Archive for the ‘Leadership’ category

Random Thoughts About Things That Confuse ME

October 12th, 2015
 People have often asked me, “Where were you when Kennedy was shot?” In fact, I was in gym class. Six years after that, on April 4, 1968, I was in Pittsburgh when Martin Luther King was shot. I was back again in Pittsburgh on June 5, 1968 when Bobby Kennedy was killed. Finally, as a young teacher in Johnstown, on May 4, 1970, four students were killed and nine more were wounded by the Ohio National Guard at Kent State University. Between the riots and civil unrest that followed these events, I was pretty sure that our world was spinning out of control, and I had just graduated from college.

It was during that time of the Vietnam War, the escalation of the Cold War, the race riots and political rallies, that a chasm began to appear between those men who still had crew cuts and white socks, and conservative hippie kids like me with my wire-frame glasses, sideburns, and mustache.

In fact, at my very first job interview, the department head, a man who was still firmly planted in the 50’s, asked me if because I was my college class president, I’d ever been involved in a campus riot. Meanwhile, there had only ever been one small demonstration at my university, and I wasn’t even on campus when it happened. But his question offended me so much that I replied, “Only the one.” Needless to say that job went to someone with a crew cut and white socks.

Throughout my life I held profound optimism that because we were a country that embraced education, espoused Judeo-Christian love, and incorporated tolerance and diversity in our stated beliefs, our philosophies would prevail and the world would become a better place. Wrong.

Because I spend much of my time on the road, Facebook is often the way I keep in touch with my virtual and real families. It keeps me apprised of changes, challenges, and the daily activities of those I both care about and want to be connected to through this last quarter of my life.

Of course, Facebook is filled with puppies, kittens, babies, and opinions, and many of those opinions remind me of the Archie Bunker character who so famously dominated the airwaves in the All in the Family sitcom of the 1970’s. That series, along with MASH and The Jefferson’s attempted to challenge the way Americans dealt with race, war, and general closed-minded prejudices.

It makes me sad when my friends, people that I love and most often respect, write posts that are passionately in support of social beliefs that embrace continued gun violence, racial prejudice, twisted religious beliefs, intolerance, greed and hatred. It would be easy to unfriend them, to write them off, and forget about them, but the teacher in me wants to try to educate them and to help them find their way. That never works because most of them are Archie Bunker’s age and older. All I’m asking is for tolerance, the embracing of diversity, and a non-violent philosophy of loving others. It’s the Golden Rule. Unfortunately, it’s often the Rule of Gold that seems to prevail.

I can tell you where I was on April 20, 1999, April 6, 2007, December 14, 2012: Columbine, Virginia Tech, and Sandyhook. Unfortunately, I can’t even tell you the name of the school or how many kids were killed on January 4, September 14, September 30 of this year. October 1, 2015, however, became more tangible because the hospital that cared for the wounded in Oregon is run by a friend, and Troy Polamalu’s cousin Brandon, a teacher at Umpqua Community College, was on campus at the time of the shooting.

Minimally, as a country, can’t we invest in behavioral health initiatives and enforce background checks.

Meathead really was the voice of reason on so many levels

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BMW . . . ing

August 20th, 2014

 

If you don’t know what that abbreviation stands for, Google it!  I’m not referring to: BMW: Born Moderately Wealthy, BMW: Brought My Wife, or BMW, Bring More Worries.  In fact, I’m not thinking about anything that is directly related to a thing, okay, well, maybe I am.     

What I’m referring to is the phrase, Bi*ch, Moan, and Whine!   For whatever reason, I’ve recently been inundated with individuals who are not happy about various things impacting their lives.  I’ve been hearing about money, jobs, marriages, fees for cable TV, healthcare and college costs, the government, animal cruelty, gasoline prices, racism, city manager selections, and a dozen or so other issues.  In fact, even though Heinz just had to pull their tainted baby food off the shelves in China (Now, that’s a reversal of fortune, Mr. Buffet).  The only thing that I haven’t heard people complaining about (euphemism for bi*ching) is the “price of rice in China.”   

Ha, bet that rang a bell for you ole folks.  What ever happened to that phrase?  We used to say that all the time in the 50’s and 60’s?  When someone was babbling on about something that we thought was meaningless in our lives, we used to say, “Now what’s that have to do with the price of rice in China?” 

Guess it’s not so meaningless anymore? (If you’re interested, you can look up the “Live Rice Index” for the price of rice in China), but I digress. My philosophy has always been, if you can do something about it, then do it.  If you can’t . . . then move on, my friend.   Truthfully, in this country, we hold the power to change nearly everything, but we choose instead to join the BMW Club.  

