aligning culture and

research technology consulting

Talent Development

Aligning Culture and

Cultivating Accountability

Leadership Retreat

Vanderbilt University Medical Center

October 2019

©2019 Advisory Board • All Rights Reserved • advisory.com

3

Today’s Agenda

Aligning Culture


Introductions


4

Cultural Alignment Starts with Strategic Direction


5

Connection Between Direction and Culture

Set Direction

Align the Culture

Guiding Decisions

Cultural Reinforcement

©2019 The Advisory Board Company • advisory.com

Visionary Organizations Align Practices with Strategic Direction

Source: Collins J and Porras J, “Building Your Company’s Vision,” Harvard

Business Review, September–October 1996: 65–77; Collins, “Aligning Action

and Values,” www.jimcollins.com, Talent Development research and analysis.

Part of Everything They Do

Staff

Selection



Three Categories to Guide Alignment

Source: Talent Development research and analysis.

Hardwiring a Supportive Culture

People

• Selection

• Role

assignments

• Performance

accountability

• Civility

• Mentorship and

collaboration



Physical Space Embodies Culture at Trader Joe’s

The Trader Joe’s Vision:

“At Trader Joe’s, we create an outstanding customer experience around the

discovery and enjoyment of amazing food and beverages. It’s what we do, and our

crew is our bread and butter, alongside the Trader Joe’s bread and butter.”

Store Design

• Nautical themed designs

• Stores feature tasting huts &

employees wear Hawaiian

shirts

• Small store fronts with a

controlled customer traffic

flow

Organization Structure

• Crew – considered the heart and soul

of Trader Joe’s

• Mates – ensure every customer has a

fun, friendly and informative experience

• Captains – exemplifies unwavering

integrity and commitment, the leaders

of the store

Product Selection

• Rotating product placements

based on what's best for the

customer not margins

• Fewer choices, subscribing to

less is more mantra

• “Try-before-you-buy” policy

Source: Llopis G, “Why Trader Joe's Stands Out From All the Rest in the Grocery Business,”

Forbes, https://www.forbes.com/sites/glennllopis/2011/09/05/why-trader-joes-stands-out-from-all-

the-rest-in-the-grocery-business/#66fed7224dec; Talent Development research and analysis.

Example: Aligned Infrastructure


Aligning Infrastructure at Vanderbilt

Increased My Health at Vanderbilt enrollment to

481K patients through infrastructure changes:

• Pillar goals and tracking

• Change to enrollment opt-out

• Overall communication & promotion.

• Integrate promotion by clinicians in encounters

• Integrate enrollment into New Employee

Orientation


Aligning Infrastructure at Vanderbilt

The Vanderbilt Comprehensive Care Clinic, established 1994

A patient-focused medical home for people living with HIV

• Designed to both welcome patients and maintain their privacy

• Fosters patient’s pride in bringing family and friends to the Clinic

• Co-location of clinic, ancillaries, research, and training in same space.

• 100 Oaks location makes access easier

Physical Environment & Work Design

• Multiple disciplines integrated into CCC

• Innovative leader who pushes the envelope, and fosters others to innovate.

• Staff are driven by mission and helping colleagues and patients.

• Medical Home Certification

Org Structure & Commitment

• Patients see multiple disciplines in one visit

• Training Center for 35k professionals annually

• Participation in research - site clinical trials, 200k blood bank samples

Service Integration


No Shortage of Recognition at 3M

Source: Collins J and Porras J, Built to Last: Successful Habits of Visionary

Companies, New York: HarperBusiness, 1994: 150–160; “A Century of

Innovation, http://www.3M.com; Talent Development research and analysis.

Rewarding Adherence to Vision

Example: Aligned People



Aligning People at Vanderbilt

Elevate Awards

Recognizing exemplary behavior,

leadership and teamwork

Defining Personalized Care

A multi-year program to elevate our

culture of service

Each quarter, VUMC gives these

organizational awards to exemplars

in the following categories:

• Credo for credo behaviors.

• Five Pillar Leader for leadership

balance across the pillars and

Credo.

• Teams who made a notable

change or impact.

• A focus on 5 key tactics in delivering

consistent, high quality service

experiences.

• Time-spaced training tailored to

both staff and clinician roles.

• Initial results – increases in courtesy

and communication scores and rank

in FY19 over prior year.

• Clinician complete rate – 11% / 418


13

Starbucks Puts Its Money Where Its Vision Is

Source: Gallo C, “How Starbucks CEO Howard Schultz Inspired Us To Dream Bigger,” Forbes,

https://www.forbes.com/sites/carminegallo/2016/12/02/how-starbucks-ceo-howard-schultz-

inspired-us-to-dream-bigger/#4fe10e48e858; Talent Development research and analysis.

Senior Leadership Stayed True to Guiding Principles

Starbucks Closes Its Doors to

Maintain Customer Commitment

$6M Lost revenue during

store closures

7,100 Starbucks stores

closed to retrain

baristas

• Starbucks was the first U.S.

company to offer comprehensive

healthcare coverage and stock to

part-time workers.

• Maintained coverage even after

2009 when the cost of offering

health insurance was up nearly

50% per partner.

Starbucks Leads the Industry

in Employee Benefits

“This is not about training, this is about

the love and compassion and

commitment that we all need to have for

the customer.”

Howard Shultz

CEO (at time)

Example: Aligned Leadership Commitment


14

Aligning Leadership Commitment at Vanderbilt

Expansion of leadership and

professional development

opportunities

Changes to ensure culture of

inclusion and respect

• These annual physician

leadership development sessions.

• New Associate Dean for

Faculty Development.

• New and revised processes for

reporting and handling of

incidents of sexual harassment,

workplace violence, and

disruptive behavior.

