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  • 08/07/2018 - Richard Corder 0 Comments
    “The Secret” and Improving the Experience of Care (2 of 2)

    In the first blog in this series I shared Robert Frost’s poem "The Secret Sits"

    "We dance round in a ring and suppose,
    But the Secret sits in the middle and knows."

    I suggested that the "Secret" is the person at the center of care. The patient, their family, and their caregivers. Sitting "in the middle" and knowing what they need and want but lacking effective ways of sharing and the ineffectiveness of provider organizations’ current means of capturing that knowledge.

    Here are some ideas for how to improve the usefulness of your data capture to improve your patients’ experience at your institution.

    1. Get clarity about your current state
      • Understand your mandatory survey data like CAHPS (because they don’t seem to be going away) and remember the facts – most hospitals must only obtain at 300 completed HCAHPS surveys over the 12-month reporting period AND your choice of vendor to administer the survey is a "choice"
      • Augment your mandatory (and old) data with real-time, point of service feedback
      • Get out of your office and experience the care environment, listen and look, make your own assessment of your environment, paying attention to the tangible aspects of cleanliness, noise, food service.
      • Listen to your staff by talking with them directly, holding town halls and reviewing your staff surveys.
    2. Get clarity about your future/desired state
      • Craft and cast a vision of the future state
      • Make it measurable – how will you know when you’re on your way and/or there. Don Berwick is quoted as saying "soon is not a time, some is not a number"
    3. Get clear about the gap, the disconnect
      • Why aren’t we achieving the future state?
      • Where are the gaps?
      • Is this an issue of skill or will?
    4. Craft a plan to close the Gap
      • Craft a "Blueprint" to close the gap
      • Define accountability for change (my colleague, Maryann Sullivan, has written a simple review of how to establish this accountability.)
      • Get specific around work flows, resources, roles and responsibilities
      • Establish Service Level Agreements
      • Develop tailored training
      • Provide coaching

    The question remains, are you dancing around the ring and supposing, or are you listening to the secret?

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  • 08/01/2018 - Richard Corder 0 Comments
    Still Naked!

    Five years ago, I wrote my first blog – "The Emperor is Naked! Taking risks to reduce risk…"

    The title pretty much gives you a clear idea of the premise of the piece. I invited the reader to consider that the brave little voice in the crowd that points out that the Emperor is in fact naked – while all around them (including the Emporer) have been fooled into believing otherwise – is like the voice that speaks up in healthcare when something (or someone) is not safe, patient centered, or effective.

    Five years later I am still convinced that there are many in healthcare leadership roles that are still naked, and worse, they are surrounded by ‘loyal subjects’ that are too afraid to speak up and share this reality with their supervisor, with their ’emperor’.

    The questions that I posed in that blog remain relevant:

    • Does your environment promote or inhibit speaking up?
    • Are your co-workers and managers so confident and conceited that they sometimes don’t acknowledge what everyone sees as true?
    • Are people ignoring what the data shows for fear of embarrassment?
    • Do people perpetuate "how" things are done to go along with the "crowd" – or because it’s the way it’s always been done?
    • Are leadership team members willing to take the risks required to speak up and act differently? (to be that little voice in the crowd)
    • What are the risks associated with speaking and acting differently?

    What I’ve been reminded of over the past five years is that the driver of not speaking up is fear.

    Overcoming fear: of being wrong, of push back, of disagreement, or of embarrassment is the essence of accountable leadership.

    The reality though, is that often the fear of acting on our thoughts is misplaced. It’s the fear of the fear that holds us back. We tend to get caught up in mind games of what will people think and how will they react. What if someone finds out that I don’t know as much as I think I know? What if they think less of me? What if I missed something? What if…..

    Enough already! If the past five years have taught me nothing else they have taught me that the mind games we play with ourselves are exactly that, mind games. Speaking up, saying out loud what we’re thinking and asking the question that no-one else is willing to ask is not as big a risk as we think it is.

    Go ahead, try it. Not doing so creates more of the same, the status quo.

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  • 07/19/2018 - Maryann Sullivan 0 Comments
    Accountability: Buzzword or Basic?

    We hear a lot about accountability when we work in hospitals.  "We don’t have it."  "We should have it." "Why don’t we have it?" Is accountability just a buzzword that gets tossed around? Or is it a fundamental, basic concept that represents a mindset and a set of skills to implement?

    So what does it mean to be "accountable"?  The Merriam-Webster dictionary defines it as "answerable".  Hmmm, not very enlightening in a practical sense.  So here is my personal definition of being accountable for something:

    • There is an objective that needs to be met
    • I am willing to be publicly measured on meeting the objective, the "what"
    • I am willing to be publicly measured on "how" I meet the objective (behaviors employed)
    • I feel empowered to utilize my skills, tools and power to meet the objective

    Mix these elements together in a beaker and I can make accountable.

    How many things are you accountable for in your organization? Can you list not only the objectives but the measures, tools, skills and decision-making authority?  If not you, does someone else have the authority to meet the objective? If not, then no one is accountable for that objective. Well, maybe the CEO, by default. But how many specific objectives does/can a CEO really manage and run with?

    Accountability should be more than a buzzword. Organizations don’t function nor perform well without accountability.

    If you are responsibility for a major function in your hospital, start filling up your beaker by:

    • Listing your function’s objectives
    • Putting names by each objective of who is accountable for it
    • Thinking about how to give that named person the elements required to be successful (i.e. measures of success, power and tools to accomplish the objective)
    • Don’t forget to publish the results for all to see
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  • 07/02/2018 - Peter Tetrault 0 Comments
    Announcing the Launch of Our Sister Company: ConverSage.

    Built on more than 20 years of experience in healthcare, Wellesley Partners, Ltd. (WPL) announces the launch of ConverSage, a virtual training and learning company. Through its advanced education capabilities, ConverSage provides effective tools to empower clinicians to improve their communication skills.

    We’re excited to announce that our website for ConverSage is now live (www.conversage.com).

    The creation of ConverSage has been driven by our belief and evidence that the right conversation at the right time is critical for safe and effective care. We believe that every caregiver deserves to be equipped to handle the most important conversations.

    Please take a look around and if you have any feedback, please let us know on Facebook or Twitter.

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  • 06/06/2018 - Richard Corder 0 Comments
    Improving the Experience of Care: “The Secret”

    Robert Frost’s poem "The Secret Sits" is two simple lines of poetry, a couplet:

    "We dance round in a ring and suppose,
    But the Secret sits in the middle and knows."

    The meaning is left up to the reader. In healthcare, the "Secret" is the person at the center of care. The patient, their family, and their caregivers. They sit in the middle and they know, they just don’t have effective ways of sharing what they know or want, and healthcare is not very good at listening and responding accordingly.

    During a recent conversation with a client hospital executive, she shared some findings that shine a light on this disconnect between what patients want and what leaders think patients want.

    When she asked her leadership peers to list the priorities to improve the experience of care, they said:

    • New facilities
    • Quiet-time to ensure rest
    • Private rooms
    • Food on demand
    • Interactive bedside computers
    • Eliminate visiting hour restrictions

    When the patients of her organization were asked to list the priorities they sought in order to improve the experience of care they receive, they responded:

    • Treat me with more respect
    • Communicate better between each other
    • Listen to my needs / requests / concerns
    • Be more happy
    • Show more empathy

    Are you surprised?

    The reasons behind this disconnect run deep. For many hospitals, clinics, and doctors’ offices the methodology for capturing the voice of the patient (the data) is broken, the tools are clumsy, and what leaders are doing with the data is not resonating, not effecting change, and not very sophisticated.

    If I ran a restaurant in a like manner, it would go something like:

    You’re served a cold tasteless entrée, on the menu as a ‘hot delicious special’. You have no opportunity to share your feedback with your server; they’re too busy with other patrons, appear far from approachable, and don’t ask you whether this is what you thought you ordered. When you do muster the courage to say something you’re told that you’ll receive a survey in the mail, and you can provide your feedback there.

    Several weeks later the survey arrives in your mail box. You try and remember the meal you’re being asked about and reality kicks in; you’re likely remembering one or two experiences blended together, or you’re still so upset about the meal that you just let the restaurant have it…

    The restaurant owner and manager receive the survey, identify the waiter and ask him or her to improve their service…

    Without weaving this analogy further, you get the idea, oh and by the way, my restaurant would quickly go out of business if this was how I responded/reacted to such service failures.

    The signal, response and desired change feel like they are all disconnected. This is how many hospitals currently "measure" the experience of care, this is the data they use to reward and recognize, and this is the data that they use to "drive change".

    What’s missing is an effective system for better capture of operations data. We need practices that capture feedback as close to real time as possible and that use this information to inform operations. The data should be used to inform where training and education is needed to close the gap between the current state and desired state.

    Are you listening to "the secret" or dancing around the ring?

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  • 05/29/2018 - Tim Sullivan 0 Comments
    Corner-Turning Discoveries

    I have been a Coach and Career Development Consultant dating back 38 years to 1980 – which is also the same year that I experienced a rather profound Corner-Turning discovery. My discovery changed my career and my life. My transformation revolved around the utter simplicity of the discovery – by listening to myself differently, it was genuinely simple to make a life-altering change.

    Why take on this journey?  Because of the joy you can find. Coaching physicians all these years has been more of a vocation than an occupation. It is more who I am than what I do. I owe all of this to a very simple discovery all those years ago.  In this series, I will outline how I’ve helped others find their Corner-Turning Discovery. My hope is that the overall composite of these stories will aid you in your own life journey.

    My Story:

    I was an emotional train wreck a decade after leaving college. Despite the fact that I had actually experienced a great deal of success in two different careers: teaching/coaching/administration in prep schools for five years and sales/sales management for a major life insurance company for the next six years. On one level, I had everything. On another, I was flailing. I didn’t love talking about money all day. I started journal writing which helped. By writing, I was able to convert some of the high emotion to logic (my greatest strength and weakness was the same – a high level of emotion). So if my emotion was aimed at helping others in teaching or sales, I was terrific. If the emotion was aimed at me, I felt like a loser and very incompetent. I made some small strides in figuring out what was troubling me so. But I was lost and very STUCK in my own doom loop of hating my job (even though in many ways I loved it). I was incredibly frustrated that I could not figure out what was the essence of my problem as well as an accompanying solution.

    Finally, I came to understand that I was spending all my time focused on TODAY’s problems and TODAY’s solutions. A merry-go-round of frustration and angst. Then I realized that my training at the Northwestern Mutual was in helping small business owners get out of focusing on their financial woes of today and do some long-range planning. Creating a long term, financial strategic plan. I never saw the parallels until the day of the Corner-Turning Discovery, an insight that I had to find on my own.

    In hindsight, it was so simple. I asked myself a simple question: imagine being 55 years old and having had a blast for the intervening 25 years. This gave me my headline to forget about today and focus on building a personal strategic plan for Tim, Inc. That was my turning point. After that, it only took me 4 months to complete a plan for success. It should have been so obvious, but I had to take all of today’s pressure (mortgage to pay, children to educate, dreams of places to see) off myself to create a vision of hope and clarity.
    It worked.

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  • 05/22/2018 - admin 0 Comments
    Accelerating Patient Safety

    Our Partner, Richard Corder, was recently asked by the Betsy Lehman Center for Patient Safety to weigh in on the keys to accelerating progress in patient safety over the next five years.

    Leaning on Dr. Paul Batalden’s observation that every system is perfectly designed to get the results it gets, Richard suggests that leadership has built and promulgated these systems, and so leadership needs to fix them.

    Check out Richard’s response where he shares how the necessary leadership skill set, coupled with rethinking data collection, modernized approaches to training and the need for more standardized practices are going to be critical elements of how we change healthcare, and ultimately make it safer.

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  • 05/16/2016 - Richard Corder 0 Comments
    Black Box Enabled Surgical Suites?

    Medical errors are estimated to be the third leading cause of death in America. This is worth repeating – the THIRD leading cause of death in this sophisticated, educated, economic power house of a country is mistakes, errors, mishaps…

    Why aren’t we outraged? Why aren’t we paying more attention?

