Good afternoon and thank you for joining the TMF health quality Institute healthcare acquired conditions in nursing homes. Your host for today, one begin.
Good afternoon, I want to welcome you all to the webinar. I will be the moderator for today's event. I will be introducing our guest speaker shortly. I hope you were able to answer the question. Do you celebrate success, and what was the last successes celebrated? It is very important that you acknowledged stuff and celebrate even the smallest of successes. We have a response from Carlo that they celebrated a 99.9% of our been scanning -- Barb band -- arm band.
That is wonderful. Some of the things I would do to celebrate success, when you're a director -- understaffed shows up every day for their shift, to me that's a huge success period -- success. At the end of their shift, I would stand at this time clock and think each one of them for showing on that day and told him the impact they made in their residents lives. As a thank you for them to -- for being there and helping us out. I hope this give you guys some ideals and maybe some of you will put some answers and as we go on.
Let's move on to our objective. , Please. We all know how valuable our time is, how to make time for the leadership responsibility and how to empower yourself to grow as individuals. >> I want to encourage you to be jotting down any questions you may have as Dave does his presentation or feel free to talk to him as we go along.
Now the time you have all been waiting for, the introduction of our guest speaker. Dave has worked at the and subgroup of the last 12 years, has been the administrator of four facilities in three states, is responsible for enzymes -- for 12 years training over 100+ new administrators. He was near Baltimore Maryland, has ABS accounting degree from Brigham Young University, an MBA from the University of Southern California, is married with five kids between three and 13 so you know he is a busy fellow. His hobbies include triathlons and travel and he needs Australia and Antarctica to complete the continent. We are so pleased you can make time to be our speaker today.
Thank you very much, I'm actually calling you from Siberia. I'm doing that Russia is shifting right now. Just kidding, I'm not.
I'm so flattered and grateful for the opportunity to discuss something that I feel very passionate about and some lessons I've learned the hard way. Hopefully those of you listening I assume are all in leadership positions whether you are a leader at a facility or at your company's office in some capacity their.
I have personally struggled and stumbled over the last 12 years with finding time to do what I was hired to do. Particularly those of us who have responsibilities where we have to think creatively and strategically, we set an agenda for the department or the division or the company. So often we get bogged down and we don't make forward progress that we were hired and paid to do. Sometimes it feels like we are on a treadmill instead of running a race.
The thing I'm going to share with you today are way beyond conceptual or theoretical for me. They are woven into my life and being really instrumental in helping me overcome my disorganized, procrastinating because that is inherent in my nature. I hope it's helpful for you as well.
This first slide is all sorts of definitions, books written on the subject alone, but I narrow it down where a manager does things right and a leader does the right things. You are all leaders but too often, we spend way too much of our time managing and not leaving. -- Leaving -- leading. I want to bring this to life, I will speak more from an executive director administrator perspective of a facility, but I think it will be easy for everyone to apply to themselves. I hope this slap someone in the face where they realize I am the leader of my organization but I am not getting to the right things, I'm just worried about doing things right.
There was a slide from an audio piece and the technology does not play. The concepts are not my own so this whole idea of monkeys which we will get into, I cannot take credit for it and I don't want to. Is from a book in a series of lectures by a guy named Ken Blanchard and you can find it in a book called the 1 min. manager -- these talks are speeches by Bill, whose hilarious. -- Whose hilarious. -- . H If you want to get this book, -- You should get the audio because is was is fantastic. He starts by defining what a monkey ends. Let me do that for you. A monkey is whatever the next move is after dialogue between two parties and -- ends. I will say it again. This is something I would write down for those of you at home. A monkey is whatever the next move is when dialogue between two parties ends. >> Dialogue in our workplace comes in the form of verbal communication, voicemails being left, and e-mails. With your department head and walks into your office and says we have a problem. Your department head , what you may or may not see that you will see now after this discussion, you will see the invisible monkey leaping off of your department heads back and is flying towards your back. By saying we've got a problem, they are shifting the burden of that problem to you as the leader instead of taking ownership themselves. And you may be more comfortable with that are happy that they did that. You may welcome that and reinforce it. If you do, you probably are going to be very important nonurgent stuff that you're getting paid to do.
