The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

The Good Boss

One of my assignments as a young captain was serving as the convoy commander for our combat engineer battalion. We were moving over 250 vehicles across the state of Colorado. Given the size and type of vehicles (Hummers, dump trucks, semi-tractors carrying bulldozers), we covered a good 15 miles of highway end to end.

I missed a turn and inadvertently split my convoy in two. Applying a few off-road techniques, I’d put the pieces back together within a couple of hours. But not before catching the attention of the battalion commander.

At our next stop, I steeled myself for one of the famous ass-chewings our commander was known for. We both stepped out of our Hummers. He looked at me and said, “Carry on, Marx!” He spun back around and climbed into his vehicle.

That was it. And you know what? For me, that’s all it took and he knew it. He purposefully chose a different form of discipline for that situation. Later, he told me that he could tell by the look on my face that I had learned the lesson and understood the gravity. He did not have to say anything more. And he didn’t.

Earlier this year, I posted the Bad Boss. It is always easier to point out the negative over the positive. So what is the Good Boss?

I don’t believe there is a magical checklist of Good Boss attributes. There are too many variables and permutations. Put simply, the Good Boss first and foremost does not follow a checklist. She understands every person is unique and should be treated as such. Just like my commander following my convoy fiasco.

I crowdsourced for input. Here is a compilation of attributes of a Good Boss. This is not research or academia or consultant or stats based on one person’s experience. It is not a checklist. These are ideas, and I imagine they reflect the thinking of your staff as well. Ponder the following and adopt as your situation dictates.

Ensures Appreciation and Value

• Thanks subordinates regularly
• Demonstrates gratitude in words and action
• Rewards success
• Personalizes awards and recognition
• Listens often
• Gives the subordinate glory for success

Mentoring

• Takes active interest in the subordinate’s career and guides growth in the job
• Teaches the subordinate how to best interact with customers
• Encourages professional development and provides educational opportunities
• Willing to learn from the subordinate
• Hopes one day the subordinate will step into his position
• Guides the subordinate to their ultimate goal, even if it means losing them

Fairness

• Never steals ideas from subordinates
• Always honest and ethical to the core
• Does not undermine anyone
• Possesses a strong work ethic
• Treats everyone without bias (race, religion, ethnicity, gender, age)

Performance

• Sets high but reasonable standards and removes non-performers
• Gets more out of subordinates than they can get from themselves
• Sustains the continuity of the organization by hiring only “A” players
• Provides insightful and regular feedback
• Elevates performance without the subordinate even noticing
• Provides appropriate tools and training for the job

Team

• Holds individuals accountable to performance standards so the team does not suffer
• Represents team and department with passion and confidence
• Makes the subordinate feel proud to be on the team
• Takes public responsibility for the action of the team when failures occur

Transparency

• Makes themselves transparent and vulnerable
• Admits errors and apologizes without excuse
• Gets to know subordinate as a person (family, hobbies)
• Is in tune with their emotions and not afraid to show it (smile, laugh, cry)
• Shares their wisdom in decision making and is open to other possibilities

Vision

• Encourages vision
• Articulates and lives the mission and values of the organization
• Tells the subordinate when to be practical and when to dream

Positive

• Remains positive when things don’t go as planned
• Always finds the good in bad situations

Individuality

• Does not micromanage and allows for creativity and self-expression
• Welcomes and supports innovation and creativity
• Recognizes individuals strengths and positions people accordingly
• Knows when to be the boss, friend, or mentor
• Knows when to lighten difficult moments

Style

• Leads by influence and not by position
• Jumps In the trenches as needed
• Walks the talk and shows flexibility
• Trusts, respects, and gives benefit of the doubt
• Possesses high emotional and social intelligence

Miscellaneous

• Promotes work-life balance
• Allows for downtime
• Able to charm Joint Commission surveyors!

Is this how your employees describe you? Which of these attributes will strengthen your leadership? Remember, one size does not fit all. Treat everyone in the style that works best for that individual and circumstance.

Be the boss! The good boss.

Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook and you can follow him via Twitter — user name marxists.

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The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

Get Off of My Cloud!

1960s entertainment nailed the future. Star Trek tricorders are here. Lapel communicators are ubiquitous. And who can forget the Rolling Stones singing about the Cloud?

Most agree that mobility and agility are the future. The cloud is the infrastructure which enables them. The cloud is the delivery of computing as a service, not a product — akin to a utility. The cloud enables technology to propel the speed of business.

