by Doug Gray | Aug 16, 2015 | change, healthcare, Leadership, Managers, physicians, strengths
Every U.S. citizen has a vested interest and an opinion about the quality and effectiveness of healthcare delivery, a $3.8 trillion industry with rapidly escalating costs.
The fastest-growing industry in healthcare is telemedicine, which is now used in over 50% of the hospitals in the U.S. to promote remote access to healthcare. Examples range from tele-surgery to tele-emergency care to tele-psychiatry. The reasons for telemedicine abound. It allows specialized care to be distributed from a central hub to a rural location or an underserved population, efficiently and at lower costs. For instance, in 2012, the Veterans Administration (VA) documented over 1.5 million telehealth sessions, for over 35% of veterans.
Problem statement and opportunity
The primary problem with telemedicine is low user adoption rates because many people resist organizational change. The result is massive waste that can be reduced. Telemedicine technology and processes exist. However, organizational readiness for telemedicine results from two variables: 1) ability to change, and 2) motivation to change. The innovation diffusion curve (see Figure 1) demonstrates an immediate opportunity for telemedicine initiatives to move from the early adopter phase to the majorities.
Organizational readiness for telemedicine can be measured. The key variables for organizational readiness include 1) executive sponsors who champion the ability and need to change, 2) buying agents convinced by case studies or ROI data of the economic value for the change, and 3) consumers driven by a compelling need for effective, inexpensive health care outcomes. The need for organizational leadership innovations in telemedicine programs is immediate.
Figure 1: The innovation diffusion curve (in Rogers (2003) Diffusions of Innovation)
Unique opportunity: Tennessee
Although resistance to telemedicine is a global problem, we have a unique opportunity to provide a solution from Tennessee. Described as the “Global Center of Healthcare,” Nashville, TN has over 400 healthcare companies, spawned from Healthcare Corporation of America (HCA). On January 1, 2015, Tennessee became the 21st state to enact “telemedicine parity” legislation requiring that insurers reimburse licensed health care providers for services delivered remotely just as they would for in-person visits. On February 15, 2015 Tennessee added law stating that telehealth providers will be held to the same level of care as direct care providers (SB 1223). That law “opened the door” for telemedicine services to be delivered remotely, at lower cost, to rural minorities in Tennessee. We are in the right time at the right place to lead innovation in telemedicine.
Sadly, there is resistance to telemedicine from consumers and administrators who do not trust the government, or the technology, or the financial benefits. A telemedicine visit may cost $50 and take 10 minutes (e.g. MD Live, Teladoc); an ER visit may cost $150 and take 3 hours; a hospital visit may cost $15,000 and take 3 days. Telemedicine has demonstrated a 10X cost savings. Unless, of course, there is organizational resistance to change, in which case telemedicine is a waste of time and resources.
One administrator said, “We have 3 telemedicine kiosks sitting in a storage room, hidden by sheets. The vendor who provided them no longer exists. The technology may be extraordinary, but I cannot get my physicians and nurses to use it.” His experience represents hundreds of wasteful healthcare initiatives.
What can you do to increase adoption of telemedicine?
by Doug Gray | Jul 6, 2015 | Business, change, Coaching, Leadership, Managers, strengths, Success, talent, talent assessment
How do you measure learning and development?
The Greeks believed that the “rope of one’s life” was defined by three fates, who spun the thread of life, measured it, and then cut it.
Instead, imagine that your career can be described using a 10’ long piece of rope. If you dropped the rope at your feet it would look like several messy loops. Most of us choose to believe that we have some impact on the “rope of our careers.”
Now imagine that you have a work team of 5 people. If they each had a 10’ long piece of rope and dropped those ropes at your feet, then how would you describe that messy image?
Talent management is a cyclical model frequently described with three loops: attraction, development and retention. Some of those key metrics include efficiency, effectiveness and outcomes. A tremendous resource for talent managers who want to demonstrate accountability, like any CFO or business leader, is at www.centerfortalentreporting.org
The ultimate goal of talent management should be to retain desired employees, not all employees.
