Company executives are adept at creating goals and strategies

Achieving Your Highest Priorities: Challenges and a Roadmap for Success
Company executives are adept at creating goals and strategies. However, many organizations fall short of accomplishing their goals, not because they lack a good plan, but because they fail to execute it. What separates great companies from good companies is Great companies have a disciplined process that allows them to identify the most important goals and accomplish them amidst the whirlwind of competing priorities. This seminar presents a four-step process that helps (you) leaders identify the most important organizational goals, find the critical elements to accomplish them, learn tools for engaging employees and a implement model for establishing a culture of personal and team accountability. Patrick Shaul, LCSW

Objectives Participants will …
be able to distinguish what separates great companies from good companies develop strategies to stay focused on strategic goals within the whirlwind of day to day activities learn how to write specific goals identify critical factors for success develop scoreboards to track success review a model to build individual and team accountability At the end of the webinar you will…..

Introduction Patrick Shaul, ACSW, LCSW
Patrick Shaul, ACSW, LCSW is a senior healthcare director with 20+ years experience and most recently was the Director of Learning and Organizational Development / Behavioral Health Services at Northside Hospital in Atlanta, GA. Patrick maintains a private practice in Lawrenceville, GA and is an adjunct professor for the University of St. Francis and Associate Professor for the University of Phoenix. He received his Bachelor of Science degree in Psychology with a minor in Educational Psychology from the State University of NY at Oneonta and Masters of Social Work degree from the University of GA. Areas of specialty include Project Management, Quality, Patient Satisfaction, Executive Coaching/ Development, Leadership and Team Development, Talent Management, Regulatory Compliance. He has presented at state conferences in SC and GA.

The discipline of getting the most important things done.
What Is Execution? The discipline of getting the most important things done. Let’s start with the definition of execution. Execution is the discipline of getting the most important things done. Not getting everything done, but getting the most important things (goals) done. Execution requires discipline

#1 REASON Why Organizations Fail?
70% of strategic failures are due to poor execution of leadership..... It’s rarely for lack of smarts or vision. Source: Charan, R. and Colvin, G. “Why CEOs Fail”, Fortune, June 21, 1999. Show why do organizations fail? Slide Ron Charon and Larry Bossidy wrote Execution: The Discipline Getting Things Done and what they found is the #1 reasons organizations fail is poor execution by leadership; not a good plan. Lots of smart executives crafting strategic plans but there is a failure to execute Great execution requires defining where you are today and where you want to be in the future and having a discipline process to get there The mission, vision, strategy and goals are all aligned and everyone executes on the goal. That’s the plan or roadmap for greatness.

Closing the Execution Gap
It’s one thing to come up with great strategies and goals, but it’s quite another to actually get them done. This is called the execution gap. - Stephen Covey As Stephen Covey, Author of The Seven Habits of Highly Effective People says, ”It’s one thing…….

Why is Execution So Challenging?
SLIDE Why is Execution so challenging? Execution is challenging for two Reasons. #1 Anytime you have a goal, it requires a new level of performance – new and different behaviors New & different behavior requires change and change is difficult Share example: learning new skill (driving), weight loss (getting up earlier to exercise or saying no the Ben and Jerry’s ice cream in the freezer or starting school (reading leisure books less) Not only is it hard to change your own habits, but it is also very difficult to change many people’s habits at the same time The point is this: The reason people ignore goals, show low levels of commitment, and don’t spend time on the goals is because change is hard #2 reason Execution is so Challenging because of the inherent conflict b/t work and goals.

Work Goals Two Reasons Why Important Urgent Acts on you Habitual
Keeps the engine running today Important Not Urgent You act on it Requires Change Builds capability for the future Inherent conflict b/t work and goals. Work is what you do every day to keep business/unit running. It acts on you. Goals require you to choose where to focus your day/energy; you act of them. Goals require change. Work will happen even if an organization does not identify it’s most important goals. Goals, however, will not be accomplished if we spend all our time in “work”. Work is the “whirlwind” of every day business functioning. Think of a snow storm swirling around you (this is work) and your goal is the move forward to the Starbucks sign and warm coffee/latte. Goals require commitment, focus, change. At the end of the day, you’ve done a lot of things; have you done the most important things?

