Focus on what’s important…

As a leader have you ever thought about what would help focus the team on the things that are most important?

With many competing priorities, and some diametrically opposed (cost versus quality, for example) the PMC TM, also known as the Business Review is the tool to help leaders focus the team and wisely use the resources available.  By shining a light on what is most important, the team has the freedom to systematically improve the performance of the organization, one step at a time.

Organizational leaders benefit from aligning the ability to act with the ability to measure through utilization of a scorecard-based PMC TM. The PMC TM is an effective solution to help focus a team, a department, division or service line on what is most important – strategically, operationally, or via regulatory requirements – helping to drive commitments and accountability to impact results.

A participant in a recent PMC TM launch commented, “This seems to be less about the mechanics of gathering and analyzing data, and more about changing to a culture of performance management.  In your experience, what are the biggest barriers to making that cultural change stick?”  It was an excellent question and one that I have thought a lot about during my time working with dozens of leadership teams. In my experience, the answer is really three things:

1.   Sponsorship – When I have seen this process fail, it has been largely because the leader of the organization isn’t engaged.  These leaders are going through the motions to satisfy an organizational requirement, but they find little value in the review.  If the sponsor doesn’t care, why on earth would the rest of the team?  Weak sponsorship spells an early death to a PMC TM.
2.   Metrics – Some teams create dozens of metrics for which there is no reliable data source.  Or they create metrics for things they think they “should” measure, not the things they are actively managing.  A good scorecard is full of the real measures that the leader and the team need in order to run their organization. 
3.   Improvement: The “So What” Factor – The purpose of the PMC TM is to pull together management teams to review performance, identify performance gaps, and take action to close those gaps.  It is really the “taking action” part that answers the “So What?” question.  Measuring for the sake of measuring achieves little.  The PMC TM is intended to drive accountability and improvement. 

Certainly there are other variables in the equation, but I consider these three the fundamentals.  Just as a basketball team cannot win games without a strong handle on the fundamentals of “pass, dribble, and shoot,” teams cannot manage performance effectively without mastering sponsorship, the metrics, and improvement. 

Read more about the Orion Advisory PMC TM 

Kara Carter is Director, Consulting Services at Orion Advisory.  Follow Kara on LinkedIn

When Teams Get Stuck

A client team facing a major organizational change is “stuck”.  They can’t move forward, they can’t move back…. Locked up in behaviors that slow the very changes they are moving toward.  Conversations focused on “my position” crop up in the boardroom and behind closed doors.  Heels start to dig in.  “Why are we having this conversation again?” asks the client. 

Those of us who facilitate or stand with teams reach into our toolkit for ground rules and processes. The leader of the group might fall back into command and control style and mandate a decision.  Dr. Roger Schwarz calls that “unilateral control”, a mindset that closes the door to new possibilities and learning.  Basically unilateral control is “my way or the highway”, and with a room full of leaders and bright, strong willed people, that can be a lot of highways! Schwarz reminds us one of the best things we as leaders or facilitators of teams can reach for when teams get “stuck” is our own mindset.

I recently had the good fortune to spend a week with Dr. Schwarz and his brilliant colleagues.  Working with Schwarz helped me characterize mindset for myself and the teams I help as; “How I want to be in the world”. Stepping away from the unilateral mindset and toward a mutual learning mindset allows room for listening to the internal voice that says; "I have information and so do others"; "Each of us sees things others don't"; "People may disagree with me and still have pure motives"; "Differences are opportunities for learning"; and "I may be contributing to the problem". 

Mutual learning embraces the values of transparency, curiosity, informed choice, accountability and compassion. It is very individual and personal work that needs to happen before we can help teams or individuals work toward change. It’s tough work. It’s daily, hourly conversation by conversation kind of tough but it pays off.  Mutually designed and agreed to outcomes, higher quality decisions, greater commitment and increased learning...richer opportunities and increased engagement. I call that real change. Here is a great piece by Dr. Schwarz on Team Effectiveness using the Mutual Learning mindset. I find it helpful.  Another “Schwarzism”..."Tell me how you see it differently”.  I am curious to hear your views.

Laura Grealish is Director, Consulting Services at Orion Advisory.  Follow Laura on Linked In

Increasing Revenue and Teamwork Through Collaborative Change

Within just three months, two teams, initially unwilling to sit next to each other in a room, shifted to a collective view of the patient care process and a self-sustaining program of innovation and improvement through collaborative change. Understand more about this team transformation here:

5 Steps to a Successful Customer Service Initiative

John DiJulius is the founder and CVO (Chief Visionary Officer) of The DiJulius Group, a consulting firm that works with companies to “Make Price Irrelevant”. Top organizations across the world use his philosophies and systems for creating world class service as part of what he calls a Customer Service Revolution. 
After years of researching the best customer service companies in the world, he has solved the mystery of why companies like Disney can get 50,000 employees to deliver legendary customer service on a regular basis, while other companies or departments can struggle to get a team of 12 to be consistent.

John has outlined 5 steps to a successful customer service initiative: Read the entire article here.