Think about it.  We have in our hands the amazing ability to influence and to change almost anything that exists.  It’s a simple formula.  We ban together and say that famous line from the movie, Network, “I’m mad as hell, and I’m not going to take it anymore.”  

Could you imagine showing up en masse anywhere and yelling that?  It would be international news.  If we could get enough people to come together to offer alternative solutions to almost any problem that we face, the offenders, enforcers, and especially the elected law makers would be forced to pay attention, and public pressure could change everything.  

The key to this tactic is to find enough people who care about ANYTHING.  

We’ve all seen what Rosa Parks, The First Lady of Civil Rights, The Tianamen Square tank man, Gandhi, Mother Teresa, Martin Luther King, and now Pope Francis, the former night club bouncer, have done to contribute to CHANGE in our world, but we . . . you, me and tens of thousands of our closest friends, can really make a difference. 

Heck, thousands of us just threw cold water on our heads to make a statement about ALS, and before that . . . ?  Probably a lot of the participants thought ALS stood for Advanced Life Support or Apply for Disability! 

What’s the quote from Margaret Mead? “Never doubt that a small group of thoughtful, committed, citizens can change the world. Indeed, it is the only thing that ever has.”  (She also said, “Children must be taught how to think, not what to think,” but that’s a different column for a different day.)  

The whole idea here is to get us together, to unit, to make change!  What would you change if you could?  Want lower gas prices?  We could do that.  Want to stop dangerous, unmarked oil trains from driving through our towns and cities.  We could do that. How about big corporations not paying taxes? 

The key is to stop the BMW-ing, and get your friends together and present positive ideas to the folks who can make the changes.  It’s an American right.  

Oh, and you might want vote this year, too! 

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What is Real and What is NOT? The Truth, or Maybe NOT . . .

April 30th, 2012

Sixty two years ago, George Orwell wrote the novel, 1984.   He described a society controlled by government where the individual had no privacy, no real freedom, and was literally put into the equivalent of a drug induced state by the pabulum of mass media television.  It was an intimidating forecast.   But now the question; how much dumber can television get with shows like:  “My Big Fat, Obnoxious Boyfriend,” “Real Housewives of  Wherever,” and “Temptation Island?” 

It was Marshall McLuhan, the Canadian educator, philosopher and academician who came up with terms like, “the global village, “medium is the message,” and the concept of the “World Wide Web” almost thirty years before Al Gore said he invented it.  Marshall described the fact that the mass media was quickly taking over our ability to think independently as we rushed into the realities of Orwell’s  Big Brother.  He explained that we would be once again living in a world of tribal drums, total interdependence and superimposed terror as opposed to thought and feelings from rational analysis.  Can you say, “Weapons of Mass Destruction?” 

The World Wide Web has placed us in a type of tribal unity for which none of us were prepared.  Why do you think tattoos are more in now than any time before 1500 B.C.?  Piercings and tattoos make you “part of the tribe.”  Hey, the majority of presidential candidate debate issues revolved around turning the clock back to the 1950’s, no web. 

It appears that, because of this tribal unity, many very obvious changes have become accepted by our current culture.  For example, according to columnist Rex Huppke, the fact that someone of any political party can say something that is completely false and stand by it makes facts meaningless and thus, dead. He goes on to theorize that, rumor and innuendo along with emphatic assertion are also part of this new communications standard. 

Dartmouth political scientist, Brendan Nyhan professes that, “In journalism, in health and education, we tend to take the attitude that more information is better, and so there’s been an assumption that if we put the correct information out there, the facts will prevail.”Nyhan says that, “Unfortunately, that’s not always true.”   Facts don’t seem to matter, and those who expose bogus facts are often more highly criticized than the person who misrepresented the truth in the first place.

We all know that the spin can change the view on any subject matter.  In many cases, it’s the quality and persuasiveness of the argument, not the facts which becomes the issue.   If you are on the right side of the spin, or if enough information can be put out there, the mass audience will be distracted from the facts, and confusion will reign supreme. 

Fact:  The United States has one of the highest infant mortality rates in the industrialized

Fact: Legislation has recently been proposed to take away additional funding for prenatal care. 

Fact:  The United States has fallen to “average” in international education scores and our State austerity measures include the laying off of teachers. 

Fact:  The incarceration rate in the United States of America is the highest in the world with only five percent of the world’s population, one-quarter of the world’s inmates are incarcerated in the United States. 

