Book Review: The Tipping Point

An instant classic and Amazon best seller, The Tipping Point is one of Malcolm Gladwell‘s signature publications. As an urgent care leadership team, we read this book to try to help us create a better marketing plan and organizational culture. It has many other important applications in both marketing and business.

The Tipping Point unpacks the familiar diffusion of innovations theory. Gladwell asks and answers an important question: What makes epidemics (social or otherwise) tip and spread beyond the innovators and early adopters?

The answer is that epidemics tend to have three rules that they share in common:

  1. The law of the few, which includes discussion of connectors, mavens, and salespeople
  2. The stickiness factor
  3. The power of context

The Tipping Point describes these three rules in detail, providing many examples (i.e. connectors has a great section on the “Six Degrees of Kevin Bacon”) from pop culture, news, and human psychology.

The important takeaways from this book are the lessons in understanding how things “go viral” and spread quickly. As a leader, I applied Gladwell’s rules in efforts to promote a culture of positive and consistent behavior, especially in patient experience and quality of care.

When I was working in public policy, I found that most people recommended, “just start in the schools” to solve most of society’s problems. In business, the corollary seems to be, “just change the culture”. What both of these have in common is that both are complex, decentralized, and difficult to change and move quickly.

Gladwell’s three rules are a good framework to use to do the work of deploying a new culture because it forces you to take deliberate action to reach the right people, create the right messages, and create the right environment for that new culture to take hold. It also means that the leader has to exercise their two most important skills to really map this out effectively: empathy and active listening.

How else would you find out who the connectors, mavens, and salespeople are in the organization without listening to people to find out who has the most people in common? Without empathy and listening, how do you work to craft effective messages that are “sticky” for your team? How do you create an environment for people to live organizational values, if you don’t understand the environment? Leaders can’t just put up signs and think everyone will read and listen to them!

I have used Gladwell’s lessons as a framework to effect positive change and I hope you do too.

KEY TAKEAWAY: For anything to “go viral”, it has to have three crucial elements: the right people, the right message, and the right environment/context. Gladwell’s lessons are applicable to situations requiring organizational change if leaders are willing to listen and empathize.

The Tipping Point is available for purchase on Amazon for $17 (not including Prime discount)

I listened to The Tipping Point on audible. I enjoyed it because Gladwell is the narrator, which makes it even more enjoyable to listen to. Highly recommend listening to this one.

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…


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.

Delivering Patient Experience Excellence Through Culture: A Case Study

“Never let a good crisis go to waste” -Winston Churchill

The situation was fragile: Disappointing financial results, low employee morale, high employee turnover, leadership in transition, and an uncertain future.

This was the challenge when I was asked to serve in the Director of Urgent Care Operations leadership role in 2016. Things needed to change and they needed to change quickly. As I began this new journey, I remember saying to my wife, “Well, I have been studying leadership theory and practice for my whole life. We will see if any of it actually works.”

There were no quick levers to pull. No big savings to realize through non-operational changes.

If the organization was going to turn around, it would require everyone who was there and some new faces to make it happen. I knew that I could not do it alone. But, how do you get a group of people moving in the right direction and fast?

I thought of my definition of leadership and used that as my starting point. The staff needed to know why we existed and had to be a part of making that vision come to life.

Urgent care needed to serve three important functions to accomplish the organization’s mission: it had to give excellent outpatient care; it had to help patients learn about our system and trust us with other aspects of their care at other entities; and it had to be financially sustainable.

To simplify that value proposition (or why we exist) so that everyone could know where the entity needed to go and help us get there, we simplified it as “POP!”, which stands for: Pipeline, Outstanding Care, and Positive Margin. Bringing POP! to the staff required a sustained and disciplined campaign to build a deliberate culture that would accomplish our goals. We launched that campaign to empower the staff to bring what POP stood for to life all day-every day-every patient.

FOCUS: Does it POP!?

One of my favorite authors, Stephen Covey, is credited with the concept “keep the main thing the main thing.”

