Welcome to Tom Peters “PowerPoint World”! Beyond the set of slides here, you will find at tompeters.com the last eight years of presentations, a basketful of “Special Presentations,” and, above all, Tom’s constantly updated Master Presentation—from which most of the slides in this presentation are drawn. There are about 3,500 slides in the 7-part “Master Presentation.” The first five “chapters” constitute the main argument: Part I is context. Part II is devoted entirely to innovation—the sine qua non, as perhaps never before, of survival. In earlier incarnations of the “master,” “innovation” “stuff” was scattered throughout the presentation— now it is front and center and a stand-alone. Part III is a variation on the innovation theme—but it is organized to examine the imperative (for most everyone in the developed-emerging world) of an ultra high value-added strategy. A “value-added ladder” (the “ladder” configuration lifted with gratitude from Joe Pine and Jim Gilmore’s Experience Economy) lays out a specific logic for necessarily leaving commodity-like goods and services in the dust. Part IV argues that in this age of “micro-marketing” there are two macro-markets of astounding size that are dramatically under- attended by all but a few; namely women and boomers-geezers. Part V underpins the overall argument with the necessary bedrock—Talent, with brief consideration of Education & Healthcare. Part VI examines Leadership for turbulent times from several angles. Part VII is a collection of a dozen Lists—such as Tom’s “Irreducible 209,” 209 “things I’ve learned along the way.” Enjoy! Download! “Steal”—that’s the whole point!

NOTE: To appreciate this presentation [and ensure that it is not a mess ], you need Microsoft fonts: “Showcard Gothic,” “Ravie,” “Chiller” and “Verdana”

Tom Peters’ X25* EXCELLENCE. ALWAYS. North Mississippi Medical Center Tupelo/26 October 2007 *In Search of Excellence

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Excellence1982: The Bedrock “Eight Basics” Excellence1982: The Bedrock “Eight Basics” 1. A Bias for Action 2. Close to the Customer 3. Autonomy and Entrepreneurship 4. Productivity Through People 5. Hands On, Value-Driven 6. Stick to the Knitting 7. Simple Form, Lean Staff 8. Simultaneous Loose-Tight Properties” Properties”

“Breakthrough” 82* People! People!Customers!Action!Values! *In Search of Excellence

“Excellence can be obtained if you:... care more than others think is wise;... risk more than others think is safe;... dream more than others think is practical;... expect more than others think is practical;... expect more than others think is possible.” is possible.” Source: Anon. tompeters.com by K.Sriram, November 27, :17 AM)

TP takes on Health/ Healthcare

When I climb Mount Rainier I face less risk of death than I’ll face on the operating table.” — Don Berwick “When I climb Mount Rainier I face less risk of death than I’ll face on the operating table.” — Don Berwick

Patient safety! IS/EMR/DSS/EBM! Prevention! Wellness! Chronic care! Elder care! Convenient care! Childhood obesity! Patient-centric!

Sexy Cures vs Quality/Safety Surgeons vs Family Practice Physicians/CIOs Fixing vs Preventing Healthcare vs Health Tom/$53K vs 1,000 Africans [Stanford?] vs Griffin/Planetree SF Internist vs Tom/Canyon Ranch Sexy Cures vs Quality/Safety Surgeons vs Family Practice Physicians/CIOs Fixing vs Preventing Healthcare vs Health Tom/$53K vs 1,000 Africans [Stanford?] vs Griffin/Planetree SF Internist vs Tom/Canyon Ranch

TP Recommendation* #1: Dubai Healthcare City to Dubai Health City *Presentation at “First Middle Eastern Healthcare Summit”/

“Every $1 spent on its wellness program ended up saving [Citigroup] $4.70, according to an academic study.” —WSJ/

Childhood Obesity > Terrorism

Bust fat docs!

