LONG Tom Peters’

EXCELLENCE. ALWAYS.

McKesson 2008 Executive Leadership Summit The Broadmoor/Colorado Springs/23 July 2008

Slides at …

tompeters.com

Part One: A Civilian Looks at Your World

DVM/Lyme/2005-2008 **Multiple diagnoses (>5) **Specialist self-certainty **Health deterioration failed to produce urgency communication **Virtually no communications between specialists **Follow-up very spotty unless bugged incessantly **Lost major test results, mis-placed 3 or 4 occasions **Near fatal drug mistake (one nurse takes charge) **Effectively, disinterest in chronic-care **Lack of curiosity

“

[Dartmouth Professor Elliott]

Fisher and his colleagues discovered that patients who went to hospitals that spent the most—

did the most procedures and

—were 2 to 6 percent more likely to die than patients that went to hospitals that spent the least.”

Source: Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer , Shannon Brownlee

“ The more doctors and specialists around, the more tests and procedures performed. And the results of all these tests and procedures? Lots more medical bills, exposure to medical errors, and a loss of life expectancy.

“It was this last conclusion that was truly shocking, but it became unavoidable when [Dartmouth’s Dr. Jack] Wennberg and others broadened their studies.

They found it’s not just that renowned hospitals and their specialists tend to engage in massive overtreatment. They also tend to be poor at providing critical but routine care.”

Source: Best Care Anywhere: Why VA Healthcare Is Better Than Yours/Phillip Longman

“If we sent 30 percent of the doctors in this country to Africa, we might raise the level of health on both continents.”

—Dr Elliott Fisher, Center of Evaluative Clinical Sciences, Dartmouth Medical School (“Overdose,” Atlantic, Shannon Brownlee.)

CDC 1998:

98,000

killed

and 2,000,000

injured

from hospital-caused drug errors & infections

HealthGrades/Denver:

195,000

hospital deaths per year in the U.S., 2000-2002 = equivalent of 390 full jumbos/747s in the drink per year —more than one-a-day.

Comments:

There is little evidence that patient safety has improved in the last five years.”

—Dr. Samantha Collier Source: Boston Globe/2005

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

“Hospital infections kill an estimated 103,000 people in the United States a year, as many as AIDS, breast cancer and auto accidents combined.

… Today, experts estimate that more than 60 percent of staph infections are M.R.S.A. [up from 2 percent in 1974]. Hospitals in Denmark, Finland and the Netherlands once faced similar rates, but brought them down to below 1 percent. How? Through the rigorous enforcement of rules on hand washing, the meticulous cleaning of equipment and hospital rooms, the use of gowns and disposable aprons to prevent doctors and nurses from spreading germs on clothing and the testing of incoming patients to identify and isolate those carrying the germ. … Many hospital administrators say they can’t afford to take the necessary precautions .

”

—Betsy McCaughey, founder of the Committee to Reduce Infection Deaths (New York Times/06.06.2005)

“Experts estimate that more than a hundred thousand Americans die each year not from illness but from their prescription drugs.

Those deaths, occurring quietly, almost without notice in hospitals, emergency rooms, and homes, make medicines one of the leading causes of death in the United States. On a daily basis, prescription pills are estimated to kill more than 270 Americans. … Prescription medicines, taken according to doctors’ instructions, kill more Americans than either diabetes or Alzheimer’s disease.”

Source: Our Daily Meds: How the Pharmaceutical Companies

Transformed Themselves into Slick Marketing Machines and Hooked the Nation on Prescription Drugs

—Melody Petersen

140,000,000 illegible prescriptions per year

—John Hammergren & Phil Harkins, Skin in the Game: How

Putting Yourself First Today Will Revolutionize Healthcare Tomorrow

**1,500,000,000,000 claims per year **30% errors **15% lost **25% paper-based

Source: John Hammergren & Phil Harkins, Skin in the Game:

How Putting Yourself First Today Will Revolutionize Healthcare Tomorrow

”I can receive a BlackBerry message from a colleague climbing a mountain, yet I still show up at a doctor’s office [and after a 45-minite wait] learn that my hospital test results have not arrived weeks after they should have.” —John Hammergren (& Phil Harkins), Skin in the Game:

How Putting Yourself First Today Will Revolutionize Healthcare Tomorrow

“stunning lack of scientific knowledge about which treatments and procedures actually work.”

Source: Best Care Anywhere: Why VA Healthcare Is Better Than Yours/Phillip Longman

Up To 500,000 Lives: “The medical system has been unable to turn proven remedies into everyday care.* Half the people who need to be treated to prevent heart attacks are not treated and half who are treated are treated inadequately. Patients go home with the wrong drugs or the wrong doses or misimpressions about the importance of taking their medications.” *More: 55% chance of “receiving the best recommended care—which means getting scientifically appropriate, evidence-based medical treatment” —The New York Times, from John Hammergren & Phil Harkins, Skin in the Game: How Putting Yourself

First Today Will Revolutionize Healthcare Tomorrow

“The results are deadly. In addition to the 98,000 killed by medical errors in hospitals and the 90,000 deaths caused by hospital infections, another 126,000 die from their doctor’s failure to observe evidence-based protocols for just four common conditions: hypertension, heart attack, pneumonia, and colorectal cancer.” [TP: total 314,000 ] Source: Best Care Anywhere: Why VA Healthcare Is Better Than Yours/Phillip Longman

“Bottom line” :

1900-1960, life expectancy grew per year; 1960-2002,

0.24% 0.64 %

per year, half from airbags, gun locks, service employment …

Source: Best Care Anywhere: Why VA Healthcare Is Better Than Yours/Phillip Longman

“Plus God alone knows how many casualties in doctors’ offices, Tom”

—Thom Mayer

“ … 25 to 30 percent of our $2.2 trillion goes to wasted care in the form of preventable errors, incorrect diagnoses, redundant treatment, unnecessary infections, and extra time spent in the hospital.

Team-based medicine, bar-code prescription scanning, evidence-based medicine—all of these are systems and innovations that are being put into place to eliminate waste so that we can re apply the money.”

—John Hammergren & Phil Harkins, Skin in the Game:

How Putting Yourself First Today Will Revolutionize Healthcare Tomorrow

“Medical Homes” “Clinical Microsystems” “Convenient Care”

“Clinical microsystem,” linked microsystems, patient-centric “care teams”

—Paul Batalden/DHMC Source: “What System?” ( Dartmouth Medicine , Summer 2006 Quality By Design: A Clinical Microsystems Approach , by Eugene C. Nelson, Paul B. Batalden, and Marjorie M. Godfrey)

Part Two: The “Last 98%”

“… it is the game.”

