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Title: LONG Tom Peters


1
LONGTom Peters Toward Health(care)
Excellence!Michigan Health Hospital
AssociationAnnual Membership MeetingGrand
Hotel/Mackinac Island/0629.2006
2
Part 1
3
March-June 2006 Sample ofHealthcare PR
4
Docs Hospitals
5
Doctors/Hospitals53 autopsy studies 24
misdiagnosis rate (The Independent,
06.27)Medical Guesswork From heart surgery to
prostate care, the health industry knows little
about which common treatments really work
(Cover, BusinessWeek, 0529) Dr David Eddy/Kaiser
Permanente Care Management Institute The
problem is we do not know what we are doing.
Eddy 15 of what doctors do is backed by hard
evidence (BW) in general, 20 to 25.What
Doctors Hate About Hospitals (Cover, Time,
05.01) It remains almost a stroke of luck to
enter a U.S. hospital and receive precisely the
right treatment. (Time) No day passednot
onewithout a medication error. The errors were
not rare they were the norm (Don Berwick, on
his wifes treatment) One medication was
discontinued by a physicians order on the first
day of admission Berwicks wife and yet was
brought by a nurse every single evening fo 14
days straight. (Time) Harvard Public Health,
2002 study More than 1 in 3 doctors reported
errors in their own or a family members medical
care. (Time)
6
Doctors/HospitalsDr Robert Wachter, Chief of
Medical Service, UCSF Medical Center Internal
Bleeding The Truth Behind Americas Terrifying
Epidemic of Medical Mistakes (Time) Dr Niteesh
Choudry, Harvard Med School More than half the
studies reviewed found decreasing performance
with increasing years of practice for all
outcomes assessed only 4 found increasing
performance with increasing age one study found
that for heart attack patients, mortality
increased 0.5 for every year the physician had
been out of medical school. (Time) My pizza
parlor is more thoroughly computerized than most
of healthcare. (Don Berwick, Time)Teaching
Doctors to Care (feature, Time, 05.29)
7
Big Pharma
8
Digger the DermatophyteLamisil/Novartis/4/11
0M/3X in 10 to 100,000
9
Big PharmaPushing Pills How Big Pharma Got
Addicted To Marketing (Cover, Forbes, 05.08)
Novartis 4 best seller, Lamisil, toe fungus,
850 for 3-month treatment, Digger
Dermatopphyte (Forbes) 42 billion on RD, 46
billion on marketing and admin. Salespeople up
100,000 in last 10 years, 1 per 9 docs vs 1 per
18 docs. (Forbes) Clinical trials favor sponsors
drug 90 of the time. The comparative studies
are a joke. Dr Jack Rosenblatt
(Forbes)Psychiatric Drugs Fare Favorably When
Companies Pay for Studies (headline, USA Today.
05.25) 57 of studies paid by drug companies, up
from 25 in 1992. Favorable outcome for sponsor
78. Sponsored by neutral 48. Sponsored by
competitor 28. USA Today /American Psychiatric
Association) Hey, You Dont Look So Good As
diagnoses ofr once-rare illnesses soar, doctors
say drugmakers are disease-mongering to boost
sales (feature, BusinessWeek, 05.08)
10
Intractable Problems
11
OtherHazardous To Your Health (New York Times
Op-ed on High Fructose Corn Syrup, 04.11)
112,000 deaths/year, 75 billion/per year
associated with too much fat 2/3rd of Americans
over-weight, 1/3rd childrenCall for Switch to
Preventive Measures as 29 billion pound Cost
of Heart Disease is Revealed (headline, The
Independent, 05.15)The Fat Police Obesity
Tests Every four-year-old in the country to be
officially screened (headline, The Independent,
05.21)The Politics of Fat (headline, Time,
03.27) childhood obesity up 3X in 25 years
12
STATE OFEMERGENCY
13
Manifesto
14
Healthcare vs Health
15
TPs Healing Wellness Manifesto2006(1)
Acute-care facilities are killing fields.
(WE KNOW WHAT TO DO.)(2) Shift the community
focus 90 degrees (not 180, but not 25) from
fix it to prevent it. (WE KNOW WHAT TO
DO.)(3) There are three primary aims for all
this Wellness-Healing-Health. (WE KNOW
WHAT TO DO.)(4) Im mad as hell and Im not
going to take it anymore. (I KNOW WHAT TO
DO.)
16

  • TomRant2006
  • Hospital quality control, at least in the
    U.S.A., is a bad, bad joke Depending on whose
    stats you believe, hospitals kill 100,000 or so
    of us a yearand wound many times that number.
    Finally, they are getting around to dealing
    with the issue. Well, thanks. And what is it
    weve been buying for our Trillion or so bucks a
    year? The fix is eminently do-able which makes
    the condition even more intolerable.
  • 2. The systemtraining, docs, insurance
    incentives, culture, patients themselvesis
    hopelessly-mindlessly-insanely (as I see it)
    skewed toward fixing things (e.g. me) that are
    brokennot preventing the problem in the first
    place and providing the Maintenance Tools
    necessary for a healthy lifestyle. Sure,
    bio-medicine will soon allow us to understand and
    deal with individual genetic pre-dispositions.
    (And hooray!) But take it from this 63-year old,
    decades of physical and psychological self-abuse
    can literally be reversed in relatively short
    order by an encompassing approach to life that
    can only be described as a Passion for Wellness
    (and Well-being). Patientslike meare catching
    on in record numbers but the system is highly
    resistant. (Again, the doctors are among the
    biggest sinnersno surprise, following years of
    acculturation as the man-with-the-white-coat-who-
    will-now-miraculously-dispense-fix
    it-pills-and-surgical-incisions-for-you-the-unwash
    ed.

17
BIGGEST DEAL OF ALL
18
!!!!!!!!!!!!!Healthcare vs Health
19
TP Recce 1Dubai Healthcare City to Dubai
Health CityCleveland Clinic and Canyon Ranch
20
State of Play
21
Funding ........... N.A.Access
N.A.Execution of chosen task
DPriorities ...... FBig Pharma
..... D-
22
Funding ........... N.A.Access
N.A.Execution of chosen task
DPriorities ...... FBig Pharma
..... D-Quality FScientific basis for
action C-/D
23
Funding ........... N.A.Access
N.A.Execution of chosen task
DPriorities ...... FBig Pharma
..... D-Emphasis on Acute care
CDe-emphasis of WPC/Wellness-Prevention-Chronic
care F (F-??)
