Excellence.Always. “Hard” is Soft. “Soft” is Hard. The “small” courtesies. Competitive Advantage #1. Tom Peters 25 November 2009 (Annotated)

“Courtesies of a small and trivial character are the ones which strike deepest in the grateful and appreciating heart.” “Courtesies of a small and trivial character are the ones which strike deepest in the grateful and appreciating heart.” —Henry Clay

New book due in February. The Little BIG Things. Toughest part of “writing” is choosing the epigraph. This is it. Perfect by my lights. What follows is a straightforward explication of Mr. Clay’s words.

#1

“The doctor interrupts after …* after …* *Source: Jerome Groopman, How Doctors Think

Keep this in mind.

#2

MBWA

“Discovered” this at HP in 1978 Managing By Wandering Around. A good idea. But more than that, a metaphor for “staying in touch”—tough for a boss, particularly as she goes up the hierarchy.

Sunday “Drive By”: The CEO of a very successful mid-sized bank, in the Mid-west, attended a seminar of mine in Northern California in the mid-80s—but I remember the following as if it were yesterday. I’ve forgotten the specific context, but I recall him saying to me, pretty much word for word, “Tom let me tell you the definition of a good lending officer. After church on Sunday, on the way home with his family, he takes a little detour to drive by the factory he just lent money to. Doesn’t go in or any such thing, just drives by and takes a look.”

Explains a lot of the sub-prime crisis. No “MBWA.”

#3

Hard Is Soft Soft Is Hard

The signature of … In Search of Excellence. See the next slide for a shorthand explanation.

Hard Is Soft (Plans, # s ) Soft Is Hard (people, customers, values, relationships)

!!!

#4

“The doctor interrupts after …* after …* *Source: Jerome Groopman, How Doctors Think

The patient is the best source of information. Sooo …

18 seconds

Shame on docs. True enough. But most managers are equally indictable on this charge!!! Are you an “18- second manager”? I’d put money on it in 5 cases out of 7.

[An obsession with] Listening is... the ultimate mark of Respect. Listening is... the heart and soul of Engagement. Listening is... the heart and soul of Kindness. Listening is... the heart and soul of Thoughtfulness. Listening is... the basis for true Collaboration. Listening is... the basis for true Partnership. Listening is... a Team Sport. Listening is... a Developable Individual Skill.* (*Though women are far better at it than men.) Listening is... the basis for Community. Listening is... the bedrock of Joint Ventures that work. Listening is... the bedrock of Joint Ventures that last. Listening is... the core of effective Cross-functional Communication* (*Which is in turn Attribute #1 of organizational effectiveness.) (*Which is in turn Attribute #1 of organizational effectiveness.) Listening is... the engine of superior EXECUTION. Listening is... the key to making the Sale. Listening is... the key to Keeping the Customer’s Business. Listening is... the engine of Network development. Listening is... the engine of Network maintenance. Listening is... the engine of Network expansion. Listening is... Learning. Listening is...the sine qua non of Renewal. Listening is...the sine qua non of Creativity. Listening is...the sine qua non of Innovation. Listening is... the core of taking Diverse opinions aboard. Listening is... Strategy. Listening is... Source #1 of “Value-added.” Listening is... Differentiator #1. Listening is... Profitable.* (*The “R.O.I.” from listening is higher than from any other single activity.) (*The “R.O.I.” from listening is higher than from any other single activity.) Listening underpins... Commitment to EXCELLENCE

The power of listening is … limitless. Read—and ponder—this list very carefully.

[An obsession with] Listening is... the ultimate mark of Respect. of Respect. Listening is... the heart and soul of Engagement. Listening is... the heart and soul of Kindness. Listening is... the heart and soul of Thoughtfulness. Listening is... the basis for true Collaboration. Listening is... the basis for true Partnership. Listening is... a Team Sport. Listening is... a Developable Individual Skill.* (*Though women are far better at it than men.) are far better at it than men.) Listening is... the basis for Community. Listening is... the bedrock of Joint Ventures that work. Listening is... the bedrock of Joint Ventures that last. Listening is... the core of effective Cross-functional Communication* (*Which is in turn Attribute #1 of Communication* (*Which is in turn Attribute #1 of organizational effectiveness.) organizational effectiveness.)[cont.]

