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that's really what most people want. They know you're not going to be perfect. They just want you to try. And that's everything. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health, where we are dedicated to transforming healthcare one connection at a time. Our keynote show is designed to share conference level value with you every week.

Now, let's jump right into the episode.

(Intro) All right, it's Keynote, and today we are going to talk about culture. We have Megan Trevorrow, Drex DeFord, and Sarah Richardson here with us today, and I'm looking forward to this conversation. Megan is going to kick us off.

I've got a few questions that Bill, Drex, and Sarah get to speak into from their collective personal experience within health IT, and I'm going to kick it off with this first question.

From each of y'all's perspective. What's the largest uphill [00:01:00] battle in terms of culture that health IT teams face today?

Wow. You know what, Megan, do this for us. How would you define culture before, before we dive into our stories? How would you define it?

Great question. Love this question. I would define culture I don't know if anybody else defines culture this way, but it helps me understand it better.

So if character is each of our personal internal values and beliefs that inform how we act and behave, culture is whenever two of those characters are together. So in essence, it's a group of people. So that could be two people, it could be a hundred people. They're shared actions and behavior.

Okay, so the four of us right now have a culture.

Yes.

But if we bring another person in, that, the culture will adapt.

The culture shifts. If Sarah left, the culture would shift because her character, her values, how she acts, how she [00:02:00] makes the room feel, her words, her expressions would leave with it too. So the culture shifts. Anytime a person is added or taken away from a group.

It's interesting. So I'll go with my story first. When I went into St. Joe's 16 hospital system, they have some fairly large IT organization. I think at the time I came in, it was about 400, 450 staff and a number of contractors. The reason it was only 450 is they had just finished a 10 year outsource to Del Perot, and they were in the process of insourcing it.

And I think the interesting thing about that was, it still had a lot of the remnants of the Del Perot culture, but it had some of the St. Joe's culture. It wasn't, it was, odd. And part of that was because they hired so many Del Perot people. Because that team was on site and they were delivering services, and then when they insourced, they just hired a whole bunch of them, [00:03:00] and they just brought that culture with them.

And what I would say is when I walked in there, I know you just defined it in a way like there is a culture, but I would almost say that it was devoid of culture. Because the St. Joe's culture was so strong around the sisters and the healing ministry and the community and, all those things.

But the culture of IT had no connection to that whatsoever. They had no connection to the mission whatsoever. And when I came in, one of the things I recognized pretty early on is we've got to connect these two things. These people have got to understand that they've just walked into a room with other people and they can't ignore those people.

Like they have to. They have to be joiners. They have to become a part of this mission. And so, we did all the things. We became big joiners. They did cultures and, it's called Values in Action Program. And we, participated significantly in that.

They had every one of our [00:04:00] meetings started with a reflection. And IT didn't start with reflections. I'm like, why every meeting in the entire organization I go to starts with a reflection except in IT? Because it was Del Perot, it wasn't. It was all those things of, it was almost, And the odd thing was I'd just been hired.

In fact, I was interim. I hadn't been hired yet, but I was introducing this whole team to the to the culture that the sisters had built over a course of 150 some odd years.

So would you say that this is a common issue when it comes to culture is either outsourcing a team to come in or just a straight up merger of two teams?

I'd be interested to hear what these guys have to say, because IT is always made up of staff, contractors, partners, there's people onsite, people offsite, there's third party service providers. That's one of the trickier things of IT. It's not It's not like you're all in the same building doing the same, especially now.

[00:05:00] But even back then it was, you were always trying to navigate this. When we had meetings with partners and contractors, we did reflections, my thing was no, they're guests in our house, so we're going to do what we do. And I understand, and we're, sensitive to the fact that the sisters of St.

Joseph was a Catholic ministry. But reflections were more about taking time to breathe and taking time to, to discuss what's important to us. And we all have very busy days. And so it wasn't a Catholic reflection per se. It was more of a reflection of what are we trying to do as a team?

How are we trying to serve the community? Some people would share quotes from Tony Robbins. And some people would share quotes from Mother Teresa and quite frankly, they were both effective.

I think some of this is trying to figure out that there is always, for [00:06:00] me, there was always an inconsistency between the IT department and the larger organization. And sometimes the larger, organization had the better culture. And so You try to pull the team toward that.

Sometimes the larger organization didn't seem to have a great pervasive culture. And so you had to build something inside of IT and try to model that behavior to pull people from the organization into what you were doing. So it's, it always is a really interesting situation with, Contractors from other organizations with people who work in your organization, work in your department, that maybe are from other companies, but they sit with you every day.

They become teammates for all intents and purposes. And then I think when COVID came and we sent a bunch of people home, that created another whole challenge to how do we put culture together and how do we keep it together when people are [00:07:00] basically living and working from across the country.

And sometimes around the world.

I'm a fan of the promise of all boats rise with the tide. When everyone rose in the same direction, getting there is one of the biggest challenges and fostering a culture that to me needs to be based on trust and collaboration, because you're always going to have high demands on the IT team. And if you're going to be accountable where.

