Slides at … tompeters

1. Tom Peters’Leading for Excellence: Surpassing “Unrealistic” ExpectationsAHCA/NCAL 55th Annual Convention & ExpoMiami Beach/10.04.2004

2. Slides at …tompeters.com

3. Goals.

4. Tom’s Healthcare9: Goals20041. Stop killing people in acute-care settings through negligence/lousy management/craft mores. (THIS IS ABOUT ATTITUDE & WILL … NOT $$$$.)2. Adopt Patient-centric acute-care models (a la Planetree).3. Embrace the Boomer Tsunami.4. Prepare for consumer-driven healthcare.5. Revise-Revolutionize the entire system (K-90) to revolve around Wellness-Prevention.6. Erase the disgrace of uninsured Americans … in Planet’s Wealthiest Economy.7. Re-orient Boomer-driven Eldercare toward Optimism (“The time of your life!”) (60 – 30 = 90 – 60).8. Re-imagine! What an Opportunity!9. Excellence = State of Mind.

5. Musings …

6. This is the most important speech I’ve given since NAESP!

7. Never felt it so keenly …Problem-focused?Opportunity-focused?

8. RegulationsSky-high (“Unrealistic”) ExpectationsInadequate FundingStaffing WoesEtc.Etc.Etc.

9. “Growth market” or … Magical Opportunity to Lead this Demographic Revolution … and Re-imagine Aging?

10. Biases.

11. 95/Ginger Cove/Life Care Services

12. T = SS – 34D

13. Cool? Oh Bleep?60 – 30 = 90 - 60

14. TP/61/CR: Diet … Eating Habits/Philosophy … Nutrition Supplements … Breathing … Stretching … Meditation (Short, Long) … Exercise … Mini-walks … Sound … Flowers … Aromatherapy … Baths … Labyrinthine … Massage … Acupuncture … Chiropractic … Big CR/“CR Pauses” … Water (Japanese bath) … “Stop. Look. Listen.” ... Monitor & Measure & Record. New World Order = Reverse 5 decades of abuse(With damn little help from my M.D. friends)

15. Revolution.Period.

16. It is the foremost task—and responsibility—of our generation to re-imagine our enterprises, private and public.—from the back cover, Re-imagine!

17. “Beware of the tyranny of making Small Changes to Small Things. Rather, make Big Changes to Big Things.”—Roger Enrico, former Chairman, PepsiCo

18. The greatest dangerfor most of usis not that our aim istoo highand we miss it,but that it istoo lowand we reach it.Michelangelo

19. IS/IT. Go for the Gold. (Or: At Least Try and Get Off the Bench.)

20. “Some grocery stores have better technology than our hospitals and clinics.”—Tommy Thompson, HHS SecretarySource: Special Report on technology in healthcare, U.S. News & World Report (07.04)

21. “Our entire facility is digital. No paper, no film, no medical records. Nothing. And it’s all integrated—from the lab to X-ray to records to physician order entry. Patients don’t have to wait for anything. The information from the physician’s office is in registration and vice versa. The referring physician is immediately sent an email telling him his patient has shown up. … It’s wireless in-house. We have 800 notebook computers that are wireless. Physicians can walk around with a computer that’s pre-programmed. If the physician wants, we’ll go out and wire their house so they can sit on the couch and connect to the network. They can review a chart from 100 miles away.” —David Veillette, CEO, Indiana Heart Hospital (HealthLeaders/12.2002)

22. Consumerism.

23. “We expect consumers to move into a position of dominance in the early years of the new century.”Dean Coddington, Elizabeth Fischer, Keith Moore & Richard Clarke, Beyond Managed Care

24. Amen!“The Age of the NeverSatisfied Customer”Regis McKenna

25. Quality.Whoops.Ouch.Yikes.

26. “Without being disrespectful, I consider the U.S. healthcare delivery system the largest cottage industry in the world.There are virtually no performance measurements and no standards.Trying to measure performance … is the next revolution in healthcare.”Richard Huber, former CEO, Aetna

27. “As unsettling as the prevalence of inappropriate care is the enormous amount of what can only be called ignorant care. A surprising 85% of everyday medical treatments have never been scientifically validated. … For instance, when family practitioners in Washington were queried about treating a simple urinary tract infection, 82 physicians came up with an extraordinary 137 strategies.”Demanding Medical Excellence: Doctors and Accountability in the Information Age, Michael Millenson

