Aspire Consulting, Ltd. Blog

Since living it, researching, helping our customers and then coauthoring a book about sustainability, I have had many interesting conversations about sustainability. They often start with, “oh, that hippie, green organic stuff, that’s  not for me or not for my company or organization”, but as the book,  A Commonsense Approach to Sustainability describes, sustainability is much more than “green” initiatives and more about creating entities that will be around in the future, while not harming the future for the next generations.

When I ask others how they will be sustainable, they often reply:

1. We recycle and plan on doing more of that.
2. We ask our suppliers if they recycle.
3. We outsource some things we know we cannot do well.

While all there are steps towards a sustainable organization, there is so much more when you look at a broader definition of sustainability.

We define sustainability as. “the efficient and effective use of ALL resources that will allow (people, organizations, companies, communities, etc.) to exist for the next generations”.

That being said there are a number of ways we encourage others to work towards sustainability:

1. Have a clear mission. If you do not have one, you cannot communicate it and your employees cannot contribute to it.
2. Communicate your mission.
3. Have as one of your core strategies sustainability. This means that decisions are measured in part for their contribution to sustainability.
4. Develop your people. They want to be efficient and effective. Your job is to get them into positions they can do that and continue to develop then, using the things you know motivate them, and their strengths.
5. Make sure your organizations leaders have the skills to support your great employees. Again there may need to be development of some of those skills knowledge and attitudes as we know many technicians are promoted into leadership positions without those skills.
6. Look at your processes. Great people will be killed by poor systems and processes.

There is more to come on this topic, but this is a great place to start. Where are you and your organization?

We know that if there is change needed to improve an organization, the tactics related to that change work only when the people involved in the change design them. This is not optional. If you want the change to work, you must involve the people doing the job to decide exactly how things will flow or it will not. Once the decision is made about exactly how the change will be implemented, support those implementing it by giving them the tools they need and by removing barriers in their way. Then recognize them. Most feel good about doing their best and even better when it is recognized.

One of our hospital clients did just that.

They had some significant difficulties in their Emergency Department. Their goals  included :

• Increase Customer Satisfaction
• Increase Efficiency
• Increase Effectiveness
• Decrease Risk

A team of employees from the emergency department, and ancillary departments got together and in a week they mapped the current processes, built a new one, and developed an implementation plan. Here are some of their changes:

• Bedside registration
• Charge nurse role redefined and will include triage responsibilities for assigned shift
• RN’s will do most blood draws
• Specimens will be transported to the lab via the pneumatic tube system. The specimen holding box will be removed.
• Beepers to be used by clerks
• Changesto medical imaging orders
• Additional  nursing protocols

9 months later here are the results:

• Patient satisfaction scores up from 20% to 99% for the nursing staff
• Patient satisfaction scores up from 1% to 80% with the overall experience
• Decrease in redraws of blood specimens
• Cost saving of approximately $140,000 annually through streamlining the process
• Decreased risk and increased revenue with a 80% decrease in patients who left before being seen or treated.

They continue to look for areas to refine their work and to support each other. They continue to be supported by their managers.  The implementation has not been simple, but clearly for this hospital well worth it.

How do those three words strike you? For many of those I know, including friends, family and clients they strike some level of fear. I would suggest that even if it was you are wrong., it would still strike a high level of doubt and fear. Doubt and fear many times leads to inactivity.

Why does this have to happen? Maybe I do live in a world of nirvana but when I make a mistake, or when others on my team make a mistake, we learn from it. We look into the cause of the problem and figure out what we might do differently the next time. While it is not so easy for ME to say I was wrong, I know that at the end there is a different outcome that will improve results. Clearly, if this is s reoccurring theme things need to change, however, for a one time event problem solving is our answer.

For your staff, can you:

1. Receive the information?
2. Process it?
3. Integrate the information to the status quo?
4. Think together about alternatives?
5. Plan another action?
6. Implement the plan?

For you and those you report to, can you:

1. Present the information is a non-accusatory or blaming way?
2. Discover the true impact of the error?
3. Think about alternative actions of correction?
4. Implement those actions to correct the issue immediately?
5. Think about plans to avoid the error again?
6. Implement those actions in a forward thinking way?

Ultimately, if it is something that you are immediately responsible for, others you report to are responsible for, or those you report to are responsible for finding ways to replace the fear of mistakes with the
culture of improvement.  It can yield great results. Where ever you are in the chain, what can you do today?

A few weeks ago,  we wrote about the unusual weather we were having i.e.,  snow at Halloween, 50’s around the December holidays, and how in the unexpected there is opportunity. Well, what do you do when the unexpected continues? We have a few days of near zero temperatures, followed by half a foot of snow, which is then followed by 50 degrees.