The accountability is that we do what we say we're going to do, but also the people are empowered in their role to make those things happen. My first background came in hospitality, where you were empowered to make that guest feel like they were the most important guests in the hotel. That's a tough and tall order when you have 5, 000 rooms, for example, in a Vegas casino.

And yet when you learn that young, I was 19 when I started there, you bring that forward and you create. These opportunities where the team can be resilient, they can [00:08:00] be adaptive, and no matter how fast technology is changing, especially regulatory requirements it's relentless. There is a level of energy in a hospital that is unlike anywhere else in the world.

And if your teams can Think about a growth mindset where everything that's hard is an opportunity to be better. It improves not only the way we deliver technology, but also improves the way that care gets delivered. Because at the same time, most of us are patients in the systems that we work in. And so I always made sure that any kind of communication gaps or any kind of conversations That needed to happen with a level of authority and that the person with whom they were speaking could be trusted.

That was something that became true so that it didn't erode trust and didn't impede progress in the outcomes we were looking to achieve. But it was literally sometimes being willing to meet with those that worked the graveyard shift. Or be willing to be there at [00:09:00] shift change to understand the real problems that were happening, or go in on the weekend and do the rounding when there were the least amount of people when it's actually hardest to keep the continuity of operations going.

When you, regardless if you're a contractor, a partner, or an FTE, when you know how everything runs. It's so much easier to be able to help make it better or different and understand when it breaks, why it's breaking. But for anybody who goes into an organization and doesn't really get under those covers and dig around to figure out how things actually work, you're going to put yourself at a deficiency.

And so then your team is basically a culture of nine to five, 7 operation. But if you're the leader, They're going to emulate your behavior. And so you better be there nights, weekends, et cetera, as appropriate and as needed and doing shifts in the tough departments got trauma one, you better be in the trauma one center on a weekend, you're going to see things that you hope you never see again.

But then those doctors and nurses appreciate you [00:10:00] because you could actually hack a shift in that department as an example. So put yourself in the shoes of those you're serving. It's an amazing culture that can be created because of it.

, one of the, one of the things that's interesting as we talk about this, when I came into St.

Joe's, there was so many systems that were against culture. They were built against culture. Let me give you one example. Department budgets, every department had a budget. One of the first tours I got out of the IT building, we went into the closets, like just the storage closets, and they were loaded with Cisco switches.

From top to bottom, every single closet in the IT, whatever was loaded from top to bottom with these Cisco switches. I'm like, what is this? And when you finally dug into it, they wanted to make sure that they got their budget money. And this, still exists in a lot of places. They wanted to make sure that no one took their budget money.

They wanted to make sure that nobody that they got it [00:11:00] and then they got more money for next year. And so they essentially squirreled all this stuff away. And so there's these mechanisms. These

were Cisco switches that were not in use.

Oh yeah. No, they were still in boxes. Stacked as high as you can be. And it was. This is not an exaggeration. It was, I don't know, 3 to 4 million worth of equipment. Still in boxes that was like, Hey, let's squirrel this away. Cause we will need, we'll need this stuff. And so departments are fighting against departments for allocation of money.

And that's. A very real thing, not only within IT, it's a very real thing within the health system, right? You have hospital systems looking at IT saying, man, you spend too much money in IT. If you didn't spend that money, we would have that money for our new, whatever that project is. And that's, so that's just on the budgeting side.

And then you have situations we may [00:12:00] inadvertently set up as managers. where people feel like they're competing to get career advancement. And so they're unwilling to work with each other. They're unwilling to form a team like, Sarah said, a rising tide floats all boats. And it's, that's really true.

The question is how do you get them all into the same boat so that they're not like, Hey, you know what? There's only one loaf of bread here in this boat. We're going to probably be in this boat for a week instead of trying to keep everybody. fed, I want to figure out how to get as much of that bread in my pockets as possible.

And if other people die, they die kind of thing. I know that's a kind of harsh way to say it, but that sort of survivor thing plays out every day in, in healthcare. I'm curious if you guys have experienced, that and Megan, I'd love to hear how how do you get through that? How do you, progress through that?

For me, a lot of this wound up. A lot of it is [00:13:00] transparency. A lot of it is, there definitely are cultures that I've walked into where what I know is the thing that makes me valuable, or the things that I control, the number of people that report to me are the, is the thing that makes me valuable.

And I hoard information, I hoard people, I hoard control. I don't want anyone else to have any. Any of that, because to do that makes me less. And when you see that kind of an environment, I think coming in and modeling the, we have to be transparent there's the five of us are way better than any one of us.

Like we can, it The sharing of information actually is a superpower because you're making everyone else better. People won't step on your toes that way. You won't step on other people's toes. And a lot of it is just working with those managers. They do that probably [00:14:00] because they've been in a very unsafe environment.

They've been smacked around because there's something that they've done that now they've, you gone into this defensive crouch, and you almost have to coax them out of it, and it takes time. But if you can get them there, you wind up with this really well running team. Everyone's transparent. They work with each other.