“ If I could have chosen not to tackle the IBM culture head-on, I probably wouldn’t have. My bias coming in was toward strategy, analysis and measurement. In comparison, changing the attitude and behaviors of hundreds of thousands of people is very, very hard.

[Yet] I came to see in my time at IBM that culture isn’t just one aspect of the game —it is the game.”

—Lou Gerstner, Who Says Elephants Can’t Dance

-fold!

Ken Kizer/VA 1997: “culture of cover-up that pervades healthcare” “Patient Safety Event Registry” … “looking for systemic solutions, not seeking to fix blame on individuals except in the most egregious cases. The good news was a

thirty-fold increase

in the number of medical mistakes and adverse events that got reported.” “National Center for Patient Safety Ann Arbor”

Thank you Ike , Charlie, Ben & Norm, George, Nelson, and Ben …

“Allied commands depend on mutual confidence [and this confidence] is gained, above all through the development of friendships.”

—General D.D. Eisenhower, Armchair General * (05.08) *“Perhaps his most outstanding ability [at West Point] was the ease with which he made friends and earned the trust of fellow cadets who came from widely varied backgrounds; it was a quality that would pay great dividends during his future coalition command.”

George Crile (Charlie Wilson’s War) on Charlie Wilson: “The way things normally work, if you’re not Jewish you don’t get into the Jewish caucus, but Charlie did. And if you’re not black you don’t get into the black caucus. But Charlie plays poker with the black caucus; they had a game, and he’s the only white guy in it. The House, like any human institution, is moved by friendships, and no matter what people might think about Wilson’s antics, they tend to like him and enjoy his company.”

Give good tea!

“In the same bitter winter of 1776 that Gen. George Washington led his beleaguered troops across the Delaware River to safety, Benjamin Franklin sailed across the Atlantic to Paris to engage in an equally crucial campaign, this one diplomatic. A lot depended on the bespectacled and decidedly unfashionable 70-year-old as he entered the world’s fashion capitol sporting a simple brown suit and a fur cap. …

Franklin’s miracle was that armed only with his canny personal charm and reputation as a scientist and philosopher, he was able to cajole a wary French government into lending the fledgling American nation an enormous fortune.

… The enduring image of Franklin in Paris tends to be that of a flirtatious old man, too busy visiting the city’s fashionable salons to pursue affairs of state as rigorously as John Adams.

was conducted.

When Adams joined Franklin in Paris in 1779, he was scandalized by the late hours and French lifestyle his colleague had adopted, says [Stacy Schiff, in A Great Improvisation] Adams was clueless that it was through the dropped hints and seemingly offhand remarks at these salons that so much of French diplomacy

… Like the Beatles arriving in America, Franklin aroused a fervor—his face appeared on prints, teacups and chamber pots. The extraordinary popularity served Franklin’s diplomatic purposes splendidly. Not even King Louis XVI could ignore the enthusiasm that had won over both the nobility and the bourgeoisie. …” Source: “In Paris, Taking the Salons By Storm: How the Canny Ben Franklin Talked the French into Forming a Crucial Alliance,” U.S. News & World Report, 0707.08

The 95% Factor:

“What I learned from my years as a hostage negotiator is that we do not have to feel powerless—and that

bonding

is the antidote to the hostage situation.”

—George Kohlrieser, Hostage at the Table

“

I am a dispenser of enthusiasm.”

—Ben Zander

Hard Is Soft Soft Is Hard

Hard Is Soft (Plans, #

s

) Soft Is Hard (people, customers, values, relationships))

R.O.I.R.

R eturn O n I nvestment In R elationships

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.

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

—Henry Clay

THE PROBLEM IS RARELY/NEVER THE PROBLEM.

THE RESPONSE TO THE PROBLEM INVARIABLY ENDS UP BEING THE REAL PROBLEM.

X =XFX*

*

Excellence = Cross-functional Excellence

**Stanford/Hagadorn **Conoco/geologists-geophysicists **Schlumberger IPM-IBM Global Services UPS Logistics (“bet the company”) **GSK/CEDD **Chiat/Day **Batalden/DHMC/“clinical microsystems” **9-11 Commission **Etc **Etc

The “XF-50”: 50 Ways to Enhance Cross-Functional Effectiveness and Deliver Speed, “Service Excellence” and “Value-added Customer ‘Solutions’”*

*Entire “XF-50” List is an Appendix to this presentation

Never waste a lunch!*

????

% XF lunches*

*Measure!

CIO Question:

% Doc lunches*

*Last 30 days

???????

“Success doesn’t depend on the number of people you know; it depends on the number of people you know in high places!” or “Success doesn’t depend on the number of people you know; it depends on the number of people you know in low places!”

Loser:

“He’s such a suck-up!”

Winner:

“He’s such a suck-down.”

George Crile (Charlie Wilson’s War) on Gust Avrakotos’ strategy:

“He had become something of a legend with these people who manned the underbelly of the Agency [CIA].”

William Easterly, The White Man’s Burden: Why the West’s Effort to Aid the Rest Have Done So Much Ill and so Little Good: “The West spent … foreign aid over the last five decades and still has and still not medicines to children to prevent half of all malaria deaths. The West spent $2.3 trillion not each new mother to prevent five million child deaths. …

$2.3 trillion

managed to get twelve-cent managed to get three dollars to But I and many other like minded people keep trying, not to abandon aid to the poor, but to make sure it reaches them.” on

Lesson: Lesson: Lesson: Lesson: locals.

Lesson: Show up Listen “locals.” Hear “locals.” Engage Try .

to the the the a lot of stuff.

“Ninety percent of success is showing up.”

—Woody Allen

MBWA

Source: How Doctors Think, Jerome Groopman

Noth ing

is “scalable”!*

“Buy in” “Ownership” Authorial bragging rights-“Born again” Champion =

One Line of Code!

Nothing is “scalable”!*

*Every replication must exude the perception of uniqueness—even if it means a half-step backwards.

(“It wouldn’t have worked if we hadn’t done it our way.”)

Easterly, maligned by many, is the arch-enemy of the

Big Plan

[his capital letters, not mine —for once] sent from afar; and the vociferous fan of practical activities of those he calls

“Searchers”

… who learn the ins and outs of the culture, politics and local conditions “on the ground” in order to use local levers and local players, and get those 12 cent medicines to community members. Read on, “Planners” vs “Searchers” …

“We made mistakes, of course. Most of them were omissions we didn’t think of when we initially wrote the software.

and again.