The 4 Breakdowns in Execution
Franklin Covey surveyed 20,000 people and found there are 4 reasons for breakdowns in execution: 1. Don’t know the goal; 2. Don’t know what to do to achieve the goal; 3. Don’t keep score or 4. Are not held accountable. Ask people in your dept if they know the hospital’s strategic goals. If they know goals, eg. increasing patient satisfaction, do they know how the hospital is doing or what specific actions they can do to impact patient satisfaction? Ask the front line cook, in addition to the baked potato and side of green beans, what is the hospital goal and how are we doing on them? Are people in your organization held accountable? Collection goals for business office, 99% accuracy for patient registration, turnover goal

A consistent regimen that leads to freedom of action.
What Is Discipline? A consistent regimen that leads to freedom of action. Definition: Execution We said earlier, “Execution is the discipline of getting the most important things done” Discipline is a consistent regimen that leads to freedom of action. It’s easy to get things done. Most people come to work each day and get all kinds of things done. But because there is so much going on, it’s really difficult to get the most important things done. Getting the most important things done requires a consistent regimen. Eg. Every dept focusing on increasing patient satisfaction or, minimizing OT when people are calling out and census is high. Training for a marathon, income properties, people have lots of great ideas and motivation but frequently do not have a consistent regimen of daily activities to complete their renovation: this is discipline

The 4 Disciplines of Execution
Focus on the Wildly Important Goals Act on the Critical Few Keep a compelling scoreboard Create a culture of accountability

Focus on the Wildly Important
Discipline 1 Focus on the Wildly Important The enemy of the great is the good Share and define quote “The enemy of the great is the good.” The reason we have so few great schools is because we have many good schools, same with hospitals or organizations. People settle or find homeostasis in “good”, not great. Some of this is changing, eg. being the employer of choice, or achieving “Top Box” scores on HCAHPS, or becoming a Magnet Hospital The real enemy of greatness is complacency and the only way to overcome it is to help people get clear and committed around where they are today and where they want to be in the future The focus today will be raising performance and results from good to great Focus on Wildly Important (WIG) = Focus on the most important goals, use own organizations terminology, eg strategic goals

Highly effective individuals are totally clear on their Wildly Important Goal(s). They have narrowly focused, well crafted goals

Discipline 1 is focusing on the Wildly Important Deliverables: Narrowly-focused, well crafted goals

which, in turn, creates the results we Get. determines what we Do. . .
How we See the world. . . Introduce See – Do –Get Model: How we see the world…determines what we do, which in turn creates the results we Get When you see things differently, you do things differently and when you do things differently, you get different results (eg. in sports, how a team sees another team, can we beat them even if we’re an underdog, determines how they practice/perform and they may upset a favorite. Eg. How a parent interprets the behavior of a child who is misbehaving determines how they respond, which determines future behavior of the child. Is child tired, hungry, wanting attention or testing limits? which, in turn, creates the results we Get. determines what we Do. . .

I can effectively accomplish 6, 8, or even 10 important goals at once.
OLD THINKING: I can effectively accomplish 6, 8, or even important goals at once. NEW THINKING: I can accomplish only 1, 2, or 3 important goals with excellence. Define your Wildly Important Goals. SLIDE: See, Do, Get, example Old Thinking – We can effectively accomplish 6, 8 or even 10 important goals at once New Thinking – We can accomplish only 1, 2 or 3 important goals with excellence. They key word is “excellence” See – the most important goals of an organization Do – Define your Wildly Important Goals Get – Laser focus on top priorities An interview with a top executive who boasted of his ability to multi-task. Said he could accomplish a number of goals, When he looked at the number he accomplished with excellence, it was 0. When he tried to accomplish 2-10 goals, the number he accomplished with excellence was 1-2. This executive became a firm believer in focusing on only 2—3 goals at a time. This does not mean you don’t have more than 2-3 goals, but to accomplish them with excellence requires focusing only on 2-3 at one time. Multi-tasking prevents excellence, eg, driving and talking on phone, watching TV and listening to your child. Example of a football field with goals on the sideline and only 2-3 goals on the field at any one time. Laser focus on your top priorities.

