Monthly Archives: November 2011

Leadership Across Organizational Boundaries ~ Building a Public/Private Initiative in Support of Our Veterans

Those of you familiar with this blog and my leadership philosophy know how strongly I feel about the importance of Intention.  When working with a client company, it is one of the first things we discuss…is your Vision in alignment with your Intention?  When it is, your value proposition, when properly communicated, will resonate with your target prospects.  If it isn’t, prospects and customers can sense it, whether they’re conscious of it or not.  When these two elements are out of alignment people feel there may be a hidden agenda…and this resonates as well.  I’m also an advocate of giving back to the community.  This is a fundamental facet of being a Transformational Leader, someone that leads from a perspective of service, of responsibility, and accountability to those they lead and those around us.  Back in 2008, I saw the remarkable power Equine Facilitated Learning can have in support of our combat veterans and their families transitioning back to civilian life.  As a veteran, I decided to act, and the award-winning Warriors in Transition program was born (the program was formally commended by General David Petraeus in 2010).

Veterans Participate in Warriors in Transition Workshop, Oahu.

We recently had the opportunity to bring our Warriors in Transition program to Hawaii.  In doing so, we also conducted demo workshops for leaders in the community.  One leader that attended was Councilman Tom Berg, representing the Leeward side of Oahu.  I must say, Tom doesn’t come across as a typical politician.  He’s forthright, inquisitive, and remarkably energetic in the support of his constituents.  He also saw how effective our approach is in cultivating presence, self-awareness, social awareness, self management, positive communications, and relationship management skills…all critical attributes for former soldiers as they navigate their way forward in the civilian job market.

In reaching out to Mr. Berg, with notable support from the Palmarie Community Transformation Alliance, a conversation began regarding the allocation of Navy property that is being transferred to state control, and its potential use in support of Warriors in Transition and the large veterans community in Hawaii (you can read more about this in the PDF press release below).

Hawaii Councilman Tom Berg Press Release

What’s exciting is that we are working together to create a plan to deliver the existing horse stables, infrastructure, and necessary acreage available at Barber’s Point over to Palmarie and Equine 808, the islands’ first and only horse rescue organization, in order to support and expand programs for our veterans and their families.

From my perspective, having co-created and facilitated Warriors in Transition since 2008, this is a remarkable and necessary development.  It points to the positive impact we can make in our community if we all come together, across organizational boundaries, to make something happen.  This is an example of government, nonprofits, and a for profit organization cooperating to address a critical need no single entity seems to be able to address.  This is where authentic, transformational leadership comes to the fore.  Of refusing to accept things as they are, and creating cross-functional teams to create the change we wish to see in the world.

For me, this represents a culmination of our approach and philosophy.  Of refusing to accept the status quo when the status quo is not serving the greater need.  It also stands as a metaphor for the adaptive challenges many companies are facing during these highly volatile times.  Of searching out new, innovative solutions for today’s world.  Of getting out of the box, and thinking creatively.  Of pushing past organizational constraints to build partnerships and teams capable of creating a new reality.

And simply put, it is the right thing to do.  I encourage you all to join in and help support the more than 2 million veterans that have been deployed to combat areas over the past decade.  Their sacrifices enabled us to go about our lives as if nothing was happening.  We owe them our gratitude and undying thanks for what they’ve done for our nation.  We owe them the same chance at success back home that they’ve enabled for us these past ten years.

© 2011, Terry Murray.


Filed under Experiential Learning, Leadership Development, Team Building

A Leadership Litmus Test

Key Concept ~ RogenSi just released their Global Mindset Index survey of employees from around the world, and not surprisingly, the results align with the recent research from other leading institutions and global consultancies.  The long shadow of subpar leadership continues to exacerbate employee disengagement during these highly volatile times.  Companies that recognize, embrace, and act upon the need for a fresh approach to leadership development will win the coming talent war and succeed in creating a flourishing, competitive advantage.  Page six of the Global Mindset Index has a list of questions you may wish to ask your own organization.  Doing so could be a valuable litmus test as to the state of leadership in your company.