24
Funding ........... N.A.Access
N.A.Execution of chosen task
DPriorities ...... FBig Pharma
..... D-Me too D-Overcomplexity/Drug
discovery D-Disease creation D-Hiring pretty
girls AHiring lotsa pretty girls A
25
BONUSFunding ........... N.A.Access
N.A.Execution of chosen task ...
DPriorities ............ FBig Pharma
........... D-FDA ..
D-Kill a few, save a lot D-
26
Bust fat docs!
27
HealthCentury21.Job 1
28
Quality!Prevention!Wellness! Chronic
care!Childhood obesity!H5N1!
29
Quality!Prevention!Wellness! Chronic
care!Childhood obesity!H5N1!
30
When I climb Mount Rainier I face less risk of
death than Ill face on the operating table.
Don Berwick, Six Keys to Safer Hospitals A
Set of Simple Precautions Could Prevent 100,000
Needless Deaths Every Year, Newsweek (1212.2005)
31
2m38s
32
Welcome to the Homer Simpson
Hospitala/k/a The Killing Fields
33
Quality!Prevention!Wellness! Chronic
care!Childhood obesity!H5N1!
34
Childhood Obesity gt Terrorism
35
Quality!Prevention!Wellness! Chronic
care!Childhood obesity!H5N1!
36
The Ultimate Culture ChangeHealthcare
vs. Health
37
Report Card.
38
Quality (100K deaths)Evidence/Outcomes-based
medicineIS/IT-in-health(care) revolutionWellness
/PreventionHealthcare to Health culture
transformationWash your hands!Home-care (as the
population rapidly ages)Med-school
re-orientation Public health
emphasisChildhood Obesity Mind-boggling (15
years?) social-moral-technological impact of
life sciences (the Singularity?)H5N1/WMDs/Envir
onmental degradationRisk assessment (private,
public)Market opportunityPublic vs/ Private
responsibilities partnerships Africa!
(Unconscionable failure to attend to/staggering
Health consequences for all)
39
Re-imagine Healthcare
Reportcard2006Evidence-based/Outcomes-based
....... DPay-for-performance
. DIS/IT (general)
..... C-Use of information
(for decisionmaking-measurement) . C-EMR
(Electronic Medical Records) ......
C-/DCPOE (Computerized Physician Order Entry)
.. C-/DQuality/100K unnecessary deaths
.. D-(kind)Acute care to chronic
care-home care shift ..... D/D-Acute-care
to Prevention/Wellness Obsession..
D/D-Patient-centric/Client-centric..
DDocs acceptance of evidence-based
............ D/D-Revolutionary-intensity
Incentives re evidence ... D- Childhood
obesity epidemic .. D- H5N1
preparedness ... DCorporate
focus on Prevention/Wellness.........
C-/DIndividual focus on Prevention/Wellness
.. DIndividuals health education/self-manageme
nt ..... C-Workforce acceptance of
self-responsibility ....... C-Workforce
transition to Brand You attitude......
C-/D 3 March 2006/Tom Peters
40
If God spoke to me by saying, Mark, youre down
to your last three words What would you want to
say to your fellow humans that would make the
most positive impact? It would be a close call
between Love Thy Neighbor and Wash Your Hands .
A close third would be Move, Move, Move. Mark
Pettus, M.D., The Savvy PatientThe most
important thing you can do to keep from getting
sick is to wash your hands. CDC/National
Center for Infectious Diseases
41
Tommy Thompson take your meds chronic illness
75 to 80 curative healthcare system to
prevention systemSource Advertising Age,
05.08.06
42
Quality!Prevention!Wellness! Chronic
care!Childhood obesity!H5N1!
43
Wash your hands.Apply 50 sunscreen.Banish
trans fatBanish high fructose corn
syrup.Exercise 30-7.Breathe.Stockpile for
H5N1. (not Tamiflu!)
44
Women.Women business owners.Boomers-Geezers.S
ingle-adults (Urban)Health-Wellness-Chronic Care
45
Quality COULD IT TRULY BE THIS AWFUL?
46
When I climb Mount Rainier I face less risk of
death than Ill face on the operating table.
Don Berwick, Six Keys to Safer Hospitals A Set
of Simple Precautions Could Prevent 100,000
Needless Deaths Every Year, Newsweek (1212.2005)
47
CDC 1998 90,000 killed and 2,000,000 injured
from hospital-caused drug errors infections
48
HealthGrades/Denver 195,000 hospital deaths per
year in the U.S., 2000-2002 390 full
jumbos/747s in the drink per year.Comments
This should give you pause when you go to the
hospital. Dr. Kenneth Kizer, National Quality
Forum. There is little evidence that patient
safety has improved in the last five years. Dr.
Samantha CollierSource Boston Globe/07.27.04
49
Welcome to the Homer Simpson Hospitala/k/a
The Killing Fields
50
Dear Mr. Mrs. Smith,XYZ hospital regrets to
inform you .

.Sincerely,A. S.
Jackson, AdministratorT. D. Jones, M.D., Chief
Medical OfficerL.S. Donald, CFOW.N. Arnold, CIO
51
1,000,000 serious medication errors per year
illegible handwriting, misplaced decimal points,
and missed drug interactions and
allergies.Source Wall Street Journal
/Institute of Medicine
52
YE GADS! New England Journal of Medicine/
Harvard Medical Practice Study 4 error rate (1
of 4 negligence). Subsequent investigations
around the country have confirmed the ubiquity of
error. In one small study of how clinicians
perform when patients have a sudden cardiac
arrest, 27 of 30 clinicians made an error in
using the defibrillator. Mistakes in
administering drugs (1995 study) average once
every hospital admission. Lucian Leape,
medicines leading expert on error, points out
that many other industrieswhether the task is
manufacturing semiconductors or serving customers
at the Ritz Carltonsimply wouldnt countenance
error rates like those in hospitals.
Complications, Atul Gawande
53
RAND (1998) 50, appropriate preventive care.
60, recommended treatment, per medical studies,
for chronic conditions. 20 chronic care
treatment that is wrong. 30 acute care treatment
that is wrong.
54
Various studies 1 in 3, 1 in 5, 1 in 7, 1 in 20
patients harmed by treatment Demanding
Medical Excellence Doctors and Accountability
in the Information Age, Michael Millenson
55
In a disturbing 1991 study, 110 nurses of
varying experience levels took a written test of
their ability to calculate medication doses.