Fact:  Average annual cost per student for a public school education $8500; average annual cost per prisoner, $23,000. 

See, many of you will not know if you should believe these facts.  Some of you will fact check them.  Others will say, so what?   Some of you will look for my prejudices regarding this list, or you may be overwhelmed and say, “I can’t change any of this anyway.”  Most, however, will not bother to read this far. 

Twitter has become the new novelette and everything is a sound bite.   As Jimmy Kimmel said, “What’s back and white and read all over? Nothing anymore.”

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People You Need (and People You Don’t)

October 31st, 2011

Tom Atchison - http://atchisontom.com/ - Nick Jacobs, FACHEA few weeks ago, I mentioned that I was in Santa Fe, NM for an ACHE educational training course. Since then, I’ve been thinking a lot about some of the things that were said there by Master Instructor, Dr. Tom Atchison, Ed.D. (a/k/a, Yoda), the President and founder of Atchison Consulting Group. In fact, a few of the tidbits that he offered have been wedged in my brain to the point of obsession. It took me 40+ years to learn some of this, and now I am dying to share it. If you are a boss, a manager, or an employee, it applies equally to everybody, and the information has been valid for as long as mankind has roamed this earth.  So, thanks to Dr. Tom, I can finally articulate it.

SSCS…yep, that’s it. SSCS. If you know what these letters stood for, you can stop reading now, but let me explain. In any group of workers, volunteers, employees, leaders, there are four very distinctive types of people:

Stars

There are the stars, and we all know the stars. No, not the “I’m going to get paid a million dollars to pose for a magazine” or for “selling the rights to my make-believe wedding” kind of stars. Rather, these are the bust your butt, be on the right seat in the bus, make it happen, hard working, cooperative, dedicated stars. They’re the people who lead the way and make things happen.

Skeptics

The next group of employees is the skeptics. Skeptics are generally really good people, sometimes slightly below the star category because they question everything in a meaningful, truth-seeking manner. The only problem with the skeptics is that they take a lot more energy than the stars. You must keep them informed, up to speed and appeased. Once they do get it, they are on board and make things happen in a big and important way. It’s just a little harder to get them there.

Cynics

Next we have the cynics. These people are insincere, and they are motivated by self-interest. They question everything, but more importantly, they dis everything, don’t cooperate and try to block every idea, action or activity. They are the ones who work behind the scenes to make sure that things don‘t get done, that people don’t cooperate and then openly criticize each and every idea no matter how sound the concept may be.

Slugs

Finally, there are the slugs. Usually they are nice enough people, but on a scale from one to ten with the stars being a ten, the slugs are exactly what they sound like. In fact, in reference to printing, the word slug came from traditional hot-metal printing where a strip of type metal is used for spacing that is less than type-high, hence a slug to fill in SPACE! They are space-fillers.

So, here’s what leaders who were present at this workshop were told. The cynics suck your life out of you by continuously challenging and undermining everything, and the slugs add no value to the organization. The problem with stars is that they are often taken for granted, or passed over because they are consistently amazing, and because we spend so much time dealing with the cynics and redoing everything the slugs don’t do.

His solution? Fire ‘em. (The slugs and cynics, that is.) Now if that seems a little harsh, maybe it’s because we all know and love both slugs and cynics. Unless you’re a tenured professor or the boss’s kid, it’s really tough to stay in a job where you do these sluggish and cynical things over and over again. Of course, if you fall into either of those categories, you could change!

Final advice? Be kind and nice and wonderful to the stars and the skeptics, and spend time explaining everything to the skeptics so that they embrace the concepts and dreams and vision and move forward with the rest of the team. Oh, yeah, and help the slugs and cynics find work, especially if you can find them work with a competitor because they will be the gift that keeps on giving cause they’ll probably be cynics and slugs for the next place, too, and all of those disgruntled patients and customers will come to you!

The new Brad Pitt film, Moneyball offers some object lessons here…

“We’re building a baseball team, here. We’re not looking for Fabio. We’ve got to think differently!”

“Who’s ‘Fabio?'”

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Steve, Dean and Nick: Be “Insanely Great.”

October 25th, 2011

Steve Jobs - HealingHospitals.com - Nick Jacobs, FACHE
During this time of economic uncertainty, the recent loss of creative, innovative leaders like Steve Jobs and Dr. Lee Lipsenthal adds to a collective national and personal concern over what seems like a serious lack of truly inventive and ethical leadership. Who will represent the next wave of 50-something leaders, and how will their personal characters influence upcoming generations?