Friends recently returned from a trip abroad. The advanced wireless infrastructures found in third-world countries both astounded and pleased them. By unintentionally leapfrogging the technological revolution, these regions had bypassed the incremental advancements of the last 30 years and gone straight from laggard to leader. Societies that have not had a telephony infrastructure, for example, are suddenly delivering the highest per capita cellular subscribers.

Leapfrog advancement. Can we do it in healthcare IT? Maybe a better question to ask is: do we need to?

YES! Mobility, enabled by the cloud, is the path to the future.

Healthcare organizations viewed as laggards now have the potential to leapfrog peers. The cloud will empower them to bypass heavy capital investment and kludgy hardware and render single-organization data centers obsolete. You can shrink implementation timelines from months to weeks. Focus your institution on implementation and optimization rather than worry over floor space or cooling requirements.

If we don’t transform our organizations by routing capital away from brick and mortar to cloud-based mobile applications and services, the third world will pass us up.

As legacy hardware and software contracts expire, look for cloud alternatives. Basic requirements for any new application should include cloud capabilities. If the vendor has no cloud offering, be concerned. Ask deep questions. You don’t want the clock turn to 2015 and you still have data centers bursting at the seams with legacy applications residing on heavy iron.

The cloud has been around for several years in one form or another. Non-healthcare industries have embraced the cloud successfully. Some worry about security, yet the number of incidents are no different in the cloud versus in-house. Breaches occur in both. Security is not the barrier.

As a leader, show courage. Move your organization forward. Become relevant by leveraging mobility. Embrace the cloud!

Hey you, get onto my cloud!

Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook and you can follow him via Twitter — user name marxists.

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The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

Satisfaction—I Can’t Get No….

“You have a Masters in Computer Science?”

The hiring manager’s initial question took me aback. Human Resources had obviously misread my degree qualifications, yet my resume still passed the screeners.

Eager to land my first salaried position, I cleared my throat and hoped my answer wouldn’t displease. “Although I do know something about computers, my Masters is in Consumer Sciences, the philosophy and practice of customer service.”

Despite her realization that I had the “wrong” degree, the hiring manager looked past this and focused on talent. And thus began my journey into the convergence of healthcare, technology, and service.

This initial position was not IT, but rather an adjunct to the corporate strategy office. Specifically, physician relations. They wanted a person with a technical background who could market the IT applications, thus endearing physicians (and their referrals) to the hospital.

IT had only achieved 5% physician adoption. They lacked the service orientation and communication skills necessary for success. By adopting service-oriented practices and strategies, we increased utilization to 85%. It was during this time that I experienced my defining moment, launching my healthcare IT career.

Customer satisfaction is a passion of mine. A service orientation mindset changes an organization. I’ve seen the positive correlation. Not only are more customers satisfied, but the benefits extend outward. Employee morale increases. Productivity increases. The organization becomes more effective and efficient.

Here are a sampling of results achieved by customer-centric teams.

• In a mid-size hospital, we deployed several applications to physicians in our region with hopes of gaining market share. We poured service all over our offerings and reached a 91% customer satisfaction rating. In one year, we went from 45% to 55% market share in four strategic indicators.
• In an academic health system, we quadrupled “top box” customer satisfaction scores in four years. Financial and quality scores increased exponentially on the same slope. Employees who were once embarrassed to be part of IT now delighted in the honor of being part of the team.
• In an integrated health system, we increased “top box” satisfaction 30% in three years. While we maintained revenue targets, we exceeded many quality targets.

How do you achieve superior customer satisfaction and sustain the gains? My team identified nine keys:

Right people in the right positions. Everything rises and falls on leadership (Maxwell). The first thing you must do is ensure the right people are operating in the right roles. Although painful, you must remove some from the “bus” and have others change seats. The quickest way to change the direction and service orientation of your organization is to put people into positions that best utilize their natural talent.

Effective communication. Personally and sympathetically counter negative perceptions and battle anecdotal commentary with facts. Establish monthly reports with dashboards on service levels, project status, key deliverables, and achievements. Share the good, the bad, and especially the ugly. Deliver presentations whenever and wherever you can, evangelizing IT. Become a valued member of every management team.

Relationship building. Strong relationships cover a multitude of sins. Assign IT leaders directly to operational leaders and make routine calls and visits to address concerns. This allows operational leaders to have a single “go-to” person for all their IT interactions and reduces associated complexities. Involve IT leaders in organizational events such as blood drives, sporting events, service opportunities, volunteering, and charity work. Establish a program for connecting with clinicians.

Strategic planning. “Where there is no vision, people wander.” This proverb characterizes IT: a bunch of well-intentioned professionals without direction. Consequently, there is stifled progress, pent-up demand, and frustration. Solicit input from your enterprise and fashion a strategic plan. Review annually and ensure organizational alignment and convergence.