28. CDC 1998: 90,000 killed and 2,000,000 injuredfrom nosocomial [hospital-caused] drug errors & infections

29. HealthGrades/Denver: 195,000hospital deaths per year in the U.S., 2000-2002 = 390 full jumbos/747s in the drink per year. Comments: “This should give you pause when you go to the hospital.”—Dr. Kenneth Kizer, National Quality Forum.“There is little evidence that patient safety has improved in the last five years.”—Dr. Samantha CollierSource: Boston Globe/07.27.04

30. 1,000,000 “serious medication errors per year” … “illegible handwriting, misplaced decimal points, and missed drug interactions and allergies.”Source: Wall Street Journal / Institute of Medicine

31. It’s the “Experience”!

32. “Experiencesare as distinct from services as services are from goods.”Joseph Pine & James Gilmore, The Experience Economy: Work Is Theatre & Every Business a Stage

33. “The [Starbucks] Fix” Is on …“We have identified a ‘third place.’ And I really believe that sets us apart. The third place is that place that’s not work or home. It’s the place our customers come for refuge.”Nancy Orsolini, District Manager

34. Experience: “Rebel Lifestyle!”“What we sell is the ability for a 43-year-old accountant to dress in black leather, ride through small towns and have people be afraid of him.”Harley exec, quoted in Results-Based Leadership

35. A Certain Sort of Experience: Women.

36. 1. Men and women are different.2. Very different.3. VERY, VERY DIFFERENT.4. Women & Men have a-b-s-o-l-u-t-e-l-y nothing in common.5. Women buy lotsa stuff.6. WOMEN BUY A-L-L THE STUFF.7. Women’s Market = Opportunity No. 1.8. Men are (STILL) in charge.9. MEN ARE … TOTALLY, HOPELESSLY CLUELESS ABOUT WOMEN.10. Women’s Market = Opportunity No. 1.

37. Experience Plus: Planetree.

38. “If one didn’t know better, one might think that hospitals set out to design systems that provide the most sophisticated technical care but deliver the worst possible experience to sick people.”—Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

39. “It was the goal of the Planetree Unit to help patients not only get well faster but also to stay well longer.”—Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

40. The 9 Planetree Practices1. The Importance of Human Interaction2. Informing and Empowering Diverse Populations: Consumer Health Libraries and Patient Information3. Healing Partnerships: The importance of Including Friends and Family4. Nutrition: The Nurturing Aspect of Food5. Spirituality: Inner Resources for Healing6. Human Touch: The Essentials of Communicating Caring Through Massage7. Healing Arts: Nutrition for the Soul8. Integrating Complementary and Alternative Practices into Conventional Care9. Healing Environments: Architecture and Design Conducive to HealthSource: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

41. 1. The Importance of Human Interaction

42. “There is a misconception that supportive interactions require more staff or more time and are therefore more costly. Although labor costs are a substantial part of any hospital budget, the interactions themselves add nothing to the budget. Kindness is free. Listening to patients or answering their questions costs nothing. It can be argued that negative interactions—alienating patients, being non-responsive to their needs or limiting their sense of control—can be very costly. … Angry, frustrated or frightened patients may be combative, withdrawn and less cooperative—requiring far more time than it would have taken to interact with them initially in a positive way.” —Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

43. Press Ganey Assoc/1999: 139,380 former patients from 225 hospitals0 of top 15 factors determining Patient Satisfaction referred to patient’s health outcomePS directly related to Staff InteractionPS directly correlated with ES (Employee Satisfaction)Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

44. Mgrs re staff: wages, security, promotion opportunitiesStaff re staff: interesting work (M: 5 of 10), appreciation (8 of 10), sense of being “in” about what’s going on (10 of 10)Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

45. The Customer Comes Second: Put your People First and Watch ’Em Kick Butt —Hal Rosenbluth (and Diane McFerrin Peters)

46. “Planetree is about human beings caring for other human beings.” —Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel (“Ladies and gentlemen serving ladies and gentlemen”—4S credo)

47. 2. Informing and Empowering Diverse Populations: Consumer Health Libraries and Patient Information

48. 3. Healing Partnerships: The importance of Including Friends and Family

49. “When hospital staff members are asked to list the attributes of the ‘perfect patient and family,’ their response is usually a passive patient with no family.”—Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

50. “Family members, close friends and ‘significant others’ can have a gar greater impact on patients’ experience of illness, and on their long-term health and happiness, than any healthcare professional.” —Through the Patient’s EyesSource: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel