Transcript Tom Peters’ Leading for Excellence: Surpassing “Unrealistic” Expectations AHCA/NCAL 55th Annual Convention & Expo Miami Beach/10.04.2004

Tom Peters’
Leading for Excellence:
Surpassing “Unrealistic”
Expectations
AHCA/NCAL 55th Annual Convention & Expo
Miami Beach/10.04.2004
Slides at …
tompeters.com
Goals.
Tom’s Healthcare9: Goals2004
1. Stop killing people in acute-care settings through
negligence/lousy management/craft mores. (THIS IS ABOUT
ATTITUDE & WILL … NOT $$$$.)
2. Adopt Patient-centric acute-care models (a la Planetree).
3. Embrace the Boomer Tsunami.
4. Prepare for consumer-driven healthcare.
5. Revise-Revolutionize the entire system (K-90) to revolve
around Wellness-Prevention.
6. Erase the disgrace of uninsured Americans … in Planet’s
Wealthiest Economy.
7. Re-orient Boomer-driven Eldercare toward Optimism
(“The time of your life!”) (60 – 30 = 90 – 60).
8. Re-imagine! What an Opportunity!
9. Excellence = State of Mind.
Musings …
This is the most
important speech
I’ve given since
NAESP!
Never felt it so keenly …
Problem-focused?
Opportunity-focused?
Regulations
Sky-high (“Unrealistic”) Expectations
Inadequate Funding
Staffing Woes
Etc.
Etc.
Etc.
“Growth market” or …
Magical Opportunity to
Lead this Demographic
Revolution … and Reimagine Aging?
Biases.
95/Ginger Cove/
Life Care Services
T = SS – 34D
Cool? Oh Bleep?
60 – 30 = 90 - 60
TP/61/CR: Diet … Eating Habits/Philosophy …
Nutrition Supplements … Breathing …
Stretching … Meditation (Short, Long) …
Exercise … Mini-walks … Sound … Flowers …
Aromatherapy … Baths … Labyrinthine …
Massage … Acupuncture … Chiropractic … Big
CR/“CR Pauses” … Water (Japanese bath) …
“Stop. Look. Listen.” ... Monitor & Measure &
Record. New World Order = Reverse 5 decades
of abuse (With damn little help from my M.D. friends)
Revolution.
Period.
It is the foremost task—
and responsibility—
of our generation to
re-imagine our
enterprises, private
and public. —from the back cover,
Re-imagine!
“Beware of the
tyranny of making
Small Changes
to Small Things.
Rather, make Big
Changes to Big
Things.”
—Roger Enrico, former Chairman, PepsiCo
The greatest danger
for most of us
is not that our aim is
too high
and we miss it,
but that it is
too low
and we reach it.
Michelangelo
IS/IT. Go for the
Gold. (Or: At Least Try and
Get Off the Bench.)
“Some grocery stores
have better
technology than our
hospitals and
clinics.” —Tommy Thompson, HHS
Secretary
Source: Special Report on technology in healthcare, U.S. News & World Report (07.04)
“Our entire facility is digital.
No paper, no film, no
medical records. Nothing. And it’s all integrated—from the lab to
X-ray to records to physician order entry. Patients don’t have to
wait for anything. The information from the physician’s office is
in registration and vice versa. The referring physician is
immediately sent an email telling him his patient has shown up.
… It’s wireless in-house. We have 800 notebook computers that
are wireless. Physicians can walk around with a computer that’s
pre-programmed. If the physician wants, we’ll go out and wire
their house so they can sit on the couch and connect to the
network. They can review a chart from 100 miles away.” —David
Veillette, CEO, Indiana Heart Hospital (HealthLeaders/12.2002)
Consumerism.
“We expect consumers to
move into a position of
dominance in the early
years of the new century.”
Dean Coddington, Elizabeth Fischer, Keith
Moore & Richard Clarke, Beyond Managed Care
Amen!
