Helping identify who is on the bus, who is off the bus, and how to implement a progressive and healthy healthcare culture. * 87% of companies find Company Culture as priority * Netflix Manifesto Discusses Behaviors (as Values) * GoreTek "we don't manage people, we expect people to manage themselves" * Good to Great companies hire from within * Changing Culture takes relentlessness, consistency, transparency, and tone at the top leadership * Company Culture does not exist without embrace of accountability

2. Robert Babb, PT, MBA
LANSDALE QUAKERTOWN MONTGOMERYVILLE TROOPER GLENSIDE
www.ptwinstitute.com

3. Name of Talk

4. Harsh Reality
Shift Happens
Eat Shift
Culture = Brand

5. • The Culture of your
organization is a reflection of
you
1
• You learn to manage culture,
or it will manage you2
• Your organization’s future
may depend on the culture3
Foundation

6. Goals of Today
• What is the Brand Culture Connection
• Culture affects your workspace1
• What others are saying about culture
• Culture bus; on or off2
• Why invest3
• Culture in action4

7. Who’s talking?
The Unique Cultures of 10 Hugely Successful Companies
entrepreneur, August 2015
Culture: Why It's The Hottest Topic In Business Today, March 2015
Recruting for Cultural Fit , And why it’s important. July 17, 2015
Harvard Business Review
The naked organization
dupress.com/articles/employee-engagement-culture-human-capital-trends-2015

8. Who Am I?

9. About PTW
LANSDALE QUAKERTOWN MONTGOMERYVILLE TROOPER GLENSIDE
www.ptwinstitute.com

12. • Create: People, Positions, Processes
• Lead: through risk and uncertainty, reduce skepticism
• Purpose : Constant/consistent (people, good will, profit)
• Growth: goal oriented
– Start with an end in mind
MBA 101
What we are told to do for success

13. What if?

14. Why care?
• Bottom line
• Its trivial
• Measurability

15. Why care?
• Good to Great, Jim Collins

16. Why care?
• Last year (2014) Merriam Webster’s dictionary stated
that ”culture” was the most popular word of the year.
• “it has become one of the most important words in
corporate board rooms, and for good reason”
• Gallup’s latest research (2015)
– only 31% of employees are engaged at work
– 51% are disengaged
– The average employee gives their company a C+ (3.1 out of 5) when asked whether they would
recommend their company to a friend
• (Deloitte research with Glassdoor).

19. Definition of culture
• Culture is the unique collection of beliefs and
practices that communicates a company’s
values, whether or not they’ve been
formalized or articulated.
• A well-designed culture unites stakeholders
in a shared understanding of "the right thing
to do."
• http://www.fastcompany.com/3020929/leadership-now/80-of-companies-dont-
care-about-company-culture-do-you

20. Missing the Boat

21. Challenges of a good culture
• Even if they are on the boat….
• Most leaders greatly underestimate how many
repetitions it takes for a message to sink in.
– Message of change, policy, needs reinforcement over and
over and over again

22. • A great culture doesn’t evolve naturally.
Challenges of a good culture

23. • Poor recite of mission, values, principles
• Lack of Persistence
• Lack of flexibility
• Poor relationships
• Poor retention
Challenges of a good culture

24. Challenges of a good culture:
Ownership/Accountability

25. Change in Culture
• Foundation of a culturized organization?
– accountability

26. Change in Culture
• Five Steps to Managing Cultural Change, Wharton
Press
• http://executiveeducation.wharton.upenn.edu/thoug
ht-leadership/wharton-at-work/2014/09/managing-
culture-change
• Don’t leave culture change to chance — create and
manage
– http://executiveeducation.wharton.upenn.edu/thought-leadership/wharton-at-
work/2014/09/managing-culture-change#sthash.uu5VroTO.dpuf
• Culture is 24/7

27. Culture Happens w/ Investment
Buy In/Invest
• Involved
• Agree
Comply/Concede
• Disagree
• Involved
Exempt/Excuse
• Agree
• Uninvolved
Resist/Resent
• Disagree
• Uninvolved
New PT Syndrome
Low ownership, some
readiness to change
Ownership, change agent
Ownership, Invested in change

28. Identify the seats
Accountability in action
See It
Own It
Solve it
Do it
Nothing in your culture will change unless the people in the
organization changes the way they think. Meaningful
change occurs on the value fulcrum only.