Listening is... the engine of superior EXECUTION. Listening is... the key to making the Sale. Listening is... the key to Keeping the Customer’s Business. Listening is... the engine of Network development. Listening is... the engine of Network maintenance. Listening is... the engine of Network expansion. Listening is... Social Networking’s “secret weapon.” Listening is... Learning. Listening is... the sine qua non of Renewal. Listening is... the sine qua non of Creativity. Listening is... the sine qua non of Innovation. Listening is... the core of taking Diverse opinions aboard. Listening is... Strategy. Listening is... Source #1 of “Value-added.” Listening is... Differentiator #1. Listening is... Profitable.* (*The “R.O.I.” from listening is higher than from any other single activity.) from any other single activity.) Listening is … the bedrock which underpins a Commitment to EXCELLENCE EXCELLENCE

*Listening is of the utmost … importance! *Listening is a proper … ! *Listening is … ! *Listening is a … ! *Listening is of the utmost … strategic importance! *Listening is a proper … core value ! *Listening is … trainable ! *Listening is a … profession !

This is not just an exhortation, “Hey, listen.” I’m suggesting that listening become a pre-occupation. That it be no less than the whole-damn-organization’s trademark.

Listen = “Profession” = Study = practice = evaluation = Enterprise value

Listen! Listen! Listening Leaders: The Ten Golden Rules To Listening Leaders: The Ten Golden Rules To Listen, Lead & Succeed—Lyman Steil and Listen, Lead & Succeed—Lyman Steil and Richard Bommelje Richard Bommelje The Zen of Listening—Rebecca Shafir The Zen of Listening—Rebecca Shafir Effective Listening Skills—Dennis Kratz and Effective Listening Skills—Dennis Kratz and Abby Robinson Kratz Abby Robinson Kratz Are You Really Listening?—Paul Donoghue and Are You Really Listening?—Paul Donoghue and Mary Siegel Mary Siegel Active Listening: Improve Your Ability to Listen Active Listening: Improve Your Ability to Listen and Lead—Michael Hoppe and Lead—Michael Hoppe Listening: The Forgotten Skill Listening: The Forgotten Skill —Madelyn Burley-Allen —Madelyn Burley-Allen

Yes you can! That is, you can study “this stuff.”

#4A

Message: Listening is a … profession! Message: Listening is a … profession!

Just like becoming a professional musician. Or a neurosurgeon.

#4B

Listen = Profession = Study = practice = evaluation = "We listen intently to and fully engage Listen = Profession = Study = practice = evaluation = Enterprise value: "We listen intently to and fully engage all with whom all with whom we work."

Core value #1. No kidding.

#4C

“You can make more friends in two months by becoming interested in other people than you can in two years by trying to get other people interested in you.” “You can make more friends in two months by becoming interested in other people than you can in two years by trying to get other people interested in you.” —Dale Carnegie

Another [key] byproduct of listening-engaging.

#4D

“The capacity to develop close and enduring relationships is the mark of a leader. Unfortunately, many leaders of major companies believe their job is to create the strategy, organization structure and organizational processes—then they just delegate the work to be done, remaining aloof from the people doing the work.” —Bill George, Authentic Leadership

Listening. The key to/cornerstone of every relationship. Superior relationships … the key to, literally, everything!

“Allied commands depend on mutual confidence [and this confidence] is gained, above all through the development of friendships.” of friendships.” —General D.D. Eisenhower, Armchair General* (05.08) *“Perhaps his most outstanding ability [at West Point] was the ease with which he made friends and earned the trust of fellow cadets who came from widely varied backgrounds; it was a quality that would pay great was the ease with which he made friends and earned the trust of fellow cadets who came from widely varied backgrounds; it was a quality that would pay great dividends during his future coalition command dividends during his future coalition command

Listening In effect, Eisenhower’s principal “weapon” as coalition leader.

R.O.I.R.

R eturn O n I nvestment In R elationships

The idea here is to think directly about your “investment” in relationship building and maintenance.

#4E

The Real World’s “Little” Rule Book Ben/teaNorm/tea DDE/make friends WFBuckley/make friends-help friends Gust/Suck down Charlie/poker pal-BOF Edward VII/dance-flatter-mingle-learn the language Vladimir Putin/birthday party of outgroup guy’s wife CIO/finance network ERP installer/consult-“one line of code” GE Energy/make friends risk assessment GWB/check the invitation list GHWB/T-notes Hank/60 calls MarkM/5K-5M Delaware/show up Oppy/snub Lewis Strauss NM/smile -$4.3T/tin ear tp.com/Big 4-What do you think? Women/genes Banker/after church Total Bloody Mess/Can they pay back the loan?

