VASVH
Winter Conference
How Leaders Create a Culture of High
Performance
March 3, 2011
8:00-11:15
Presented by
Tom Atchison
This session will be valuable
to me if I learn, solve,
understand, create….
SECTION ONE
Overview of Concepts
Human
Motivation
TANGIBLES
INPUTS
OUTPUTS
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Cash
People
Policy/Procedures
Strategy
Plant
Information Systems
Communications
• Profit
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Market Share
Products
Customer Satisfaction
Growth
Productivity
• Quality
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Meaning
Caring
Giving
INTANGIBLES
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Mission
Values
Vision
Inspiration
• Leadership
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Recognition
Motivation
• Inner Peace of • Culture
• Followers
Purpose
• Commitment
• Joy
• Job Satisfaction
• Pride
• Team Spirit
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Trust
• Quality
Leadership/Management
Leadership
Management
Leaders lay the track.
Managers make sure the trains run
on time.
Leaders are thermostats.
Managers are thermometers.
Leaders are gyroscopes.
Managers are compasses.
Leadership—Management
Inspires
Influence
Listens
Vision Focus
Manages change
Minutes (1440)
Relationships
People
Predictable
Control
Talks
Tactics Focus
Reacts
Money
Plans
Policies
Farmer – Soil – Seed
Farmers don’t grow crops.
They create the conditions in which
Crops can grow—flourish.
Leaders don’t motivate anyone.
They create cultures that unleash
human potential!!
Remember
Balance
No Balance, No Business
No People, No profits
One Thing Learned
One Application
Questions
SECTION TWO
Leadership – Defined
Two Important Questions
1. Why would anyone subordinate their selfinterest to follow someone else?
2. And, why would someone follow you/me?
The Answer to Both Questions
Values + Vision+ Trust
Leadership - Definition
“Leaders
have trusting followers
with aligned values who commit
to achieving a vision within a
culture of performance”
-Tom Atchison
Remember
Values
First
Values - Definition
• Decision Rules
• Motivational Influences
• Behavioral Drivers
BEHAVIORS
FEELINGS
EMOTIONS
VALUES
Hard
Easy
Sample Values
1. Friendship
2. Being Liked
3. Risk Avoidance
4. Quality of Care
5. Patient Satisfaction
Vision - Definition
• Visions are statements of destination, so, they
are forward-looking.
• Visions are conceptualizations of hopes for the
future.
• Visions express a sense of the possible (not the
probable).
• Visions are unique, they set you apart from
everyone else.
Transcendent Purpose
VISION
Inspirational
Directional
Measurable
STRATEGY
TACTICS
INDIVIDUAL PERFORMANCE
Trust - Definition
• Trust is the perception of honesty, openness and
reliability/ dependability.
• Trust increases in direct relationship to the
frequency of meaningful interactions.*
• Trust takes a long time to develop and can be
weakened or broken easily.
• Trust is the lubricant needed to ease tensions
• Trust is the glue that holds teams together
• Trust and being liked are not the same
One Thing Learned
One Application
Questions
SECTION THREE
Corporate Culture
What is Corporate Culture?
Corporate Culture is the
organization’s
personality and is strong
to the degree that
behaviors reflect values.
Cultures
• USA
• Fort Worth---San Francisco
• Europe
• Istanbul
Culture
creation/strengthening is
the process of converting
words to behaviors. It is
personality development.
Behavior* is the Culture Metric
Behaviors are different from emotions, feelings and
impressions. Behaviors have these characteristics:
1. Observable
2. Repeatable
3. Measureable
The two metrics for behavior are:
1. Frequency, and
2. Duration
*Words lie—Behaviors are the truth
Strength of Culture
Organizational Dynamics
Executives---Physicians
Decision Process
Influence---------------------------------Control
Perception of Time
Long Range--------------------------------Now
Sense of Self
Part of a Team---Protection of Individual Prerogative
Locus of Control
Corporate Strategy-------------------Practice Needs
First Loyalty
To the Corporation-----------------------To the Patient
One Thing Learned
One Application
Questions
SECTION FOUR
What Leaders Do
to Manage Change
Change Quotes
“Change before you have to.”
“If the environment changes faster than you do, you will be out of business”
-J. Welch
“Manage change or react to change.”
-T. Atchison
“All organizations are perfectly aligned to get the results they are getting.”