It actually is a team. It's not just a collection of people, but they're all pulling the wagon in the same direction, and it can be hard to do. I've walked into some places where people are in a defensive crouch, and they've been there for 10 years, and they're not coming out of it, and unfortunately we've got to let them go.

Yeah, we have to make a, we have to make a change, especially if that's what you want long term. Some people will come, some people have to be really pushed, and some people will never be able to get in the boat with you.

And Megan, you've worked with a lot of college athletes and teams and whatnot. Have you ever walked into that kind of environment [00:15:00] where it was like the team just was not coming together and they were like every person for themselves?

It really leadership isn't the answer or isn't the only answer to this, but man, it can solve this problem quicker than any groundswell from people at the bottom ring of the org chart working up. I believe people with any title can influence culture around an organization, but when the leader has the priority of aligning.

So when I think about my background within sports it's, college athletic departments. My observation going in is coaches are so under supported by the athletic department, who's only putting pressure on them with small budgets, high expectations, and high performance from 18 year olds. What

could go wrong?

No budget, inexperienced staff. Got it.

Million dollar contracts on [00:16:00] ESPN and don't mess it up. But it's like what you were saying, Drex, of because that's their reality, they have to develop this armor of, okay I don't have any support, so it's either me or this doesn't happen, so I'm going to bulldoze my way to make sure that my team is taken care of.

So whenever there is like a peer to peer moment, it's They're not ready to receive it because they never have. So that's why I say leadership, like the quickest way to turn this, ship of culture is if the leadership actually starts advocating for what's my next tier of leaders need the most?

And let me get them that. Advocate for them and get them resources and make them feel supported because they are supported. And then it trickles down.

On the budget thing, let me tell you, I literally, I'm interim and within the first month, I said, all right, there's no more department budgets. There's an IT budget and it's this bucket of money.

And oh my gosh, it's a lot of money. Look how much money it is. It's amazing. And I had all these direct reports and I said to [00:17:00] them, all right, you no longer have department budgets. Your departments don't have budgets. You don't have budgets. We have a budget and here it is. Here's how you get this money.

You come in to this group and you talk about what you need the money for. And then we all get to look at it and say, that's important. That's a priority. Yeah, let's do it. And yeah, transparency. Exactly.

It forces everybody to put their big boy hat on too, right? Because the decision that you're making isn't the decision that you're making for yourself or for your part of the department.

You're making a decision for the organization. What does the organization need the most? What does What do, the patients and families that are the core of our mission actually need us to do first to make this environment better? Yeah, it's really interesting.

And you'd assume those conversations are happening.

But they're not. I don't know that we assume that they're I know Bill and [00:18:00] Sarah both have been turnaround people. So when you go into turnaround environments, This stuff isn't happening. So you almost step into the environment, assuming that it's not happening and that you're going to have to figure out how to.

with a collection of characters that you may have in front of you, you got to figure out how you're going to make that, how you're going to make that work. And maybe it will work with them, and maybe it'll work with them, but they have to be in different roles. And then sometimes some of those people can't be there at all.

But

Sarah, you brought up, and it's a great point, We're not only talking about, IT, the culture within IT and the culture between IT and administration, but the culture between IT and the clinicians and the medical staff and the people that are actually delivering care. That, and you gave us one way, which is essentially, [00:19:00] hey, round.

Go spend time with them, be with them. And the people I know who have done that have been really effective as leaders. I remember when B. J. Moore shot me a picture of him in a surgeon gown and whatever. He was from Microsoft this is his first job in healthcare. It's like he's sitting there watching.

literally a brain surgeon doing brain surgery. I'm like, dude, you have my respect forever. I would be on the ground. I would be like the minute they started the surgery I would have passed out. That's part of it. But how do you bridge that gap? IT and the medical staff really haven't always been best of buds.

They feel like We've hurt them in some ways. We've done some things with technology and just may force them to do some things. Sarah, that's a question. I'm not really sharp today. Sarah, what are your thoughts on that?

I remember having to implement [00:20:00] CPOE in several facilities.

And this even goes back to early stories with putting the EMR in place. Welcome to late 90s, early 2000s, when you might have had a rudimentary one, but now it was time to. Step up the game and physician's telling me that the EMR ruined their life. And I said, Hey, it ruined mine too. So let's figure this out together.

And it was true. And they were like,

Oh,

and that, that was a way that it worked. And so the team really appreciating that we're not doing this to you. We're doing it with you. And often back to my earlier statement, it's tied to something regulatory or compliance, whether it was HIPAA, whether it was meaningful use.

There were reasons why we were doing the things that we were doing. And so when we came to a common understanding about. What's the goal we need to achieve and why we need to achieve it? How do we use the uniqueness of our organization to get there? And when I had multiple hospitals, and at 15 at one point, every hospital was a little bit different.

And so you had to meet them where they are. [00:21:00] So the baseline of what you're trying to implement is not going to change. And in that specific environment, corporate mandate. Here's what I always used to find fascinating about working for a massive corporation, had several divisions and you had to do all these different things.