    I understand that healthcare, as a "system", is a complicated, ever changing industry that relies on fallible human beings to work well in complex, difficult to repeat situations each and every day. But, here’s the reality – healthcare is NOT alone! There are industries equally as risk-filled with far better safety records! Why is it that the same level of safety we demand for our automobiles or airline travel is not demanded to protect a life, our’s or a loved one’s, when we enter a hospital?

    There are many industries, other than healthcare, that work in complex environments where the actions of one human can impact the life of another. Healthcare leaders need to acknowledge the reality that we have much to learn from other industries. While we cannot mimic others entirely, the same general operating principles (including mindfulness that serves as the overarching organizational spirit) that are the foundation for other high reliability organizations (i.e.: aviation, nuclear power) can work just as well to prevent harm from occurring in health systems.

    One example of a safe practice or technology that could shared across industries is the in-flight data recorder found on all commercial airliners. It was because of the in-flight data recorder on board the two Boeing 747s that crashed into one another on the island of Tenerife in 1977 that we learned so much about the decisions and behaviors resulting in that game-changing airline disaster.  The time stamped voice commands of those at the controls were captured in real-time, and provided a blueprint of what "not to do" along with a snapshot of what needed to be changed.

    Now envision this: following a surgical procedure, regardless of the outcome, we have the opportunity to review every piece of data related to the procedure.

    We currently have the technology by which we can go back and look at thousands of time stamped data points to review and/or recreate events as they transpired in the operating room. We can capture voice, video, blood pressure, oxygen levels, numbers of plasma/blood transfusions. The data would stream from the medical equipment in the room, from the microphones, the cameras, and any other sources that we choose to capture, into a device that allows playback, review and re-enactment.

    We could assess team work, learn from the practice of those at the top of their game, and use this data to improve. We could revisit poor outcomes and learn what should be done differently in similar circumstances. This is not a pipe-dream, nor is it my idea; it has been developed and is currently being used and piloted by Dr. Teodor Grantcharov, a general surgeon at St. Michael’s Hospital in Toronto, Canada.

    An innovator if ever there was one.

    The choice to innovate is not, in fact, a choice – it’s an imperative.

    I firmly believe we have the expertise, the intelligence, the resources, and the creativity to make healthcare less costly, more effective, more patient centered, and far better. We need to give ourselves the permission to try, to innovate, to disrupt our environments in ways that lead to safer, more effective and more humane healing environments.

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  • 04/21/2016 - wellesleypartnersltd 0 Comments
    Site Launch

    Our new website is finally up. We’ve worked hard to get a beautiful new site ready and we’re proud to show it off. Thanks for reading our blog. We have lots of great blog posts in the works. Please check back or contact us now to find out how we can help you.

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  • 321
    04/14/2016 - Peter Tetrault 2 Comments
    3 Questions for Personal Development
    1. What did I learn today?
    2. What will I do differently tomorrow?
    3. How can I help?

    Answering these questions might seem easy, but ask these every day if you aspire to be a great leader. (Note that the first two are asked of oneself!)

    The human race has always sought answers – in religion, science, philosophy, government and on and on. We crave ever more information so WE CAN HAVE THE ANSWER! It’s how we are trained – from the earliest age: "Johnny, how much is 2+2?" When Johnny doesn’t know the answer he gets fearful, embarrassed and begins to have self doubt. Have you made someone feel like Johnny recently?

    Great leadership focuses on great questions that engage and provide motivation to those we strive to lead. I’ll bet on an organization motivated by great questions working as a team as opposed to one with little or no room for creativity. (For a good discussion on leadership read Edgar Schein in the Annual Review of Organizational Psychology and Organizational Behavior:  http://www.annualreviews.org/doi/pdf/10.1146/annurev-orgpsych-032414-111449)

    I have a favorite saying: "A problem well stated is a problem half-solved." (Thank you Charles Kettering!) Problems are better defined by asking questions – and asking the right questions brings about an institutional focus that will deliver results through innovation and creativity.

    So, the next time you start looking for answers, take a step back to review your current circumstances and to make sure you’ve asked the right questions. How can I/we help?  

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  • Career building stages
    11/12/2015 - Peter Tetrault 0 Comments
    3 Steps to Help Attain Career Goals

    As Millennials continue to age they will continue to gain power and influence in the workplace as us Boomers leave the stage for retirement – whatever retirement means today.

    In 2020, a short 4 years from now, the leading edge of Millennials will be turning 40 years of age. As age 40 is firmly in my rear view mirror, allow me to share a small preview of things to come.

    As any ophthalmologist will tell you, around the age of 40 your eye muscles will start to lose some elasticity. The impact? Your will notice that you, or some of your peers, will need help in order to easily read. And for those that already have worn glasses, the advent of progressives lenses, or bifocals, will appear on the scene.

    Bifocals are both a blessing and a curse. They are difficult to get comfortable with, yet they prevent the nuisance of constantly taking along 2 distinct lens prescriptions. Look through the lower half, and you can focus on what is close to you. Look through the top half, and you can see clearly into the distance. The key is that you can see clearly, no matter how far away the object of your sight is.

    Your career view needs bifocals

    You and your current employer, or entrepreneurial effort, needs your focus and attention. For most this is easily done – many people live almost entirely in the present. Focusing on the present, the near term, helps insure your current success and helps define your next career step.

    But, don’t forget to look at the long term too – raise up your eyes and look through the top half of the bifocals into the far away distance. Are your short term career moves in sync with your vision of where you want to be 10 years from now? Is your current work effort leading you to a next step that will be closer, or further away, from your long term goal?

    If you have been neglecting your long term goals try this:

    1. Write down what you want to be doing 10 years from now
    2. Write down how your current work effort is either leading you closer or further away from your goals
    3. Write down 3 things you commit to do in the next 30 days that will improve your chances for achieving your long term goals

    Integrating your near term decisions and actions into your long term goals is more of an art than a science. The one deadly action isn’t getting it wrong; it is not spending the time trying to get it right!

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  • wordle
    10/09/2015 - Peter Tetrault 0 Comments
    4 Options for Dealing with Too Little Conflict

    When is the last time you had an animated discussion at work with one of your colleagues? If you can’t remember when, I suggest you have four primary options:

    • Look to reposition yourself inside your organization
    • Start looking for your next career stop
    • Learn how to overcome your fear of conflict
    • Accept that you have become part of "the machine" (problem)

    When we are fully committed to our work our commitment is manifest by energy, moral courage and a willingness to stand up for what we believe to best for the organization. Sometimes, this commitment will go against others and/or the status quo of the organization.

    Conflict is the mother of collaboration. When people aren’t committed enough to openly state and resolve differences of opinion there is little chance for change and improvement.

    Standing up to authority is critically important for organizations to learn and grow. If you are out of practice, or simply not wired to engage in spirited debates, you need to find the skills and experiences necessary to raise your concerns and ideas to others. When you do, you will probably find that your concerns or ideas are shared by others – most often we are not alone – but the fear to discuss important topics at work can keep us silent and that makes us think we are alone. Learn to be more afraid of silence than of potential conflict.

    Words to live by: you don’t have to enjoy conflict – just get good at it!

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  • Summer Sun
    06/15/2015 - Peter Tetrault 0 Comments
    4 Questions for Career Decisons

    Summer has arrived – three cheers (and 4 questions)!

    Whatever your choice of summer time fun and relaxation, I have a suggestion – use some of those free mental moments to think about the current state of your career and "what’s next". Invest some time now in order to help you make your career take off when Labor Day arrives.

    While getting some sun at Marconi Beach…

    1. "Am I on the right career path? Do I love my work?"

    If you can easily answer this question then skip the rest of this paragraph. If you can’t – have you built your personal score card? What are your motivators? Financial, emotional, prestige, integrity? What do you truly value? If you haven’t explicitly defined what you value how can you know if you are achieving what matters most to you?

    While riding the ferry to the Vineyard…

    1. "What are my top strengths – when someone at work seeks me out, why do they do so?"

    Make sure you not only know your signature talents, but that you have taken the time to package your key strengths so that they can be easily seen and understood by everyone. You may find new opportunities in your current workplace simply by doing more of what you love doing now.

    While you await the beginning of the performance at Jacob’s Pillow in the Berkshires…

    1. "Why do I continue to sabotage myself by doing _______ (fill in the blank)?"

    Answering this one may require the assistance of someone whom you trust completely, like an executive coach, to provide some honest feedback – something we should get at work, but rarely do. What blind spot of yours trips you up time after time? (Nobody gets away clear on this one – and by definition we need help to identify blind spots!) If you don’t know it’s a problem you won’t work to fix it. We all have things to fix!

    As the birds wake you in your tent at Lake St. Catherine…

    1. "It’s June 2018 and I’m in this exact spot – I’m the most fulfilled I’ve ever been at work. What am I doing and how did I get to this point in my career?" (Imagine you are writing a speech to people who are important to you.)

    Putting your mind into the future and looking back (appreciative inquiry) is a simple yet powerful tool that helps us leave behind the minutia of the present and to orient our thinking to the longer term and the big picture. And don’t forget to have a pencil and paper handy – having your ideas written down will help when you are back at work and up to your eyeballs with "to do’s"!

    If you need help with any these questions, you may need an executive coach. Already have one? Great! If not – make getting one a priority when you get back from your summertime fun! Enjoy!

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  • MD per 100,000 population by state
    04/08/2015 - Peter Tetrault 0 Comments
    Reduce Non-Clinical Classroom Time for MDs
    Physicians per 100,000 population by state (2011)

    Physicians are some of the most time squeezed professionals on Earth. Whether practicing at a hospital, or as part of a care delivery organization, physicians must keep up to date clinically while they serve their panel of patients. Additionally, many physicians are doing research or have management responsibilities within their organization. Lastly, in order to be a practicing clinician within their organization, these same physicians are required to learn the technology systems used in order to document their clinical encounters (mostly EHRs). How do most organizations train their physicians? In classrooms watching trainers move through PowerPoint slides while lecturing. Do we want our physicians spending up to 20 hours of their time in classrooms learning to use an administrative system? Physician staffing shortages are a reality. Utilizing their time for non clinical activities only exacerbates a bad situation. Most believe there are not enough Primary Care Physicians in the U.S. today, and the situation is only getting worse. (See Chart) According to the Association of American Medical Colleges, there were 744,224 licensed and active physicians in the U.S. in 2011. Of those, 208,802 were aged 60 or older. At the same time there were 80,279 enrolled in the 137 accredited U.S. medical schools. Assuming no attrition, medical school graduates transitioning into their clinical residency (3 to 7 years) will average 20,070 per year, fewer than those retiring. There must be a better way to train physicians then spending the equivalent of 1,875,000 eight hour shifts (750,000 physicians times 20 hours training divided by 8 hours per shift) learning how to properly document a clinical encounter. Virtual Immersive Learning is one solution. Can you recommend others?

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  • Maximize your training $ ROI
    03/31/2015 - Maryann Sullivan 0 Comments
    2 Modalities, 1 Goal: EHR Learning

    Recently, I was talking with a top tier EHR trainer at a very large regional health system. She told me that while their EHR vendor had a strict requirement for all trainees to take the standard EHR training courses, including eLearnings and classroom training, when a team of Emergency Department clinical staff began to use the new EHR they were unable to efficiently and effectively apply what they had learned. Why? Because they were so lost they didn’t know where to begin. According to Wikipedia, "E-learning(or eLearning) is the use of electronic educational technology in learning and teaching."  (http://en.wikipedia.org/wiki/E-learning ) But "e-Learning" is frequently as simple as a few PowerPoint slides with a simple test to take at the conclusion of the slides. Static PowerPoint based eLearning gives you assurance that your staff has seen the material. They have probably even understood some of the information. But this modality gives you no insight into whether or not the staff can apply what they’ve learned in a realistic, job-oriented scenario. In contrast, adaptive or virtual immersive training provides adequate integration, realism and immersion (the learner must engage with their full focus to make it through the training) that you will know for certain that your staff is ready to go.According to Wikipedia, "immersion into virtual reality is a perception of being physically present in a non-physical world. The perception is created by surrounding the user of the VR system in images, sound or other stimuli that provide an engrossing total environment." In layman’s terms: when your staff has experienced Virtual Immersive Learning they have already worked with your new EHR in their actual work role.