Eight out of 10 made calculation mistakes at
least 10 of the time, while four out of 10 made
mistakes 30 of the time.Demanding Medical
Excellence Doctors and Accountability in the
Information Age, Michael Millenson
56
20 not get prescriptions filled50
use meds inconsistentlySource Tom
Farley Deborah Cohen, Prescription for a
Healthy Nation
57
In health care, geography is destiny.Source
Dartmouth Medical School 1996 report
58
Geography Is DestinyOften all one must do to
acquire a disease is to enter a country where a
disease is recognizedleaving the country will
either cure the malady or turn it into something
else. Blood pressure considered treatably high
in the United States might be considered normal
in England and the low blood pressure treated
with 85 drugs as well as hydrotherapy and spa
treatments in Germany would entitle its sufferer
to lower life insurance rates in the United
States. Lynn Payer, Medicine Culture
59
Geography Is DestinyE.g. Ft. Myers 4X
Manhattanback surgery. Newark 2X New
Havenprostatectomy. Rapid City SD 34X Elyria
OHbreast-conserving surgery. VT, ME, IA 3X
differences in hysterectomy by age 70 8X
tonsillectomy 4X prostatectomy Breast cancer
screening 4X NE, FL, MI vs. SE, SW. (Source
various)
60
A healthcare delivery system characterized by
idiosyncratic and often ill-informed judgments
must be restructured according to evidence-based
medical practice.Demanding Medical Excellence
Doctors and Accountability in the Information
Age, Michael Millenson
61
Without being disrespectful, I consider the U.S.
healthcare delivery system the largest cottage
industry in the world. There are virtually no
performance measurements and no standards. Trying
to measure performance is the next revolution
in healthcare.Richard Huber, former CEO, Aetna
62
Practice variation is not caused by bad or
ignorant doctors. Rather, it is a natural
consequence of a system that systematically
tracks neither its processes nor its outcomes,
preferring to presume that good facilities, good
intentions and good training lead automatically
to good results. Providers remain more
comfortable with the habits of a guild, where
each craftsman trusts his fellows, than with the
demands of the information age.Source Michael
Millenson, Demanding Medical Excellence
63
As unsettling as the prevalence of inappropriate
care is the enormous amount of what can only be
called ignorant care. A surprising 85 of
everyday medical treatments have never been
scientifically validated. For instance, when
family practitioners in Washington State were
queried about treating a simple urinary tract
infection, 82 physicians came up with an
extraordinary 137 strategies.Demanding Medical
Excellence Doctors and Accountability in the
Information Age, Michael Millenson
64
Most physicians believe that diagnosis cant be
reduced to a set of generalizationsto a
cookbook. How often does my intuition lead
me astray? The radical implication of the Swedish
study is that the individualized, intuitive
approach that lies at the center of modern
medicine is flawedit causes more mistakes than
it prevents. Atul Gawande, Complications
65
Deep Blue Redux 2,240 EKGs 1,120 heart
attacks. Hans Ohlin (50 yr old chief of coronary
care, Univ of Lund/SW) 620. Lars Edenbrandts
software 738.Only this time it matters!
66
Dr Larry Weed/POMR (problem-oriented medical
record)/Etc Its impossible to keep up with
the avalanche of knowledge. Therefore its
essential to use a valid diagnostic-decision aid
like Larrys Neil de Crescenzo, VP Global
Healthcare/IBM Consulting There is no other
profession that tries to operate in the fashion
we do. We go on hallucinating about what we can
do. Dr Charles Burger (using Weeds software
for 20 years)
67
100 studies Statistical formulas gt Human
judgment. In virtually all cases, statistical
thinking equaled or surpassed human judgment.
Atul Gawande, Complications
68
PARADOX Many, many formal case reviews failure
to systematically/ systemically/statistically
look at and act on evidence.Source
Complications, Atul Gawande
69
Genius Required?
70
Leapfrog Group
CPOE/Computerized Physician Order
EntryICU staffing by trained
intensivistsEHR/Evidence-based Hospital
ReferralDuh I Welcome to the computer
age.Duh II How about using experts?Duh
III If you do stuff a lotta times, you tend to
get/be better.
Source HealthLeaders
71
The Benefits of FOCUSED EXCELLENCE
Shouldice/Hernia Repair 30-45 min, 1
recurrence. Avg 90 min, 10-15
recurrence.Source Complications, Atul Gawande
72
Hospitals Pay Appropriate Attention
To Medical ErrorsYes
.. 1Aware and Trying Hard ...
8Aware But Tepid Response ... 22No
....... 25An Inexcusable Tragedy
.. 44Source 12.2005 Poll/tompeters.com
73
About Time!100,000 Lives CampaignDon
Berwick/Institute for Healthcare Improvement
74
Whats your name? Whens your birthday?
75
Attention/ Being There Job One!
76
You Your Calendar
77
You must be the change you wish to see in the
world.Gandhi
78
The Necessary IS/Web REVOLUTION
79
We all live in Dell-WalMart-eBay-Google World!
80
We almost all live in Dell-
WalMart-eBay-Google World!
81
Some grocery stores have better technology than
our hospitals and clinics. Tommy Thompson,
former HHS SecretarySource Special Report on
technology in healthcare, U.S. News World Report
82
Computerized Physician Order Entry/CPOE 5 of
U.S. hospitalssource HealthLeaders/06.02
83
Henry Lowe, U. of Pitt. School of Medicine
Broadband, Internet-based, multimedia
electronic medical records
84
Telemedicine E.g. HANC Home Assisted
Nursing CareBP, ECG, pulse, temp
85
Telemedicine Reduces days/1000 patients and
physician visits for the chronically
illDecreases costs of managing chronic
diseaseExpands service areas for
providersReduces travel costs to and from
medical ed seminarsDouglas Goldstein,
e-Healthcare
86
Our entire facility is digital. No paper, no
film, no medical records. Nothing. And its all
integratedfrom the lab to X-ray to records to
physician order entry. Patients dont have to
wait for anything. The information from the
physicians office is in registration and vice
versa. The referring physician is immediately
sent an email telling him his patient has shown
up. Its wireless in-house. We have 800
notebook computers that are wireless. Physicians
can walk around with a computer thats
pre-programmed. If the physician wants, well go
out and wire their house so they can sit on the
couch and connect to the network. They can review
a chart from 100 miles away. David Veillette,
CEO, Indiana Heart Hospital
87
Health
88
Healthvs Healthcare
89
Healthvs Healthcare
90
Healthvs Healthcare
91
Gwen former healthcare exec has wonderful
health insurance and an abundance of healthcare.
