Slides used by Values Coach CEO and Head Coach Joe Tye in his presentations for the leadership team of Carilion Clinic in Roanoke, Virginia - March 22-23, 2016

1. Build your castles in the
air

2. Cultural Blueprinting for
a Culture of Ownership
The Carilion Clinic
March 22-23, 2016
Joe Tye, CEO and Head Coach
Values Coach Inc.
Copyright © 2016, Values Coach Inc.

10. There is an invisible barrier on
the potential of your organization

11. “I got a whole new team
and didn’t have to change
the people because they
changed themselves.”
Paul Utemark, CEO
Fillmore County Health System
Geneva, Nebraska

12. Including this very special
organization

13. leadership

14. From the Pulitzer Prize winning book
Leadership by James MacGregor Burns

15. When Sally and I were in the
market for a second home in
Arizona our criteria were:
 Spectacular back yard
 Low to zero maintenance
 Affordable

17. And this is our primary
residence, the house where
we lived for 20 years and
raised our two children –
photo taken April 2013…

19. Lesson #1
Things aren’t
always what
they seem.

20. Lesson #2
What you really
want might be
closer than you
think.

21. Lesson #3
You must be
willing to jettison
old baggage to
move forward.

22. Lesson #4
There is almost
always a way to
create a win-win.

23. A word about the
assumptions we make.

24. What do you get when
you break the word
“assume” into its
constituent parts?

27. 27

28. 28

30. Question #1
When did the
healthcare crisis
begin?

32. Florence Nightingale firsts include:
• Medical records
• Laundry and housekeeping
• Infection control
• Nutrition service
• Pharmacy
• Materials management
• Patient library
• Medical triage
• Nursing uniforms
• Chaplain service

33. We need to respark the
spirit that Florence first
sparked at the Scutari
Barrack Hospital!

34. Question #2
When will the
healthcare crisis
end?

42. Companies that study employee
engagement* consistently find:
~ 25% fully engaged
~ 60% not engaged
~ 15% aggressively disengaged
* e.g. Gallup, Avatar, Press Ganey, Modern Survey

43. Engaged:
Spark Plugs
43

44. Not Engaged:
Zombies
44

45. Disengaged:
Vampires
45

49. We can do
better than
this.

50. We can BE
better than
this.

51. The Healthcare
Crisis Within

52. Disengaged people,
especially disengaged
managers, are a
quality defect

54. The real tragedy of
disengagement >>>

55. It has a life-diminishing
impact on the disengaged.

56. “Disengagement [is] one
of the chief causes of
underachievement and
depression.”
Edward M. Hallowell, M.D. in HBR, 12-10

59. Cynthia Pearsall

60. Mina Ubbing

61. CeCe Peters

62. From “Sarah Sighting”
to Poster Child for
Passion

63. The journey from mere
Accountability
to a culture of
Ownership

64. Ac
count
able

66. Accountability
Doing what you are supposed
to do because someone else
expects it of you. It springs
from the extrinsic motivation
of reward and punishment.

69. No one ever
earned a
DAISY Award
by being held
accountable!

70. Ownership
Doing what needs to be done
because you expect it of
yourself. Ownership springs
from the intrinsic motivation
of personal pride.

71. 22,899,796 views91,968– avg 5 stars

74. 74

76. Who Owns Left Field?

77. What 648 of you told
me about the culture
of The Carilion
Clinic…

78. Speaking on behalf of
the 352 who did not
participate…

80. 87%

81. 80%

82. 78%

83. 77%

84. 75%

85. 74%

86. 68%

88. 55%

89. 52%

90. 42%

92. 17%39% 44%

93. ~14%

94. $850,000,000 annual SWB
X
14%
=
>>>>>>>>>>>>>>>>>>>>>>>>>

95. $119,000,000

96. And that is just the direct
cost of subsidizing your
BMW Club – it does not
account for the deleterious
impact on HCAHPS,
productivity, retention etc.

97. Let’s some more math…
Out of 6,480 possibilities
(648 people x 10 questions)
there were only 759 (12%)
“strongly agree” responses.

98. How much more effective
would Carilion Clinic be –
in every dimension – if
you had 92% “strongly
agree” responses?

99. Several additional
questions…

100. Were you surprised
by any of these
results?

101. Who is responsible for
changing these results?

102. Invisible
Architecture
“Invisible Architecture” is a
trademark of Values Coach Inc.

103. Invisible Architecture™
is more important than
bricks & mortar

104. The Blueprint
Behind the
Blueprint™

105. Invisible architecture
is to the soul of your
organization what
physical architecture
is to its body.

106. It begins with a
shared vision…

108. 108

110. 3 stages

111. TheFoundation

112. Core values define who you
are, what you stand for, and
what you won’t
stand for

113. Integrated DNA Technologies Inc. values (excerpt)
Be yourself
Unless you’re
a jerk
113

114. From the Cypress Semiconductor values (excerpt):
CYPRESS IS ABOUT WINNING
We do not tolerate losing.
We thrive on competing against the world's best.
WE MAKE OUR NUMBERS
We make 20% profit.
We each set goals and achieve them.
We ship 100% on time and get zero returns.

