The most important organization in the world

Welcome back to Leadership as a Practice. We took a brief hiatus for the holidays but are back with more exciting content for you to enhance your own leadership practice.

Part of the reason for the break is that my wife and I are expecting our first child this Spring and we had some planning to take care of. As our family grows, we did some deep thinking about what it means to become a family with a child.

Coincidentally, I have been listening to a new podcast called At the Table with Patrick Lencioni, and a recent episode was about how to create a strategy for the family, or as Lencioni describes it, the most important organization in the world. My wife listened to the podcast as well and we both decided to try creating a family strategy with core values, defining objectives, standard objectives, and a regular cadence of checking in on progress.

Lencioni3Together, we read Lencioni’s book, The 3 Big Questions for a Frantic Family, which describes the process families can use to develop their strategic plan. This past Saturday night, we went out to dinner with the book, a legal pad, and pen and mapped out our strategy. The book describes that this process should be fast and we found that to be true. With the prompts and descriptions from the book, we spent about 20 minutes discussing the strategy and 10 minutes refining it. After reading our strategy over several times, we felt comfortable with the product.

From there, Lencioni prescribes developing a “rallying cry” or your family’s short term goal (2-6 months). I have also heard this idea called the “burning platform” in business discussions. The “rallying cry” will be reached by accomplishing “defining objectives”. From there, you define “standard objectives” or the themes that are always important to the family (ex: Physical health). After all of that work, the family meets weekly for 10 minutes to do a stoplight score (green for on schedule, yellow for close, and red for off schedule), which helps prioritize goals for the upcoming week.

My wife and I have our first check-in meeting this week, so we decided that we wouldn’t share our strategy with Leadership as a Practice readers until later (but stay tuned).

At work, I’m a big advocate of the value of strategic planning as well as disciplined and intentional implementation of the plan. Applying it to our family was something that occurred to me but I couldn’t figure out how to implement it. Lencioni’s model has helped my family get focused and organized. Our strategy has already helped us make decisions that are aligned. It also serves as an excellent model for a quick strategic plan for a functional department at any business.

Do you lead with intention both at home and at work? If you have any stories about this topic, I would love to hear them. Please send them to me here.

KEY TAKEAWAY: Strategic planning is a valuable exercise to accomplish both professional and personal goals. Leaders can establish a plan quickly and implement it. What better place to start than at home?


The 3 Big Questions for a Frantic Family is available for purchase on Amazon for $24.95 (does not include Prime discount)

Competing with health care literacy

This is the second in a three part series on healthcare literacy. The first was about identifying the competition.

Think about what the average patient knows about a hospital. If all the consumer knows about a hospital is from TV, what are their expectations?

If what Hollywood shows a patient is all he knows, imagine how disappointed he is to sit for hours in an Emergency Department. After a long wait, a patient gets a bed in the department with doctors and mid-level providers who appear to be moving slowly ordering tests and waiting for the results.

The average patient may be thinking, “Isn’t it supposed to be an ‘Emergency’ room? Why is everything so slow? Where is George Clooney?”

The Institute of Medicine defines health care literacy as, “the degree to which individuals have the capacity to process, and understand basic health information and services needed to make appropriate health decisions.” It turns out that most patients, even well-educated ones, can be health care “illiterate”. For some patients, their first experience may also be their first time admitted to a hospital.

The University of North Carolina Chapel Hill has put together this helpful data map to show health literacy estimates based on the 2003 National Assessment of Adult Literacy (NAAL). The US Centers for Disease Control (CDC) has some basic facts and materials available on health care literacy in the United States as well. The data shows that there are many communities in the United States where the population has low health care literacy.

My working theory is that health literacy is one of the health care industry’s biggest competitors. Add in issues with health insurance literacy (which I will discuss more next week) and improving the patient experience is a real challenge. Patient experience is about demonstrating service behaviors like smiling, using a patient’s name, and checking on them to meet their needs, but it is also a lot more than that. Patient experience is also about education. Patients expect clinicians to be excellent teachers while being expert care givers.

Overcoming gaps in health care literacy requires empathy, emotional intelligence, and communication skills. Empathy and emotional intelligence help clinicians learn when a patient or their family does not understand, even though they may not voice their confusion. These concepts are about understanding how families get and share information with each other about the patient. It is about getting one level deeper with the patient and family to build trust.

Communication is another obstacle. Some days, I spend all day in meetings watching people present information. I listen to how clinicians explain things to patients. We have many opportunities for improvement in this area. There are some helpful tools out there to improve communication in health care settings, like Getwellnetwork. Still, technology will not do all this important work for us. Much of delivering care is still direct person-to-person contact.