Wildly Important Goals (WIGs)
What is an important goal? A goal with significant consequence and value. What is a Wildly Important Goal? A goal that makes all the difference. Failure to achieve this goal renders any other achievements inconsequential. Identifying Your Wildly Important Goals Define the difference between a WIG and an important goal. SLIDE – Important Goal “a goal with significance and value” WIG “a goal that makes all the difference. Failure to achieve this goal renders any other achievements inconsequential. Example, TSA and customer service, getting bags to destination etc. WIG = keeping planes safe, no terrorist activities ED triage - Customer service, confidentiality important, wait times– WIG is keeping people alive Hospital A: poor MD relations, low census, financial px, high turnover, low patient satisfaction scores, older equipment. What is most important goal? Finance. Without a stable financial base, hospital will fail Land One Plane at a Time – which one is the most important? The one you’re on. The next one to land

Line of Sight Line of sight = being able to see how my individual work
contributes to the achievement of team goals and how team goals contribute to organizational goals. We said earlier the reasons people do not accomplish goals is b/c they don’t know them, don’t think they can impact the, don’t know how organization is doing on goal or are not held accountable. Creating a Line of Sight allows employees to see how their individual work contributes to the overall hospital WIG. Org WIG cascades to dept then to employee Share Ritz Carlton Example. Person stayed in one hotel, wanted certain hypo-allergenic pillow and change location of desk to put it in front of the window. Six months later, stayed at another RC hotel: what kind of pillow did she have? Hypo-allergenic. Where was the desk? In front of the window. Our responsibility as a manager is to create the line of sight for all employees to the WIG, eg. demonstrate how employees in your dept affect patient satisfaction or retention. Eg. Use WIG process when new ICU opened and new nurses were hired. Group identified their retention goal and strategies and people were held accountable. First year retention was 95%. Only one nurse left and that was b/c of relocation. Group identified how everyone within the dept impacted retention, not just the supervisor. EG Patient access, goal=accuracy which equals increased patient satisfaction

Where Do WIGs Come From? Categories of WIGs Organizational Directive
Desperate Need (Stabilize) Gap Closure (Normalize) Bold Vision (Optimize) Where do WIGs originate? Organizational Directive Supermarket: Increase YOY sales by 10 percent. Human-resources team: Decrease turnover of first year employees from 50% to 25% this quarter. Desperate Need Auto manufacturer: Reduce debt by $7 billion within five years. Software developer: Regain 20 percent of lost market share in the next 12 months. Gap Closure – You see a px or opportunity that should be addressed proactively. Increase the competence of new managers from 70% to 90% on key leadership competence as measure on the performance evaluation Bold Vision – Kennedy: land a man on the moon and return him safely to earth before the end of the decade. Achieve status as Magnet Hospital or receive the Malcolm Balridge National Quality Award

How to Structure a Goal…
A measure tells you if you have achieved your goal. From X to Y by When A measure consists of: Performance gap: from X to Y. Gap-closure timeframe: by When. SLIDE: How to structure a goal Measures tell you if you have achieved the goal. They should be written in the format “from X to Y by when” “X” is where you are; “Y” is where you want to go Share the Kennedy vs. Eisenhower goal. Put a man on the moon by the end of the decade and return him safely home” vs. increase US involvement in space exploration. Improve Patient Satisfaction versus Increase our patient satisfaction score from 78% to 90% by the end of the 3rd qtr. Increase the number of admitting MD’s from 1200 to 1300 by the end of the fiscal year Decrease overtime cost by 5% at the end of the 3rd quarter How not to craft a goal. “Hit our numbers” “Increase collections” “Reduce med errors” Lose weight, travel more These are too vague Be specific: X to Y by when Remember to limit the number of goals, eg. HR has many metrics, which are WIGs versus goals.

Act on the Critical Few Discipline 2
Eighty percent of results come from twenty percent of activities Focus in D-2 are those critical few elements that will help accomplish the goal “Eighty percent of results come from twenty percent of activities”. Will discuss Pareto Principle or 80/20 Rule –

Act on the Critical Few D2 is acting on those critical few elements that will impact the WIG D2 is still in the whirlwind Who can explain the Pareto Principle? Also known as the 80/20 rule. 80% of the Results come from 20% of the activities. In the late 1800’s, economist and avid gardener Vifredo Pareto established that 80% of the land in Italy was owned by 20% of the population. While gardening he later observed that 20% of the peapods in his garden yielded 80% of the peas that were harvested. And thus was born a theory that has stood the test of time and scrutiny. Some examples where 80% of the Results come from 20% of the activities wineries produce 100% of the wine, yet 6 wineries (20%) produce 80% of the wine. Grocery store study: 80% of the produce sales come from which 2 products? (Lettuce & potatoes). 20% of the church members donate 80% of the collections. Deliverables: Those critical few activities that best predict the achievement of the WIGs.

