Monkeys: LIBERATING Time Management Concept [Video]

Monkeys are the “leading cause of death” of new leaders.

Recent conversations with a few new(er) leaders about this common pitfall, prompted me to post this here. If you don’t have time (28 min) to watch this, then you probably really need to watch this. ūüėČ

This time management concept saved my professional life.

After about 7 years in operations of skilled nursing facilities at The Ensign Group, a skilled nursing, seniors housing, home health & hospice, and radiology company, I spent 5 years there as the Chief Human Capital Officer. What an exciting time. Ensign’s “First Who, Then What” approach to growth meant we had to attract and train a lot of AITs into facility-level CEOs fast. ¬†Over those 5 years, I personally participated in the training of about 100 new leaders. Week long boot camps, case studies, online tests, conference calls, assignments, analysis, etc. ¬†I saw, up close and personal, what helped new leaders succeed … and fail. ¬†

Monkeys has a lot to do with both.

I’ve trained the topic to groups in the hundreds at association conferences to 1:1. And, I wrote about monkeys years ago here:

But, this is the video that gives a thorough explanation of Monkeys and that my colleagues and friends have found most useful to understand the time management concept from theory to practical application.  While there are several healthcare operations and Ensign references, the principles are universal.

I hope it helps you or someone you know:

 

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Jim Rome, John Wooden, Skilled Nursing “Success”

When I was in High School, my buddies and I listened to a new, up-and-coming, cocky¬†sports talk radio guy, Jim Rome. ¬†He¬†constantly played his verbal trump card against people critiquing successful players/teams. ¬†He would simply respond by saying, “Scoreboard!

Does anyone have a better scoreboard than John Wooden? ¬†The best¬†coach in sport. ¬†Scoreboard? 10 national championships at UCLA. ¬†But, why do I love and respect and listen to the man? ¬†Because of how he won. ¬†Coach Wooden came to mind today because of a conversation with another guy who’s the “best” at his sport, my friend David Howell, a facility CEO for The Ensign Group in southern California. In my opinion, Howell’s¬†one of the best SNF EDs in the country. ¬† It’s almost unbelievable to see what he’s built out of his small SNF in a very blue-collar neighborhood. ¬†His facility won Ensign’s highest total quality award today and he shared with me what he was planning on saying at the ceremony … Wooden, “C.S. Wooden” ūüėČ

alg_wooden_net1

I want to share these two thoughts from a talk Coach Wooden gave and that Howell shared today as well.  But, you really ought to watch the whole talk below.

  1. Winning is not in the definition of success. ¬†Here’s what C.S. Wooden said success is: Peace of mind attained only through self-satisfaction in knowing you made the effort to do the best of which you’re capable. I believe that’s true. If you make the effort to do the best of which you’re capable, trying to improve the situation that exists for you, I think that’s success, and I don’t think others can judge that; it’s like character and reputation — your reputation is what you’re perceived to be; your character is what you really are. And I think that character is much more important than what you are perceived to be. You’d hope they’d both be good, but they won’t necessarily be the same. Well, that was my idea that I was going to try to get across to the youngsters.”

  2. This. ¬†Poem by George Moriarty, called The Road Ahead, Or The Road Behind.”
    “Sometimes I think the Fates must grin as we denounce them and insist the only reason we can’t win, is the Fates themselves have missed.

    Yet there lives on the ancient claim: we win or lose within ourselves. The shining trophies on our shelves can never win tomorrow’s game.

    You and I know deeper down, there’s always a chance to win the crown. But when we fail to give our best, we simply haven’t met the test, of giving all and saving none until the game is really won;

    of showing what is meant by grit; of playing through when others quit; of playing through, not letting up. It’s bearing down that wins the cup.

    Of dreaming there’s a goal ahead; of hoping when our dreams are dead; of praying when our hopes have fled; yet losing, not afraid to fall, if, bravely, we have given all.

    For who can ask more of a man than giving all within his span. Giving all, it seems to me, is not so far from victory. And so the Fates are seldom wrong, no matter how they twist and wind.

    It’s you and I who make our fates — we open up or close the gates on the road ahead or the road behind.”

Congratulations to David, Lito, and the entire Brookfield team. ¬†You’ve been a stunning SUCCESS for many years before winning the Flag today.