It was like we had a choice. It all came from the same place. We all had to do it. I used to think, if you don't want to do it this way, why do you work for this company? And I love that environment, because there were strategies that came from corporate that we had to figure out at the division level. But then we also had to implement individually at every hospital, but we had to know how they worked and how they functioned.

And what's most important, And building that trust, accountability, and the relationship and the culture with any unique individuals and facilities is that know who people look to as the authoritarian in an organization to actually get things done. It may or may not be the CEO. Pretty often, it's the administrativist.

The executive assistant to certain people, or it's the person who's running the loading dock because she [00:22:00] controls all the supplies or where things are, like, know who actually has influence in an organization and make sure that they are sharing with you some of those perspectives because the other factor is, Those people usually around for a really long time.

A strong executive assistant has probably had five or six executives under his or her purview over a period of time. They tell you what works, they tell you what doesn't work. And those are the people that you want to know authentically and not just try to become BFFs with because they happen to be an influencer.

Really get to spend time with them and know them and appreciate how things happen. That's why I feel like I've always been successful with the clinical staff as I Treated them like human beings who also were clinicians, as an example, and knew how to They needed things to run, so they felt like they could deliver the best patient care.

So Sarah brings up an interesting point, Drex, and I want to give you a nice hard one here. We love our champions, right? And we try to cultivate our champions. We try to have as many champions within the organization as possible. [00:23:00] But there's also this other group, and I call them the curmudgeons.

Affectionately, I call them the curmudgeons. And there's nothing you're ever going to do to make these people happy. And you can't fire them. You can't move their clinicians, their You know, they're the head of cardiology who's bringing in a ton of money. And they're just going to be a curmudgeon from now until forever.

How do you, do that? I under we talk about champions all the time. Get your champions, cultivate your champions, give them what they need. All that stuff. We don't talk about curmudgeons much.

I think the I've definitely had folks like that and, you kill them with kindness.

I'm not sure exactly how to describe it. You don't run away from them. So a lot of this is go to their staff meetings, listen to what they have to say. Don't be emotional. Don't go into a defensive crouch. They've got complaints. You need to hear them. [00:24:00] And the next time you come back to the staff meeting, talk about what you did around those complaints, or talk to them one on one about those complaints.

Talk to them outside the meeting. Tell them why some of the things that they're saying, you In the meeting that is causing the chaos and the rest of the group, tell them why that's not really the whole story or why they may not, there's more information that they really need to be able to understand what's actually happening here.

That it's not, I'm not making a decision in a smoky backroom without anybody's input. Maybe as Sarah said, it's coming down from on high. We have to figure out how to work on it. So I'm willing to work with you, Dr. Smith. Explain to me what you think might be a good alternative to what I've suggested in doing this.

And a lot of this is then You know, you're slowly but surely compromising their, themselves into your team, into your situation. And if you have champions [00:25:00] that you can build around them, then you wind up, this isn't just a game of one on one, it becomes a game of three on one, or a game of four on one.

I'm not saying that they'll ever relent, But they will understand over time. They will, become more understanding of the situation. And that you really are trying. And that's really what most people want. They know you're not going to be perfect. They just want you to try. And that's everything.

I'm going to build on this and I'm going to come back to you Megan, because I want you to tie some of this stuff up in terms of leaning into conflict and those kind of things. We, talked about the individual things you can do as the CIO and whatnot, but sometimes there's this, IT.

And medical staff thing going on. And I just want to share this story because I think it's so powerful is Alistair Erskine, who's practicing MD, right? So he figured out a way, it did all the hard work [00:26:00] and there is some hard work associated with this to take his IT staff on rounds all over the hospital.

And they use, video. And he has the key players there. So much like you would have clinicians there for a second opinion and all that other stuff, he had the entire IT staff there as he's having the conversation, as they're hearing, Hey, this EHR, this information should be right here on this screen.

I don't know why it's tucked all the way over here, but every time I have to get to it and I get to it like 40 times a day, I have to go all the way over here. And he just looks into the screen and he's you got that? Like this. And he's just looking at him like, if we know it we can, fix it.

But just the whole dynamic created a discussion between IT and FHIR. And the clinical staff, and it creates that connection. That connection, since the pandemic, has been eroding, I believe.

Rounding, rounding is [00:27:00] incredibly important in all of this. We used to put our folks I know doctors are very important, but realistically, in most health systems, the people who do most of the work are the nurses.

And if you can get the nurses squared away, And get the nurses on board as champions. They will square away the physicians. But no matter how you slice it, that getting out, going to Gemba, being in the place where the work is done, listening to people complain about the problems that they have.

That they're not going to put in a service desk ticket for. A lot of those things are just little things that if you're not there, you're never going to hear about it. So you can't stay in the department. You can't be isolated from the rest of the organization. You got to go and listen to those stories.

And if you do, the IT department's culture, which hopefully gets better and better over time, becomes one of those things that everyone else in the organization is exposed to. And they start to I [00:28:00] like it. I like what those folks are doing. They really are trying, and it makes a, huge difference.