One hope that I have for the future is Dr. Dean Ornish, a man who has been a personal friend, mentor and physician to both Mr. Jobs and Dr. Lipsenthal. To describe Dr. Ornish as a man of character, knowledge and creative medical vision would be akin to calling Winston Churchill a “good dinner speaker.”

Dr. Ornish and I have a long history of friendship, respect and support for each other’s work. Years ago, wanting to avoid being a heart surgery patient, I began to explore alternatives to legacy procedures and regimens. And, not unlike Steve Jobs, whose initial interest was also to avoid having his body violated by surgery, my research led me to the work of a young Dr. Dean Ornish. As soon as I learned more about his extraordinary program for coronary artery disease reversal, it was a simple decision to invest my own personal funds in one of his intensive workshops, held near his home in California.

Dean Ornish at PopTech (2009) - Camden, Maine - Nick Jacobs, FACHE - HealingHospitals.com

Dean Ornish at PopTech, Camden, Maine (2009)

 

As providence would have it, my own work resulted in what became a steady stream of research grants, and my subsequent personal decision to include Dr. Ornish in our appropriations for the next half-dozen years at the hospital and research institute where I previously served as President and CEO. Each year, I fought to have at least one million dollars invested in the Preventative Medicine Research Institute in California so that Drs. Ornish and Lipsenthal could continue to move forward in their research, as well.

Once, Dr. Ornish asked me, “Nick, what do you really want from our work together?” Without a moment’s hesitation, I replied, “Dean, I want to lose the question mark after the name of the town, ‘Windber.’  Whenever I tell people where we’re based,  they usually respond, ‘Windber?’…’You mean Windber, PA… the old coal mining town?'” Some history here: I had been hired by the board of rural 102-bed, acute care hospital in that historic, rural community to either radically turn it around, or shut it down. For me, the latter option was never a consideration.

Among the many transformational changes we made as part of the turnaround was to be among the first hospitals — and most probably the first rural hospital — in America to implement Dr. Ornish’s evidence-based program that arrests (and can even reverse) the effects of coronary artery disease. The results — with patients of broadly diverse ethnic backgrounds — were so successful, that we were asked to present to the World Congress on Cardiology in Belgrade, Serbia in 2007 on our outcomes and research discoveries, garnered from our experience implementing the Ornish program.

We were also instrumental in introducing the program at other sites for Highmark Blue Cross, as well as a host of other innovations and reforms at our own hospital; from live music playing, to fountains, delicious, nutritious food, cooked by classically-trained chefs, 24-hour family visitation and… wait for it… pajama bottoms for the comfort, dignity and modesty of our patients.

The goal: an environment entirely dedicated to the healing of body, mind and spirit.

The result: among other verified successes, one of the lowest hospital acquired (i.e., nosocomial) infection rates – less than 1%) in the U.S., where the national average is around 9%.

And, yes, we were profitable. Consistently profitable, quarter over quarter.

On one flight in a private plane with my board chairman and me from Cincinnati, Dr. Ornish and I had mutually planned to spend some “quality time” together – collaborating, planning and just trading stories about our experiences. Instead, he wound up honoring an emergent commitment as a personal health advisor and consultant to the leader of an Asian nation, and spent the majority of our flight in direct, one-on-one communication with this person. Awesome? That’s just the kind of guy he is.

My personal hope is that Dean Ornish will take up the mantle for both Jobs and Lipsenthal, as he takes his wellness programs to new levels through mobile apps and enterprise solutions using  iPhones and other mobile devices, and iPads and other tablets, making innovative use of social media technology. (Talk to my friend Mike Russell about that.) My further hope is that  Dr. Ornish’s success as an agent of influence and change will continue to be used in a powerful way, to not only help improve the health of the world, but to continue to positively influence public policy in the United States, as well.

Newsweek cover - Dr. Dean Ornish - Healing Hospitals - Nick Jacobs, FACHEDean Ornish has long been recognized as a leader, a man of character and a visionary, but with the loss of two of his closest friends, the pressure to perform grows exponentially greater. So, my best to you Dr. Ornish. Thanks for your confidence in my work. Keep the faith, and keep up the good fight to make a phenomenal difference in this world, thinking in insightful new ways and never resting on your laurels. As your friend  Steve Jobs famously said at his Stanford commencement address, “Stay hungry. Stay foolish”…but especially the phrase he immortalized early in his career: be “insanely great.”

