The Report Room - Nursing professionals, health care, medical profession

New Belgium Brewery has nothing to do with the healthcare industry. And that's exactly why I chose to interview Brian Simpson of New Belgium. Brian is one of many employees of the company who has been there for a long time - almost 20 years in Brian's case, and I wanted to find out what enables the company to retain its employees for so long. You're going to be amazed at the things this company does to make its employees happy - but it's more than that. They've convinced their employees that they are truly cared for because they are.

The healthcare industry is slowly learning that the values at the core of what we do need to saturate the culture of the organization and be better communicated early on in the hiring process. New Belgium Brewery makes sure that every new hire understands both the history and the values of the company beginning on day one. They also help employees understand that it's the employees that make the company what it is. If that sounds impossible to you I challenge you to listen to this episode. You'll hear how the company has done it and I want you to ask yourself what we could do in the healthcare industry to make similar changes… and why do they seem so far fetched to us?

When an industry thinks of itself as a big player and doesn't get down to the level of its team members, it's no wonder that people are treated as commodities and the morale of the organization suffers. Not only that, performance declines and its customers (patients in our case) are not cared for well. What can we learn from other industries about culture and employee retention? A lot in my opinion. I'm excited to start the conversation about innovative ways to care for our people better and build healthcare teams that thrive and carry out the vision of patient care in extraordinary ways. New Belgium Brewery is an example of a company I'd love to see us model.

We often talk about giving our people ownership of the organization, but do we really mean it? New Belgium Brewery has taken that to a whole new level by giving each employee stock in the company after only one year of employment. It's one of the ways that ownership is made a reality. Along with paid sabbaticals, employee rewards and connections, and a host of other innovative means the New Belgium leadership is setting a new standard in culture and employee morale that the healthcare industry needs to learn from. I hope you listen and open your mind to the possibilities of what might happen at YOUR organization.

The leadership of New Belgium Brewing was concerned about the health of their employees, so instead of encouraging them to get regular checkups or fund a new healthcare incentive they did the unthinkable, they hired a Doctor of their own to be on site for the benefit of employees and their families. The response has been overwhelming, with employees and their families not only appreciating the gesture but also taking full advantage of the doctor-patient ratio that makes truly personal care a reality. You can learn more about how this brewer is making a difference in the healthcare of its employees, on this episode of The Report Room.

• [1:08] Who is Brian Simpson and why did he go to work at New Belgium?
• [2:12] The history of New Belgium Brewery.
• [4:00] The role of core values and beliefs at the company.
• [8:38] The New Belgium milestone program for employee retention.
• [10:00] How the company provides paid sabbaticals.
• [15:00] Why New Belgium Brewery brought healthcare "in house."
• [17:37] What Brian likes most about working for New Belgium.
• [18:10] The path ahead for New Belgium.

• New Belgium Brewery

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Measuring performance in any organization is a very clear way to insert much-needed accountability into the system of managing and rewarding employees. But the argument is being made more and more these days that the traditional ways of doing performance management are not the most helpful approaches. Today's guest is Dr. Anna Tavis and I decided to invite her on the show after reading an article she co-wrote on the Harvard Business Review called, "The Performance Management Revolution." In her article, Dr. Tavis highlights why some companies are taking another look at their performance measurement systems and how a handful of them have made dramatic changes to the process with great results. I'm curious how these innovations can be applied to the healthcare sector, so I wanted to hear more from Dr. Tavis - and I hope you take the time to listen.

Much of the change that's happened around performance measurement has to do with the desire of managers to not only rightly assess and reward performance but also to address issues of culture and trust within the organization that can bring the organization's performance as a whole to a much higher level. Dr. Anna Tavis shares some of the ways companies of all stripes are changing their performance management processes on this episode. If you're the person in charge of performance management for your organization or part of a PM team, you'll discover some great ideas from what she has to share.

One of the key components of how companies are approaching the issue of measuring performance in new ways has to do with the role of the managers in the organization. Rather than training management to be the watchdogs of the organization who are ready to dole out punishment for those who are not performing, the emphasis is on supervisory positions as more of a coaching role. The manager's job is to help the employees grow and learn in their role, encouraging and cheering them on to higher levels of accomplishment. This approach is showing great promise in the way it encourages a team mentality over the adversarial relationships that have existed in the past. Find out more about this performance management revolution from Dr. Anna Tavis on this episode of The Report Room.

The old systems of performance review often entail the use of quarterly or annual reviews to assess employee performance with the promise of financial bonuses or other rewards tied to that review. But Dr. Anna Tavis says that tying the reward to the review skews the process in ways that are not helpful. If that assertion makes sense to you, or if you're curious how it could be true, you need to hear Dr. Tavis' explanation of it on this episode of the podcast.