What Gwen does not have is health. And there is
nothing our health system can do to give it to
her. The battle cry is always health, but in
fact the struggle has always been over
healthcare. For all its inspiring, high-tech
cures, medicine is just not very effective at
curing our eras major killers. Medicine
doesnt do much chronic disease. When the
most common killers of our era are mostly
incurable and our preventive treatments pretty
feeble, you have to wonder about medical care as
a whole. There is a widely held view that
medical care contributes little to health. (John
Bunker/ Journal of the Royal College of
Physicians) Source Tom Farley Deborah Cohen,
Prescription for a Healthy Nation
92
Part 1 The Leading Causes of HealthSource
Tom Farley Deborah Cohen, Prescription for a
Healthy Nation
93
Our mistake is not that we value medical
carebut that we have misunderstood what it can
and cannot do.Source Tom Farley Deborah
Cohen, Prescription for a Healthy Nation
94
Smoking, excess drinking, lack of exercise,
shitty diet 40 of deathsSource Tom Farley
Deborah Cohen, Prescription for a Healthy Nation
95
Sanitary revolution mortality in major cities
down 55 between 1850 and 1915Source Tom
Farley Deborah Cohen, Prescription for a
Healthy Nation
96
Curve ShiftingSource Tom Farley Deborah
Cohen, Prescription for a Healthy Nation
97
Context Change The Most Powerful Force (??)
Wastebaskets Japan v U.S. Christchurch NZ v
Sydney AUSBroken windows
98
Bump into factor Extra-size portions, eat
more. Higher shelf space snacks, more
obesity. More liquor stores, more crime. High
vs low fat Japanese who emigrate to U.S. suffer
3X increase in heart disease.Source Tom Farley
Deborah Cohen, Prescription for a Healthy Nation
99
10 Sardinians, Adventists, OkinawansDont
smoke. Put family first. Be active every day.
Keep socially engaged. Eat fruits, vegetables,
whole grains. Other nuts, red wine, pecorino
cheese, small portions.Source National
Geographic (National Institute on Aging),
November 2005
100
An estimated 60 to 90 percent of doctor visits
involve stress-related complaints.
Newsweek/09.27.2004
101
Wellness
102
The curative model narrowly focuses on the
goal of cure. From many quarters comes evidence
that the view of health should be expanded to
encompass mental, social and spiritual
well-being. Institute for the Future
103
Ontario To Split Health Ministry Headline/
Globe And Mail /06.05 (New ministry will focus on
Prevention/ Wellness/Eldercare)
104
Savior for the Sickvs. Partner for Good
Health Source NPR
105
Companies Step Up Wellness Efforts Rising
health costs provide incentive to promote
healthier employee lifestyles headline/USA
Today/08.05
106
Prevention Program At Dow Chemical Aims To Save
Money IBD/08.05
107
Sprint/Overland Park KS Slow elevators, distant
parking lots with infrequent buses, food court
as poorly placed as possible, etc.Source
New York Times
108
Toms Story
109
Obesity/-79(-36) BP (140-85 to 90-60) Blood
sugar (180-87) Blood chemistry (normal)
Cholesterol (140-58) Metabolic rate/RMR (250)
Mental state (dramatic improvement)
110
Off Univasc (lt1/2)BextraLipitorToprolPropra
nolol
111
Aging reversal!!!!Why wasnt I informed
until age 59?
112
FixesDietExtreme exerciseMeditationSuppleme
ntsEliminate all alcohol(Meds)
113
Determinants of HealthAccess to care
10Genetics 20Environment 20Health
Behaviors 50Source Institute for the Future
114
Planetree A Radical Model for New
Healthcare/Healing/Health/Wellness Excellence
115
It was the goal of the Planetree Unit to help
patients not only get well faster but also to
stay well longer. Putting Patients First,
Susan Frampton, Laura Gilpin, Patrick Charmel
116
Much of our current healthcare is about curing.
Curing is good. But healing is spiritual, and
healing is better, because we can heal many
people we cannot cure. Leland Kaiser,
Holistic HospitalsSource Putting Patients
First, Susan Frampton, Laura Gilpin, Patrick
Charmel
117
The Nine
Planetree Practices1. The Importance of Human
Interaction2. Informing and Empowering Diverse
Populations Consumer Health Libraries and
Patient Information3. Healing Partnerships The
importance of Including Friends and Family4.
Nutrition The Nurturing Aspect of Food5.
Spirituality Inner Resources for Healing6.
Human Touch The Essentials of Communicating
Caring Through Massage7. Healing Arts Nutrition
for the Soul8. Integrating Complementary and
Alternative Practices into Conventional
Care9. Healing Environments Architecture and
Design Conducive to HealthSource Putting
Patients First, Susan Frampton, Laura Gilpin,
Patrick Charmel
118
1. The Importance of Human Interaction
119
There is a misconception that supportive
interactions require more staff or more time and
are therefore more costly. Although labor costs
are a substantial part of any hospital budget,
the interactions themselves add nothing to the
budget. Kindness is free. Listening to patients
or answering their questions costs nothing. It
can be argued that negative interactionsalienatin
g patients, being non-responsive to their needs
or limiting their sense of controlcan be very
costly. Angry, frustrated or frightened
patients may be combative, withdrawn and less
cooperativerequiring far more time than it would
have taken to interact with them initially in a
positive way. Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
120
Press Ganey Assoc/1999 139,380 former patients
from 225 hospitals0 of top 15 factors
determining Patient Satisfaction referred to
patients health outcomePS directly related to
Staff InteractionPS directly correlated with ES
(Employee Satisfaction)Source Putting
Patients First, Susan Frampton, Laura Gilpin,
Patrick Charmel
121
Perhaps the simplest and most profound of all
human interactions is KINDNESS. But if it is so
simple, it is surprising how frequently it is
absent from our healthcare environments. Many
staff members report verbal abuse by
physicians, managers and coworkers. Putting
Patients First, Susan Frampton, Laura Gilpin,
Patrick Charmel
122
Planetree is about human beings caring for other
human beings. Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel (Ladies
and gentlemen serving ladies and gentlemen4S
credo)
123
2. Informing and Empowering Diverse Populations
Consumer Health Libraries and Patient
Information
124
Planetree Health Resources Center/1981Planetree
Classification SystemConsumer Health
LibrariansVolunteersClasses, lecturesHealth
FairsGriffins Mobile Health Resource
CenterOpen Chart PolicyPatient Progress
NotesCare Coordination Conferences (Est goals,
timetable, etc.)Source Putting Patients First,
Susan Frampton, Laura Gilpin, Patrick Charmel
125
3. Healing Partnerships The Importance of
Including Friends and Family
126
When hospital staff members are asked to list
the attributes of the perfect patient and
family, their response is usually a passive
patient with no family. Putting Patients First,
Susan Frampton, Laura Gilpin, Patrick Charmel
127
The Patient-Family ExperiencePatients are
stripped of control, their clothes are taken
away, they have little say over their schedule,
and they are deliberately separated from their
family and friends. Healthcare professionals
control all of the information about their
patients bodies and access to the people who can
answer questions and connect them with helpful
resources. Families are treated more as intruders
than loved ones. Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
128
Family members, close friends and significant
others can have a far greater impact on
patients experience of illness, and on their
long-term health and happiness, than any
healthcare professional. Through the Patients
EyesSource Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
129
A 7-year follow-up of women diagnosed with
breast cancer showed that those who confided in
at least one person in the 3 months after surgery
had a 7-year survival rate of 72.4, as compared
to 56.3 for those who didnt have a
confidant.Sourcde Institute for the Future
130
Institute of Medicine/ Crossing the Quality
ChasmRespect for preferencesInvolvement in
Decision MakingAccess to careCoordination of
careInformation and educationPhysical
comfortEmotional supportInvolvement of Friends
and FamilyContinuity of careSource Putting
Patients First, Susan Frampton, Laura Gilpin,
Patrick Charmel
131
Care Partner Programs (IDs, discount meals, etc.)
