Paul O’Neill on Protecting Our Healthcare Workforce #NPSFLLI7

LLI Screen ShotBreakout sessions at last week’s Lucian Leape Forum included Dr. Lucian Leape himself, Paul O’Neill, Former Chairman and CEO, Alcoa, 72nd Secretary of the US Treasury and more. I had the long-awaited pleasure of hearing Paul O’Neill speak in person, during his breakout session entitled, Operationalizing, Disseminating and Implementing Joy & Meaning In Work and Workforce Safety, along with Julie Morath, RN, MS, President & CEO, Hospital Quality Institute of California. O’Neill’s unwavering standards and expectations in business, and for healthcare, have been an inspiration for many. Therefore, it came as no surprise that he seemed irritated with our progress to date, pulling no punches when asking the group how many of us in the room knew the real-time facts about injury to the people who do the work in our hospitals, and, did a system currently exist to provide that information with a 24-hour lapse? No one in the room raised a hand, and he shared that only 6/100 in a recent audience responded affirmatively to the same questions.

“We’re too far away from this type of excellence,” he said, following with a story that while at Alcoa, the company’s screen saver included real-time safety data. When a particularly concerning near miss appeared on his screen one day, O’Neill picked up the phone and called the team in Russia where it had occurred, asking for more information about what had happened. The personal attention to this near miss resonated throughout the organization, furthering the culture and behaviors that make organizations stronger. It’s this type of response and awareness to healthcare professional harm, as well as patient harm, that will move us to where we need to be.

“Why can’t we do this (in healthcare)?” was O’Neill’s resounding and animated challenge, many in the room knowing full well why we have not. Healthcare culture, leadership that says one thing but fails to support the necessary changes at pivotal moments, inertia–all of these however, are choices made by leadership. Either you’re in or you’re out.

Much of O’Neill’s breakout session was based on the LLI white paper, Through the Eyes of the Workforce, a must read for anyone serious about improving the quality and safety of care. Key takeaways from this breakout, as well as the summary session that followed, include:

  • It will be very challenging to protect patients if we first can’t protect our own.
  • The physical and psychological safety of our healthcare workforce is pivotal to ever improving the quality and safety of care.
  • Real leadership is enabling not controlling.
  • A leader’s first responsibility is to his/her people.
  • Safety is not negotiable – it’s not a trade-off. You figure out how to pay for it. A pre-condition is that people who work ‘here’ will not get hurt.
  • Habitually excellent organizations don’t “report” – they share information and act in a timely way when things go wrong.
  • The response is key when people do share information. You can shut down a reporting culture in a heartbeat if you criticize someone for what/how/where they shared information.
  • How would your healthcare workforce answer O’Neill’s 3 Questions: 1) Am I treated with dignity and respect by everyone each day? 2) Do I have what I need so I can make a contribution that gives meaning to my life? 3) Am I recognized and thanked for what I do?

We were reminded that it is hard to make a business case for healthcare professional safety, but data also shows that unhappy, un-empathetic, uninspired or unrecognized healthcare professionals directly impact the safety of patients, which directly impacts the “business case” in immeasurable ways. Too often, many in healthcare have observed our colleagues defend or excuse sub-optimal results, or continue to look the other way when observing behaviors that clearly are not in the best interest of colleagues or patients. O’Neill’s unwillingness to compromise standards or expectations is not only inspiring, those values created a company in Alcoa with a safety record that set the bar for his industry, as well as other high-risk industries. O’Neill left the group with many pearls, but following is one that particularly resonated along with advice from the world of storytelling:

“Organizations are either habitually excellent or they’re not – there’s no in between,” said O’Neill.

“Do or not do, there is no try,” fictional sage Yoda advises via the story world of Star Wars.

It is time for healthcare to do differently.


Informal Influence in Healthcare #NPSFLLI7

The 7th Annual National Patient Safety Foundation and Lucian Leape Institute Forum and Gala was held last week in Boston, gathering patient safety leaders together to share knowledge, recharge and re-energize their efforts in making care safer for healthcare professionals and patients. The opening keynote, Using Informal Influence to Drive Positive Change in Healthcare, was given by Andrew Knight, PhD. Assistant Professor, Organizational Behavior, Olin Business School, Washington University. Knight has studied innovation implementation, leadership and teams in high risk environments, such as the surgical suite, ICUs, Emergency Departments and the military.