-D. Berwick, MD
“If you change nothing—nothing changes.”
-T. Atchison
“Hope is not an effective strategy for change.”
-T. Atchison
“Remember, the stone age didn’t end because they ran out of stones.”
-Rick
“We cannot solve today’s problems working from mindsets that created them.”
-paraphrase from Albert Einstein
CHANGE
Dynamics of Change
The Easy to Hard Continuum
Midpoint
I understand
I want, I control
I don’t want and
don’t control
Dynamics of Change
The Anxiety/Behavior Continuum
Window of Opportunity
for Change
Happy individuals
resist change
Angry individuals
resist change
“Contrary to popular belief,
happiness doesn’t result from
relaxation or completely stressfree living, but from meeting
challenges with intense activity
and interest.”
Mihaly Csikszentmihalyi
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Pride Indicators*
1 – Strongly
Disagree
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2 – Disagree
3 – Uncertain
4 – Agree
5 – Strongly
Agree
I have a sense of loyalty to this company.
I identify with this company.
I think about the future of this company.
I’ve regretted that I chose to work for this company.
I do extra work here because I want this company to succeed.
I feel that I share in the success and failure of this company.
I feel a sense of ownership in this company.
It would take very little for me to move to another company.
I take pride in being part of this company.
*Any indicator less than 4.0 needs to be addressed.
© MetriTech
REMEMBER
1. Each person is correct from their point of
view;
2. Collect all points of view;
3. Find points of greatest agreement; and
4. Focus of the future.*
*You can’t un-ring a bell!!
Remember
1.Always agree on the end game,
2.Always agree on metrics, and,
3.Specificity is the key.
Managed Change
Vision
Think Small
Move Fast
Evaluate
Celebrate
Remember
1. We are very much controlled by our historical
relationships with symbols.
2. Understand “Pre-emptive behavioral response
clusters.”
3. What do you symbolize—to various
people/groups?
4. What are your organization’s most important
cultural symbols?
One Thing Learned
One Application
Questions
Section Five
Talent
Component #5: Talent
Talent vs. FTE
Values fit
Alignment interviews
Developmental on-boarding
Re-recruitment of high performers
Professional development
Credentials fit
Competencies interview
One-time orientation
All treated equally
No Prof. development
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Talent Management
1. Hire to fit, not to fill.
2. Designate the human resources executive as
the Chief People Officer (CPO).
3. Develop and promote to capacity.
4. Remove non-productive or toxic personalities.
5. Specificity to rewards for performance.
“Hiring Grid”
DOMAIN
1. Knowledge
2. Skills
3. Attitude
DX
Academic
Credentials/Tests
Competencies
Climate/Opinion
Surveys
RX
Education
Training
Recognition
Practices
4. Motivation
Culture
Assessment
Organizational
Development
5. Values
Culture
Assessment
Organizational
Development
6. Capacity
7. Personality
Interview/Work
Performance
API, Myers-Briggs
Selection
Therapy/Drugs
Time Spent in Each Cell
Noise Level
3
2
Cynics
SKEPTICS
Who is a low performer, feels
undervalued and always
complains?
Who is very hard-working,
creative, critical and annoying?
Stabilizers
4
SLUGS
1
STARS
Who currently behaves the
Who is a low performer, but
way you wished everyone
reluctantly does just enough to
behaved?
stay?
Contribution to Performance
N/600
One Thing Learned
One Application
Questions
Personal Contract for Change
I, ________________________________________________________
(Name)
Promise to ________________________________________________
__________________________________________________________
__________________________________________________________
These changes will be performed by:
__________________________________________________________
(Date)
I need to work with the following people if I am to fulfill this contract:
__________________________________________________________
__________________________________________________________
__________________________________________________________
Tom Atchison
Suggested Readings
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Jim Collins, Good to Great
Jim Collins, How the Mighty Fall
Steve Covey, Jr., The Speed of Trust
James C. Hunter, The Servant
James T. Philips, Lincoln on Leadership
Michael H. Hoppe, Active Listening
Carson Dye and Andrew Garman, Exceptional Leadership:
Sixteen Critical Competencies
Joe Bujak, MD, Inside the Physician’s Mind
Henry Mintzberg, The Rise and Fall of Strategic Planning
Tom Atchison, Leadership’s Deeper Dimensions
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