Unrestricted visits (Most Planetree hospitals
have eliminated visiting restrictions
altogether.) (ER at one hospital has a policy
of never separating the patient from the family,
and there is no limitation on how many family
members may be present.) Collaborative Care
Conferences Clinical Guidelines
DiscussionsFamily SpacesPet Visits (POP
Patients Own Pets)Source Putting Patients
First, Susan Frampton, Laura Gilpin, Patrick
Charmel
132
4. Nutrition The Nurturing Aspect of Food
133
Meals are central eventsvsThere, youre
fed. Irony Focus on nutrition has
reduced focus on food and serviceSource
Putting Patients First, Susan Frampton, Laura
Gilpin, Patrick Charmel
134
KitchenBeautiful cutlery, plates, etcChef
repSource Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
135
Aroma therapy (eg smell of baking
cookies)Source Putting Patients First,
Susan Frampton, Laura Gilpin, Patrick Charmel
136
5. Spirituality Inner Resources for Healing
137
Spirituality Meaning and Connectedness in
Life1. Connected to supportive and caring
group2. Sense of mastery and control3. Make
meaning out of disease/find meaning in
sufferingSource Putting Patients First,
Susan Frampton, Laura Gilpin, Patrick Charmel
138
6. Human Touch The Essentials of Communicating
Caring Through Massage
139
Massage is a powerful way to communicate
caring. Putting Patients First, Susan Frampton,
Laura Gilpin, Patrick Charmel
140
Mid-Columbia Medical Center/Center for Mind and
BodyMassage for every patient scheduled for
ambulatory surgery (Go into surgery with a good
attitude) Infant massageStaff massage (caring
for the caregivers)Healing environments
chemo!Source Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
141
7. Healing Arts Nutrition for the Soul
142
Planetree Environment conducive to
healingColor!Light!Brilliance!Form!Art!Mu
sic!Source Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
143
8. Integrating Complementary and Alternative
Practices into Conventional Care
144
Griffin IMC/Integrative Medicine
CenterMassageAcupunctureMeditationChiropracti
cNutritional supplementsAroma therapySource
Putting Patients First, Susan Frampton, Laura
Gilpin, Patrick Charmel
145
CAM (Complementary Alternative Medicine) 83M
in US (42)CAM visits 243M, greater than to PCP
(Primary Care Physician) (With min insurance
coverage)W-Educated-Hi incDont tell PCP
(40)And lt30 procedures used in conventional
medicine have undergone RCTs (randomized clinical
trials) Source Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
146
9. Healing Environments Architecture and Design
Conduciveto Health
147
Planetree LookWoods and natural
materialsIndirect lightingHomelike
settingsGoals Welcome patients, friends and
family Value humans over technology .. Enable
patients to participate in their care Provide
flexibility to personalize the care of each
patient Encourage caregivers to be responsive
to patients Foster a connection to nature and
beautySource Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
148
Access to nurses stationHappen
tovsHappen withSource Putting Patients
First, Susan Frampton, Laura Gilpin, Patrick
Charmel
149
Conclusion Caring/Growth Experience
150
Care!Control!Connect! Engage!Grow!
De-stress!
151
Learn more about Planetree/ The Planetree
Alliance www.planetree.org
152
Life Sciences Revo Rocks Our WorldComing
soon to a
153
On February 12, 2001, anyone with access to the
Internet Could suddenly look at a new atlas
One containing the whole human genome.
Source Juan Enriquez, As The Future Catches You
154
WE ARE BEGINNING TO ACQUIRE DIRECT AND
DELIBERATE CONTROL OVER THE EVOLUTION OF ALL
LIFE FORMS ON THE PLANET.Source Juan
Enriquez, As The Future Catches You
155
In a couple of decades the worlds dominant
language became strings of ones and zeroes.
