Culture Change – Slow Down to Go Fast

Culture Change – Slow Down to Go Fast

StrategyDriven Article |Workplace Culture|Culture Change – Slow Down to Go Fast

When my children were taking violin lessons and were given a new piece to learn, they would start from the beginning and race through the song at breakneck speed. One day, their teacher offered an insight that radically altered how they were able to progress. He told them that if they wanted to play fast, they would first have to practice slow. Similarly, taking the time to slow down and plan improvements to workplace culture also produces more effective results down the line.

Workplace culture isn’t something you can instantly fix, swap out, or quickly reboot. It’s not like a used car you can trade in when it no longer runs smoothly. Culture change requires culture work – and success necessitates effort and attention. Rather than being daunted by this task, we need to take a breath, slow down, and intentionally chart our course forward.

We recently worked with an organization who took the advice to slow down and take the time to invest in their long-term workplace culture to heart. Their decision was precipitated by a harassment complaint that revealed many layers of dysfunction – they could no longer ignore the impact their unhealthy culture was having.

Management was distant and unaware of the tension between employees, staff turnover was high, valued customers were leaving, and the human resources department admitted they were overwhelmed with the flood of complaints. The task of improving their workplace seemed enormous, but they decided to roll up their sleeves and get to work.

Senior management started by doing a cultural assessment and mapping out a plan. They began with a number of simple fixes to jumpstart the process. They revamped their respectful workplace policy, as well as held a training day for all staff to inform them of the current cultural assessment. Supervisors and management began joining employees in the common area during breaks.

To begin the long-term work of culture change, the organization initiated dialogue with staff and instituted weekly check-ins. They also revamped their performance management process to include a quarterly focus on employees’ goals, and provided all supervisors with training on conflict resolution and how to give effective feedback. These, along with a number of other changes, started to slowly shift their workplace culture in the right direction.

Now several months into the process, they are beginning to see the positive results! Staff are happier and more engaged, which has led to better productivity and an improvement in the quality of work being done. Their human resources department feels supported by management, and complaints have dropped as supervisors gain confidence in their ability to coach and support employees.
This organization realized that it would take time to replace the unhealthy culture with a healthy one, and that it couldn’t happen all at once. As a result of their patient and intentional work, they have seen a slow but marked improvement in their culture.

Culture is often so ingrained that people take it for granted. When we recognize that there are long-standing issues that we need to address, the work ahead can feel overwhelming, but culture won’t be improved with one-off initiatives like taco Tuesday or yearly surveys. Culture develops over time, and therefore takes time to change. Taking small steps to create a culture that will become the new standard may feel like slow work, but the rewards of a healthier culture are more than worth the wait.

 

 

 

Do Ethics Really Make You a Better Leader in Business?

http://www.leadershipdigital.com/edition/daily-leadership-innovation-2019-03-29?open-article-id=10125816&article-title=do-ethics-really-make-you-a-better-leader-in-business-&blog-domain=leadershipnow.com&blog-title=leading-blog

Do Ethics Really Make You a Better Leader

ETHICS IS NOT a word used very often behind the walls of companies and organizations. Many companies have a set of values and company policies. However, very few companies educate leaders about ethics and encourage leaders to discuss ethics with their teams. 

Ethics are usually an afterthought, taken seriously only after an event that causes a business or team to fall apart. If understood and put into practice by a dedicated leader, ethics have the potential to turn stagnant, declining teams into productive and engaged ones. Ethics enable new teams to continue to grow, sustain, and thrive as the individuals and the business evolve.

Ethics are the foundation for peace and progress. Don’t we all crave both peace and progress at work? Ethics are timeless principles for behavior toward ourselves and others that translate to specific actions.

Ethics are what fuel personal growth and make large-scale collaborative efforts work. The lack of clarity about what ethics are and what ethics really involve in action is the primary barrier for many leaders in practicing ethics at work. Here is how an understanding and intentional practice of ethics at work make leaders, and therefore businesses, stronger and more successful.

Truthfulness over time opens and repairs communication lines.

Ethics prize the principle of truthfulness. Though it seems straightforward, it often takes courage to truly be truthful with team members and peers. Leaders that practice truthfulness with team members build genuine trust over time. Leaders that practice truthful, transparent communication build a team culture of interpersonal respect and alignment.