Results Activities The 80/20 Rule
Graph of your typical day. You have activities/things you do and you get results Activities

Results My Workload Activities The 80/20 Rule
Your workload of daily activities Activities

Results My Workload 80% 20% Activities The 80/20 Rule The Critical Few
DISCIPLINE 2: Act on the Critical Few 20% of activities produce 80% of results In most situations, small, highly leveraged activities will produce the greatest return. 20% is greatest predictor of achievement Most of us spend virtually every day of the year executing on something. – we’re busy. To accomplish our goals, we want to focus on the 20%, the critical few, that will get the results we want. Cutting grass is 20% which makes lawn look better or vacuuming is 20% to make house look clean. what are the 20% of activities that you do if people are coming to visit? 20% Activities

Act on the Critical Few Highly effective individuals invest their energies in the few activities that have the greatest impact on their WIGs. ICU and retention strategies: provide opportunities for learning and growth, mentoring/buddy system with new hires. The result was retaining all but 1 nurse after 1 year and that nurse moved. We discussed the Departure Risk Matrix in the first seminar. Rounding on employees could be one of the critical few activities you do

Act on the Critical Few Goal Critical Few 80/20 activities that
lead to the goal X to Y by When we can influence weekly By July 18th Number of Calories X=180 pounds Weight Training and Aerobic Exercise LOSE WEIGHT Review example in slide: there could be other activities but you want just the “critical few” Kennedy Space Program: What is the goal? What were the critical few activities to successfully land man on the moon and return him home safely: 1. Communication system, 2. Enough oxygen, and an 3. excellent Navigation system (4 M pounds of thrust to get outside Earth’s gravitational pull, then a slingshot effect and minimal thrust to keep going) Many activities can impact patient satisfaction: What are your critical few? Have you identified them? Use Best Practices that work for you EG. Med/Surg unit had rounding, all shifts, focusing on 4 Ps, Position, Potty, Pain, Personal Needs and give their name and asking, “is there anything else I can do for you?” For me training for a Half Marathon. The WIG: Completing the Atlanta Half Marathon on Nov 27th (Thanksgiving) in a time of less than 2 hrs.12 min. Critical Few: 1. increase baseline mileage, 2. increasing longer run once a week, 3. run 4x/ week. Some people choose a running group, increase carbs, get more sleep, do sprints. Y=150 pounds Work Out Partner

Act on the Critical Few Leading vs. Lagging indicators:
Leading – you can impact it and course correct before you reach the goal. Lagging – you’ve reached the goal and can’t course correct Leading – you can impact it and course correct before you reach the goal. Lagging – you’ve reached the goal and can’t course correct EG. Running and splits Weekly weighing vs. waiting til end of year Visa bill vs. tracking statements online Leading: daily activities that impact your budget Lagging: monthly dept budget report Leading: daily rounding with patients Lagging: Press Ganey scores (b/c they reflect the previous qtr and you can no longer impact those numbers. So when you think about identifying the critical few, think leading indicators, not just lagging indicators

React to the urgent and try to do everything. NEW THINKING:
OLD THINKING: React to the urgent and try to do everything. NEW THINKING: Focus on critical activities that best predict and lead to the achievement of the WIG. Analyze, identify, and act the 80/20 activities. SLIDE Disciple 2 Roadmap: See – Do - Get Old Thinking – React to the urgent and try to do everything (How do you feel?) Now, a new mindset……… New Thinking – Focus on the critical activities that best predict and lead to the achievement of the WIG. We want to “trim” to the critical few Do – (The Do part for you is to Analyze, identify and act on the 80/20; narrow our focus Get – Achievement of the WIG Achievement of WIGs.

