Leadership Retreat Banner Gateway Medical Center / M.D. Anderson

The Florence Prescription
for a
Culture of Ownership
Banner Gateway Medical Center
M.D. Anderson Cancer Center
October 21, 2016
Joe Tye, CEO and Head Coach
Values Coach Inc.
Copyright © 2016, Values Coach Inc.

Our plan for today:
Morning
 Culture of Ownership
 The Lion in Your Mirror
Afternoon
 Creating a Cultural Blueprint

Culture does not change
unless and until people
change.

People will not change
unless given tools and
structure, and inspired to
use them.

And they will only do this
to the extent that it is
coherent with their own
personal core values.

“I got a whole new team
and didn’t have to change
the people because they
changed themselves.”
Paul Utemark, CEO
Fillmore County Health System
Geneva, Nebraska

Who would you rather work with?

Who would you rather live with?

There is an invisible barrier on
the potential of your organization

From the Pulitzer Prize winning book
Leadership by James MacGregor Burns

When Sally and I were in the
market for a second home in
Arizona our criteria were:
 Spectacular back yard
 Low to zero maintenance
 Affordable

And this is our primary
residence, the house where
we lived for 20 years and
raised our two children –
photo taken April 2013…

Lesson #1
Things aren’t
always what
they seem.

Lesson #2
What you really
want might be
closer than you
think.

Lesson #3
You must be
willing to jettison
old baggage to
move forward.

Lesson #4
There is almost
always a way to
create a win-win.

A word about the
assumptions we make.

What do you get when
you break the word
“assume” into its
constituent parts?

39
This story has a
happy ending!

Question #1
When did the
healthcare crisis
begin?

Florence Nightingale firsts include:
• Medical records
• Laundry and housekeeping
• Infection control
• Nutrition service
• Pharmacy
• Materials management
• Patient library
• Medical triage
• Nursing uniforms
• Chaplain service

Question #2
When will the
healthcare crisis
end?

Companies that study employee
engagement* consistently find:
~ 25% fully engaged
~ 60% not engaged
~ 15% aggressively disengaged
* e.g. Gallup, Avatar, Press Ganey, Modern Survey

Disengaged people,
especially disengaged
managers, are a defect

“Disengagement [is] one
of the chief causes of
underachievement and
depression.”
Edward M. Hallowell, M.D. in HBR, 12-10

Building a
culture of
ownership

Checklist
complete and
all systems go?

I’ve got my
application in
at Southwest

The journey from mere
Accountability
to a culture of
Ownership

Accountability
Doing what you are supposed
to do because someone else
expects it of you. It springs
from the extrinsic motivation
of reward and punishment.

Son, you’ll be proud
of your old Dad…
Today they held
me accountable.

“In the long run…
accountability encourages a
culture of evasion, denial,
and finger pointing.”
Richard Farson and Ralph Keyes: The
Innovation Paradox

No one ever won a DAISY
Award by being held
accountable!

Ownership
Doing what needs to be done
because you expect it of
yourself. Ownership springs
from the intrinsic motivation
of personal pride.

22,844,690 views
86,976– avg 5 stars

What 362 of you told me
about your perceptions of
the Banner Gateway/
M.D. Anderson culture

93
Banner employee survey comment
“This campus and current
leadership is the best I have ever
worked with and they are
committed to raising the level of
performance, support and being
the best.”

94
“Management is directly concerned
only to find out what is wrong with
an employee over and over again.
More positive praise is needed, it
helps motivate and brings a team’s
morale up. I believe this is not
given.”

$113,000,000 annual SWB
X
16%
=
>>>>>>>>>>>>>>>>>>>>>>>>>

Let’s do some more math…
Out of 3,982 possibilities
(362 people x 11 questions)
there were only 710 (18%)
“strongly agree” responses.

Several additional
questions…

Were you surprised
by any of these
results?

Who is responsible for
changing these results?

Invisible
Architecture
“Invisible Architecture” is a
trademark of Values Coach Inc.

Invisible Architecture™
is more important than
bricks & mortar

The Blueprint
Behind the
Blueprint™

Invisible architecture
is to the soul of your
organization what
physical architecture
is to its body.