We will get back to this monkey in the second. If you look at this matrix, horizontal access is important, vertical axis is urgent. We all spent time in quadrant one. It is important and urgent. An example of that is, the kitchen is on fire. That is important and definitely urgent. Hopefully we don't spend a lot of time in quadrant for, but some of us to spend an extraordinary amount of time there because it's stuff that we enjoy doing. That may not be the most important stuff that we will move -- that will move our department facility forward.
That you have something that is not important urgent, and this is the type of stuff that really buries most leaders. In a few minutes I will concentrate and put the target on newer leaders in particular and talk about them. But all of us as leaders, unimportant, very urgent, it takes up a lot of time because the urgency makes it feel important. Another way of saying that for you is that it is something only you can do. We have been to take a lot of stuff that is not important necessarily, but we take it off of the place of the people that we leave -- lead. In context of QIO, that is very important stuff. But it may not feel as urgent, or may have other things pushing it away. There is no doubt that QIO is important, but is an urgent? That quadrant three is why you are in the position you are as a leader. It is to be able to manage resources, one is much -- what is yourself and your time, allocate resources so that the very important nonurgent stuff gets the attention that it needs.
A question for all of you is to ask yourselves, what is keeping me from quadrant three stuff? We all have different responsibilities and assignments, so not going to pretend or be presumptuous and say the reason I'm going to talk about this will try to everyone equally, but I am going to share some observations from my own school of hard knocks and some observations that I have colleagues and these 100+ new administrators that I've had the opportunity to train. There are some common pitfalls that we need to be aware of to avoid so that we can better manage our time which is how we are going to end this discussion today.
Let me start with the typical plate of an administrator. What you see in front of you right now is stuff that I've got to do, and if you are an administrator or director of nursing, I think you'll agree that this is a pretty representative, reasonable representation of an administrator's to do list. Each of these represent a monkey because these are next moves. And monkey is whatever the next move is after dialogue between two parties ends. Whether it is research the price of some gel overlays or whatever the case may be, whoever has that next move has the monkey. There is one to work and when to supervise and your job as a leader is to supervise monkeys so that you have time for your self-imposed quadrant three very important nonurgent tasks or monkeys that you know are going to add value to your department or organization.
As your skin into these assignments you see things under today. -- Skin
These are things I make during my rounds and checking into the facility in the morning, on the right-hand side if you list all of the things you have to do, that is what I'm going to challenge you to do. Find all the monkeys and put them on a piece of paper just like this. Today, yesterday, before. These are long-term projects. Do any of you have things to do that you have had on your to do list for over a week or over two weeks or a month or two months? If you do, you have some work to do on the monkeys in your life and how they are managing you versus you supervising them. >> I'm not going to read each bullet point. I'm expecting you will have read most of these bullet points by now so we can see, I don't know if you can see it, but now you can if you're on the webinar. You see the monkey. That is what they look like. They are mean, they have attitude problems, and they want to destroy you. I want you to think of them and few monkeys in that way. Before you may have seen the departments -- had who says hey we have a problem, I want you to see that monkey and see him with the space -- this phase because these monkeys will not rest after they have made you to an effective to be successful and put your job in jeopardy, but they will also not rest until they go home with you . They are not going to be satisfied with ruining your job, they are only satisfied when they ruin your personal life as well. Here is what I mean.
When I was overwhelmed with monkeys in my very first facility, in 2002, I didn't have time to get to any of my stuff during the work day. So I was the most productive before work or after work. I don't know if you can relate.
