Being Vulnerable

Being Vulnerable

It’s annual review time at my organization and while we could debate the usefulness (or uselessness) of such an exercise and discuss how other large companies are ditching them in favor of other forms of assessments, that’s for another day.  I just redistrict-1264717_1920ached my third anniversary in this role and the other day one of bosses (yes,plural) asked me where I saw myself in a couple of years. My predecessors never stayed longer than three years, choosing to move into different roles so some are wondering if it’s about “that time” for me.  The short answer is no – I have a lot to learn yet.  But I didn’t know how to answer him and that was confusing to me because in previous roles I would have had a clear path to the next step in my career or education but this transition to operations has caused me to rethink my trajectory. I honestly don’t know what’s next and it’s a little scary for me. Prior to operations, I was on a clear path to becoming a leader of learning/leadership development. The work I was doing and the education I was gaining were both intentional choices to help prepare me for that next step. Then, in the words of Emeril, “BAM” I was in operations. Now you could absolutely argue that this move would help me as much as any degree to become a Chief Learning Officer, and you’d be right but it’s given me an opportunity to pause and really reflect. I had no intentions of entering into operations and yet here I am…and don’t think I don’t love my job because I absolutely do…this just wasn’t on my plan. Growth opportunities usually aren’t always planned and I will always be eternally grateful for this one. Now before you start thinking this is a topic of neediness, it’s not. It’s about the value of being vulnerable, opening up to others, and the impact it can make on you and them.

Not that long ago, I’d been particularly discouraged by a number of things at work and honestly had been wondering if this whole “leader of operations” thing is for me. I’m guessing you’ve all been in this spot before or will be and it’s rough. This feeling is so foreign to me. In previous roles, I was confident, I was surrounded by professionals in my same field, I was accomplished, I was good at what I was doing…really good, to be honest. Suddenly,compassion-857748_1920 I found myself feeling like I didn’t know what I was doing…feeling isolated …and feeling like I was failing. What a place to find yourself, huh?  But at work, I never let on like anything was wrong. I was the same happy, positive, optimistic person I had always been. Trying the ole, “fake it til you make it” routine.  Something had to change, so I reached out to one of my closest colleagues.  After sharing my feelings (the other F word for business types), he confided in me that he found himself in that spot often and challenged me to reflect on my first few days/months of my role compared to where I am today. He also said that because of his drive to be the best and constantly evolve that he sometimes forgets to stop and reflect on what has allowed him to be successful and identify what worked. Well that hit home for me. Ever heard of being unconsciously competent? Healthcare operations is so fast paced that often we don’t feel like we have time to reflect, right?  We were and are getting top results (high quality, efficient care wrapped in a world-class experience) but I couldn’t say that any one thing I was doing helped us get there. So I stopped suffering in silence and started opening up to others – being vulnerable – and I have been truly blessed by these conversations. Within 48 hours I’d gotten so many little nuggets of reinforcement. It was both bizarre and amazing. Maybe I was getting them all long but I just was just oblivious. Maybe the universe was trying to tell me something. Who knows, but the timing was perfect.

Just recently, unprovoked, during a performance eval conversation, one of my employees told me that I had helped her grow in ways she didn’t know possible. I had helped her out of this invisible box she’d not known she was in.  She told me that when I first started and had asked her to send an email to another director, it was so scary – she’d never had to do that before. She reached out to family members to help her formulate the email and after doing that over and over again she felt so empowered. She was so proud of herself for accomplishing something I never even knew which then made me so proud for her and I told her so! She had several examples of how I had helped individuals and the team in ways I’d never stopped to consider. Wowza. Maybe, just maybe I was good at what I was doing, I just didn’t realize it.

