.”
- 13. “The fundamental rules that have governed how relationships work are being rewritten, because of easy, no-cost information sharing.”
- 14. “Gen X employees (born between 1965 to 1983) want frequent and real-time conversations and Gen Y (1984 or later) wants to continuously receive real-time information. They both want to be involved in decisions. Gen X employees place more importance on managing themselves while Gen Y employees have high expectations for full participation and collaboration.” -- Press Ganey, 2010 Pulse Report
- 17. Engagement
- 18. Information and honesty
- 19. ControlThey want to work “in partnership”
- 22. Patient satisfaction-- Press Ganey
- 23. “Building a partnership with those who work in the hospital is the key…to higher employee retention, increased productivity and improved quality of care.” – Press Ganey
- 24. “Building a partnership with those who work in the hospital is the key…to higher employee retention, increased productivity and improved quality of care.” – Press Ganey
- 32. Physician relations is tied to marketing is tied to housekeeping is tied to reimbursement is tied to quality, etc. Each brings something valuable to the direction of the hospital.
- 38. It’s Not about You
- 39. “The fundamental rules that have governed how relationships work are being rewritten”
Editor's Notes
- I love the Factory.I have taken several classes at the Viking school next door. Classroom that’s a working kitchen. Steakhouse classics. Northern Italian cuisine. Basics of cutlery.I am an eager student – but not a good one!The expert chefs there use words and terms and techniques that are way outside my experience or my vocabulary or my skill set!In fact, for the cutlery class, they gave me my own special kitchen utensils.
- However hard the chefs try…….going to the Viking school is like stepping into a foreign country to me.Sort-a like being in this room this morning.
- I’m not an IT guy.A lot of this is foreign language to me, too.But I value the work and deeply appreciate the results when it all comes together.
- My work is in the dynamic interaction that takes place when individuals work together.We call our work “public affairs” because our work is inherently political.In the hospital arena – where my firmfocuses all our time – our work is in the political interplay between doctors and nurses and administration and boards and managementcare and government – and this important constituent call “patients.”
- This is not Capitol Hill politics. This is not wonkish policy talk.This is grassroots politics – where the rubber hits the patient bed, so to speak. It’s where the work gets done.
- You know how important this is if you’ve tried to get doctors to adopt your EMR or hospital CFOs to use your reimbursement software.The right politics can break down barriers and speed you along.The wrong politics can result in what we call “aggressive failure.”
- As active political observers of the hospital marketplace, I share this observation:Facebook is changing the way we run hospitals todayOr it better….if we want to remain competitive and successful....WHAT’S GOING ON?
- The “new normal” of massive information transparency – the new normal of being Naked – has changed….The way we live….andWhat we expect from each other….andWhat we expect from the companies we do business with.This is all past tense, by the way…
- You’ve heard today about how information transparency is changing and ought to change healthcare. That’s why we’re here.Quality of care and…..Quality of hospital balance sheets hinge on success hereGetting transparency right impacts just about every operational decision today. But as employers of thousands of people, hospitals must also consider how information transparency is changing US And how this, in turn, changes how we will work together. And how we are to lead these organizations in this “new normal.”
- Psychologist Dr. Rachna Jain says:“Social media is changing the foundation of the ways we relate….it is changing our interpersonal psychology.”
- How? Lots of ways, of course.It’s fast and demanding. Do you remember busy signals? Mail came once a day? When Fedex seemed fast?And there is a torrent of data (I won’t even call it information) but oceans of data that wash over you.And it’s engaging. It’s a dialogue. It’s participatory.It can feel downright intimate.AND WE LIKE IT. A LOT. It’s not a leap to see how this experience is also reshaping the political dynamic between employees and employers.A good quote
- Charlene Li says:“In an era when the Internet has ushered in a culture of openness and sharing, business executive no longer have the ‘luxury of remaining ensconced in their executive suites, opening up when they felt the need to. The fundamental rules that have governed how relationships work are being rewritten, because of easy, no-cost information sharing.”(Charlene Li, author, “Open Leadership: How Social Technology Can Transform the Way You Lead”)Hospitals are not immune (maybe a decade behind, but not immune…) to this evolution.