High Performance

One of the key tenets of our work is our belief that those closest to the work have the potential to make significant impact in day to day results.  Whether working with a team in a bank, a medical clinic, or a hospital environment, we have found this to be true. Here are a couple of examples that demonstrate the power of engaging frontline teams in managing and improving their work: An operations research team within a financial services company achieved an 80% reduction in the loss write offs and an 84% reduction in the time taken to respond to a customer phone call. How did this team accomplish these things?  Success was largely attributed to two factors:

First: Leadership sought to increase the employees’ level of ownership in day to day performance. 

Second: Leadership provided a structure and method to make performance improvements.  

This team, with leadership behind it, used the FasTrac TM collaborative problem solving process, and got to work identifying opportunities and solutions to improve its performance with loss write-offs and call response. The team successfully addressed these challenges, and job satisfaction levels increased by 17%, too. One leader shared:
“You have to let people manage themselves.  Management’s job is to stretch them… challenge them.”
A cross-functional medical team, made up of employees from Ultrasound, Physical Therapy, Occupational Therapy, and Nursing, was brought together and given the challenge of improving on-time portable ultrasound exams by 33%.  This meant improving on-time performance from 57% to 90% within 4-months. The inability to complete the exams on-time reduced the Technologists’ productivity, led to employee dissatisfaction and frustration, and introduced the potential for risk to patients. Using the FasTrac TM approach, the team identified 13 potential causes for exams not starting on-time and eight solutions.  

The team had just 90 days to develop, investigate, and test these solutions. The team met the challenge and surpassed it by completing 100% of exams on-time within the 120 day target. One team member shared: 
“The FasTrac TM project exposed the group to tools, like mapping, which enabled the team to define the steps involved and assign accountability to ensure we met our goals.”
Involving the front line in managing and improving the work and results has been, and will continue to be, part of the equation in creating a high performing culture and successful bottom line.
For more information about Orion Advisory or to contact us, go to our website.

Mary Ann Yauger is Director, Consulting Service at Orion Advisory LLC. Follow Mary Ann on LinkedIn 

Challenges Faced by Physicians in Leadership Roles

How to lead a confederation of over 30 ICUs across a multi-location organization was the daunting challenge facing our client, a newly appointed ICU physician leader, in particular because none of the respective members (also leaders) were his direct reports. He recounted:

"[In] medical school and residency, your entire training is focused on making you a better individual performer. They didn't spend 1 minute in my medical school residency or fellowship teaching me how to lead a team or even really teaching me how to be a member of a team, never mind assuming as a physician I would be the leader . . . Everything was about improving your own procedural skills and improving your own diagnostic skills, improving your own ability to see a patient and generate a differential diagnosis. None of it was spent on how . . . I get a group of nurses, respiratory therapists, medical students, residents and fellows, and everyone else who you have to interact with to function well as a team, and so most physicians don’t do it well."

This is not an uncommon perspective we have heard from our physician leader clients, and one that, in the new world of healthcare, has increasing impact on an organization's success in creating positive change quickly.

A recent HBR blog posting captured some of the dynamics of this reality, highlighting the challenges that physicians face when assuming leadership roles. Noting that they are on the cusp of revolutionary change in health care, they feel underqualified to lead.

Based on his experience, Richard Winters, MD, MBA, offers four challenges with solution ideas for each. Read about his solutions on the HBR Blog (registration is free).

Linking Mindset to Transformation

I’d like to introduce two concepts that are emerging in discussions across our client communities, cultural transformation and mindset.

In our work, regardless of the specific outcome we are seeking, some degree of change within the existing culture will be required, or the desired outcome will be impacted by the existing culture.  Both are true and typically occur simultaneously.  It’s critical we stop thinking of organizational culture as a single thing, but rather, a group of individuals who each have their own mindset that drives their behavior.  When the mindset of leadership is to expect more and expect it faster, we must remember to support the culture (the mindset of all of those individuals) that delivers it.  This support typically goes beyond the technical capabilities of our organization’s people and the technology we provide them.  Understanding their mindset is getting to the “heart” of what makes them tick and motivates them to want to do more and/or do it differently.

Our clients spend many hours and resources to create business strategies to improve market share, ROIs and increase the value of their service or product.  These strategic initiatives always require the culture to transform in order to deliver.  This cultural transformation is achieved when people have a common understanding of the initiatives and believe there will be value for them by engaging in the initiative.  As we work with leaders to develop their business strategies, the corresponding change strategy includes an assessment of the mindset of leadership and those responsible for implementing the change or impacted by the change. It is important to define and communicate this alignment between the mindsets of leadership and the supporting culture.

What is the thing we call mindset really? Consider the following:

  • Awareness is your perception of reality.  Mindset formulates those perceptions.
  • Knowledge is the content of your mind.  Mindset constructs the meaning you make of that content.
  • Thinking is the process of your mind.  Mindset shapes what and how you think.
  • Emotion is your feeling state.  Mindset determines what you feel in any given situation
  • Behavior is the manner in which you conduct yourself.  Mindset causes you to behave as you do in any situation.
  • Based on individual mindset, a person’s reality will be formed by how they interpret a situation. 
Reality = Situation + Interpretation1

When seeking cultural transformation within an organization, begin with understanding the mindset of the organization.  Interpretation of the same situations may vary greatly across your organization, depending on individual mindset.  To the extent leaders are able to help the organization interpret the same situation similarly through strong change strategies and meaningful two-way communication, their chances for a successful cultural transformation increase greatly.

