If you work with people, work on culture

In my current role as a patient experience leader for a health care system, a large part of my focus is on culture. If you are already familiar with this blog, you have already seen me discuss culture a lot in the context of leadership and in book reviews. I talk so much about culture because it is what makes systems and processes work reliably and without constant auditing.

For years, I have been working to put the pieces together in terms of how to build culture. Using ideas from authors like Simon Sinek, Malcolm Gladwell, Joseph Michelli, and Adam Grant (to name a few), I have created my own definition of leadership and have advocated for articulating a vision and creating systems and processes to bring that vision to life. However putting the pieces together both from research and experience, has at times has felt like a struggle.

Culture CodeThen along comes Daniel Coyle, author of the best-selling book The Culture Code. In this book, Coyle has compiled a clear and well explained definition around the common characteristics of organizations with exceptional cultures that lead to consistently excellent outcomes. Using examples from organizations like Pixar, the San Antonio Spurs, the famous Upright Citizens Brigade improv group, and Navy SEALs, Coyle shows us what these organizations do differently that allows them to deliver results for the enterprise and its people.

The three over-arching characteristics that every group has in common are:

  1. Build Safety
  2. Share Vulnerability
  3. Establish Purpose

Under each of these simple two-word ideas are many different anecdotes, research studies, and case studies that show not only what these concepts mean, but what building them entails for leaders.

He also delves into the nuances of these concepts that may vary depending on the business. For example, in the book he compares organizations that build a culture for high service reliability (Union Square Hospitality Group – think Shake Shack) vs. creativity and innovation (Pixar).

Health care service delivery is an example of a setting where the culture must be built for high service reliability. Much of this work involves creating genuine connections with patients and their families, which helps determine how to meet their needs both including bridging the gaps in their understanding of their condition, the treatment, the workings of a hospital, and the health care system at-large.

Coyle covers the impact of empathizing with the patients in order to the increase their health outcomes and covers how to create an environment for the staff that promotes empathic behavior.

In the book, Coyle discusses a Harvard neurologist named Marci who researched the impact of listening in the medical setting. She studied non-western healers who used methods that were scientifically questionable, yet found that some practitioners had remarkable results.

To explain these outcomes, she says, “What these healers all had in common was that they were brilliant listeners. They would sit down, take a long patient history, and really get to know their patients…They were all incredibly empathic people who were really good at connecting with people and forming trusting bonds. So that’s when I realized that the interesting part wasn’t the healing but the listening and the relationship being formed. That’s what we needed to study” (Coyle p.154).

In health care, we tend to think of communication as “provider to patient”, with the patient simply answering the provider’s questions. As I take a few steps back think about it, wouldn’t someone want to feel known as a person, and not just by a diagnosis? Just listening to the patient gives the provider an opportunity to create that relationship.

Culture in the health care setting, because of the nature of the work at times being life-or-death, is especially important. Guides like The Culture Code help us build those cultures in a safe and sustainable way.

KEY TAKEAWAY: The best companies are deliberate about building their cultures. In health care, specifically, culture can deliver superior patient outcomes if there’s a focus on the caregivers and seeing the patient as a person, rather than a diagnosis.


The Culture Code is available for purchase on Amazon for $28.00 (does not include Prime discount)

Lessons from my government relations days

Tomorrow begins the 439th session of the Maryland General Assembly. In honor of that occasion and the swearing in of the 116th U.S. Congress on January 3rd, this blog post is about my time as a government relations professional from 2010-2016.

Growing up, it was hard not to get the bug for politics and public service. My father, Ron Sachs, is a second-generation photo-journalist and covers Capitol Hill and the White House for his own news agency called Consolidated News Photos. As early as I can remember, we would talk about the events of the day at the dinner table, in the car on the way to school, or running errands.

It felt almost inevitable that I would do something related to government or politics in my career.

And I did.

From 2010-2016, I worked as a government relations professional for a national advocacy organization, a local chamber of commerce, and a hospital system. That experience taught me several important lessons that I have integrated and also used as a health care professional in an operations function.

1) Relationships, relationships, relationships

If the three keys to real estate are, “location, location, location”, the three keys to advocacy are, “relationships, relationships, relationships”.

Relationships are critical for several practical reasons as an advocate. To understand why, it’s crucial to empathize with the official to whom you are advocating.

Most officials with power (and by power I am referring to the ability to impact policy) are inundated with requests. Think about your member of Congress. All day they receive correspondence by mail, phone, and email asking her to do many different things. People ask to vote one way or another on a bill, to sign a letter, to fix their road, to help with expediting a passport, etc. Meanwhile, they are meeting people, spending time on the floor with their colleagues voting, spending time in committee, and raising money for their re-election.

How does someone get through all of these requests prioritize them? Relationships.

For me, relationship building started during the elections. I enjoyed meeting elected hopefuls and learning the reasons that they were running for office, taking an interest in their campaign, and offering any advice. At this point in their political life, they are looking to meet people and make friends.

Once they are elected, everybody else is now looking to meet them. A pre-existing relationship goes a long way to accessing the official just as everyone else is trying to gain access.

That is also why it is vital that the relationships are based on trust and are not purely transactional. Elected officials are people and spending the time to build authentic and trusting relationships are what separates out the most effective advocates. Think of your best relationships where you have trust, open communication, and share work together. Those principles are the same in building impactful relationships with elected officials.

