A Change I Want to Share

I wanted to share some exciting news with you. In the coming days, I will be launching a new platform, www.leadingthechangewithjohncouris.com.

Leading the Change is a dynamic and exciting outgrowth of this blog which so many of you follow directly or via my LinkedIn profile. Over the last two years Inventing Health has expanded its focus beyond issues facing the health care field to explore topics in executive leadership, organizational culture, and motivational management, among other issues.

With this expansion came the need to develop a more robust platform. Leading the Change is being established to provide not only insightful and timely content from me on a wide-range of issues, but to offer a space to advocate for effective policies that ensure all Floridians have access to world-class care. Additionally, it will spotlight the innovative, cutting-edge work of Tampa General Hospital and provide a forum to feature other innovative leaders who are making a dramatic impact in the health care industry.

I look forward to continuing a thoughtful dialogue on not only today’s health care and how we can work together to improve care and outcomes, but to engage on management and executive leadership topics.  I can’t wait to share it with you. Stay tuned for information on how you can subscribe and join me in Leading the Change!

Curiouser and Curiouser

I read with great interest a recent article in the Harvard Business Review sent to me by GE Healthcare Account Executive, Jennifer Miller.  In The Business Case for Curiosity, Francesca Gino discusses the benefits to encouraging a “curious” workplace and offers some strategies to help leverage curiosity in driving your business.

As Gino explains, there are several benefits to cultivating curiosity in your organization.

1. Cultivating curiosity at all levels helps leaders and their team members adapt to whatever comes their way. When we are curious, “we tend to think more deeply and rationally about decisions and come up with more creative solutions,” Gino explains.
2. Leaders can drive curiosity—and improve performance—through subtle management shifts and organizational design.
3. Curiosity increases efficiency and helps minimize risk. It helps decrease decision-making errors as it forces us to challenge assumptions as opposed to simply assuming our assumptions
4. It helps contributes to workplace improvements as team members are driven to find creative solutions to challenges facing an organization and become conditioned to seek improvements.
5. Curiosity facilitates better communication and reduces group conflict as team members are better able to see different perspectives and work collaboratively to solve problems.

These all rang true to me, and I try to employ tactics to drive curiosity at TGH from encouraging learning opportunities and modeling curiosity in my own approach to problem-solving, as I have discussed in my most recent blog posts. I also try to encourage team members to ask questions and think about how they can contribute to the overall goals of the organization. 

It is fitting that it was Jennifer who sent me this article as our partnership with GE is rooted in curiosity. Today, Tampa General Hospital and GE Healthcare are partnering to create a new 9,000-square-foot care coordination center which will open next year. The center will use predictive analytics to help improve the experience and outcomes for patients, families and hospital staff. The center will allow us to be more efficient and shorten the time patients are in the hospital by better managing their care. This technology will also help to reach our goal of providing coordinated patient care after they leave the hospital.

It is true what they say, that you will never know where the next great idea will come from. We can all listen. We can all ask questions. When you make exploration an integral part of your organization, you will help drive creativity and innovation.  

Always Learning

I was fascinated by a recent article I read in the Harvard Business Review advocating the importance of creating a work culture that encourages ongoing learning.  In the piece, Four Ways to Create a Learning Culture on Your Team, authors Tomas Chamorro-Premuzic and Josh Bersin encourage managers to prioritize their own ongoing learning—as well as that of their team members—as a way to remain vibrant and successful and help drive the impact of your business. 

The authors argue that the desire to seek knowledge, learn, ask questions and apply information in new ways is more critical than ever as our organizations are radically and constantly evolving in response to the ongoing digital revolution. Businesses that celebrate a constant quest for knowledge in its team members, they explain, will have a leg up on the competition. As the take away, they provide four tips to implementing a culture of learnability with your own organization.

• Reward continuous learning and critical thinking as a way to ignite innovation.
• Give meaning and constructive feedback to highlight “knowledge gaps” in order to promote learning and improvement.
• Hire curious people to build a team driven to problem solve and innovate new business.
• Lead by example when it comes to your own ongoing learning.

What has stayed with me from the article is the recommendation that leaders promote a culture of learning by practicing what they preach and leading by example. This makes perfect sense to me as I continue to be driven each day by the desire to learn new things and take what I have learned and incorporate it into the work I do.

It is this passion to continue to learn and seek opportunities to learn more, lead by example and the belief that there is always room to grow that has led me pursue a Doctor of Business Administration. In January, I will begin working towards a Ph.D. in Business Administration at the Muma College of Business at the University of South Florida. 