If you are part of a team that is working to establish a healthy and effective performance assessment program for your organization, Dr. Anna Tavis, a performance management specialist has this advice for you: Take ownership of the process as it relates to your overall goals as an organization. Ask yourself whether the things you're measuring in your evaluations are aligned with the goals and vision of the entire team. And figure out if the method by which you're evaluating is truly assessing your effectiveness toward those goals. You can hear more great suggestions like this from Dr. Tavis on this episode of the podcast.

• [0:29] My introduction of Dr. Anna Tavis, and the issue of performance management.
• [1:16] The background that has equipped Dr. Tavis for her current work in performance management.
• [2:36] The process of researching and writing her article with Peter Cappelli.
• [4:30] How we've come to the place we are in managing and appraising performance.
• [11:32] The trend toward no more performance evaluations for employees.
• [14:13] What are companies doing today instead of annual evaluations?
• [18:13] Why some companies are resisting these new approaches.
• [20:39] How should compensation be decided if it's not connected to performance?
• [25:02] What are the risks and losses possible by making these changes?
• [27:08] Books and articles Dr. Tavis recommends about this topic.
• [28:46] Dr. Tavis' recommendation: Every organization needs to take ownership and align their performance measurement systems

• Dr. Tavis' website: http://annatavis.com/
• Find Dr. Tavis on LinkedIn
• Dr. Tavis on Facebook.
• Dr. Tavis on Twitter
• Dr. Tavis' HBR article on Performance Management.
• Reinventing Performance Management article on HBR.

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• BrianWeirichRN@gmail(dot)com

If you're wondering what palliative care is, you're not alone. The phrase, "What is palliative care" is searched on Google almost 100,000 times every month. The reason for the widespread interest is that it's a fairly new area of focus in the history of health care and it specializes in pain management and end of life issues and scenarios. But don't confuse it with hospice. The two are very different things. On this episode of The Report Room, I chat with palliative care nurse, Carey Ramirez about those differences, his journey into palliative care, and why the discipline is an area of important focus for health care both now and in the future.

Most people are familiar with the idea of hospice care so it's important that you understand that palliative care is not a synonym for hospice. Palliative care is for anyone with a serious illness and can be administered at any age and at any stage of an illness, not just during the dying process. Hospice provides care for terminally ill patients who may have only months to live. People who receive hospice are also no longer receiving curative treatment for their underlying disease while those receiving palliative care may be. You can hear why those distinctions are important from my guest today, Carey Ramirez.

One of the questions I asked Carey Ramirez on this episode was what his typical day was like. He described a day filled with a series of emotionally-laden conversations with patients and their families that could even include the subject of death and dying. It's not a job that just anyone can do, but Carey seems especially equipped for it, not only through his training but also by virtue of his temperament, personality, and gifts. You can hear how Carey moved into the area of palliative care and why he's eager to see the subject taught in nursing and medical school, on this episode.

As a palliative care nurse, Carey Ramirez is often asked by a patient if they are dying. It's at that moment that a combination of knowledge, education, experience, and compassion go to work to help him assess exactly what that particular patient needs to hear - and how best to say it. He doesn't shy away from speaking the difficult truths the question demands but also doesn't want to cause unnecessary harm to the patient on an emotional level by an abrupt or uncaring response. You can hear what his years as a palliative care nurse have taught him about dealing with such difficult questions, on this episode.

When I asked Carey what resources he recommended for those who are interested in pursuing more knowledge about palliative care, he was quick to reference two books. First, he mentioned a more recent book, "Being Mortal" by Atul Gawande. His other recommendation was "On Death and Dying," a classic by Elisabeth Kubler-Ross. Both books equip healthcare professionals to face the difficult questions they'll face as they deal with the life and death situations they face daily. You can hear more of the suggestions Carey made concerning nursing and palliative care in particular, on this episode.

• [0:28] My introduction of my guest and today's topic.
• [1:35] What is palliative medicine?
• [3:00] How palliative care is different from hospice.
• [4:32] Carey's first nursing job and the path that led to palliative care.
• [7:43] Why are healthcare professionals focusing on end of life issues now?
• [11:58] How to get around the difficulties of talking about death and dying.
• [16:19] How Carey's typical day runs at the hospital.
• [18:02] A typical conversation Carey has with patients and family.
• [22:59] How often do patients ask, "Am I dying?" and what does Carey say?
• [25:45] What are the basics about palliative care that  nurses need to understand?
• [30:46] How does Carey separate himself from the emotional load of his work?
• [32:58] What Carey feels is the best part of his job.
• [34:06] What nurse leaders can do to support palliative medicine.
• [39:06] Resources Carey recommends for those seeking to know more about palliative care.
• [40:35] Advice for those facing death or helping someone who's dealing with death.