I would take monkeys home with me in this monkey cage called a laptop and I would be in bed with my wife at night, and she is just beautiful inside and out, and there I am, and instead of paying attention to her, whom I paying attention to? These monkeys that I brought home. Night after night, returns in two months and months turn into quarters which turning two years that I have allowed these monkeys that my staff should be working on and I should be supervising, I have allowed them to attach themselves to my back and I'm working on them instead. So I don't want monkeys to go home and get in between you and your spouse.
We see these monkeys and in order to combat them, we need to understand some principles. If you do not complete a task that you have given yourself or excepted from a subordinate, it is called procrastination. If you don't complete a task, it is called insubordination. It is a subtle addition -- different but has [ Indiscernible - low volume ]
We have a problem, I can fix that. You have taken from a subordinate, and I hate that term because I come from a culture that is very anticorporate so I hate like -- I hate words like subordinate but I use it here for clarity's sake. You take something from a subordinate, now how long do you have to finish that? We need more schools in the nurses station. I will get that for you. If I don't do it, I have to put that now -- I have to do that space with all of these other monkeys. They are all competing for my time and attention so I can't get to that. So I procrastinate. Why do I do that getting those chairs? Is because I can. There are other things that are more important that I need to be working on and I'm not going to get in -- I'm going to get into trouble. Will a lose credibility with myself? Absolutely. That is not a clear and present consequence that may or may not happen. You multiply a simple thing like that times all these things on my to do list, and it's very easy to get overburdened. On the other hand, if I don't complete a task that might Bousquet, it's called insubordination. There is some magic in viewing everything on your to do list this way. If you want to that process of putting one piece of paper, everything you have to do, and you identify how the -- how much of this is procrastinate couple -- able, and how much is insubordinate, that is a good step to realizing what things you should turn from Cresson H insubordinate, by giving them to someone else to do. If you give them to someone else, a subordinate, and they don't do it, then it is insubordination. You are not setting up people to fail, you're making stuff that things -- making sure that hangs get done. An inferior job by a subordinate is 100% better than a superior job procrastinated and never done by you. As you look at your to do list and compiled all of your monkeys and said okay, how many of these have been on my to do list for over a month? I challenge you to ask yourself or your colleagues for some help if you have a hard time getting rid of monkeys, how much is really only doable by you? Is there someone else that could do it?
Chances are you will find that you have people that work for you and your department and facility that can, if given the opportunity, do that they, whatever it is.
That is their chance to grow. I want us to approach this not from a self-centered perspective of letting you get to the important stuff, while that is really important, and equally important perspective to have for all of the work that you take on yourself, is that every time you take on a subordinate's monkey, something that they could possibly do or coach them through it, you're telling them that you don't trust them, they are not capable of it, and they would do an inferior job. It may be true, maybe they would do an inferior job, but an inferior job done by a subordinate is better than a superior job never done but you because you don't have time for it.
And you miss daily and weekly, huge opportunities to bet those monkeys to your staff and giving them chances to grow and expand their abilities by taking those on yourself. Starting to sound like a broken record, but I'm passionate about that point. They can do so much more if we will just give them a chance.
I want you to think about this one pager go water. Wire monkeys particularly attractive to newer leaders over maybe veteran leaders?
Let me go to one of the answers to that. These are the people that I've been spending most of my last seven years with. That that gets his or her first facility, the brand-new director of nursing, there are these things invisible but real, -- the distance of this As a function of the new leaders experienced or inexperienced and the responsibility that you have. The greater the responsibility, and the less experienced they have, the bigger the credibility gap and the bigger sense of insecurity that our new leaders will feel. If this is the situation you find yourself and, how are you going to -- what are you going to do to bridge that gap?