I have thought about getting a Ph.D. for years, but the timing has not worked until now. By entering the DBA program, I hope to build on my hard and soft skills and all that I have learned thus far in my over two decades of applied experience. The reality is that the health care industry is always changing and at a dramatic pace, especially as the paradigm of health care delivery moves from provider driven to consumer-focused. To remain vital, you must always be willing to learn, adapt and implement. I hope that what I learn as part of this program, will help better inform the work I do at TGH and out in the community. 

As I work towards my Ph.D., I will also continue to advocate for and encourage my leaders to pursue additional educational opportunities and degree programs. I will also be there to support them along the way. By prioritizing education, we will each not only realize personal and professional goals, we will continue to elevate the quality of work and services provided by TGH. We will build upon and implement all that we have learned and experienced to continue to provide the highest quality service and care—a win for us all.

Dying with Dignity

The last week has been incredibly difficult as I had to say goodbye to my beloved friend and companion, my German Shepard, Lola. Like for many of us dog owners, Lola was more than a pet, she was a faithful companion and loyal friend. She could be found by my side every waking minute I was at home. 

Lola’s illness came on fairly suddenly.  I immediately sought the care and advice of one of the best vets in the region. I wanted to explore all possible treatment options for her. I was prepared to embrace any recommended treatment, no matter the cost. At the same time, I knew I wanted to the right thing by her. I wanted to make sure she was free of pain. I did not want to keep her alive just to make it easier on me. She deserved to die just as she had lived—with dignity and on her own terms.  And so, after long and thoughtful conversation with the vet, and considering all options, I knew the best thing for Lola was to let her go. It was difficult and sad, but peaceful. She did not suffer. 

Lola’s death fell near the anniversary of the passing of my “other” best friend, my father. A vibrant and healthy man, my father died in 2015 after battling cancer. At the end of his life, my family and I were fortunate enough to help make important end of life decisions for him. We were able to move him to a wonderful hospice facility, where he peacefully spent his last few days free of machines, comfortable and surrounded by family in a beautiful and calm setting. While it was an incredibly difficult time, I was comforted in the choice we were able to make regarding my father’s end-of-life care.

Lola’s death as well as my father’s, once again reminds me of the importance of being able to make the appropriate end of life decisions for our loved ones. Often, as health care professionals, we are focused on patient outcomes and restoring their health. As an industry, what we sometimes fail to realize is that the best outcome can sometimes be letting a person go. Each year, it is estimated that 30% of Medicare expenditures (over 50 billion dollars) are attributed to the 5% of patients that will die that year with one-third of those costs occurring in the last month of life.  Furthermore, most studies show that if the person is sick enough, this type of medical intervention does not have a positive impact. In fact, it can make those last few days and months of life worse.

So whether you are a health care professional or a family member, the reality is that we need to openly discuss end of life options before it is too late. And as health care professionals, we also need to devote resources to offering patients and their families the kind of services and space they need in those final difficult days. It was what I was able to provide my father and what I think all families deserve. 

The house is a lot quieter now without Lola. It will take me a while to get used to her not being right there next to me. But, I remain grateful of the time we had together, and I was honored that I was able to make the choice I did at the end of her life.

Walking in their Shoes

As I noted in a recent post, I spent several hours each month working on the front lines with team members across the hospital. Over the course of the last year, I have helped transport patients, worked with surgeons, residents and fellows, logged in 20,000 steps in one night delivering meals, accompanied nurses in the Cardio Thoracic ICU and Neuro ICUs on rounds and vitals, changed beds sheets with patient care techs, drawn blood with phlebotomists, and worked on medical surgical floors with nurses and therapists. In many ways, this is one of my favorite parts of the job—so much so, that I have been doing it for years. 

My intention in shadowing team members is not to spy on them, micromanage operations or garner unnecessary attention. I do this to be a more effective leader and team captain. Through this direct experience with my team members, I am able to understand my team better, grasp the challenges they face and see first-hand the amazing work they do. Additionally, it provides me the opportunity to garner vital feedback and gain invaluable insight into our operations.  

Working side by side my team members, I’m able to build a stronger connection with them. I gain an insight into who they are as people which improves communication. Witnessing their work up close, I can provide better feedback as I have a greater understanding for the complexities of their work, the challenges they face, and the sheer amount they have to accomplish. 

This time I spend with my team members also strengthens our ability to collaborate. Working together in this capacity, we develop a deeper understanding that we’re all in this together and have a greater appreciation for the unique talents we all bring to the table. 