29. Identify your Seats
Are we leading the right people?
High Performers
Low value drivers
High Performers
High Value drivers
Low Performers
Low value drivers
Low Performers
High Value Drivers
Performance
Cultural Values

31. Culture Engine
“Nothing gets people to change faster than getting them
to change about the way they think”
The Art of Reframing; Reviewed by Kelly Sanders in Impact
• “Great leaders can look at the same things through multiple perspectives”
• “Have a clear vision of what is needed to achieve success”
• “Leaders need to understand 4 key areas of the leadership terrain”
Structural
Human resources
Politics
Symbolic

32. Servant leadership
(is the foundation of leading others in your culture)
• Clarify and Reinforce
– Educate others w/ words and actions
• Listen intently and observe closely
– Understand the world others live in
• Act as selfless mentors
– Boost others
• Demonstrate persistence
– Lovingly tenacious, invest in others to educate
– Inspire others to lead
• Hold others accountable

33. Good to Great
• Greatness is an inherently dynamic process,
not an endpoint. The moment you think of
yourself as great, your slide toward
mediocrity will have already begun”
– If you want greatness for your organization,
working the culture becomes your number one
priority

34. To enthusiastically deliver quality driven
physical therapy and quantifiable
fitness programs and services
to our valued customers
while exceeding
their expectations
and forming
meaningful
relationships.
Mission

35. Values built into our Mission
• Enthusiastic
– Purpose, Passion, Fun
• Quality Drive
– Empathy, Evidence Driven
• Quantifiable
– Measure, Celebrate Success
• Value your customers;
– Servant Mentality,
– adaptable, flexible
• Exceed expectations
– Delight our customer, Raving Customers
• Form Meaningful relations
– Engage, Empathy, use the resources
• Remain profitable
– Successful outcomes

36. Our Valued Customers are:
Anyone in contact or potentially in contact, any
other person or entity that has a stake in
what PTW has to offer, including:
 Customers exploring (walk in tours and phone
calls)
 Current and past patients and customers
 Medical professionals
 Case managers, insurance companies, lawyers
 Community organizations
 Sports teams
 And much more!
PTW Mission Defined:

37. • Values
– Webster's: Ideas of a traditional or conservative kind which are
held to promote the sound functioning of an organization and to
strengthen the fabric of society
• Morals, Standards, ethics, and ideas that build the
foundation of your decision making throughout the
organization.
– Success: you need to practice them every day, to
every person, at every level.
– Values are set from “Tone at the Top”, making
company culture transparent in most
organizations.
Shift happens
Align vision with Organizational values

38. How to implement
• Who is on the bus
• Do it 10
• Solve it 9
• Own it 8
• See it 7
• Wait and see 6
• Cover your tail 5
• Confusion 4
• Finger pointing 3
• Its not my job 2
• Ignore it 1

39. Accountability not in action
Observe behaviors
Poor
Culture
Finger
Pointing
Cover
your tail
Its not my
job
Ignore
Wait and
see
Tell me
what to
do

40. Line of Accountability
above or below
See It
Own It
Solve it
Do it
Poor
Culture
Finger
Pointing
Cover your
tail
Its not my
job
Ignore
Wait and
see
Tell me
what to do

41. Implementing your culture
• What type of culture do you have now
• Re establish your mission
• Identify Values
• Guiding principles

42. Dysfunctional
• Conflict, disagreement
• Rudeness to each other,
customers
• Managing by intimidation
• Tension, bullying

43. Tension environment
• Tension
– Cliques, isolation of teammates, customers
– Jokes of sexual/political in nature
– Roles and efforts are undermined
– Gossip is prevalent, permitted
– Poor leadership

44. Acknowledgment level
• Respect is communicated often
• Leaders and team members pro actively
engage peers
• Credit giving willingly
• Still Not Good Enough!
• Keep working on it

45. Civility Environment
• Consistent sanity
• Work relations are professional
• Formal, diplomatic, maybe distant
• Work environment psychologically safe and
respectful
• AVERAGE

46. Validation level
• Workplace inspiration
• Credit giving for achievements
• Responsibility given for the engaged
• Players act independently and cooperatively
– Accountability
– See it, own it, act on it

47. Goal
• Invest our time in energy of communications,
coaching, and celebration of desired culture
– High performers, High value drivers
• invest in, compensate, celebrate them
– High performers, Low Value drivers
• Self servers, missing commitments to culture/values, share
with the competition
– Low performers, low value drivers
• share with the competition, lovingly set free
– Low performers, high value: guide, mentor, invest,
re assess, guide again, share with the competition if
no willing to practice with performance

48. What is the Culture like now?
• Dysfunctional
• Tension
• Civility
• Acknowledgement
• Validation

49. • How do we surround ourselves with the right people?
• How do we get to work for folks that work for the
common cause?
• How do we communicate what the common cause it?
How do we hire the Right one?