“Terrible experience
but beautiful facility.”
– Online review

Core values define who you
are, what you stand for, and
what you won’t
stand for

Integrated DNA Technologies Inc. values (excerpt)
Be yourself,
Unless you’re a
jerk
128

From the Cypress Semiconductor values (excerpt):
CYPRESS IS ABOUT WINNING
We do not tolerate losing.
We thrive on competing against the world's best.
WE MAKE OUR NUMBERS
We make 20% profit.
We each set goals and achieve them.
We ship 100% on time and get zero returns.

Organizational values define
strategies while personal
values define culture.

Culture is to the
organization what
personality and
character are to the
individual.

Where will I
take you for
lunch?

This is not a trick
question…
It’s the reality of
competing today.

Same
business
Different
cultures

People pay to
shop at Costco…

People shop at Wal-Mart
because they don’t have
to dress up like they do
for the Dollar Store.

Describe your culture
in just 6 words.

I borrowed this
concept from…

One of my very favorites
“Cursed with Cancer,
Blessed with Friends”
9 year old Hannah Davies

Southwest Airlines Motto
Servant’s Heart, Warrior
Spirit, Fun-Loving Attitude

Cypress Semiconductor Motto
The Marine Corps of
Silicon Valley

150
From managers sitting
in the same room at
one large medical
center’s leadership
retreat

151
We love patients
and each other

152
We are ALWAYS
here for you

153
Multiple priorities,
limited resources,
great expectations

154
We’re entitled,
hating it,
and staying

155
Disjointed
departments
working against
each other

156
Negativity reigns
while circling the
drain

157
I’ve been here
longer – you leave

158
Beatings will
continue until
morale improves

The Florence Challenge
Emotionally Positive
Self Empowered
Fully Engaged

Culture is to recruiting
and retention what
marketing is to gaining
and earning customer
loyalty >>>>>>>>>>>>>>

Modern Healthcare cover story 1/19/2016
“Nurse shortage looms”

A Key Point!
You cannot allow
people to opt-out of
positive culture
change!

One final point:
Cultural work can’t be just
a “flavor of the month”

Culture doesn’t change
unless and until people
change

176
Workplace attitude is
determined by what
you expect and what
you tolerate…

177
And over time, what
you tolerate will
dominate over what
you say you expect!

“We complain to get
sympathy, attention,
and to avoid stepping
up to something we’re
afraid of doing.”
Will Bowen: A Complaint Free World

179
“One toxically negative
person can drag down
morale and productivity
of an entire work
unit.”

181
“It is a leadership
responsibility to create a
workplace environment
where toxic emotional
negativity is not
tolerated.”

182
“We have a toxic employee in our
department that management does
not know how to handle. This
employee is poisoning the entire
department. Good employees are
all wanting to leave because of one
bad apple. Sad to see.”

The privileges of being a
manager also entail certain
foregone freedoms

When you accept the
title and pay raise, you
assume a responsibility
to support a culture
initiative as if it had
been your own idea.

It would be wrong for a
manager to deprive
people of something that
could help them because
of his or her own
negative attitude

192
The simple promise that
will change your life…
And change your
organization…

The Pickle Challenge
has taken on a life of
its own!

Are you up for taking
The Pickle Challenge
for Charity here at
Banner?

Caveat: You will get resistance
to The Pickle Challenge.
It will be most vociferous from
people who could most benefit
from taking it to heart.

“And in changing our
organizations, we can
change our world for the
better.”
218

How to see the Lion
in Your Mirror –
8 Strategies

These strategies can
help you be better in
every dimension of
your work and your life

Strategy #1
Get very clear
about your
personal values

234
“People who are clearest
about their personal vision
and values are significantly
more committed to their
organizations.”
James Kouzes and Barry Posner:
A Leader's Legacy

Culture of Ownership Classroom
Midland Memorial Hospital

Core Action Value #1
Authenticity

Integrity

Awareness

Perseverance

Enthusiasm

Leadership

The goals you achieve
The contribution you make
The person you become

Will be determined
by the values that
guide your life

Strategy #2
Make fear
your ally

Fear is the most
serious of all learning
disabilities!
Edward Hallowell: Worry

The absence of fear is
not courage!

Three bad things happen
when you in the thrall of
anxiety…

Bad Thing #1
Memory is distorted: past
successes seem small and
insignificant while past
failures seem huge and
certain to be repeated.

Bad Thing #2
Perception is distorted: the
dangers facing you are
blown out of proportion
while you underestimate
the resources you have.