So Megan, in the culture course, we talk a lot about, you talk a lot about, leaning into conflict.

Yes.

And you're hearing that there's no shortage of conflict in, within the health IT team, within the hospital system and whatnot. How, what does it look like to effectively lean into conflict?

The interesting thing that I'm noticing within this healthcare IT space is that there's such peer to peer relationships.

There's no authority or title that anyone can lean on. The degree that people can Develop rapport. Everything that you're listing out, you just gave like a masterclass, Drex, of go show up face to face, one on one, ask questions, seek to understand, start with curiosity approach it with positive assumptions, it's, you just hit the checklist of how to embrace conflict well with people that, it doesn't serve as a [00:29:00] checklist of, okay, we, we had a good conversation.

It's actually momentum building when you do it well. And it starts with a, somehow face to face. I love what Emory's doing with connecting the IT team to the mission. I think that's a big gap within either remote teams, but specifically within health IT is the, lack of connection to mission. And no, it's like the cook is in the back of the kitchen, and they never see anyone in the restaurant enjoying their food.

So, how do you stay inspired? How do you remember your why? So doing things like that, where you create, I don't know, proactive ways of connecting your team to the mission giving them a reason to wake up and go to work. So, things like that is the proactive things, but when it comes to those moments of conflict, the approach with curiosity and questions and seeking to understand and finding out there might be something that I don't know.

I don't even know to ask for. I've, personally had too many conversations where I'm probably coming in like fiery because [00:30:00] someone's missed an expectation of mine. And thank the good Lord I asked a question and I find out like something's going on and empathy happens right away. And not like I'm taking people off the hook for anything.

We're not lowering standards of performance or expectation, but there's a, an empathy moment that happens of, that makes total sense. I'm so glad that I didn't come in accusing. But I start with the question, now I understand more of your story and what you've got on your plate. And your issue with the button in the bottom right corner that I had no idea about.

So that's seeking to understand. Stephen Covey talks about it and there's a reason why his book, Seven Habits of Highly Effective People, is an ongoing bestseller and that's one of his key points.

I want to talk about generations. Sarah, you always have this number at the top of your head. How many generations are in the workforce right now?

Five.

Five. Five generations in the workforce right now. They have different ideas, thoughts expectations, there's, [00:31:00] and invariably, the older you get, it's man this next generation, they don't want to work hard. Or as soon as those words come out of your mouth, you're like, oh my gosh, I'm my father.

What just happened here? I don't know. But what let's, talk about generations a little bit. And Sarah, I think I'll start with you. I just, the, I how do you stay connected to the younger generation? How do you inspire the younger generation while still, the healthcare system still wants you to get a lot of work done.

I hear work life balance more than I've ever heard it in my career. I didn't even hear that term, I think, until I was like 35 years old. It was not a, it wasn't really a thing when I came into the workforce. It was like no, you're going to work and you're going to work as much as it takes to get this job done.

Talk to us about connecting with this with, all five generations and how we need to think about that or approach that.

It [00:32:00] starts to a degree with how you're hiring people. Now granted, you walk into a facility, you probably are inheriting obviously your entire team with very few roles to backfill.

This is before you've even started to call people from the culture perspective of who needs to go and who needs to come in. I am really specific about asking questions, cultural questions, when I interview people because if you don't want to be in a 24 7 365 operation, if you don't like to see people who are sick, if the morgue scares you, as an example, you probably don't want to work in a hospital.

And it's a terrible thing to find out after the fact because I've had that happen where someone's oh, I don't do like bodies. I'm like, data centers next to the morgue, like there will be bodies in the hallway. Granted that they're zipped up, but I get it you just gotta come to that basic

question.

Your data center is next to the morgue man. You got good real estate. Man, my data center is like underneath the, downspout for the roof, I think. Yeah

We had that problem too, actually. A lot of, I always, you'll hear me often say you can't [00:33:00] make it up, because you can't sometimes. Now, with that being said, Every generation is the same as really any person.

They have all the special things they bring to the table and they have their idiosyncrasies. So when you're a leader, it's your responsibility to meet with every single person in an organization when you get there. And I've had people say, that's impossible. I have this many people. Figure it out. Because that first 100 days, you better make everybody feel like they matter.

And if you have to do it in a 15 to 1 ratio through coffee with Sarah, okay, fine. But really understanding where people are coming from and asking them all the same questions when you first get there, as an example, so they have a baseline for, Oh, what's she going to ask me? What's she gonna do with the information?

Because trust is built over periods of time and having interactions with people that to a degree are predictable. They know how you're going to respond to a certain scenario. And so one of my favorite books is by Colin Powell. It's lessons I learned in leadership, he calls it. And he would write a letter to his new team and say, here's all the things about me you can expect, like the basics, like I don't work after this period of time.

If you [00:34:00] call me on this, during this period of time, here's how I'm going to respond. Like he just tell people, this is how I function. So you get a baseline for this is how you work with me and then you learn how to also work with them and then that curiosity perspective. So I also make sure I stay plugged in.

