During the last nine years, I have visited and provided assessments for over 300 hospitals throughout the country and have found that every hospital has the same three goals: high clinical quality, exceptional patient experience and profitability.
I have met administrators, physicians, directors, managers and staff in those facilities and realized that success is dependent upon the leader of the organization — the difference between managing and leading.
Putting the puzzle together: Leaders can change culture and realize vision
In his book, “Start With Why,” Simon Sinek describes the roles of a successful organizational team:
• Leader/CEO — Establishes the WHY/vision
• Operations/COO — Establishes the HOW/roadmap
• Managers, staff — Provides the WHAT/elements-processes-output
The leader’s role is to establish the why, or the vision, for the organization. That vision becomes the goal of every employee. If employees are only immersed in their individual tasks without understanding their role in the organization’s vision, there is no energy, loyalty, pride or joy in working. Think of a puzzle – if people are only focused on their small piece of the puzzle, they will not understand how the pieces fit together to create a picture. Once individuals understand how they fit into the vision, they know how they help achieve the goal. The vision must be relevant to each employee.
Sinek used Apple as an example of how the company message is communicated. He highlighted how Apple follows the progression of why, how and what.
“Everything we do, we believe in challenging the status quo. We believe in thinking differently.” (WHY)
“The way we challenge the status quo is by making our products beautifully designed, simple to use and user friendly.” (HOW)
“And we happen to make great computers.” (WHAT)
Sinek noted that Apple is an anomaly and that most organizations begin with the what (features) and fail to communicate the why.
Create a culture that inspires: The Zappos way
For anyone who is not familiar with Zappos, the company is an online retailer. It started as a shoe retailer but has expanded into clothing and other goods. Customers rave about both the products (not unique) and the service (unique). A tour through the Zappos headquarters provides insights into the leadership of the organization — the culture permeates the organization. The guide states, “Tony Hsieh, founder and CEO, has always said that culture is the number one priority. If you can get that right, everything else will naturally fall into place. That is why Zappos is one of the 100 Best Companies to Work For.”
Another employee quoted in the 2010 Zappos Culture book said, “If you mention Zappos to one of our customers, you’ll probably hear about the amazing product selection and service we offer. If you mention Zappos to one of our business partners, you’ll probably hear about the amazing growth and success we’ve had. However, if you ask our employees what they’re most proud of, you’ll probably hear about our Zappos Culture. Above all else, our culture is what drives our success and keeps each employee coming back each day inspired to continue it.”
Zappos’ 10 Core Values are posted throughout the organization.
- Deliver WOW through service
- Embrace and drive change
- Create fun and a little weirdness
- Be adventurous, creative, and open-minded
- Pursue growth and learning
- Build open and honest relationships with communication
- Build a positive team spirit
- Do more with less
- Be passionate and determined
- Be humble
Draw strength from your figurative circle
Another consistent quality of a leader is that he not only cares about the company, he cares deeply about each employee — and they know it. In his TED Talk, “Why Great Leaders Make You Feel Safe,” Sinek stated that great leaders establish the right environment of trust and cooperation. When danger, such as the economy, competition and healthcare reform, surrounds the organization, the leader draws everyone into a “figurative circle” — a safe spot — where information is shared — and will solicit solutions from others. Leaders will sacrifice profitability to save people. Team members will sacrifice for the leader when they know that the leader would sacrifice for them first. This leads to trust, cooperation and creativity.
Fostering Creativity, Change and Commitment
When an organization is governed by rules, people fear the manager. When there is open, honest communication and when employees have flexibility and can make decisions within reasonable boundaries, employees do not fear their leaders. Leaders appreciate that a good idea can come from anyone. People doing the work often have a greater sense of what the problems are and how to solve them.
Quint Studer clearly defined the difference between leaders and managers in “The Culture of High Performance: Achieving Higher Quality at Lower Cost.” He found that leaders (physicians, administration, directors) understand that if change does not happen, the results will be worse. Managers do not feel the same urgency. The biggest reason that organizations don’t achieve high performance is that the executive team doesn’t understand that other managers might not be on the same page. Leaders are not just in the C-suite — they are employed throughout the organization, in every facet of the business. The reason for change needs to be understood by the entire organization. Yet, in every organization there are several barriers to change: denial, rationalization, blame, discomfort or lack of skill. Training and education are essential for change.
In order for change to occur every employee needs to feel valued and needs to understand that he/she has a responsibility to contribute to the organization. In “Good to Great,” Jim Collins wrote that a leader is one who leads with passion. Passion is demonstrating a relentlessness to achieve the desired outcome.
Initiate change by painting the picture
Great leaders create great organizations. The culture determines why employees want to come to work and why they want to stay. (People leave their supervisors/manager, not their jobs.)
Another Zappos employee stated, “The culture that the leadership establishes can be best described as that warm feeling you get when you walk into your parents’ or a friend’s home. You’re not fearing what the day is going to bring you, but instead positively anticipating your work day. It is being a part of something unique and special.”
How does that leader communicate the vision? Think of Martin Luther King, Jr. He never said that he had a strategic plan for the future. He created a vision of little white girls and little black girls holding hands on the playground. Everyone could relate to that dream. He painted a picture of the future state.
When great leaders initiate change, the status quo is not an option. Those who cannot adapt to the new culture may be trained — but may ultimately be asked to leave the program/organization.
In summary, leaders establish the why of the organization. The how and the what will follow. This quote from a Zappos employee seems quite appropriate. “When I was a boy, there was one permanent ambition among my comrades in our village on the west bank of the Mississippi River. That was to be a steam-boatman. We had transient ambitions of other sorts, but they were only transient. When the circus came and left, it left us all burning to become clowns. The first minstrel show that came to our section left us all suffering to try that kind of life. Now and then we had a hope that if we lived and were good, God would permit us to be pirates. These ambitions faded out, each in its turn, but the ambition to be a steam-boatman always remained.” That’s from “Life on the Mississippi” by Mark Twain. What does that have to do with Zappos.com and the culture you might ask? Dreams. Not being afraid to think about what you’d like to be, and what you can someday become. A mind of a child has no limits, but as we get older that way of thinking goes away. Zappos has leadership. Zappos.com has a way of bringing it back!
Judy E. Jones, MS, is vice president of Stryker Performance Solutions. As one of the co-founders of Marshall | Steele, she has more than 20 years in healthcare service line development. Among her many professional roles, she has served as vice president for corporate business development for a healthcare marketing company, director of corporate marketing for Tenet Healthcare, director of surgical marketing programs for OrNda HealthCorp, vice president of marketing for Health Connections and director of advancement for the Samueli Institute. In this last position, Ms. Jones was responsible for the development of healthcare partnerships to support research opportunities, communication and marketing. Prior to her healthcare career, she was associate dean of students at Tulane University and associate director of admissions at the University of Denver. She holds a master of science degree from Ithaca College, and a bachelor of arts degree from the University of Michigan.