Comprehensive governance. Implement a formal but agile governance process comprised of and led by customers. This ensures IT alignment with organizational vision and gives you a level of rigor, accountability, and transparency not previously possible. Include rank-and-file customers, senior executives, and especially nurses and physicians.

Continuous quality improvement. Your survey vendor will provide in-depth analytics and recommendations based on the results. For instance, after learning that nurses represented our most dissatisfied customer group, we swept through nursing floors and made sure IT became a clinical care enabler. We added hundreds of mobile computers to patient floors to satisfy their greatest complaint — lack of devices.

Aligned incentives. Create a single key performance indicator on which incentives and raises are based … the annual customer satisfaction score. Everyone will become focused on service.

Execution excellence. Without excellent execution, all other strategies are moot.

The secret weapon. The secret weapon is heart. Heart is the wellspring from which motivation emanates. Empathy, compassion, and humility combine to mold a heart that seeks to serve. I’ll hire those with high talent and high heart but mediocre skills any day over someone who has low talent and no heart. Skills can be taught, heart is caught.

Superior customer satisfaction and information technology need not be mutually exclusive. It is less a matter of programs and more about a sustainable leadership imperative that transcends culture. It is a journey, not a destination, and requires a steadfastness of focus, discipline, and courage.

Unlike The Stones, you can get Satisfaction. Hey, hey, hey, that’s what I say …

How do you create a service oriented culture? Share your ideas below and I will send you a presentation I did on developing a customer service culture plus the accompanying Gartner case study.

Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook and you can follow him via Twitter — user name marxists.

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The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

Caught, Not Taught

As a parent, the most frightening rite of passage for me to tackle was not the sex talk, it was the car talk. As in watching my kids head down the street solo in a two-thousand pound, steel and fiberglass projectile. They had attended classes, studied a manual, and passed a test. But were they really prepared?

Not fully. They lacked one critical element.

In the workplace, I advocate professional development and have witnessed the benefits of classroom teaching. When I began to analyze this process, however, I realized traditional training suffered a maximum effectiveness. Think about this. After reading a book on teamwork, were you able to convert all the learned lessons into action? Why do some managers respond to training while their classmates do not? Why do leaders take life-changing courses, yet nothing changes?

Critical skills can only be caught, not taught. My children, for example, had the head knowledge for driving, but that information didn’t come to life until they took it on the road. Experiencing the streets helped them to catch—or ingrain—the skills for successful driving.

How do you help your team catch? Ability to drive is a necessity that comes with an inherent motivator—drive or be stuck living under my roof with my rules!

How can you create this driving-like context that motivates your staff to live out what they learned in the books? The following methods have worked for me.

Never fly solo. Do your best to always have a sidekick with you. If I have a team member in the hospital or a funeral to attend, I take an emerging leader with me to provide comfort. When I walk around to visit the team, I have a manager with me. They learn from the experience through observation and active participation.

Be vulnerable. When I have tough decisions to make or challenges to contend with, I open the kimono. I don’t shelter my team or pretend to know the answers. I include them. The young leader learns there is no voodoo or secret sauce. Some day they will face a similar issue and it will be familiar.

Share the stage. When I’m invited to speak, write, or interview, I often have one of my leaders with me. Sometimes observing, and other times co-presenting. One of our young directors had not presented before, so I had him observe me at a local university. The next time, we co-presented. Now he speaks routinely on the national stage.

Be transparent. Leverage social and business media. I Facebook friend any of my team who has interest. I connect with any on Twitter or LinkedIn. In the work environment, I mircoblog daily about what I am doing and why. This allows multiple avenues for insight. For instance, I may share my thought process on how I deal with setbacks.

Engage a mentor. Ongoing, planned partnerships focused on helping a person reach specific goals over a pre-determined period. Unfortunately, the art of mentoring has rarely caught on in the business world, healthcare included. Mentoring can be a difference maker.

Connect to others. As a leader, how do I impact the heart of my team? How do I create an environment where we can cultivate compassion? How do I help them view their job as more than a paycheck, but as a contribution to a patient’s life?

Ask questions. Whenever I’m around people I admire, I fire off a number of questions, then just listen and learn. I soak up wisdom.

Create hang time. It’s easier to talk when we’re not disguised in stuffy work attire. A non-business setting encourages conversation, but you must create these situations. I have surprised my team with an ice cream fest and invited individual members to attend employer-sponsored professional sports with me. I attend their symphony performances or listen to their garage bands at a local bar. I invite them to join my family for Broadway shows (we always buy extra tickets.) Make it happen!