For urgent care, POP! was our “main thing.” For many organizations, including for-profit, non-profit and government, mission creep and over-diversification are tempting. Disguised as opportunities or response to an urgent need, losing focus on the core mission and competencies of your organization can be devastating.

POP! functioned as a tool to keep the organization laser-focused on what needed to be done; fulfilling our core purpose or “Main Thing.” As one of the main decision-makers for the entity, staff would come to me with proposals for new tools, services, or offerings. When that happened I would always ask, “Does it POP!?” At first, I would receive a confused stare in response. If the answer was “no,” then my answer would be correspondingly “no” as well.

It was vital that we were disciplined in doing work that “POP!ed” to achieve our goals. Everything else was not necessity but, “nice to have.” My goal was to set an example for the other leaders at our entity to be just as focused and disciplined about achieving our goals.

REMINDERS: “Reflexion

I have previously written about the concept of reflection as a reflex. By making POP! as present as possible in the centers, we encouraged staff to keep “where we are going” at the top of mind. In doing this, staff could be empowered to make decisions and use their own judgment on urgent tasks within the context of POP! In other words, we encouraged their “reflexion” to be, “Does what I am about to do POP!?”

More than just the framework, it had to be deployed in a way that kept it top of mind.

In addition to putting up signs in the centers that explained POP! in simple terms, we also deployed POP! baskets for the staff. These care-packages (pictured below) had food items that POP!ed, such as Pop-tarts, Tootsie Pops, Popcorn, Pop chips, Ring Pops, etc., where the staff could help themselves.

2018-10-10 12.32.20

The team began speaking the language of POP! in emails and other correspondence. For example, “Team – for our centers to POP!, we must increase the number of patients we see every day. We do this by demonstrating Outstanding Care, which motivates our patients to give us positive online reviews.” Communicating that kind of alignment gives the staff a context by which to understand where leaders are coming from in presenting new initiatives and driving results.

To track our progress in achieving POP!, we created a daily dashboard that was distributed to the entire staff both via email and was discussed in newly instituted daily team huddles. The dashboard was composed of seven metrics that we used to track whether we were achieving POP! goals and used a stop-light (red, yellow, green) to allow staff to understand our performance on a daily basis.

Through these initiatives, staff had a consistent stream of communication about where the entity was going (POP!) and whether we were getting closer (daily dashboard).

RECOGNITION: Giving credit in a consistent manner

To bring POP! to life, we deployed both formal and informal recognition to the staff to show appreciation for their hard work and to keep them motivated.

At daily huddles, I would present small tokens of appreciation to the staff that were demonstrating behaviors that helped us POP! Sticking with the theme, I would purchase a Funko POP! figurine (see example pictured below) for a specific team member. In a public setting (usually at a huddle), I would speak about how that team member’s actions make us POP! and then would give them the figurine as recognition.

2018-08-07 10.33.56

More formally, the leadership team came up with a recognition program with a $100 monthly bonus attached to it. Team members nominated each other for the monthly award, but had to nominate via a form that asked how the nominee created a pipeline, delivered outstanding care and helped generate a positive margin for the entity. Again, the idea was for the nominator to think in terms of POP! so that the team was all working together in pursuit of a common goal and vision.

PARTNERSHIP: Leadership development

To be successful, our leaders needed to be our most enthusiastic POP! ambassadors for it to “stick” with the staff. They needed to use the language of POP! while communicating with the staff and giving examples on a daily basis of how our work contributes to that overall vision.

In addition to coaching via weekly 1-on-1 meetings and taking and sharing the results of our DISC assessments, the leadership team read several relevant articles and books together and discussed them in weekly leadership meetings. These outside readings helped us not only learn from authors, but helped us take ideas and make them our own to bring POP! to life.

For example, the leadership team read The New Gold Standard and discussed it prior to our first retreat. Out of that discussion, the team defined a new approach to team-member selection and created a plan to deploy it. Under the new selection criteria and “leadership system,” which included a new, day-long, urgent care specific orientation, as well as a plan for engagement and leadership development, we dramatically reduced employee turnover.