Sprint/Overland Park KS: Slow elevators, distant parking lots with infrequent buses, “food court” as “poorly” placed as possible, etc. Source: New York Times

“Bump into factor”: Extra-size portions, eat more. Higher % shelf space snacks, more obesity. More liquor stores, more crime. High vs low fat: Japanese who emigrate to U.S. suffer 3X increase in heart disease. “Bump into factor”: Extra-size portions, eat more. Higher % shelf space snacks, more obesity. More liquor stores, more crime. High vs low fat: Japanese who emigrate to U.S. suffer 3X increase in heart disease. Source: Tom Farley & Deborah Cohen, Prescription for a Healthy Nation

HealthWorks! NMMC! Mississippi! Global Leadership! #1 Problem of our time!

The greatest danger for most of us is not that our aim is too high and we miss it, but that it is too low and we reach it. The greatest danger for most of us is not that our aim is too high and we miss it, but that it is too low and we reach it. Michelangelo

“One who does less than he can is a thief.” —Gandhi

“What’s Really Propping Up the Economy: Healthcare has added 1.7 million jobs since The rest of the private sector? None.” Source: Title, cover story, BusinessWeek,

PLANETREE/ PLANETREE ALLIANCE: A DIFFERENT MODEL

1. The Importance of Human Interaction Informing and Empowering Diverse Populations: Consumer Health Libraries and Patient Information Healing Partnerships: The importance of Including Friends and Family Nutrition: The Nurturing Aspect of Food Spirituality: Inner Resources for Healing 6. Human Touch: The Essentials of Communicating Caring Through Massage 7. Healing Arts: Nutrition for the Soul 8. Integrating Complementary and Alternative Practices into Conventional Care 9. Healing Environments: Architecture and Design Conducive to Health The 9 Planetree Practices 1. The Importance of Human Interaction 2. Informing and Empowering Diverse Populations: Consumer Health Libraries and Patient Information 3. Healing Partnerships: The importance of Including Friends and Family 4. Nutrition: The Nurturing Aspect of Food 5. Spirituality: Inner Resources for Healing 6. Human Touch: The Essentials of Communicating Caring Through Massage 7. Healing Arts: Nutrition for the Soul 8. Integrating Complementary and Alternative Practices into Conventional Care 9. Healing Environments: Architecture and Design Conducive to Health Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

The Importance of Human Interaction 1. The Importance of Human Interaction

none of THE top 15 factors determining P atient S atisfaction referred to patient’s health outcome PS directly related to Staff Interaction PS directly correlated with Employee Satisfaction Press Ganey Assoc: 139,380 former patients from 225 hospitals: none of THE top 15 factors determining P atient S atisfaction referred to patient’s health outcome PS directly related to Staff Interaction PS directly correlated with Employee Satisfaction Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

Kindness is free. “There is a misconception that supportive interactions require more staff or more time and are therefore more costly. Although labor costs are a substantial part of any hospital budget, the interactions themselves add nothing to the budget. Kindness is free. Listening to patients or answering their questions costs nothing. It can be argued that negative interactions—alienating patients, being non-responsive to their needs or limiting their sense of control—can be very costly. … Angry, frustrated or frightened patients may be combative, withdrawn and less cooperative—requiring far more time than it would have taken to interact with them initially in a positive way.” —Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

Informing and Empowering Diverse Populations: Consumer Health Libraries and Patient Information 2. Informing and Empowering Diverse Populations: Consumer Health Libraries and Patient Information

Planetree Health Resources Center/1981 Planetree Classification System Consumer Health Librarians Volunteers Classes, lectures Health Fairs Griffin’s Mobile Health Resource Center Open Chart Policy Patient Progress Notes Care Coordination Conferences (Est goals, timetable, etc.) Planetree Health Resources Center/1981 Planetree Classification System Consumer Health Librarians Volunteers Classes, lectures Health Fairs Griffin’s Mobile Health Resource Center Open Chart Policy Patient Progress Notes Care Coordination Conferences (Est goals, timetable, etc.) Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

Healing Partnerships: The Importance of Including Friends and Family 3. Healing Partnerships: The Importance of Including Friends and Family