Offer social opportunities. Do you learn etiquette from a manual? Emerging leaders who seek to become vice presidents should know how to handle themselves in a cocktail party situation and know the difference between red and white wines. My wife and I purposely host parties in our home to create a safe place in which to practice so they can learn to be comfortable mingling among executives. It’s also another occasion to get acquainted with and show appreciation to their significant others.

Outcomes?

I’ve had the joy of watching my directs blossom in their careers. Although I invested greatly in their formal training, their development accelerated during active observation. In the last couple of years, several became CIOs. Others took senior leadership positions in professional organizations.

My kids turned out to be pretty good drivers. But if you ask them how they learned, they’ll tell you they caught it by doing it – by making wrong turns, slamming on the brakes at stoplights, and bumping over curbs while parallel parking. The manual finally made sense.

It was caught, not taught.

Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook and you can follow him via Twitter — user name marxists.

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The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

Are You an Insider?

My siblings and I took a beating from our peers because of the Bavarian clothes our parents insisted we wear long after our arrival in USA. We were, however, embraced on the futbol pitch. The seven of us kids had the benefit of growing up on the soccer field in Germany. When we arrived here in the mid ‘70s, American soccer was in its infancy. Coaches welcomed our soccer finesse, experience, and smarts. It took time for our teammates to accept us foreigners who played with a different style, but our impact proved undeniable.

What was good for those teammates is equally good for IT.

One of my first healthcare jobs held a single yet challenging objective: “make docs happy.” In that competitive environment, physician loyalty was paramount. My role was one-third ombudsman, one-third consultant, and one-third party planner.

I loved it. I met with physicians daily to make sure their concerns and ideas were appropriately vetted with hospital administration. I dived deep into practice management and provided consulting services ranging from business development to system selection to establishing regional CME events. The most enjoyable aspect was organizing some serious parties to celebrate accomplishments and recognize the medical staff and their contributions to our healthcare system.

Despite my established healthcare background, I transitioned into the position of IT director as an outsider. I brought with me a different skill set. I viewed things differently from my tradition- oriented IT peers.

It was not easy for me or my new cohorts at first, but we helped each other. Mixing outsider perspective and experience with solid IT operations made for a dynamic environment resulting in vastly improved performance and outcomes.

As a believer in the diversity approach, I’ve purposefully sought to develop teams comprised of traditional and non-traditional workers. In a former post, “Got Clinicians?” I share the absolute necessity for ensuring appropriate clinical insights. Now I aim to encourage you to build a healthy mix of non-healthcare experienced talent into your fold.

Most would agree that healthcare, conservative by culture, is three to five years behind the technology curve. Bringing in outsiders who have worked in progressive industries such as finance or international business will help push the organization forward and help ensure currency. Not just currency, but also what is on the horizon. A couple of the chief technical officers I’ve hired have had zero healthcare experience. On both occasions, my organizations experienced a massive technological bounce.

Promoting only from within will continue to retard the growth curve as compared to other industries. It’s all about striking that healthy balance.

So, what about you and me? Even outsiders eventually become insiders. How do we stay fresh and think with the objectivity of an outsider? Spend at least 50% of your learning outside of healthcare.

Some methods to avoid becoming a healthcare IT junkie:

• Conferences. Choose wisely. Skip HIMSS every other year and go to the consumer electronics show instead. You will see things that will eventually be shown at HIMSS three years later.
• Blogs. Read posts that are on the bleeding edge.
• Magazines. Check your subscriptions. At least half should be outside of healthcare and, of course, a high percentage should be business and non-technical.
• Peers. Spend time with non-healthcare peers. I previously posted on how we compare notes regularly with companies in different verticals. Next up, Kimberly-Clark.
• Organizations. Actively participate in professional groups such as SIM where you are exposed to peers from across industries.
• Hiring. Keep yourself on your toes by hiring outsiders who are smarter than you.
• Diversity. Don’t hire your twin
• Advisory boards. Participate in those that are vertical agnostic.

Fitting in to please everyone is a worthless pursuit. Avoid that temptation. Hiring outsiders is healthy for your team. This will create more opportunity as new technologies are transferred to the team. Hiring outsiders is beneficial to your organization as you begin to deploy new tools that will enable mission fulfillment. Hiring outsiders advances healthcare. You’ll leverage technology and help reduce the cost of healthcare, elevate patient and clinician satisfaction, and ultimately improve the quality of care.

Most of us German-transplant kids had successful soccer careers in high school and beyond. We helped our coaches take our teams to the next level. Goal! And for at least a few hours each week, we were free from our lederhosen.

Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook and you can follow him via Twitter — user name marxists.

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