We fixed them by doing it over and over, again

We do the same today. While our competitors are still sucking their thumbs trying to make the design perfect, we’re already on prototype version

#

5.

the time our rivals are ready with wires and screws, we are on version By

#

10.

It gets back to planning versus acting: We act from day one; others plan how to plan— for months.”

—Bloomberg by Bloomberg

Culture of Prototyping

“Effective prototyping may be

the most valuable core competence

an innovative organization can hope to have.”

—Michael Schrage

“Experiment fearlessly”

Source: BW 0821.06, Type A Organization Strategies/ “How to Hit a Moving Target”—

Tactic #1

“ This is so simple it sounds stupid, but it is amazing how few oil people really understand that

you only find oil if you drill wells.

You may think you’re finding it when you’re drawing maps and studying logs, but you have to drill.” Source: The Hunters , by John Masters, Canadian O & G wildcatter

Lesson: Talk to the “locals.” Lesson: Listen to the “locals.” Lesson: Hear the “locals.” Lesson: Listen to the “locals.” Lesson: Hear the “locals.” Lesson: Listen to the “locals.” Lesson: Hear the “locals.” Lesson: Lesson: Listen to the “locals.” Hear to the “locals.” Lesson: Lesson: Listen to the “locals.” Hear to the “locals.” Lesson: Respect the “locals.” Lesson: Empathize with the “locals.”

For projects involving children or health or education or community development or sustainable small-business growth (most projects),

women

are by far the most reliable and most central and most indirectly powerful local players even in the most chauvinist settings.

“Forget

China

,

India

and the

Internet

: Economic Growth Is Driven by

Women

.”

Economist , April 15, 2006, Leader, page 14 —Headline,

“Women are

the

majority market”

—Fara Warner/ The Power of the Purse

“The

most significant variable

in

every

sales situation is the

gender

of the buyer, and more importantly, how the salesperson communicates to the buyer’s gender.”

—Jeffery Tobias Halter, Selling to Men, Selling to Women

The Perfect Answer Jill and Jack buy slacks in black…

“AS LEADERS, WOMEN RULE:

New Studies find that female managers outshine their male counterparts in almost every measure” TITLE/ Special Report/ BusinessWeek

“One thing is certain: Women’s rise to power, which is linked to the increase in wealth per capita, is happening in all domains and at all levels of society. Women are no longer content to provide efficient labor or to be consumers with rising budgets and more autonomy to spend. … This is just the beginning. The phenomenon will only grow as girls prove to be more successful than boys in the school system.

For a number of observers, we have already entered the age of ‘womenomics,’ the economy as thought out and practiced by a woman.”

—Aude Zieseniss de Thuin, Financial Times, 10.03.2006

10 UNASSAILABLE REASONS WOMEN RULE Women Women Women Women make [all] the financial decisions.

control [all] the wealth.

[substantially] outlive men.

start most of the new businesses.

Women’s Women work force participation rates have soared worldwide.

are closing in on “same pay for same job.” Women are penetrating senior ranks rapidly [even if the pace is slow for the corner office per se].

Women’s leadership strengths are exceptionally well aligned with new organizational effectiveness imperatives.

Women are better salespersons than men.

Women buy [almost] everything—commercial as well as consumer goods.

So what exactly is the point of men?

TP:

“How to flush $500,000 down the toilet in one easy lesson!!”

< CAPEX > People!

… no less than

Cathedrals

in which the full and awesome power of the Imagination and Spirit and native Entrepreneurial flair of diverse individuals is unleashed in passionate pursuit of … Excellence.

“You have to treat your employees like customers.”

—Herb Kelleher, upon being asked his “secret to success” Source: Joe Nocera, NYT , “Parting Words of an Airline Pioneer,” on the occasion of Herb Kelleher’s retirement after 37 years at Southwest Airlines (SWA’s pilots union took out a full-page ad in USA Today thanking HK for all he had done; across the way in Dallas American Airlines’ pilots were picketing the Annual Meeting)

#1

cause of Dis-satisfaction?

Employee retention & satisfaction:

Overwhelmingly, based on their

immediate manager!

Source: Marcus Buckingham & Curt Coffman, First, Break All

the Rules: What the World’s Greatest Managers Do Differently

EXCELLENCE. BEDROCK.

LEADERSHIP. THE 10Ps.

PURPOSE.

PASSION.

Potential.

Presence.

Personal.

PERSISTENCE.

PEOPLE.

Promotion. Potent.

Positive.

“I am a … Dispenser of Enthusiasm !”

—Ben Zander

“

You must

be

the change you wish to see in the world.”

Gandhi

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

MBWA

Kevin Roberts’ Credo 1 . Ready. Fire! Aim.

2. If it ain’t broke ... Break it!

3. Hire crazies.

4. Ask dumb questions.

5. Pursue failure.

6. Lead, follow ... or get out of the way!

7. Spread confusion.

8. Ditch your office.

9. Read odd stuff.

10.

Avoid moderation!

“Leaders

‘do’

people. Period.”

—Anon.

On NELSON:

“[other] admirals more frightened of losing than anxious to win”

2 per Year/ 20 per Decade = Excellence + Legacy

Nudge.

Sway.

K.I.S.S.

90K in U.S.A.

ICUs

given day;

178

on any steps/day in ICU.

50%

stays result in “serious complication”

Source: Atul Gawande, “The Checklist” (New Yorker, 1210.07)

** Peter Pronovost , Johns Hopkins, 2001 **Checklist, line infections **1/3 rd at least one error when he started **Nurses/permission to stop procedure if doc, other not following checklist **In 1 year, 10-day line-infection rate: 11% to … 0% Source: Atul Gawande, “The Checklist” (New Yorker, 1210.07)

**Docs, nurses make own checklists on whatever process-procedure they choose **Within

weeks

, average stay in ICU down 50% Source: Atul Gawande, “The Checklist” (New Yorker, 1210.07)

**Replicate in Inner City Detroit (resource strapped —$$$, staff cut 1/3 rd , poorest patients in USA) **Nurses QB the process **Project manager for overall process implementation **Exec involvement (help with “little things”—it’s all “little things”) **Blue Cross/insurers, small bonuses for participating **6 months, 66% decrease in infection rate; USA: bottom 25% in hospital rankings to …

top 10%

Source: Atul Gawande, “The Checklist” (New Yorker, 1210.07)

“[Pronovost] is focused on work that is not normally considered a significant contribution in academic medicine. As a result, few others are venturing to extend his achievements.