A practice for cultivating trust is to have regular one-on-one meetings with team members. In your one-on-one meetings, leave technology and distractions behind. Give your team members dedicated focus, ask if they have questions, and give them positive and constructive feedback. Leaders develop trust through transparent and genuine communication. Teams united in honesty and truthful communications move forward as a cohesive unit. 

Opportunities for individual development fuel collective progress.

Leaders that understand and practice ethics at work are also better at motivating and empowering individuals in order to fuel collective progress. Another foundational ethical principle is the concept of non-stealing. In workplaces, non-stealing goes far beyond just stealing of physical possessions. Non-stealing in leadership involves not stealing (but instead giving) opportunities, knowledge, and acknowledgment to team members.

Leaders can practice the ethical practice of non-stealing by giving knowledge, skills, and opportunities to team members enable progress. In one-on-one meetings, share your skills and knowledge with team members. Mentor them as they work through a special project or assignment on their own. When individuals are given opportunities to grow individually, they are more dedicated and skilled contributors. Leaders that practice non-stealing understand that individual peace and progress must happen for each team member in order for the whole to move forward.

Non-attachment enables creative problem solving and the generation of new ideas.

Leaders often find themselves stuck, leading a stagnant team because they are attached to their ways or outdated beliefs. Beliefs about what is right or beliefs about people’s limitations often hold back the team from progressing. Leaders who are not open to new ideas and feedback compromise the collective progress of the team.

Non-attachment is practiced by letting go of your outdated beliefs about people, ways, results, or status. New ideas and suggestions that team members bring to the table are often the answers to proactively solving or avoiding problems. Don’t hold firm beliefs about the way things should be, how far someone should progress, or the exact way results should turn out. Allow space for limitless possibility and evolution to happen. Invite and evaluate new ideas and suggestions with an open mind. This practice enables collective progress. 

Positive communication and mindfulness foster focus and protect valuable energy.

Finally, ethical leaders are masters of cultivating the conditions for collaboration. In dynamic, fast-paced business environments, leaders and teams often find themselves rushing and producing work full of errors. People burn out quickly after long days of exhausting meetings. Small disagreements or misalignments turn into political issues. Arguments deter focus and negatively impact productivity and engagement. Ethical leaders know how to practice control of energy in order to cultivate focus and ease for their team. 

Control of energy involves communicating with a positive tone. Even when giving constructive feedback, ethical leaders start with a positive affirmation and use a tone of equanimity throughout the conversation. This is a sustainable rather than a short-sighted approach. This control of energy helps to cultivate calm and protect the energy of the team and themselves. Control of energy also involves taking constructive rest breaks often to restore and rejuvenate. A walk outside, away from the screen and often chaotic work environment can do wonders to reset your mind and body. Lead by example and encourage your team members to do the same. 

Ethics are the foundation for strong leadership and collaboration.

When understood and put into practice at work, ethics have the potential to fuel productivity and motivation. Ethical leaders cultivate focus, trust, and connection, which are key ingredients for successful leadership. Leaders that practice ethics in action find that the principles reach far beyond company walls and add value to their lives outside of work as well. Ethics are universal and add value to our work and life.

How can you put ethics into practice to strengthen your leadership? Many leaders don’t realize that diverse teams often have very different individual perceptions of what ethics look like in practice. Teams need to learn a collective language for ethics in order for ethics to be accessible instead of vague. Leaders can lead by example by putting ethics into.

 

 

 

 

DOJ supports striking entire ACA: 5 things to know

https://www.beckershospitalreview.com/legal-regulatory-issues/doj-supports-striking-entire-aca-5-things-to-know.html

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In a March 25 court filing, the Department of Justice said it supports a judge’s ruling that the entire Affordable Care Act should be invalidated, according to CNN.

Five things to know:

1. In December, a federal judge in Texas held that the ACA is unconstitutional. He sided with the Republican-led states that brought the lawsuit, Texas v. United States, calling for the entire ACA to be struck down because Congress eliminated the healthcare law’s individual insurance mandate penalty.

2. The case is now pending in the 5th Circuit Court of Appeals. In a filing with the appellate court on March 25, the Justice Department said it supports the federal judge’s ruling that invalidated the ACA.