Screen Shot 2014-09-21 at 8.51.32 AMKnight’s talk provided a number of take home tools for healthcare leaders to approach internal change with new power. He supplied a different lens through which to view company politics, one that allows for consideration of “the other” versus leaving a footprint on even your mother’s forehead to reach the top. He shared insight into the influence skills and the collaboration across teams necessary to move quality and safety initiatives forward. And, he stressed that data alone has not been the sole catalyst for the large-scale adoption of change needed to make the healthcare workplace as safe as we need it to be, using the tragic story of Ignac Semmelweis as evidence. Many are familiar with Semmelweis’ story–the doctor who discovered hand washing as a “cure” for the high number of deaths related to childbirth in Vienna clinics. His findings at the time went against the medical community’s thinking of the day, with physicians even taking offense at the request to wash their hands before caring for a patient. Unable to convince, or influence, others of his findings during his lifetime, Semmelweis was ultimately committed to a psychiatric hospital at the age of 47, and beaten by guards two weeks after his arrival. As the story goes, Semmelweis died shortly after from the same infection he was trying to protect patients from through hand washing. This simple, cost-effective step in the delivery of care at the desired 100% adoption rate still eludes health systems today.

Additional takeaways from Knight’s talk include the following. He is an excellent speaker and the topic couldn’t be more timely for healthcare.

  • When it comes to navigating the waters of company politics, do you consider yourself an innocent lamb, a straight shooter, a survivalist, company politician or Machiavellian? Knight asked the group to respond via a text message survey. Results showed a normal distribution, the majority claiming to be survivalists with one Machiavellian in the group, prompting Knight to tongue-in-cheek, warn all to watch their backs.
  • A more realistic view of company politics was offered, such as: Instead of considering what tactics might be used to influence someone, walk a mile in their shoes to understand exactly how what you offer might affect another. Or, instead of kissing up to those in power, feel free to compliment those you admire!
  • Driving positive change is hard work! A 2005 study showed more than 50% of attempts to implement innovations end in failure, and that over $500 Billion is wasted annually on new technology implementations, according to Morgan Stanley
  • To implement change, groups outside one’s direct circle of influence need to buy-in, collaborate, support, and supply resources to be successful. Influence skills can help gain the buy-in!
  • Informal influence at all levels of the organization is what makes for the successful adoption of new initiatives.
  • A numeric equation to map the political landscape related to change was provided, quantifying the amount of current support for any given project, by any given stakeholder, indicating likelihood of success.
  • “For most change initiatives we need commitment. Compliance is rarely enough.”


Trying to Find Flow in Healthcare Once Again

It has been some time since we have written about the concept of flow on ETY (see What is Flow, and How Can It Improve Healthcare?, Achieving A Flow State in Healthcare: Can We Do It?), and after recently finding Warren Miller Entertainment’s website once again, I was reminded that flow is not far away if one remembers to seek it.

As defined by Mihaly Csikszentmihalyi, being “in flow” means achieving a state of mind, or being, where time stands still and an individual is so in tune with the moment, and so engrossed in the activity, that all awareness of the self or self-consciousness is overtaken by the activity at hand, and a feeling of well-being is experienced. It could be likened to mindfulness at its most intense level–something we are trying to embed within the healthcare culture. We had asked: Could learning to find flow in our healthcare work return the joy and meaning that Dr. Lucian Leape speaks of, and as a result, improve the patient’s experience of care?

As you ponder these thoughts on a summer Friday, enjoy the following peek at Warren Miller’s 2014 annual kick-off to ski/snowboard season–always a visual example of flow in my mind:

So Many Heroes Among Us – A Thanks to All Caregivers

John_Nance_charting-bookJohn Nance, a leader and pioneer in both aviation and medical safety and quality–and for the past 18 years, a familiar face to television audiences as the Aviation Analyst for ABC News and Good Morning America–joined us this year in Telluride for our Patient Safety Summer Camps. John, along with other international patient safety leaders, have come to Telluride over the last 10 years to share their knowledge and passion for patient safety and patient-centered care with the rising leaders of healthcare. It is with a heart full of gratitude that we have welcomed Lucian Leape, Cliff Hughes, Paul Levy, Helen Haskell, Rosemary Gibson, Kim Oates, Richard Corder, David Classen, Carole Hemmelgarn, Bob Galbraith, Gwen Sherwood, Patty Skolnik, and so many other wonderful “teachers” each year to our faculty. Many come to CO every summer because they believe so strongly that we must Educate the Young if we are to deliver the highest quality, safest care possible to our patients.

