On April 30th we were fortunate to have Ann Rhoades as a grand rounds speaker focusing on culture. Ann is credited as a co-founder of JetBlue Airline, was a senior leader at Southwest Airlines and now hones her skills full-time as the founder at PeopleInc, a consulting firm specializing in helping businesses improve upon their culture. So what exactly is culture? Ms. Rhodes would argue it is not necessarily the same for each company; however, it should be created and upheld just like all other functional areas of an institution. Culture needs to be built systematically and measured just like all other metrics. Culture is not soft or unmeasurable; rather it needs to be strategically designed and implemented similar to all other areas of measureable work. For companies that have continued success, culture that is on par with performance is the key to staying number one. Ann articulated this by discussing her time at Southwest and JetBlue. Both airlines have emerged over the past several years as industry leaders in keeping flying affordable while still maintaining a decent overall flying experience for customers. Ann praised the business model for both of these companies but said you can really trace their success to the overall culture of each company and the effort made to establish company values as the foundation upon which all other business practices are built. At Boston Children’s you would be hard pressed to find someone was not proud to be part of this organization. Some of us have direct patient contact, while others provide important tertiary work that keeps the organization going. No matter what your role is, we all get to brag that we’re part of a world leader in pediatric healthcare. By industry standards, we are the number one pediatric institution in the United States, something that each and everyone one of us has a stake in maintaining. That level of accountability is something Ann echoed in her presentation. The key, however, to maintaining number one status is to consciously and consistently build a measurable culture across the enterprise, one that is reflected in the everyday attitude and work performance of each and every employee. To achieve continued success, values and culture must have the same worth as other measured metrics. So, how do you make sure your culture is a success and is built to be effective? Ann shared her outline on how to grow a meaningful culture and how to sow the cultural seeds of success:
- Blue print values – This is the very basis and foundation for culture. A cultural blueprint is not something that is meant to be fancy or complicated. It is the very foundation for which your culture grows. No one person in an organization should be responsible for drafting the blue print. Rather, the cultural blue print comes together after input from various people throughout an organization. Ann told the story of how Microsoft flew in representatives from each of the countries they had offices in when coming up with their cultural blue print. Input from all areas of the company was considered fundamental to their blue print. The word ‘passion’ was used throughout the initial drafts of Microsoft’s blue print. As it turns out, Passion has a very different and more controversial meaning in some countries. Had Microsoft rolled out their cultural blue print, several team members right off the bat would have been a bit skeptical and would have had a hard time buying in to their new cultural values, the same ones they were expected to embrace every day! Since Microsoft’s leadership was diligent and included a perspective from all areas, they were able to avoid a big potential crack in their foundation.
- Hire A Players – Ann emphasized the importance of hiring A players. An A player is someone who not only has advanced skills and knowledge, but can deliver based on values. This can be tricky, as we tend to judge employees based on their credentials; who has what advanced degree, who is certified in what specialty etc. Yet, we sometimes forget to ask people not just WHY they want to work for Boston Children’s but HOW they would apply their skills to this organization. How would they uphold the culture? Ann spoke about a very specific example of something she encountered regarding A players. At one company she was consulting for, the CEO actually fired one of his direct reports (and the godfather to both of his children) not because he was in effective at his job. His technical skills were fantastic. However, no matter what they tried, his values and work style did not mirror those of the company. As a result, that work style would trickle down to his employees and how they upheld values. The CEO made a tough call by removing a good friend from a position he was not suited for. Leadership sets the cultural standards for their organization. It may seem like an extreme move, but for that particular leader, values and skills went hand in hand.