I’ve often heard the higher you climb in leadership, the more lonely it becomes and I guess I was living that, but I didn’t have to be. I had (and have) plenty of other leaders, friends, who were in the same boat I was, who are supportive and who look up to me. So herestethoscope-562567_1920‘s the deal. Healthcare is changing at a blinding speed with no sign of slowing down, so as leaders, we have to figure out how to stay sane. Take time to take care of yourself. Stop and celebrate the successes and failures and learn from them both. Realize you don’t have to have all the answers and you don’t have to have it all figured out…after all, if it’s called the PRACTICE of medicine, then it should surely be the PRACTICE of leadership. For the love of Pete, the President of the United States has a whole slew of advisors to help so create your own “cabinet”.  Find a mentor or coach to help you prioritize yourself and carve out time to reflect. The common requirement for all of these things is vulnerability. What self-care are you giving yourself? What are you doing to take an account for your accomplishments? Be vulnerable to yourself. Be vulnerable with others.

Lead on.

It Has To Be Simple

It Has To Be Simple

Not long after becoming a manager of organization development for a large healthcare system, the OD team and I decided we needed to develop a written statement that succinctly expresses our commitment to keeping things simple. We were going to post this statement boldly as a reminder that although healthcare is incredibly complex, we were committed to simplifying things where and when we could. So we did. We decided to start preparing for this new way of thinking by all reading “Insanely Simple: The obsession that drives Apple’s success“. The idea was for us to develop wildly impactful interventions that operational teams and leaders could use easily and deliver them in an insanely simple format. The iPhone is a crazy complex piece of technology but it’s interface was designed to be intuitive and simple to use.

Understanding healthcare finance is about as complicated a thing as a leader has to decipher…but instead of learning the many theorists and academic nature of finance, how about helping leaders translating that data into information. I’ve encountered some incredibly intelligent and strategic finance leaders, but rare is the one who has such a command of the data that they can translate it into operational information. My friend Dave is one of them and I can honestly say that I look forward and enjoy hearing him deliver his financial reports.

As a leader, we are live in a world of complexity. For example, our department scorecards have a litany of metrics – all very important mind you. My current scorecard, for example, has 40+. Every month, I go through a ritual of gathering data from multiple sources to populate my scorecard and report it monthly to the hospital executives. This process forces me to remain vigilant of the results of my team’s performance. I also share that scorecard with my team because it’s important for them to be aware of the end result of their work. Month after month we go over a few of the areas we didn’t quite meet the target and a few areas where we can celebrate successes…and we have a lot of celebrations. My team is amazing. Our current employee engagement scores at the 93rd percentile (Gallup) and our patient experience scores are consistently in the top decile (OAS CAHPS/Press Ganey). I could go on and on about my team, but you’d get bored of hearing all the accolades.

I followed this routine consistently for almost three years before attending a Studer Group  conference. Sure I’d heard of them, read a couple of their books, but had never met the legend himself or heard him spread his wisdom in person. Forgive me if you aren’t a Studer fan, I understand, but I am and I’ll share why. And no, I’m not some paid promoter – although for the right amount of money I could be!  Quint Studer’s processes are time tested, developed through experience as an operations leader, and if you execute accordingly – you get results. Basically, it works.

I came back and actually integrated some of my learnings into practice. Not in a, “Hey I went to this conference so the flavor of this month is hardwiring excellence”, but in a strategic, methodical, team-inclusive way. I started with cascaded leader accountability…sure my leaders knew their roles, but we lacked true alignment. This included a single-page (read: simple) matrix of goals and individualized weights – not all leaders had direct accountability for every goal, along with 90-day action plans, and individual scorecards. These are to be reviewed monthly at our now-consistent leader meetings. There are other things on the agenda, but that’s a large chunk. Now you may be saying, but Gary, that doesn’t sound revolutionary…and you’re right. But it’s a foundational component to simplifying focus. My leaders went from trying to manage to the entire scorecard to just a handful of true Key Performance Indicators. How “key” can something be if there are 40 other “key” indicators?