Your world and your language are about to
change again. THE DOMINANT LANGUAGE AND
ECONOMIC DRIVER OF THIS CENTURY IS GOING TO
BE GENETICS.Source Juan Enriquez, As The
Future Catches You
156
We face the biggest change in tens of thousands
of years in what it means to be human. In
just 20 years the boundary between fantasy and
reality will be rent asunder. (Rodney Brooks,
AIL/MIT) We are at an inflection point in
history. It is about the defining cultural,
social, and political issue of our age. It is
about human transformation. Source Radical
Evolution The Promise and Peril of Enhancing Our
Minds, Our Bodiesand What It Means to Be Human,
Joel Garreau
157
GRIN Genetics, Robotics (nanotech), Information,
NanotechSource Radical Evolution The Promise
and Peril of Enhancing Our Minds, Our Bodiesand
What It Means to Be Human, Joel Garreau
158
Ray Kurzweil Singularity
159
415-page doc, Department of Commerce/NSF
Converging Technologies for Increasing Human
Performance Source Radical Evolution The
Promise and Peril of Enhancing Our Minds, Our
Bodiesand What It Means to Be Human, Joel Garreau
160
Soldiers having no physical, physiological, or
cognitive limitations will be key to survival and
operational dominance in the future. Michael
Goldblatt, Director, Defense Sciences
Office/DARPASource Radical Evolution The
Promise and Peril of Enhancing Our Minds, Our
Bodiesand What It Means to Be Human, Joel Garreau
161
Singularity/Bionic Tom, circa 2006 Medtronic
pacemaker (heart micro-management)
psychotropics (mental micro-management) Google
(mind-extensionsmart-beyond-measure) Samsung
cell phone (instant-permanent planetary
connectedness) Orvis shirt (smart skin)
162
If you dont like change, youre going to
like irrelevance even less. General Eric
Shinseki, Chief of Staff. U. S. Army
163
H5N1
164
Kroll/SARS dont over-reactKroll/H5N
1 devastatingSource Newsweek/10.24.05
165
T.T.D./Healthcare27
166

Healthcare27 1. Fully utilize Physicians
Assistants to do routine work in a timely
fashion. (Doc in a Kiosk at WalMart is
great!) 2. Maximize Outpatient services! 3. Short
hospital stays work! 4. Support home care to the
max. (E.g., Declaration of IndependentsBeacon
Hill/Boston) 5. STOP THE 100K NEEDLESS
DEATHSmuch/most of the quality stuff is
eminently fixable. (Don Berwick for President!
AHA for Hall of Shame!) (Strong, vicious insurer
incentives!!!) 6. FLIP HC 177 DEGREES TO
EMPHASIZE PREVENTION WELLNESS. (Steps are
being taken but not enough. Med schools Awful!
Insurers Little better. Support for
appropriate-proven alternative therapies is an
important part.) (HUGE INCENTIVES FOR EFFECTIVE
WELLNESS-PREVENTION PROGRAMS-MEASURABLE
SUCCESSES.)
167

Healthcare27 7. Boomers will determine HCs
(very different?) future. (They are from a
different demanding planet compared to
yesterdays Oldsters.) 8. Focus on Women. (Its
my genericand correctrallying cry, and it
applies to HC in spades, women-as-patients-with
different-woes-than-men women-as-HC decision
makers at the consumerand commerciallevel.) 9.
Patient/Consumer-driven may be a buzz phrase
bandied about all to easily but it is true.
(And changes the game.) 10. Reduce incentives for
unnecessary tests. (Malpractice caps would help,
though the issue is complex. Insurers-HMOs doing
so-so on this.) 11. OUTCOME-BASED MEDICINE IS A
MUST! (There is a long, long way to go!) (Measure
until youre blue in the face!) 12. Science-based
medicine is a terrific idea!! (Many therapies
unproven scientifically, uneven in application
when proven.)
168

Healthcare27 13. Over the next 5-25 years, the
Life Sciences Revolution will make the likes of
the info revolution look like small beer. (Get
ready.) 14. Radical increase in best practices
utilizationinculcate in Med school! 15. Med
school revolution imperativeoutcome-based
medicine, abiding emphasis on Wellness
Prevention, etc. 16. Get info to Patients! (HIPAA
mostly good.I wanna see my records!) (Detailed
hospital-by-hospital, disease-by-disease,
doc-by-doc success records a must despite
controversy.) 17. Upgrade IS-IT in the entire
system, starting with acute-care institutions.
(Current grade D-.) (Winners include Indiana
Heart Hospital Inova Fairfax Heart
Institute.) 18. Healtheon WebMD-like (if it had
worked) mega-, integrated-info network
will-should emerge. (A healthcare Google?)
169

Healthcare27 19. MOVE HEAVEN EARTH TO
IMPLEMENT ELECTRONIC MEDICAL RECORDS. NOW. 20.
By hook or by crook, something approximating
basic universal care, starting with kids50 state
partial experiments is a help some are quite far
along. (Market-based as much as possiblebut
this is far from a perfect market.) 21. Deal
with the enormous HMO I want my doc perception
problem. (Fact MARCUS WELBY, STATISTICALLY,
AINT THAT GREAT A HEALER IN TODAYS HIGH
SCIENCE WORLD! Incidentally, same perception
problem re Congress, schools. My Congressman is
great, Congress has 434 other crook-clowns. My
kids school is good, the system is awful.) 22.
Blitzkrieg of Patient/Customer/Citizen education
(eg re outcomes-based HC Get the most for
your HC dollar). (Corporate cuts should motivate
this.) 23. Healing-centric care supported.
(E.g., Planetree modelreduces future problems.)
170
Healthcare27 24. Emphasize front-to-back
customer care practicescuts waaaaay down on
malpractice claims among other things. 25.
Specialization in acute care works wonders,
regardless of howls! (E.g., Shouldice/hernia
repair.) 26.Shorten the FDA approval process.
(Tom, age 63, wants the good new stuff and will
accept associated risk so will most
boomers-geezers.) 27.DONT MESS AROUND WITH
H5N1/AVIAN FLU!
171
T.T.D./ACTION.NOW.
172
Visible Signs/Measures (Creech)TRAIN. TRAIN.
TRAIN. (P.S.)Med school, Nursing school
cirriculum (P.S.)BOLD!/Big change EASIER than
modest change (P.S., etc.)EXCELLENCE. ONLY.
ALWAYS. DAMN IT.EVP/Patient SafetyP.S.O.sFund
the living hell out of it (P.S.)CEO (etc)
REFLECT IT IN CALENDAREMERGENCY STATUSH.M.O.s
Big/Enormous (/-) incentives for docs,
hospitals, etc, etcBOARD Patient Safety
CommitteeBOARD WPCC CommitteePatient Safety
BALDRIDGE (POTUS?)CERTIFICATION/RE-CERTIFICATION
for One All (P.S., etc)
173
WPOCC Rules!!!!!!! (Wellness/Prevention/Obesity/C
hronicCare)WPOCC N.G.A. (AK)Dramatically
higher involvement in WPOCCINSURANCE COMPANY
VISIBILITY/SPONSORSHIP/MEGA-INCENTIVESAwards
Galore P.S./WPOCC)BOARD Committee
H5N1GovtHHS Split HC PWO (Ontario)Write off
½ of med school loan if pay with 3-5 years
service in Public HealthGlamorize Family
Practice, Public Health Service, etcFAT
legislation?? (Almost certainly) (Density, HFCS,
Trasfats, etc, etc) (A FIRST FOR TP)SUE the hell
out of One All re Obesity (Cigarettes II)
174
Research LEAP _at_ N.I.H. (Etc, Etc, ETC)INCENTIVES
_at_ SCHOOLS (BIG!!)EMR Intensify!!!!!!!!!!!!!No
leadership position in AHA (AMA?) (DEANs?)
