1. Leadership Fundamentals Ten Practical Strategies for Passionate SOMC Leaders 1,2 A Presentation for the SOMC Medical Care Foundation, Inc. Leadership Team Kendall L. Stewart, MD, MBA, DFAPA January 5, 2011 1 I view this as a crucial communication. 2 Please allow me to make my case. Please consider adopting these leadership strategies. Please ask clarifying questions.

2. Why is this important? During the past two decades, SOMC leaders have produced and sustained some exceptional results. That’s why leaders exist.That’s why leaders exist How did we do it? What have we learned? What insights would we like to pass on to the leaders who follow us? 1,2 This practical presentation will summarize ten of the most important strategies we have embraced. After listening to this presentation, you will –Have an increased appreciation for how hard being an effective leader is, –Realize that—because it is so hard and so few are willing to pay the price—leadership is one of the most rewarding ways to spend your life. –Be able to identify three practical strategies that will enable you to achieve and sustain exceptional results.strategies –Be able to explain how to deploy these strategies in the work environment. 1 With this talk, I am beginning to pass the baton to the next generation. 2 While it may seem premature, now is the time for you to begin your own succession planning.

3. What ten leadership strategies should you embrace? Focus on results.results Become a process improvement expert.process improvement Manage yourself first. Manage yourself Field the best-possible team.team Remind yourself that most of the work in the world is done by average people.average Extrude net-negative people.net-negative people Embrace discomfort. Embrace discomfort Learn to manage crises while striving prevent them.manage crises prevent Think, innovate and act. Thinkinnovateact Manage physicians effectively. 1,2 Manage physicians 1 Many physicians are looking to BS you, game you, intimidate you or some combination of the three. 2 Doctors employ these strategies because they work; think hard about that.

4. Focus on results. Why? –It’s why leaders exist. –We all tend to forget this. –This makes people uncomfortable. –(Energizing) discomfort is a very good thing. –A relentless focus on results will set you apart as a leader. –It’s a also a huge competitive advantage.competitive advantage How? –Begin every meeting by inquiring about results. –Focus on the results that matter. –Insist on comparative data.comparative data –Expect perfection. –Always ask about the plan. –Always ask about the task list. –Hold everyone accountable. 1,2,3accountable 1 Always know your current performance metrics, what’ve you’ve done, what you’re doing and what you’re going to do. 2 Expect your colleagues to know these things too. 3 If you don’t volunteer, someone will likely ask.

5. Become a process improvement expert. Why? –Processes are the ways things get done in life. –If you keep doing the same things, you will keep getting the same results.doing the same things –In spite of this obvious truth, most people will keep on doing the same things. –Leaders have the power to improve processes. 1,2improve processes –Don’t let that power go to waste. How? –Identify and critically examine the process that is producing the current, imperfect result.critically examine the process –Consult the process owners. –Suggest improvements in the process. –Find a process improvement champion; you may be it. –Push back hard on the resistance you will get when you do.resistance –Insist that people give the changed process a reasonable chance. –Keep on improving your processes. 1 You will hear and learn about many process improvement models. 2 The SOMC Improvement Model is Seize an Opportunity and Make a Change. 3 At a deeper level, we primarily follow the PDCA (Plan, Do, Check, Act) or PDSA (Plan, Do Study, Act) Model.

6. Manage yourself first. Why? –You can’t manage others until you do. –Everyone is watching whether you are practicing what you preach. practicing what you preach –You will not be a credible persuader unless you do.credible persuader –You cannot hide your moods—and people take them personally.moods How? –Recognize that as a leader you are always on stage.always on stage –Acknowledge that everyone is watching. –Accept that what the people around you want most is predictability and an even temper.predictability –Recognize your arousal. –Exit the stage and contain it immediately. 1,2 1 This became crystal clear soon after I moved to Portsmouth. 2 I was mowing and garage sale hobbyists were parking on my grass.

7. Field the best-possible team. Why? –It’s the only way to achieve and sustain exceptional results. –Because it’s so painful, only a minority of leaders will pay this price.price –This creates a significant opening for you and your colleagues. How? –Accept this as your chief fiduciary duty to the organization.fiduciary duty –Prop up your colleagues when they weaken—and they will. –Ask them to prop you up in return when you weaken—and you will. 1,2 1 We accept this reality without question in the world of sports; at work, where excellence really matters, we avoid it. 2 Replacing people who are sincere and doing their very best is the hardest part of being a manager.

8. Remind yourself that most of the work in the world is done by average people. Why? –Because it’s true. –The management literature about turning everyone into stars is nonsense. 1 turning everyone into stars –This approach is neither necessary nor desirable—and it won’t work. How? –Ruthlessly assess everyone’s strengths and weakness—including your own.assess everyone’s strengths and weakness –Play to everyone’s strengths.strengths –Ignore their weaknesses unless they significantly impact organizational performance. 2 1 Following Studer, we were poised to divide all SOMC into three categories. 2 This is another SOMC innovation to which we aspire; human beings appear to be preferentially wired to focus on the negative.