One of the key themes I continuously discuss with business leaders is the need to align leadership, strategy, and organizational culture in order to create sustainable, breakthrough results.  Aligning authentic, transformational leadership, mindful strategy, and a creative organizational culture is the recipe for success in today’s dynamic business environment.  Engaging the mind, heart, and spirit of your employees has never been more important.  It is their passion, creativity, and intellectual horsepower that drives the creation and commercialization of intellectual property in today’s economy.  They are the source of competitive advantage, yet from the recent research, it appears this message is failing to find its way to the corner office.

Global consulting firm RogenSi just released the results from their Global Mindset Index survey, and their findings warrant discussion.  Here are some of there findings:

● Fourteen percent of employees say their leaders are inspirational.

● Twelve percent of employees are optimistic about their future opportunities.

● Nine percent of employees state their leaders are creating a motivational work environment.

● Ninety-two percent of employees feel their emotions are being controlled by their achievement at work.  Fear is a significant motivating factor.

● Ninety-one percent of employees are experiencing unstable motivation.  This is due to poor leadership communications, clarity of a shared vision, and a lack of feeling authentic engagement.

● Twenty-three percent of employees are showing five or more symptoms of depression.

These findings align seamlessly with the results published by McKinsey (only 1% of “C” level & “one step down” executives score “excellent” in eight key leadership competencies – 90% score below average), Gallup (nearly 3 out of 4 employees are emotionally and cognitively disengaged with their employer), and Maritz Research (approximately 10% of employees trusts their leadership and believes their honest and ethical – 12% of employees feel their company actually listens to them and cares about them – 14% of employees feel their company shares their own, personal values).  It also supports the disconnect that is apparent when we compare what CEOs say that they want and how they actually behave (the IBM Global CEO Survey found that the single most important leadership attribute CEOs are looking for in future leaders is creativity and the ability to cultivate creativity throughout the organization – yet a study published in the Journal of Experimental Social Psychology reports that the careers of people that consistently express creative thinking are sidetracked on their way up the ladder).

This slash and burn harvest mentality; of leading by creating fear, may have worked during the Great Recession, but as we slowly pull out of the global, economic malaise it will eventually reach a tipping point.  We may already be seeing signs of this event.  The Department of Labor recently revised the productivity growth figures downward for the year, from 2.7% to 2%, and they’re forecasting growth of only 1.5% to 2% in the foreseeable future.  Perhaps we’re seeing a point of diminishing returns from business as usual?

The problem with creating a culture of fear is that it triggers the fight, flight, or freeze response from our Core Mammalian Emotional System.  These emotions (seeking, fear, panic, rage, caring, playfulness, and lust) are part of our primary survival mechanisms that helped us evolve over time.  We share these hard-wired, ancient emotional systems with all mammals.  For the past several years, we’ve seen the freeze response reveal itself through poor workforce engagement levels. People have hunkered down and gone into survival mode.  As the economy improves, however, and competing job opportunities arise, it will be the best and brightest associates that have the mobility to move on to fresher pastures.  For many organizations, they’re about to reap that which they have sown.

Herein lies the opportunity.  Organizations that lead with authenticity, and approach the management of their organizational culture like the strategic asset it is, will flourish.  Rather than cultivating a culture of fear, creating a culture that promotes seeking (i.e. professional development plans, employee education, etc.), caring (the expression of authentic empathy by leadership), and to a certain degree, playfulness (most juvenile mammals learn survival behaviors through play; depressed mammals don’t engage in play – highly effective leaders laugh three times more often than mediocre managers) will engage the hidden workforce that lies just below the surface in many organizations.  Doing so will also create a talent magnet for high potentials seeking opportunities to join the firm.

This isn’t just about wanting happy associates…this is mission critical to the organization’s competitive positioning, adaptability, and ability to execute in rapidly shifting markets.  If we are to believe the research (and I do), there is such a dearth of quality leadership across business today that a company that elevates leadership development to a strategic imperative will inevitably outperform their competition.  The early adopters of this perspective will be the winners of the new century.

© 2011, Terry Murray.