The 80/20 Analyzer Process Narrow Down Choices Pockets of Excellence
Barriers Brilliant & Creative Candidate Activities Narrow Down Choices 80/20 Activities SLIDE Funnel – How do we identify the critical few? Brainstorm Candidate Activities Look at Barriers, Pockets of Excellence, Brilliant & Creative Start with a lot of potential candidate activities. Whittle it down to the critical few Apply 80/20 rule, Narrow to critical few: a choice. You start with a lot of stuff. Develop a systematic way to narrow the choices For example> critical few for retention, ICU – ongoing education, mentoring. For example > Business office: daily reports to include amount of cash collected, number of calls made, ADC with patient mix For example > ED: rounding in wait rooms, 15 min status reports Critical Few

Analyze and Identify My 80/20 Activities – The Critical Few
BARRIERS What obstacles could hinder me from achieving the WIG? POCKETS OF EXCELLENCE What do the best performers do differently? BRILLIANT AND CREATIVE What haven’t I thought of that could make all the difference? SLIDE 80/20 – To identify the most leveraged activities necessary to achieving the goal, it is important to consider 3 things: Barriers (who or what) can stand in your way. Money, space, resistance to change, remember people usually resist change Pockets of Excellence – what are people doing right? What are the best performers doing? Which depts. or areas doing it well? Best Practice, Benchmark. Imagination Creative & Brilliant – brainstorm; bench mark HCAB Hardwiring for Service Excellence, Hardwiring Right Retention Example of Creative & Brilliant: Ritz Carlton barrowed system from FedEx to keep track of customer preferences, out of industry. 6 Sigma from GE applied to healthcare. FMEA Failure Mode Effect Analysis– co-pilots – planes crashed b/c no one spoke up, the “Pause” in OR. Crew Resource Management in OR’s

Keep a Compelling Personal Scoreboard
Discipline 3 Keep a Compelling Personal Scoreboard People play differently when they are keeping score DISCIPLINE 3: Keep a Compelling Personal Scoreboard > When you attend an athletic event, what is purpose of scoreboard? Tell you who is winning. Have you ever arrived at an athletic event late and scoreboard was not working? Who’s winning? (People play differently when they’re keeping score) Do people play differently when they keep score? Think about kids on a playground….How? (Increase intensity, passion, for example, on a pick up basketball game, people always yell out score, 8-4, or tennis match, Love 40. Balls and strikes. When you keep score on turnover, budgets, census, OT hours, agency use, cost of benefits, we behave differently for example when NSH focused on decreasing OT and agency use

Highly effective individuals know at every moment if they are winning. Highly effective people know at every moment if they are moving towards their goals that is, if they are winning They know the score, eg. weight loss example, daily census, vacancy rate, lost injury reports, inventory in central supply, grades in school

SLIDE: Discipline 3 is behind 1 & 2, still in the whirlwind Deliverable: Personal Accountability Scoreboard – by the end of Discipline 3, you will have created a personal accountability system, and evaluated your team scoreboard Personal scoreboards - the purpose of a personal scoreboard is to motivate me, not team, to win Scoreboards for dept – what is our “days to fill” rate for dept? Scorecards for myself – HR - what is my personal “days to fill” rate? What are my tasks to help dept reach “days to fill” fate? Personal scorecards build the dept scoreboard Deliverable: Personal Accountability Scoreboard

You’re not really serious unless you’re keeping score.
What’s the point? You’re not really serious unless you’re keeping score. The point about personal scoreboards is “you’re not really serious unless you’re keeping score.” High Performer’s know the score Eg. Hospitals and Patient Safety Think about those things in your life that are important – do you keep up with how you’re doing, eg. Blood pressure, mortgage, school grades? Baseball players and batting average Hospital can say patient satisfaction is important but if they don’t survey patients or don’t track and share information, it’s probably not important Eg. Patient satisfaction scores, retention numbers, quality scores, tracking budget numbers, knowing census, admissions and discharges Director of business office got a call every day from CEO and asked 3 questions: how much have we collected today? How much do we have outstanding? How much do you think we will collect by close of business? Census, Staffing levels, OT costs

People disengage when they…
❑ Don’t know the score. or ❑ Can’t affect the score. SLIDE: People disengage when they Don’t know the score Can’t affect the score Think about your own staff? They’re busy, are they also focused on WIG? Therefore, there are two things we want to do with our people: Get them the score and get show them how they can affect the score (line of sight) = them engaged. Eg. How each employee’s actions affect the dept budget Knowing the score will increase engagement.