As an industry, we must get better at practicing these crucial skills. Recently, I learned about a helpful tool called the Hemingway App. The site runs an algorithm, which makes sure writing is understandable to the average person. In fact, I experimented with putting this blog posts through the site.

Next week, I will post on health insurance literacy, a related topic. The health care industry must improve in how it helps people understand their entire care experience, including billing.

KEY TAKEAWAY: Assessing a patient’s health care literacy can help clinicians reach patients. Clinicians can help patients understand their condition through empathy, emotional intelligence, and communication techniques.

How important is the customer experience to Apple?

Remember, back in 2001 when everyone thought Apple was crazy for opening retail stores? Now, almost 18 years later, the world’s most profitable company looks like they will have the last laugh.

What Apple knows well is that they cannot really rest on their success in the past to ensure future success. They need to continue to innovate and keep the customer experience on top of mind if consumers are going to continue to pay a premium for Apple products over increasingly formidable competitors both at home and abroad.

Going into retail was Apple’s initial innovation, which was soon followed by the Genius Bar (technical support), then followed by the open concept layout of their stores. Despite this innovation, for some of us, the Apple store was losing its charm and felt more like we were being herded to various queues, surrounded by crowds, rather than having a positive experience. They needed to do something to continue their retail success

I started thinking more about this when I was recently in the Apple store with my wife to replace her iPhone 6 with an iPhone XS. We went to the Apple store in one location but then ended up following-up at a different Apple store to get the actual phone because it required an ID for the cellular account and I forgot mine at home. I couldn’t help but observe how their flow had changed from my last visit.

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At the first store, we were greeted before we even walked into the store. I must have looked determined, because when I was about 15 feet from the threshold of the store, one of the sales associates was already waving “hi” to me. He asked us what brought us to the store, talked to us for a few minutes to assess our need and then handed us off to another sales associate. The sales associate’s responsibility was to help us with our device of choice. Once we chose the phone, it was retrieved from inventory by a third associate, called a “runner”.

Observing the same dynamic at the second store, I did something my wife only reluctantly tolerates – I began talking to the sales associate about her training and the flow of the stores. Just to note, I have done this an embarrassing number of times, most recently also shopping at Lululemon and comparing notes with a friend who works for Madewell.

According to the sales associate I spoke with, Apple changed their workflow with one objective in mind: keep the customer company throughout the process of making a purchase. Once customers are initially greeted, they are then led into 1 of 2 queues: one for service and one for sales. Customers who are “just browsing” are left on their own. The sorting process prevents associates from wasting their time with customers who were just in the store to wander around.

For service, the queue is straightforward: If you had an appointment, they honored the appointment and hand you off to a technician. If you did not have an appointment, they would schedule one for you, thus moving you to a different queue. The annoying part of the technician queue was that you needed an appointment to be seen, which could be weeks from now. Not super helpful once you have purchased your device.

The sales queue is more complicated than the service queue: Based on your input to the greeter, you are then sorted by product and are directed to meet a sales associate at the correct product display/demo table that houses the product you are interested in purchasing. That person then stays with you for the remainder of your experience at the Apple store. While the sales associate used to also pull the desired item from inventory, Apple has now chosen to hire runners to pull products from inventory, ensuring that the sales associate remains with the customer until the purchase is complete. My math suggests that they had to add staff in this model.

This begs the question: Why? Did Apple have trouble with customers leaving while the associate is going to the back to retrieve the item from inventory? Is this somehow a faster experience for customers? What is this new system about?

My view is that this change is all about making the purchase of a premium product a premium experience. The sales associate now functions both as a concierge and troubleshooter for any issue the customer may have with their new, beautiful, device. The sales associate can also make sure the device is set up correctly, limiting return visits for technical service that is really more about the user’s competency with the device. The associate could also up-charge some subscriptions or accessories, although, truthfully, I have not witnessed them doing that behavior.

Apple, like many other companies, is focused on getting their customer service system right as much as they are in getting their products right. Paying attention to the experience of buying an item or interacting with it in a physical place is crucial.

Apple is not the only example of a company making the purchase of a premium product a premium experience. Recently, my wife and I bought a Peloton (incidentally, we love it). We bought it after walking into a Peloton retail location in our neighborhood. The sales associate, Danny, gave us a memorable experience, answering many questions (we didn’t go to the store with the initial intention of buying anything), and setting up time for us to try the bike, taking a class in a private room in the store with plenty of water and clean towels. We went back three times before we made the purchase, each time with no pressure. Delivery was also easy, featuring complete set up and orientation to the bike, right in our home by a two-member delivery team.

