Aligning Delivery & Financing Systems to Build a Culture ...
Aligning Culture and
Transcript of Aligning Culture and
research technology consulting
Talent Development
Aligning Culture and
Cultivating Accountability
Leadership Retreat
Vanderbilt University Medical Center
October 2019
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Today’s Agenda
Aligning Culture
Cultivating Accountability
Introductions
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Cultural Alignment Starts with Strategic Direction
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Connection Between Direction and Culture
Set Direction
Align the Culture
Guiding Decisions
Cultural Reinforcement
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Visionary Organizations Align Practices with Strategic Direction
Source: Collins J and Porras J, “Building Your Company’s Vision,” Harvard
Business Review, September–October 1996: 65–77; Collins, “Aligning Action
and Values,” www.jimcollins.com, Talent Development research and analysis.
Part of Everything They Do
Staff
Selection
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Three Categories to Guide Alignment
Source: Talent Development research and analysis.
Hardwiring a Supportive Culture
People
• Selection
• Role
assignments
• Performance
accountability
• Civility
• Mentorship and
collaboration
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Physical Space Embodies Culture at Trader Joe’s
The Trader Joe’s Vision:
“At Trader Joe’s, we create an outstanding customer experience around the
discovery and enjoyment of amazing food and beverages. It’s what we do, and our
crew is our bread and butter, alongside the Trader Joe’s bread and butter.”
Store Design
• Nautical themed designs
• Stores feature tasting huts &
employees wear Hawaiian
shirts
• Small store fronts with a
controlled customer traffic
flow
Organization Structure
• Crew – considered the heart and soul
of Trader Joe’s
• Mates – ensure every customer has a
fun, friendly and informative experience
• Captains – exemplifies unwavering
integrity and commitment, the leaders
of the store
Product Selection
• Rotating product placements
based on what's best for the
customer not margins
• Fewer choices, subscribing to
less is more mantra
• “Try-before-you-buy” policy
Source: Llopis G, “Why Trader Joe's Stands Out From All the Rest in the Grocery Business,”
Forbes, https://www.forbes.com/sites/glennllopis/2011/09/05/why-trader-joes-stands-out-from-all-
the-rest-in-the-grocery-business/#66fed7224dec; Talent Development research and analysis.
Example: Aligned Infrastructure
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Aligning Infrastructure at Vanderbilt
Increased My Health at Vanderbilt enrollment to
481K patients through infrastructure changes:
• Pillar goals and tracking
• Change to enrollment opt-out
• Overall communication & promotion.
• Integrate promotion by clinicians in encounters
• Integrate enrollment into New Employee
Orientation
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Aligning Infrastructure at Vanderbilt
The Vanderbilt Comprehensive Care Clinic, established 1994
A patient-focused medical home for people living with HIV
• Designed to both welcome patients and maintain their privacy
• Fosters patient’s pride in bringing family and friends to the Clinic
• Co-location of clinic, ancillaries, research, and training in same space.
• 100 Oaks location makes access easier
Physical Environment & Work Design
• Multiple disciplines integrated into CCC
• Innovative leader who pushes the envelope, and fosters others to innovate.
• Staff are driven by mission and helping colleagues and patients.
• Medical Home Certification
Org Structure & Commitment
• Patients see multiple disciplines in one visit
• Training Center for 35k professionals annually
• Participation in research - site clinical trials, 200k blood bank samples
Service Integration
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No Shortage of Recognition at 3M
Source: Collins J and Porras J, Built to Last: Successful Habits of Visionary
Companies, New York: HarperBusiness, 1994: 150–160; “A Century of
Innovation, http://www.3M.com; Talent Development research and analysis.
Rewarding Adherence to Vision
Example: Aligned People
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Aligning People at Vanderbilt
Elevate Awards
Recognizing exemplary behavior,
leadership and teamwork
Defining Personalized Care
A multi-year program to elevate our
culture of service
Each quarter, VUMC gives these
organizational awards to exemplars
in the following categories:
• Credo for credo behaviors.
• Five Pillar Leader for leadership
balance across the pillars and
Credo.
• Teams who made a notable
change or impact.