At this year’s Summer Camp, John spoke about the similarities between aviation and healthcare, highlighting the importance of Teamwork, Effective Communication, Leadership, and the power of Debriefing after all activities. His educational messages came to life when one of our faculty, Dr. Roger Leonard, boarded his flight back to the east coast. Roger’s story, shared below, exemplifies almost every skill John spoke to our group about just days ago. While there is still much work ahead for those of us on the Quality and Safety mission, we sometimes forget all the good things our professional caregivers do in the face of very dysfunctional health systems and decreasing resources. Thank you Roger, and a heartfelt thank you to all caregivers who make a difference each and every day in the life of another.

Not Retired,” Previously posted on the Telluride Summer Camp blog, by Roger Leonard MD

My flight from Denver to Washington Dulles was late to depart due to thunderstorms.  We left at 10:30 pm and I tried to sleep, but was sufficiently alert to hear the page at approximately 2 am: “Any medical personnel on board?”   The flight attendant escorted me to first class where a passenger had what she thought was a seizure.  And she was probably right – only it was due to sudden cardiac death.  No pulse, no breathing, unconscious.  Male, perhaps 45 yo, looked fit, no companion.

The flight crew assisted me in lifting him into the aisle.  Because of their training, by the time that I started CPR, one of the attendants had the AED out and started handing me the pads for placement.  V.Fib.  We shocked once and got a rhythm.  He started to breathe and the oxygen tank was right there.  He had a rhythm, he had a strong pulse, he was breathing.  I said: “This is good.”

I tried to get a BP, but the sphygmomanometer was broken.  We got another emergency kit and it had a cuff that worked – BP ~115 systolic.  I admit that I struggled to get accurate BP recordings because my ears felt like I was 12 ft underwater from the altitude change (and probably a need to see an audiologist).  We sorted through the medical kits and I finally found the NS under the neatly packed top layer of drugs.  Found the tubing, tried to maintain sterile technique, and got a decent IV in his forearm while fighting postural movements of his upper extremities.  Then came VF arrest #2 and #3.  Shock, shock, back to NSR.  I was able to push lidocaine 100mg IV.

While scrounging around the medical kits, I found an endotracheal tube.  To me great relief, he kept breathing on his own and had good color.  I hadn’t intubated anyone in 40 years.  Meanwhile, the pilot was diverting us to Louisville where the EMS team met us.  You know how tight the aisles are.  We managed to get him onto a back-board, but then had to tilt him to nearly 90 degrees to turn the corner.  He was on his way to the hospital and after refueling, we were on our way to Dulles.

I got applause and handshakes as I returned to my seat.  How strange!  After our 4 days together, I could only think that “it’s about the patient, not about me.”  I was particularly aware of the calm and effective work of the flight attendants on our team.

In Louisville, we needed new fuel and a new flight plan.  So, with the extra time I asked to gather all the attendants and debrief.    What went well?  1) We successfully resuscitated a passenger with SCD at 30,000 feet.  2) An AED was mission critical and the staff was trained in its use.  3) Our treatment lasted about 45 minutes; we were calm; we explained what we were doing among the team; no one panicked including the other passengers.  4) EMS personnel were at the door upon the Captain’s diversion.

What didn’t go well?  1) the first BP cuff malfunctioned.  2) I struggled with obtaining accurate BPs.  3) I was slow to get what I needed out of the medical kits; the IV bag, couldn’t find a tourniquet  4) The patient had not regained consciousness upon departure, but groans were evident.

How can we improve?  1) preventive maintenance (PM) on medical equipment.  2) I suggest a digital BP cuff that reads the result without my impaired use of the stethoscope.  3) We should ask nearby passengers to vacate their seats so that we might spread out the medical equipment and drugs.  4) have EMS use an entrance that avoids tight turns, if possible.