Everybody knows how we’re doing on our goals. NEW THINKING:
OLD THINKING: Everybody knows how we’re doing on our goals. NEW THINKING: We’re only serious about our goals when we start keeping score. Build a compelling personal scoreboard. Hold yourself accountable to a personal scoreboard. Old Thinking: Everyone knows how we’re doing on our goals New Thinking: We’re only serious about our goals when we start keeping score See Old and New thinking 15% know the goals; that is 1 in 6 in your dept. and of that 1 in 6 only 19% are passionately engaged in the goal That is, 1 in 5 of the 15% are engaged; that’s a low number Do – Build a compelling scoreboard and institute regular scoreboard updates in my personal system. Hold yourself accountable to it. And what do you get? Get High engagement, quick course correction and motivation, all the stuff that occurs when we know the score and keep the score. Get: For example, how many of you know your bank balance, Visa bill, tuition balance? Think about the things that are important to you, that are vital to you. That’s what we want to keep score on. These are examples of scoreboards. Things that are vital we keep score, for example, if you have high BP or diabetes. Points if you’re doing Weight Watchers High engagement, motivation and quick course correction.

Criteria For Building Your Personal Scoreboard
SLIDE: Criteria for building a scoreboard Simple Visual Gives immediate feedback. Tells you immediately if you’re winning or losing, for example, Must focus on the Critical Few Ask: What makes a scoreboard compelling? Easy to read, Specific, Visual, Visible, motivates people, gives immediate feedback, X to Y by When, Displays current information

Simple Example of a Simple scoreboard – dashboard, speedometer, driving to work and course corrections if speeding and seeing a radar gun or runners taking their pulse or looking at their stop watches every ¼ mile

Visual Visual and Visible– for example, United Way thermometer (and Visible) Front of USA Today. Lots of visual graphs

Tells You Immediately If You’re Winning or Losing
Gives immediate feedback. Tells you immediately if you’re winning or losing, for example

Must Focus on the “Critical Few”
Scoreboard Must focus on the Critical Few: SLIDE – What are the few things that are predictors of you achieving your goal, the 20% activities that get the 80% of the results. Trim tab is part of the rudder that can turn a huge ship. Trim Tab 20% are the lead indicators that predict your goal accomplishment. For example, training to increase patient experience; what are the 20% of the critical few activities that are lead indicators (predictors) that will product 80% of results, ie, increase in HCAHPS score? The Trim Tab is a small section of the rudder which changes the direction of the ship. One person can start a change. A teacher who took over a school started by cleaning the school. Eventually others starting helping. Broken window theory. Cleaning subway cars in NY.

Create Your Own Personal Scoreboard
Criteria: 1. Simple 2. Visual 3. Tells you immediately if you’re winning or losing 4. Must focus on the “Critical Few” Make scoreboards fun, eg. ED had ambulances to track wait times, Maternity Dept. had bassinettes to track time before baby joined mother in room, Environmental services had a cleaning cart with different instruments to measure time to clean a room, Engineering built a scoreboard with lights to measure time to fix repairs

Create a Cadence of Accountability
Discipline 4 Create a Cadence of Accountability No Accountability, No Commitment

Discipline 4 is a true implementation discipline. Need to add accountability. Without a cadence of Accountability, it’s very easy for all the great plans created so far to evaporate and get sucked into the “whirlwind” Right now nothing is going to be different until Discipline 4 is adopted and acted on. You are at high risk of everything just dissipating. Deliverable: By the end of Discipline 4, you will have established a weekly cadence of accountability for achieving your goals SLIDE: Create a Cadence of Accountability. Highly effective individuals organize and execute on their top priorities No Accountability; No Commitment, Metronome Share the metaphor of the metronome – a rhythm of planning, follow through, reporting and accountability; the work gets done, then take a rest, in the quiet space, the rest. Without the rest, we’d have one continuous note. A rhythm, a pace Cadence of Accountability – a recurring cycle of planning and accounting for results. Discipline execution of Goals require a cadence – a rhythm of planning, follow through and reporting Deliverables: Work-Compass Process and WIG-Session Process

Maximize the time spent on your critical few.
OLD THINKING: I execute! NEW THINKING: Execution falls apart without personal planning and team accountability. Maximize the time spent on your critical few. Account weekly. SLIDE See – Old Thinking – I Execute New Thinking – Execution falls apart without personal planning and team accountability; if no accountability, them I’m out here as the lone range. People need to know what each other do Story in NY Times about person who came to work every day and acted like he worked at the company for 4 months. No one challenged him. He learned buzz words, the lingo and blended in. Called himself a project manage from the Chicago office. No one held him accountable. Do – Maximizes the time spend on your critical few. Time spend on 20%. Account weekly Get – Timely accomplishment of goals. Want to accomplish your goals by the finish line, that is, end of fiscal year Timely accomplishment of WIGs.