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Going “Rogue” – An Open Letter to Healthcare CEOs

October 17th, 2011

For the past three years, I have had a chance to dig heavily into the future, and I’m pretty convinced that the old saying, “Necessity is the mother of invention,” has never been more true than in today’s healthcare environment.  What was a given before in healthcare management may no longer be so in the future, and since most hospitals only Chief Innovation Officer is the President him or herself, their tasks of visualizing, understanding, deciding and directing the future of the organization will be shifting even more heavily from quantitative deciding-and-directing to the more qualitative visualizing-and-understanding side of this leadership equation.

Although I understand the reluctance of most CEO’s to be on the bleeding edge of creativity, my experiences at my former positions can significantly reduce or mitigate the majority of risk from any decision regarding innovation.

Our new competitive environment has an insatiable appetite for information, access and connectivity and it’s a well known fact that a periodic injection of chaos fosters creativity and forces your co-workers to leverage technology.   Because most organizations already have an environment that is built on trust and collaboration, injecting a little creativity can put their CEOs in more of a position to be the orchestrator and the inspirer.

That Used to be Us That Used to be Us is the new book by Thomas Friedman and Michael Mandelbaum in which they analyze four specific challenges Americans face as a nation—globalization, the revolution in information technology, the nation’s chronic deficits, and our pattern of excessive energy consumption—and spell out what they believe needs to be done to sustain the American dream, and achieve true supremacy based on innovation and excellence.

As an innovator and futurist,  several sections of this book captured my imagination and brought closure to a myriad of beliefs that I have instinctively embraced over the past few decades.  When my responsibilities revolved around the CEO position, I always saw my job as being a contributor to an environment where creative decisions were embraced allowed to happen and then those innovators were rewarded and inspired to keep going.

As the co-founder of a Research Institute, one issue that continually resonates with me is that  “We don’t have enough ‘rogue’ CEO’s in healthcare administration to take risks so that the rest can benefit from both their successes and knowledge.”

Well, fortunately, I’m your guy.

For the last several years I have been out there implementing unusual things, and many of these disruptive ideas are coming to pass in a big way.  I was the first hospital CEO to blog, starting in 2005 (HealingHospitals.com), was an early Planetree board member, created the first breast cancer research center dedicated to the Department of Defense, and filled my hospital with Integrative Medicine, hotel amenities, and music.

Below, I’ve listed thirteen new examples of areas of innovation, in which we’ve been working for the past three years, as well as numerous ways to pay for these initiatives.

 Thirteen Examples of Disruptive Technologies and Practices That Hospitals Need to Understand 

  1. Robotic algorithmic software that improves emergency room flow by 37 to 50 percent.
  2. Financial transaction software that reduces electronic transfer fees exponentially (25% of health care income is from electronic transfers.)
  3. Utilization of nurses and actuaries as patient advocates to significantly reduce your employee health costs.
  4. Preventative medicine reimbursements that can double a physician’s income and add bottom line profits to hospitals.
  5. Treble growth potential of your organization through adding Integrative Medicine
  6. Diabetic retinopathy telemedicine for Family and Internal Medicine docs.
  7. Proteomic and genomic testing creating new “hospital income.”
  8. Peritoneal lavage that extends Stage 4 cancer patients from three months to five years or more.
  9. Bone scaffolding that supports bone growth and virtually eliminates bone infection.
  10. Special bandages that protect and stem cell cocktail sprays that heal burn wounds
  11.  Access to a cancer consortium that allows small and medium hospitals to become Certified Cancer Centers
  12. Hospitals paid “not to play” during an energy crisis as a back-up to the power grid.
  13. Green hazardous waste disposal costing 25% less than traditional methods

If you’d like to learn more about any adopting any of the concepts above, or receive a leadership presentation that will enable your staff to see the opportunities (rather than just the threats) in our current, uncertain environment, here’s where to find me.

Why Are Hospitals The Way They Are? from Nick Jacobs, FACHE on Vimeo.

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The Smurfs and Culture

July 29th, 2011

The other day, I was imagining a conversation between our U.S. elected officials about the Smurfs.  On one side of the aisle, the rhetoric would go something like this: “I believe that Poppa Smurf  represents Karl Marx. He is not the leader of the Smurfs but an equal who is admired by the others for his age and wisdom.”  Then they might say, “And Brainy Smurf represents Trotsky, as he is the only one who comes close to matching Papa’s intellect.  He wears round glasses, is often isolated, ridiculed for being too professorial and is even ejected from the village for his ideas.”