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  • 9-info-tech-e1389127561311
    03/25/2015 - Maryann Sullivan 197 Comments
    3 Benefits to Virtual Immersive EPIC Training

    Many hospitals are implementing or updating EPIC EMR software. When we inquire as to what clients need they tell us that they need training that is engaging, effective and efficiently delivered. Historically, go-live has meant resources working at sub-optimal levels as users ramp up their knowledge and comfort with the EPIC system. The cost, in efficiency, of this learning curve is substantial and incremental to the already extraordinary out-of-pocket costs associated with the classroom training that is the current industry standard training approach. There is an alternative. WP Virtual Learning has built and delivered a virtual, interactive training capability that replaces classroom training. Where individual instruction is required, avatars, videos and scenes with voice overs replicate the true-to-life where the learner actually works. This is far more realistic than a classroom setting. The learner responds to "live" patients, the actual screen they will be using and the correct workflow exactly as they will be doing when the software is implemented and "live". A few reasons why this approach is more effective and cost efficient: • In one example, we reduced a 4 hour classroom training session (exclusive of travel time) to 2.5 hours • The training will be available for refresher courses, new hires, job changes, etc. • The learner is fully engaged at all time, not waiting for instructors or classmates to catch up, not checking email or texting a friend. The learner must stay engaged throughout the training to move forward with the session This new-to-healthcare paradigmof training will change the way training is delivered throughout the industry. Why? Because the current classroom-based training is just not up to the task of delivering what healthcare organizations need.

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  • blog ehr 1
    03/16/2015 - Maryann Sullivan 0 Comments
    5 Reasons to Use Virtual Immersive Learning for EHR Implementation

    If your organization, like most, is now dependent upon an "Electronic Health Record" (EPIC, Allscripts, Cerner or Meditech) then you really need to be looking at changing the way you deliver training to the clinicians and schedulers who are now reliant upon the system for doing their work. Classroom training, the current standard for most training delivery, is extraordinarily expensive. Because it’s expensive, many organizations cannot devote enough staff time to training, leaving those who use the system frustrated and inefficient during patient interactions. Introducing Virtual Immersive Training for Healthcare System Training Using a virtual instructor and avatars, virtual training: 1. Measurably improves the effectiveness of training, whether complex or simple 2. Significantly reduces the time spent by your staff engaged in training (travel and training time) and allows self-paced 24/7 access 3. Significantly reduces the cost of training delivery (trainers, rooms, computers ) 4. Increases staff satisfaction by training them on their actual job versus generic transactions 5. Frees up resources to help clinicians personalize the use of their systems to increase their personal productivity While virtual training for "go live" will deliver significant benefits, having virtual, high quality training available as needed can deliver consistent and long term benefits to the bottom line of your institution as new hire and refresher training needs are met with no incremental costs. If you’d like to see a short video of the virtual capability, please click here.

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  • 03/11/2015 - Maryann Sullivan 0 Comments
    Virtual Immersive Learning: The Preferred Training Solution

    In educational psychology, research shows that for instruction to be effective, it has to be engaging and meaningful. Learners need to be provided with active roles in their learning and learning has to make sense from their point of view. With simulation, or role playing, the student has an active role where he or she is involved in cognitive or behavioral interactions with the learning event.

    In the training industry for virtual immersive learning products, there are four levels of interactions or interactivity. What characterizes level 4 simulation training from levels 1-3 is the addition of a real-time, or immersive, aspect into the training setting. Level 4 simulation training replicates significant features of the real world in a fully interactive fashion.

    Level 4 simulation training allows individuals to learn and practice real world activities in a safe, realistic and secure online environment. Virtual immersive learning simulations are timed so that responses are measured in terms of appropriateness within the context of the situation. Level 4 training ultimately provides time and cost savings to customers by reducing the time required to train and by increasing the effectiveness of the training.

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  • Scary Boss
    12/11/2014 - Heather Holmes Floyd 0 Comments
    Ways to Deal with A “Scary” Boss

    You pick up speed walking to the elevator or duck into the men’s room if you see your director approaching. Just trying to avoid a stressful interaction. You’re a professional, and good at what you do, yet you live in fear of your boss calling you out or judging you negatively. Avoiding your boss because of the fear of a potentially negative outburst is a huge distraction – both to delivering your best, most creative work and to your long term career. Whether your fear is based in reality, or not, here are some thoughts to help you to move past your self-defeating behavior:

    • Misplaced fear: could your emotions really be a fear of something or someone else that you’re attributing to your boss? Not sure? Why not call your coach and talk this through to find out what’s really bugging you?
    • Exaggerated fear: Is your boss stressed out and you’re getting the brunt of it? While your boss’s behavior may make you feel uncomfortable, odds are this will pass if you are not the cause of the boss’s outbursts.
    • Self fear: Do you, in your heart of hearts, know that you could, or should, be doing better or differently? In either of these cases the shortest way to resolution is to tackle the issue head-on. Are you avoiding your boss in order to avoid validating that your fear is based on your self-knowledge that you are, to some degree, actually failing? Sitting down with your boss may be exactly what you need to help map out a plan for improvement.

    If the thought of a meaningful sit down with your boss seems impossible, ask your coach to do some role playing with you to help you find the correct tone and words for a positive conversation with your boss – other than you, the only person with the power to change the current dynamic. Creating value by anticipating your boss’ needs and consistently delivering against your responsibilities is sure to help reduce your fear factor. Regardless of the cause, fear of your boss is bound to have a negative effect on your performance. Turn your fear into a motivator for change. Work to get to the root cause. After successfully working on this, you can breathe a sigh of relief, stop avoiding and, instead, begin to reclaim who you are at work while focusing on your personal and professional growth and success. ….and you might want to hold that elevator the next time you see her coming!

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  • Fear wordle
    07/24/2014 - Peter Tetrault 0 Comments
    The Fear Cycle at Work

    When is the last time you experienced, or witnessed, the outward manifestations of fear at work? Last year? Last month? Last week? Yesterday? How well did you deal with it? If you have room for improvement, read on. One of the most common issues I see as an executive coach is the failure to act. In the extreme, people give it a name: procrastination. It comes in many different flavors, but at its root there is a reluctance to proactively make change for the betterment of self, team and/or organization. Early on in my coaching career I attributed this phenomenon to either a lack of commitment to a goal or a lack of skill within the individual/team/organization. In reality, the failure to act can be founded in a much more fundamental primordial response – fear. Not so you say? Fear is supposed to generate either a fight or flight response? It does sometimes, but not always. Here are some observable fight responses to fear in the workplace. When afraid, some individuals decide not to flee – so driven by fear, they respond by:

    • Failure to delegate
    • Take credit for everything "good"
    • Pass the blame for everything "bad"
    • Don’t mentor
    • Retain all decision making authority
    • Have no succession plan
    • Avoid risk
    • Over control
    • Micromanage

    All of these behaviors are polar opposites of what we think of when we think of effective leadership. If you, or your boss, exhibit these behaviors its time for change! We may fear many things: our work environment, our subordinates, or ourselves (fear of failure or success). When fear manifests itself in observable behavior we tend to address it, organizations build "solutions" to visible signs of management dysfunction. But what about procrastination? Procrastination is to leadership what heart disease is to health – a silent, deadly killer! You can try to avoid fear (choosing "safe" work environments), accept it (surrender), or adapt to it (experience, learn, process) and move forward. To learn to successfully convert fear into positive behavior can be difficult on ones’ own. Use your coach to help you build the process that works for you.

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  • 04/15/2014 - Peter Tetrault 0 Comments
    Listening Skills for Improved Work Relationships

    If you’ve worked with one of our coaches, you’ve heard of "the 94%". One of Tim’s most tried and true models, he created it after reading a magazine article where a psychologist stated that 94% of the time people view events through how it impacts them personally. (The article was a long time ago – we can’t find it for attribution. Free cup of coffee to anyone who can find it for us!) Tim’s interactive model of behavior, when followed, helps two individuals through a process where each can be heard and, in turn, listen to another’s 94%.

    Why did this idea strike a chord inside of Tim? Because he intuitively understood that individuals in the workplace are often at odds over some goal, process or "territory" because they are personally invested in their view, or opinion, being right and have stopped listening and being open to new or competing ideas. (After all – who holds onto personal views when they themselves believe them to be wrong?)

    Per Chris Argyris:  "There seems to be a universal human tendency to design one’s actions according to four basic values: 1) To remain in unilateral control; 2) To maximizing "winning" and minimize "losing"; 3) To suppress negative feelings; and 4) To be as "rational" as possible"1. Or, as John Kenneth Galbraith said: "Faced with the choice between changing one’s mind and proving there is no need to do so, almost everybody gets busy working on the proof".

    With this naturally occurring intransigence, how in the world do people come to consensus about anything at work? With no consensus there can be no innovation or new course plotted. Simply put, no consensus results in the status quo being supported and maintained – again! Enter Tim with the ability to teach individuals how to break down the fortified bunkers of the adult mind through listening and constructive dialog. Are you or your organization stuck? Are you unable to reach consensus in order to create a plan of action to make things better? Learn how to quiet oneself in order to engage others through listening. Learn how to practice being open and how to help others do the same. Learn how to apply "the 94%".

    1)   Argyris, Chris. Teaching Smart People How to Learn (Harvard Business Review Classics) Harvard Business School Press (May 19, 2008)

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  • 04/08/2014 - Maryann Sullivan 0 Comments
    Academic Health Centers: New Models Needed

    In their article Transforming Academic Health Centers for an Uncertain Future, published in the New England Journal of Medicine, Dzau et al from Duke University School of Medicine argue that AHC’s must rethink how they deliver on their core missions. Given the transformation of health care delivery that is occurring, due in large part to severe funding constraints that taking place, we agree. The advice offered in the article is largely sound: AHCs should focus on care redesign, improve the "yield" of research funding, streamline medical education using state-of-the-art techniques and reduce the impact of decentralized decision-making.

    As we said in our 2012 article, "Effective Organizational Model for the Health Care Delivery System of the Future", taking on enormous challenges at the enterprise level is virtually impossible. While it is true that today’s "ultra-decentralization" of management decisions is a major barrier to organizational improvement, it will also be true that ultra-centralization will not work either. One solution will not fit every problem. As management consultants who work with large, successful AHCs on topics including organizational development, it is painfully obvious to us that new management models for AHCs are critically important.

    The current ponderous, decentralized decision-making process slows managerial innovation to a crawl, sub-optimizes every dimension of organizational effectiveness and is extremely cost ineffective. However, the challenges facing AHCs are extremely complex and developing solutions that are more effective are unlikely to originate in the "C-Suite". Large for profit corporations learned this lesson many years ago and healthcare needs to draw from that experience in order to avoid the wasted time and costs of re-creating the same mistakes. Driving decision-making to a "business unit" level (or Service Line in healthcare language) is the only way to effectively deal with complexity at a speed that keeps pace with market forces. These lessons are well known and documented in the literature of for-profit organizations. They will hold true in healthcare as well. Healthcare leadership, i.e. Boards, CEOs, and physician leadership need to leverage the lessons learned from "corporate" experience. We recognize that the nonprofit mission is different, and that not all lessons from the for-profit world are transferrable, but this is one idea that is essential for AHCs to remake themselves in a timely manner.

    Dzau VJ, Cho A, ElLaissi W et al, Transforming Academic Health Centers for an Uncertain Future. NEJM 2013; 369;11.
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  • Time to change
    03/11/2014 - Heather Holmes Floyd 0 Comments
    4 Actions to Re-energize Your Career

    My most motivated clients never get lulled into thinking that their current position/job is where they need to remain. When they talk about creating a new challenge from what is possible, rather than from strict necessity, their motivation to figure out what could possibly come next becomes infectious. In my recent work with a physician, it became apparent that her passion for medicine was old and needed to be renewed. Her alternative was to look elsewhere to bring passion into her career once again. Use these steps as a spring board to achieve "what’s next".