From that discussion also came months of work to put together an urgent care “Credo Card,” which is pictured in the photo above with the Funko POP! figurine. We solicited feedback from staff at all three locations over the course of five months of facilitated discussion. We asked the staff how we bring our organizational values of Respect, Integrity, Service, Excellence and Stewardship to life every day in our centers. We synthesized the comments into a card that staff must carry with them at all times.

One panel of the cards are reviewed at every staff huddle, every day, to keep those behaviors top-of-mind. The card has become a part of the team’s identity as an entity and they proudly wear them on their name badges.

RESULTS: The path to POP!

While urgent care had not yet achieved a positive margin when I left to take a new role in the company, our results in just 12-months speak for themselves:

-Revenue growth: 56%

-Improvement in net margin: 15%

-Online review improvement: 20%

-Reduced labor expense by 1% while fully staffing each location.

-Second in the company on financial outcomes relative to budget (in real dollars).

REFLECTION: KISS, pride and gratitude

KISS is short for, “Keep it simple, stupid,” and is some of the best advice I have ever come across. By aligning our work under the ongoing theme of POP!, everyone could understand it and get on board. It wasn’t complicated or confusing or business-speak. It was just simple and easy for our audience (the whole team) to understand.

In setting out a new vision or direction: keep it simple, keep it focused, and keep it fun…stupid.

As I mentioned earlier, this was my first real shot in a professional leadership role. While I had been an observer and a student of leadership for as long as I can remember, in this role I got to actually be in the arena professionally. I am so proud of what the team was able to accomplish and that we did our work with positive spirit and integrity.

I feel immense gratitude to the leadership team: Charity Dorazio (IT), Sara Ehrlich (Quality, Patient Safety, Education), Jennifer Harrison (Administration), Perry Johnson (Manager), Vonnie Johnson (Financial Manager), James Lanier (Manager), Patrice McCall (HR), Shanna Muschik (PR/Marketing), Nichole Reilly (Manager/Business Development), Dr. Richard Samuel (Medical Director), and Susan Savery (CFO). This group of leaders demonstrated incredible passion, resilience, honesty, and team-work on our journey together. They are some of the best professionals that I have ever been around and I am so proud to have been on a team with them.

Team, if you are reading this, thank you.

KEY TAKEAWAYS: By creating a simple and easy to understand direction and consistently reinforcing it through many different avenues, leaders can inspire and empower the whole team to partner with them to achieve shared goals. Create a clear focus, align systems, processes and behaviors and then make it happen!

Book Review: How to Win Friends and Influence People

Originally published in 1936, How to Win Friends and Influence People continues to teach us important lessons in human relations. After reading the book it was clear to me not only why it stands the test of time, but also that the book provides the building blocks upon which most every customer service manual and program is based.

The book is an essential read for anyone who works with people (that includes just about everybody) and wishes to get along better in a social setting.

The book is divided into four parts: Fundamental techniques in handling people, six ways to make people like you, how to win people to your way of thinking, and be a leader: How to change people without giving offense or arousing resentment. In each section, Carnegie explains each lesson using engaging anecdotes and easy explanations. At the end of each section he breaks down the key lessons, “In a Nutshell”.

In addition to the newest version of the original, the Dale Carnegie institute produced an updated version of How to Win Friends and Influence People for the “digital age”. I read this version as well and find it to be timely and current and would recommend it as a suitable modern substitute for the original.

As I mentioned, if customer service was a house and the cool rooms in it were Disney, Starbucks, The Ritz-Carlton, and Chick-fil-a, How to Win Friends and Influence People is the foundation where that house rests. All of those successful customer service cultures teach many of Carnegie’s lessons to their team.

In one of many examples, all those companies emphasize using the customers name throughout their interaction. In the section, “Six ways to make people like you”, principle number 3 reads, “Remember that a person’s name is to that person the sweetest and most important sound in any language”.

Starbucks is well known for always taking the customer’s name (although not always correctly) and writing it on their coffee cup. That communicates to the customer that the particular cup of coffee they are holding was made especially for them.