“The Age of the
Never Satisfied
Customer”
Regis McKenna
Quality.
Whoops.
Ouch.
Yikes.
“Without being disrespectful, I
consider the U.S. healthcare delivery
system the largest cottage industry in
the world. There
are virtually no
performance measurements
and no standards. Trying to
measure performance … is the next
revolution in healthcare.”
Richard Huber, former CEO, Aetna
“As unsettling as the prevalence of
inappropriate care is the enormous amount of
what can only be called ignorant care. A
surprising 85% of everyday medical
treatments have never been scientifically
validated. … For instance, when family
practitioners in Washington were queried about
treating a simple urinary tract infection, 82
physicians came up with an extraordinary 137
strategies.”
Demanding Medical Excellence: Doctors and Accountability
in the Information Age, Michael Millenson
CDC 1998: 90,000 killed
and 2,000,000 injured
from nosocomial
[hospital-caused] drug
errors & infections
HealthGrades/Denver:
195,000
hospital deaths per year in the U.S., 2000-2002 =
390 full jumbos/747s in the drink per year.
Comments: “This should give you pause when
you go to the hospital.” —Dr. Kenneth Kizer, National Quality
. “There
is little evidence that
patient safety has improved in the
last five years.” —Dr. Samantha Collier
Forum
Source: Boston Globe/07.27.04
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
It’s the
“Experience”!
“Experiences are as
distinct from services
as services are from
goods.”
Joseph Pine & James Gilmore, The Experience Economy:
Work Is Theatre & Every Business a Stage
“The [Starbucks] Fix” Is on …
“We have identified a ‘third
place.’ And I really believe that
sets us apart. The third place is
that place that’s not work or
home. It’s the place our
customers come for refuge.”
Nancy Orsolini, District Manager
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
A Certain Sort
of Experience:
Women.
1. Men and women are different.
2. Very different.
3. VERY, VERY DIFFERENT.
4. Women & Men have a-b-s-o-l-u-t-e-l-y
nothing in common.
5. Women buy lotsa stuff.
6. WOMEN BUY A-L-L THE STUFF.
7. Women’s Market = Opportunity No. 1.
8. Men are (STILL) in charge.
9. MEN ARE … TOTALLY, HOPELESSLY
CLUELESS ABOUT WOMEN.
10. Women’s Market = Opportunity No. 1.
Experience
Plus:
Planetree.
“If one didn’t know better, one might
think that hospitals set out to design
systems that provide the most
sophisticated technical care but
deliver the worst possible experience
to sick people.” —Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
“It was the goal of the
Planetree Unit to help
patients not only get well
faster but also to stay well
longer.” —Putting Patients First, Susan Frampton,
Laura Gilpin, Patrick Charmel
The 9 Planetree Practices
1. The Importance of Human Interaction
2. Informing and Empowering Diverse Populations: Consumer
Health Libraries and Patient Information
3. Healing Partnerships: The importance of Including Friends
and Family
4. Nutrition: The Nurturing Aspect of Food
5. Spirituality: Inner Resources for Healing
6. Human Touch: The Essentials of Communicating
Caring Through Massage
7. Healing Arts: Nutrition for the Soul
8. Integrating Complementary and Alternative Practices
into Conventional Care
9. Healing Environments: Architecture and Design Conducive
to Health
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
1. The Importance of
Human Interaction
“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
Press Ganey Assoc/1999: 139,380 former patients
from 225 hospitals
0 of top 15 factors determining Patient Satisfaction
referred to patient’s health outcome
PS directly related to Staff Interaction
PS directly correlated with ES (Employee Satisfaction)
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
Mgrs re staff: wages, security, promotion
opportunities
Staff re staff: interesting work (M: 5 of 10),
appreciation (8 of 10), sense of being “in” about
what’s going on (10 of 10)
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
The Customer Comes
Second: Put your People
First and Watch ’Em Kick
Butt —Hal Rosenbluth (and Diane McFerrin Peters)
“Planetree is about
human beings caring
for other human
beings.” —Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel (“Ladies and