Love, Part 1: “Have I told you lately that I love you?”

 

 

Who knew that Rod Stewart was such a management guru? ¬†He doesn’t look like one. ¬†But let’s judge the man by his words not his appearance, huh?

Rod_Stewart_and_Ron_Wood_-_Faces_-_1975

 

“Have I told you lately that I love you?”

And with that simple question, Rod does more good in the world of “performance management”¬†consulting than most consultants ever could.

Have you ever wondered what you’re boss was thinking about you and/or your performance? ¬†I have. ¬†I’ll get to that in a second. ¬†I was speaking with a colleague the other day whose performance over the course of the last 24 months has been staggering. ¬†As a new leader in the industry he has assembled a team, collaboratively¬†defined its¬†vision, elevated care and customer service, and has achieved fantastic financial, clinical, compliance, and regulatory results. ¬†Can I paint a more successful picture?

And yet, after another record breaking month of results were posted, he was concerned that his boss wasn’t happy with him. ¬†Why? ¬†Because he hadn’t emailed him or called him to comment on his performance. ¬†It had been a few months now. ¬†No thank you. ¬†No Attaboy. ¬†Silence. ¬†So, instead of appropriately celebrating or feeling satisfaction, this top performer’s strongest emotions were¬†concern and doubt.

I experienced something similar several years ago. ¬†My boss was on the road almost all the time. ¬†Not only that but he had the weight of the organization on his shoulders and hundreds of people wanting a piece of his time. ¬†As the weeks, then months went by I tried to just give him (AND MYSELF) the benefit of the doubt …

I’m sure he would call or email me about my performance if he had any concerns.

I know he’s just really busy.

He hired me because I don’t need the supervision or direction.

But, given enough time, its natural to FILL THE VOID with the worst case scenario.

I began to do what my colleague was doing. ¬†I began to not only doubt my boss’ appreciation of my work but I began to doubt if he thought my role was even important to the organization. ¬†After all, if nobody’s talking to you about your work (good or bad), your work must not be that important to people.

The benefit of the doubt turns into the TYRANNY OF THE DOUBT.

Maybe its just me and my colleague, but I don’t think so. ¬†I’ve had people I’ve managed express similar feelings during overdue conversations with me as well.

A few months ago, I kept missing a 1:1 with one of my department heads. ¬†Things kept getting in the way. ¬†One postponement after another. ¬†Sure, we’d talk briefly in our daily department head meeting or in the hallway but we missed quality 1:1, focused time to talk about her department (employees, goals, challenges, etc.) ¬†When we finally met, I told her how impressed I had been by her improvements and resident/patient satisfaction I was seeing. ¬†She was stunned. ¬†She fought back the tears. ¬†You see, she thought I was avoiding her because I was unhappy with her. ¬†I had inadvertently created a void and she filled it with the worst case scenario. ¬†Shame on me.

As leaders, we can way too easily fall victim to the illusion that silence creates. ¬†“All is well.” ¬†We can forget that even (especially) our top performers need regular feedback. Ironically, too often we spend an inordinate amount of time with under-performers at the expense of quality time grooming, coaching, rewarding, and recognizing those whose work we rely on so very much.

Let’s make the time.

–> Let’s set reoccurring appointment reminders on our calendars to reach out and fill the void with true conversation that builds loyalty and reaffirms mission.

Stooping to Greatness, Part 1

It’s ironic that I spend as much time as I do here and with colleagues on time management. ¬†Ironic because I’m not naturally a very organized person. ¬†The opposite is true.

I’ve learned the hard way (and the incredibly rewarding way) that the only way I can get to the VERY IMPORTANT x NON-URGENT stuff that will either transform a facility or take it to the next level is to become great at time management.

There’s a great thought in scripture that goes like this: Where your treasure is, there will your heart be also (Matthew 6:21). ¬†Adapted to the nursing home administrator, we can say …

What you spend your time on, that’s what matters most to you.