50. More reason to invest in Culture
• It will manage you if you don’t manage it
• You won’t have to fire folks (3 in 14 years)
• References from good to great
• References from Culture Engine
• References from

51. How to change Culture

52. More reason to invest in Culture
• High staff turnover through surprise
• Low staff turnover with high fire rate
• You have partial performers who put your
organization into disarray
• You have low staff morale
• You have hesitancy to share your patients
with colleagues

53. Problems
You have no mission, values and identified principles for your people to decide
how to behave
(you have a lot of notes to write)
OR
You have a mission
You have values
You have principles or behaviors
You manage by announcement
• Leaders do a good job defining purpose or policies, procedures
• They publish and announce details, and expect employees to
automatically align to them
Reference: Culture Engine (2/3 rule, have mission, don’t know it)

54. Brand-Culture
What others have said
• Harvard Business Review, Bill Taylor
• https://hbr.org/2010/09/brand-is-culture-culture-is-br
• Can’t think about your customers unless you think about your people
• It is about caring more than other companies
– about customer
– about colleagues
• Its about how the organization conducts itself in a world with endless
opportunities to cut corners and compromise on values.
• Its what helps you stand out among your customers, and stand out
from the crowd in a hyper-competitive marketplace.
• The “power couple” inside the best companies, is an iron-clad
partnership between marketing leadership and HR leadership.
• Your brand is your culture, your culture is your brand

55. Health Care is Changing

56. Brands losing
• Your culture is identified by your value systems
• The closer your values are aligned with
mainstream and successfully culturized, the
more value you create (Shultz)

57. Brands down and out, came back
71 87 92 2011

58. Why Culture builds your Brand
• Company beliefs should be integrated into the fabric of
the brand
• In order for any brand to survive in competitive society,
it must be unique
• The employees of the organization make it unique
• The brand must give the audience a reason to believe
• It must offer a crystal clear benefit to the consumers
• In other words, all your staff (of independent thinkers)
needs to share the same values

59. More reasons to invest in Culture
• Companies with strong culture
– Gore (we don’t manage people)
– J & J (Credo) - Progressive
– Netflix (Manifesto)
– Disney - Chick Fil A
– Twitter
– Southwest Airlines, Wegmans, REI, Citrix, Nike
– Zappos
– AMAZON??

60. Principles that guide our practice
Minimize non essential conversation
Use forms, close endeds to your advantage
Guide conversations
Kitchen Table Conversation
Spotless
Lasting Impressions
Consider yourself dumb

61. Principles that guide our practice
Follow the leads
Fun
Urgency
Anticipate
Have a plan

62. Summary
Culture beats Scheme
Implementation
Constant reminder and reference
Tone at the top
ACCOUNTABILITY

63. THANK YOU

64. The Unique Cultures of 10 Hugely Successful Companies
http://www.entrepreneur.com/article/249293
Culture: Why It's The Hottest Topic In Business Today, Forbes, March 2015
http://www.forbes.com/sites/joshbersin/2015/03/13/culture-why-its-the-hottest-topic-in-
business-today/
Netflix Manifesto
http://www.slideshare.net/reed2001/culture-1798664
Recruiting for cultural fit, Harvard Business Review, July 2015
https://hbr.org/2015/07/recruiting-for-cultural-fit
Culture and Engagement, The Naked Organization, Deloitte Press, 2015
http://dupress.com/articles/employee-engagement-culture-human-capital-trends-2015/
Good to Great, Collins

65. Five Steps to Managing Cultural Change, Wharton Press
http://executiveeducation.wharton.upenn.edu/thought-leadership/wharton-at-
work/2014/09/managing-culture-change
Change the Culture, Conners Smith
http://www.amazon.com/Change-Culture-Game-Breakthrough-
Organization/dp/1591845394/ref=pd_sim_14_2?ie=UTF8&refRID=0FAMKE0RTSZ4Y3S8CT
GY&dpSrc=sims&preST=_AC_UL320_SR208%2C320_
Journey to the Emerald City, Conners
http://www.amazon.com/Journey-Emerald-City-Roger-
Connors/dp/073520358X/ref=sr_1_1?s=books&ie=UTF8&qid=1442067155&sr=1-
1&keywords=journey+to+the+emerald+city
The Culture Engine
A Framework for Driving Results, Inspiring Employees, and Transforming your Workspace
Edmunds
http://www.amazon.com/Culture-Engine-Framework-Inspiring-
Transforming/dp/1118947320/ref=sr_1_1?s=books&ie=UTF8&qid=1442068399&sr=1-
1&keywords=the+culture+engine

66. The End
Thanks for listening