No detailed explanation forthcoming. Sorry. It is, in full, a series of stories of “little” “relationship” things—that literally changed the world. E.g., a whirlwind 96-hour “social” visit to Paris by King Edward VII which paved the way to a British-French entente which determined the outcome of World War I.

#4F

“if you don’t listen, you don’t sell anything.” —Carolyn Marland

!!! (So true.)

#4G

Questioning, the art [and “profession”] of.

Listening’s corollary: the Art & Practice of Asking.

Ask! Leading with Questions: How Leaders Find the Leading with Questions: How Leaders Find the Right Solutions by Knowing What to Ask Right Solutions by Knowing What to Ask —Michael Marquardt —Michael Marquardt Smart Questions: Learn to Ask the Right Smart Questions: Learn to Ask the Right Questions for Powerful Results Questions for Powerful Results —Gerald Nadler and William Chandon —Gerald Nadler and William Chandon The Art of Asking: Ask Better Questions, The Art of Asking: Ask Better Questions, Get Better Answers—Terry Fadem Get Better Answers—Terry Fadem How to Ask Great Questions How to Ask Great Questions —Karen Lee-Thorp —Karen Lee-Thorp Change Your Questions, Change Your Change Your Questions, Change Your Life—Marilee Adams Life—Marilee Adams Asking the Right Questions: A Guide to Asking the Right Questions: A Guide to Critical Thinking—Neil Browne and Critical Thinking—Neil Browne and Stuart Keeley Stuart Keeley

Again: Can be studied.

Listen! Ask! Listen! Ask! Listening Leaders: The Ten Golden Rules To Listen, Lead & Succeed Listening Leaders: The Ten Golden Rules To Listen, Lead & Succeed —Lyman Steil and Richard Bommelje —Lyman Steil and Richard Bommelje The Zen of Listening—Rebecca Shafir The Zen of Listening—Rebecca Shafir Effective Listening Skills—Dennis Kratz and Abby Robinson Kratz Effective Listening Skills—Dennis Kratz and Abby Robinson Kratz Are You Really Listening?—Paul Donoghue and Mary Siegel Are You Really Listening?—Paul Donoghue and Mary Siegel Active Listening: Improve Your Ability to Listen and Lead Active Listening: Improve Your Ability to Listen and Lead —Michael Hoppe —Michael Hoppe Listening: The Forgotten Skill—Madelyn Burley-Allen Listening: The Forgotten Skill—Madelyn Burley-Allen Leading with Questions: How Leaders Find the Right Solutions by Leading with Questions: How Leaders Find the Right Solutions by Knowing What to Ask—Michael Marquardt Knowing What to Ask—Michael Marquardt Smart Questions: Learn to Ask the Right Questions for Powerful Smart Questions: Learn to Ask the Right Questions for Powerful Results—Gerald Nadler and William Chandon Results—Gerald Nadler and William Chandon The Art of Asking: Ask Better Questions, Get Better Answers The Art of Asking: Ask Better Questions, Get Better Answers —Terry Fadem —Terry Fadem How to Ask Great Questions—Karen Lee-Thorp How to Ask Great Questions—Karen Lee-Thorp Change Your Questions, Change Your Life—Marilee Adams Change Your Questions, Change Your Life—Marilee Adams Asking the Right Questions: A Guide to Critical Thinking—Neil Browne and Asking the Right Questions: A Guide to Critical Thinking—Neil Browne and Stuart Keeley Stuart Keeley

#5

“The four most important words in any organization are …

Ta da …

The four most important words in any organization are … “What do you think?” are … “What do you think?” Source: courtesy Dave Wheeler, posted at tompeters.com

“WDYT” = Certification of me as a person of Importance whose opinion is valued. “WDYT” = Certification of me as a person of Importance whose opinion is valued.

Biiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiig deal. (Remember, The Little BIG Things.)

Tomorrow: How many times will you “ask the WDYT question”? [Practice makes better!] [This is a skill!] Tomorrow: How many times will you “ask the WDYT question”? [ Count! ] [Practice makes better!] [This is a STRATEGIC skill!]

Not to be left to chance. Yup … can be MEASURED.

#5A

From Enemy/Reluctant User to Champion/Savior/Owner: The Axiom From Enemy/Reluctant User to Champion/Savior/Owner: The “one line of code!” Axiom

Ask my opinion of a system revision. I give you an earful. You go back and make a couple of tiny changes [“a line of code”] to accommodate me. Now I “own” the thing—and become a champion rather than a resistor. More or less... GUARANTEED … to work.