You may protest. ¬†You may say, “No, Dave. ¬†The reality is I can’t get to what matters most to me because I have to spend so much time on this other stuff that keeps coming at me.” ¬†As we climb up to the balcony and look down at our operations and at ourselves, we’ll probably see way too much work that is reactive vs. proactive. ¬†Reversing that pattern is what separates the great leaders/facilities from the pack. ¬†So …

  • First things first = First who, then what. ¬†Let’s first surround ourselves with people more talented and driven than ourselves. ¬†They’re there. ¬†In every position. ¬†If we settle for less than “A” talent, we will be settling for mediocrity and burnout.
  • Second (simultaneously), get the fundamentals in place. ¬†Apply our Daily, Weekly, Monthly system approach to marketing, expense management, labor, clinical metrics/outcomes.
  • Third, control the monkeys before they lead to your downfall.
  • Fourth (and finally!), you now have time to dedicate to the fine-tuning, pro-active, culture building work that ONLY YOU can lead.

This post is the first of a series that I’ll dedicate to what I believe is the most important work of a healthcare leader: to create a powerful, unique culture.

Culture Model
My step-by-step, “how-to” reinvent the wheel. If you take your parent organization’s mission statement or use some other company’s culture stuff, you are missing the chance of a leader’s lifetime. There is a POWER that comes from the creative process. Or, the birthing process. What you collectively give birth to becomes your baby. You want to protect it. Nurture it. It becomes your competitive advantage that your competitors cannot replicate.

DOWNLOAD PDF Version Here: Culture Model

The title for this post, Stooping To Greatness, is stolen from a similarly themed article by Patrick Lencioni. ¬†I’m a big fan of his books that illustrate simply and powerfully that what matters most to create lasting, quality success is the SOFT stuff. ¬†The attention to people and culture.

Ready, Fire, AIM

ready fire aim

One of the most important lessons of the last 12 months for me has been the perils of firing before sufficiently aiming.  With the Myers Briggs personality preferences as context, its easy to understand why this can be a huge stumbling block for some (like me) while a no-brainer for others.

By aiming, here’s what I mean …

  • Taking the time to engage those who will be affected by the ‘fire’ in discussion, debate, persuasion, listening, reconsidering.
  • Creating a plan and …
  • Creating it WITH the people who have to implement the ‘fire.’
  • Taking the time to test, reconfigure, test some more, get a scoreboard of results to show the org. BEFORE flipping the switch to require the change.¬† This is particularly necessary when there are mixed reviews with the current state.

There’s a balancing act here.¬† On the one hand you can aim too long (analysis paralysis) and results may suffer from that inaction.¬† On the other hand (the one that I dealt with most during the last 12 months) to pull the trigger too quickly (even if the decision is logical and the right one) can lead to a botched implementation that prevents the ‘right decision’ from taking root.

Though somewhat against my nature, I’m working at ‘taking the time’ to talk with most involved parties.¬† I’m convinced this doesn’t have to be a slow process.¬† It just has to happen.¬† I’m reminded of what the book 5 Dysfunctions of a Team teaches on this topic … that without conflict/debate/dissent/discussion, real buy-in or commitment cannot take place.¬† But, with that pre-decision conflict, even those who disagree can come around and commit — knowing that their voices were heard AND having had a chance to better understand the rationale/intent of the other side.

The Speed of Trust

This is not a book review.

The Speed of Trust is a superbly TITLED book.

The writing itself was a bit too predictable, formulaic, and fluffy for my personal tastes. ¬†I understand FranklinCovey is having success teaching its principles and I don’t mean to disparage the concepts or ideas expressed at all. ¬†Just the opposite. ¬†I believe deeply in what the title of the book, Speed of Trust, means to relationships and organizations.

Think about it in your own life.  I recently did.  Check out the quick back and forth between me and my wife about choosing a family photo to purchase from a recent family photo shoot.  Start from the bottom.

Thoughts?

