• Stephen Harden

Thoughts on Organizational Culture and Leadership by President and co-founder of LifeWings Partners

Updated: Jun 7, 2018





Conversations with low performers are always hard to have. Nobody likes them, everybody dreads them. Consequently, they don't get done near as often as they should. Unfortunately, no one wins, not even the low performer, when the needed conversation is avoided.


I just finished a leadership training session with two hospitals in South Florida. Both are part of a very good five hospital system in and around Hollywood, Florida. The system is in the process of implementing the LifeWings Patient Safety System in all of their ORs. For several months now, my colleagues and I have been shuttling back and forth to Florida as we conduct leadership training, teamwork training for the physicians and staff, and create and implement Safety Tools like checklists, standard operating procedures and communication scripts.


Our session on Thursday provided the hospital and OR leadership teams the change leadership tools they needed to ensure the implementation was a success. I always stress with these executive teams the 80/20 rule - that is the leadership team will only devote 20% of the total time invested on the project but 80% of the success of the project will be be due to that effort.


One of the issues that always comes up is "What do we do with the folks that just won't change with the new culture?"

After leading these sorts of culture changing implementations for almost 20 years, my experience has been that, in a well run change initiative, about 3% of the workforce will never change, no matter what you do. Naturally, I have come to call them the "three per centers."


They make up the bulk of your "low performers." Regardless of what you call them, you have to have a conversation with them, and in that conversation, clearly indicate the consequences of further low performance, and BE ABSOLUTELY WILLING TO IMPOSE THOSE CONSEQUENCES if performance doesn't improve.


During our training session, I asked the leadership team if they wanted me to conduct a short session on how to have those conversations. It was at the end of a long day and I truly expected them to say, "No, we already no how to do that." I was a more than surprised with the almost unanimous exclaim from the group to proceed.


I ended up spending more time on the "why" than I did the "how." I pointed out that to do nothing was not an option...leaving the 3% undisturbed and in place was like leaving a cancerous tumor untreated. All of their hard work in moving the other 97% to higher levels of performance would slowly be undone as the 3% "anchor" dragged them back down to where they were to begin with.


I left them with this thought, "If you are not willing to have the conversations with the low performers, you might as well save your time and energy and not start on this implementation. If you don't challenge the 3% and move them up or out, you will end up two years from now being very frustrated that you haven't permanently changed your culture."


Later that night when reviewing the workshop with the system CMO, he told me the time they spent discussing the 3% was one of the most useful sessions of the day. I asked him why. He responded, "Because all the middle level managers want the hospital administrators and executive team to have all of those conversations. And they don't realize we can't be everywhere at once. If we are to succeed, each one of them has to take responsibility, and have the uncompromising willingness to speak up hold their employees and staff accountable."


He sounded like a TopGun pilot. I think he, and his hospital system, will continue to excel.

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