Photo Credit: AP/Richard Drew

Furthermore they might add, “The smurfs don’t have private property, have adopted a collective-style economy and no individual Smurf is represented as either superior or inferior to others.” Someone would yell out, “They probably even have healthcare for everyone!” Consequently, the conclusion from one side of the aisle would be that the Smurfs are Socialists and are destroying the fabric of our society.

Then the other side might say something like: “Gargamel represents capitalism and embodies all the negative attributes associated with that economic system, such as greed, ruthlessness and the pursuit of personal gratification.”  “Gargamel is the quintessential symbol of Wall Street and will take his billions in tax cuts but never create even one job,” this side would say. At the same time, they might surmise that, “Azrael represents the worker in the ruthless, free-market state that is Gargamel’s house, and his union must be busted!”  Their final conclusion would be that, “The wealthy are taking all of our money and destroying the middle class.”

Is it any wonder we can’t get a debt ceiling bill?

One of my last professional trumpet playing jobs, “Smurfs on Ice,” was nearly 25 years ago. So, Brainy, Jokey, Grouchy, Greedy, and Stinky were all part of my early years, and now they are coming back, but the world is not the same!  So, be careful Smurfettes. Don’t invest in the market, real estate or dot.coms.  Try to avoid those outrageous credit card interest rates.  Don’t, whatever you do, don’t believe what the heads of the big banks and insurance companies are saying, and, for goodness sakes, buy gold, or maybe buy precious blue stuff.

When I was a kid, I was on journey to learn. So, when my dad bought me a box of vocabulary words and helped me learn ten new words every night, it wasn’t because he wanted us to grow up and be rich.  To him, the most important thing that he could do for his children was to make sure that they got an education.  He was all about the awareness that comes from exposure to information.

It started for me as a simple challenge to read the Bobbsey Twins books, and then the Hardy Boys, and from there, works by Mark Twain, Shakespeare, Dickens, Poe, Roth, Hemmingway and Tolstoy. Going through life without all of these friends would have been an empty and lonely journey. I’ll never forget when my brother, a young teacher at the time, introduced me to his classical record collection.  Yes, I was a trumpet player, but when I discovered Mahler, Beethoven, Mozart, Bach, Wagner, Brahms, Handel, Stravinsky, Chopin, Mendelssohn, Berlioz, Bartok and Sibelius, my life was changed forever.  Between the written word and the music, the mysteries, joys, challenges and humanness that is life became more apparent to me every day.

We have migrated away from anything but basic education and our favorite pastimes are video games, celebrity magazines and reality TV shows. Maybe that’s why we seem to have lost our way in this country.  We no longer embrace a culture of open mindedness, understanding and compromise.  Is it any wonder our U.S. Representatives can’t work together?  Maybe they are simply unenlightened…Maybe they all need to spend some time with the Smurfs and read a few blue books.

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Communication: It Can Make or Break You

March 8th, 2011
This might be one of those blog posts that you cut and paste to forward to your friends, family, peers or boss …or you may forget that you read it as soon as you have finished it. My experiences in healthcare leadership have placed me face to face with thousands of people who communicate in remarkably different ways. It has been my experience as a non-medical, non-scientific professional that the majority of the communication problems that exist in the workplace seem to be rooted in the nuances between only two of the four basic personality types.

We often hear statements like “He just doesn’t understand me.” “We are talking about the same thing, but she is on a totally different wavelength.” “I just don’t trust him. He embellishes the truth.” “What do you mean by the word, ‘is?’” Although we might drive the same make of car, live in somewhat similar homes, read the same newspapers (whether in print or on an LCD screen) and even enjoy Lady Gaga, we sometimes really have challenges with communication.

Bridging the communications gap - Nick Jacobs, FACHE - HealingHospitals.com
These differences can come from the styles of training, education, or upbringing that we’ve had. Whatever the case, it is real, and honestly, it can be maddening for both sides. One personality type sees the world as completely filled with opportunities. Of course they recognize that there are mountains to climb, but they also embrace the fact that there are hundreds of different paths leading to the summit, and that no one way is the absolute right way to get there. These are people who, when given all of the reasons in the world why something won’t work, can find ways to legitimately avoid those obstacles and make it work. Remember, “There’s a pony in there somewhere.”

Like the creator of the DiSC personality profile, let’s call these people the high “I’s: Initiative, influential, inspiring, impressive, interacting, and interesting.” They tend to accentuate the positive, eliminate the negative, and “Don’t mess with Mr. In-between.” They often do not embrace exact detail because to them it usually doesn’t matter. Theirs is a broad picture painted with pastels that blend easily into one another.