    • What would I like to change; what needs to be different?

    There is no need to settle for the status quo. Our clients find their passion in looking at: Who am I; What do I want and How do I get there? It’s a refreshing exercise and often yields a fresh perspective. Create that fresh vision and then build your goals and strategies to achieve them. If you want different results, it’s time to make a shift.

    What is that dream or idea that you just can’t seem to get yourself to focus on, work toward or reach? Perhaps it’s time to acknowledge its importance and commit to doing it (assign a deadline). Maybe the dream doesn’t fit anymore and you should let it go. By making choices you will begin to separate out what is really important to you and what truly deserves your time and commitment.

    • Act on "Aha" moments in your life:

    What have you learned about yourself that you should be paying more attention to? "Aha" or peak moments can be those that propel you forward or are stumbling blocks and barriers. Invest the time to reflect on these moments and learn from them. What do you want to repeat or never do again?

    • Create your own Individual Development Plan (IDP):

    Creating a personal strategic plan is helpful and can get you on your way to seeing what’s next. However, if it goes into hiding in your desktop or desk drawer, it’s not useful. Schedule a time to review it regularly: once a week, once a month or at a significant time (your birthday, annual work review, anniversary, etc). Put it in your calendar like any other work or personal appointment.  As you review your IDP, be sure to include thoughts from the above 3 points. These are easy ways you can invest time in yourself – your career – and make sure you are consciously pursuing your passion. The world is constantly evolving and changing – don’t you want be changing as well?

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  • 02/24/2014 - Heather Holmes Floyd 0 Comments
    5 Ways You May Be Blocking Your Own Success

    Have you succumbed to any of these self-defeating habits? What, or who, is standing the the way of your success?

    1.) Your saboteur’s voice is louder than your own:
    How loud is the voice in your head that tells you that you can’t, you’re not smart enough, don’t have the time, the talent, the resources to do what you really want to do with your life? Turn the volume down on the excuses and turn up the voice that knows you can and want to be successful.

    2.) You’re too busy:
    You’re moving too quickly, you’re stressed, there’s no time to slow down to figure out what needs to change. There is a barrier in the road and you "can’t" devote the time and energy necessary to move it out of the way.

    3.) You have no roadmap (or definition of success):
    You get in your car to program your GPS and don’t have an address. How can you possibly get there if you don’t know where you’re going? In terms of your personal success, defining our values, goals and vision of where you’re ultimately headed is the minimum you will need to get there.

    4.) You’re a firm believer that if you want something done correctly, you must do it yourself:
    There’s not enough time in your day to do it all yourself. What would it look like for you to delegate and give up some of the control? Teach those around you how to fish, rather than spending time out on the high seas and coming back with fish for them. Surround yourself with a talented team and then let go of their jobs.

    5.) Have you become overly cautious?
    That’s right, it’s about putting yourself out there and taking risks. How can you push beyond your comfort zone while daring to believe in you?

    The Executive and Leadership Coaches at Wellesley Partners are well versed in helping individuals (and teams) discover their meaning of success and helping to create the road map to get there.

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  • 11/18/2013 - Maryann Sullivan 0 Comments
    5 Must Haves for Clinical Transformation

    As consultants we help our clients deal with the extraordinary change in the health care industry. While we celebrate the many wins our clients achieve, we can also become discouraged at the slow pace, or complete lack of, change that we see in many institutions. We see the toll it takes on leaders and staff. This is why we were so intrigued when we heard about a hospital that has made an extraordinary leap in their patient satisfaction scores while also improving outcomes and quality. We felt compelled to find out why – how had this institution succeeded where so many others were struggling?

    In our latest whitepaper, Harrington Hospital Success Story: the Five "Must Haves" for Clinical Transformation, we identify real world levers that are available to create lasting, real world, change.

    For example, the role of the CEO is "frequently carried out as a facilitator between Board Committees and the physician staff of the hospital." In the case of Harrington, Ed Moore took a different approach. He demanded the entire community: administration, clinicians, and the Board itself strive towards achieving better outcomes than historically seen. He backed up his approach with action (removing the change resistors) and he personally attended to the details using frequent meetings to assess progress and retain focus. Continue on to the whitepaper to read more on how simple it is to change, even though it isn’t easy!

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  • 10/11/2013 - Heather Holmes Floyd 0 Comments
    Physician Leaders: piloting the ship, or going down with it?

    I’ve worked with and studied a lot of physician leaders. They have all been excellent clinicians, surgeons, and care givers. However, when tapped to lead (a clinic, department, or hospital) there is sometimes a lack of experience and skills that are needed to be an effective leader.

    Trained as experts to make life-saving decisions, doctors are sometimes reluctant to listen to others’ opinions. Sometimes this is the result of a conscious decision and sometimes this is a result of an unconscious decision – which can be the result of the type of training they have experienced. Typically this trait of taking a "rely only on myself" quality is most pronounced when multi-tasking, under stress or in times of change, all of which a leader faces on a regular basis.

    As we have all seen, leaders have significant impact on the individuals and teams in their organizations. This impact can be either very positive or very damaging. So, when you’re looking to promote a talented physician (and this also applies to other clinical staff as well) to a leadership role, please consider whether or not they possess the following qualities:

    • Good listener: one who can consistently listen and be open to others’ opinions and perspective. Is it "my way or the highway"? Do they always need to be right or act like they have something to prove?
    • Effective communicator: can this person talk to their peers, other leaders and subordinates with the same degree of effectiveness? Can they deliver difficult messages in a constructive manner?
    • Collaborates/relates well to others:  does she/he behave in a way that indicates a core belief that functioning as a team is a preferred and productive way to manage? Or, is it more about the individual and trying to outwork any issue or challenge that needs addressing?
    • Has a shared group vision: is there a singular agenda or is this person open to what is best for the team and organization?  Sometimes called collective thought—there needs to be a clearly defined mission, with ways to measure milestones, successes and, inevitably, failures (so you can learn from them).
    • Will lead, not dictate: ask yourself if this individual is truly a team player and willing to continue to roll up his/her sleeves and do the work and lead by example, not just sit behind a desk in their new corner office expecting the work to be done as they dictate.
    • Humble: Finally, I’ve found that being humble, open and willing to learn goes a long way. Yes, practitioners at this level have become experts in their specialty.  However, when steering a larger ship, there are new qualities, skills and tools that need to be learned and integrated into their job. Are they humble enough to realize this and to do the development work that is required?

    If the clinician you’re looking to promote has at least 3 of the above qualities, then there’s a good chance they will become successful and effective leaders. We all know it takes a solid foundation of non clinical skills in order to effectively navigate the stormy waters of clinical leadership.

    If you have an already promoted a leader who needs some skill development, contact us. Or if you have a practitioner who you’re thinking about promoting and have some nagging questions, contact us. Coaching for skill development is what we do. Let us help!

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  • 05/20/2013 - Peter Tetrault 0 Comments
    To go farther, recommit to your team

    Working with people in teams can be challenging and exciting. As unique individuals, we bring all of ourselves – including moods, cultural background and our personality traits – to work every day. Then we bump into our co-workers with their own uniqueness and the fun begins!

    Sometimes we attribute workplace frustration to the complicated nature of teamwork. When we experience feeling stuck or blocked at work is when we are more likely to engage in behaviors that are focused on relieving our emotional frustration instead of achieving organizational goals. For those of us who are uncomfortable having direct, open and candid conversations it can become a habit to look for workarounds in order to avoid what makes us uncomfortable. One of those workarounds can be to withdraw somewhat from the team and to act unilaterally. This type of short term focused behavior will not help us make progress toward our long term career goals.

    Recently I ran across the (reportedly) old African proverb "If you want to go fast, go alone. If you want to go far, go together."  Regardless of its origin, what a great sentiment!

    Do you sometimes "go alone" when reacting to work frustration? Going alone – by prioritizing individual goals, making unilateral decisions and attempting to amass power in order to gain control over one’s situation – can provide the feeling of relief. But is that progress? And if it is, to where?

    Sometimes working with others on a team can feel slow. Wouldn’t it be better if we were to "go alone" in pursuit of our goals? After all, a lot of time and effort is involved in building team chemistry and alignment. Don’t be fooled into focusing on short term feelings and frustrations. Instead, choose to be open to the sustaining and fulfilling nature of teams and the positive impact it has on our long term success.

    Your career is a long term event. To have a rewarding journey – and to make it fulfilling over a longer time – make sure to go with others. Any short term delays encountered by traveling with others will, over time, reveal themselves to be inconsequential.

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  • 05/13/2013 - Tim Sullivan 0 Comments
    Lap 2 – A Key Skill For Organizational Change

    Many years ago, I created a metaphor for a cognitive model that addresses a prevalent problem for our clients that I repeatedly observe:  large projects which are stuck, costly, maddeningly slow. Our clients attribute the main cause of this enormous problem to the highly matrixed nature of their organizations.

    After considerable analysis, we found structure to be a factor, but not the root cause issue. We created a simple model of skills, or lack thereof, to provide a better explanation. We created the following metaphor of the four different laps in a relay race to describe the skills that are required for a large project. First, the model:

    • Lap One Skills – a person with the ability to very rapidly understand the "gestalt" of the business leader, to build trust with this "client". This person is flexible, mentally quick and deeply empathetic. While this is an extraordinary skill, one which is vitally important to the success of large projects, many times this person is not skilled in the hand-off to someone who will create action and implement a solution.
    • Lap Two Skills – given the high level understanding of his/her Lap One colleague, the Lap Two person is like an architect. This person has the patience and experience to think the project through on multiple levels:  from high level vision to details, from technical barriers to organizational barriers, from the strategic to the tactical and with both a bias for action and a process focus.  One of our best Lap Two colleagues calls it "let’s go slow to go fast."  The best Lap Two people I know, however, get very bored with the detailed execution.
    • Lap Three Skills – the General Contractor. Given a blueprint from a Lap Two colleague, the slogan here is "give me the right resources and I’ll bring this project in on time and on budget." This person is a brilliant juggler of resources, a "can do" person, oriented to tracking down and dealing with multiple and varied details and a communicator of status, issues and milestones. The General Contractor loves detail, execution and results.
    • Lap Four Skills – a close cousin to his/her Lap Three colleague, the Lap Four person has chosen to be a specialist and less of a general manager.  He/she "does windows" or plumbing or electric. Focused, quiet and a very key player to their team, the Lap Four person revels in accomplishment of tasks and in being the "go to" person for their specialty.

    The "perfect" Lap Two profile is found in less than 5% of the population. The lack of these skills is the single biggest cause of failure of leadership of large projects. Without a Lap Two designer, our Lap One visionary tends to provide too little direction to the Lap Three General Contractor who can unwittingly begin to progress toward a slight variation of the vision. Over time, expectations are not met, huge disappointments and frustrations can ensue. Roles and responsibilities are not likely to be clear because there is no document laying out the overall march.  Lack of accountability, confusion, turf orientation, frustration and anger are the symptoms of the dysfunction.

    My advice? Locate your Lap Two folks and treasure them, coddle them and have them do "their thing" at the beginning of each important initiative.

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  • 03/14/2013 - Maryann Sullivan 0 Comments
    Are healthcare providers hearing the wake-up call?

    Sometimes the last people to know that an organization is about to hit a catastrophic iceberg are the leaders of the organization, even though they spend millions on writing strategic plans to avoid such an event.  It can be too devastating to leadership to consider that one’s oftentimes beloved institution, with a culture that has one’s own stamp on it, grown by close colleagues, is about to be threatened to its very foundation.  It can be too devastating to acknowledge that our beliefs may no longer be true, our skills may no longer be adequate, and/or our very way of life within the institution needs to change.  Adults hate change…why look into the abyss?