Yet his work has already saved more lives than that of any laboratory scientist in the last decade

.”

—Atul Gawande, “The Checklist” (New Yorker, 1210.07)

Compression hose would mostly fix the hospital problem:

“According to the American Heart Association, up to two million Americans are affected annually by deep vein thrombosis. Of those who develop pulmonary embolism, up to 300,000 will die each year. ... Deep vein thrombosis also is among the leading causes of preventable hospital death. Even more disturbing is the fact that, according to a U.S. multi-center study published by two of ClotCare's editorial board members,

58%

of patients who developed a DVT while in the hospital received no preventive treatment despite the presence of multiple risk factors and overwhelming data that prophylaxis is very effective at reducing these events.”

—Marie B. Walker, clotcare.com, March 2008

“Everything matters” -80% Source: Nudge, Richard Thaler and Cass Sunstein, etching of fly in the urinal reduces “spillage” by 80%, Schiphol Airport

“

Experiences

are as distinct from services as services are from goods.”

—Joe Pine & Jim Gilmore, The Experience Economy: Work Is Theatre & Every Business a Stage

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

W

vs.

>TG R

2-cent candy

Part Three: Five Pianos

Planetree:

A Radical Model for New Healthcare/Healing/ Wellness Excellence

Tom Peters

“How will you know when the healthcare industry has finally entered the 21 st century? When error rates at hospitals are close to zero. When doctors and nurses use evidence-based protocols in your treatment. When

you can decide how much to spend on treatment, and you have the information and the opportunity to

determine the best value. When your primary care physician is in charge of your extended care team, operating as your command central. When all members

of the medical community—nurses, doctors, pharmacists and specialists—work together seamlessly on your

behalf. When their combined efforts are tracked, measured, and reported on—and the insurance reimbursements awarded to them are based on performance. When you see that hospitals, pharmacies

and doctors are working harder in all aspects to make sure you are an informed consumer who has trust and confidence in the services they offer and the prices they charge.”

—John Hammergren & Phil Harkins,

Skin in the Game: How Putting Yourself First Today Will Revolutionize Healthcare Tomorrow

The 9 Planetree Practices 1.

2.

The Importance of Human Interaction Informing and Empowering Diverse Populations: Consumer 3.

Health Libraries and Patient Information Healing Partnerships: The importance of Including Friends 4.

5.

6.

and Family Nutrition: The Nurturing Aspect of Food Spirituality: Inner Resources for Healing Human Touch: The Essentials of Communicating 7.

8.

Caring Through Massage Healing Arts: Nutrition for the Soul Integrating Complementary and Alternative Practices 9.

into Conventional Care Healing Environments: Architecture and Design Conducive to Health Source: Putting Patients First , Susan Frampton, Laura Gilpin, Patrick Charmel

1.

The Importance of Human Interaction

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

none

of THE top 15 factors determining

P

atient

S

atisfaction referred to patient’s health outcome

PS directly related to PS Staff Interaction directly correlated with Employee Satisfaction Source: Putting Patients First , Susan Frampton, Laura Gilpin, Patrick Charmel

“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

2.

Informing and Empowering Diverse Populations: Consumer Health Libraries and Patient Information

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

3.

Healing Partnerships: The Importance of Including Friends and Family

“Family members, close friends and ‘significant others’ can have a far greater impact on patients’ experience of illness, and on their long-term health and happiness, than any healthcare professional.”

— Through the Patient’s Eyes

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

4.

Nutrition: The Nurturing Aspect of Food

Kitchen Beautiful cutlery, plates, etc Chef reputation

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

Aroma therapy

(e.g., “smell of baking cookies”—from kitchenettes in each ward) Source: Putting Patients First , Susan Frampton, Laura Gilpin, Patrick Charmel

5.

Spirituality: Inner Resources for Healing

Spirituality: Meaning and Connectedness in Life 1. Connected to supportive and caring group 2. Sense of mastery and control 3.

Make meaning out of disease/ find meaning in suffering

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

Griffin:

redesign chapel

(waterfall, quiet music, open prayer book) Other :

music, flowers, portable labyrinth

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

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

Mid-Columbia Medical Center/Center for Mind and Body Massage for every patient scheduled for ambulatory surgery

(“Go into surgery with a good attitude”)

Infant massage Staff massage

(“caring for the caregivers”)

Healing environments: chemo!

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

7.

Healing Arts: Nutrition for the Soul

Planetree: “Environment conducive to healing”

Color!

Light!

Brilliance!

Form!

Art!

Music!

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

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

8.

Integrating Complementary and Alternative Practices into Conventional Care

Griffin IMC/Integrative Medicine Center

Massage Acupuncture Meditation Chiropractic Nutritional supplements Aroma therapy

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

9.

Healing Environments: Architecture and Design Conducive to Health

“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

F.Y.I.: It works!

Griffin Hospital/Derby 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)

9 July 2008/HealthLeaders

2008 Top Leadership Team in Healthcare: Griffin Hospital

Appendix

Tom peters on implementation: The Lists

“Never forget implementation , boys. In our work, it’s what I call the ‘last 98 percent’ of the client puzzle.”

—Al McDonald, former Managing Director, McKinsey & Co, to a project team, reported by subsequent McKinsey MD, Ron Daniel

The

“Have you …”

50

“Mapping your competitive position” or …

While waiting last week [early December 2007] in the Albany airport to board a Southwest Airlines flight to Reagan, I happened across the latest Harvard Business Review, on the cover of which was a yellow sticker. The sticker had on it the words “Mapping your competitive position.” It referred to a feature article by my friend Rich D’Aveni. His work is uniformly good —and I have said as much publicly on several occasions dating back 15 years. I’m sure this article is good, too—though I didn’t read it. In fact it triggered a furious negative “Tom reaction” as my wife calls it. Of course I believe you should worry about your “competitive position.”

But instead of obsessing on competitive position and other abstractions, as the B-schools and consultants would always have us do, I instead wondered about some “practical stuff” which I believe is more important to the short- and long-term health of the enterprise, tiny or enormous.

“Unfortunately many leaders of major companies believe their job is to create the strategy, organization and organization processes—remaining aloof from the people doing the work.”

—George Kohlrieser, Hostage at the Table (GK is, among other things, a hostage negotiator with a 95% success rate)

1. Have you in the last 10 days … visited a customer?

2. Have you called a customer … TODAY?

3. Have you in the last 60 90 days … had a seminar in which several folks from the customer’s operation (different levels, different functions, different divisions) interacted, via facilitator, with various of your folks?