• A focus on 5 key tactics in delivering
consistent, high quality service
experiences.
• Time-spaced training tailored to
both staff and clinician roles.
• Initial results – increases in courtesy
and communication scores and rank
in FY19 over prior year.
• Clinician complete rate – 11% / 418
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Starbucks Puts Its Money Where Its Vision Is
Source: Gallo C, “How Starbucks CEO Howard Schultz Inspired Us To Dream Bigger,” Forbes,
https://www.forbes.com/sites/carminegallo/2016/12/02/how-starbucks-ceo-howard-schultz-
inspired-us-to-dream-bigger/#4fe10e48e858; Talent Development research and analysis.
Senior Leadership Stayed True to Guiding Principles
Starbucks Closes Its Doors to
Maintain Customer Commitment
$6M Lost revenue during
store closures
7,100 Starbucks stores
closed to retrain
baristas
• Starbucks was the first U.S.
company to offer comprehensive
healthcare coverage and stock to
part-time workers.
• Maintained coverage even after
2009 when the cost of offering
health insurance was up nearly
50% per partner.
Starbucks Leads the Industry
in Employee Benefits
“This is not about training, this is about
the love and compassion and
commitment that we all need to have for
the customer.”
Howard Shultz
CEO (at time)
Example: Aligned Leadership Commitment
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Aligning Leadership Commitment at Vanderbilt
Expansion of leadership and
professional development
opportunities
Changes to ensure culture of
inclusion and respect
• These annual physician
leadership development sessions.
• New Associate Dean for
Faculty Development.
• New and revised processes for
reporting and handling of
incidents of sexual harassment,
workplace violence, and
disruptive behavior.
• Expansion of the Office of
Inclusion and Health Equity.
• Robust education targeted for
clinicians, staff, and leaders.
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Exercise
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Exercise
Infrastructure People Leadership Commitment
Using the one-page tool, think about your area. Identify places in each bucket where you
think the culture is aligned. These are things you want to emphasize and keep doing.
Discuss in your table groups. What themes do you see across the areas of alignment you
identified when analyzing your leadership areas?
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Exercise
Continuing to use the one-page tool, think about your area. Identify places in each bucket
where you think the culture is misaligned. These are things you want to stop doing,
change, and/or work with leadership to address.
Infrastructure People Leadership Commitment
Discuss in your table groups. What themes do you see across the areas of misalignment
you identified when analyzing your leadership areas?
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Today’s Agenda
Aligning Culture
Cultivating Accountability
Introductions
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DALLAS
HOUSTON
NEW
ORLEANS
MEMPHISATLANTA
NEW YORK
BOSTON
DETROIT
CHICAGO
MINNEAPOLIS
OMAHA
BILLINGS
SALT LAKE
CITY
PHOENIXLOS
ANGELES
SAN
FRANCISCO
PORTLAND
SEATTLE
ST LOUIS
SAN DIEGO
WASHINGTON
BAHAMAS
SPOKANE
DES
MOINES
ALBUQUERQUE
MILWAUKEE
OKLA CITY
CINCINNATI
CHARLOTTE
CASPER
DENVER
ORLANDO
(300) (200)
(300)
(300)
(100)(100)
(200)
(300)
(200)
(100)
(100)
(200)
(200)
(300)
(200)
(100)
(300)
(300)
(300)
(200) (300)
(200)
(200)
(200)
(200)
(200)
(300)
(200)
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(100)
(200)
SEATTLEGOAL: Be in
no later than day 5 Seeing America
Pacific Mountain Central Eastern
MIAMI(200)GOAL: Minimize
Travel CostsGOAL: Maximize
Tourism Points
Total Points Total Costs
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Getting It Done
Source: Talent Development research and analysis.©2019 Advisory Board • All Rights Reserved • advisory.com
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Three Accountability Prerequisites
Source: Talent Development research and analysis.
Setting Up for Success
Overcoming the Hill
• Defining Standards: I understand the standard I am targeting
• Communicating About Resources:
I have the resources necessary to succeed
• Navigating Obstacles: I can navigate potential obstacles to success
Building Skill
• I have the skills necessary to accomplish this assignment
Strengthening Willingness
• I am willing to invest in the desired outcome
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©2019 The Advisory Board Company • advisory.com Source: Talent Development research and analysis.