We become physicians to heal the sick, relieve suffering, comfort those in need, and occasionally we may save a life.  I do not know the outcome for this gentleman.  I am worried; yet, I am hopeful.  I strive to role-model humility.  Yet, transparency reveals that I am proud to be a physician and proud of our team of strangers at 30,000 feet.

Returning Joy & Meaning to Healthcare Work in 2014


The success of our Telluride Roundtables and Summer Camps over the last ten years can be credited, in large part, to the generous time and participation of our faculty made up of patient safety leaders from around the world. The students and residents chosen to participate through the Telluride Scholars Program have been the beneficiaries of the knowledge and experience these great leaders and teachers all are so willing to share each year.  Rosemary Gibson, Rick Boothman, Cliff Hughes, Kim Oates, Peter Angood, Kevin Weiss, Bob Galbraith, David Longnecker, Helen Haskell…the list goes on and on.

In the summer of 2011, students had the great fortune of working with Lucian Leape, who joined the faculty of our Telluride Patient Safety Summer Camp. It was an honor to have him with us, and something our alumni–young and old–will always remember. Lucian’s focus that week was managing disruptive behavior and returning joy and meaning to the healthcare profession. The photo included captures him in action doing what he does best–educating the young. As we begin a new calendar year still struggling with many of the issues Lucian called to light in his 1999 seminal work, I believe his teachings on Joy and Meaning in the workplace are more important today than ever before, and that those strategies will play an even greater role in preventing harm to our patients.

Caregivers at the frontlines consistently put considerable energy into achieving the highest quality, safest care possible for their patients in the face of considerable economic pressure and evolving healthcare models. We expect so much from our caregivers, and they far too often extend themselves beyond what is healthy–physically, emotionally and mentally–to meet the growing demands of the new healthcare. Lucian’s work on joy and meaning in the workplace is based on Alcoa leader Paul O’Neill’s premise that every employee should be:

  1. Respected
  2. Supported
  3. Appreciated

As healthcare leaders, we need to clear a safe path for all frontline associates to be respected, supported and appreciated. At the same time, we also need to eliminate the disruptive behaviors that have plagued healthcare for far too long. This year, a driving focus should be on ensuring those well intended healthcare professional are elevated, their humanness not only accepted but also protected through just culture approaches and human factor partnerships that mitigate and finally eliminate the potential for patient and employee harm while embracing a workplace built upon the high reliability foundations of a true learning culture.

As Lucian continues to remind us, it is our dedicated caregivers working at the bedside that need to feel safe — to know that their effort is appreciated and celebrated, that they have our support, and are respected for the work they do.

What Doctors Feel

Screen Shot 2013-06-07 at 9.49.58 AMI came across a post last week on Slate, The Darkest Year of Medical School, revisiting the idea that medical students lose not only empathy during their medical education, but according to author and NYU physician, Danielle Ofri, “altruism…generosity of spirit, love of learning, high ethical standards—are eroded by the end of medical training.” On June 4th, Ofri also published What Doctors Feel: How Emotions Affect the Practice of Medicine, having performed numerous interviews to draw her conclusions. I read some of the comments on her blog post above–many sharing “medical school was great”. Yet research–past and present– shows many students are not having that experience.

Ofri’s post and newest publication caught my eye as we embark upon the 9th year of the Telluride Patient Safety Educational Roundtable and Resident/Student Summer Camps. This will be my third year in Telluride. The first year I attended, I had the privilege to share a breakout discussion with Lucian Leape and a group of students in the shadows of the San Juan mountains. Throughout that week, Lucian emphasized the need to get a handle on the bullying that occurs in medicine, and instead, instill a greater respect for all in the medical workplace. He shared that unless we are able to do this — treat one another with respect — patients would pay the price, as well as healthcare providers and students.

Having not yet read Ofri’s book, I wonder if medical students who report enjoying medical school overall, were safely ensconced within a workplace with the culture of respect that Dr. Leape refers to as being so very important to patient well-being. It is safe to assume just how empowering a culture of respect would be for students, making them feel competent, part of a team and confident in their newly acquired skills. It’s also safe to assume how students who were bullied might feel (see Bullying in Medicine: Just Say No).