#6

“The deepest human need is the … need to be appreciated.” —William James

Once again. ALL POWERFUL. (And usually neglected or half-hearted.)

“Thank you” lingers on: 10 years

3M exec retires. At going away party, someone comes up to him, very emotional, to thank the exec for a thank you note he’d sent 10 years ago. (I’ve got a ton of similar stories.)

Tomorrow: How many times will you mange to blurt out, “Thank you”? [Practice makes better!* *The engineer from Manchester.]] [This is a skill!] Tomorrow: How many times will you mange to blurt out, “Thank you”? [ Count ’em! ] [Practice makes better!* *The engineer from Manchester.]] [This is a STRATEGIC skill!]

Not a casual idea. Measure it.

*appreciation is of the utmost … strategic importance! *appreciation is a proper … core value ! *appreciation is … trainable ! *appreciation is a … profession !

One more time. A topic worthy of serious “professional” study. One more time. A topic worthy of serious “professional” study.

And the answer is …. otis

Teacher gives a science exam. Students prepped—know what’s coming. Quiet in the room. Then din. Students complaining. “Will the last question count?” Teacher: “Most definitely.” And the last question is: “What is the first name of the person who cleans the room after class?” (Hint: Otis.) Teacher: “As you go forward in life, you will meet many people. All of them are important. Each one deserves your attention and respect …” Source: Deborah Norville, The Power of Respect.

“It was much later that I realized Dad’s secret. He gained respect by giving it. He talked and listened to the fourth-grade kids in Spring Valley who shined shoes the same way he talked and listened to a bishop or a college president. He was seriously interested in who you were and what you had to say.” —Sara Lawrence-Lightfoot, Respect

Self explanatory. Usually honored in the breach.

#7

It helps to know people in … high places!

Conventional wisdom. Not silly …

It helps more to know people in … “Low” places!

My “wisdom.” “Low” is where the … real work … is done.

??????? “Success doesn’t depend on the number of people you know; it depends on the number of people you know in high places!” or “Success doesn’t depend on the number of people you know; it depends on the number of people you know in low places!”

TP on Charlie Wilson’s War, by George Crile: Make friends by the bushel with those several levels down and with various disenfranchised groups. Gust Avrakotos’ strategy: “He had become something of a legend with these people who manned the underbelly of the Agency [CIA].” Eg, Gust apparently knew every executive secretary by name—and had helped many of them out with personal or professional problems. You could almost say he had the “invisible 95%” of the Agency working for him which allowed him to make incredible things happen despite furious resistance from the top of a very rigid organization. I have spoken and Blogged on this topic before, arguing among other things that the key to sales success is “wiring” the client organization 3 or 4 levels down—where the real work gets done. Most would agree perhaps—but damn few make it the obsession it needs to be to foster success. One added (big) benefit is that “those folks” are seldom recognized, and thence the “investment” will likely yield long- lasting, not transient, rewards.

The CIA go-to guy in Charlie Wilson’s War was a middle manager— but he was able to work miracles in a rigid institution because of his tight and extensive relationships with the organization’s “underbelly.”

Loser: “He’s such a suck-up!” Winner: “He’s such a suck-down.”

Maximizing “friends in low places” is a winning strategy.

C(I)>C(E)

Internal “customers” [C(I)] often more important than external customers [C(E)]. If your whole organization is at your beck and call, you can repeatedly work miracles for the external customer. If your “internal customers” are peeved at you, they can torpedo your work with your outside customers in a gazillion (or more) ways.

“Suck down for success!” * ** *** **** **** *“He [Gust Avrakotos] had become something of a legend with these people who manned the underbelly of the Agency [CIA],” from Charlie Wilson’s War **Getting to know “the risk guys” [GE Power] ***“Spend less time with your customer!” **** C(I) > C(E) *****The ATT systems sales exec

An AT&T systems sales exec started me down this path.

#8

“I regard apologizing as the most magical, healing, restorative gesture human beings can make. It is the centerpiece of my work with executives who want to get better.” —Marshall Goldsmith, What Got You Here Won’t Get You There: How Successful People Become Even More Successful Even More Successful

“… most magical, healing, restorative gesture human beings can make.”Talk about “strong language”! And Goldsmith is the unquestioned #1 executive coach—i.e., worth paying attention to. “… most magical, healing, restorative gesture human beings can make.” Talk about “strong language”! And Goldsmith is the unquestioned #1 executive coach—i.e., worth paying attention to.

pause

“I regard apologizing as the most magical, healing, restorative gesture human beings can make. It is the centerpiece of my work with executives who want to get better.” —Marshall Goldsmith, What Got You Here Won’t Get You There: How Successful People Become Even More Successful Even More Successful

Worth re-reading.

