Building a Culture of Leadership
Managing Net-Negative People
A Critical Organizational Leadership Process
Kendall L. Stewart, MD, MBA, DLFAPA
Six Disciplines Client Summit 2013
1Thank
you for inviting me back and for your willingness to experience some energizing discomfort this morning.
with miserable people in the workplace may be the biggest leadership challenge in America.
3Please let me know in your evaluation whether I have provided you with some practical perspectives you can
actually use.
2Dealing
Southern Ohio Medical Center
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SOMC is a 222-bed 501(c)(3) not-for-profit hospital in
Portsmouth, Ohio.
With 2,200 employees, 140 physicians and 800
volunteers, we admit about 13,000 patients, perform
about 13,000 surgeries and treat thousands of others
in our ambulatory facilities each year.
We serve in one of the most challenging economic and
healthcare environments in the United States.
In spite of these challenges, we have produced and
sustained some exceptional organizational results.1,2
This presentation will describe one of our key
strategies and its execution.
Many SOMC leaders would say our strategies for
managing negativity in the workplace are among our
most innovative leadership initiatives.
Six Disciplines Client Summit 2013
1And
2See
we still have a long way to go in our passionate pursuit of patient-centered perfection.
our Leapfrog scores, VPP Star status—and last month’s Consumer Reports ranking.
Why is this important?
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1As
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Leaders exist to produce
exceptional results.
Net-negative employees are the
second most important obstacle
to our success.
The first obstacle is our own
failure to identify and
appropriately manage these
people.
This presentation will enable you
to:
 Identify them, and
 Manage them expertly.
This presentation will not make
this easy.
But it will show you the way.1,2
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After listening to this
presentation, you will be able to
answer the following questions:
 How do net-negative
employees behave?
 What are some of the myths
about these people?
 What are some of the barriers
to managing net-negative
people?
 What are three practical
strategies for managing them
successfully?
 Why should you follow this
process?
 How can you do it?
a psychiatrist, I am very good at figuring out what is wrong and what needs to be done.
woman consulted me for anxiety but declined to follow my advice.
How do net-negative people
behave in the workplace?1,2
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They are negative and miserable
most of the time.
They bring others down.
They complain and whine.
They point out problems in a
negative way.
They undermine their leaders.
They are often hardworking and
contemptuous of those who don’t
share their passions and
perspectives.
They live to game the system and
get their way.
They stir the pot behind the
scenes.
They talk about people instead of
to them.
1Knowing
2If
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what you now know, would you hire this person again?
you would not, this person is net-negative. (Studer, 2008)
They are often intelligent and
skilled clinicians—and bitterly
dismissive of the idiots they have
to work with.
They expect special treatment—
because they are special.
They are passive-aggressive.
They love the “We-They” position.
They are cynical and disparage
all efforts to improve as “crap.”
They believe they can outlast the
leader—and they often do.
They only follow the rules they
like.
They take nonverbal
contemptuous communication to
a whole new level.
What are some of the myths
about net-negative people?
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1Some
2A
They can be safely ignored.
No one pays any attention to them anyway.1,2
They enjoy being miserable.
They will eventually leave on their own.
They are bad people.
They bring a helpful difference of opinion.
You can’t get by without them.
You can’t afford to get rid of them until you
find replacements.
They never change.
people appear to be genetically predisposed to be miserable.
Georgia farmer complained about his wife’s weight.
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What are some of the barriers to
managing net-negative people?
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Confronting them is very unpleasant.
They are frequently the best workers you’ve got.
They are so secretive it’s hard to get the goods on them.
Their colleagues complain about them, but won’t take a
stand.
When under fire, they can behave perfectly until you move
on to something else.
They always have a reason for acting the way they do.
It’s always someone else’s fault.1,2,3
They are usually opinion leaders.
They are often powerful or politically well-connected.
“HR won’t let me fire them.”
Six Disciplines Client Summit 2013
1A
surgeon stomped out of surgery because some equipment didn’t work.
I called him about his patients who were waiting, he only wanted to discuss the equipment malfunction.
3Another surgeon came in to complain that the Director of Surgical Services wouldn’t speak with him.
2When
Why should you tackle this
challenge?
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It is a real problem.
Dealing with it is hard; your willingness to step up will give
your organization a clear competitive advantage.1,2
You will decrease the turnover of your net-positive people.
You will increase morale immediately.3
You will increase your credibility as a leader.
You will send a strong message to those leaning to the
negative side.
You will create the kind of organizational culture that
produces results.
You will attract better people to the organization.
Six Disciplines Client Summit 2013
1I
have mostly ignored, pitied and been inspired by miserable people throughout my life.
courageous medical student recently taught me what a mistake that approach has been.
3We now have a senior SOMC leader in the physician dining room every day.
2A
How can you do it?
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Get all the key leaders in the room.
Admit this is a serious problem.
Admit to each other how you have put this off and how
much you would like to keep on avoiding dealing with the
problem.
Extract a commitment from everyone to deal with this and
to see it through.
Design and deploy the process.1,2
Agree on timelines.
Follow the process.
Hold yourselves and other leaders accountable.
Watch for leaders to “decide” that the net-negative people
are no longer net-negative.
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Six Disciplines Client Summit 2013
1Our
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process is to follow the process.
there is no process, our process is to design and deploy a process.
What are the process steps?
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1This
Annually, leadership teams
meet to discuss each of their
employees and determine the
Net Contribution for each
employee.1
Leaders are asked a simple
question to begin the
discussion: “If this person left
SOMC today, would you
rehire them?”
The leadership team reviews
each employee’s positives
and negatives.
