Six Disciplines Client Summit 2013 Building a Culture of Leadership Creating and Sustaining a High-Performance Leadership Culture High-Performance Leadership Culture Some Practical Perspectives from SOMC Leaders 1,2,3 Kendall L. Stewart, MD, MBA, DLFAPA 1 Any person who aims to speak about leadership must approach that task with fear and trembling. 2 I will speak about leadership at SOMC, where I have more than 30 years experience. 3 I hope my limited perspectives will be thought-provoking.

Why is this important?  After listening to this presentation, you will be able to answer the following questions:  Why is leadership excellence such a challenge?  What common leadership flaws limit leadership effectiveness?  Why is physician leadership such a challenge in health care?  What are some of our expectations for SOMC leaders?  How are we sustaining our culture of leadership excellence?  What are our results?  Every leader says she wants to create and sustain a culture of excellence in her organization.culture of excellence  But only a minority of organizational leaders are willing to pay the price.  Complacency, impatience and a natural resistance to change are hard to overcome. 1 natural resistance to change  Success is a huge barrier.  For those who are serious and willing to pay the price, here are some practical strategies that will work.  The work is incredibly hard, almost entirely thankless and never done.  But we signed up for it. 1 Persuading leaders to do what it takes is harder than teaching a man to be romantic.

Why is leadership excellence such a challenge? Six Disciplines Client Summit 2013  There is no formula for producing successful leaders.  Every leader is flawed; the biggest flaw is that the leader doesn’t see it.  There are all kinds of “successful” leaders including negative, disruptive and evil leaders.  And there is a leadership Bell Curve too.  There are those who want to lead and can’t, and those who could but won’t.  There is the inevitable leader turnover.  Leaders first try what worked in their last job; when they figure out that approach is wrong, they master new skills then move to the next level and repeat the same mistakes. 1,2  Leaders are always part of the solution and part of the problem.  And this is the short list. 1 Your first day as a new leader is terrifying—unless you are completely stupid. 2 On my first day as a read doctor, I took over a service of 30 crazy people.

What common leader flaws limit leadership effectiveness?  The inflexible leader  The leader who does not walk the talk  The risk-adverse leader  The always-late leader  The blaming leader  The excuse-making leader  The passive-aggressive leader  The abrasive leader  The abusive leader  The clueless leader  The gossiping leader  The emotional leader  The impulsive leader  The unprepared leader  The fearful leader  The thin-skinned leader 1  The perfectionist leader  The selfish leader  The entitled leader  The angry leader  The lazy leader  The naïve leader  The avoidant leader  The unrealistic leader  The complacent leader  The leader who keeps secrets  The leader who needs to please 2  The leader who tells people what they want to hear  The resistant leader  The coasting leader  The procrastinating leader 1 Exceptional leaders expect and thrive on opposition; this is why salespeople usually make such poor leaders and Board members. 2 The widespread notion that if anyone is unhappy the leader is to blame is particularly pernicious.

Why is physician leadership 1,2,3 such a challenge in health care? Six Disciplines Client Summit 2013  Our health care system is physician-centric; physicians are highly influential leaders—ready or not.  We trained in a feudal system; we expect to be feudal lords and ladies of our own fiefdoms within a few years of finishing our training.  Physicians want leadership titles and more money, but we rarely want to actually lead.  We believe leadership is easy; we just show up and tell people what to do.  And we have one prescription for everything; just do whatever it takes to make physicians happy. 1 Physician leaders are often elected by their peer for one-year terms; their job is to carry complaints to administration. 2 Most hospitals have physicians they employ, physicians employed by their competitors and independent physicians. 3 Few physician leaders identify with administration or embrace any significant organizational perspective.

What are some of our expectations for SOMC leaders?  We expect leaders to manage their emotional arousal appropriately.  We expect leaders to have servant hearts.  We expect leaders to grow thick skins.  We expect leaders to field the best-available teams.  We expect leaders to embrace (energizing) discomfort.  We expect leaders to focus on results.  We expect leaders to be respectful team players.  We expect leaders to lead by example. 1,2,3  We expect leaders to hold themselves and others accountable.  We expect leaders to talk to people instead of about them. 1 “This is Physician Leadership Rounds, not Physician Blaming Rounds.” 2 “Every problem in here is your problem” 3 “Anger is a leadership flaw; angry behavior is a leadership failure.”

What are SOMC’s top ten leadership strategies? 1 Six Disciplines Client Summit Twice each year, the executives meet with all new leaders to go over these principles and to explain WHY and HOW.  Focus on results.results  Become a process improvement expert.process improvement  Manage yourself first. Manage yourself  Field the best-possible team.best-possible team  Remind yourself that most of the work in the world is done by average people.average people  Extrude net-negative people.net-negative people  Embrace discomfort. Embrace discomfort  Learn to manage crises while striving to prevent them.manage crises prevent  Think, innovate and act.  Lead physicians effectively. Lead physicians

How are we sustaining our culture of leadership excellence?  Physician Leadership Rounds  Physician Leadership Council  Physician Leadership Institute  Physician Executive Fellowship  Administrative Partnerships  Leadership Rounds  Leadership Council  Leadership Development Institute  Leadership Teams  BookNotes  Leadership Blog  Innovations Group

What are our results? Patient-Centered Perfection is the Goal Safety  Quality  Service  Relationships  Performance

What do our patients think 1 about our leadership culture? 1 I recently learned how quickly our patients expect us to respond from Amazon.

What do our employees think about our leadership culture?

What do our leaders think about our leadership culture? 1 1 In our 2012 survey, a number of SOMC leaders made negative comments about our recent decisions not to hire tobacco users.

What do our physicians think about our leadership culture? 1,2 1 ”Excellent” Percentile Rankings 2 Professional Research Consultants, May 2013

What have you learned? Six Disciplines Client Summit 2013  Building and sustaining an organizational culture of excellence is hard.  It cannot be done without leaders who are passionately committed to excellence.  Most leaders are not; the top 10% is only 10%.  Fortunately, you do not need everyone; you just need enough to get it done.  And if you look hard for potential, clarify your expectations and give them the support and tools they need over time, you can find enough passionate leaders to do it. 1 1 As an aspiring leader, I heard the voice of God in Kmart.

Where can you learn more? Six Disciplines Client Summit 2013  Download “Expectations for SOMC Leaders” and use this document as a resource for your own expectations white paper.Expectations for SOMC Leaders  Join the discussion about practical approaches to more effective leadership on the SOMC Leadership Blog.SOMC Leadership Blog  Learn more about Southern Ohio Medical Center here.here  Review and download this presentation and related presentations and white papers here.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.Results That Last: Hardwiring Behaviors That Will Take Your Company to the Top  Learn more about how to confront others effectively by reading A Portable Mentor for Organizational Leaders.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.Six Disciplines Execution Revolution: Solving the One Business Problems That Makes Solving All Other Problems Easier.

How can you contact me? 1 Six Disciplines Client Summit Speaking and consultation fees benefit the SOMC Endowment Fund. Kendall L. Stewart, M.D. VPMA and Chief Medical Officer Southern Ohio Medical Center Chairman & CEO The SOMC Medical Care Foundation, Inc th Street Waller Building Suite B01 Portsmouth, Ohio