If you are a very meticulous person, both intellectually and emotionally, it is not uncommon for you to want things to be as perfect as they can be. This does not mean that neat people or conscientious people should be categorized in any way because multiple types can have these traits, but if you notice your neighbor on his stomach hand trimming the grass blade by blade with tiny scissors, be worried, my friend, be very worried. Let’s call these people the high “C’s.” They are conscientious, cautious, compliant, correct, calculating, concerned, careful and contemplative. They are the detail people. These are the folks who can discuss the use of one word in a sentence for hours. They represent the Faculty Senate, so to speak.

Without stereotyping anyone, let’s consider the person who made straight A’s all through school. They sometimes become obsessed with those A’s, and would go to almost any length short of cheating to make them. To a valedictorian, an A minus can represent a form of failure. How does this perfection addiction impact their thinking over a lifetime? Where do communication points break down with this type of “no one can do it better than me,” souls? When is enough enough as points are made and subjects are explored. If we don’t know the grading scale, we must continue to push the topic until we feel that it has been completely exhausted. This type of perfection can drive the “We live, we love, we die” people absolutely crazy.

In order for things to make sense to the “Cs,” everything must be linear; your sentences, your thought patterns, your decision making must all be orderly and logical. Black and white and perfection are usually the only things that will bring them comfort. Even with that, they many times will revisit the issue, question it again and again, and then let the person with whom they are attempting to communicate know that they are at fault because their communication techniques don’t match their C needs.

Another trait of these individuals is that they are usually risk averse, and, if you don’t answer them based on their detailed perfection level, some will consider you foolish or untruthful. So, how do we find the common ground?

Let’s face it. Communication can make or break a company, can ignite relationships …or end them. Neither group are bad people, we are just different, and goodness can and does come from both personality types. So, what is the answer to these communication problems?

First, we must recognize and then celebrate these differences. It is absolutely critical for us to find comfort zones and then to celebrate them. An “I” personality answer like, “We’ll figure it out,” may not be what the detailer is seeking, but it certainly is a valid answer. On the other hand the I’s could go that extra step to try to provide the “C’s” with what they feel will meet their needs (in as complete detail as possible).

And if you’re on the other team, make a solemn vow not to avoid the dreamers because a lot of science emanated from science fiction, and they are often times our creators, our artists, and our miracle workers.

So, as we “embrace the differences,” remember that it does “Take Two to Tango,” and that one of you can be creative while the other can strive for perfection. A team like that will never be caught short. As Steve Jobs said, “Your time is limited, so don’t waste it living someone else’s life. Don’t be trapped by dogma – which is living with the results of other people’s thinking. Don’t let the noise of other’s opinions drown out your own inner voice. And most important, have the courage to follow your heart and intuition. They somehow already know what you truly want to become. Everything else is secondary.”

In closing, it was Einstein who said, “Imagination is more important than knowledge…” So, let’s all imagine a better world, a world that is not run and controlled by the economists, but one that embraces the passions of our hearts and our emotions.

We really can have it both ways.

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Finding the Cure…for Bullying

January 21st, 2011

No workplace bullying - Nick Jacobs - healinghospitals.comThis week, NBC’s Today Show featured another story about bullying. As I have have mentioned in previous posts here and elsewhere, I believe that bullying is the quintessential cancer on our lives in places of business, in the military, politics, and relationships of all types.  The good news – actually the very good news –  is that there has been some incredible work being performed on this topic through the efforts of Dr. Matt Masiello at my former place of employment, the Windber Research Institute in Windber, PA.  Grants through the Highmark Blue Cross Foundation of Pittsburgh have fueled this initial effort and the academic and quantitative analysis being done by Clemson University has documented this work.  I believe that this joint effort is a magnificent  example of what can be done to change the future course of events currently being controlled by bullies.

The Today Show story that I saw featured the Massachusetts school where, due to cyber-bullying, a young girl committed suicide last year.  Apparently, another girl is now having the same experience at the same school. With the help of programs like this comprehensive anti-bullying program, the former Secretary of Education from PA, Jerry Zahorchak, (now Superintendent of the Allentown PA school system), embraced the effort to quell and discourage this type of destructive behavior.  And the program, under the direction of Dr. Matt Masiello has successfully been introduced across the  entire State of PA. (Matt had started the Allegheny County’s Goods for Guns program in 1994, when he was the head of pediatric intensive care at Allegheny General Hospital. To date, this program is responsible for collecting more than 11,000 illegal guns from the streets of Pittsburgh.) Matt has had the same success with this anti-bullying program. Now, both Massachusetts and Maryland are looking into embracing this effort.