(Etc?) without Safety tourNo Medical Chief
(gt150 beds?) without Safety tour)FORGET ABOUT
ME!!! (Except Wellness, ChroniCare)VIGOROUSLYSUP
PORT Home CareAmerican OBESITY African AIDs
(??)ELIMINATE/OBLITERATE HIGH FRUCTOSE CORN
SYRUP!ELIMINATE/OBLITERATE TRANSFATS!(HFTC/TF
The Real WMDs)FDA Kill! Kill! Kill! (Please)
175
CEO Bonus 50 P.S./WPOCCOBNOXIOUS
labelsIncentives for BILLBOARDSNatl Advertising
CouncilPARENTING education, etc.
176
STOP THE GRATUITOUS KILLING
177
STOP THE GRATUITOUS KILLING
178
STOP THE GRATUITOUS KILLING
179
STATE OFEMERGENCY
180
Part 2
181
Tom PetersEXCELLENCE. ALWAYS.
182
EXCELLENCE. THE MANDATE.
183
It is not the strongest of the species that
survives, nor the most intelligent, but the one
most responsive to change. Charles Darwin
184
EXCELLENCE. THE WORD.
185
SynonymsPurityTranscendenceVirtueEleganceMaj
estyAntonymsMediocrity
186
EXCELLENCE. GAMECHANGER.
187
Excellence1982 The Bedrock Eight Basics 1. A
Bias for Action 2. Close to the Customer 3.
Autonomy and Entrepreneurship 4. Productivity
Through People 5. Hands On, Value-Driven 6. Stick
to the Knitting 7. Simple Form, Lean Staff 8.
Simultaneous Loose-Tight Properties
188
ExIn 1982-2002/Forbes.comDJIA 10,000 yields
85,000 EI 10,000 yields 140,050
Forbes/Excellence Index /Basket of 32
publicly traded stocks
189
EXCELLENCE. ALWAYS.
190
Why in the world did you go to Siberia?
191
The Peters Principles Enthusiasm. Emotion.
Excellence. Energy. Excitement. Service. Growth.
Creativity. Imagination. Vitality. Joy.
Surprise. Independence. Spirit. Community.
Limitless human potential. Diversity. Profit.
Innovation. Design. Quality. Entrepreneurialism.
Wow.
192
Business (at its best) An emotional, vital,
innovative, joyful, creative, entrepreneurial
endeavor that elicits maximum concerted human
potential in the wholehearted service of
others.Excellence. Always.Employees,
Customers, Suppliers, Communities, Owners,
Temporary partners
193
Business The Ultimate Creative Endeavor.
194
Business The Ultimate Personal
Development-Growth Experience.
195
Business The Ultimate Transcendent Service
Opportunity.
196
EXCELLENCE. YOU ME.
197
This is the true joy of Life, the being used for
a purpose recognized by yourself as a mighty one
the being a force of Nature instead of a
feverish, selfish little clod of ailments and
grievances complaining that the world will not
devote itself to making you happy. GB
Shaw/Man and Superman
198
Life is not a journey to the grave with the
intention of arriving safely in a pretty and
well-preserved bodybut rather a skid in
broadside, thoroughly used up, totally worn out,
and loudly proclaiming, Wow, what a ride!
anon.
199
EXCELLENCE. INNOVATE. OR. DIE.
200
A focus on cost-cutting and efficiency has
helped many organizations weather the downturn,
but this approach will ultimately render them
obsolete. Only the constant pursuit of innovation
can ensure long-term success. Daniel Muzyka,
Dean, Sauder School of Business, Univ of British
Columbia (FT/09.17.04)
201
Forbes100 from 1917 to 1987 39 members of the
Class of 17 were alive in 87 18 in 87 F100
18 F100 survivors underperformed the market by
20 just 2 (2), GE Kodak, outperformed the
market 1917 to 1987.SP 500 from 1957 to 1997
74 members of the Class of 57 were alive in 97
12 (2.4) of 500 outperformed the market from
1957 to 1997.Source Dick Foster Sarah
Kaplan, Creative Destruction Why Companies That
Are Built to Last Underperform the Market
202
I am often asked by would-be entrepreneurs
seeking escape from life within huge corporate
structures, How do I build a small firm for
myself? The answer seems obvious Buy a very
large one and just wait. Paul Ormerod, Why
Most Things Fail Evolution, Extinction and
Economics
203
More than 1 RD spending, last 25 years?
204
GM
205
Innovation The Secrets
206
Parallel universe!
207
Venture fund (E.g. Gerstner/Amex,
Dow/Marriott, Grove/Intel, Bedbury/Starbucks)
208
2/50Scott Bedbury/Starbucks/lt1/lt4 of 400/
grabbed best/all wanted to be there/2-50
209
This is so simple it sounds stupid, but it is
amazing how few oil people really understand that
you only find oil if you drill wells. You may
think youre finding it when youre drawing maps
and studying logs, but you have to drill.
Source The Hunters, by John Masters, Canadian
O G wildcatter
210
We made mistakes, of course. Most of them were
omissions we didnt think of when we initially
wrote the software. We fixed them by doing it
over and over, again and again. We do the same
today. While our competitors are still sucking
their thumbs trying to make the design perfect,
were already on prototype version No. 5. By the
time our rivals are ready with wires and screws,
we are on version No. 10. It gets back to
planning versus acting We act from day one
others plan how to planfor months. Bloomberg
by Bloomberg
211
Culture of PrototypingEffective prototyping
may be the most valuable core competence an
innovative organization can hope to
have.Michael Schrage

212
Demos! Heroes! Stories!
213
Never doubt that a small group of committed
people can change the world. Indeed it is the
only thing that ever has. Margaret Mead
214
You only find oil if you drill wells. T he
Hunters, by John Masters, Canadian O G
wildcatter
215
FAIL, FAIL AGAIN. FAIL BETTER. Samuel Beckett
216
The secret of fast progress is inefficiency,
fast and furious and numerous failures.Kevin
Kelly
217
EXCELLENCE. 4/40.
218
4/40
219
De-cent-ral-iz-a-tion!
220
Ex-e-cu-tion!
221
We have a strategic plan. Its called doing
things. Herb Kelleher
222
Execution is the job of the business leader.