A positive experience with these companies doesn’t happen by accident.

In business, it is critical that we not only pay attention to the product, but the experience people have in accessing that product. In health care, we have a lot to learn from retail regarding how to match clinical (product) excellence with experience excellence.

KEY TAKEAWAY: Businesses design the shopping and customer experience with a similar focus to how they design their products. A lot can be learned from companies, like Apple, who take the retail experience seriously.

Strategic Planning in a Changing Environment

In preparing for battle, I have always found that plans are useless, but planning is indispensable. -Dwight D. Eisenhower

Strategic planning excites me because it engages the planners in imagining an “ideal state” in the future where all is possible. What often derails quality planning is the external environment, which many see coming at them fast and unpredictably.

But the future does not have to be a scary place. We do not have to be passive about our future, bracing for impact. Instead, we have a responsibility to be a part of shaping the future. As leaders, we do that through planning by focusing on the future we would like to see and working backwards to develop strategy and tactics to reach it.

While the world is changing quickly, it is not totally opaque and random. There are trends that planners can use to understand how the evolving industry environment is taking shape.

That’s the main topic of this post.

I read a wonderful report from Nielsen at the beginning of 2018 that summarized a comprehensive approach to planning for an uncertain future.

In the report, it discussed 12 “change drivers” (see image below) to evaluate that will shape the future environment. By analyzing and synthesizing these drivers, we can get a better view of what the future will look like in our industry, especially from the consumer perspective.

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While this approach is helpful, it would be silly to think that it is a a crystal ball that show us the future (if I had a crystal ball, mine always would see the Nationals winning the World Series). Instead, it is an opportunity to perform a holistic scan and to figure out where the greatest opportunities and threats are going to come from.

Using tools like this one from Nielsen can help planners pinpoint areas to focus. For example, in health care the trends that are most significant may be customer values and attitudes, population, tech adoption, and policy and legislation. Once the list has been narrowed down, planners can use tools like the Implications Wheel to explore different possible future scenarios and their impact on both the industry and the organization.

In the health care context, a good question for the Implications Wheel would be: what are the implications of the baby boomer generation getting older and inevitably sicker on hospital care in Maryland over the next five years? From there, planners can consider various scenarios and understand what actions to take to promote an ideal future.

Perhaps from the exercise, hospitals do more out in the community with baby boomers, encouraging regular blood sugar and blood pressure checks to promote wellness. Perhaps planners recognize that medicare funding may be at risk, which would then mobilize hospitals to work on a plan with policymakers to mitigate that risk.

The point is that we can use the historical data, trends, and intuition we have to think holistically about the future. The 12 “change drivers” and Implications Wheel are important tools to help us understand the opportunities and threats between us and our desired future. Once we understand these areas, the planner can take action to either take advantage of opportunities or minimize threats in pursuit of a larger vision of the future.

Strategic planning, done right, is not a wish list. Rather, it is a helpful guide to navigating a changing environment in pursuit of an “ideal” future state. I hope you find these tools as helpful as I have during your next personal or professional strategic planning session.

KEY TAKE-AWAY: There are many excellent tools to help you understand what stands between you and your ideal future. It is vital to be proactive about the future and it is our responsibility to help shape the future in a positive way. Start with the end in mind and make that future urgent.

My First Post: Welcome to The Blog

Thank you for taking a look at my new website! This is my first blog post and I am really excited about getting started! By way of background, I thought I would tell you a little about why I am starting to write publicly. The main reasons are:

  • Engaging with others in continuous learning
  • Sharing what I am learning
  • Creating a central repository of ideas and information on a variety of topics, including:
    • Leadership
    • Innovation
    • Strategy
    • Any other topic that is interesting and top of mind

One of my personal goals is to engage in continuous learning. I enjoy taking what I learn and synthesizing it with what I know to help form a deeper understanding of the world and continue to hone my practice as a leader. While I learn new things, I enjoy sharing them with my family, friends and colleagues as well as learning from their experience.

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Photo by rawpixel.com on Pexels.com

Another reason I started this site is because people I spoke to about my latest learnings were often asking me what I was reading and where some of my ideas came from. I will be sharing that information on this site as well as on social media (please follow me on twitter and connect with me on LinkedIn).

Finally, my goal is to use this website to create a central hub for ideas and reflections on articles, books, and other forms of media for my family, friends, colleagues, and team to access conveniently.

I hope you find this website helpful and informative. If you have any recommendations or suggestions, feel free to contact me on the “Contact” page of this website. Thank you for reading!