4. Have you thanked a front-line employee for a small act of helpfulness … in the last three days?

5. Have you thanked a front line employee for a small act of helpfulness … in the last three hours?

6. Have you thanked a frontline employee for carrying around a great attitude … today?

7. Have you in the last week recognized —publicly—one of your folks for a small act of cross-functional co-operation?

8. Have you in the last week recognized —publicly—one of “their” folks (another function) for a small act of cross-functional co-operation?

9. Have you invited in the last month a leader of another function to your weekly team priorities meeting?

10. Have you personally in the last week-month called-visited an internal or external customer to sort out, inquire, or apologize for some little or big thing that went awry? (No reason for doing so? If true —in your mind—then you’re more out of touch than I dared imagine.)

1. Have you in the last 10 days … visited a custome r?

2. Have you called a customer … TODAY ?

Blog1231.07

FLASH!

FLASH!

FLASH!

FOR IMMEDIATE ACTION!

FOR IMMEDIATE ACTION!

FOR IMMEDIATE ACTION!

OLD YEAR’S RESOLUTION!

Call (C-A-L-L!) (NOT E-MAIL!) 25-50 (NO LESS THAN 25) people … TODAY * … to thank them for their support this year (2007) … and wish them and their families and colleagues a Happy 2008!

** *** **** ***** ****** *Today = TODAY = N-O W (not “within the hour”) **Remember: ROIR > ROI. ROIR = Return On Investment in Relationships. Success = ƒ(Relationships).

***This is the most important piece of advice I have provided this year.

****This is … Not Optional.

*****Trust me: This is fun!!!!

******Trust me: This “works.” Happy 2008!!!

I posted this at tompeters.com

on New Year’s Eve 2007.

11. Have you in the last two days had a chat with someone (a couple of levels down?) about specific deadlines concerning a project’s next steps?

12. Have you in the last two days had a chat with someone (a couple of levels down?) about specific deadlines concerning a project’s next steps … and what specifically you can do to remove a hurdle? (“Ninety percent of what we call management consists of making it difficult for people to get things done.”—Peter “His eminence” Drucker.) 13. Have you celebrated in the last week a “small” (or large!) milestone reached? (I.e., are you a milestone fanatic?) 14. Have you in the last week or month revised some estimate in the “wrong” direction and apologized for making a lousy estimate? (Somehow you must publicly reward the telling of difficult truths.) 15. Have you installed in your tenure a very comprehensive customer satisfaction scheme for all internal customers?

(With major consequences for hitting or missing the mark.) 16. Have you in the last six months had a week-long, visible, very intensive visit- “tour” of external customers?

17. Have you in the last 60 days called an abrupt halt to a meeting and “ordered” everyone to get out of the office, and “into the field” and in the next eight hours, after asking those involved, fixed (f-i-x-e-d!) a nagging “small” problem through practical action?

18. Have you in the last week had a rather thorough discussion of a “cool design thing” someone has come across —away from your industry or function—at a Web site, in a product or its packaging? 19. Have you in the last two weeks had an informal meeting —at least an hour long—with a frontline employee to discuss things we do right, things we do wrong, what it would take to meet your mid- to long-term aspirations?

20. Have you had in the last 60 days had a general meeting to discuss “things we do wrong” … that we can fix in the next fourteen days?

UniCredit Group/ UniCredito Italiano* ** —3 rd party measurement —Customer-initiated measurement —Primary $$$$ incentives —“Factories” —Primary Corporate Initiative —Etc *#13 **TP/#1

The director of staff services at the giant financial services firm, UniCredit Group, installed the most thorough internal customer satisfaction measures scheme I have seen —with exceptional rewards for those who make the grade with their internal customers.

21. Have you had in the last year a one-day, intense offsite with each (?) of your internal customers —followed by a big celebration of “things gone right”?

22. Have you in the last week pushed someone to do some family thing that you fear might be overwhelmed by deadline pressure?

23. Have you learned the names of the children of everyone who reports to you? (If not, you have six months to fix it.) 24. Have you taken in the last month an interesting-weird outsider to lunch?

25. Have you in the last month invited an interesting-weird outsider to sit in on an important meeting?

26. Have you in the last three days discussed something interesting, beyond your industry, that you ran across in a meeting, reading, etc?

27. Have you in the last 24 hours injected into a meeting “I ran across this interesting idea in [strange place]”?

28. Have you in the last two weeks asked someone to report on something, anything that constitutes an act of brilliant service rendered in a “trivial” situation— restaurant, car wash, etc? (And then discussed the relevance to your work.) 29.

Have you in the last 30 days examined in detail (hour by hour) your calendar to evaluate the degree “time actually spent” mirrors your “espoused priorities”?

(And repeated this exercise with everyone on team.) 30. Have you in the last two months had a presentation to the group by a “weird” outsider?

You = Your calendar

*

*Calendars

never

lie

All we have is our time. The way we spend our time

is

our priorities,

is

“strategy.” our

Your calendar knows what you really care about. Do you?

31. Have you in the last two months had a presentation to the group by a customer, internal customer, vendor featuring “working folks” 3 or 4 levels down in the vendor organization? 32. Have you in the last two months had a presentation to the group of a cool, beyond-our-industry ideas by two of your folks?

33. Have you at every meeting today (and forever more) re-directed the conversation to the practicalities of implementation concerning some issue before the group?

34. Have you at every meeting today (and forever more) had an end-of-meeting discussion on “action items to be dealt with in the next 4, 48 hours? (And then made this list public —and followed up in 48 hours.) And made sure everyone has at least one such item.) 35. Have you had a discussion in the last six months about what it would take to get recognition in local-national poll of

“best places to work”?

36. Have you in the last month approved a cool-different training course for one of your folks?

37. Have you in the last month taught a front-line training course?

38. Have you in the last week discussed the idea of Excellence? (What it means, how to get there.) 39. Have you in the last week discussed the idea of “Wow”? (What it means, how to inject it into an ongoing “routine” project.) 40. Have you in the last 45 days assessed some major process in terms of the details of the “experience,” as well as results, it provides to its external or internal customers?

41. Have you in the last month had one of your folks attend a meeting you were supposed to go to which gives them unusual exposure to senior folks?

42. Have you in the last 60 (30?) days sat with a trusted friend or “coach” to discuss your “management style”—and its long- and short-term impact on the group?