gentlemen serving ladies and gentlemen”—4S credo)
2. Informing and
Empowering Diverse
Populations: Consumer
Health Libraries and
Patient Information
3. Healing
Partnerships: The
importance of
Including Friends
and Family
“When hospital staff members are
asked to list the attributes of the
‘perfect patient and family,’ their
response is usually a passive
patient with no family.” —Putting Patients First,
Susan Frampton, Laura Gilpin, Patrick Charmel
“Family members, close friends and
‘significant others’ can have a gar
greater impact on patients’ experience
of illness, and on their long-term
health and happiness, than any
healthcare professional.” —Through the
Patient’s Eyes
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
4. Nutrition: The
Nurturing Aspect
of Food
Meals are central events
vs
“There, you’re fed.”*
*Irony: Focus on “nutrition” has reduced focus on “food” and “service”
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
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
7. Healing Arts:
Nutrition for the Soul
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
Access to nurses station:
“Happen to”
vs
“Happen with”
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
The Eden
Alternative
The Ten Principals of the Eden Alternative
1. The three plagues of loneliness, helplessness, and boredom
account for the bulk of suffering among Elders.
2. Life in an Elder-centered community revolves around close
and continuing contact with children, plants, and animals.
These ancient relationships provide young and old alike with a
pathway to a life worth living.
3. Companionship is the antidote to loneliness. In an Eldercentered community we must provide easy access to human
and animal companionship.
4. A healthy Elder-centered community seeks to balance the
care that is being given with the care that is being received.
Elders need opportunity to give care and caregivers need
opportunities need opportunities to receive care.
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
The Ten Principals of the Eden Alternative
5. Variety and Spontaneity are the antidotes to
boredom. The Elder-centered community is rich is rich
in opportunities to sample these ancient pleasures.
6. An Elder-centered community understands that
passive entertainment cannot fill a human life.
7. The Elder-centered community takes medical
treatment down from its pedestal and places it into the
service of genuine human caring.
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
The Ten Principals of the Eden Alternative
8. In an Elder-centered community, decisions should
be made by the Elders or those as close to the Elders
as possible.
9. An Elder-centered community understands human
growth cannot be separated from human life.
10. Wise leadership is the lifeblood of any struggle
against the Three Plagues. For it, there can be no
substitute.
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
Conclusion:
Caring/Growth
“Experience”
“The most basic
question we need to
pose in caring for
others is this: Is this a
loving act?” —Leland Kaiser, “Holistic
Hospitals”
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
Talent I.
“The leaders of Great
Groups love talent and know
where to find it. They revel in
the talent of others.”
Warren Bennis & Patricia Ward Biederman,
Organizing Genius
EVP = Challenge,
professional growth,
respect, satisfaction,
opportunity, reward
Source: Ed Michaels et al., The War for Talent
High T/O Is Not Inevitable!
CostCo
vs.
Wal*Mart
Talent II.
“AS LEADERS, WOMEN
RULE: New Studies find
that female managers
outshine their male
counterparts in almost
every measure”
Title, Special Report, BusinessWeek, 11.20.00
Lead.
“Ninety percent of what
we call ‘management’
consists of making it
difficult for people to get
things done.” – P.D.
“Create a
‘cause,’ not a
‘business.’ ”
G.H.:
“Management has a lot to do
with answers. Leadership is a
function of questions. And the
first question for a leader
always is: ‘Who do we intend
to be?’ Not ‘What are we going
to do?’ but ‘Who do we intend to
be?’” —Max De Pree, Herman Miller
BZ: “I am a …
Dispenser of
Enthusiasm!”
“You must be
the change you
wish to see in the
world.”
Gandhi
“The single best
way to predict
the future is to
create it.”
—anon