THERE ONCE WAS A TIME WHEN A THREE-MINUTE PHONE CALL WOULD HAVE AVOIDED SETTING OFF THE DOWNWARD SPIRAL THAT RESULTED IN A COMPLETE RUPTURE. Relationships (of all varieties) : THERE ONCE WAS A TIME WHEN A THREE-MINUTE PHONE CALL WOULD HAVE AVOIDED SETTING OFF THE DOWNWARD SPIRAL THAT RESULTED IN A COMPLETE RUPTURE.

I believe this is true 100% of the time. Most of my personal and professional disasters could clearly have been reversed or ameliorated with such a call.

The “three-minute call” often-usually-invariably leads to a strengthening of the relationship. It not only acts as atonement but also paves the path for a “better than ever” trajectory.

THE PROBLEM IS RARELY/NEVER THE PROBLEM. THE RESPONSE TO THE PROBLEM INVARIABLY ENDS UP BEING THE REAL PROBLEM THE PROBLEM IS RARELY/NEVER THE PROBLEM. THE RESPONSE TO THE PROBLEM INVARIABLY ENDS UP BEING THE REAL PROBLEM.* *PERCEPTION IS ALL THERE IS!

Think Richard Nixon, Bill Clinton, Martha Stewart. None, and a host like them, ever got in trouble for “the act itself”—but instead for the cover-up.

pause

THE PROBLEM IS RARELY/NEVER THE PROBLEM. THE RESPONSE TO THE PROBLEM INVARIABLY ENDS UP BEING THE REAL PROBLEM THE PROBLEM IS RARELY/NEVER THE PROBLEM. THE RESPONSE TO THE PROBLEM INVARIABLY ENDS UP BEING THE REAL PROBLEM.* *PERCEPTION IS ALL THERE IS!

Yup … another one worth re-reading immediately.

Potlatch.

Potlatch is the ritual of overwhelming one with gifts to the point at which one is paralyzed. I’m not quite suggesting that, but I am simply saying that an “overwhelming”-“disproportionate”-“asymmetric” response to a screw-up is more or less … ALWAYS … warranted. (FYI: Also central to this idea is a culture that encourages timely truth-telling around screw-ups.)

Shit happens. Be prepared.

Potlatch-plus. Shit happens—to the best of us. Have slack resources ready to react to problems before they occur.

*effective “Repair”/Apology is of the utmost … strategic importance! *effective repair is a proper … core value ! *effective repair is … trainable ! *effective repair is a … profession !

Once more … a craft … a profession … a trait worthy of study.

#8A

Comeback [big, quick response] >> >>Perfection

Human irrationality at its best: Addressing a screw-up brilliantly may well result in a stronger relationship than one marked by flawless delivery but no tests of response to adversity.

Acquire vs maintain*: 5X *Recession goal: Higher “market share” current customers

The economics are clear. It costs far, far more to dig up a new customer than to maintain a current relationship— hence justification for spending lavishly to patch a pothole to keep a current customer happy or regain her or his confidence.

#8B

“One of the secrets of a long and fruitful life is to forgive everybody of everything every night right before going to bed.” —Bernard Baruch “One of the secrets of a long and fruitful life is to forgive everybody of everything every night right before going to bed.” —Bernard Baruch

Carrying grudges has high personal costs (wear and tear on the psyche), and high professional costs; in the latter case, the damage that can be done by even weak enemies is immeasurable! So: If you’re wise you’ll forgive and move on.

#9

Enterprise Value: “We are thoughtful in all we do.”

I have come to love the word “thoughtful.” Especially in difficult times. It is a “way to live in the world”—and I firmly believe it can contribute directly to the bottom line. It is a matter of trust and character and courtesy— all three pay big dividends. (Not to mention the fact that thoughtfulness results in a more attractive image when one looks in the mirror or discusses what one does with our children.)

Thoughtfulness is key to customer retention. Thoughtfulness is key to employee recruitment and satisfaction. and satisfaction. Thoughtfulness is key to brand perception. Thoughtfulness is key to your ability to look in the mirror —and tell your kids about your job. “Thoughtfulness is free.” Thoughtfulness is key to speeding things up— it reduces friction. it reduces friction. Thoughtfulness is key to transparency and even cost containment—it abets rather than stifles cost containment—it abets rather than stifles truth-telling. truth-telling.