HR enters and analyzes the
initial review results.
Managers/Directors schedule
follow-up with HR for NetNegative review.
Step 1
Determine
Net
Contribution
Provide
Monthly
Feedback
Document
Expectations
Identify
Specific
Behaviors
Clarify
Expectations
process can be initiated at any time, but it is “hardwired” as a part of the annual performance management cycle.
What are the process steps?
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Leaders are required to
meet with HR on every
employee identified as netnegative.
HR works with the leader
to identify and document
specific negative behaviors
(not attitudes).
HR coaches the leader
through writing clear
behavioral expectations
and the documentation
format (a letter and
Performance Manager™).
HR helps prepare the
leader for the critical
conversation to come.
Determine
Net
Contribution
Provide
Monthly
Feedback
Document
Expectations
Step 2
Identify
Specific
Behaviors
Clarify
Expectations
What are the process steps?
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Leader meets with each employee
to share whether they were
identified as net-positive or netnegative.
Leaders are coached to be very
specific about the positive
behaviors a leader would like
repeated and the negative
behaviors that must cease.
Employee is provided an
opportunity to ask clarifying
questions.
For those that contribute negatively,
the leader reviews improvement
expectations and consequences for
the next year:
 Not eligible for tuition assistance or
internal job bidding.
 If behavior does not improve, will not
have a position at SOMC.
Determine
Net
Contribution
Provide
Monthly
Feedback
Identify
Specific
Behaviors
Step 3
Document
Expectations
Clarify
Expectations
What are the process steps?
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Leader documents both
positive and negative
feedback in the annual
performance review
within Performance
Manager™.
 Leader provides “NetNegative” letter
(completed with HR
during Step 2) to
employee as a follow-up
to the expectation
conversation. (Note:
this letter is also
scanned into personnel
record)
Determine
Net
Contribution
Provide
Monthly
Feedback
Identify
Specific
Behaviors
Step 4
Document
Expectations
Clarify
Expectations
What are the process steps?
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1The
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Leader meets with the net-negative
employee monthly to review
progress on improvement.1,2
If there is improvement, the leader
acknowledges the improvement
and asks for the behavior to be
sustained.
If there is little to no improvement,
the leader reviews the observed
behaviors and reiterates what is
expected.
These conversations are
documented in the “Feedback”
section of Performance Manager™.
There should be NO SUPRISES for
the employee regarding where they
stand during and at the conclusion
of this process.
Determine
Net
Contribution
Step 5
Provide
Monthly
Feedback
Document
Expectations
first time we completed this process in 2008, we did not require documented follow-up.
Over the years we have moved from none , to quarterly, to monthly follow-up required.
Identify
Specific
Behaviors
Clarify
Expectations
What are our results?
120
100
80
70 Total
60
102
40
20
0
30
5.4%
2008
24
25
2010
2011
1.1%
2009
Net- Identified
Cummulative Net- Terminated
34
1.6%
2012
What are our results?
Net Organizational Contribution
Process Began
Percentage/Percentile
100
95
90
85
80
75
75
68
63
36
36
29
70
FY03 FY04 FY05 FY06 FY07 FY08 FY09 FY10 FY11 FY12 FY13
YTD
GPTW Survey Overall Statement
Retention Rate
Employee Survey
What have you learned?
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Most of us harbor net-negative people in
our organizations.
They are cancers and they are
metastasizing.
Unchallenged, they will kill your
organizational will to succeed.
These are not easy problems to fix.
But you can—and must—fix them.
Following a fair and proven process—in
spite of the way you feel—is the answer.
Their victims will thank you for it.
Six Disciplines Client Summit 2013
What is your personal
commitment to a next step?
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D.
E.
F.
I will personally lead the design and deployment of
such a process in my organization, and I will
persevere until it produces results.
I will make a formal proposal to my executive
colleagues to design and deploy such a process
within 30 days.
This idea has merit, and I will initiate a concept
discussion with key colleagues next week.
This is a real problem in my company, but I don’t care
enough to get involved.
This idea has no merit, and I will make no personal
commitment of any kind.
I may be a net-negative person, and I will resist this
idea with every fiber of my being.
Where can you learn more?
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Consult directly with the SOMC HR leaders who designed and
deployed this leadership process, Vicki Noel1, NoelV@SOMC.org,
and Ken Applegate, AppgateK@SOMC.org.
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Join the discussion about practical approaches to more
effective leadership on the SOMC Leadership Blog.
Learn more about Southern Ohio Medical Center here.
Review and download this presentation and related
presentations and white papers here.
Read Results That Last: Hardwiring Behaviors That Will Take
Your Company to the Top to review some leadership
strategies that successful health care executives have
embraced.
Learn more about how to confront others effectively by
reading A Portable Mentor for Organizational Leaders.
Learn more about how to execute these leadership strategies
more successfully by reading Six Disciplines Execution
Revolution: Solving the One Business Problems That Makes
Solving All Other Problems Easier.
Assess your own level of happiness here.
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1Vicki
Six Disciplines Client Summit 2013
Noel contributed greatly to the preparation of this presentation.
How can you contact me?1
Kendall L. Stewart, M.D.
VPMA and Chief Medical Officer
Southern Ohio Medical Center
Chairman & CEO
The SOMC Medical Care Foundation, Inc.
1805 27th Street
Waller Building
Suite B01
Portsmouth, Ohio 45662
740.356.8153
StewartK@somc.org
KendallLStewartMD@yahoo.com
www.somc.org
www.KendallLStewartMD.com
1Speaking
and consultation fees benefit the SOMC Endowment Fund.
Six Disciplines Client Summit 2013