Hill: Set Expectations
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Key Leadership Impactions of Health Care Discussed Last Year
Remember:
Expectations Change with Environment
1 Tracking of physician performance will continue to increase in scope and
consequence.
2
Physicians will face increasing pressure to trade individual autonomy for
institutional scale and impact.3
Providing standout patient experience is an increasingly important
business imperative.
Source: Talent Development interviews and analysis.
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Frequently Incomplete Resource Need Assessment
Source: Talent Development research and analysis.
Hill: Communicate About Resources
Assignment:
Design new fall
prevention
protocol
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Costs of Not Communicating About Resources
Source: Talent Development research and analysis.
Hill: Communicate About Resources
Failure to Downward Manage
Leader neglect forces individual
team members to “figure out”
resource access
Failure to Upward Manage
Leader consciously ignores
resource considerations, leaving
individuals in untenable position
Poor Outcomes
• Missed deadlines
• Substandard work-arounds
• Unsustainable results
• Shortages shifted to others
To
Do
To
Do
!To
Do
To
Do
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More Than Just “Godspeed”
Source: Talent Development research and analysis.
Hill: Run Interference
Leader
Leaders can lend
network to team
Leaders have
more positional
authority
Leaders have
deeper
understanding of
organization and
positional structure
Upper
Management
Peer Leaders
Patient
Families
Board of
Directors
Contracted
Technicians
Employed
Physicians
Junior Staff
Vendors
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Exercise:
Addressing
Hills
Think about a place where you are seeing more variable results than you would like. Use
the “hill” categories we have discussed to identify leadership actions you can take to
address “hill” barriers.
Set Expectations Communicate About Resources Run Interference
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Three Accountability Prerequisites
Source: Talent Development research and analysis.
Setting Up for Success
Overcoming the Hill
• Defining Standards: I understand the standard I am targeting
• Communicating About Resources:
I have the resources necessary to succeed
• Navigating Obstacles: I can navigate potential obstacles to success
Building Skill
• I have the skills necessary to accomplish this assignment
Strengthening Willingness
• I am willing to invest in the desired outcome
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©2019 The Advisory Board Company • advisory.com Source: Talent Development Research and Analysis
Skill
Unconscious
Incompetence
Conscious Incompetence Conscious Competence
Unconscious Competence
?
Unaware of need for skill
!
Recognizes need to
learn new skillAcquires skill; makes
conscious effort to use it
Naturally deploys new skill
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Consider Four Kinds of Skill
Technical
SkillAbility to use specialized techniques specifically
acquired for and distinct to a particular profession
Organizational
SkillAbility to navigate the politics and infrastructure of
an organization to achieve a particular objective
Interpersonal
SkillAbility to communicate information, resolve
differences, and work effectively with others
Procedural
SkillAbility to effectively integrate new tasks,
information, and skills into daily routines
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Three Accountability Prerequisites
Source: Talent Development research and analysis.
Setting Up for Success
Overcoming the Hill
• Defining Standards: I understand the standard I am targeting
• Communicating About Resources:
I have the resources necessary to succeed
• Navigating Obstacles: I can navigate potential obstacles to success
Building Skill
• I have the skills necessary to accomplish this assignment
Strengthening Willingness
• I am willing to invest in the desired outcome
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Will
WILL
The degree
of investment
an individual
will make
Extrinsics
Intrinsics Morale
External motivators for
action—
e.g., compensation,
rewards/consequences
Internal motivators for
action—
e.g., desire for a
challenge
Emotional
predisposition to act
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Common Categories of Intrinsic Motivation
Further Exploring ”Intrinsics”
What Drives This Person?
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Finding Meaning in Leisure
Further Exploring a “Sense of Purpose”
Look to Hobbies to Understand Drivers of Purpose
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Today’s Agenda
Aligning Culture
Cultivating Accountability
Introductions
research technology consulting
Talent Development
Aligning Culture and
Cultivating Accountability
Leadership Retreat
Vanderbilt University Medical Center
October 2019