Filed under Leadership Development

Hospital Leadership, Strategy, and Culture in the Age of Health Care Reform

With just eleven months to go before the Value-Based Purchasing component of the Affordable Care Act is scheduled to go into effect, it is an auspicious time to consider how health care providers, and hospitals specifically, plan to successfully navigate the adaptive change to come.  The delivery of health care is unique, complex, and currently fragmented.  Over the past thirty years, no other industry has experienced such a massive infusion of technological advances while at the same time functioning within a culture that has slowly and methodically evolved over the past century.  The evolutionary pace of health care culture is about to be shocked into an entirely new reality.  One that will inevitably require health care leadership to adopt a new, innovative perspective as to the delivery of their services.

First, a bit on the details of the coming changes.  The concept of Value-Based Purchasing is that the buyers of health care services (i.e. Medicare, Medicaid, and following the government’s lead, private insurers) should hold the providers of health care services accountable for both cost and quality of care.  While this may sound practical, pragmatic, and sensible, it effectively shifts the entire reimbursement landscape from diagnosis/procedure driven compensation to one that includes quality measures in five key areas of patient care.  To support and drive this unprecedented change, the Department of Health and Human Services (HHS), is also incentivizing the voluntary formation of Accountable Care Organizations to reward providers that, through coordination, collaboration, and communication, cost-effectively deliver optimum patient outcomes throughout the continuum of the health care delivery system.

The proposed reimbursement system would hold providers accountable for both cost and quality of care from three days prior to hospital admittance to ninety days post hospital discharge.  To get an idea of the complexity of variables, in terms of patient handoffs to the next responsible party in the continuum of care, please take a look at Figure 1.  Each circle represents a functional unit within the current health care system.  A unit that functions and communicates both internally and externally with teams of professionals focused on optimizing care.  With each handoff and with each individual in each team, variables of care and communication are introduced to the system.

Figure 1. Click to Enlarge

Historically, quality systems from other industries (i.e. Six Sigma, Total Quality Management) have focused on wringing out the potential for variability within their value creation process.  The fewer variables that can effect consistency, the greater the quality of outcomes.  While this approach has proven effective in manufacturing industries, health care presents a collection of challenges that go well beyond such controlled environments.  Health care also introduces the single most unpredictable variable of them all; the individual patient.

Another critical factor that cannot be ignored is the highly charged emotional landscape in which health care is delivered.  The implications of failure go well beyond missing a quarterly sales quota or a monthly shipping target, and clinicians carry this heavy, emotional burden of responsibility with them, day-in and day-out.  Add to this the chronic nursing shortage (which has been exacerbated by layoffs during the recession), the anxiety that comes with the ambiguity of unprecedented change, the layering of one new technology over another (which creates more information and the need for more monitoring), and an industry culture that has deep roots in a bygone era and the challenge before us comes into greater focus.

Which brings us to the question; what approach should leadership adopt in order to successfully migrate the delivery system through the inflection point where quality of care and cost containment intersect?  How will this collection of independent contractors and institutions coordinate care and meet the new quality metrics proposed by HHS?  The fact of the matter is, health care is the most human of our national industries. The shifting demographic needs and economic constraints of our society required change.  Hopefully this change will prompt leadership to revisit how they choose to engage and integrate the human element within the system.  The scope of change demands no less.

In contemplating this approach, a canvasing of the peer-reviewed research into both quality of care and cost containment issues points to a possible solution; the cultivation of emotional intelligence in health care workers.  After reviewing more than three dozen published studies, all of which confirmed the positive impact cultivating emotional intelligence has in clinical settings, I believe contemplating this approach warrants further exploration.

Emotional intelligence is a skill as much as an attribute.  It is comprised by a set of competencies in Self-Awareness, Self Management, Social Awareness, and Relationship Management, all leading to Self Mastery.  Fortunately, these are skills that can be developed and enhanced over the course of one’s lifetime.

Keeping the continuum of care patient flow chart in mind (Figure 1), let’s examine how emotional intelligence factors into the proposed quality measures the Department of Health and Human Services will be using come October, 2012:

1.)  Patient/Caregiver Experience of Care – This factor really comes down to a patient’s perception of care.  Perceptions of care are heavily shaded by emotions.  Patients consistently rate less skilled surgeons that have a greater bedside manner as better than maestro surgeons that lack, or choose not to display, these softer skills.  Additional research into why people sue over malpractice demonstrates people don’t sue over a medical mistake in and of itself.  People sue because of how they felt they were treated after the error occurred.  There’s a difference between curing an illness and healing a patient and that difference lies in the expression of authentic empathy through healthy, professional boundaries.

