Some Attributes of The One Percent Part 1

For the last four and a half years, I have been blogging on this site about important events in healthcare. The ThedaCare Center for Healthcare Value has grown rapidly in that time. In fact, we have created a team of highly talented individuals that have a world of expertise in a range of subjects. The Center has made the strategic decision to use my blog as a place to showcase this talent. Mike Stoecklein, for example, recently shared thoughts some time he spent with W. Edwards Deming, and the importance of understanding how to understand and react to variation. Mike is contributing again (read below) regarding his work as Network Director for the Healthcare Value Network. We will continue to showcase the ideas and work of the great team members at the Center going forward. I will continue to contribute as I have in the past when I believe there is something very important that our audience should be aware of. As always, we invite you to comment on our blog and send us suggestions.

- John Toussaint, MD

CEO, ThedaCare Center for Healthcare Value

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Some Attributes of The One Percent, Part 1

When I reconnected with John Toussaint in 2009 and heard he was up to something new (the ThedaCare Center for Healthcare Value), I told him I was interested to learn more and perhaps play a helpful role.  We met briefly at the IHI Annual Forum. He was on his way to attend a short breakout session featuring ThedaCare and something they called their "collaborative care model" (something that turned out to be a pretty big deal). John told me, "I'm interested in working with the "top one percent" in healthcare. We both agreed that most healthcare managers and clinicians may not fully understand, nor are they interested in, the kind of management transformation that healthcare needs. We don't know what percent DOES understand and IS interested, but we think it a small percent - very small. Thus, we call them the "one percent."

That was three years ago, and today, we have a better idea of what the "one percent" looks like. I now serve as the Network Director at The ThedaCare Center for Healthcare Value, and I have the good fortune of interacting with a lot of people who are trying to make a difference in healthcare transformation. Some of them are employed by one of our 60 Healthcare Value Network member organizations (or the 12 founding members of the newly formed Clinical Business Intelligence Network), and some are not (yet) members of these peer-to-peer learning networks. I would like to propose three attributes of the "one percent."  I think there are more than 3 attributes, thus the "part 1" in the blog title.

Before I describe these attributes, I want to be clear that when I describe the "one percent" I am talking about people, not organizations. People manage the organizations, and some of them have attributes of good leadership. The organizations they are associated with are one vehicle that they use to make a difference. People may move from one organization to another (hopefully, not too much), and organizations may also come and go (As Dr. Deming stated, "survival is not compulsory.")  However, its the people who make the difference.

The three main attributes I am thinking about are those that make up the tagline for our peer-to-peer learning networks: Learn, Share, and Connect.

Learn - Those that make up the "one percent" realize that much of what they have learned in the past (in school and on the job) is simply wrong and needs to be thrown overboard. It's the mythology of the prevailing style of management and it is inflicting a lot of harm and making matters worse. New knowledge is required and those that make up the "one percent" admit they do not know it all (they are humble), and are committed to learning every day. They learn from everyone and everything.There is no hierarchy when it comes to their learning plan.

Share - The "one percenters" do not withhold knowledge they have gained.They share it widely with everyone, including competitors. Yes, you read that correctly, they have a "win-win" approach with everyone. They realize that they can compete on quality (or what they claim to be quality), but for many things, it is in their best interest to share with others.  They realize that this work is a "gang tackle" (a John Toussaint term) and the stakes are too high, and the timeline for action is too short to worry about who knows and who does what. Dr. Deming (someone I spent a bit of time with in my younger years) said it this way, "no one will do you so much harm as a lousy competitor."

Connect - Everyone I know has a "day job" - an employer or a Board of Directors - someone they answer to.  However, those in the "one percent" save sufficient energy and time to look up from their day job and connect with others who are also part of the gang tackle. They see themselves as a part of a much larger effort, a large community of like-minded individuals.

If you think you are part of the "one percent," we'd like to hear from you. Please join us in this gang tackle called the transformation of healthcare management.

- Mike Stoecklein

Network Director, ThedaCare Center for Healthcare Value