A quote attributed to Albert Einstein is “Insanity: doing the same thing over and over again and expecting different results” How many times do you do this in small or large ways at work or at home? I can think of a few examples quickly. I have a loose door now.  About once a week I hammer it back in place. I watch many businesses  over and over again claim they have no time for planning and  continue to get in their own way when it comes to improving their company or organization.

One potential solution is to stop, step back and take a look at your processes.  A good hard look. Where are you, and where do you want to be?  What really are the barriers that are getting in your way? Once you have gathered that list, think about the true causes of those barriers. Which causes when removed will remove the barrier? What steps can you begin to implement immediately that will make a difference towards you doing something different? Develop a time line for implementation of those steps. Then go to it. Take action to do something different.

We have most recently seen our customers make the decision to do something differently. They put together plans that will increase inrevenue and savings and result in over 1 million dollars and 150 thousand  dollars  in improvements to their bottom line. Wouldn’t it be great if you could do that too!

We often work with teams to remove wasted resources from processes. Typically, the return on investment is 3 – 4 times in the first year, with the savings continuing each year there after. That is not the best part however. For us, the best part is what happens with the team during the week long process.

 We are most often working with teams that span many departments, who may or may not know each other and who often find themselves on the other “sides” of disagreements.

 These disagreements arise about responsibilities and resource allocation, with the numerous departments protecting their turf. Things begin to change almost immediately, however, once they begin to learn about each other’s roles, the difficulties they face, focus on a clear goal related to improvement, and focus on those things that they know are important to their customers.

 The people who actually perform the work are in the room. They have the opportunity to configure a process in an ideal way for both them and their customers. Comparing the ideal process and the way things are currently, and identifying the barriers to reaching the ideal is where the real fun begins for the group. The group begins to identify solutions to the true causes of the barriers and the pace of the efficiencies picks up and the engagement and ownership grows.

 As the week goes on there is a buzz that travels around the organization. Something is happening and employees are talking about it. If they can, people stop by to see the work that is happening.

At the end of the week, the group presents their proposed improved process to management. The energy and ownership is clear, as is the desire and drive to implement the new process. They have gone from a group of unconnected departments to a team on a mission to reach a goal and improve things for their customers. The transformation is amazing.

We often get the question, “what is more important to an organization’s success, developing its people, or having solid processes in place?” Ultimately, they are equally important. In reality they are only important once the strategy has been identified.

Strategy is the foundation of the organization and all goals, actions and results are driven from it. It is the times of the year that we know companies are developing their strategy for the upcoming year(s). Take time to develop a clear plan. Everything you do will come off that. Next, budget so you have the appropriate people and work flow to implement that plan. Sometimes things are already in place and sometimes there is an investment making sure that you get them in place.

We often recommend starting with developing the people in an organization. They ultimately are the ones who must implement the strategy and reach towards the goals, whether there are good or bad systems in place. We believe that the power and attitudes of engaged leadership and staff can go a long way towards identifying issues, changing culture into one of a customer focused perspective and moving the company forward despite less than optimal processes.

Once people are developed, you can begin to see where there is resistance to changing processes to optimal. Those who are truly leading the organization will begin to make process changes as they come up: however some longer and more complex processes require concentrated efforts with a focused attention and systematic view that can be difficult to implement without outside assistance. A proven step by step process improvement model and approach will yield great results, improving the time to delivery, decreasing variation, and increasing quality while delighting your customers.

Wherever you are in your organization development, continue to drive towards engagement of both your customers and employees through a strategy aligned with your leadership and the goals they are working towards and processes that allow for easier attainment of those goals.

We do have a customer that whose job it is to put out fires, literally – a local fire department. However, we find that when we begin working with most of our customers they are also in firefighting mode. This is true if they  are a healthcare facility, an information technology company, a human services organization, an insurance company, or a school district. Most of them consider this to be the “norm” for their industry. How many times have you said or heard something like “that’s the way it is here in (insert industry), we are different than other industries. We cannot avoid these things, they are the unexpected that are thrown on us.”  Yet as we continue our work, and each person looks at their days, we ultimately get unanimous agreement that somewhere between 35-60 percent of their time is “non-valued added” to their success or the success of the areas they manage.

Non- value added things might include rework of a failed project or proposal. Rework of that project or proposal because additional information was discovered that changed the scope. It might also include looking for people to get information from that you need for your work; when you expected to get the information some time last week. Non-value added work is cleaning up an avoidable mess. Non- valued added work is duplicating work that others are also doing. Non-value added work is really anything that is not specifically aligned with the successful completion of the goals of the organization.