“Family members, close friends and ‘significant others’ can have a far greater impact on patients’ experience of illness, and on their long-term health and happiness, than any healthcare professional.” “Family members, close friends and ‘significant others’ can have a far greater impact on patients’ experience of illness, and on their long-term health and happiness, than any healthcare professional.” —Through the Patient’s Eyes

Care Partner Programs Unrestricted visits Collaborative Care Conferences Clinical Guidelines Discussions Family Spaces Pet Visits Care Partner Programs (IDs, discount meals, etc.) Unrestricted visits (“Most Planetree hospitals have eliminated visiting restrictions altogether.”) (ER at one hospital “has a policy of never separating the patient from the family, and there is no limitation on how many family members may be present.”) Collaborative Care Conferences Clinical Guidelines Discussions Family Spaces Pet Visits (POP: Patients’ Own Pets) Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

Nutrition: The Nurturing Aspect of Food 4. Nutrition: The Nurturing Aspect of Food

Kitchen Beautiful cutlery, plates, etc Chef reputation Kitchen Beautiful cutlery, plates, etc Chef reputation Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

Spirituality: Inner Resources for Healing 5. Spirituality: Inner Resources for Healing

1. Connected to supportive and caring group 2. Sense of mastery and control 3. Make meaning out of disease/ find meaning in suffering Spirituality: Meaning and Connectedness in Life 1. Connected to supportive and caring group 2. Sense of mastery and control 3. Make meaning out of disease/ find meaning in suffering Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

redesign chapel music, flowers, portable labyrinth Griffin: redesign chapel (waterfall, quiet music, open prayer book) Other : music, flowers, portable labyrinth Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

Human Touch: The Essentials of Communicating Caring Through Massage 6. Human Touch: The Essentials of Communicating Caring Through Massage

Massage is a powerful way to communicate caring.” “Massage is a powerful way to communicate caring.” —Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

Massage for every patient scheduled for ambulatory surgery (“Go into surgery with a good attitude”) Infant massage Staff massage (“caring for the caregivers”) Healing environments: chemo! Mid-Columbia Medical Center/Center for Mind and Body Massage for every patient scheduled for ambulatory surgery (“Go into surgery with a good attitude”) Infant massage Staff massage (“caring for the caregivers”) Healing environments: chemo! Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

7. Healing Arts: Nutrition for the Soul

Color! Light! Brilliance! Form! Art! Music! Planetree: “Environment conducive to healing” Color! Light! Brilliance! Form! Art! Music! Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

Music in the parking lot; professional musicians in the lobby 5 pianos volunteers Griffin: Music in the parking lot; professional musicians in the lobby (7/week, 3-4hrs/day) ; 5 pianos ; volunteers ( hrs arts & entertainment per month). Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

Integrating Complementary and Alternative Practices into Conventional Care 8. Integrating Complementary and Alternative Practices into Conventional Care

Massage Acupuncture Meditation Chiropractic Nutritional supplements Aroma therapy Griffin IMC/Integrative Medicine Center Massage Acupuncture Meditation Chiropractic Nutritional supplements Aroma therapy Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

83M in US (42%) CAM visits 243M, greater than to PCP (Primary Care Physician) (With min insurance coverage) W-Educated-Hi inc Don’t tell PCP (40%) <30% procedures used in conventional medicine have undergone RCTs (randomized clinical trials) CAM (Complementary & Alternative Medicine): 83M in US (42%) CAM visits 243M, greater than to PCP (Primary Care Physician) (With min insurance coverage) W-Educated-Hi inc Don’t tell PCP (40%) <30% procedures used in conventional medicine have undergone RCTs (randomized clinical trials) Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

9. Healing Environments: Architecture and Design Conducive to Health

Woods and natural materials Indirect lighting Homelike settings Goals: Welcome patients, friends and family … Value humans over technology.. Enable patients to participate in their care … Provide flexibility to personalize the care of each patient … Encourage caregivers to be responsive to patients … Foster a connection to nature and beauty “Planetree Look” Woods and natural materials Indirect lighting Homelike settings Goals: Welcome patients, friends and family … Value humans over technology.. Enable patients to participate in their care … Provide flexibility to personalize the care of each patient … Encourage caregivers to be responsive to patients … Foster a connection to nature and beauty Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