Key Question What are the three most important things I can do this week to impact the scoreboard? The accountability that we are talking about is around a single, very important question Read Question Why don’t we just say “what are the three most important things I can do this week?” (because it won’t be focused on the goal ) Key Questions The essence of Discipline 4 revolves around one question each week. “What are the three most important things I can do this week to impact the scoreboard?” This is not the same as determining the three most important things in general. Impacting the scoreboard is the key. This is different than “what stuff do I need to do this week.” Where does “stuff” reside? The Whirlwind. Need to step out of whirlwind The question (what do I need to do this week) focuses on the “day job” (the whirlwind, the “work”) the other question (what are the 3 most important things I can do this week to move the scoreboard) focuses on the Goals. For example, impacting patient satisfaction This process should be used each week to select and activate key activities that will drive the Goals – putting the big rocks first

Key Question Work Compass
Set Up WOW Display Monday Tuesday Wednesday Thursday Friday 8:00 Purchase Product Set Up WOW Display Set Up WOW Display 9:00 Run the Ad 10:00 11:00 12:00 1:00 Purchase Product Once we know the 3 most important things I can do this week to impact the scoreboard, we put them into our calendar. To do list and color coding are OK but having a planning system is imperative eg. MS Outlook, notebook, Franklin Covey planner, PDA, blackberry. The key is having an organized, consistent system Run the Ad 2:00 3:00 4:00

The Time Matrix Necessity Discipline Waste Deception
SLIDE The Time Matrix Example Explain – Time Matrix is a tool to help maximize our time to get the results we want. A framework for managing our time for results. Everyone’s time at work falls into one of these four quadrants Describe each quadrant in terms of urgency and importance I –Necessity – Urgent and Important. It’s in your face, take care of it now. Crisis, deadlines, JCAHO showing up. What are some of Q I for you? What about at home? Call from school or your teens saying, “this is my only phone call” III – Deception – Urgent but Not Important eg (Needless interruptions, unnecessary reports, etc). This is your frame of reference. Interruptions are caused by people who think you care. Busywork, not right people at mtg. IV – Waste (Trivia, busy work) How many people have quit and not left? 85% of e-commerce down during work. eBay story. The computer can be a place to hide during work. March Madness, streaming video of games with a “boss button’ that brings up a spreadsheet II Discipline: this is where Goals reside. Goal setting, planning, role clarification Q I & III is the “whirlwind”. Link this concept to the 80/20 Deception Waste

The Time Matrix Orienting new staff JCAHO at door Equipment breakdown
Training Delegation PI Examining root causes Example of Time Matrix Review slide Q1 crisis management, JCAHO showing up, pt. complaints Q III continuous JCAHO prep, trending and proactively solving pt complaints Ex of 4 D’s working together: Store 334 D1 Improve store sales year over year D2 Improve store conditions What were the critical few? The store conditions. They made a bet – improving store conditions would improve store sales. Eg fresh bread daily, clean out storeroom, change look of deli D3 Each department had five measures. Were they working on all 5 every week? No. Managers asked them to focus on 1 until they got a rhythm. Then they added 2 or 3. Employees torn down scoreboard. Kept at process D4 Weekly mtgs. Jim asked each team member, “What’s the one thing you are going to do this week to impact the scoreboard?” What happened to Jim Dixon both personally and professionally when he implemented the 4 Disciplines? People started smiling. What else did you learn? Can’t do it alone. Team needs to be invested, involved. Slow process and tendency may be to give up. It takes time to change, for example, new golf grip Multiple people at same meeting Busy work Wrong people at meeting Some s Surfing the Internet Too much time sitting behind desk