How does this all relate to firefighting? Begin with planning and prioritizing and this will give you a jumpstart at removing some small bits of that work. Once some of the non-valued added work is taken out, you begin to have more time to plan what you are doing on a daily basis. As you plan, you have the opportunity to discover the causes of some of the problems and put steps and processes in place to prevent them.  As you plan,  you have the opportunity to be proactive and work on programs and processes before they become an “emergency” As you plan you become more focused and productive.  Imagine what you might do if you were to have an additional 3—4 hours to complete your work. What great creative things could you do to help move the organization forward?

I received a notice today from the supervisor of my town detailing how over the past three years, under her direction, the town has regained its financial footing by cost cutting, innovative management practices, and shared sacrifices that have led to success and a recent tax cut. The letter went on to detail that the town now has the financial measures in place that are well within the state Comptroller’s recommendations for municipalities. This is a good thing, and I am grateful for that, as I live in one of highest taxed towns in one of the highest taxed counties in the country. I cannot help to contrast that with what I have seen each weekday for the last two weeks. A caravan of trucks, directly from the town department of public works gathers at the end of my road. It seems that they are attending to a couple of large holes that they dug. Now, it may just be my bad timing, but it seems that I never pass by when they are actually doing anything related to the holes. And since I have no idea what their project is, no understanding of what they are hoping to accomplish, I suppose they could be doing everything in a very efficient and effective manner. My perception is different though.
It makes me think of many times we miss the “low hanging fruit” that is right in front of us to improve effectiveness. Right now in hospitals that might be reducing readmissions, for professional services improving accounts receivables, for a group of not-for-profits sharing space or staff and for a bank improving customer loyalty.
Take a look around you and see where you might get some quick wins in terms of efficiencies and effectiveness. Better yet, ask your employees where the low hanging fruit lie and let them help you and your company grab some of it!

A colleague passed on an interesting article from the Healthcare sector: “Cost Reduction in Health Systems; Lessons from Analysis of $200 million saved by top performing Organizations” By Chip Caldwell, Greg Butler, and Nancy Poston
Of most interest to me was the difference between the characteristics of senior leaders in “Top performers” as compared to “non-starters”.
Non-starters spent too much focus on analysis, looking for the perfect answer, which most importantly frustrated their best managers, and did not allow for implementation. Non-starters also are slower to adapt to change and seem to fear it more than top performers. This was often fear of physician reactions, criticism from the board or community, or nursing resistance. Supporting their hesitancy to change was thinking that it was not the right time (and it never would be), a new regulation was pending, JCAHO was coming, a key leadership position was just about to start. Non- starters were more likely to say no to almost anything. They were looking outside for help in terms of higher reimbursement, and always felt that they were different from any benchmark that came up.
On the other hand, top performers value speed in thought and implementation. They interpret data, until they have “enough” critical information. Top performers, set goals related to that data, and implement the needed changes. Top performers also build their managers self-confidence rather than criticize. In both, one on one and group meetings, Senior leaders looked for the positive in new ideas put forth by their managers.
Other important behaviors of top performing organizations include collaboration cross functionally and departmentally, recognition of the critical role of nursing, recognition that the status quo is not satisfactory, relationships built, and recognition of the manager level as key to supporting and implementing change.
Non- starters can quickly move to among the better performers by building a clear accountability structure, define, align and communicate goals, meet regularly so that senior leaders can support the attainment of the goals and play the important role of removing barriers and obstacles, also informally check in and provide support, and develop their managers and let them work

I am looking around me and seeing signs of spring, of growth, and reemergence. It is quite an amazing thing. I saw my first rabbit of the spring the other morning. The sun is warm and inviting enough that I leave my door open when home. The plants in my house are sprouting new growth; even turnips left in a bag seemed to know it was spring as they started growing tops and root systems.

As I understand it, the longer days give the plants what they need in terms of light. The winter hibernation ends. The root systems begin to move the rain and nutrients into the trees. Flowers and leaves open. Photosynthesis occurs and the plants receive nutrition and grow further.

Although most of us do not hibernate, why not use the signs of spring to look around and see what we can nurture. What areas we can grow for ourselves, our relationships, and our businesses.

Might you consider using this as a season of renewal?

Clean old files to make room for new; reorganize your office so your current customers, clients, and prospects are top of mind; donate clothes that you might not wear again to make room for new. Sort through your basement boxes; throw out or donate what you do not need, and create a fresh space.

Plant seeds, literally and figuratively. Sow seeds intentionally reconnect with prospects languishing in your funnel, till the ground by focusing on moving from prospect to customer, reignite your current clients with the information of your new knowledge and ways you can help them. Fertilize. Find people you know who know you but have not worked with you or referred others. Let your blooms grow and find new prospects and customers who have not known you before, and bring forth the best of your mature growth combined with the new attitude, skills and knowledge.

Ultimately, let your best shine fresh in the new light. Look for ways to reinvigorate what and how you do what you do. Look to prosper and grow anew. Have a great spring season!