Sound Texture Lighting Color Smell Taste Sacred space Sound Texture Lighting Color Smell Taste Sacred space Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

“Happen to” “Happen with” Access to nurses station: “Happen to” vs “Happen with” Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

The Eden Alternative* The Eden Alternative* *ElderCare

The Ten Principals of the Eden Alternative 1. The three plagues of loneliness, helplessness, and boredom account for the bulk of suffering among Elders. 2. Life in an Elder-centered community revolves around close and continuing contact with children, plants, and animals. These ancient relationships provide young and old alike with a pathway to a life worth living. 3. Companionship is the antidote to loneliness. In an Elder- centered community we must provide easy access to human and animal companionship. 4. A healthy Elder-centered community seeks to balance the care that is being given with the care that is being received. Elders need opportunities to give care and caregivers need opportunities to receive care. Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

The Ten Principals of the Eden Alternative 5. Variety and Spontaneity are the antidotes to boredom. The Elder-centered community is rich in opportunities to sample these ancient pleasures. 6. An Elder-centered community understands that passive entertainment cannot fill a human life. 7. The Elder-centered community takes medical treatment down from its pedestal and and places it into the service of genuine human caring. Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

The Ten Principals of the Eden Alternative 8. In an Elder-centered community, decisions should be made by the Elders or those as close to the Elders as possible. 9. An Elder-centered community understands human growth cannot be separated from human life. 10. Wise leadership is the lifeblood of any struggle against the Three Plagues. For it, there can be no substitute. Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

“The most basic question we need to pose in caring for others is this: Is this a loving act?” “The most basic question we need to pose in caring for others is this: Is this a loving act?” —Leland Kaiser, “Holistic Hospitals” Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

Conclusion: Caring/Growth “Experience”

Care!/Love!/Spirit! Self-Control! Connect!/learn!/ involve!/Engage! Understanding!/Growth! De-stress!/heal! Whole patient & family & friends! be well!/stay well!

F.Y.I.

Financially successful. Expanding programs- physically. Growing market share. Only hospital in “100 Best Cos to Work for”— 7 consecutive years, currently #6. Griffin Hospital/Derby CT (Planetree Alliance “HQ”) Results: Financially successful. Expanding programs- physically. Growing market share. Only hospital in “100 Best Cos to Work for”— 7 consecutive years, currently #6. —“Five-Star Hospitals,” Joe Flower, strategy+business (#42)

"All sane persons agree that 'healthcare needs an overhaul.' And that's where the agreement stops. Healthcare issues are thorny, and system panaceas are about as likely as the sun rising in the West. But there is good news here and there — and great news courtesy the Planetree Model. "In the midst of ceaseless gnashing of teeth over 'healthcare issues,' the patient and frontline staff often get lost in the shuffle. Enter Planetree. While oceanic systemic solutions remain out of reach, Planetree provides a remarkable demonstration of what healthcare — with the patient at the center — can be all about; and is all about among Planetree Alliance members. "I know this may sound ridiculous, but everything about the 'model' works. It is great for patients and their families — and is truly about humanity and healing and health and long-term wellness, not just a 'fix' for today's problem. It is great for staff — Planetree-Griffin is rightly near the top of the 'best places to work in America' list, year in and year out. And Planetree also works as a 'business model' — any effectiveness measure you can name is in the Green Zone at Griffith. "For 25 years my 'gig' has been 'excellence.' Put simply, there is no better exemplar of customer-centered, employee-friendly excellence, in any industry, than Griffin-Planetree. The Planetree model works — and in my extensive work in the health sector, I 'sell' it shamelessly, and pray that my clients are taking it all in." tom peters/response to request for comment on Planetree