At The Ritz-Carlton, using the customers name is emphasized twice in their, “three steps of service”. Chick-fil-a training also emphasizes using the customers name whenever possible.

Carnegie weaves developing empathy throughout the lessons of the book, including being empathetic in a genuine way. He talks about the importance of listening and letting other people tell their stories, not just listening to respond but truly listening to understand.

I recommend this book to everyone I work with and meet. In the future, I could see everyone in my organization reading it. If we all lived by Carnegie’s lessons, not only would customer service improve, but society in general would improve as well.

We share this earth with 7.6 billion other people. We need to treat other people with respect and dignity if we are to accomplish anything, if we want to live better lives or even more fundamentally, if we want to survive.

KEY TAKEAWAY: How to Win Friends and Influence People is a must read. It not only describes the fundamentals of human relations, but is used as the bedrock to delivering exceptional customer service experiences for many successful companies. Even if you are not in the service business, you should read this book and embrace its lessons of being genuine, empathetic, and listening well.

How to Win Friends and Influence People is available for purchase on Amazon for $16 (does not include Prime discount)

Book Review: The New Gold Standard

I especially enjoy books that, “pull back the curtain” on the operations of organizations that are well-known for their customer service. There are many good ones out there about Disney, Starbucks, and other companies. In hospitality, The Ritz-Carlton has long been well-known for their service. Their motto, “We are Ladies and Gentlemen serving Ladies and Gentlemen” embodies the type of service and respect that are embedded in every Ritz-Carlton Hotel across the globe.

newgoldBefore I get into the book, one quick story about an experience I had at the Ritz-Carlton. I was fortunate to attend a conference for work several years ago at a Ritz-Carlton hotel. I arrived by taxi and when we pulled up to the hotel it took me a minute to settle up with the driver. When I was ready to exit the cab, a gentleman wearing a beautifully pressed uniform had already loaded my luggage onto a bell cart, opened the door of the car, and said, “Welcome to the Ritz-Carlton, Mr. Sachs. We hope you enjoy your stay”.

I had never been to that particular city before, let alone the hotel. I did not even make the reservation and somehow he knew my name. How did he do that?

In The New Gold Standard, author Joseph A. Michelli takes us behind the scenes of the Ritz-Carlton to show us how the magic is made for every guest experience. The Ritz-Carlton makes every employee live the “three steps of service”, which emphasizes using the guest’s name.

While reading the book I realized that the gentleman who helped me during my stay had most likely looked at my luggage tag to find my name. How brilliant! Something so small got my stay off to an incredible start. Was he told to do that? Is that in the Ritz-Carlton manual?

The long and the short of it is that it is not. There is no manual to work at the Ritz-Carlton. Instead, empowerment is the foundation of the Ritz-Carlton approach to service. Staff at the hotel are encouraged to find new and innovative ways to deliver on the company’s motto and the three steps of service. In fact, each and every employee is empowered to spend up to $2,000 of the company’s money each day to resolve an issue with a guest. How many companies allow that?

The hotel emphasizes empowerment through daily communication in the hotel’s “lineup”. At lineup, all staff are present. They reference and read from the main service elements (every employee carries a business card sized “credo card” with them at all times), discuss what is happening at the hotel that day, and learn about a “Wow experience” that could come from any Ritz-Carlton across the globe (there are a couple of great examples in the book).

These are only a couple of the many norms, processes, and checks that drive the disciplined and deliberate behind-the-scenes magic of the Ritz-Carlton that most guests will never see. For the Ritz-Carlton, service is at the core of their product and they set a very high bar for themselves. They are a model when it comes to understanding the impact of hiring excellent staff and treating them with respect, whether they clean the rooms, work at the front desk, or are the CEO of the company.

KEY TAKE-AWAY: Staff empowerment is at the foundation of the Ritz-Carlton approach to service. To promote a culture of service, it is vital to hire excellent staff who believe in the mission, vision, values, and culture because they will be the ones who must bring those ideas to life in new ways every day. 

The New Gold Standard is available for purchase on Amazon for $28 (does not include Amazon prime discount)