Bad Thing #3
Vision is distorted: you
cannot see the possibilities
for a great outcome
because you are so fixated
on images of doom.

Anxiety tries to
become fear.
Paul Tillich: The Courage to Be

Fear can paralyze or it
can catalyze

You’ve heard that the
acronym F.E.A.R. stands
for Fantasized Evidence
Appearing Real.
It also stands for…

Fabulous Excuse
for Avoiding
Responsibility

Good Thing #1
It alerts you to the fact that
you are not ready for some
possible future event.

Good Thing #2
It galvanizes you to
take action.

Good Thing #3
It opens your eyes to the
fact you are on the wrong
path in life (one reason
“midlife crisis” is so often
a time of searing anxiety).

Good Thing #4
When it is a call
to focus*
* Procrastination is
always rooted in fear

Good Thing #5
When it is a call
to faith*
* Faith begins at the point
where certainty ends

Worry is like paying
interest on a debt
that you probably
don’t even owe!

Toxic worry is abuse
of the God-given gift
of imagination!

10 Actions You
Can Take to Have
More Courage

Action #1
Find your Big Why* –
your Path with Heart**
* A term used by Gary Keller, Founder
of Keller Williams Realty
** A term coined by Carlos Castaneda

Caring is the root
of courage – you
wouldn’t be
afraid if you
didn’t care…

And you act in
spite of your
fear because
you care

Action #2
Give fear a name
and it becomes just
a problem.

It’s easier to solve
problems than it is
to conquer fear.

Action #3
Manage the time
zone in which you
park your attention.

When afraid of the
future, focus your
attention on the
work that needs to
be done today.

When afraid of what’s
happening today, keep
your vision on the
dream of a brighter
tomorrow.

Action #4
Decide to
have energy.

Courage without energy is
just a good intention;
energy without courage is
more likely to run away
than it is to stand and fight.

“Laziness” is
often usually fear
in disguise!

More than we care to
admit, whether or not we
have energy is more a
mental choice than a
physical condition.

Action #5
Put yourself on a severe
diet when it comes to how
much tragi-tainment you
allow to enter into your
head.

Action #6
Get enough sleep, because
as Vince Lombardi said,
fatigue makes cowards of
us all.

Action #7
Practice courage
rituals

Action #8
Laugh! It is physiologically
impossible to be afraid
when you are laughing.

Action #9
Fear breeds in isolation –
especially in times of high
anxiety it is essential to
reach out and stay
connected with others.

Action #10
Confront your
irrational fears

Share your courage
with others, keep your
fears to yourself.
- Jonathan Swift

Strategy #3
Make adversity
your teacher

“It’s not what happens to you it’s
what you do about it.”
W Mitchell

Every great accomplishment
was once the “impossible
dream” of a dreamer who
simply refused to quit when
things got tough.

The bigger the
dream – the
greater the
challenges!

Law #1
The rain falls upon and bad
things happen to good
people – including you

Law #2
There are millions of
others who would love to
have your problems

Law #3
Crisis creates opportunity

Law #4
One door closes, another
door opens

Law #5
Falling on your face is
good for your head

Law #6
You will pass
through the
valley of the
shadow

Law #7
Conquering weakness will
make you stronger

Law #8
Without the valleys, you
won’t appreciate the
mountains.

Law #9
Sometimes you meet the
most important people
in your life when you are
flat on your back.

Law #10
Challenges, not successes,
define our character

“Brick walls are not
there to stop you, they
are there to make you
prove how much you
want something.”
Randy Pausch: The Last Lecture

How badly to you want to:
Get out of
debt?

Lose weight?

Get a graduate
degree?

Write your
book?

Start your
business?

Travel the world?

338
Strategy #4
Erase the malignant
echo of negative
self-talk

Negative self-talk is
telling yourself lies…
And then believing
those lies.

The most important
speech any of us
ever give (the one
you were never
trained to give) is...

342
What is the first word a
child learns to say?

For a variety of evolutionary
reasons, the human mind
automatically gravitates
toward negative, frightening
and depressing thoughts.
Mihaly Csikszentmihalyi: The Evolving Self: A
Psychology for the New Millennium

Experts refer to ANTs –
automatic negative thoughts

Psychologists say that up to
80% of self-talk is negative –
and that we can abuse
ourselves at a speed of 400
words per minute!