We also changed the way we present the scorecard to the team. We created a single document listing only the goals/metrics on the leader accountability matrix, categorized them by campus priority and color-coded them in the traditional red-yellow-green. Simple. In one glance, you can get a snapshot of our performance. Does that mean everything else is unimportant? Of course not, but those other 30+ metrics on the full scorecard are on maintenance mode.  How has this worked? Honestly, it’s taken some getting used to. I am cheap and being a good steward of resources, I took the screenshots of the fansimplicitycy software and created my own templates in Excel – sure it lacks some of the functionality – I run a surgery center, not Apple – but it gets the job done. There’s a learning curve for using the templates. There’s a learning curve to learning how to prioritize using this new matrix. There’s a new process of reviewing process at monthly leadership meetings in a structured way. So we started this journey two months ago and my leaders are resilient and agile…so we’re making good progress. Is it hardwired yet? No. Will it be? Absolutely…because we are relentless. Making things simple isn’t easy…in fact, many would say it’s harder than creating the original “thing” but it’s necessary for operations leaders. Our teams are busy and bombarded with too much “stuff”. Let’s help them stay out of the weeds.

The Challenge

Take a few minutes to look at your processes, reports, activities. Are there ways to translate data into information in ways that are easy to understand? How can you help create focus and accountability without adding complexity?

If you’re interested in reading the tool-packed book from Studer, it’s called, “A Culture of High Performance: Achieving Higher Quality at a Lower Cost.

Lead on.

Fire Your Boss?!

Fire Your Boss?!

activity-988835_1920Many years ago, I had the honor of working at a children’s camp for some of the world’s bravest kids. I mean seriously, is there any better feeling than knowing you helped create life-long memories for kids who would never, ever have an opportunity to attend any other camp? These are normal kids with diseases and conditions like cancer, heart disease, asthma, epilepsy that would otherwise keep them from riding horses, climbing rock walls, swimming, etc.

With work like that, you would assume that the work environment would be just as rewarding, but that’s not always the case. I was getting pretty frustrated with the unspoken expectations, the clique-y nature of my “team”, and being ostracized for “not being like the last guy”. I was spending my days off at a local bookstore and ran across a book called, “Fire Your Boss”. That thing called out to me like a beacon to lost ships. The title alone was exactly what I wished would happen in my case…nearly did once – nearly. So I bought it. I didn’t have a clue what it was about, as I didn’t even bother to read the back cover. With a title like that, how could it be bad? I kept the book hidden in my office, reading it when I could without being caught. One day, I’d truly had enough so I left the book out in the center of my desk and stacked up all the clutter so there was no missing it. Oh to be young and reckless. (self note: that would be a cool topic!).  My boss was nosy, so I had no doubt she would come poking around my desk and see it. I hoped she’d see it and I hoped it would give her pause. After a few days of her not mentioning it, disappointed, I gave up on my little cold war and took it back to my shared double-wide. Let me tell you, living and working on the same property is not for the faint of heart. Who knows if she ever saw it. Oh well. You win some, you lose some.

I make light of the situation but in reality I was miserable. I moved 1000 miles from home to a new job in a new town where I knew no one. It was beyond scary. I loved the actual work I was doing, but I detested the place I worked. I tried to focus on the positive and remain in good spirits for the team of summer staff and volunteers I was leading, but I knew I wasn’t doing them or myself justice. I tried to find ways to be successful and was able to create my own wins…now that was a skill that has proven to be beneficial in lots of ways since then.

I actually learned a lot from that book. It’s based on the premise that when you fire your boss and hire yourself, your perspective on the world changes. Talk about a freeing concept. Taking back control of anything is empowering, but taking back control of your work life is amazing. No longer did I feel trapped, I had discovered a way out.  The key to accomplishing this is discovering and adopting a new mindset and following the author’s seven steps…all these authors and their number of pills to swallow, steps to climb, laws to follow.  Seven Habits of Highly Effective People…21 Irrefutable Laws of Leadership…The Three Laws of Performance…all great books, but stop the madness already! I like more provocative titles…First, Break All the Rules…Fire Your Boss…NUTS!…Wicked! But, I digress.