Even now, I have people in my life who are in each generation and just asking them about how the world works for them and things that they're curious about and things that they, Because I love to text. It's my preferred method of communication. And yet, texting with a 20 year old, you might not be able to actually decipher what they're sending you because it's a mixture of, acronyms, emojis, and trying to stay cool.

I think I'm cool. I'm 50. I realize I'm highly uncool. But in our own organization I spent a couple days with Kat because she's that 20 something generation that How does she think about work and how can I be helpful to her and vice versa? So here's the other thing, the older we get and the more [00:35:00] experiences we have, to a degree in some cases, the less we know, because we start to compartmentalize those things that are incoming for us.

I appreciate learning the new things and staying relevant through every generation in my life. And that's an important lens for us to have, whether we're at work or we're at home. Have

you ever seen Kat type on her phone? Very

fast.

She typed her term paper. I know for high school, I don't know if in college, but she used to type them on her phone because she's faster.

on her phone that she used on a typewriter. And I use

voice to text. She's wow, people actually use that? I'm like, yes, I'm using it right now.

The point that you brought up, Bill, is interesting because the, when you were 35, there were no, you had boundaries built into your life. So you showed up to work and you could leave work and leave work at work.

And you didn't have an Apple watch or a phone that had. No boundary connection to you. So we've I think we've drifted into a needed conversation around lifestyle. [00:36:00] Because I'm like, so not a millennial, but I am. And I talk about lifestyle all the time, but it's but we have to, because we, there's no boundaries if we don't watch out for it and it's uncomfortable to say no, especially with people that are eager and want to be seen working and add value to work and it's no boundaries at all.

And, so it's if we just look at all the data points in front of us, burnout, huge conversation right now, but we don't want to talk about lifestyle because that's, for the like up and coming generations that care about lifestyle and the bean bags. And I get that there's like an association with the up and coming generation as they really need to just show up and just do the work.

But when it comes to lifestyle, I think I can see why it's a needed conversation because there aren't built in structures of boundary right now in the workforce.

There's but you can, there's ways to leverage that. So I showed up turning around an IT department and there were a lot of things to work through.

One of the problems [00:37:00] was there was a lot of turmoil in the project management office. So I went in and spent some time with them, got to know them. Didn't just go back once, obviously went back again and again. There's a chronic problem with two of the people that worked in the project management offices show up every day late to work or.

Several times a week they would show up late to work and I sat down with them at lunch one day and just talked about a bunch of different stuff and eventually came around to the, you guys have a chronic late problem and we got to figure this out or it's not going to end well for you. What is the problem?

It turns out these two guys were surfers and they like to surf in the morning and they did their best to get off their boards and get in the car and make it to work on time. But sometimes that didn't work out because the surf was really great and they were just out there having a really good time.

And we started early. And so I had this Kind of came down to me sitting down with them and sitting down with their boss and reaching a new agreement. [00:38:00] Okay. On these days, every week, you guys surf in the morning, but you come in at this time and you're not going to leave until seven o'clock at night, you're going to work a full day, but you're going to do it and fit in surfing in the morning.

These two guys became the best project managers I've ever seen. And it was such a small thing. Now we had to shift some meetings because. They weren't going to be there on Wednesday mornings because they were going to surf that day, but I mean it wasn't something that was insurmountable.

It was just something that no one had ever asked the question to cry to try to understand. Is there a way we can work around this? Because you're really good employees and I want to keep you, but there's something that is causing you to be a bad influence in the culture. And once we pulled that off, it was great.

You brought up the topic of bad influence on the culture. I've coached and worked with CIOs over the years. Who [00:39:00] are, who believe that everybody is redeemable. And I believe everybody is redeemable. Everybody has value. They can create something. They can deliver something and that kind of stuff. There are times where people have hung on to people way too long or that there's people in the organization that literally are culture killers.

And they might even be really high performers for culture killers. Let's talk about, that's an interesting, that's a difficult topic. And I'd love to, I guess Drex, I'll start with you, because you seem to be the most sympathetic and it's interesting. Surf if you want. Come into work when you're ready.

By the way, I had No, come on, bill. I had at least two dozen surfers. I know exactly what you're talking about. Yeah. It's, Southern California. What are you gonna do?

It's they're definitely people though that when you're in an organization, when you first come into an organization, you'll find folks that are very high performers, but they may be those information [00:40:00] hoarders or they're people that sometimes, you, wind up finding people that are, just leave them in their office. Don't let them come to any meetings and interact with the other humans. We'll bring them pizzas and they just need to do whatever it is that they do in that room so that we can keep going. But that also creates this situation of a lot of other people, sometimes in the department or in the organization, looking at that special treatment and kind of saying, why does that person get to be, have bad behavior?

And we just continue to support them. And from a culture perspective, I'm. Probably the wrong term, but I used to refer to them, I still refer to them as internal terrorists. These are the people that are actually really agitating the culture and creating a bad, festering kind of feeling among other employees when they're And you will have people from outside the department that will point at that person and say, [00:41:00] don't ever let Joe go.