While we might not all have the opportunity to work on the front lines with team members each month, they’re ways in which we as managers can gain a deeper insight into who our team members are as people and glean their perspectives on their work and the organization:

• Ask questions! Ask questions that enable you to understand their process-why they work the way they do. Spend time talking with them to learn what they value most about their work and what they would change if they could.
• Get to know them as people. Always spend the first five minutes talking with them on a subject outside of work. Relay a personal anecdote of your own to encourage them to share something about themselves. This will allow you to build a connection and a sense of trust.

The most effective leaders are ones that listen, act on what they learn and teach along the way. They are also ones who have empathy and an understanding of who their team members are outside of work. Spending time walking in your team members’ shoes will help you develop these skills.

Present and Accounted For

Over the last couple of months, I have met with nearly all of 8,200+ team members in groups of 200 to 300 to present, review and discuss our new organizational strategic plan. Over the course of these two hours sessions, my goal is to communicate to them the direction for the organization, explain their critical role in our evolution and engage with them—answering questions and gaining feedback and insight.

For me, this experience has been beneficial on many levels. It’s been so productive, in fact, that I will be holding one-hour sessions twice a year with my team moving forward. While the topics will vary, I will use this time to engage and connect with team members across the organization. 

One of the biggest takeaways from these sessions for me is the reminder to be present—to entirely focus on my team members when I am with them, to listen and be in the moment. Being present and engaging with others in a focused way allows me to not only create meaningful connections with my teammates and colleagues but helps me and my organization perform at a higher level. I genuinely believe that to lead successfully you must be present.

There are tremendous benefits to being present. Being focused and thus being present, demonstrates to team members that you are engaged, empathize and understand them. You show them that you are actively listening and hearing them. You build camaraderie and connection. Conversely, when you are not focused or present, team members get discouraged and lose motivation. They think if he does not care, why should I.

Being present improves your skills as a leader and manager as it enhances one’s ability to cope with stress, to stay level-headed and allows you to operate from a proactive position as opposed to a reactive one. Often, problems don’t need a definitive solution, they merely need clarity of thought and attention.

Practicing being present can take just that, practice. Here are a few tips to help you focus and thoughtfully engage with colleagues and team members:

• Take a moment to clear your head before each interaction. This will allow you to focus on the person in front of you and the issue at hand.
• Don’t multi-task and give your team member or colleague your full, undivided attention. If this is not possible, reschedule your conversation.
• Don’t interrupt or prematurely form opinions. You want to listen actively. 
• Recap or summarize what your colleague or team member is sharing. This forces you to listen for comprehension and allow you to ask probing questions to understand more thoroughly. 

At the end of the day, what drives us all to do and be our best is the connections we create with others. Being present, listening and focusing on others makes that possible.

From the Bottom Up

Over the course of my career, I’ve had the opportunity to work with some amazing folks, and I’m not just talking about my direct reports or folks on my immediate team. Every day I work with compassionate and dedicated professionals from hospital dieticians, to transport staff, to operating room nurses to occupational therapists to world-renowned oncologists. They all give 110 percent to the patients in their care and the organizations in which they work. 

In my current role at Tampa General, as was the case in previous positions, I spend several hours a month shadowing team members throughout the hospital. I get to witness their hard work and dedication first hand. I get to “live” the work of the hospital in a profound and very specific way. I am able to talk in-depth with team members, hear their ideas for improving efficiency, see their problem solving skills in action and witness the challenges they face up close.  

These hours each month are some of the most productive - and certainly the most meaningful - I have had the chance to experience. They also directly inform the work that we are trying to accomplish, particularly in the area of innovation. 

Regardless of the industry in which you work, when you are trying to on-board a new initiative or program, you must harness the experience and knowledge of those who are in the trenches every day. You must ensure that your approach supports and enhances the work that is already being done as you work towards achieving buy-in across the organization. If you take the opposite approach and issue a directive to implement a plan or program that was developed by only a small isolated team, you are sure to experience failure. 

For example, at Tampa General we are currently working with GE Healthcare to implement a command center that will serve as mission control for the hospital. The center will use artificial intelligence and predictive analytics to help improve efficiency and shorten the time patients are in the hospital by better managing their care. However, the center will not achieve success on technology alone. It will rely on the expertise and knowledge of team members who are on the ground doing the work. In order to make this center as effective as possible, we must involve team members from across the hospital in the process as we get the center off the ground. 

By involving folks at all levels of your organization as you build a new program, you will not only gain their knowledge and experience, you will empower them to give everything they have to achieve success. They will be able to spot potential problems and work through them as well as see areas for improvement and make recommendations. They will take pride of ownership, feeling heard and engaged.  

The bottom line is that if you’re going to make real change and do it successfully, it has to be built from the bottom up.