For more information on a culture of respect, and how to create one, see Lucian’s papers:

Perspective: A Culture of Respect, Part 1: The Nature and Causes of Disrespectful Behavior by Physicians
Perspective: A Culture of Respect, Part 2: Creating a Culture of Respect

Lucian Leape via @theNPSF on Culture Change for Safer Healthcare: A Daily Commitment

Please enjoy this message from the National Patient Safety Foundation and Dr. Lucian Leape. This video serves as the foreword to the NPSF Online Patient Safety Curriculum.

Have a safe and happy holiday weekend!

McDonald and Mayer Receive ACMQ Founders Award For Body of Work in Patient Safety and Quality

Last week, Dave Mayer MD, the host of Educate the Young, and Tim McDonald MD/JD, were honored for the quality and safety contributions they have made throughout their careers. The pair received the American College of Medical Quality (ACMQ) Founders Award–an award shared by an esteemed group of luminaries in patient safety and quality, such as Carolyn Clancy, Brent James and Don Berwick.

Because of their dedication to students, residents and care providers and their constant premise of “Educating the Young”, many have joined the patient safety movement along the way using their teachings as touchstones for change. Here are excerpts from the shared acceptance speech they gave last week:

All of us working in the quality and safety domain move at such an urgent pace, trying to implement new ideas or best practices that can reduce harm or increase the quality of care for our patients. Because of this, there is little time to reflect on the past and much work still to be done.

Everything we’ve accomplished was made possible by many other thoughtful, clever, original, and wonderful people who invested their passion, soul and expertise in this work.

Whatever we may have accomplished came as a result of our focus always staying true to three things…

First, the importance of the Patient Voice. We have learned more about safety and quality from patients and family members than we have from many of our colleagues. Ten years ago through Rosemary Gibson’s mentorship, we brought patient and family advocates to our Telluride Patient Safety Roundtable long before the term “patient partnership” was a common phrase in quality and safety. They have been a huge part of our work through the years – helping design and implement the Seven Pillars program, being members on our safety and quality committees, creating and teaching in our quality and safety educational programs from our medical school up through our Master’s Program – their support and partnership with us has been so critical to our mission and a classic demonstration of a partnership for patients as CMS envisioned

Second, the importance of Honesty. We did it wrong for too many years. Deny and Defend models when harm occurs don’t work – it is a morally and ethically wrong approach – and it stifles learning and improvement. As Rick Boothman the CRO from Michigan says” “we don’t need a court system to tell us when we have done wrong – we know when we have done wrong.” This isn’t rocket science. We need to be honest and transparent at all times – when we do things well and when we don’t do things so well.. Through the seven pillars we have learned that the honest approach is just not the right thing to do but the smart thing to do for physicians and patients alike.

Third, the importance of a Learning Organization. We are and will always be educators – why this award means so much to us. “Educate the Young” has been an important mission for both of us through the years. The investment ACMQ has made to medical education demonstrates their commitment to “Educating the Young”. The College’s Quality Scholars program that brings students and residents to this meeting is a great example of ACMQ’s commitment to producing the next generation of physician leaders who hopefully always begin each day with their quality and safety compass pointing north.  We congratulate and applaud the scholars who are here today for your interest, commitment and leadership to high quality patient care.

ACMQ Leadership also asked that Dave and Tim share some of the highlights of their work over the years. I will share these highlights in a subsequent post so that others can benefit and build on this work, moving the needle even further in the direction of transparent, safe, patient-centered care for all of us, and our families.

John Harbaugh, Don Berwick, Lance Secretan and the Principles of New Leadership

Having moved to Baltimore about a year ago, I couldn’t help but enjoy watching last Sunday’s AFC Championship game. While the Chicago Bears will always be my number one football team, I have enjoyed following the Baltimore Ravens through their relatively short NFL history because like the Bears, the Ravens have a “blue collar” work ethic–built on strong, physical defenses led by all-pro middle line-backers.  Plus my wife’s family is from Baltimore so our Sundays have always had some element of purple to them–even while living in Chicago.