9. Extrude net-negative people. Why? –This is only way to field the best-possible team. –If you don’t, you will fail as a leader. –If you tolerate these corrosive folks, your best people will get fed up and leave.tolerate these corrosive folks –When you show that you mean business, some of the troublemakers will leave on their own. –Others will behave better. How? –Identify the net-negative people who report to you.net-negative people –Consult with your fellow leaders and colleagues to make sure. –Confront them. –Give them a fair chance to shape up—and stay shaped up. –When they fail to do so, act. 1,2 –Require your leaders to do the same. 1 Many SOMC leaders believe this painful process is the key to our sustained success. 2 We began with ourselves.

10. Embrace discomfort. Why? –Above all else, we all long for comfort and seek to avoid discomfort. –But people only change when they feel uncomfortable.change when they feel uncomfortable –Successful leaders feel uncomfortable every day. –And they make the people around them uncomfortable too. –It is not easy to get this exactly right. How? –Focus on results. –Face reality. –If you do, you will find plenty to feel uncomfortable about.uncomfortable –Talk about your discomfort. –Confront your colleagues when they grow complacent. –Ask hard questions. 1,2Ask hard questions –Hold yourself and others accountable. 1 “Why are more than 80% of SOMC employees overweight or obese?” 2 “What exactly are SOMC leaders going to do about that?”

11. Learn to manage crises while striving to prevent them. Why? –Crises will happen.Crises –If you don’t prepare for them, you will manage them badly.prepare for them –If you don’t prevent them, you will get a lot more practice in managing them than you want. How? –Prevent crises by anticipating them and intervening early.anticipating them –Convene the management team quickly. –Acknowledge arousal and calm down.arousal –Try to identify the real (or most pressing) problem. –Seek accurate information. –Clarify your goals. –Identify your options. –Doing nothing will frequently be the best option. –Communicate, communicate, communicate.Communicate 1 Real teams are the byproduct of some huge task that can be accomplished no other way—often during a crisis. 2 Our team’s first real tests were extruding net-negative executives and the prison hostage crisis.

12. Think, innovate and act. Why? –The tasks in your jobs are endless. –You can never complete them all. –But you will feel compelled to try. –If you fall into this trap your task list will consume you.trap How? –Schedule time to stop and think. 1,2Schedule time to stop and think –Are these the right tasks? –When your results fall short, you must change something. –Identify the result you want. –Imagine how you would accomplish that in the perfect world with no barriers. –Design and deploy an improved process. 1 Some of our best thinking occurs during working meals on business trips. 2 If you are interested, send me an email message requesting the Safety and Quality Focus Group white paper from December 2010.

13. Manage physicians effectively. Why? –It’s no secret. –Physicians can be difficult.Physicians can be difficult –Power really does corrupt. –The bell curve applies to us too. 1,2bell curve –And insecure people with special status can be very, very needy, demanding and annoying.insecure people How? –Make your expectations clear up front.expectations clear –Accept our feelings. –Accept us as we are—if you can. –Focus on our strengths.strengths –Be clear about whether you are informing, consulting or seeking our consent. –Never underestimate the power of published comparative data. 1 We cannot recruit only star physicians; the top ten percent is only ten percent. 2 We will sometimes settle for physicians who will turn out to be net-negative.

14. What are some next steps? Carefully consider whether these practical leadership strategies make sense. If they do, make a commitment to embrace them and to conform your personal attitudes and behaviors to them. Recognize that this will be hard and that it will demand patience, persistence and the adoption of a leadership lifestyle. 1,2 Begin by completing a rigorous SWOT analysis of the business unit you lead.SWOT analysis Make yourself and each other uncomfortable— starting now—and for the rest of your professional lives. Commit to lead by example. Focus on results. Learn to make a compelling case for change.compelling case 1 Most SOMC leaders say would say they spend an average of 50 hours each week in the pursuit of exceptional results. 2 We balance our personal and professional lives by weaving them together; there is no bright line for leaders.

15. Where can you learn more? 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 Review practical techniques for conducting crucial conversations in Crucial Conversations: Tools for Talking When Stakes are High. Crucial Conversations: Tools for Talking When Stakes are High Consider adding the practical and comprehensive Successful Manager’s Handbook to your personal library.Successful Manager’s Handbook Reflect on what sets great organizations apart by reading Good to Great: Why Some Companies Make the Leap... And Others Don’t.Good to Great: Why Some Companies Make the Leap... And Others Don’t

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