    I’m actually worried for the hospital systems of the U.S.  I don’t think they realize that the game may be changing so radically that it may feel like they’ve hit an iceberg, regardless of the fact that they are wealthy institutions, rich in capital and knowledge.  Consider the following recently publicized facts:

    I. The largest company dedicated to meeting the health and well-being needs of Medicare beneficiaries (UnitedHealthcare) and the largest retirement community in the country (The Villages) have formed an exclusive relationship designed to create "additional health benefit options and facilitate coordinated, comprehensive care" at a new patient-centered health system for Medicare consumers.

    • Threat:  The payer has hired the primary care staff, including MDs, and bypassed the traditional health system, except for specialty care which it will better control.

    II. The proportion of companies with more than 20,000 employees offering High Deductibles went from 41% in 2007 to 59% in 2012. "If we’re not already at the tipping point for [consumer-directed health plans] — and we may well be — at this rate of growth, it’s coming soon," said Sharon Cunninghis, Mercer’s U.S. business leader for health and benefits.

    • Threat:  Consumers are beginning to see the "list price" for health care and realizing what Steve Brill so adeptly revealed in "Bitter Pill", Time Magazine:  prices are too high, and large, insular health systems, basing negotiations with payers on a "discount %" methodology, have not been paying attention to true costs.

    III. Memorial Sloan Kettering Cancer Center, IBM, and WellPoint (a managed healthcare company) announced earlier this year that they are teaming to incorporate Watson, the supercomputer, into medical practice.  As "MedGadget" reported, "medical literature evolves at the blink of an eye, and it is impossible even for the most learned of physicians to keep up with all the data involved in . It’s in fact estimated that only 20% of what the average doctor practices is evidence-based."

    • Threat:  if Watson-like technology has the magnitude of impact that Google has had, large amounts of the bureaucratic apparatus of health care may no longer be needed.  Consider a world where the physician really isn’t the person with the answer, the computer is.  Consider how the power would transfer from the health system (who has the docs) to the patient and the payers.  I’m not sure it is possible to fully imagine the impact on the organizational design and management structure required by a health system when it’s the patient who is directing care using their mobile device.

    IV. The Harvard Medical School invited David Goldhill, author of Catastrophic Care, How American Health Care Killed My Father, to speak with Ashish Jha, Professor of Health Policy and Management, Harvard School of Public Health.  Clearly, Mr. Goldhill is becoming a force for the voice of the patient in driving health care.  He believes that health systems have treated the payers, not the patient, as the customer in heath care and that they must now be made accountable to the patient.  He is not to be underestimated.  If you remember Ross Perot, you realize that one man, with a platform and a message, can indeed radically change the public debate.

    • Threat:  the threat here is that new institutions arise that really "get it".  As the UnitedHealthcare example shows, a newly configured organization can develop a new delivery model based on consumer knowledge, price transparency, partnership with the patient and widely disseminated medical knowledge.  Wow.  Are our health systems ready for this?

    These are just some of the tectonic shifts occurring on the ground and in the press.  Those who "will not see" these shifts are likely to be doomed.  Those who don’t have the fortitude to address these trends head on could be doomed.  Those who do have the courage to take on the magnitude of change could still be doomed.  And those who have the courage to take on the change and the brilliance to design the future, versus longing for the past, will not be doomed.

    Advice to those who want to be part of the solution?  There are 3 changes you can make immediately that would improve the likelihood of weathering the changes to come:

    1. Start hiring from other industries… finance people, IT people, HR people, supply chain people, customer service experts, call center experts, again, you get the idea.  All roles but your core clinical ones should have a good percentage coming in from non-healthcare industries.  Service-based industries, most likely.
    2. Specialize:  put the power with the service line chief.   The challenges are just too large to take on at the global level.  Reduce the power of the central infrastructure, except where centralization is key to cost reduction (i.e. supply chain).  Hold the service line chief accountable for Triple Aim plus revenue growth and staff talent.  (For more information, read our whitepaper on Accountability in Healthcare. 
    3. Get your chargemaster out, look at it and start managing pricing seriously on a rational basis.  Develop cost models based on real costs, not RVUs.  Consumers will get the hang of this soon and the earlier your house is in order, the better it will be.
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  • 02/14/2013 - Maryann Sullivan 0 Comments
    An accountable healthcare organization – it is possible!

    I was excited to read recently that the Cleveland Clinic took the radical step of eliminating their departments of medicine and surgery! In the article Cleveland Clinic’s 4 radical approaches to care integration, patient satisfaction, by Karen Cheung-Larivee, December 7, 2012, published on FierceHealthcare, Karen states that they were "rethinking the organization based on patient needs." Radical!?

    In my recent whitepaper on accountability in health care, I make the point that physician leaders are not empowered to run a Service Line, not in the sense that they have full accountability for all 5 critical goals:
    "Triple Aim"
    • Excellence in clinical outcomes
    • Value
    • Patient Satisfaction
    Institutional success
    • Revenue growth
    • Culture that attracts and retains the very best clinicians, leaders and staff.

    Most service line chiefs do not have full authority and consequent accountability for everything that happens to their patients, including inpatient services and nursing. Also, frequently, they must fight political battles with the Chief of Medicine or Chief of Surgery who manage a function rather than a cohort of patients. So the old model of a Department of Surgery and a Department of Medicine are one of the many confounding elements that make service line accountability difficult. Yet, here we have one of the most renowned healthcare institutions tearing away the old assumptions and operating under a new model.

    This type of fundamental restructuring of organizations can be a game changer. It genuinely empowers leadership in the service lines to drive improved outcomes, process improvement, staff development and more, all while being able to look at the full financial impact of their decision, whether inpatient or outpatient, surgical or noninvasive.

    Once organizations truly begin to rethink how they serve their patients, from the patient’s point of view, I truly believe that improving value (better outcomes at best cost) will truly be within reach. What do you think?

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  • 02/07/2013 - Peter Tetrault 0 Comments
    Authentic Business Coaching: Getting Naked

    In his 2010 book, Getting Naked, Patrick Lencioni writes about an approach to engaging with one’s clients. He talks about the humility, selflessness and transparency needed to become a trusted advisor to those who hire us. Lencioni posits, and I concur, that "most of us live our lives trying to avoid awkward and painful situations… (leaving us) susceptible to the three fears that sabotage client loyalty":

    • Fear of losing the business
    • Fear of being embarrassed
    • Fear of feeling inferior

    As a business coach my role is to become my client’s trusted confidant. If what Lencioni says about consultants is true, it is doubly true for effective coaches. If I’m listening to a client and a question comes to mind do I ask it without concern about how it may impact my "image" or do I first concern myself with how I might be perceived (impression management)?

    Much has been written about personal branding – and this blog, our tweets and our Facebook page indicate that we pay attention to our company’s brand. But what, if any, place in a coaching or consulting practice is impression management a valid concern?

    For Wellesley Partners coaches, being effective has one overriding rule: being present, in the moment – being authentic. We connect to our clients – emotionally, not just intellectually. We understand the world through their eyes – feel their joy and feel their discomfort – in order to help them understand and grow through their unique experience.

    Only through the outreach of caring (love) can we as coaches properly execute the role we are hired to play. Caring is demonstrated when we have the courage to confront our clients with their blind spots rather than being overly concerned with pleasing them. If there are only two emotions: love and fear, we must become adept at shedding our fears and find the courage to give voice to the questions that will draw our clients closer to the world that they seek. When we demonstrate our trust in our clients by "getting naked", we invite them to trust us in return.

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  • 02/01/2013 - Peter Tetrault 0 Comments
    Our Unequal United States: Where you Live Matters

    The healthcare marketplace in the U.S. is undergoing rapid, wholesale change with no end in sight. The population continues to grow and, more importantly, age. At the same time the total amount of knowledge and capabilities that exist in the medical field is growing at an exponential rate as scientifically generated results from the laboratory are translated into new treatment protocols at an ever faster pace. The knowledge required to function as a Primary Care Physician today dwarfs that required of the previous generation of physicians.

    Additionally, and regardless of the final details, the role of government will continue to grow. The scope of the government’s role will expand as implementation of the ACA (Affordable Care Act) is phased in over the next decade. Even if the ACA is repealed or significantly modified, the government’s percentage of involvement will grow as the population ages and end-of-life costs continue to be the majority of an individual’s medical lifetime cost.

    Lastly, we are already facing staffing issues in the U.S. with vast discrepancies of accessibility to physicians based on where you live. According to the Association of American Medical Colleges, there were 744,224 licensed and active physicians in the U.S. in 2011. Of those, 208,802 were aged 60 or older. At the same time there were 80,279 enrolled in the 137 accredited U.S. medical schools. Assuming no attrition, medical school graduates transitioning into their clinical residency (3 to 7 years) will average 20,070 per year, fewer than those retiring. Thus, a diminishing pool of physicians will be serving a dramatically growing population as the uninsured population of the U.S. (40+ Million) is absorbed into the covered population under the ACA.

    Change in this marketplace is unavoidable unless we find a way to suspend the economic theory (law?) of supply and demand. As my IT friends like to joke about their projects: pick any two – (high) quality, (low) cost, or timeliness. Which of us would accept poor quality, delayed access or increased costs regarding our personal access to healthcare?

    To me, the plain but not simple answer involves seriously addressing the supply side of the equation. But creating more MDs more rapidly is viable only in the longer term and probably only after medical schools have drastically revamped their existing educational model.

    Demand can be somewhat mitigated by the transfer of tasks from MDs to non MD clinicians, by increasing MD efficiency through the careful application of new technologies and by executing against the universally discussed focus on creating and maintaining health as opposed to focusing on the treatment of illness.

    Each potential solution, or combination of solutions, presents its own challenges. And it may be that we must do them all to prevent either an access crisis or a fiscal crisis.

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  • 01/30/2013 - Maryann Sullivan 0 Comments
    Big Data: Becoming Truly Patient-Centered

    I was recently working with one of my clients at a large, highly respected academic medical center. We started chatting about the scope of their data warehouse project and I was struck by the lack of focus on the patient and what the institution needed to put in place to better serve the patient. Not uncommon in what I run across in healthcare today.

    For many years, the provider market has touted the need to become patient-centric…versus its historically provider-centric model. Yet, as with many new concepts that take years to be embraced, it is not always clear how a new paradigm impacts operational work.  In the case of patient-centeredness, does this new concept have any impact for data warehousing? It should, but it won’t if leaders of these projects don’t think beyond their normal paradigm.

    What is a Patient-Centered Warehouse?

    Being patient-centered for many warehouse builders translates to a very simple notion…the patient identifier is central to gathering myriads of data elements. Most of these data elements, however, are gathered inside the footprint of the institution where the warehouse is being built, typically, a hospital system that includes ambulatory and inpatient settings.

    A truly patient-centered warehouse would have an entirely different perspective…it would hold the life information of the patient, including dietary, dental and non-system providers, perhaps dermatologists, clinics, pharmacy purchases and more. It would extend far beyond the walls of the traditional hospital system.

    To treat the "whole" patient, we need to have the "whole picture". The challenge, anyone would say, is that we can’t always get the data. There are privacy concerns, cross institutional questions and technical challenges.  However, check out the "Consolidated Wealth Reporting" websites. I know that Fidelity Investments is launching one. Here is a link to one from Fortress Financial Services, LLC:  http://www.fortress-llc.com/Our-Consolidated-Wealth-Reporting-Service.9.htm . The financial services business has solved the challenge by having the consumer give access to whatever information they choose to consolidate.

    A similar model is quite possible in healthcare. We have to develop the tools and technology, but a truly patient-centered approach to gathering and utilizing patient information is well within reach using current technology. What a healthcare system truly needs to embrace are technologists who come from other industries and who can accelerate the innovation that healthcare so desperately needs.