You would never tolerate
anyone else speaking to you
the way you allow your
spoiled inner brat to get
away with.

Like graffiti on a subway car –
after a while you don’t notice it

You might even think it’s beautiful

351
A crucial point!
That voice will
always be in the
second person. It’s
not you talking!!!

354
Two steps for using the
power of Metaphorical
Visualization™ to erase the
graffiti of negative self-talk:

355
Step #1
Visualize the words as
clearly as you possibly can
as graffiti that has been
scrawled on the walls of
your mental attic.

358
Step #2
Visualize a janitor (The
Janitor in Your Attic™)
painting over the graffiti
and replacing it with
positive affirmations.

You can rewire the hardware by
reprogramming the software!

361
Caveat!
For your challenge to your
Spoiled Inner Brat to be
credible you must also
take action if what Brat
says is factually accurate.

362
Strategy #5
Make your body
play a constructive
part in that inner
dialogue…

Your body tells your
mind how you feel…

How your mouth
tells your mind
what to think…

Smile from the outside in and
you’ll eventually be smiling
from the inside out.

Strategy #6
Leave behind the
emotional baggage

Strategy #7
Create memories of
the future

Joe’s Youroscope
The small seed planted
yesterday will blossom into
a treasure and today
another opportunity will
come from out of the blue…

Joe’s Youroscope (contd.)
Today is a fine day to make
a choice, make a friend,
make a difference, and to
take decisive action on a
long postponed decision…

Joe’s Youroscope (contd.)
Call a friend, call a
prospect, and call
your Mom.

379
You can remember the
future more clearly and
more accurately than you
can remember the past.

380
The difference
between wishful
thinking and
positive thinking…

381
Wishful thinking is
hoping for something and
waiting for someone else
to make it happen.

382
Positive thinking is
expecting something and
working to make it
happen.

Strategy #8
Take to heart the
seven promises of The
Self-Empowerment
Pledge™

“I attribute my
success to the fact
that I never gave or
took an excuse.”
Florence Nightingale

Seven Simple Promises
That Will Change Your Life*
* One for each day of the week.

If you’ve been waiting
for someone else to
empower you, you
should know that…

No one can empower you
but – YOU – and once you
have empowered yourself…
No one can
take that
power away.

If you knew it would
change your life for the
better – profoundly and
permanently – would you
invest …

A minute a day for
the next 365 days

Would you give up one
television commercial
a day for a year to
change your life?

If your answer
is yes, here’s
what you need
to do.

Every morning start
your day by making that
day’s promise – which
will take you about
15 seconds.

Repeat the promise
again in in the middle
of your work day.

Once more before you
leave for home.

And one more time right
before you go to bed.

Repeat these promises like
you really mean them!

Let’s take a look
at the seven
promises…

You keep promising yourself that you
will be responsible, accountable, and
determined; make a contribution, be
resilient in the face of adversity, have a
positive perspective,
and that your faith
will shine through.

Then you catch yourself whining and
complaining, procrastinating,
gossiping, blaming others for your
problems, taking when you should be
giving, and pretending
that you have no power.

You end up with what
psychologists call…
Cognitive Dissonance

Which is trying to simultaneously
hold two incompatible beliefs

At that point, one of two
things MUST happen.
Either you take the easy
way and stop making
the promises…

Or you keep making the
promises until you begin
to change your attitudes
and your
behaviors.

And as you do that, you
will begin to achieve better
results in every dimension
of your life.

Read these seven promises
one more time…

Now ask yourself these
two questions…

Question #1:
If you personally were to take
these seven promises to heart,
would you be better off than
where you are headed now –
personally, professionally,
financially, and spiritually?

Question #2:
If everyone where you work made
a good faith effort to live these
seven promises, would you do a
better job of serving customers
and of supporting each other?

If your answer to these
two questions is…
And if you’re
being honest,
that’s what your
answer will be.

Then why wouldn’t you
invest those 365 minutes
in yourself? Do it,
because no one can
empower you
but you.

Will you do it? Will
you give up one TV
commercial a day…
To change
your life?

And one last thing…
Let me introduce you
to the person you
once were

Wouldn’t it be
nice to become
that you again?

Leadership Retreat Banner Gateway Medical Center / M.D. Anderson

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