Larry Bossidy Ram Charan/ Execution The
Discipline of Getting Things Done
223
Ac-count-a-bil-ity!
224
GE has set a standard of candor. There is no
puffery. There isnt an ounce of denial in the
place. Kevin Sharer, CEO Amgen, on the GE
mystique (Fortune)
225
615A.M.
226
????????Work Hard gt Work Smart
227
EXCELLENCE. WANTING.
228
This is not a mature category.
229
This is an undistinguished category.
230
EXCELLENCE. DRAMATIC.DIFFERENCE.DOABLE.
231
798
232
415/SqFt/WalMart798/SqFt/Whole Foods
233
7X. 730A-800P. F12A.93-03/10 yr annual
return CB 29 WM 17 HD 16. Mkt Cap 48
p.a.
234
?
235
Its simple, really, Tom. Hire for ?s, and,
above all, promote for ?s. Starbucks middle
manager/field
236
1/100 Best Companies to Work for/2005
237
Wegmans
238
EXCELLENCE. 1.
239
Cirque du Soleil!
240
And the Winner is 1.
Audacity of Vision2. Innovation/RD/Design3.
Talent Acquisition Development4. Resultant
Experience5. Strategic Alliances6.
Operations7. Financial Management8.
Overall/Sustaining Excellence9. Wow!10.
Lovemark!
241
EXCELLENCE. OPPORTUNITY.
242
Women are the majority market Fara
Warner/The Power of the Purse
243
Forget China, India and the Internet Economic
Growth Is Driven by Women. Headline,
Economist, April 15, Leader, page 14
244
The Perfect Answer
Jill and Jack buy slacks in black
245
(No Transcript)
246
1. Men and women are different.2. Very
different.3. VERY, VERY DIFFERENT.4. Women
Men have a-b-s-o-l-u-t-e-l-y nothing in
common.5. Women buy lotsa stuff.6. WOMEN BUY
A-L-L THE STUFF.7. Womens Market Opportunity
No. 1.8. Men are (STILL) in charge.9. MEN ARE
TOTALLY, HOPELESSLY CLUELESS ABOUT WOMEN.10.
Womens Market Opportunity No. 1.
247
Goldman Sachs in Tokyo has developed an index of
115 companies poised to benefit from womens
increased purchasing power over the past decade
the value of shares in Goldmans basket has risen
by 96, against the Tokyo stockmarkets rise of
13. Economist, April 15
248
EXCELLENCE. OPPORTUNITY.
249
2000-2010 Stats18-44 -155 21(55-64
47 )
250
44-65 New Customer Majority 45 larger
than 18-43 60 larger by 2010Source Ageless
Marketing, David Wolfe Robert Snyder
251
EXCELLENCE. VALUE ADDED.
252
55B
253
The Only? Answer PSF (Professional Service
Firm model/The Organizing Principle) Brand
You(Distinct or Extinct/The Talent) Wow!
Projects (Different vs Better/The Work)
254
ChicagoHRMAC
255
support function / cost center/ overhead
or
256
Are you Rock Stars of the Age of Talent
257
Department Head to Managing Partner, IS
HR, RD, etc. Inc.
258
EXCELLENCE. ATTITUDE.TRANSFORMATION.
259
Purchasing Officer Thrust 1 Cost (at All
Costs) Minimization Professional? Or/to Full
Partner-Leader in Lifetime Value-added
Maximization?(Lopez Arguably Villain 1 in
GM tragedy/Anon VSE-Spain)
260
HCare CIO Technology Executive (workin in a
hospital) Or/to Full-scale, Accountable (life
or death) Member-Partner of XYZ Hospitals
Senior Healing-Services Team (who happens to be a
techie)
261
EXCELLENCE. EXPERIENCE IT.
262
Experiences are as distinct from services as
services are from goods. Joe Pine Jim
Gilmore, The Experience Economy Work Is Theatre
Every Business a Stage
263
The Starbucks Fix Is on We have
identified a third place. And I really
believe that sets us apart. The third place is
that place thats not work or home. Its the
place our customers come for refuge.Nancy
Orsolini, District Manager
264
The Value-added Ladder/Memorable
ConnectionSpellbinding Experiences
Gamechanging SolutionsServicesGoods Raw
Materials
265
CXOChief eXperience Officer
266
EXCELLENCE. THE STORY.
267
Storytelling is the core of culture.
Branded Nation The Marketing of Megachurch,
College Inc., and Museumworld, James Twitchell
268
CSTOChief Storytelling Officer
269
EXCELLENCE. K.I.S.S.
270
450/8
271
I wanted GE to operate with the speed,
informality, and open communication of a corner
store. Corner stores often have strategy right.
With their limited resources, they have to rely
on laser-like focus on doing one thing very
well. Jack Welch/Fortune/04.05
272
The art of war does not require complicated
maneuvers the simplest are the best, and common
sense is fundamental. From which one might wonder
how it is generals make blunders it is because
they try to be clever. Napoleon on Simplicity,
from Napoleon on Project Management by Jerry
Manas.
273
EXCELLENCE. BEDROCK.
274
Management has a lot to do with answers.
Leadership is a function of questions. And the
first question for a leader always is Who do we
intend to be? Not What are we going to do? but
Who do we intend to be? Max De Pree,
Herman Miller
275
EXCELLENCE. PASSION.
276
Nothing is so contagious as enthusiasm.
Samuel Taylor Coleridge
277
EXCELLENCE. BEDROCK.
278
Organizing Genius / Warren Bennis and Patricia
Ward BiedermanGroups become great only when
everyone in them, leaders and members alike, is
free to do his or her absolute best.The best
thing a leader can do for a Great Group is to
allow its members to discover their greatness.
279
Leaderships Mt Everest/Mt Excellencefree to
do his or her absolute best allow its
members to discover their greatness.
280
The role of the Director is to create a space
where the actor or actress can become more than
theyve ever been before, more than theyve
dreamed of being. Robert Altman, Oscar
acceptance
281
In the end, management doesnt change culture.
Management invites the workforce itself to
change the culture. Lou Gerstner
282
Our MissionTo develop and manage talentto
apply that talent,throughout the world, for the
benefit of clientsto do so in partnership to
do so with profit.WPP
283
Les Wexner From sweaters to people!
284
Leaders do people. Period. Anon.
285
DD21M
286
A review of Jack and Suzy Welchs Winning claims
there are but two key differentiators that set GE
culture apart from the herd First
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