What really struck me though was the trophy presentation and interviews in the Baltimore locker room after the game. Winning teams always talk about the “great chemistry” the team shares–players and coaches expressing admiration for each other–but this locker room was different. It felt different from the 1985 Super Bowl-winning Chicago Bears, different from last year’s New York Giants’ press coverage. I could feel something more powerful coming through the Ravens players’ interviews. From the owner, to the coaches and down through the players, they all talked about the love and respect they had for each other, and how they always had one another’s back–in good times and bad. It was different…

John Harbaugh and Danny

John Harbaugh and brother-in-law, Dan Crouse and family

Having had the opportunity to meet and talk with John Harbaugh, the Ravens coach, at a fundraiser right after moving to Baltimore, it was clear he is the “real deal”. Coming from a family of great football coaches (John will face brother Jim and his 49er’s en route to a Superbowl championship in what sports pundits are calling the Harbowl or Superbaugh), one could easily tell that being an NFL coach was his true “calling” in life, and what he loved doing most. But it was more than just coaching–it was clear his passion was leading from the heart and serving as a role-model and mentor to the young men on his team. He was humble, caring, and passionate about football–and by the smile on his face when he told stories about his players, you could tell he really loved them. He had no ego, a wonderful sense of humor, and repeatedly poked fun at himself and his own weaknesses. By the end of that evening, I could see why the Ravens players also loved and respected him, and took to his leadership style. It was clear he could be a great leader at any Fortune 500 company.

The Ravens post-game locker room celebration this weekend reminded me of my encounter with John Harbaugh, and about my recent discussions on 21st century healthcare leadership. As in football, it starts with higher ground leadership qualities, and the increasing call for leadership from the heart that inspires others to greatness, and in so doing, brings joy and meaning back into the patient care environment. Those of us that have attended any of the annual Institute for Healthcare Improvement (IHI) meetings over the last 10-12 years understand the power of these John Harbaugh-like qualities each time Don Berwick takes the stage for a keynote talk. Be it his Escape Fire story, or the year he shared his wife’s personal health experience, he was and remains, a consummate storyteller who leads from the heart, knows his calling and inspires all of us to reach a higher level in patient care (see Leadership and Love). His talks elevate others, making everyone in the audience feel as though their work has more meaning after listening to him speak. He is truly one of the multipliers that Darrell Kirch referred to in his keynote at last years AAMC meeting, and as discussed in our recent post, #AAMC12 Calls for New Vision of Leadership. Many safety experts believe high quality, low risk patient care cannot be accomplished unless more leaders possessing these qualities join the healthcare improvement journey.

We have been discussing Lance Secretan, an executive leadership coach who believes it is the following eleven concepts that people are now searching for in those that lead organizations. His philosophy is based on leading from the heart, and his “Higher Ground Leadership” program is based on these concepts. More of his work can be found at:, and I agree that it is these principles, and the examples set by the John Harbaughs, the Don Berwicks and the Lucian Leapes of the world, that we should strive to emulate when we are given the gift of leading others.

  1. Leadership. Many of us are yearning for an alternative to business-as-war and leaders-as-warriors. We yearn for spirit in the workplace and for servant-leaders—people who lead with their hearts as well as their heads and wills.
  2. Values. Business has more opportunity to influence the future than any other institution in the world. New Story Leaders choose to make business an instrument for positive change.
  3. The End of Competition. The root meaning of ‘compete’ is to strive together—exactly the opposite of its usual meaning. The New Story Leader respects our interdependence—our oneness—and sees how it opens opportunities for growth, both within the organization and out in the marketplace.
  4. The Cause. People want to work for a Cause that inspires the soul. A Cause acts as a magnet for passion. It articulates the higher purpose of an organization, it describes how we serve.
  5. The New Customer. The New Story Leader devotes even greater attention to meeting the needs of employees as they do for customers. This goes beyond the usual incentive and reward systems —to practices that awaken passion and satisfy the soul. The result is a dramatic improvement in profitability.
  6. Integration. The New Story Leader creates an environment in which “work” and “life” are not just “balanced,” but blended into an integrated, seamless whole.
  7. The Calling. People are looking for more than a paycheck. They seek joy, meaning and fulfillment from their work. A Calling results in work that engages, nourishes and expresses our souls. The leader’s mission is to enable each follower to find, grow and excel in her or his Calling.
  8. Soulspace. We ask people to contribute to the highest standards of which they are capable while putting them in the dreariest, most uncreative environments in their lives. Imagine the extraordinary work that could flow from sacred workspaces designed to inspire the soul.
  9. Technology. The Internet, as an example—can be a medium for the web of human consciousness, described by Pierre Teilhard de Chardin as the noosphere. New Story Leaders will reinvent their organizations within this context.
  10. Learning. The most important ‘fringe benefit’ is no longer healthcare or a pension; it is the right to learn. Learning inoculates against irrelevance and positively feeds the soul.
  11. Inspiration. The role of the New Story Leader is to inspire others. This ability grows organically from one’s own inspiration.