I don't know what we'll do without Joe. And that's the kind of thing that winds up keeping them in place. But at some point, if you can't redeem them, you have to let them go. And my experience has been that when you let them go, people will come out of the woodwork to say, I don't know what took so long.

I'm really glad you did that. What do you need from me to make sure that we can cover the work that Joe is doing? Because this is going to be a way better place without Joe. And I know a lot of people, or at least a couple of people don't think that's going to be the case. So finding those internal terrorists, and if you can turn them around, if you can't make the change.

Really does cement a much better culture over time. It's painful now, but it's

better in much time do you give that?

Some of it is, I think in that first hundred days, there's a lot of things that you can sort through and figure out. You don't want to necessarily go in like a bull in a China shop and start making a whole bunch of wholesale changes.

There'll be some that [00:42:00] you'll see right out of the gate that you'll need to make, but you got to give it some time. You got to, See if you can figure out if there are those kind of people exist in your organization and have some conversations with them. See what you think about. them being redeemable, or maybe just being in the wrong position and you need to move them.

There's folks like that too, but then at some point you have to make the move. And and you can't make it two years later. It's too long.

Yeah. There, there's a CIO who I was coaching and I went in there the first month and I interviewed all of his staff and he goes, give me the readout on my staff.

And I did it. And that person you need to get rid of. He's what's the readout? And I'm like it doesn't play well with other, I went through the litany of stuff. I'm like, you just, he's not going to work. And he's no, Three years later, no, it was a little over three years later.

He was getting ready to leave the company. And he decided to move on that person because he didn't want to leave that person in [00:43:00] place for the next person coming. And people came out of the woodworks like thanking him. They're like, Oh, thank you. It's about time. It's about time. And he's I don't know why I didn't listen to you and do that.

Like when you, That whole

period of time, while you've been delaying too, that's impacted how much progress you could have made in the culture of the organization. How much progress you could have made with the other people that were surrounding that individual. You depowered them. You took energy out of them because they were still dealing with that person.

It's, it makes me sad sometimes when I see it. Megan, I want to talk to you about how much potential is there.

I want to talk to you about your sports. Background because there's it's interesting when you're talking college kids and whatnot there. You can't just fire you just can't come in there and go you're fired.

You're fired. You're fired. And sometimes The the best player is just the natural person to get picked to be [00:44:00] the the captain of the team. And it's the exact wrong person to be the captain of the team. How do you, fix those things?

There's so much to say here.

I do agree, one, with the approach that y'all are talking about when it comes to when there's someone that seems like they're derailing the constantly to not avoid the discomfort of. Taking them off the team. But there's also something, I don't know. I've seen. Are

you going to say we pulled the trigger too quickly?

No, it's okay. There's one story. And ever since I saw this documentary, I started watching it or looking out for it within the sports teams I work with. And it's, I think sports environments approach developing potential. And that's such an overused word right now, but I'm using it. There's a commitment to helping athletes realize potential, or people to realize the potential in themselves.

Not just within [00:45:00] their performance on the court, but inside their character. And the best coaches with the best performing teams focus on character development. And that's why they recruit players for their character and not necessarily their skillset because they can train skillsets and the best coaches, including Nick Saban, he shifted his coaching career when he started coaching character rather than performance.

And so he's even if you are the top performer, you're not going to be on this team unless you, until you buy into how we operate, which is what Sarah was talking about, that it felt really good to be a part of a team where you knew how to show up. And if you didn't want to operate that way, you didn't have to be here.

You can escort yourself out. So, clarity from the coach in that way, but there was one story, and I don't know y'all's opinions on this, but it's stayed with me for years, and it's the story of the Chicago Bulls with Michael Jordan and Scotty Pippen and the decision to bring on [00:46:00] Dennis Rodman, who had been pushed off every team.

Teams had tried and were like, Nope, actually we don't want him. And their story was we absorbed his character, his lack of like character, and he didn't buy into how he operated initially, but the character and, The leadership of Michael Jordan, Scotty Pippin, holding the line on the culture was strong enough that they could take on a Dennis Rodman.

So, sometimes we have, we approach culture like we're clear on our values and how we operate. But we never give weight to, no, I've got like anchors here on this culture. So like anybody can join this team and they will fall in line because, The leader will not be the one course correcting.

It's the peers that will be course correcting. So I think the coach knew we could bring on Dennis Rodman because I know Michael and Scotty will keep him in line and they will make him a count or invite him to a count rather than the coach always having to course correct his behavior. So I guess what I'm trying to say is [00:47:00] like the strength of the individuals on the team and how much they own the culture can allow a low character hidden potential athlete or team member to join the team and help realize, no, this is who I am.

I think he would just, We know his story. He came from, yeah, tough story. He acted the way he did. Everyone acts the way they did. Yes,

everyone knows Dennis Rodman. Yes.

And I love that he found his way. When he was in that environment, in that culture, and that's the power. They, I think that his trajectory was shifted because he was believed in enough to be like we can handle some of the moments that he's going to bring to our culture.