43. Have you in the last three days considered a professional relationship that was a little rocky and made a call to the person involved to discuss issues and smooth the waters? (Taking the “blame,” fully deserved or not, for letting the thing-issue fester.) 44. Have you in the last … two hours … stopped by someone’s (two-levels “down") office workspace for 5 minutes to ask “What do you think?” about an issue that arose at a more or less just completed meeting? (And then stuck around for 10 or so minutes to listen —and visibly taken notes.) 45. Have you … in the last day … looked around you to assess whether the diversity pretty accurately maps the diversity of the market being served? (And …) 46. Have you in the last day at some meeting gone out of your way to make sure that a normally reticent person was engaged in a conversation —and then thanked him or her, perhaps privately, for their contribution?

47. Have you during your tenure instituted very public (visible) presentations of performance?

48. Have you in the last four months had a session specifically aimed at checking on the “corporate culture” and the degree we are true to it—with all presentations by relatively junior folks, including front-line folks? (And with a determined effort to keep the conversation restricted to “real world” “small” cases—not theory.) 49. Have you in the last six months talked about the Internal Brand Promise?

50. Have you in the last year had a full-day off site to talk about individual (and group) aspirations?

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.

R.O.I.R.

R eturn O n I nvestment In R elationships

Job One.

“You must care.”

Melvin Zais —General

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

—Henry Clay

The magic number 25.

Mbwa.

Calendars never lie.

Excellence.

Always.

Tom Peters/0709.07

MBWA * *5,000 miles for a 5-minute face-to -face meeting (courtesy super agent Mark McCormick)

When Bob Waterman and I wrote In Search of

Excellence

in 1982, business was “by the numbers”—and the Americans were struggling (to put it mildly) with hands on, tactile stuff, like Japanese quality. Then, at Hewlett Packard, we were introduced to the famed “HP Way,” the centerpiece of which was in-touch management. HP had a term for this … MBWA.

(Managing By Wandering Around.)

Bob and I fell in immediate love. Not only was the idea per se important and cool, but it symbolized everything we were coming to cherish —enterprises where bosses leaders were in immediate touch with and emotionally attached to workers, customers, the product. The idea is as important or more important in fast-paced 2007 as it was in 1982.

“20-minute rule”

—Craig Johnson/30 yrs

Craig Johnson, a famed Venture Capitalist for three decades …

refuses to invest in companies that are more than a 20-minute drive from his office.

To guide them through the serpentine path ahead, he insists that he must be in constant touch as banker, advisor, friend.

*Hank Paulson, China visits, Fortune 1127.06

*

China is clearly our most important economic partner. Our dialog with China was not what it might have been when Hank Paulson took over as Secretary of the Treasury. Immediate improvement occurred for numerous reasons, not least of which were Paulson’s

SEVENTY TRIPS

China while at Goldman Sachs. to

“I call 60 CEOs

[in the first week of the year]

to wish them happy New Year. …”

—Hank Paulson, former CEO, Goldman Sachs Source: Fortune , “Secrets of Greatness,” 0320.05

MBWA, Grameen Style!

“Conventional banks ask their clients to come to their office. It’s a terrifying place for the poor and illiterate. …

The entire Grameen Bank system runs on the principle that people should not come to the bank, the bank should go to the people.

… If any staff member is seen in the office, it should be taken as a violation of the rules of the Grameen Bank. … It is essential that [those setting up a new village Branch] have no office and no place to stay. The reason is to make us as different as possible from government officials .” Source: Muhammad Yunus, Banker to the Poor

“

You must

be

the change you wish to see in the world.”

Gandhi

“

It’s always showtime.”

—David D’Alessandro, Career Warfare

“… a blinding flash of the obvious”

—Manny Garcia

“All this” [this little riff] is indeed, as seminar participant and leading Burger King franchisee Many Garcia once said to me, “obvious.” * But observation over four decades ** suggests that amidst the hubbub and travails of a typical day’s work, the so called obvious is often-usually left unattended. For perfectly good reasons, another week passes without a visit to our equivalent of the Starbucks shops or HP R&D labs, without the equivalent to Hank Paulsen’s “How ya doin’?” call to a key customer. My [Tom Peters] Job One in life? Remind busy folks of the obvious!

* Manny Garcia/1983: “Tom, I hope you won’t be insulted when I say this was the best seminar I’ve ever been to—and it was a blinding flash of the obvious.” ** I had two commanding officers during my two Vietnam tours in U.S. Naval Mobile Construction Battalion NINE (1966-1968). One was a Howard Shultz look-alike —instinctively in the field. The other was an in the office “leader.” The one produced. The other didn’t. At age 24 I learned an incredible life lesson, though I couldn’t describe it well until tripping over HP’s MBWA/Managing By Wandering Around.

The “XF-50”: 50 Ways to Enhance Cross Functional Effectiveness and Deliver Speed, “Service Excellence” and “Value added Customer ‘Solutions’”

X =XFX*

*

Excellence = Cross-functional Excellence

A 2007 letter from John Hennessy, president of (1) Stanford University, to alumni laid out his long-term “vision” for that esteemed institution. The core of the vision’s promise was more aimed at solving some of the world’s complex systemic problems. (2) The chief of ago, announced a “revolutionary” new drug discovery process—human-scale Discovery multi-disciplinary research GlaxoSmithKline , a few years centers of interdisciplinary excellence, called Centers of Excellence in Drug . (It worked.) (3) Likewise, amidst a study of organization effectiveness in the key to that success was their oil industry’s sector, I came across a particularly successful firm—one physical and organizational mingling of formerly warring (two sets of prima donnas) geologists and geophysicists . , exploration

(4) The cover story in approach, Dartmouth Medicine “microsystems,” patient outcomes in hospitals by forming , the Dartmouth med school magazine, featured a “revolutionary” as “the big idea that [might] save U.S. healthcare.” The nub is providing successful multi-function patient-care teams , including docs, nurses, labtechs and others. (“Co-operating doc” may top the oxymoron scale.) (5) One of the central responses to 911 is an effort to get intelligence services released , home to some of the world’s most viscous turf wars, talking to one another—we may have seen some of the fruits of that effort in the recently National Intelligence Estimate order of magnitude since Gulf War One . And in the military, inter-service co-operation has increased by an —some of the services’ communication systems can actually be linked to those of other services, a miracle almost the equal of the Christmas miracle in my book!

1. It’s our organization to make work—or not. It’s not “them,” the outside world that’s the problem. The enemy is us. Period.