116. 116
“People who are clearest
about their personal vision
and values are significantly
more committed to their
organizations.”
James Kouzes and Barry Posner:
A Leader's Legacy

117. TheSuperstructure

118. Culture is to the
organization what
personality and
character are to the
individual.

119. Where will I
take you for
lunch?

121. or…

123. This is not a trick
question…
It’s the reality of
competing today.

124. Same
business
Different
cultures

125. People pay to
shop at Costco…

126. People shop at Wal-Mart
because they don’t have
to dress up like they do
for the Dollar Store.

127. Same
business
Different
cultures

128. Nap
Rap

129. Describe your culture
(current and ideal) in
just 6 words.

130. 130
From managers sitting
in the same room at
one large medical
center’s leadership
retreat

131. 131
We love patients
and each other

132. 132
We are ALWAYS
here for you

133. 133
Multiple priorities,
limited resources,
great expectations

134. 134
Disjointed
departments
working against
each other

135. 135
We’re entitled,
hating it,
and staying

136. 136
Negativity reigns
while circling the
drain

137. 137
Beatings will
continue until
morale improves

139. Southwest Airlines Motto
Servant’s Heart, Warrior
Spirit, Fun-Loving Attitude

140. Cypress Semiconductor Motto
The Marine Corps of
Silicon Valley

141. The Florence Challenge
Emotionally Positive
Self Empowered
Fully Engaged

149. Therapy pets
can even sign!

150. Culture is to recruiting
and retention what
advertising and
promotion are to
marketing >>>>>>>>>>>

151. Modern Healthcare cover story 1/19/2016
“Nurse shortage looms”

152. A Key Point!
You cannot allow
people to opt-out of
positive culture
change!

153. Another key point:
Cultural work can’t be just
a “flavor of the month”

154. Culture doesn’t change
unless and until people
change

155. TheInterior

158. 158
A positive workplace
culture begins with
intolerance for toxic
emotional negativity.

159. 159
Emotional climate is
determined by what
you expect and what
you tolerate…

160. 160
And over time, what
you tolerate will
dominate over what
you say you expect!

162. 162
“One toxically negative
person can drag down
morale and productivity
of an entire work
unit.”

163. 163
“It is a leadership
responsibility to create a
workplace environment
where toxic emotional
negativity is not
tolerated.”

164. 164
The simple promise that
will change your life…
And change your
organization…

166. Work sucks
then you die

167. You
Idiot!

168. The Pickle Challenge
has taken on a life of
its own!

169. 169

176. Midland Memorial Hospital

179. Caveat: You will get resistance
to The Pickle Challenge.
It will be most vociferous from
people who could most benefit
from taking it to heart.

181. For one week will you
turn complaints into
contributions for the
Carilion Foundation
Lend a Hand Fund?
>>>>>>>>>>

182. 48,000 times

183. Are you up for
the challenge?

184. Does this stuff really
work? Can you
really change the
culture? >>>>>

185. Midland Memorial Hospital
Values and Culture Initiative

186. Daily Leadership Huddle
Midland Memorial Hospital

187. “Keeping the Pickle
Pledge in the leadership
huddle keeps the
culture of ownership
front and center.”
-Bob Dent

190. MMH Values Trainers #1

191. MMH Values Trainers #1

192. 63%

193. 87%

194. 36% 61%
Refrain from toxic
negativity and treat others
with respect
February August

195. Hours wasted on toxic
emotional negativity
February August

196. Annual Cultural Productivity
Enhancement:
$7,200,000

197. Employee Incentive Bonuses
for Patient Satisfaction:
$2,000,000

198. HCAHPS Overall
65.4 64.6 63.9 55.5 67.9 67.8 81.4 67.5 66.9
82.9
71.1
75.0
83.3
26.4 32.6 33.3 33.3 21.9 17.7
15.8
29.7 30.3
11.4
26.7
22.8 7.2
4.3
5.6
7.3
8.7
2.2 2.3
7.2
2.8 2.9
2.4
64.3
61.5
63.2 64.0
66.9 67.0 67.0 68.7
69.9
70.9
77.1
40
50
60
70
80
90
100
10-9 8-6 5-3 2-0 National Top Box VBP Achievement VBP Benchmark Accumulative Score (TB%)
Arrow marks beginning of Values and
Culture Initiative

199. Emergency Department

200. Wes Barnt Bob Dent Kyle Graham Katy Longbotham

201. “If we each do our
part, we will change
our lives for the
better.”
201

202. “If we all do our parts,
we will change our
organizations for
the better.”
202

203. “And in changing our
organizations, we can
change our world for the
better.”
203

204. And one last thing…
Let me introduce you
to the person you
once were

218. Wouldn’t it be
nice to become
that you again?

219. Remember this…
Culture does not
change unless and
until people change

220. Are you ready for
that challenge?