Yeah. But how do you develop, so in a turnaround, You wouldn't do that. You need your, you need the Jordan and the Pippin to do it. And for me in turnarounds, it usually takes about a year or [00:48:00] so before those people are saying back to me the things, they're reinforcing culture to me.

But I go, alright yeah, I now have a group that can hold the line. And you need to develop that very quickly. As quickly as you can. It just takes so much time. But you need to, this is why you see, coaches, when you get hired as an NFL coach, All of a sudden, they bring their entire coaching staff with them.

You're like, oh, why are they doing that? They're doing that because they don't have to start from scratch. They know, I don't have to worry about the line coach because he was with me at Green Bay and he was with me over here. I know they're going to, it's, we're going to consistently I brought people

with me during the turnarounds, right?

I brought folks with me that I, that already knew what I wanted and how I thought. They were our built in culture and they were able to spread it that much faster. And I always started off too early on, like with the first all hands, I have a presentation called what I believe, and I literally would walk through [00:49:00] this is what I believe.

If you can get on board with this, we are going to be great. And then there was always a short period of time after that where there were some people who self selected. I'm not going to be able to get on board with that. Here's my resignation.

That's great. That's good because of that clarity.

That's what can happen.

Sarah, have you ever, the Dennis Rodman story, so I think about people that I know who are very much in love with each other and very different and have very stormy marriages, but they would die for each other. Even though sometimes you're just like, why are you guys together? And that is definitely the feeling I had about the Bulls during that time.

Like how, do they hold this together? Have you ever been in that situation, Sarah, where you've had people on the staff that you were just like, They're so good. They're so good. And we're right on the edge, but I'm able to keep [00:50:00] them there. How'd you do that?

The first thing I'll throw back with the whole thing with the Bulls is don't underestimate Phil Jackson, because he had not been the coach that would not have worked.

And that's only after they had won a couple of championships. They could bring Robin in and continue that dynasty. Even after that two year gap, when Michael left and came back, that was a really important factor. And then he did it again at the Lakers. And if you watch the Shaquille O'Neal. You see what he, how he got Shaq to be that good.

He's you're going to listen to me or you're not going to play here. There has to be that level of honesty between the leader and any of the players. And even for my last organization I had a hardcore rogue warrior on that team. And. After I've left, people have said, it is a job managing that person's personality.

And I always ask the question, and is it worth it to you? And they'll say, yes, for the same reasons that you shared with me. And [00:51:00] so every so often you have that rogue player who is exceptionally good. And are they good enough for you to have to be their brand manager, as an example? And if the answer is yes, then take that extra time to do it.

This person very specifically knew how to do something nobody else knew how to do, but we had to be able to do it. And I'm not afraid to have the healthy conflict or the dialogue. And we would get into shouting matches, not in front of others, about how we needed to show up how we needed to do things.

And it was like, our job, then our agreement was, We're there to not only deliver amazing quality of products for the organization and for others, it's also to make each other look good. And not good from a, hey, you're going to get accolades from this, but hey, you're going to have runway and air cover to do your job well.

And so I did not know as a CIO how to do some of the things that we needed to do. I'd never done them before. This person had done it over and over again. Not in healthcare. Guess what? You start digging into the plumbing of cloud [00:52:00] operations and software development, doesn't really matter what industry you're in.

And people can fight me on that statement all day long. There are some basics that do not change. And so when you find the best person who's ever built that airplane, and you're a heck of a pilot, guess what? Those two things can come together exceptionally well. Some of the fun and building high performing teams that can do things that no other teams have ever done before is your ability to do things To not only individually manage their personalities, also figure out how to get them to work together and find the like, and so we're talking about this rogue warrior and talking about like somebody who'd been in the organization for 19 years, who wanted to retire there.

They have absolutely, to this day, nothing in common except the desire to do the right thing. If you can agree on that, you can get there somehow. And that's the type of energy that I was willing to and will always be willing to put out there for the right players in the right environments.

And that's perfect on that because I [00:53:00] remember early on in Jordan's career, they interviewed, I think it was Larry Bird, And they said, what do you think of Michael Jordan and all of his scoring accomplishments and that kind of stuff?

He goes someday he'll realize it's about championships, not scoring titles. And Michael did figure out it was about championships. The reason that whole thing worked is if you were to ask from the water boy to Phil Jackson, what are we about in Chicago? It was, we're here to win championships.

It was at the clearest I don't care if Rodman fouls out of every game, if we win the championship, I don't care if he whatever, if we win the championship, and anything he did, any behavior that did not align with winning championships, There's like you can watch these videos There's videos where Jordan is in his face like yelling at him like no We are gonna win a championship and we [00:54:00] can't do it with you on the bench.

So get your head in the game But yeah, I mean they would get in his face and say Remember what this is about. Do not throw that punch get thrown out of this game Like this is important for you to be here. So it was there's a lot of clarity You Megan, I want to thank you for your your work with culture within our organization and now helping us to take that message out to the industry and have these kinds of conversations amongst leaders.

This is going to be really helpful and I want to thank you for doing that.

Yeah. Great discussion.

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