3. “The Department of Justice has determined that the district court’s judgment should be affirmed,” lawyers for the Justice Department wrote to the 5th Circuit Court of Appeals, according to Politico. “[T]he United States is not urging that any portion of the district court’s judgment be reversed.”

4. The filing signals a major shift in the Justice Department’s position. When Jeff Sessions was attorney general, the administration argued only certain parts of the ACA, like protections for people with pre-existing conditions, should be struck down, but the rest of the law could stand, according to CNN.

5. A coalition of Democratic-led states is challenging the Texas ruling. Regardless of the outcome, the 5th Circuit’s ruling is likely to be appealed to the Supreme Court, according to Politico.

Access the full CNN article here.

Access the full Politico article here.

 

 

Nicklaus Children’s Hospital to freeze wages, lay off staff

https://www.beckershospitalreview.com/finance/nicklaus-children-s-hospital-to-freeze-wages-lay-off-staff.html

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Miami-based Nicklaus Children’s Hospital is making cutbacks in response to industry pressures, including dwindling reimbursement, according to the Miami Herald.

Nicklaus Children’s executives outlined the cutbacks in a memo to staff obtained by the Miami Herald. The hospital will eliminate pay raises for all employees this year, limit the number of new hires and reduce pension contributions, according to the report.

These cutbacks could create significant savings for Nicklaus Children’s, which has roughly 3,500 workers. Labor costs make up 57 percent of the hospital’s operating expenses, according to the report.

The letter to staff also said it is necessary for Nicklaus Children’s to reduce the size of its workforce to lower operating expenses.

In a written statement to the Miami Herald, a hospital spokesperson said the cutbacks and layoffs will help preserve the hospital’s financial position in the face of several industrywide challenges, including “reductions in reimbursement … a shift from inpatient services to outpatient care, and financial pressures due to rising costs and increased competition.”

Access the full Miami Herald article here.

 

 

Trump admin now backs elimination of ACA in court

https://www.healthcaredive.com/news/trump-admin-now-backs-elimination-of-aca-in-court/551319/

UPDATED: AHA blasted the decision, calling it “unprecedented and unsupported” by law or facts and warned it would lead to repeal of Medicaid expansion and gut protections for those with pre-existing conditions.

Dive Brief:

  • The Trump administration has reversed its stance on the Affordable Care Act, arguing in a court filing Monday that the entire law should be eliminated instead of just removing provisions protecting people with preexisting conditions.
  • The move came hours after Democratic attorneys general defending the ACA filed their brief arguing that the landmark law is still constitutional even without an effective individual mandate penalty. Both filings are in the Fifth Circuit following an appeal of a Texas judge’s decision from December declaring the law unconstitutional after Congress set the mandate penalty to zero in tax overhaul legislation. That decision was stayed pending appeal.
  • Industry groups lambasted the administration’s about-face. America’s Health Insurance Plans CEO Matt Eyles said in a statement the decision was, like the Texas ruling, “misguided and wrong.” He added the payer lobby “will continue to engage on this issue as it continues through the appeals process so we can support and strengthen affordable coverage for every American.” Federation of American Hospitals CEO Chip Kahn said in a statement the decision is “unfortunate but not unexpected considering [the administration’s] long-held views on the health law.”

Dive Insight:

Elimination of the ACA would be a particular blow for some payers that have found increasing profitability in the individual market. Centene and Molina have found success with the exchanges and have expanded their footprints.

It would also put major hospital chains in a bad spot. Companies like HCA, Tenet and Community Health Systems have exposure that could subject them to reduced patient volumes and more bad debt, Leerink analyst Ana Gupte said when the Texas ruling first came down.

Public support for the ACA has gradually increased over the years, and the latest polling from the Kaiser Family Foundation shows about 53% of respondents giving a favorable view and 40% unfavorable. Individual components of the law are even more popular.

The ACA, which just days ago marked its ninth anniversary, brought forth massive change in American healthcare. A repeal of the law would do the same, stripping insurance coverage for as many as 17 million people.