Karen Branick
Practice Leader
Orion Advisory LLC

1BeingFirst, 4Sight Advanced Change Leadership Skills and Development Course and The Change Leader’s Roadmap, Linda and Dean Anderson

Sponsorship Matters

In a recent LinkedIn survey of change management professionals, over 71% indicated that the top contributing factor to successful change initiatives is “active and engaged sponsoring: committed, consistent, and positively supporting and impacting progress”.  ( 1)

No change, whether transformational or incremental, happens without support, and pivotal to that support is sponsorship and change leadership. This is a fact of life, regardless of environment or organization. In our collective experience at Orion Advisory, sponsorship is make-or-break for real change.

Sponsors are essential to the beginning of an effort. They help determine the “vision” and think through the particular challenges and pitfalls that may arise with it. They constitute teams and secure resources to allow the work to get off the ground while simultaneously ensuring sufficient coverage to attend to the normal day to day operations of the organization.

As change efforts unfold, Sponsors are there to help ensure the team remains an open venue where ideas are freely exchanged. The Sponsor also protects the team by being an advocate of their work and an apostle of the achievements toward achieving the vision. As achievements yield results, Sponsors are the leaders of recognition and celebration with the team.

You may know from your own experience that it takes time to do the work of sponsorship along with all the other activities that comprise a leader's day to day life at work. Our experience has been that sponsoring is a learned activity. What’s more, simply being in a position of leadership does not automatically translate to being an effective Sponsor. The work of sponsorship involves leadership and leading, but people have to learn how to do it. Just because someone may be a leader in an area doesn’t mean they are a “natural” and can effectively sponsor teams.

Yet, even in environments where people have some experience working on teams and projects that are “sponsored,” the actual work of sponsoring is not generally taught, especially in healthcare, and can look daunting at the outset. But with practice, sponsoring can become second nature. Most often, it is a skill that is learned like any other, and with coaching, sponsoring can not only become integrated into one’s work, but also be a “source of joy,” as is often shared by Sponsors. No one is born a great Sponsor.

Good Sponsors realize that sponsorship is a part of their job as leaders. But it takes time to learn how to become a Sponsor and more time to do the work of sponsoring—along with any and all of the other activities that comprise someone’s daily job.

We will follow this with additional insights on sponsorship and leadership over the next several weeks.

(1) Change is good change factor survey results. 10/24/2013 LinkedIn

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The Change Journey

More than ever, understanding the dynamics of transformational change is becoming table stakes for the survival of senior leaders.

Over the past several months, we have been working with healthcare organizations on a new reality that they are facing within the industry reconfiguration of healthcare reform, and with financial services firms that need to recreate their organizations to accommodate the new landscape they envision for the future. Almost without fail, we have seen a thematic struggle that they experience during transition from an old way of doing things to a new way of doing things. The changes required necessitate a shift across their entire business model, including changes to structure, systems, operations, services and technology.

The new state also requires fundamental shifts in mindset, organizing principles, behavior, and culture, as well as organizational changes, all designed to support the new direction. A critical mass of the organization must operate from new mindsets and behaviors for transformation to succeed and be sustained.

One of the things that makes this so difficult is that the future state is not an improved version of the past, but rather a new state; the change journey must begin without full clarity and definition of the final destination - the very definition of transformational change - with the new state emerging from visioning and trial and error and learnings. The change strategy approach employed must move well beyond traditional project or program management, or even change management tactics, and consider multiple inter-dependencies and the flexibility to adapt.

If this is true, the competitive advantage is the capability to navigate and respond quickly, since the pursuit of a specific tactical path is almost impossible, and is unknown by its very nature. What we seek is the collective intelligence of the organization to envision, create, test, and innovate until the best future becomes apparent in an environment that is multi-complex. Three areas seem to emerge:
  1. Content - This includes strategy, the "what", "who" and "how" of services provided, structure, systems, operations, technology, and business processes.
  2. Process - The plan to go from current state to future state; the ability to do, learn, and adjust to create sound solutions, best practice sharing, standard practices / procedures, documentation, and full realization of the desired state.
  3. People - The emotional reactions and engagement with the change - includes changes in mindset and behaviors required by the future state; understanding the impact of existing culture on the change; how to engage people in design and implementation; and how to ensure commitment and capacity to change to positively impact the culture.
We believe that understanding the new environment of transformational change and crafting appropriate strategies to meet its challenges will have a central role in determining tomorrow's winners and losers.

Thanks for inspiration from 
Anderson, Dean, and Linda Ackerman Anderson. Beyond Change Management: How to Achieve Breakthrough Results Through Conscious Change Leadership. San Francisco: Pfeiffer, 2010. Print.

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