This I believe.

*Thoughtfulness is of the utmost … strategic importance! *thoughtfulness is a proper … core value ! *Thoughtfulness is … trainable ! *Thoughtfulness is a … profession !

One more time.

#9A

none!

Press Ganey Assoc: 139,380 former patients from 225 hospitals: none of THE top 15 factors determining P atient S atisfaction referred to the patient’s health outcome P.S. directly related to Staff Interaction P.S. directly correlated with Employee Satisfaction Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

Stunning. Patient satisfaction is almost exclusively related to the quality of interactions with hospital staff—which in turn is primarily caused by the quality of staffers’ interactions with one another.

“There is a misconception that supportive interactions require more staff or more time and are therefore more costly. Although labor costs are a substantial part of any hospital budget, the interactions themselves add nothing to the budget. Kindness is free. Listening to patients or answering their questions costs nothing. It can be argued that negative interactions—alienating patients, being non-responsive to their needs or limiting their sense of control—can be very costly. … Angry, frustrated or frightened patients may be combative, withdrawn and less cooperative—requiring far more time than it would have taken to interact with them initially in a positive way.” —Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

Be kind. Have happy patients. Save $$$. Grow market share.* (*Griffin Hospital, Planetree Alliance.)

“Kindness is free.”

#10

The “Eight Courtesies” The “Eight Courtesies” 1. Stay in touch. (MBWA.) 2. Invest in relationships. (Make friends. Obsess.) Obsess.) 3. Listen. (Respect. Learn. Student. PROFESSIONAL. Sustainable Competitive Advantage #1) Sustainable Competitive Advantage #1) 4. Ask (Engage. Inspire. Consult. React.) 5. Thank (Appreciate. Acknowledge.) 6. Network. (“Suck down.” C(I)>C(E).) 7. Apologize (Unequivocal. Rectify. Over-react. Forgive. ) Forgive. ) 8. Practice thoughtfulness. (Kindness is free. This is … STRATEGIC.) This is … STRATEGIC.)

The story/this story/my story in summary form.

Big 5 Big 5 1. Listen. (Respect. Learn) 2. Ask. (Solicit. Engage. Inspire.) 3. Thank. (Appreciate. Acknowledge.) 4. Apologize (Rectify. Build.) 5. Practice thoughtfulness (A way of life. A staple of “good business.”) (A way of life. A staple of “good business.”)

Sometimes (such as short presentations) I focus “just” on what I call “The BIG 5.”

#11

“ If I could have chosen not to tackle the IBM culture head-on, I probably wouldn’t have. My bias coming in was toward strategy, analysis and measurement. In comparison, changing the attitude and behaviors of hundreds of thousands of people is very, very hard. [Yet] I came to see in my time at IBM that culture isn’t just one aspect of the game —it is the game.” —Lou Gerstner, Who Says Elephants Can’t Dance Who Says Elephants Can’t Dance

To do “all this stuff” is primarily a “cultural” issue. (As Lou Gerstner found out to his dismay at IBM.)

“… it is the game.”

Ken Kizer/VA 1997: “culture of cover-up that pervades healthcare” “Patient Safety Event Registry” … “looking for systemic solutions, not seeking to fix blame on individuals except in the most egregious cases. The good news was a thirty-fold increase in the number of medical mistakes and adverse events that got reported.” “National Center for Patient Safety Ann Arbor” “National Center for Patient Safety Ann Arbor”

“Culture change” can be accomplished in even the least likely places—Big Time. Mostly, hospital staffs hide mistakes—it’s perhaps the “culture of medicine.” The Veterans Administration hospitals successfully attacked that culture. Reporting “incidents” became “the thing to do”—and was rewarded. As a result mistakes reported throughout the system increased by a … FACTOR OF THIRTY! Armed with buckets full of precious data, the VA became, among other things, America’s best model of patient safety.

30 -fold!

Quite a lot, eh?

#12

“Courtesies of a small and trivial character are the ones which strike deepest in the grateful and appreciating heart.” “Courtesies of a small and trivial character are the ones which strike deepest in the grateful and appreciating heart.” —Henry Clay

The uncommon “common courtesies”—the primary basis for staff and customer satisfaction and retention— and superior relationships in general. And high profitability. And the deepest of deep blue oceans