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  • 01/08/2013 - Peter Tetrault 0 Comments
    Peace to Perfection: a continuum that impacts performance

    Decision making can sound formal and grand, and it can be. But as managers of people, we make decisions on a daily basis that can have significant impact on both our organization’s results and our personal success. Do we always take stock of our motivations and what our goals should be before we respond in the moment? Or do we let our individual personality preferences impact our decisions in ways that are counterproductive to our own goals? When we do, it can have significant consequences for our individual, team or organizational goals. Emotionally driven decisions can be an ineffective response to what is only a set of facts or circumstances.

    Have you ever accepted less than someone’s best because you didn’t have the "energy" to address their sub optimal work product? (Avoiding confrontation to keep the peace.) Have you ever kept at something or someone too long and/or too hard because the vision in your mind’s eye was so compelling that you just had to have the work "just so"? (Demanding perfection.)

    My clients do a good job, most of the time, achieving their desired place on the Peace to Perfection continuum. Sometimes, however, especially under unusual levels of stress, they make decisions too close to either end – which can get in the way of creating an environment of maximum performance.

    So what?

    Staying too close to the "peace" end can end up pushing work from its assigned area to others – including oneself – in order to get things done, ultimately ruining trust and teamwork.

    Staying too close to the "perfection" end can end up demoralizing staff and driving good people, whom you want to keep, to other departments or organizations to avoid burnout and in the interest of self preservation.

    To remain one of those effective managers that attract and keep good people, one needs to maintain perspective and a sense of what is right in the moment – and that requires the mental ability to process the emotions of the moment and then purposefully respond to the set of facts and needs in a way so as to achieve your desired goals.

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  • grit-150x150
    12/19/2012 - Peter Tetrault 0 Comments
    Meet The Parents (of Focus, Determination and Grit)

    Meet three children: Focus, Determination and Grit. Triplets. Born to parents: Values and Mission.

    The three children work extremely well together, getting things done, working through problems and helping each other see past danger and fear. When given a task from their parents, true greatness is achieved. Their parents are Values and a Mission, so when the children are given a task, they understand what they are building, who and what’s it for, and why they are building it.

    When working on other tasks, however, Focus, Determination and Grit struggle. Focus asks Grit why they are doing what they are. Grit simply replies, "We must work through this. You can do it, Focus." Focus is confused but continues on. Determination then asks, "Why am I so determined to do this task? Who are we doing this for?" Grit, again says, "don’t worry about it. Just get it done". Along the way, each child makes assumptions and decisions based on their incomplete understanding and takes a few shortcuts and wrong turns because they don’t truly understand why they are doing what they are, the true task and who they are helping.

    Focus, determination, grit, values and mission live in all of us. Imagine combining all of those people into one and you have…yourself. You may be stronger in one facet than the other, but if you try, you can engage each one and align your values to your grit.

    Without values, what’s the point of being determined, focused and full of grit? You will likely become quite productive, but won’t feel connected to the work you are doing.

    This analogy can be used for individuals as well as for organizations. Without clearly articulated values and a mission to connect to, focus, determination and grit are useful but woefully under achieve against their potential. Both individuals and organizations make the mistake of working through issues and problems with powerful focus and determination, only to find that they lost the future vision.

    I challenge you to define your values. Write a mission statement for your life, your work. Focus, Determination and Grit are much more effective when working for a common purpose!

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  • 12/13/2012 - Peter Tetrault 0 Comments
    Choosing Between a Coach and a Consultant

    The Importance of Self Knowledge "Know Thyself" has been the subject of philosophers and poets for millennia. Its genesis may be unclear: Greek, Egyptian or Hindu, but its importance cannot be over-stated. Self-knowledge is a requirement for self-actualization. Coaching & Consulting The coaching industry has grown tremendously over the last decade. I’ve heard some say they believe it has gradually replaced small scale consulting – and that part of the reason for this phenomena is budget constraints that eliminate consulting line items but don’t impact learning and development – where coach funding usually lives. But there are real differences between these two helping professions.

    When asked what was the most difficult thing, Thales replied, "To know thyself." When asked what was easiest, he replied, "To give advice."

    Coaching is about asking powerful questions. Consulting is about giving advice. Why Coaching? As a coach I assist my clients in their journey of discovery. I help build self-sufficiency, not dependence.  I assist clients see more potential by opening their eyes to blind spots. As a coach I help my clients develop multiple perspectives – not focus on just one – in order to discover and capture more possibilities. There are many Consultants cleverly disguised as Coaches currently in the market place. So, the next time you are thinking about engaging a coach, take the time to reflect on what you are looking for in order to fully capture your expectations. Be clear for the benefit of all. If you are looking for an individualized guide to help, as opposed to being given "an answer", you are looking for a coach. Choosing a Coach The next challenge, then is selecting a coach. My advice here (as a Consultant) is the following: 1. Be sure that they "Know Themselves" in order to help you do the same. Are they giving advice or asking questions to help you solve a problem on your own? What are their motivations? To enable or to fix? 2. Establish a relationship of trust. The ability to establish a relationship of trust is paramount. Be sure that you connect with and trust your coach. 3. Be sure they are constantly learning. Are they continuing to increase their own skills? Are they practicing under another coach’s guidance and supervision? There are many reasons why one selects a specific coach – but beware of hiring a consultant for a coach as they will not necessarily help you bring out yourbest. So my advice is this: know yourself. And my question is this: do you know what you are really looking for?

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    12/07/2012 - Peter Tetrault 0 Comments
    Make Smart Career Moves

    For many, staying on their current path is easier than mustering the will and energy to take control. But if you spend a little time thinking about this past year, you may find new opportunities for a new role, more money, or a new opportunity that you wouldn’t have thought of before.

    Here are some questions to ask yourself to begin the process…

    1. Am I on a career path that I feel brings out the best in me?
    2. What are my strengths? Have I uncovered any new strengths this year?
    3. What’s the best part of my job? How can I find ways to do more of this and less of the work I don’t like or am not as good at?
    4. Do I have the work-life balance I want?
    5. What is missing for me right now?
    6. What one problem am I always trying to solve?
    7. If one amazing thing could happen to me this coming year, what would it be? (No boundaries!) How can I make it happen? Even a small component of that amazing thing?

    Some resources that you can tap to enhance this process…

    Ask your friends, your partner, your family what they see as your greatest strengths. What do they find as most valuable in you and your relationship with them?

    Think about those things. How do they relate to your job? Do the same strengths that show at work also show in your personal life? What can you learn from personal you that can positively bleed into professional you? What about vice versa?

    Find a coach or mentor to discuss your ideas with. Bouncing ideas off of someone that you trust helps build excitement, and uncover new ideas and approaches you may not have thought of before.

    Take a personality assessment. Learn something new about yourself by taking a personality assessment like Myers-Briggs, Gallup’s Strengths Finder, the DiSC assessment or Prevue. All are great assessments that may provide insight into who you are and how you interact with others. (Your employer may pay for you to take one of these, or reach out to a colleague or friend who may have access to an assessment.)

    Most importantly…

    Write it all down and put it in a place that you will go back to it next year around this time. If you’ve never gone through this process before, think about all of your past work and life experiences. Answer the questions above with your complete history in mind. This then becomes your starting point. Make this an annual process that uses current data to enable smart and informed course-correcting decisions for your future.

    Making big career and life decisions become much easier when you know your past, know yourself and have a good idea of where you’d like to go.

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  • 11/29/2012 - Peter Tetrault 0 Comments
    Entrepreneurship is a Universally Required Skill

    Back in the day, you joined an organization out of college and worked your way "up". Somewhere along the way you topped out. Sometimes a recruiter called and stole you away for a competitor! Fast forward 40 odd years and collect your gold watch! Those days are gone – good, bad or indifferent. So what? What have you lost?

    The answer to what has been lost depends greatly on whom you ask. To the "organization man/woman" what has been lost is: opportunity, a track to run on, security, promotion, advancement, prestige. To an entrepreneur what has been lost is: restrictions, conformity, mind-numbing tedium, senseless rules, meaningless reports. Which of those two do you most align with? Regardless of your preference, with the elimination of the old social employment contract we now must provide for ourselves what has been "lost".

    What have I really lost?

    The biggest loss we must deal with in the "new normal" is that of structure – a framework including a long term goal within which our short term actions can be adjusted as events unfold. Since this is no longer "given" to us we must take control – and responsibility – to create it for ourselves. Without it those of us who are not natural-born strategic planners risk flailing about without direction – taking the next career opportunity that presents itself regardless of the long term implications.

    Since now we must provide our own strategic thinking about our careers we are, basically, all self-employed – entrepreneurs. We are the founders of our own company – Me, Inc. – and as founder and sole employee we are responsible for the success of the firm.

    Personal Branding

    Today many people have already taken steps to market themselves – they’ve started creating their own personal brand. But the fullness of Tom Peters’ thoughts have been lost as many only pay attention to the advertising aspect of branding and not enough time on the product, the market research and positioning of the product. And some may be so caught up in their personal brand that they abuse the opportunity they currently have (Anyone you know at work spend time on Facebook or LinkedIn to the detriment of their current productivity?).

    People may buy sizzle, but in the end they eat steak

    Unless you think the product line for Me, Inc. is just fine as it is, I suggest you visit Me, Inc.’s product development lab to find out all you can about the "product" that sales and marketing will be presenting to the marketplace. Self-assessment is the first step in determining what your product looks like now – and more importantly – what it can look like in the future.

    There are a plethora of self-assessments that you can take – but the most informative device might just be a simple mirror. Examine all three of the "yous" that most of us have: the "you" that others see, the "you" that you wish others to see as well as the "real you" that may be visible to only a select few. Once you know the current product inside and out you may decide that it needs a little work before you are prepared to re-launch it in the marketplace.

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  • 11/28/2012 - Peter Tetrault 0 Comments
    What’s the difference between a coach and a mentor?

    And which do you need? Mentorship is becoming increasingly popular in the business world, and rightfully so. It’s a great tool when you know your desired goal, and you can work with someone who has succeeded at reaching that goal, or has experiences that may help you reach it yourself. Business coaching is extremely effective when you are looking to make a change or face a problem at work and are "stuck" with no movement.

    A coach is someone who asks the right questions to help you define goals and barriers as well as a plan to reach your goals and overcome your barriers. A coach doesn’t tell you how to solve a problem, but might provide insight on common reactions or issues that someone in your situation might encounter. A coach’s expertise is people – and a different perspective on your situation.

    A mentor is someone with the experience or knowledge that you are seeking; someone who has been in your shoes, whose opinion you respect and whose advice you are seeking. A mentor’s expertise is experience and knowledge.

    Both a coach and a mentor are powerful allies for individuals looking to enhance their career: a coach to build self-awareness, define goals and build a plan, and a mentor to help execute the plan in a logical and efficient manner.

    I believe that once someone spends the time to define meaningful goals and an action plan, that person will accelerate their success if they have a mentor to help and nudge them along the way.

    So, in summary here are the benefits of each:

    Coach – kick-starter/catalyst

    • Create meaningful goals and a future state worth working towards
    • Provide information and insight and perspective on personality type and common pitfalls and barriers
    • Overcome barriers and limits

    Mentor – long-term check-ins and on-going learning and accountability

    • Provide feedback on goals/action plans
    • Give insights of a time when they shared a similar experience
    • Outside accountability to push you to continue achieving short term goals and quick wins

    Have you ever had a coach or a mentor? What were the benefits you experienced?

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  • 11/26/2012 - Peter Tetrault 0 Comments
    How to Bring Up the Subject of a Business Coach

    Yes, there is a polite way to do it. Here are a few questions you might consider:

    Are you the right person to be broaching this topic with your colleague?

    • What are your reasons and motivations for recommending this action?
    • Have you and your colleague discussed work frustrations and hopes before?
    • Do you know if the person already has a coach or mentor?
    • How would you respond if the roles were reversed?
    • Who might be better positioned to talk about this?

    Why might someone use a coach?