- In its 2010 Pulse Report, Press Ganey reported on its survey of 235,000 employees at 383 hospitals.Among its findings:“Gen X employees (born between1965 to 1983) want frequent and real-time conversations and Gen Y (1984 or later) wants to continuously receive real-time information. They both want to be involved in decisions. Gen X employees place more importance on managing themselves while Gen Y employees have high expectations for full participation and collaboration
- It’s a short path between the power of social media……where dialogue and transparency andcollaboration is king….…to the expectations of today’s workforce. Their expectation is that they will be an “engaged partner” working in “collaboration” with their employer as they go about the business of business.
- These Gen X and Gen Y employees want….A relationship with leadership ; engagement; information and honesty; Want some measure of control. (Yikes! Control? We’ll talk about that in a minute….)They want to work “IN PARTNERSHIP”CFO: Ooooo they want love! Seems warms and fuzzy to me. How sweet. Where is the ROI??And when it works…it WORKS!
- When it works, it works!Press Ganey finds a strong correlation between the level of employee partnership andEmployee retentionEmployee recommendation of the hospitalPhysician satisfaction andPatient satisfactionTA-DA!
- Building a partnership with those who work in the hospital is the key……to higher employee retention……increased productivity…….and improved quality of care.”Yes! The Holy Grail of hospital management!We must be all over it.
- Wrong!
- 49% of the 235,000 employees are characterized as detached, discontented and distancedThe closer to the bedside the worse it getsThe Gen X employees – the core of the current workforce -- are the least satisfied of the bunch.If you are running for mid-terms elections, these are Not the poll results you want. In fact, this is not sustainable.
- Look, it’s hard for hospital’s to change – and there’s a lot of change going on right now…Hospitals are, by nature, conservative, slow moving and skeptical. If you’ve ever tried to sell something to a hospital, you know the barriers that must be crossed. And…I must say…this can be good thing. This is life and death stuff. But the Internet is here to stay…and the change in our relationship dynamics is here to stay…….and our healthcare workforce is fragile….WHAT TO DO?
- Let me offer you two lessons from the world of politics.We love looking at political campaigns because they are – by their very nature – relational. Every candidate and everycampaign works desperately to build a relationship with you – the voter.And here’s an insight: Everyone is a voter!
- We vote all the time.We vote for our favorite grocery store….For our favorite movie….In a hospital, doctors vote their with referrals, nurses with their retention and with their service, patients with their feet.I think we have something to learn from people whose profession is building relationships and pursuing votes…
- There are (at least) two lessons from politics for usHow Can We Work Together?How Can Leader Best Lead? Each one of these topics can be its own speech and book, but let me give you a few headlines that I think are very important.
- How Can We Best Structure Our Relationships?This is how a lot of organizations still work today.It’s the classic pyramid structure. It is, of course, a fundamental business structure.Titles and floors and silos. Chairs with arms. Chairs without arms.It blossomed in the era of assembly line manufacturing and it was exceptionally effective.But, in its classic form, it is rigid, hard to change and isolating. Information is tightly held. Innovation and responsiveness is difficult.See how’s its crumbling? That’s appropriate.But there is another approach. It’s called a WEB
- Let’s talk about the WebNow, imagine you are on a campaign team, running the Dork for Congress campaign.Fundraising, media, advertising, events, speech writing, grassroots mobilization, etc.All different and distinct units, but all tightly connected together. There is recognition that every element affects the other….in real time.The web model is essentially flat. All the strands are connected. Information flows back and forth in real time.Flexible. Nimble. Strong.This is not leadership by consensus (which is a recipe for disaster). There is still a center that holds it all together…but it’s stronger. Just like a web.