There are actually 6 loops in talent management. Think of your process as 6 inter-related loops that include: talent acquisition, learning and development, leadership development, performance, total rewards, and succession planning. Here is a definition of each loop, plus some comments.
- “Learning and development” services support all of the organizational activities aimed at improving the performance of individuals and groups within the organization. The learning and development process includes addressing gaps in skills, knowledge and competencies, and then building the strategic talent capabilities of the organization through a systematic focus on competence required to meet business objectives. Aspects of learning and development may include job profiles, competency mapping, knowledge management, behaviors, skills, ability tracking, learning content, training, coaching and assessments.
Despite the trend toward digital content delivery, adoption of digital content remains below 20% in most industries. Make certain that you are using short, sensational videos, interactive quizzes, and social followers or gamification to promote goals of instructional designers. The bottom line? Be careful if investing in digital solutions and expecting high user adoption rates.
The 70:20:10 model for learning and development is a guideline or frame of reference that is now used to both 1) promote learning and 2) restrict learning. Let us assume that learning results from 70% on-the-job or self-directed learning, 20% from managerial or client feedback, and 10% from courses and reading. Then what does that mean in your organization?
- Do you expect to foster innovation internally, by engaging employees or actively managing their professional development plans?
- Do you restrict that manager who spends more than 20% of her time and energy on that direct report that has high potential, but lacks procedural knowledge of customer delivery?
- Do you invest in external coaching and consulting for your top 20% producers, as a development tool to increase retention some 14 months on average?
We do not need any insight from the Greek fates to measure the impact of learning and development on the “rope of our careers.”
We do need to foster learning communities in order to increase engagement, retain desired employees, and serve our clients and customers.
If you need help measuring the impact of learning and development for individuals or organizations, then contact us today.
by Doug Gray | Jun 22, 2015 | change, Coaching, Leadership, Managers, strengths, talent
Hello friends,
I thought you may want to see some recent trend data for external coaching and internal coaching, by industry and size of company.
Highlights:
- After the recession, companies are investing more than ever in leadership development and key talent, with both external and internal coaching
- 39% of these 140 companies use internal coaches for leaders who are lower in the organization, and over 75% use external coaches for their senior leaders (directors and above)
- The top 3 types of coaching remain 1) development-focused coaching, 2) performance-focused coaching, and 3) 360 debriefs
- Fees invoiced at a standard or fixed rate per engagement, rather than an hourly or variable rate, have increased from 26% in 2012 to 38% in 2014
- Hourly rates for executive coaching range from $600+/hour for CEOs and direct reports to $300/hour for directors and above; naturally, those rates vary by size of the company, industry, and level of the leaders
- The top 3 topics covered in coaching engagements have not changed for many years; they include: 1) executive presence/ influencing skills, 2) relationship management, and 3) leading teams and people development
If you should have any questions, please let me know.
Doug Gray, PCC, CEO/Founder www.action-learning.com
2014_TCB_Executive_Coaching_Survey
by Doug Gray | May 28, 2015 | Business, change, Coaching, exercise, Leadership, Managers, strengths
Like most of you, perhaps, I have demonstrated some expertise at the ability to ride a bicycle since the age of 3.
Unlike most of you, I have perfected that skill in multiple expedition bicycle races, featured on CBS Sport three times, bicycle tours throughout Europe, the maritime provinces, and the U.S. Big deal, right?
So what would happen if I tried to UN-LEARN that skill?
1. In this cool video clip, a bicycle was re-engineered so that when the handlebars were turned one way, the wheel would go in the opposite direction.
2. It took an adult 8 months to LEARN how to ride this new bike.
3. It took his 3-year old son 3 weeks to LEARN how to ride this new bike.
What do these two facts say about the brain’s ability to learn a new behavior, then to unlearn that behavior after 8 months of reinforcement?