This is a key driver in patient decision-making as well.  Patients tend to choose a hospital based upon one or two criteria; the recommendation of their primary care physician (with whom they have an established relationship) and/or upon the recommendations from family members or friends that have experienced care in a particular hospital.  A quick look into the field of Applied Behavioral Economics supports this finding.  Economic decision making is 70% emotionally driven with the remaining 30% based in rational thought.  In many instances, it would appear that hospital marketing doesn’t seem to reflect an understanding of this phenomena.  Waiting room times in Emergency Rooms have little to do with why patients choose a hospital, yet we see billboards everywhere that have the actual E.R. wait times electronically flashing along the roadside.

A patient’s experience of care can be highly impacted at the handoff points within the continuum of care.  Any new model of care will require exceptional cross-organizational communications to emerge.  This requires a high level of engagement and commitment to the new vision at every patient touch-point.

This metric also addresses the caregivers’ experience of care.  This speaks largely to the experience of nurses that are delivering that care.  The research related to the impact of cultivating emotional intelligence in nurses clearly demonstrates a reduction in stress, improved communication skills, improved leadership and retention, the ability to quickly connect and engage patients, as well as a reduction in nurse burnout (which leads to turnover and additional stress amongst the remaining staff).

2.)  Care Co-ordination – Again, this will require optimal engagement and pro-active communication intra-organizationally and cross-organizationally.  Each handoff introduces opportunities for variable care to emerge that must be seamlessly co-ordinated.  Poor co-ordination also introduces the risk of eroding the quality of the patient’s experience.

3.)  Patient Safety – Research shows that the cultivation of Emotional Intelligence competencies in nursing contributes to positive patient outcomes, lowers the risk of adverse events, lowers costs at discharge, and reduces medication errors, all while lowering nurse stress, burnout, and turnover.  Each time a nurse resigns it adds to the nursing shortage on the floor, requires additional hours from other nurses, and costs the hospital approximately $64,000, on average, to backfill the open position.  Improving how an institution cares for its nurses improves the level of patient care and safety as well.

4.)  Preventive Health – Elevating Self-Awareness and Social Awareness in clinicians helps them quickly connect and effectively communicate with patients.  Subtle, non-verbal cues become more readily apparent, helping clinicians understand the fears and emotions of their patients.  Self Management and Relationship Management helps clinicians communicate appropriately and supports the expression of authentic empathy through healthy, professional boundaries.  All of these factors come into play when speaking with patients about lifestyle choices, course of treatment, and preventive health care.

5.)  At-Risk Population/Frail Elderly Health – Like preventive health, being measured on the care of the community’s at-risk population and elderly will require a fresh, innovative approach to community outreach and pro-active communication.  These are not populations that can be easily reached via Facebook or Twitter.  This requires human contact and deep engagement with each population, both of which are supported through the development of a mindful approach (i.e. emotionally intelligent) to the challenges at hand.

It will be interesting to see how reform unfolds and how leadership within the health care delivery system chooses to respond to the challenges that lie ahead.  Systems and hospitals that choose to take an honest, evidence-based look at how they choose to lead, how they create and execute strategy, and the organizational culture they’re cultivating will be well served in preparing to successfully navigate this unprecedented change.

© 2011, Terry Murray.

1 Comment

Filed under Health Care, Leadership Development, Organizational Culture

Terry Murray Discusses Leadership in Today’s Economy with Mike Stein of KWAM 990 Memphis

I had the opportunity to be interviewed by Mike Stein of KWAM 990 Memphis earlier today.  We discussed the state of leadership in corporate America, the role organizational culture plays in employee engagement, and how companies can ignite breakthrough performance in challenging, adaptive times.  You’re welcome to listen to a podcast of the interview by clicking the link below.
© 2011, Performance Transformation, LLC.
© 2011, KWAM 990 Memphis.

Leave a comment

Filed under Leadership Development