Connect with Carey: Carey.Ramirez (@) uchealth.org

BOOK: Being Mortal

BOOK: On Death and Dying

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but after hearing this conversation you'll be eager to see it implemented in your local hospital systems. It's an innovative new way to get insights into the real experiences that both patients and families are having while receiving care at your facility so that you can both improve the level of care you provide overall and anticipate needs before they actually become issues. I was very impressed with some of the things Fran Culler and her team have been able to accomplish for patients and families in their facility. I am certain you will be too.

But what I'm chatting with Fran Culler about on this episode goes a step further. Naturally, we want our patients to receive the very best care possible while they are in our care, but the reality is that their families are often just as impacted by what we do as the patient. On this episode, I asked Fran to give us an overview of exactly what a family and patient council is and how it goes a step beyond patient centered care to give a comprehensive level of quality to the experience that everyone we serve receives.

The typical Family Patient council is a group of people including hospital staff, former patients, administrators, chaplains, and others who care about the quality of care the organization is providing. They come together regularly to assess the quality of care being given, receive concerns that are expressed, and formulate plans to take action on things that otherwise might go unnoticed or could make the quality of care better for patients and families alike. You'll enjoy hearing some of the stories Fran Culler shares about the improvements her team has been able to make in their hospital. I was quite impressed with their accomplishments and I hope you are inspired to take some action in this direction at your medical facility.

When a patient is in the care of any medical team it's important to realize that it's not just the patient who is affected. Many times family members won't leave their bedside and the fear and stress of the event extend far beyond the hospital room. A family and patient centered approach focuses on all of those issues and more to ensure that those who are most impacted by a patient's stay in the hospital are cared for where they are and in ways that make a difference to them. You'll hear Fran Culler's experience as part of a Family Patient council in northern Colorado on this episode.

Asking departing patients and their families to complete an exit survey is a great idea but it's often the last thing on the minds of people who are heading home from the hospital. But getting a true sense of what those people experienced while in the care of the hospital staff is still vitally important for the sake of quality control and quality of care. On this episode of The Report Room Fran Culler shares many stories of what her family patient council has been able to do to improve the quality of care for their patients and their families - from the addition of more handicapped parking spaces in the parking lot to pet visiting hours and washing machines. You'll be surprised and encouraged to hear what's possible when people come together to make the patient and family experience better for everyone.

• [0:27] My introduction to Fran Culler? and the issue of patient and family centered care.
• [2:44] What IS a patient-family care?
• [4:46] How the patient family advisory council at Fran's facility came to be and how the team works.
• [7:56] Could this work for large and small medical organizations?
• [9:32] How the hospital staff members are selected.
• [11:10] How and when meetings happen.
• [13:12] A typical council meeting and the kinds of impact they've been able to have.
• [20:48] The first one or two steps a hospital should take to start its own council.

• Institute for Patient and Family Centered Care

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We face adversity every day. Learning to handle the difficulties that are inherent in life and death situations is one of the most important things we can do. Toward that end, I wanted to chat with someone who's been in the trenches for a long time and knows what it takes to build teams that can overcome adversity together. I'm honored that Jim Tressel, President of Youngstown University and former College Football Coach agreed to join me for a conversation about the subject. Jim's the author of two amazing books, "The Winner's Manual" and "Life Promises for Success." While it may seem strange that I'm chatting with an educator about healthcare leadership it won't take you long to discover exactly why I felt Jim was the perfect person for this conversation. Enjoy.

It's been said that the success of any organization rises or falls on leadership. Jim Tressel is a clear advocate of that philosophy. In this conversation I spoke with Jim about some chapters in his book that focus on the issues of adversity and success and how leaders can help their teams face both situations in a way that brings even greater success to the entire organization and benefits the people who are being served. This is a very insightful interview so I hope you'll set aside the time to listen.

Every person in an organization has their own personal ambitions and desires in life. That's a good thing. But sometimes those desires can come in conflict with the good of the organization. A good leader is one who has developed the skill to encourage and support the personal ambitions of each team member but at the same time is able to encourage them toward giving their highest for the overall goals of the team. Jim Tressel has learned that lesson on the playing field as a successful college football coach and continues to apply it as President of Youngstown University. I trust you'll be helped by what Jim shares with us about team dynamics and overcoming adversity together.

One of the most difficult parts of building a strong team that can withstand the pressures of adversity and success is getting the right people on the team in the first place. I asked Jim Tressel what he does to ensure that he's selecting the right people for his teams and he spoke at length about the importance of how a person thinks. It found his comments to be not only insightful but also practically helpful as I think about adding people to teams in the healthcare field. If you are in charge of hiring for your area of specialty you'll want to hear what Jim has to say. If you're not, you may be some day so I'd recommend you give this conversation your attention.