2. Friction free! Dump 90% of “middle managers”—most are advertent or inadvertent “power freaks.” We are all—every one of us—in the Friction Removal Business, one moment at a time, now and forevermore.

3. No “stovepipes”! “Stove-piping,” “Silo-ing” is an Automatic Firing Offense. Period. No appeals. (Within the limits of civility, somewhat “public” firings are not out of the question—that is, make one and all aware why the axe fell.) 4. Everything on the Web. This helps. A lot. (“Everything” = Big word.) 5. Open access. All available to all. Transparency, beyond a level that’s “sensible,” is a de facto imperative in a Burn-the-Silos strategy.

6.

Project managers rule!! Project managers running XF (cross functional) projects are the Elite of the organization, and seen as such and treated as such. (The likes of construction companies have practiced this more or less forever.) 7. “Value-added Proposition” = Application of integrated resources. (From the entire supply chain.) To deliver on our emergent business raison d’etre, and compete with the likes of our Chinese and Indian brethren, we must co operate with anybody and everybody “24/7.” IBM, UPS and many, many others are selling far more than a product or service that works —the new “it” is pure and simple a product of XF co operation; “the product is the co-operation” is not much of a stretch.

“We have met the enemy and he is us.”

Walt Kelly/“Pogo” —

Schlumberger!

A January 2008 BusinessWeek cover story informed us that Schlumberger may well take over the world:

“THE GIANT STALKING BIG OIL: How Schlumberger Is Rewriting the Rules of the Energy Game.”

In short, Schlumberger knows how to create and run oilfields, anywhere, from drilling to fullscale production to distribution. And the nugget is hardcore, relatively small, technically accomplished, highly autonomous teams. As China and Russia, among others, make their move in energy, state run companies are eclipsing the major independents. (China’s state oil company just surpassed Exxon in market value.) At the center of it all, abetting these new players who are edging out the Exxons and BPs, the Kings of Large-scale, Long-term Project Management wear Schlumberger overalls. (The pictures in the article from Siberia alone are worth the cover price.) At the center of the center of the Schlumberger “empire” is a relatively newly configured outfit, reminiscent of IBM’s Global Services and UPS’ integrated logistics’ experts and even Best Buy’s now ubiquitous “Geek Squads.” The Schlumberger version is simply called IPM, for Integrated Project Management. It lives in a nondescript building near Gatwick Airport, and its chief says it will do “just about anything an oilfield owner would want, from drilling to production”—that is, as BusinessWeek put it, “[IPM] strays from [Schlumberger’s] traditional role as a service provider* and moves deeper into areas once dominated by the majors.” (*My old pal was solo on remote offshore platforms interpreting geophysical logs and the like .)

8.

“XF work” is the direct work of leaders!

9.

“Integrated solutions” = Our “Culture.” (Therefore: XF = Our culture.) 10. Partner with “best-in-class” only. Their pursuit of Excellence helps us get beyond petty bickering. An all-star team has little time for anything other than delivering on the (big) Client promise.

11. All functions are created equal! All functions contribute equally! All = All.

12. All functions are “PSFs,” Professional Service Firms. “Professionalism” is the watchword —and true Professionalism rise above turf wars. You are your projects, your legacy is your projects —and the legacy will be skimpy indeed unless you pass, with flying colors, the “works well with others” exam!

13. We are all in sales! We all (a-l l) “sell” those Integrated Client Solutions. Good salespeople don’t blame others for screw-ups—the Clint doesn’t care. Good salespeople are “quarterbacks” who make the system work-deliver.

14. We all invest in “wiring” the Client organization—we develop comprehensive relationships in every part (function, level) of the Client’s organization. We pay

special attention to the so called “lower levels,” short on glamour, long on the ability to make things happen at the “coalface.”

15. We all “live the Brand”—which is Delivery of Matchless Integrated Solutions which transform the Client’s organization. To “live the brand” is to become a raving fan of XF co-operation.

C(I)>C(E)*

* Internal customer relations [C(I)] are perhaps-often more important than external relationships [C(E)]. That is, if you Internal Relationships are excellent, you’ll have your whole company working for you to get your jobs to the head of the queue.

16. We use the word “partner” until we want to barf! (Words matter! A lot!) 17. We use the word “team” until we want to barf. (Words matter! A lot!) 18. We use the word “us” until we want to barf. (Words matter! A lot!) 19. We obsessively seek Inclusion —and abhor exclusion. We want more people from more places (internal, external —the whole “supply chain”) aboard in order to maximize systemic benefits.

20. Buttons & Badges matter —we work relentlessly at team (XF team) identity and solidarity. (“Corny”? Get over it.) 21. All (almost all) rewards are team rewards. 22. We keep base pay rather low —and give whopping bonuses for excellent team delivery of “seriously cool” cross-functional Client benefits.

23.

WE NEVER BLAME OTHER PARTS OF THE

ORGANIZATION FOR SCREWUPS.

24.

WE TAKE THE HEAT —THE WHOLE TEAM. (For anything and everything.) (Losing, like winning, is a team affair.) 25.

“BLAMING” IS AN AUTOMATIC FIRING OFFENSE.

26.

“Women rule.” Women are simply better at the XF communications stuff —less power obsessed, less hierarchically inclined, more group-team oriented.

Women’s Negotiating Strengths *Ability to put themselves in their counterparties’ shoes *Comprehensive, attentive and detailed communication style *Empathy that facilitates trust-building *Curious and attentive listening *Less competitive attitude *Strong sense of fairness and ability to persuade *Proactive risk manager *Collaborative decision-making Source: Horacio Falcao, Cover story/May 2006, World Business , “Say It Like a Woman: Why the 21 st -century negotiator will need the female touch”

Women’s Strengths Match New Economy Imperatives: Link [rather than rank] workers; favor interactive-collaborative leadership

style [empowerment beats top-down decision

making]; sustain fruitful collaborations; comfortable with sharing information; see redistribution of power as victory, not surrender; favor multi-dimensional feedback; value technical & interpersonal skills, individual & group contributions equally; readily accept ambiguity; honor intuition as well as pure “rationality”; inherently flexible; appreciate

cultural diversity

.

—Judy B. Rosener, America’s Competitive Secret: Women Managers

“TAKE THIS QUICK QUIZ:

at once?

appearance?

Who manages more things

Who puts more effort into their

Who usually takes care of the details?

people?

do’ list?

events?

Who finds it easier to meet new

conversation?

Who asks more questions in a

Who is a better listener?