    • They are at the beginning of their career:

      They need some help navigating the work environment, clarifying priorities and learning how to adapt to new situations

    • „They are mid career:

      They are looking for work-life balance, considering whether or not they should pursuit new responsibilities or shed old ones

    • „They are closer to the end of their career than the beginning:

      How to stay engaged in a more manageable way, reduce workload or need to prepare for retirement

    • „

      They are experiencing stress:

      How do they sort out competing interests, demands and priorities in order to move forward

    • „They are feeling stuck:

      They are uncertain about "what’s next" and could use some structure and a systematic way to work out some tough questions in order to determine next steps

    • „They are new to leadership:

      How do they achieve success in their new assignment while "learning on the job" as they continue to develop their leadership capabilities

    How can you do this properly?

    • „Think about what you want to communicate
    • Find an appropriate place and time: private and unhurried
    • Be non-judgmental – state what you are feeling and seeing – be certain about "you"
    • Ask questions that call for thought and elaboration: "I’ve noticed you seem to be (from list above), would you welcome some help with that? What help would you want?"
    • Keep your emotions in check
    • Do not take offense if your colleague is not interested
    • Do not push the conversation – let your colleague pull you along once the topic is opened
    • Do not revisit the conversation – let your colleague take control and set the pace
    • Do not make either a yes or no "personal" – it’s professional

    If you have additional thoughts, questions or comments on this, please leave a comment below.

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  • 11/21/2012 - Peter Tetrault 0 Comments
    Recipe: The Perfect Career

    Description

    Take a healthy dose of self-awareness, values and goal-setting; blend with action planning, strategy, reality and a dash of pie-in-the-sky dreaming. Let set for a while. Once the concepts form into a mold, use the mold to create an action plan. Analyze the plan using honesty, reality and goal-verification.

    Ingredients

    • 4 cups Personal History
    • 2 cups of Goals
    • 1 cup of Self Awareness
    • 2 tbsp of Reality
    • 2 tbsp Dreaming
    • 1 pint of Action Planning
    • 3 tsp Honesty
    • 2 tsp Strategy

    Directions

    1. Preheat your brain and heart for some honesty. Prep by lining your bowls with dreams and reality.
    2. Combine personal history, context for change and present situation into a bowl. Fold together until you start to see themes. Set aside. This is your "starter", which you will use now and in future baking/planning sessions.
    3. As your mixture sits, crack goals and pie-in-the-sky dreaming into a bowl and add self-awareness. Your coach will help you blend the two together. After a few minutes, barriers will begin to reveal themselves. Blend (discuss) barriers with your coach until only real (vs perceived) barriers exist.
    4. Ask your coach to add insight on personality type and barriers to the bowl containing goals and self-awareness.
    5. You now have two bowls – one with current state (personal history, context for change and present situation) and one with future state (goals, self-awareness, barriers and insight). Slowly add future state contents into the current state bowl. Blend.
    6. Once the two bowls are fully combined, choose a "pan" (or "PLAN") to bake your creation in.
    7. Bake overnight (or over a few weeks). When the plan comes out of the oven (and has had some time to set in your mind), you’ll begin to see the steps you’ll need to take to reach your goals.
    8. Sprinkle epiphanies, realities and new ideas to your creation as they arise.
    9. Each year, using the "starter", repeat this process and bake a new plan for yourself, using the old plan as learning experiences and history to add in step 1.

    Prep Time: Your life up until now

    Cook Time: The rest of your life

    Ready In: Up to you

    Good luck!

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  • 11/14/2012 - Tim Sullivan 0 Comments
    Build a Personal Strategic Plan for Your Career

    Many moons ago, at the ripe young age of 32, I felt like a beached whale. Over the first decade of my career, I had been very successful in two different careers, i.e. prep school teaching/coaching and insurance sales. I was very successful. I was miserable. Something was very wrong but I couldn’t figure out what. Being Irish, I blamed myself.

    My instinct told me to inventory my background and my skills in order to take control of my career and my life. Three concrete steps came to me.

    First, having undergraduate and graduate degrees in Classics, I reverted back to this disciplined training with its many messages of "study the past if you would divine the future." This was the beginning of me taking control of me. So, without much idea of where it might lead me, I wrote a life history. Data! Patterns were noted and genuine insight ensued.

    Secondly, I took my in-depth insurance training and applied this to myself. In sales, we had been very well trained (by a great company, the Northwest Mutual) in the following manner:

    1. Understand your product well
    2. Position this product in the marketplace by developing your "ideal prospect"
    3. Build a comprehensive sales strategy (the approach)

    I took these three "product marketing" directives and came up with three corresponding questions to relate to my dilemma:

    1. Who am I? (Product Knowledge)
    2. What do I want? (Product Positioning)
    3. How do I get it? (Sales Strategy)

    This helped me create a lot of hard data. I came to understand why I was wandering in the desert and began to compile snippets around a picture of the ideal job for me.

    Thirdly, I decided to take the pressure off of myself of trying to find the exact next job at age 32 simply because, even armed with all this data, I was still in a fog about the "solution" to my problems. Instead, I decided to try to create the "last job" in my career (age 55-65). I will explain more on this in a later post but it was this exercise that allowed me a way to portray how I would define success on my own terms. The answer was so very simple but it only came by asking the right question.

    I knew what I wanted (question two: what do I want) and it was driven from some very comprehensive work on question one (who am I, really?). It was all I needed.

    So I was my own first client. This same "front-end piece" is precisely what I have taken thousands of clients through for all these intervening years. Like me, each person starts to "get it" quickly. Momentum is created. A body in motion…

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  • 11/14/2012 - Maryann Sullivan 0 Comments
    Health Care Business Intelligence: Where to Start

    One of the greatest challenges in health care right now is that the data environment built over many decades does not support the kind of analytics required to drive accountability.  Accountability for delivering value (the right care at the right price) at the provider level requires a data environment that delivers "the story" quickly and efficiently to senior executives, the Board and to providers on the ground.

    The challenge is daunting…even in public companies, where accountability to shareholders is paramount, challenges in data management are enormous.  Just recently I read an article from McKinsey’s "Global Survey".  It cited the fact that while "more than 75% of respondents to the survey report that their organization’s greatest benefits from data use flow from clear and timely reporting of financial and performance metrics", 3 of the top 4 "barriers to increasing the use of data and advanced analytics are

    • Lack of skills in translating and synthesizing data for use by decision makers
    • Lack of sufficient data"

    In major hospitals and provider systems, the challenge is compounded by the fact that data has historically reside in "point solution" software…3rd party applications that support a specific function extremely well.  Examples are ERPs, operating room software, EHRs and registration systems, to name just a few.

    The Situation for Finance

    The impact of these disparate software packages is that finance is left chasing and cleaning data, reconciling spreadsheets, rather than analyzing the data.  Because they haven’t needed to, financial departments have not built a data infrastructure that will support the delivery of insight to the leadership and to the clinicians. 

    Now, however, CFOs have realized that they must build the right analytical infrastructure to acquire adequate data from the disparate systems and improve data quality, all while trying to transform their finance functions into analysts versus "data dogs".  This is a very large undertaking, one that requires both the vision and the patience to achieve the vision.

    Tackling the Problem: Think Like a City Planner

    I would compare where to start with what has happened here in Boston in the Seaport area.  City planners, the mayor and some very forward thinking business folks realized that, if they were going to rehabilitate the water front on the South side of the canal into a vibrant part of the city, transportation to the area would be prerequisite!  Once the commitment for "T" stops and bus routes were in place, office towers, one by one, and restaurants, one by one, and hotels, one by one, started to be planned and built, all providing great value as each opened.

    Building a data environment is very similar.  Create your vision!  Think big! Have a business intelligence architect create the entire map of your city!  Then build your "T"…meaning, put in place the technical infrastructure required to manage large data volumes, put the right "meta data management" tools in place for access to that data and become expert in how to build and deliver dashboards to the end users.

    Become a Hero to Your Business Partners

    Once you’ve built your infrastructure, then you can begin to solve specific information challenges:  a labor productivity dashboard, a volume dashboard, an occupancy dashboard.  Once the infrastructure is in place, there will be so much demand, you have to think about that city plan… start small, build your first building (your first subject area), complete the entire project.  Source the right data, make the data accessible on a self-service basis to the business users and create meaningful dashboards and reports useful to managing performance.

    Thinking big can feel futile.  It can feel risky – what if I’m wrong?  It doesn’t have to be risky!  But building the proper infrastructure for true business intelligence is work that has to be done.  Your organization is depending on your getting this right.


    McKinsey Company, McKinsey Global Survey results @ www.mckinseyquarterly.com, Dec 2011.

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  • 11/09/2012 - Peter Tetrault 0 Comments
    The Six Components to finding Work-Life Balance

    Do you walk in the door late at night, finding your significant other and/or children asleep, your dinner drying out in the oven?  You promise yourself that tomorrow will be different; you’ll make it home in time to connect with your family and share stories about your days.  You vow to keep this promise to your loved ones, but more importantly, to yourself.

    Feeling out of balance leads to feeling out of control, in conflict (internally and with loved ones), and this can, at times lead to depression and burn-out. You really have no other choice but strike a better balance.

    You’ve been trained to give selflessly for long hours, however, you now have a choice to make.

    Ask yourself, what do I long for?  Create not from circumstance but from possibility. What’s possible here? More time for family, fun, professional development, the next promotion, exercise, peace and quiet, time for ME?  I can hear you saying, I don’t have any extra time to do this, no time to work toward achieving better balance.

    The desire to change must come first, then, very importantly, followed by a change in your behavior, that’s where the plan and structure comes in.  Here are some ideas to help, below:
    WHAT’S NEEDED TO MAKE A CHANGE:

    • Desire: do you want to make a change in your current situation?
    • Choice: know that this choice is yours to make.  It’s your life, and only you may choose to change it.
    • Clarity: ask yourself what you want to be different? The break it down into specifics and write it down (into your planner, calendar, journal, wherever you’ll see it) on a regular basis.
    • Perspective Shift: it’s time to see your life from a new perspective/lens (as in a new pair of glasses).  The old ones are dusty or the prescription is outdated so remove them and clean them off or find a new pair through which to view your life in a clearer way.
    • Plan: create a plan and/or a set of goals to help you get to this new and improved place. Set smaller, realistic goals at the beginning (i.e. dinner one night/week at home or one recreational activity/week with a loved one or yourself).
    • Structure: this is a reminder for you. Identify a word/photo/thing/quote/visual to remind you of the new path that you’ve chosen to walk down (example: put a photo of your children/spouse/partner/animal next to your computer so you’re reminded about what or who you want to get home to. Or set your phone alarm for twice a day: the first is when you need to begin to wrap up your day and second: when you need to be walking out of work for the day.

    KEEPING THE BALANCE
    Your balance today might not be your definition of balance a year from now.  Re-assessing your balance on an annual basis  (maybe at the start of the new calendar or academic year, or at your annual work evaluation) is crucial.  Make an appointment with yourself to do this. Imagine commuting home on time, knowing that you have the evening ahead of you to unwind, connect and feel in balance.

    If any of this is resonating with you, it’s time to make a choice to create better balance in your life.  Contact me and we’ll figure it out together. Here’s to creating from what’s possible!

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  • 11/09/2012 - Peter Tetrault 0 Comments
    Leadership in the Moment

    Today’s business climate is filled with uncertainty. The elections are over, but what will happen next? We still have a Democratic Senate and a Republican House. Little can be counted as being set or settled. The tax code is scheduled to sunset – and the federal government can’t manage to pass a budget which has us heading into sequestration. Growing government involvement in healthcare is the direction, but the ACA leaves much of the detail to be determined. This economy is in recovery, yet at the slowest rate of growth since recovering from the depression.

    Much of the Tri-state area is reeling from Sandy which brutalized our infrastructure, killed scores and will take years to repair.

    How good are you – the leader – at operating in times of uncertainty? What is the uncertainty doing to your team and your organization?

    Most writings on leadership say leaders need to (pick any 3): set strategic direction, put in place an appropriate leadership team, execute the strategy, create the culture, be the face of the organization to the outside world, plan the priorities for resources, etc.