(Pause and reflect here…)
One of my Dartmouth College professors, in an obtuse course called Developmental PsychoBiology, taught me that we have neural pathways that reinforce certain behaviors. Call them habits. When we practice using our right hand with a fork to eat spaghetti, we can reinforce that pattern until it becomes “learned.” If we want to eat spaghetti with chopsticks we need to learn a new neural pattern, until it becomes a habit.
Too many adults say “you can’t teach an old dog new tricks.” Nonsense. There is abundant empirical evidence to the contrary, for both dogs and humans. Such a perspective is based upon ignorance.
So an executive coaching question may be, “What new behaviors do you need to learn?”
Examples include:
- calling 10 former friends to say “Hello, how are you? I miss you.”
- being kind to someone who needs kindness
- supporting the strengths of your loved ones, immediately, by doing or saying something complimentary and true. Immediately. Repeatedly.
- learning a new skill, such as how to play the banjo, speak Spanish, or write javascript
- self-advocate for that promotion or new challenge at work
- re-design your career or future
If you need a boost (and we all need a boost at times) then give me a call today.
I’d like to know what you are interested in doing. Or UN-Learning.
by Doug Gray | Feb 8, 2014 | Business, change, Coaching, Leadership, Managers, strengths, Success, talent assessment
Motivation is a messy subject. Perhaps each of us has wondered, “Why do people do what they do?” Or, “Why is my child acting like that?” or “How can I understand why I want that shiny object?”
Those three questions are mirrored by academics, who state that all definitions of motivations attempt to explain 3 qualities:
1. What originates, and energizes human behavior
2. What drives human behavior toward/away from goals
3. How behavior is maintained via systems orientation.
So how do you apply these 3 qualities to your business or your life?
Start with Expectancy Theory. It is a valuable theory because it is new, treats both internal and situational forces, and assumes that each individual is rational and capable. Expectancy Theory assumes that behavior is determined by a combination of forces, that people make independent decisions for subjective reasons, that differences can be studied systematically, and that individuals make decisions based on their perception of a likely reward makes intuitive sense. A rational view for any business leader.
The 3 main concepts of expectancy theory are described as: 1. performance – outcome (the belief that behavior X will likely lead to outcome Y), 2. Valence (different value or subjective worth,) and 3. Effort-performance expectancy (the belief that effort level X will lead to outcome level Y.)
Let me explain expectancy theory with a common example. Imagine a manager of sales people. For 12 years she has monitored sales goals (e.g. reach and frequency metrics) and her district has won national awards. But the stretch goals are created by a third party vendor, using complex algorithms, that cannot be modified by the sales representatives. Their performance-outcome is beyond their control. Too often, their sales goals are set 120% or more above the previous year’s goals. The result is de-motivating. Sales representatives hope for goal correction in the third quarter, so that they improve their national standing before the forth quarter returns. As described by the effort-performance aspect of expectancy theory, some salespeople simply cannot exert enough effort to yield a desired outcome. Expectancy theory assumes any value, when multiplied by zero, will yield zero motivation. Sadly, that was true year after year for too many sales people.
Perhaps they needed to apply expectancy theory to their management tactics!
Expectancy theory has value to managers because it has predictive validity, respects subjective differences of direct reports, can be applied to SMART goals for performance reviews, outcomes can be directly linked to reward systems, and is simple to apply (especially if managers ask people, “What motivates you?)
Expectancy theory has value to organizations because outcomes can be tied to rewards and compensation, it acknowledges different designs of jobs and roles, and it acknowledges influence of groups with different membership needs.
So, can you apply Expectancy Theory to your compensation rewards? Or to your business?
If stuck, contact Doug Gray at 704.895.6479 or at www.action-learning.com.
If academic, here are some good sources:
Porter, L. W., Bigley, G. A., & Steers, R. M. (2003). Motivation in Organizations. Motivation and work behavior (6th ed.) (pp. 1-39). Boston: McGraw Hill.