Here’s how I see this exchange, through the speed of trust lens:

  • Even in the mundane communication(s), love is expressed, setting a positive, supportive, sincere tone.
  • My reply was honest and I thought it would be fun to have the kids ‘vote.’
  • Her response was SPEEEEEDY. ¬†Cut to the chase. ¬†No fluff. ¬†No framing. ¬†No setting the table. ¬†No positioning statements. ¬†Just her true, actual opinion.
How valuable, how precious to an organization or team or relationship to have true, actual, authentic, unfiltered, un-sugar-coated opinions and dialogue?!
If our relationship lacked trust, her response would’ve been very different. ¬†And it would’ve been longer. ¬†Maybe a little something like this …

You know, I really like the idea of printing them out. ¬†I wish I could figure out how to do that myself. ¬†Would you be able to do that for me this evening? ¬†I wish I was as good with computers as you are [read: flattery leading up to a soft disapproval of your opinion to soften the blow]¬†…. as far as the kids voting goes. ¬†I love the idea. ¬†On the one hand it could be really fun to see the differences in how they see the family. ¬†On the other hand it might not turn out exactly as you/we might think/hope it would. ¬†What do you think? ¬†I could possibly see Caleb choosing the opposite of Madi just to be different. ¬†You know what I mean? ¬†I don’t know. ¬†Maybe we can talk about it more tonight before dinner when you get home. ¬†Maybe we could limit it or make it a blind test somehow so they don’t know which one they’re picking. ¬†I don’t know. ¬†You know? ¬†I’d hate to see something that’s a positive possibly turn into a negative. ¬†But, I love the idea of printing them out. ¬†Can you do that for me from work or do you have to be home for that? ¬†Thanks!

xoxoxoxoxoxoxox 

Now multiply the difference in the authenticity and speed of the response by the number of times you communicate as a team in department head meetings, in emails, in 1:1s and you come to realize just how critical it is to MAKE time to develop the trust as individuals and as a team.  A couple of books that I use and highly recommend to others (a lot less textbook feeling than Speed of Trust) are:

Leadership & Self-Deception (best for 1:1 relationship trust repairing/building)

5 Dysfunctions of a Team (best for team trust/dynamics issues)

Administrator-Director of Nursing Diagnostics

During the last couple years I’ve visited with over 50 nursing home administrators and their department head teams to assist them
  1. Define their facility culture,
  2. Implement world class service practices,
  3. Strengthen their teams, and/or
  4. Improve their marketing efforts
I’ve had the pleasure of working with leaders at facilities everywhere across the spectrum of performance (from beginning of turnaround to market leaders). ¬†While I find my work fulfilling and important, I’ve concluded that those numbered areas of focus above are SECONDARY to the area in the facility that is really the FOUNDATION of everything is the relationship between Administrator and Director of Nursing. ¬†In fact, as I look back at most struggling situations (clinical, regulatory, financial) the vast majority of them involve a weak, strained, or dysfunctional ED-DNS ‚Äėpartnership.‚Äô
The opposite is also true!  Where there is a strong, trusting, caring relationship between the administrator and the DNS, real transformation can take place Рgiven competent, inspired leaders.
All efforts toward cultural change, implementing higher standards, or improving the facility must come AFTER the ED-DNS relationship is solid.  Otherwise, the initiatives will be planted on a weak foundation and will fall by the wayside after a few months.  Unless there is a unified front where the ED-DNS are on the same page and are authentically committed to the initiative regardless of what it is, no change will be lasting.
In healthcare we rely on DIAGNOSTICS to identify the problem.
Diagnostics
Diagnostics
I’ve developed a cultural diagnostic tool for administrators and directors of nursing to assess how strong their relationship is. ¬†Scoring themselves on a series of statements will not only give them a grand total but it serves as a powerful basis for conversation as the two most important facility leaders take steps toward that optimal ED-DNS relationship of trust.
A sample of the statements to be scored:
(Scoring:  3 = Always         2 = Sometimes          1 = Rarely)
  • We run decisions for hiring, firing, and discipline by each other regardless of position. We give each other a ‚Äėheads up‚Äô so there are no surprises.
  • Our loyalty to each other is greater than our loyalty to anyone else in the facility.
  • We leave meetings/conversations confident that we are both completely committed to the decisions that we agreed on, even if there was initial disagreement.

You get the idea.

We often wonder why bright ideas, great programs, change initiatives fail after 2 or 3 months in the facility. ¬†This is why. ¬†No matter how brilliant the program/system, if the ‘top’ is not first committed to each other and second committed to the brilliant program/system, it is destined to fail. ¬†Get this relationship right. ¬†You get the change (culture, clinical, etc.) you desire.

Of course, this assumes competent, inspiring administrators and directors of nursing to begin with. ¬†More on how to find and retain those all-stars later …