    For many, and I would argue for most, uncertainty contributes to stress. And uncertainty can arrive from three sources: work, self and life situations. Uncertainty in one part can create stress in another. Stress has been shown to dramatically impact productivity – the signs can be absenteeism, turnover, increased workers’ compensation claims, high need for medical care, etc.

    Stress is not always bad though – many are propelled by stress to their highest levels of performance. But over time, and without returning to a "relaxed state", stress can overwhelm and debilitate.

    So in these times I’m suggesting you consider yourself your organization’s CSR: Chief Stress Reliever. Engage your team often. Listen just a little more carefully. Buttress your support systems. Don’t drop employee support programs or space for physical activity and wellness. Allocate some extra resources to pay for others who engage your people and help them deal with their issues (like business coaches).

    In today’s workplace, dominated by office workers, stress is most likely related to inter-personal relationships and "people problems" consisting of unclear management, tension among team members and fear of the unknown. Help your people take charge of their future – unlock your peoples’, and your organization’s, creativity and potential!

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  • 10/31/2012 - Tim Sullivan 0 Comments
    Want Your Career to Go Faster – Maybe You Should Slow Down

    The vast percentage of people I first meet for coaching are quite emotional, if not agitated. They have a problem (not so well defined) which they have been trying to solve (with rather random efforts) – unsuccessfully.

    The more emotional they get, the more blocked they feel. The more blocked they are, the faster they try to solve their problem. Faster and faster they go and it’s a doom loop.

    So, my first advice is "WHOA"! Slow down. I ask the person to describe what they do for a living. In short, they analyze data, synthesize, do research, form preliminary plans, get feedback on these plans, plan a specific course of action, meet with their constituents, kick off the solution, constantly course correct, measure, alter course and manage toward objectives.

    Perfect, I say. Are you following your typical work pattern, then, as you look to solve your career problems? Huh, they ask.

    Where’s the data, where is your analysis, where is your preliminary plan? I don’t have time to do all that, they say.

    You need to run your career and life like it is a business. Call it "Me, Inc." You are the CEO. You are in control. You, you have no data so there can be no analysis. No analysis equals no strategic plan. So, you go in ever decreasing circles of frustration.

    If you really are the CEO of Me, Inc and if you really want to be successful, you need to define success on your terms. By the way, you need a Board of Advisors to keep yourself honest. The only product of Me, Inc is your career. And you have a crisis. You have little or no data. Ergo, no plan.

    You seem to have a very pressing question. Yes, I do. It all makes sense to me but how do I get started? Specifically, what can I do to stop running around in circles?

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  • 10/24/2012 - Peter Tetrault 0 Comments
    Take the time to know yourself

    I encourage my clients to look for career options that use both their signature skills as well as ones they will enjoy. Money is important too – everyone likes to have physical and financial security, but for most it is not the best marker for career satisfaction. Nevertheless, as a current career segment draws to a close – voluntarily or not – individuals can get nervous about "what’s next" and begin to rationalize why taking on an assignment that is available in the moment, even if it lacks fulfillment, is the right move. Make a couple of those rationalized decision in a row and all of a sudden your career may be off the rails.

    It is an axiom that what got you to where you are today may not get you to where you want to go. Regular self-assessment is one way to make sure you are working towards your career goals with the right skills. The process of self-assessment should be a reflective process. What can you learn about yourself from your recent history? Your not so recent history? Ask yourself some thoughtful questions and write down the answers.

    Take time daily in small increments

    Most people find "self" time is hard to find and when found doesn’t come in large blocks. Be creative and, if necessary, start out by taking snippets of time from other activities.

    If you delay starting until you can find 4 hours per week to devote to your career remodel it will never happen. Instead, look at your schedule for tomorrow and find 15 minutes. As you begin this process you should focus on creating motion and progress and not be concerned with how fast results are realized. Once you get in the habit of saving time for investing in your career work you will be surprised how quickly the results will come!

    Start with self assessment

    Career change is not just about what’s next. Good career development is taking time to fully understand the product offered by you (Me, Inc.) in the marketplace; creating a future for the product in your mind’s eye and going about achieving that vision. You may be tempted by, and take, some detours along the way – and that’s ok. Keep your motivation close and refer to it often. For most, your ability to realistically document your vision and what you want to change will help fuel your motivation for the paths ahead. There may be many curves in those paths, but the journey is as rewarding as the destination!

    Where to begin? Here are some suggested questions to begin your self assessment:

    • What do I do well? What can I do better?
    • What brings out my best? What blocks me from bringing out my best?
    • What are my areas of concern that need further development?
    • What the three key events in my career that were critical turning points? Why?

    There are literally hundreds of good questions. Find the ones that are right for you.

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  • 10/24/2012 - Tim Sullivan 0 Comments
    The 3 simple questions that guide your career

    Career planning is no different than strategic planning for an organization.

    First, you must know and understand the history of your "company", aka Me, Inc. We call that the WHO AM I? phase, or the PRODUCT KNOWLEDGE phase. Without history, we cannot learn from the successes and failures of our past. We refer to this as "No Data, No Plan."

    Once you have historical data and themes (otherwise known as PRODUCT POSITIONING), you can start seeing strengths and barriers that have been hidden for most of your life. You will learn what it is you want to "sell" from Me, Inc. You’ll learn what you are an expert at and what is holding you back from reaching your potential. We call this – WHAT DO I WANT?

    Finally, once you’ve defined the product and positioned it in the marketplace, you can make a step by step plan to get to the place you want to be, which is the HOW DO I GET THERE? Phase.

    So it’s as simple as that:

    1. Who are you?
    2. What do you want?
    3. How do you get there?

    Only four things can prevent you from doing this planning:

    • lack of purpose
    • lack of tools
    • lack of motivation
    • lack of time

    Think about these barriers. Each one is a deal breaker if your goal is to take control of your life and your career. There is neither other way nor any other person to help you. Only you can help you. Once you are the owner and driver of your own change process, others can help you. But you must be the president of Me, Inc.

    It’s not easy to work through these things but if having a career that you are excited about every day means something to you, maybe it’s worth the time and effort.

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  • 10/23/2012 - Tim Sullivan 0 Comments
    A message from our CEO and fearless leader

    First time blogger.

    Being as old as the hills, I admit to being a tad confused with all the social media hype. Initially, I balked at being a blogger, tweeter, facebooker because it seemed like everyone was just hawking their favorite brand – namely, themselves. Being first a Catholic and trained that any sort of vanity was a grievous sin, I declined to play.

    As I have learned more, it also struck me that there are other purposes for blogging other than self-aggrandizement. What about the opportunity to reach more people to perhaps teach and to help?  With this as my goal, I am now committed – starting today I am an official, bona fide BLOGGER.

    A little background on me. For thirty years, I have been a career development consultant doing individual coaching/advising with well over 5,000 business professionals. My career has focused on helping folks who are stuck: under-performing or performing wonderfully but still somehow feeling shipwrecked or just plain lost.

    How to help these executives significantly improve their personal productivity has been my business life. In truth, i cannot think of a more rewarding career for myself. My career started as a Classics teacher and hockey coach. Now my classroom is in corporations and my "students" are adults. Once a teacher, always a teacher!

    To aid my "students" I have created hundreds and hundreds of home-brewed models, exercises and metaphors that have helped folks gain back control of their lives. For decades now, my clients have said "Sully, you have to publish this stuff." I now plan to do just that as The Ancient Blogger.

    Fasten your seatbelts! I plan to have a lot of fun doing this and will do it in my own style, my own voice.

    – The Ancient Blogger

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  • 10/18/2012 - Tim Sullivan 0 Comments
    No Data, No Plan

    I would like to offer an analogy to compare career and life planning with business planning. I realize that most of you are business people and could never imagine trying to help a client or start a project where you were given no data about the client/project’s history. In other words, they were unwilling to give you any data for you to analyze and all they really wanted from you was a crackerjack marketing plan. Wouldn’t you say that’s a rather impossible task? The same would hold true for any consultant. For example, if you are a CPA or a financial consultant, how could you ever create a financial forecast if you are not able to study the historical financials?

    How old are you? Let’s say you are 30. Say you are a 30 year old company. How much data do you have on your company?  The idea here is that it is virtually impossible to help somebody build a career plan and life plan without very carefully analyzing the history of this 30-year old person. To whit, how much data could you come forward with if I asked you by tomorrow to bring all the data on You, Inc. and organization that was incorporated today? If you are like most people, you could come up with virtually no data!

    In this case, as with business planning, if we have no data, there can be no analysis, and no business design and therefore no plan in effect. Both you and this mythical company are stuck.

    So the difficulty here is that with no data, there can be no plan. What everyone ends up with then is pure and unadulterated emotion. When asked "what should I do" – I am stuck, frustrated, angry and feeling very blocked. Emotion, here, is our enemy.

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  • 10/16/2012 - Peter Tetrault 0 Comments
    Why you should read a commencement address every year

    Each year, we are inspired by successful individuals who are asked to share their knowledge and wisdom to graduating seniors. What better time to inspire students than just before they are heading out into the work force, right? Well, we try to continue to stay inspired by reading commencement addresses if we are not in attendance. This is a favorite of ours that we often refer to in order to remind ourselves and others that it is possible to "give meaning to your life" once you decide to take the reigns:

    "You alone will have to define the feedback which is essential to give meaning to your life.  For some, that feedback will include things like money, power, fame, status or countless other ingredients that are available to you.  Down deep, you will come to know that you – you alone – have to decide this question or live your years in anguished unfulfillment.  In connection with this point, you should also be aware that for a good part of your life you will be playing to those in the grandstand, a grandstand which includes your parents, your teachers, and your peers.  At some point, however, you will discover that that grandstand loses its preeminence or, at least, that a more important grandstand exists inside yourself.  So as you work to define your required feedback, remember that ultimately it is a lonely enterprise, for your deepest satisfactions must finally be internal not external." Read the full commencement address.

    Robert Ward, May 28, 1979.

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  • 10/16/2012 - Tim Sullivan 0 Comments
    Cold Lessons

    A guy named David received a parrot for his birthday. The parrot was fully grown, with a bad attitude and worse vocabulary. Every other word was an expletive. Those that weren’t expletives were, to say the least, rude. David tried hard to change the bird’s attitude and was constantly saying polite words, playing soft music, anything he could think of to try and set a good example.

    Nothing worked. He yelled at the bird and the bird yelled back. He shook the bird and the bird just got more angry and more rude. Finally, in a moment of desperation, David put the parrot in the freezer.

    For a few moments he heard the bird squawk and kick and scream. Then suddenly there was quiet. Not a sound for half a minute. David was frightened that he might have hurt the bird and quickly opened the freezer door. The parrot calmly stepped out onto David’s extended arm and said, "I believe I may have offended you with my rude language and actions. I will endeavor at once to correct my behavior. I really am truly sorry and beg your forgiveness."

    David was astonished at the bird’s change in attitude and was about to ask what had made such a dramatic change when the parrot continued, "May I ask what the chicken did?"

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  • 10/02/2012 - Tim Sullivan 0 Comments
    Let go of fear to move forward in your career

    A career is like a long, winding river with a natural but powerful current. If we allow ourselves to let go of the shore, push off and "go with the flow", we will discover new things about the river (our career) as we round each new corner and bend. But first we have to let go.

    Too Slow?

    Fear is the emotional element that keeps us tied up to the dock on the bank of the river. We imagine very scary things around those corners of the river – so emotionally we want to stay put. When we stay put we’re safe – but we remain stuck in place. Our new career discoveries come out of the ebb and flow of new experiences that happen to us as we move along. New things are revealed. For most people "safe" is not the long-term solution to a highly rewarding career voyage.

    Too Fast?

    Sometimes we can also be too foolhardy, too rushed – in too big a hurry to power around corners in the river to reach our destination sooner. A river has tributaries and eddies. Optional courses are available. Much can be missed by rushing.

    …Just Right

    So pace is important. Don’t fight the current. Keep your hands on the tiller with your eyes wide open looking for new opportunity. Go with it. It’s a natural process.

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