Robbins, S.R., & Judge, T.A. (2012). Essentials of Organizational Behavior (11th ed.) (p. 18). Saddle River, NJ: Prentice Hall.
by Doug Gray | Jan 28, 2014 | book review, Business, Coaching, global, Leadership, Managers, strengths, talent
Diversity in Corporate America.
I recently did some research on trends in diversity and leadership coaching. As you may know, an international assignment is often mandatory for high potential employees in global companies. Recent research indicates that corporate leadership teams with more diversity yield higher shareholder values. Initiatives within companies designed to identify and promote internal talent lead to higher retention and engagement rates. Global markets require experienced leaders. Many companies want to increase cultural diversity for the employees who are relocated, and for those in the host culture. There is a subset of executive coaches who specialize in supporting the diversity goals of those companies. That subset is called “diversity coaches.”
One article is an interview with Bo Razak, a senior consultant and diversity coach, conducted by Wendy Conklin, editor of The Diversity Factor (2006.) Razak specializes in diversity issues, and developing leadership skills that can support organizational missions such as increasing diversity awareness.
Razak states that executive coaching “for diversity” narrows the focus or framework to specific leadership capabilities that support the leader in developing his or her capacity to incorporate diversity into all aspects of work (37). Also, the coaching engagement may be shorter term than another executive coaching engagement. The diversity coaching engagement may focus on “leading by feeling” so that members of subordinated groups may feel supported with examples of empathy, or awareness of group identity and its effects.
Group identity is so central to Razak’s description of diversity coaching that I include his explanation. “Everyone has multiple group identities, including age, ability/ ableness, class, education level, ethnicity, gender, gender identity, nationality, race, first language, religion / spirituality and sexual orientation. In organizations and society, the extent to which we are aware of the meaning and impact of these identities is key to understanding the impact of diversity and changing the status quo.” (38)
Razak describes 4 critical factors for diversity coaches.
1) The primary factor is organizational support for diversity coaching, and diversity issues, that are tied to compensation rewards. He states that leaders need to adopt a “diversity lens” and become inclusive in language, action, and words.
2) Leaders need to become comfortable with a common language that is inclusive and enables them to discuss words like “gender” and “sexual orientation” in any strategic or operational discussion,
3) Leaders must pay attention to the dynamics of difference, and multiple perspectives from multiple group identities, by engaging a broad range of perspectives.
4) And leaders must actively solicit feedback on how they are embracing the capabilities of diversity, and make open statements that reflect awareness of multiple perspectives.
My takeaways from this article include the following:
1) My 25 year-old nephew was recently promoted into a role that required an international assignment. That experience is exciting for him, and he is young for such an assignment. I cannot imagine that he will eagerly embrace that culture; he would benefit from such a diversity coach.
2) Diversity coaching requires a systems approach to others. The coach must be aware of the layers of corporate expectations. The leaders/ coaching clients must be willing to engage in anything called diversity coaching. If it is an EEO requirement for compliance, or an extension of a training, those requirements may minimize the impact of diversity coaching. Razak states that compensation must be tied to behavioral outcomes based on the diversity coaching. That point reminds me of Peter Drucker’s maxim that “what gets rewarded leads to results.”
3) Selecting and matching coaches with leaders/ coaching clients requires a high level of awareness of group identity. But there are no rules. It may be ideal to match people from dramatically different group identities in order to be more effective. For instance, if I were being coached by a Hispanic, lesbian woman from Brazil, and I am a Caucasian, heterosexual male from the U.S., we may be well matched. Or it may be a setup for failure.
4) Diversity coaching may be a shorter-term engagement than executive coaching engagements. However, the effects of diversity coaching may be more anecdotal than measurable, and longer term rather than shorter. And in a country that is more ethnically diverse, such as Canada, diversity coaching may be more effective than a country that is more ethnically homogenous, such as Japan.
Conklin, W. (2006). Executive Coaching for Diversity: An Opportunity for Leaders to Learn and Change. Diversity Factor, 14(2), 37-42.
What are some of your takeaways from this subject?
Call me or contact me to discuss them today.
Recent Comments