So I eventually fired my boss, started learning how to give myself back the power I had given away and made some changes. I left the operations team and went to work on the administrative team. I was now a fundraiser. I went from creating memories to telling the stories of how those memories impact the lives of so many kids. I got to travel across the state spreading the magic of camp and surprising to me, I was actually half good at it. If I had not been on the Ops team, I would never had been able to tell the stories first-hand. Reading a brochure doesn’t quite do justice to a story about kids overcoming their embarrassment to take their shirts off at the pool because of scars from their heart surgery but finding the courage from each other to show off that scar like a badge of honor. Being there and cheering them on as they do it, however, was life-changing  for them and for me. I found that I had a knack for sharing their story. I measured success in two ways, 1. the amount of money or donations I collected, and 2. the number of people I could make cry. Those tears were proof that they felt through my words, what I felt in person. Not exactly something you’d put on a scorecard, but it was definitely a KPI.

So what does this have to do with leadership? Everything! For starters, you can learn a LOT from working in toxic environments. You learn what NOT to do and sometimes that is just as important as learning what TO do. You live and breathe and experience the output of poor leadership. Like putting your hand on a hot burner, you never want to feel that again so you don’t touch it and you do everything you can to prevent others from experiencing that pain. Secondly, as a leader, you have to make tough choices about your own career and take risks for your own sanity. Patrick Lencioni says the team you’re on is more important than the team you lead. We could debate that all day long (and I have), but the nugget I take away is that to be a successful leader, you have to build relationships and alliances with your own colleagues. I was not successful at doing that when I worked in camp operations so I knew I needed to make a change…for my team, for the campers, and for myself. That notion is especially true in healthcare operations. Can you imagine the director of the emergency department and the director of radiology warring? Who loses? Both teams for sure, but more importantly the patients lose. “Oh, the CT is down in the ED…I’ll get right on that…next week.” Really? People can die because of delayed imaging because if you don’t know what’s wrong, you can’t very well fix it.

So I leave you with a few questions…are you building relationships with your peers? Are you feeling empowered in your career or are you feeling trapped? Are you maximizing your potential for your team, your patients (customers), and yourself? If not…it’s time to be a leader and make some changes.

Lead on.

Once upon a time…

Once upon a time…

The title suggests the beginning of a fairy tale, but this is no children’s story friends. This blog begins the story of the journey I’ve taken toward becoming a healthcare leader.  A senior leader of an ambulatory surgery and endoscopy center, despite not having clinical training.

My story begins with a conversation. A benign conversation, but seemingly benign conversations can change your life. Over drinks, I’m sure, I was lamenting about my current work woes and I how I really needed a change. I loved the actual work I was doing but the work environment was a different story. You will hear much more about that work in later posts. I digress…back to conversations and how my journey in healthcare began.

So my friend Ryan was telling me about the work he was doing in a large hospital system and thought I might be a good fit for a department called Physician Relations. He was friends with the director at the time and suggested I send my resume because why not.  I took him up on that offer and the story you’d expect me to tell is…the rest is history. Well that’s true. Although the process took six months and a couple of “it came down to you and one internal candidate and they chose the internal candidate” responses, I was finally admitted to the club.

I hope to use this blog as a medium for sharing the stories and experiences that helped shape my life both professionally and personally. Stories of unspoken expectations, mutinous staff, angry physicians, crazy bosses, amazing colleagues, along with stories of celebrating life, kids literally living to experience the “32-foot monster”, camp names and traditions, eating whole lobster for three days straight, and getting to work with some of Florida’s bravest kids and exceptional clinicians. There are leadership lessons to be gleaned from all those experiences and my goal is to share them here for the benefit of others. I hope you find this blog entertaining, interesting, intriguing, and inspiring…if not, I will share some of my favorite wines to drink while reading.

Lead on.