• Expansion of the Office of

Inclusion and Health Equity.

• Robust education targeted for

clinicians, staff, and leaders.


15

Exercise


17

Exercise

Infrastructure People Leadership Commitment

Using the one-page tool, think about your area. Identify places in each bucket where you

think the culture is aligned. These are things you want to emphasize and keep doing.

Discuss in your table groups. What themes do you see across the areas of alignment you

identified when analyzing your leadership areas?


22

Exercise

Continuing to use the one-page tool, think about your area. Identify places in each bucket

where you think the culture is misaligned. These are things you want to stop doing,

change, and/or work with leadership to address.

Infrastructure People Leadership Commitment

Discuss in your table groups. What themes do you see across the areas of misalignment

you identified when analyzing your leadership areas?


24

Today’s Agenda

Aligning Culture


Introductions


DALLAS

HOUSTON

NEW

ORLEANS

MEMPHISATLANTA

NEW YORK

BOSTON

DETROIT

CHICAGO

MINNEAPOLIS

OMAHA

BILLINGS

SALT LAKE

CITY

PHOENIXLOS

ANGELES

SAN

FRANCISCO

PORTLAND

SEATTLE

ST LOUIS

SAN DIEGO

WASHINGTON

BAHAMAS

SPOKANE

DES

MOINES

ALBUQUERQUE

MILWAUKEE

OKLA CITY

CINCINNATI

CHARLOTTE

CASPER

DENVER

ORLANDO

(300) (200)

(300)

(300)

(100)(100)

(200)

(300)

(200)

(100)

(100)

(200)

(200)

(300)

(200)

(100)

(300)

(300)

(300)

(200) (300)

(200)

(200)

(200)

(200)

(200)

(300)

(200)

(200)

(100)

(200)

SEATTLEGOAL: Be in

no later than day 5 Seeing America

Pacific Mountain Central Eastern

MIAMI(200)GOAL: Minimize

Travel CostsGOAL: Maximize

Tourism Points

Total Points Total Costs



Getting It Done

Source: Talent Development research and analysis.©2019 Advisory Board • All Rights Reserved • advisory.com


Three Accountability Prerequisites


Setting Up for Success

Overcoming the Hill

• Defining Standards: I understand the standard I am targeting

• Communicating About Resources:

I have the resources necessary to succeed

• Navigating Obstacles: I can navigate potential obstacles to success

Building Skill

• I have the skills necessary to accomplish this assignment

Strengthening Willingness

• I am willing to invest in the desired outcome


©2019 The Advisory Board Company • advisory.com Source: Talent Development research and analysis.

Hill: Set Expectations



Key Leadership Impactions of Health Care Discussed Last Year

Remember:

Expectations Change with Environment

1 Tracking of physician performance will continue to increase in scope and

consequence.

2

Physicians will face increasing pressure to trade individual autonomy for

institutional scale and impact.3

Providing standout patient experience is an increasingly important

business imperative.

Source: Talent Development interviews and analysis.


Frequently Incomplete Resource Need Assessment


Hill: Communicate About Resources

Assignment:

Design new fall

prevention

protocol



Costs of Not Communicating About Resources


Hill: Communicate About Resources

Failure to Downward Manage

Leader neglect forces individual

team members to “figure out”

resource access

Failure to Upward Manage

Leader consciously ignores

resource considerations, leaving

individuals in untenable position

Poor Outcomes

• Missed deadlines

• Substandard work-arounds

• Unsustainable results

• Shortages shifted to others

To

Do

To

Do

!To

Do

To

Do



More Than Just “Godspeed”


Hill: Run Interference

Leader

Leaders can lend

network to team

Leaders have

more positional

authority

Leaders have

deeper

understanding of

organization and

positional structure

Upper

Management

Peer Leaders

Patient

Families

Board of

Directors

Contracted

Technicians

Employed

Physicians

Junior Staff

Vendors



43

Exercise:

Addressing

Hills

Think about a place where you are seeing more variable results than you would like. Use

the “hill” categories we have discussed to identify leadership actions you can take to

address “hill” barriers.

Set Expectations Communicate About Resources Run Interference





Overcoming the Hill





Building Skill





©2019 The Advisory Board Company • advisory.com Source: Talent Development Research and Analysis

Skill

Unconscious

Incompetence

Conscious Incompetence Conscious Competence

Unconscious Competence

?

Unaware of need for skill

!

Recognizes need to

learn new skillAcquires skill; makes

conscious effort to use it

Naturally deploys new skill



Consider Four Kinds of Skill

Technical

SkillAbility to use specialized techniques specifically

acquired for and distinct to a particular profession

Organizational

SkillAbility to navigate the politics and infrastructure of

an organization to achieve a particular objective

Interpersonal

SkillAbility to communicate information, resolve

differences, and work effectively with others

Procedural

SkillAbility to effectively integrate new tasks,

information, and skills into daily routines





Overcoming the Hill





Building Skill






52

Will

WILL

The degree

of investment

an individual

will make

Extrinsics

Intrinsics Morale

External motivators for

action—

e.g., compensation,

rewards/consequences

Internal motivators for

action—

e.g., desire for a

challenge

Emotional

predisposition to act

http://www.advisory.com/


Common Categories of Intrinsic Motivation

Further Exploring ”Intrinsics”

What Drives This Person?


Finding Meaning in Leisure

Further Exploring a “Sense of Purpose”

Look to Hobbies to Understand Drivers of Purpose


57

Today’s Agenda

Aligning Culture


Introductions

research technology consulting

Talent Development

Aligning Culture and


Leadership Retreat

Vanderbilt University Medical Center

October 2019

aligning culture and

Documents