One of the natural bents of human nature is to become complacent. Satisfaction with the way things are is fine if it's in the form of inner contentment but when it leads us to complacency it's an obstacle to higher achievement and greater success. You and your teams will have no chance of overcoming the adversity you face day to day if members of the team are drifting into a complacent attitude. On this episode, Jim Tressel guides us to understand the tendency toward complacency and to understand what healthcare leaders can do to equip their teams to fight the pull of the status quo and perform at the level of excellence. It's a great conversation with one of my heroes. I hope you'll take the time to listen.

• [0:27] My introduction of Jim Tressel.
• [3:51] Discovering how to bring individuals into a group mission with effectiveness.
• [8:10] How to handle adversity and success.
• [16:32] The characteristics President Tressel looks for when hiring team members.
• [19:03] Staying motivated during adversity and success.
• [25:41] Handling transitions from lesser positions to senior positions.
• [28:55] Jim's mentors and what he looks for in a good mentor.
• [29:50] Books all aspiring leaders should read.

• BOOK: The Winner's Manual
• BOOK: Life Promises For Success
• John Maxwell
• BOOK: Talent is Never Enough
• Connect with Jim Tressel on Twitter: @JimTressel5

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• BrianWeirichRN@gmail(dot)com

Nursing Management is a position many nurses attain in time, but to move from nursing to the position of CEO is not very common at all. Today's guest is Lamont Yoder, CEO at Banner Health at Banner Gateway & Banner MD Anderson Cancer Center. Though Lamont's path from nurse to CEO is uncommon it's one he feels more and more nurses should strive to follow. He believes that having nurses at the highest levels of healthcare administration is one of the best ways to improve the quality of healthcare overall. On this episode Brian asks all the questions you'd want to hear about an intriguing journey like Lamont's, so be sure you set aside time to listen.

It as in the natural course of events in his career as a nurse that Lamont Yoder discovered that he had gifts and abilities that suited him for leadership roles. He naturally gravitated toward the positions of responsibility and through his contributions in those roles he was recognized and tapped for other, more weighty roles over time. On this episode, Brian asks Lamont to share how he moved from nurse, to nursing management, to CEO and what made him feel it was a good fit for him. And Lamont not only shares his personal story but also how new or experienced nurses could set the stage so that they could follow in his footsteps if they so chose.

One of the practices Lamont intuitively adopted when he first got into nursing management roles was to find mentors he could learn from. But beyond that he realized that those mentors should not only be people who were at the next level he wanted to attain but people who were one level above that. By learning from people two levels above him he was able not only to see the role he would move into next with greater clarity, he'd also be able to learn what was ahead so he could position himself to move even higher over time. If you're eager to build a career of upward mobility into nursing management and executive leadership. Lamont has a lot of great advice for you in this episode.

One of the most memorable accomplishments during Lamont's career was the ground floor to grand opening creation of a brand new, state of the art healthcare center. Lamont remembers the time with fondness not only because of what was achieved but also because of the challenges and innovation that were part of the process. Lamont shares the story on this episode and gives a bit of vision to upcoming nurses relating to what they can shoot for in the ever expanding nursing field.

With a job as demanding as nursing can be one of the most difficult things to attain as an individual or as a team is work-life balance. Brian asked Lamont how he maintains his own work life balance on this episode and Lamont shared how everyone on their team, from nursing management to executive management are expected to maintain their own work-life balance in a way that sets the example for the rest of the staff. You'll enjoy hearing some of the practical ways Lamont's teams accomplish that, on this episode.

• [1:41] Lamont's first nursing job and why he chose nursing as a career.
• [2:30] Why Lamont moved into hospital leadership.
• [4:43] Mentors and coaching Lamont received over the years.
• [7:00] The roles Lamont has enjoyed the most and where he's grown the most professionally.
• [9:19] What Lamont looks for in a CNO position.
• [11:24] How Lamont made the decision to move from CNO to CEO.
• [12:57] Why Lamont stays very involved in nursing as a CEO.
• [15:43] What successful leaders in nursing need to understand to be successful.
• [17:40] How to move from a nursing position to an executive leadership position.
• [19:06] The task of work/life balance and how it has to be exampled from the top.
• [21:37] What will nursing look like in 10 to 15 years.
• [22:15] Those who are heroes to Lamont.
• [23:10] What Lamont would tell his 25 year old self.
• [23:35] The best read for healthcare leaders.
• [26:04] How to connect with Lamont.

• Author Daniel Pink - the book Drive
• Lamont on LinkedIN - on Facebook - and on Twitter and LamontYoder(at)gmail.com

• Twitter @BrianWeirichRN
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