Who has more interest in communication skills?

Who is more inclined to get involved?

Who encourages harmony and agreement?

better intuition?

Who has

Who works with a longer ‘to

Who enjoys a recap to the day’s

Who is better at keeping in touch with others?” Source: Selling Is a Woman’s Game: 15 Powerful Reasons Why Women Can Outsell Men , Nicki Joy & Susan Kane-Benson

27. Every member of our team is an honored contributor. “XF project Excellence” is an “all hands” affair.

28. We are our XF Teams! XF project teams are how we get things done.

29. “Wow Projects” rule, large or small—Wow projects demand by definition XF Excellence.

30. We routinely attempt to unearth and then reward “small gestures” of XF co operation.

31. We invite Functional Bigwigs to our XF project team reviews.

32. We insist on Client team participation —from all functions of the Client organization.

33. An “Open talent market” helps make the projects “silo-free.” People want in on the project because of the opportunity to do something memorable —no one will tolerate delays based on traditional functional squabbling. 34. Flat! Flat = Flattened Silos. Flat = Excellence based on XF project outcomes, not power-hoarding within functional boundaries. 35. New “C-level”? We more or less need a “C-level” job titled Chief Bullshit Removal Officer. That is, some kind of formal watchdog whose role in life is to make cross functionality work, and I.D. those who don’t get with the program.

36.

Huge (H-U-G-E) co-operation bonuses. Senior team members who conspicuously shine in the “working together” bit are rewarded or punished Big Time. (A million bucks in one case I know —and a non cooperating very senior was sacked.)

James Robinson III:

$500K

(on the spot, collaboration)

Alan Puckett: Fire

the best! (failure to collaborate)

37.

Get physical!! “Co-location” is the most powerful “culture changer. Physical X-functional proximity is almost a guarantee (yup!) of remarkably improved co operation —to aid this one needs flexible workspaces that can be mobilized for a team in a flash.

38. Ad hoc. To improve the new “X-functional Culture,” little XF teams should be formed on the spot to deal with an urgent issue —they may live for but ten days, but it helps the XF habit, making it normal to be “working the XF way.” 39. “Deep dip.” Dive three levels down in the organization to fill a senior role with some one who has been pro-active on the XF dimension.

40. Formal evaluations. Everyone, starting with the receptionist, should have an important XF rating component in their evaluation.

41. Demand XF experience for, especially, senior jobs. The military requires all would-be generals and admirals to have served a full tour in a job whose only goals were cross-functional. Great idea! 42. Early project “management” experience. Within days, literally, of coming aboard folks should be “running” some bit of a project, working with folks from other functions —hence, “all this” becomes as natural as breathing.

43. “Get ’em out with the customer.” Rarely does the accountant or bench scientist call one the customer. Reverse that. Give everyone more or less regular “customer-facing experiences.” One learns quickly that the customer is not interested in our in-house turf battles!

44. Put “it” on the–every agenda. XF “issues to be resolved” should be on every agenda —morning project team review, weekly exec team meeting, etc. A “next step” within 24 hours (4?) ought to be part of the resolution.

45. XF “honest broker” or ombudsman. The ombudsman examines XF “friction events” and acts as Conflict Resolution Counselor. (Perhaps a formal conflict resolution agreement?) 46. Lock it in! XF co-operation, central to any value-added mission, should be an explicit part of the “Vision Statement.” 47. Promotions. Every promotion, no exceptions, should put XF Excellence in the

top 5 (3?) evaluation criteria.

48. Pick partners based on their “co-operation proclivity.” Everyone must be on board if “this thing” is going to work; hence every vendor, among others, should be formally evaluated on their commitment to XF transparency —e.g., can we access anyone at any level in any function of their organization without bureaucratic barriers?

49. Fire vendors who don’t “get it”—more than “get it,” welcome “it” with open arms.” 50. Jaw. Jaw. Jaw. Talk XF cooperation-value-added at every opportunity. Become a relentless bore!

51.

Excellence! There is a state of XF Excellence per se. Talk about it. Pursue it. Aspire to nothing less.

X =XFX*

*

Excellence = Cross-functional Excellence

“C-levels” to Abet Cross-functional Excellence

CGRO

/ Chief Grunge Removal Officer

CXFCO

/ Chief Cross-functional Communication Officer

CIS-CDO

/ Chief Information Sharing & Common Database Officer

CHRO(PL) /

Chief Human resources Officer (Project Managers, Love and Care of)

CPMFO

/ Chief Project Management Finance Officer

CTAO

/ Chief Team-space Assignments Officer

CE(XFNC) /

Chief Executioner (Cross-functional Non-cooperation!)

CXFBPO

/ Chief Cross-functional Brownie-points Officer

In We have “C-level” officers for any damn thing you can mention. So I thought I’d add my voice to the fray. If XF (Cross-functional) performance is a/the paramount issue for modern enterprise effectiveness (where one is bringing to bear the wherewithal of the entire enterprise to provide high-value, systemic “solutions” for customers), then XFX/Cross-functional excellence is necessarily priority #1. And we need an exec to lead the charge—try these job titles on for size!

The “XF Bible”

Building a Knowledge driven Organization: Overcome Resistance to the Free Flow of Ideas. Turn Knowledge into New Products and Services. Move to a Knowledge based Strategy

—Robert Buckman

The 180 degree “Middle Manager Flip” @ Buckman Labs … From:

“information choke points”

To:

“knowledge transfer facilitators,” with

100% (!!!)

of their rewards based on spurring co-operation across former barriers.

Bob Buckman runs Buckman Labs, a half-billion dollar, Memphis-based specialty chemicals company. You might well roll your eyes at the overused “customer solutions” moniker—but Buckman does just that with panache and for profit, creating and applying chemical compounds in customized ways to deal with production and cleanup issues for specific customer facilities in the likes of the paper and leather-making industries. The devotion to custom “solutions” is the bedrock, the alpha to omega, of the firm’s extraordinary new-product and financial record. Those closer to the intellectual fray than me claim that Bob gets “inventor” rights in the now ubiquitous “knowledge management” arena.

In any event, this book is the Buckman Labs saga in extraordinary detail —it is particularly valuable because it moves so far beyond the relatively easy software-technology bit and emphasizes the way in which a company’s culture must be jerked around 180-degrees to destroy former functional barriers. E.g., middle managers, typically choke points guarding information and access to their domain, became “knowledge transfer facilitators,” with 100% (!!!) of their rewards based on spurring co-operation across former barriers.