- How does this Web thinking or Lattice thinking apply to a hospital? It recognizes that physician relations is tied to marketing is tied to housekeeping is tied to reimbursement is tied to patient satisfaction.It recognizes that each element brings something valuable to the overall conversation about how to move the hospital forward…It’s structured so these elements work together. They are connected ; They are sharing information and decisions ; They are working in partnershipxxxxxxxxxxxxxxxxxx(We see some hospitals doing this today…mostlyon a small scale, but it’s a start. And they often find untapped power when they do.)(This is NOT about BUY IN, by the way. This is about tearing down the false wall between strategy and execution.)When they talk about Gen X or Gen Y talk about partnership – this is what they are talking about.
- So…One lesson is: We must seriously consider the web-like approach to management.Second lesson: How Can Leaders Best Lead?Here’s One Approach: Be a political candidate. All the time.If you are leading a healthcare organization of just about any size, you are a political candidate.-- You are bringing leadership, a vision and a goal-- You want people to vote for you. What does it mean to be a political candidate? / What does it mean to ACT politically?
- People have relationships with people, not institutions. They must see you.You and leadership must be physically visible.The more we use electronic communication to disseminate information, the more valuable personal relationships become…
- People must trust the messenger before they trust the messageEveryone knows a politician they don’t trust. Someone who could say “the sky is blue!” and you wouldn’t believe them.If you are not trusted, the most sensible rational reasonable message in the world will fail.How do you build trust? Well…how do you build trust in your personal relationships?You are physically present. Mentally present. Candid. Consistent. Honest.Invested.There is no secret here – quite often it just hasn’t been a priority.
- Vacuums are dangerousYou know the leadership team that says: If I don’t talk about this subject, then no one will talk about this subject.Truth is: They’re gonna talk. You are not in control.Your choice is whether to participate in the conversation or pretend it isn’t happening.Here’s my ground rule: If you don’t give them information – even if it’s I don’t know or I can’t talk about that yet – they will make it up. (and it won’t be in your favor…)(If you don’t believe me, watch cable television tonight.) Join the conversation.
- Emotions are more powerful than facts This is about relationships. That’s what Gen X and Gen Y told Press Ganey they want. Not more facts! Relationships!People vote for candidates they like, that they identify with.Voting decisions are emotional decisions. And we vote all the time.Don’t’ be the leaderwho throws the spreadsheet on the powerpoint slide and says “See! I think that explains everything…”Facts are important (don’t’ get me wrong), but they support emotions.
- It’s not about you (or it’s shouldn’t appear to be about you)One of the most important lessons from the world of politics.It’s not about you. It’s about them.They may not like you. They may not like your leadership team, they don’t care about your strategic plan or your quarterly report or your MOR.But they may care agreat deal about their colleagues, their patients and their hospital. This is a passion you can tap.This PASSION is what they are talking about when they say they want to work in collaboration, in partnership with you. They are not satisfied with being a worker. They want to put their passion to work.This is a powerful force. Ask them for help, give them leeway to tackle a challenge, hold them accountable and get out of the way.But when they are mobilize and own it, they can be unstoppable.When you hear about grassroots movements sweeping the state or sweeping the country, this is how its happen. The connection between PASSION and ACTION. That is the opportunity for us.
- “The fundamental rules that have governed how relationships work are being rewritten”We cannot pretend this isn’t happening.In fact, we can use this revolution of information transparency to realign, restructure and reignite our healthcare systems.
- One last lesson from politicsIt’s a mistake to run last season’s campaign. To think and act as if you are opposed by the same candidate, that the political environment hasn’t changed since the last time you ran for officeDon’t fight the last war.It’s a mistake to do what we’ve always done and expect that 49% of disconnected, detached and distanced employees to engage.
- The winners will be the organizations that recognize we are running a new campaign, and living in a new world……and structure themselves to succeed in it.Being Naked is changing the very nature of work itself.Let’s change with it.# # #