The Trump administration’s new stance presents an intensely stark contrast with the growing field of Democratic presidential contenders, who have shifted the healthcare conversation to the left as the 2020 field shapes up. Candidates have proposed various forms of Medicare for all as well as scaled back versions that still greatly expand government coverage.

It moves the DOJ away from even some Republicans. During last year’s midterms a few GOP candidates said they approved of the ACA’s most popular element — protection for people with preexisting conditions (although voting records didn’t necessarily back them up).

Most Democrats in Congress aren’t fully backing any single-payer model at the moment, but their support for the ACA is strong. Democrats in the House of Representatives are expected to announce a legislative package Tuesday that would strengthen the ACA by eliminating short-term health plans that don’t comply with the law and increasing subsidies for exchange plans.

Since the GOP’s quite public failure to repeal the law two years ago, efforts to do so through Congress have sputtered to nearly a halt. Instead, the Trump administration started chipping away at the law’s provisions. It cut the open enrollment period for ACA plans, as well as the advertising budget for promoting sign-ups, and stopped cost-sharing reduction payments to insurers.

More recently, HHS has bolstered short-term and association health plans that offer cheap but skimpy coverage not in line with ACA requirements. Analysts fear proliferation of these plans could draw young and healthy people away from the exchanges, jeopardizing the stability of the risk pool.

A Democratic-led House panel launched an investigation into short-term plans and is requesting documents from Anthem and UnitedHealth Group, among other companies.

The legal issue at hand is known as severability — the question of whether a single provision of the law, in this case the individual mandate, becoming unenforceable invalidates the entire statute. The mandate was also the key question in the original U.S. Supreme Court ruling allowing the ACA to move forward.

The high court has since lurched to the right, which is notable if the appeal on the Texas ruling reaches that stage, although that would likely be far down the road.

 

 

 

Hospital cost containment plateaus, Kaufman Hall reports

https://www.healthcaredive.com/news/hospital-cost-containment-plateaus-kaufman-hall-reports/551173/

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Dive Brief:

  • Hospitals are having a harder time controlling costs through labor and efficiencies and improvement efforts plateaued last year, according to Kaufman Hall’s 2018 National Flash Report. Profitability indicators show that operating margin improved by about 5% compared to 2017.
  • Kaufman Hall, which analyzed more than 600 hospitals, found that volume trends underperformed compared to the previous year. Higher-acuity patients resulted in higher reimbursement per adjusted discharge and adjusted patient day.
  • Drug expenses are one reason for the cost issues. Drug costs increased by about 4% from 2017. Also, bad debt and charity care grew, though at a slower pace at the end of the year. One piece of good news for hospitals is that revenue increased in 2018.

Dive Insight:

Kaufman Hall found that 2018 was generally a year of improvement in regards to profitability. However, volume indicators showed underperformance as discharges continue to drop.

Revenue indicators showed promise, but an ongoing problem is expenses. Hospitals are trying to contain costs by reducing full-time equivalents and bed numbers. However, those savings only go so far and hospitals expect they’ll need to add staff in the coming years. A recent Healthcare Financial Management Association/Navigant survey reported that 78% of hospital CFOs said their organizations’ labor budgets will grow in the coming years, with 18% expecting an increase of more than 5%.

Another factor working against hospitals is drug costs. A recent InCrowd survey found that physicians are pessimistic that those prices will change, with 82% saying it’s unlikely the situation will improve next year.

The Trump administration backs cutting prescription prices as a way to reduce costs. HHS released a proposal in January to end safe harbor protections for drug rebates through pharmacy benefit managers in Medicare Part D and Medicaid managed care plans. Those savings would instead go directly to consumers.

Hospitals have implemented cost-containment strategies, but the report shows there comes a point when hospitals can’t cut anymore. It appears the industry may have reached that point. “Hospitals will need to think more innovatively on how to manage expense,” according to the report.

Kaufman Hall pointed specifically to the West, which experienced “worsening labor efficiency.” Hospitals in this region “need to consider how to employ more advanced approaches to labor management,” the authors wrote.

There are other ways to squeeze dollars out of hospital costs, according to a recent McKinsey & Company report. It estimated that between $1.2 trillion and $2.3 trillion could be saved over the next decade on productivity gains and not expanding the workforce. The report highlighted potential opportunities to improve productivity through efficiency and care coordination.