- Accountability and Results: Holding everyone accountable to culture is just as essential as holding employees responsible for results or the bottom line. This is something we can truly appreciate in healthcare. Often times, we look to reporting and metrics to gage how well we are doing. We are an enormously successful and innovative enterprise because of how well we have been able to consistently deliver excellent results. However, what if our caregivers were only concerned with readmission rates? What if the concerns of a tired parent were not valued? What would happen to the family experiencing a language barrier lost in the lobby? There is no doubt that Boston Children’s values caregiving that reaches far beyond the bedside. We hold ourselves accountable to every patient and make sure they have as positive an experience as they can. However, Ann made it a point to explain that accountability can be as simple as consistent praise for a job well done, or recognition that you did a fine job. We need to be accountable to our colleagues and support one another in all that we do. When we think of a hospital we envision busy doctors and nurses on their feet all day delivering care to patients. However, many of us work in areas that provide tertiary care to the institution and have very little to no direct patient care. However, we’re still accountable to our own areas of expertise because they help keep Boston Children’s a well-oiled machine that continues to grow and provide care to patients from every corner of the globe.
- Customer Branding – Branding is important, and coming from the Marketing Department, I know all too well how integral building a brand can be to creating a lasting image. When we think of the Boston Children’s Brand, the first visual that comes to mind is probably Nan, the nurse cradling a baby that has served as our icon for many decades. For exceptional companies, ‘brand’ extends far beyond an icon, color scheme or name. According to Ann, employees are the brand. Values need to be upheld by the way employees conduct themselves each and every day. Since employees are the brand, they must embrace the culture! By employing caregivers, thinkers and innovators who uphold our culture, we ourselves maintain the Boston Children’s brand, one that has been built over many decades and will continue to be the premier brand of pediatric medicine for many decades to come.
- Continuous Discipline- Ann reiterated over and over again that in order to stay number one, and continue to be the best, we must continuously look for ways to improve. Boston Children’s Hospital is known for cutting edge innovation and for providing unsurpassed care to our patients. However, great care goes far beyond the patient caregiver relationship. We all have a steak in continuing to keep Boston Children’s a premier medical institution. The moment we lose our drive to continue to make this organization great is when the quality of care will slip, tertiary work will suffer and the ability to be the best will falter. Ann so wonderfully articulated this point by telling the audience, “when you think your hot, you’re not!”. So how can we make sure we continue to strive to be the best? Well, from personal experience I can tell you that Boston Children’s offers a lot of resources to help people work at improving themselves and their work life. Try signing up for LEAN/Six Sigma training. Embracing these techniques can help put a fresh pair of eyes on a project or workflow. Or, start by attending a Management Grand Rounds lecture. We’ve have some pretty successful and inspiring people walk through our doors who are eager to share their secrets to success with us. Take advantage of some of the reimbursement benefits available to our employees who consider furthering their education. I can also speak from experience that this is an excellent resource to help curb the cost of obtaining an advanced degree! Maybe you can start smaller, by grabbing a cup of coffee with a co-worker and chatting about how you can better help one another. But above all, make sure the Boston Children’s Values are part of your day to day!
Aside from her “Built on Values” model, Ann offered some additional advice to the audience on how to uphold great culture. She encouraged hospital leaders to ‘get out in the field’. She noted VP’s at JetBlue spend their first thirty days in the field shadowing employees to fully understand what they go through day in and day out. From there, they are able to invoke their employees when making decisions. This should not be limited to VPs. If possible, shadowing other employees is a great way to understand how the many pieces of this institution come together to ensure our patients have the best possible experience. Give praise generously! Praise does not need to be a monetary achievement or an award. Rather, be consistent with giving praise for a job well done. The more we encourage one another, the easier it is to create a lasting culture. Leaders should empower employees to be drivers of culture through their actions. Ann told the story of a man who was desperate to catch his Southwest flight. His grandson had been in a terrible car accident and was to be taken off of life support. This poor man wanted nothing more than to be with his family during this time, but, as fate would have it, he twenty minutes late to boarding his flight and would most likely miss take-off. Southwest had gotten word that this man needed to be on this exact flight. The pilot made the decision to delay the plane until the man was able to board. Twenty minutes of inconvenience for some folks made an entire world of difference to this one man. The pilot of that plane felt empowered by his organization to make the decision to stall. The pilot knew his actions were more a reflection of Southwest’s company values than anything else. Ann encouraged us all to be like this pilot each and every day when we come to work. Make culture a part of who you and why you are here.
Sr. Administrative Associate, Marketing & Communications