This anti-bullying program is based on a European program with which Dr. Masiello had become familiar.  This is a school system-wide effort that is very well documented and results in tremendous awareness and reduction of bullying at all grade levels.

The trainers bring a group of teachers and administrators together in the school system, and then “train the trainers” as to how this effort can become part of the philosophy of the school.  They start the training in the spring, typically launch the school wide effort in the fall and run it for at least a year. During that time, detailed records are kept measuring outcomes.

Matt Masiello, MD - Windber Research Institute - Nick Jacobs - Taking the Hell OUt of Healthcare

Matt Masiello, MD

Matt is a wonderful physician, a truly giving person and a saint of a man who is the only U.S. representative on the board of the World Health Organization’s Health Promoting Hospitals program. I hired him before I left Windber Research Institute, and he has worked tirelessly to address both this problem and the problems of childhood obesity.

The Olweus Bullying Prevention Program (Olweus.org on the web, @Olweus on Twitter) has impacted more than 400 school districts and 20% of all school-aged children in Pennsylvania. It has also had up to a 50% reduction in student reports of bullying …and bullying others.

For more information, please contact me or Dr. Matthew Masiello at the Windber Research Institute.

Michael & Marisa’s anti-bullying song – “The Same”

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Light Up Night

November 20th, 2010

50th anniversary Light Up Night - Nick Jacobs, FACHE - HealingHospitals.comMy apartment is about two blocks away from Pittsburgh’s Cultural District and the same distance from the Sports District where the theaters, stadiums and plenty of restaurants are all nearby. Last night was the 50th anniversary celebration of “Light Up Night,” when the Holiday trees, choirs, and seasonal celebrations begin. Literally tens of thousands of people make their trek into the City for this special night. Zambelli puts on its finest fireworks display of the year, while lighted, horse drawn carriages, food vendors, and music fill the city. It is intended to be a special night for families, and last night was no different. Except for a few distractions.

Because my place is on a main drag and literally one apartment up from street level, activity sometimes feels like it is taking place directly in my living room. Most of the time, this reminds me that I’m alive and it is stimulating, exciting and always evolving. Last night, however, things were somewhat reminiscent of a war zone. Literally a block away, the Clemente Bridge was the staging point for some magnificent fireworks and the crowds were everywhere.

Not long into the celebration, however, it began to feel like Chicago during the filming of the Blues Brothers. Sirens were raging past my apartment at the rate of one a second to what could have been a gun battle. Instead, it was one gun and one victim with plenty of other potential participants standing by ready to mix it up. Then, a few minutes later, another burst of sirens went in the other direction toward an Irish Pub about a block from my apartment. There, another man had been shot. When the news came on, it was apparent that every available policeman in the City had been called to the Wood Street scene to attempt to keep things from boiling over as young men were escorted in handcuffs toward waiting police vans.

I am NOT a sociologist, but it seems very clear that this is just the beginning of what could literally escalate into a form of anarchy as we continue to pursue our current philosophy of greed in this country. While working on a grant a few months back I saw a statistic that was mind numbing. Young African American men in what are considered high crime areas of this city are experiencing an unemployment rate of about 75+ percent. The national average for young black men is about 45 percent and in Pittsburgh, with a few point differentiation due to my sometimes less-than-precise memory, that more global average jumps to about 55 percent.

This week, however, we heard that unemployment compensation would probably not continue to be extended, and last week we heard that education was only one of the potential targets for domestic budget cuts. Not unlike the hospital employees who consistently take all of the premium parking spaces so that their walk into the building is the very closest possible, there seems to be a breakdown in logic. If we don’t correct the problems that we have in our education system; if we don’t help people who have, for no reason of their own become jobless or disabled; if we stop caring about the middle class, and stop helping the poor to establish themselves; where will it lead as a nation?

My personal belief is that we can cut both domestic and military budgets; we can delay some gratification, and we can tweak some of the laws that allow profits to benefit the one or two percent of us who are clearly now in the elite class of protected citizens. The question is, can we do this in a way that does not destroy those who are struggling to survive? Take away the parking places, and you discourage patients from using your hospital which leads to lay-offs. Take away the safety nets, and we might soon have an out of control population that will cost us more than any of the tax breaks or safety net cuts give us. Let’s cooperate in repairing this mess. PLEASE.

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