The Time Matrix

The Devil’s Triangle SLIDES : The Devil’s Triangle Share the concept of the Devil’s Triangle: Spend all day in QI, QIII and Q IV and not enough time in QII, which is were WIGs reside. You start the day in QI taking care of urgent and important stuff. You then slide down to QIII where you are busy but it may not be highest priorities. Then you need a break and slip over to Q IV to rest. A crisis arises, and you’re back in QI. Keeps you out of Q II. Q III can be last minute requests from your boss. You can tell your boss you will make their Q I your Q I but ask for a time to meet with him and explain Q II, Planning. Take boss from Q I to Q III Maximize the Time Spent on Your Goals Everyone works in one of four quadrants based on the urgency and importance of the task. To maximize the time you can spend on Goals, eliminate Quadrants III and IV and minimize Quadrant 1

The Work Compass Conduct retention interviews with staff.
Complete departure risk matrix Schedule 30 minutes w/staff members Educate staff on NRC-Picker model. The Work Compass is a tool for defining each week the objectives and task you must accomplish to move the scoreboard Read –This week’s focus: What are the few objectives I must accomplish this week to move the scoreboard? Fill out the Work Compass in preparation for the Goal Session. Remember, you focus is on what you can do each week to move the scoreboard The Work Compass should be filled out at the beginning of each week This is a tool that will enable participants to execute on QII priorities Schedule staff mtgs on all shifts Meet w/Susie to dev Picker pres.

The Work Compass Work Compass Show how the Work Compass is used
Set Up WOW Display Monday Tuesday Wednesday Thursday Friday 8:00 Purchase Product Set Up WOW Display Set Up WOW Display 9:00 Run the Ad 10:00 11:00 12:00 1:00 Purchase Product Show how the Work Compass is used Make the distinction between “the most important thing I need to do this week” and “the most important thing I need to do to move the scoreboard this week.” The Work Compass is not a “to do” list. Think in terms of “From X to Y by When.” For example, where am I now and where do I need to be by the end of this week? These are Q II activities, Important but Not Urgent Keeping a regular cadence will keep them from becoming urgent It is essential to translate task from the Work Compass into a planning system Discuss the importance of planning when using the Work Compass Explain that there are many types of planning tools. Although we are showing the paper version, some people use hand held devices, MS Outlook, etc. Execution will break down at this point unless you transfer the key tasks into your planning system. Make sure you schedule these tasks first before you schedule any other task for the week. The “Big Rocks” story – focus on the things we say are most important, the Big Rocks, first Run the Ad 2:00 3:00 4:00

Highly effective individuals regularly and frequently account to each other on their commitments.

Hold a Weekly Accountability Session
What are the 3 most important activities I can do this week to move the scoreboard? Account: % of my tasks completed. To account for performance on individual and team commitments from the previous week

How did I do with my tasks? How did our group do? Update my scoreboard. Learn from success and failure. To review the scoreboard to know whether or not we are winning

What are the three most important activities for me to accomplish next week to impact the scoreboard? Plan. To plan how to move the scoreboard during the coming week. Clear the path for others. How can you be a resource for others? Helping others accomplish their goals. Think interdependently

The weekly Goal Session creates a “cadence of accountability” because it is held weekly and serves 3 purposes: Account: % of my tasks completed. To account for performance on individual and team commitments from the previous week Update my scoreboard. Learn from success and failure. To review the scoreboard to know whether or not we are winning Plan. To plan how to move the scoreboard during the coming week. Clear the path for others. How can you be a resource for others? Helping others accomplish their goals. Think interdependently Can meet more or less than weekly We work together to account EG. Med Surg WIG sessions held weekly. First week one supervisor did not attend and therefore her rounding data was not put on scoreboard. Team scoreboard looked bad. Everyone attends now or sends a rep. LOD team and WIGs meetings. People accounting to each other on their 3 most important things, eg. meeting with 3 managers, copying information for class, ordering books

Traditional Meetings vs. WIG Sessions
SLIDE: Jim Stuart “The goal defines the team – not the organizational structure” Share example above

Summary Focus on the Wildly Important Act on the Critical Few
Keep a Compelling Scoreboard Create a Culture of Accountability

Bibliography Franklin Covey, Four Disciplines of Execution
Used with permission from Franklin Covey

Patrick Shaul, LCSW

Company executives are adept at creating goals and strategies

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Company executives are adept at creating goals and strategies

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