The New Leaders of Healthcare

Healthcare in the US is rapidly changing. We might not know exactly what healthcare will look like in 5-10 years but it definitely will be quite different from the model we have today. A good friend likes to say the “fee-for-service” model is a zombie…while it is still walking around, it is really dead and will be gone in the not so distant future. Quality, wellness and value are the terms we hear today and shareholders are now either battling or partnering to “acquire” as many patients as they can to ensure their survival and a seat at the table. This appears to be a good thing since the current care provision model has not been ideal.

With all this change going on around us, it begs the question, “What type of leadership is needed for success in these changing times?”  Peter Pronovost’s wonderful post, Leadership qualities for a patient safety turn-around, called for a new type of healthcare leader – one that leads from the heart with love.  Peter’s call reminded me of the time I spent with Lance Secretan and learning about his Higher Ground Leadership philosophies (see Healthcare Leadership of the Future Is About Inspiration) . Similar to Peter’s call, Secretan shares that:

great leadership is not a formula or a program, it is a human activity that comes from the heart and considers the hearts of others. It is an attitude, not a routine…

In Secretan’s new book entitled, The Spark, The Flame, and The Torch, he continues his call for leaders that inspire versus motivate. As he astutely points out the definition of motivation is “to provide a motive to induce, incite or impel”.  Motivational leadership moves people toward a goal set by the motivator.  Secretan states that this is the “old story leader” – something we all have seen many times before.  Yet the definition of inspiration comes from the Latin term “spirare” meaning spirit, to breathe or give life to. To be inspired means to love what we are doing and to be inspirational leaders, all of us must first find our own “Destiny, Character and Calling” – something that relies on leaders first finding our own personal true North Star and deciding what we want our lives to be about.

There seems to be more of this “new leader” talk in healthcare today. Dr. Robert (Bob) Rosen, the founder of Healthy Companies ( and his team partner with CEOs and executive teams in helping build high-performing organizations. Over the years, Healthy Companies has interviewed or worked with more than 250 CEOs from 34 countries, including AT&T, Booz Allen Hamilton, ING Group, Macy’s, MedStar Health, New York Life, Northrop Grumman, Singapore Airlines, Toyota and more. They have built an extensive knowledge base of leadership best practices through research in the characteristics of successful CEOs and healthy companies.

At a recent leadership development session, Bob shared his thoughts on leadership for the 21st century, challenging all of us around the premise of “Who you are drives what you do”. As Rosen and colleagues teach, healthy leaders of the 21st century will be “mindful” leaders that incorporate two important qualities in all their work:

  1. Open mindsets around self-awareness, broad-minded thinking, win/win mentality, we-centric
  2. Positive emotions based on hope, empathy, trust, gratitude

Open mindsets and positive emotions such as self-awareness, hope, empathy, trust and gratitude are qualities I believe inspire, versus motivate, people. I found Rosen’s thoughts similar to Secretan’s philosophies on Destiny, Character and Calling. Both Secretan and Rosen talk about a passion leaders must have for their work. Funny, this is also what Lucian Leape, the father of patient safety, has been telling us the last few years…healthcare leaders need to bring joy and meaning back into the workplace. The qualities Lucian talks about – being respected, supported and appreciated – are qualities that come through inspirational leadership, not motivational leadership. Four great scholars – Pronovost, Secretan, Rosen and Leape – all sharing similar thoughts on what type of leaders are now needed today – those that are driven by a higher calling, value all individuals in an organization, lead from the heart, and inspire all of us to do the healing work we came into healthcare to do.

Healthcare is definitely changing. Maybe the successful healthcare leader of the 21st century will also be changing. Maybe we are moving away from leaders who were driven by financial metrics and the volume of care provided while ignoring the quality and safety of the care provided. Hopefully that old leadership model will also be the zombie of the future.