Embed from Getty Images

2) It’s about Who and Why, Not What

Again, in a myriad of legitimate requests, how do officials with power make decisions about what to pay attention and prioritize. Another way of looking at it, why do certain things happen when others do not?

For years, good organizations like think tanks and NGOs have had outstanding ideas on solving some of our country’s biggest challenges like climate change, immigration reform, and health care reform. Many smart and capable people have these bright ideas (let’s refer to these as “What”, as in “what should be done”), but do not have the skills to get these ideas adopted.

It is because there are many good “What’s”, but usually they do not come with the right “Whos” and “Whys”.

To get things done, you need to have a “what” that solves the correctly defined problem (why) and the right people on-board who support your “what” (whos). The problem is defined not just as the issue itself, but how important that issue is to the elected’s constituents and who supports and opposes the “what”. If your “what” is a good solution to a problem, but causes many political issues for the official, it will not happen.

In a group of officials, there are leaders in the legislative body or organization who are power brokers and can get things done. These people are not necessarily its presiding officers (just like the CEO is a business is not necessarily the center of power in that organization). Those “whos” are all crucial to getting your “what” implemented. It’s knowing the right people to need to convince first, before others will get on board. In some smaller legislative bodies, the right one person’s buy-in may be enough, but that person usually chooses to lead very selectively. That’s where the relationship with that “who” is crucial.

3) Navigating the system is vital

We have all probably seen the video below from School House Rock on how a bill becomes a law.

While this technically outlines the process, there are many nuances and tricks in the system that help a bill get through the process or stall a bill in the process.

For example, if the committee chair, “puts the bill in a drawer”, meaning does not bring it to a vote, the bill will die right there, even if the committee would pass it if it came up for a vote.

Similarly, there are special procedural rules at different stages of the legislative process and those can change depending upon how the rules are written for specific instances with specific bills.

Having a working knowledge of how the process works and a notion about what the outcome will be on a particular bill is an art. Thus, knowing the processes, systems of government, and what every committee or agency does and who is on it and how it reports is important. Further, the ability to translate the workings of government to other professionals is a big part of the job.

In navigating an organization in the private sector, this includes knowing reporting structures, governance, and who is authorized to make which decisions.

Every organization has politics, group dynamics, and governance. Knowing how the system operates, both “on paper” and “in reality”, serves professionals well regardless of the environment.

KEY TAKEAWAY: Relationships, having the right people engaged for the right reasons, and knowing the system and processes are essential skills for advocacy whether it is at home, in an organization, or in government.

Book Review: Start with Why

Start with Why by Simon Sinek is a personal favorite of mine and should be in every leader’s tool box. I have suggested this book to many other leaders and we reference it often. I have shared the book with the urgent care leadership team and we have read it and discussed it as a group.

If it has not occurred to you yet, the key question you should ask at this point is, well, why?

I’m glad you asked…

GCircle

The Golden Circle

The main thesis of the book is that the greatest leaders and the greatest companies describe why they do what they do before they describe how they do it and what they do. Sinek calls this model the “Golden Circle” (pictured). He provides many examples and evidence for how this approach has been used by the Wright Brothers, Apple, and Martin Luther King, Jr.

The book goes on to explain how the Golden Circle works biologically. Sinek touches on other crucial concepts as well like the diffusion of innovation curve. His argument is compelling and, like in Leader of One, inspires us to go deeper and to take action to define our personal, “Why”.

If you are curious to learn more about the value or starting with why, please watch this TED Talk by Simon Sinek:

I cannot tell you how helpful it is to be in a meeting with others who have read this book. I find that the more I get into the details on something, the more I risk, “losing the forest for the trees”. It is very easy to lose the big picture, which Sinek touches on towards the end of the book in the section, “The Biggest Challenge is Success”.

When I am in meetings or environments where everyone has read this book, it creates a needed check and balance when we start to put “what” and “how” over “why”. It always brings a smile to my face when someone speaks up in a discussion to ask, “So why are we doing this?”

The book offers an extremely important tool for teams to use to make sure that they are keeping the mission and vision in mind in daily decision making. In other words, Sinek’s concepts promote keeping the many activities of a complex organization in alignment to the organizations, “why”.

So next time you are in a situation where the group is about to do something because it seems like a good idea, but is really unaligned or outside of the organization’s scope, speak up and ask “Why are we doing this?” or “How is this action going to help us achieve our mission and vision?” Thanks to Sinek, many more of us have the tools to ask these essential questions.

Sinek closes his books with a simple request, “If this book inspired you, please pass it on to someone you want to inspire”. I found that simple ask to be very powerful. I have personally shared Sinek’s books with many.

I would ask you the same: if you find this site helpful and/or inspiring, please share the URL and ideas with others. Thank you.

TAKE-AWAY: Ask, “Why” to make sure that operational decisions are aligned with the mission and vision of the organization. Take the time to find your personal why.


Start with Why is available for purchase on Amazon for *$16

Companion: Find your Why is available for purchase on Amazon for *$20

*Prices do not reflect Amazon prime discount

Sinek offers a free daily email called, “Notes to Inspire”. To sign up, click here.