Slides used by Values Coach CEO and Head Coach Joe Tye in presentation for the 2017 annual conference of the Wyoming Hospital Association, part 1 of 3 parts.

2. The Florence Prescription
From Accountability to a
Culture of Ownership
Wyoming Hospital Association
September 21, 2017
Joe Tye, CEO and Head Coach
Values Coach Inc.
Copyright © 2017, Values Coach Inc.

3. Our itinerary
 Blueprinting Your Invisible
Architecture
 Strategies for Building a
Culture of Ownership

4. Why we do what
we do >>>>>

7. Guiding insight #1
Culture does not change
unless and until people
change.

8. Guiding insight #2
People will not change
unless given tools and
structure, and inspired to
use them.

9. “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

17. There is an invisible barrier on the
potential of your organization

18. The Leadership
Challenge

19. 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

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

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

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

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

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

27. Question #1
When did the
healthcare crisis
begin?

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

30. We need to respark the
spirit that Florence first
sparked at the Scutari
Barrack Hospital!

31. Question #2
When will the
healthcare crisis
end?

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

40. Spark
Plugs
40

41. Zombies
41

42. Vampires
42

47. Disengaged people, especially
disengaged managers, are a
quality defect

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

52. The Satisfaction 
Engagement 
Ownership Continuum...
And the retention
problem child

53. I sure am
satisfied

55. Checklist
complete and
all systems go?

56. Check!

57. I’ve got my
application in
at Southwest

58. Me too!

59. 10 minute
turnaround:
Check!

60. Problem child
Engaged but not loyal

61. The journey from mere
Accountability
to a culture of
Ownership

62. Ac
count
able

64. 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.

65. Son, you’ll be proud
of your old Dad...
Today the boss held
me accountable.

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

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

71. What a culture of
accountability feels like
to the person being
held accountable?

72. “Culture eats
strategy for lunch.”
Peter Drucker

73. What happens when
your culture eats
your strategy for
lunch?

75. 34,876,693 views
138,944 – avg 5 stars

77. Just when you thought United’s PR
catastrophe couldn’t get any worse

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

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

87. First
impressions

88. The Great Wyoming
Values and Culture
Challenge

89. 89
Star Valley
Medical Center
Memorial Hospital
of Converse County

91. END RESULT
Crowned Values King – Bring Home the Trophy!

92. Posted version
Compassion
Advocacy
Respect
Excellence

93. Posted version
Compassion
Advocacy
Respect
Excellence
Group version
Integrity
Enthusiasm
Loyalty
Stewardship
Ownership
Fun

94. Service
Environment
Inspiration
Respect (ful) (ed)
Honesty/Integrity/Transparency
Community
(Com)Passion
Positive
Team Spirit
Family Atmosphere
Appreciation
Pro-active
Effective Communication
Innovation
Spirituality
Competency
Confidence
Ownership
Loyalty
Courageous/Determination
Dignity
Ethics
Trust
Humility
Patient-centered
Fun
Wisdom
Hospitality
Stewardship
Perseverance
Engagement
Commitment
Attentiveness/Consideration
High Standards (Hiring Bar)
PLEASE CIRCLE YOUR TOP 5 ONLY!

95. From…
Compassion
Advocacy
Respect
Excellence
To...

97. Invisible Architecture™
is more important than
bricks & mortar

98. The Blueprint
Behind the
Blueprint™

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

100. 3 stages

101. TheFoundation

102. Integrity
Compassion
Accountability
Respect
Excellence

103. The problem with
generic values
statements >>>>>

104. Problem #1
They do little to
differentiate you from
everyone else who has
the same posted values

105. Problem #2
They establish minimal
expectations (of course
patients expect integrity
and excellence and etc.)

106. Problem #3
They are unlikely to
inspire team members
(who likely don’t know
them anyway)

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

108. TheSuperstructure

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

110. Where will I
take you for
lunch?

112. or...

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

115. Same
business
Different
cultures

116. People pay to
shop at Costco…

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

118. Same
business
Different
cultures

119. Nap
Rap

120. “Advertising is a tax
you pay on having an
unremarkable culture.”
Robert Stephens, Founder of Geek Squad

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

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

123. Describe your culture
in just 6 words.

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

125. Cypress Semiconductor Motto
The Marine Corps of
Silicon Valley

126. The Real Marine Corps
The Few, the Proud,
the Brave*
* And you’re not one of them

127. 127
From managers sitting
in the same room at
one large medical
center’s leadership
retreat

128. 128
We love patients and
each other

129. 129
We are ALWAYS
here for you

130. 130
Multiple priorities,
limited resources,
great expectations

131. 131
We’re entitled,
hating it,
and staying

132. 132
Disjointed
departments
working against
each other

133. 133
Negativity reigns
while circling the
drain

134. 134
I’ve been here
longer – you
leave

135. 135
Beatings will
continue until
morale improves

136. The Florence Challenge
Emotionally Positive
Self Empowered
Fully Engaged

144. Therapy pets
can even sign!

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

146. And...
Cultural work can’t be just a
“flavor of the month”

147. Culture doesn’t change
unless and until people
change

148. TheInterior

152. 152
Employee disengagement costs our
economy $500 billion per year!
The organizational cost of emotional
toxicity is more than $12,000 per
year per employee!

153. 153
Workplace attitude is
determined by what you
expect and what you
tolerate…

154. 154
And over time, what you
tolerate will dominate
over what you say you
expect!

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

156. Sometimes nurses really
do eat their young

157. Toxic Emotional Negativity
The healthcare
crisis within

160. Actual result for a critical
access hospital:
$3,280,000

161. Actual result for a large
community hospital:
$13,930,910

162. Actual result for a multi-
hospital system:
$119,000,000

163. Build a
Culture of
Ownership

164. Midland Memorial Hospital
Values and Culture Initiative

165. RN Turnover:
 32% reduction overall
 43% reduction for new nurses
(in first 2 years of employment)

166.  Significant reductions in
overtime and $2.5 million
annual reduction in contract
labor expenses
 Total employee count reduced
by over 100 FTEs

167.  Patient satisfaction from
record low to record high
 Emergency Department from
bottom 10% to top 10%

168. Emergency Department

169. Annual Cultural
Productivity Benefit
$7,200,000

170. Do you have to start with the
right people on the bus?

171. You can’t always
choose who you have
on the bus!

173. You can’t just throw
all the “wrong” people
off the bus!