Now I'm speaking from personal experience that I've seen this time and time again, with newly placed leaders. You look for opportunities to prove your worth. You look for opportunities and go out of your way to collect monkeys. People say we have a problem, I can do that. Let me show you how credible and capable I am. Our newer leaders, because of this credibility gap, they are like magnets and so what do we do? We get different ways to capture opportunities. We have 3 x 5 cards so if we see a problem, we can write it down and add that to our growing list of monkeys so we can fix things and become a problem solver and a source of solutions to our people and our departments and facilities -- this credibility gap. How well my going to be able to show that I should be in a position of have the responsibility that I have other than showing people. That is one reason why that is sort of a deeper motive from the collection. Only you can really open the blinds, but the light in, and see how much of what you're keep it to yourself and working out for yourself that could be done by other people, is because of this.
The irony of course is that a huge part of my past failures were because of this. Instead of building credibility with people, the opposite happened. I frustrated people with poor follow-through, and for how long's -- things to get done. -- Things took to get done. About four months into this, I noticed this disconnect with my department heads and my door was always open, but they were coming into my office less and less. I finally asked my new director of nursing who had been with me a few months, I asked if anything was amiss that she knew about. She said do you really want to know? And I said yes I do. I was unsure about this but she said they are tired of you saying you will do all of this stuff and then you don't do it. So they are not comfortable coming to you anymore to follow-up, so they come to me and I am getting tired of doing your job and my job as well. >> The light came in and I saw the ridiculousness of my situation and somehow I have been shooting myself in the foot by taking on all of these marquees -- monkeys and not having the time to do all of the.
-- Was tired of supervising me. However as the question, how is a coming is supervising the monkey. Every time I get asked that, I can't help but smile and cry at the same time because I realize I am back in the wrong spot for that monkey.
This credibility gap is real and I want you to pay attention and look at that.
There is another good piece of this that I recommend. Read the book, I am not on commission, it is just a great book. Do you have a stop doing this?
We have an ever-expanding to-do list trying to build momentum and do more and it really works. -- Made as much use as [ Indiscernible - low volume ] they displayed a remarkable discipline -- extraneous junk is monkeys that should be done by your subordinates. Chance for them to grow and freeing you up to work on the important and nonurgent stuff that you're getting paid to do.
We are done with the theory, let's go to the nitty-gritty. Identified and write the things that other people could do and now there is debate on whether or not this is administrator only work, but this is stuff that department heads can and should do. I turned all of those monkeys into assignments. What have they become? They have become insubordinationable items. which ensures that they will get done. There will be opportunities for growth for these department heads and put it in proper position as a mentor and leader instead of as a fellow monkey worker. You will notice that they have to report back by a certain time so that you put the follow through on them so you don't have to remember to ask . That leaves my monkey list looking like this.
Now I have time for important nonurgent stuff and these are the things that I am calling important and nonurgent, these are also things are I probably would not have spent my time today because I would have been working on urgent for my department heads and stuff they should be working on themselves.
That is the essence of what I wanted to share with you. What I invite you to do is to repeat this exercise with a colleague or to. Go to your inbox, your voicemail, your sticky notes, anywhere you keep everything you have to do. Put it all on one piece of paper and that I want you to highlight everything that could possibly conceivably be done by a subordinate . Most of these things probably came from a subordinate. We have a tendency to reward people for coming up with new and interesting monkeys for us to do. Let's say I apologize this is taking so long, I realized that you are better equipped to get this done that me. So for example, the credentialing package for the new health plan, you have been asking them for two months. Let me give it back to you. You should have this back to me by Friday. If you don't have any answers to the questions or have the corporate offices or phone number, I'm sure [ Indiscernible - low volume ] and if they say I don't have time for that -- that brings up the question that is probably on many of your minds. Our staff don't have time for more work, do they? Neither do you.
Here's the thing. That conclusion, when people do not have the time to do it. It has to yield to the bigger and more important conclusion of observation that you have to do your nonurgent work and your team will find a way to order the chairs for the nurses station and get the credentialing done.
There is another thing I forgot to talk about which I am just reminded of right now. Not only is there a credibility gap , but our industry also happens to attract a ton of leaders. Most of this are in long-term care because we have a card for it and we are drawn to the service of it, the compassion of it and because of that we have the leadership mentality that says I'm not going to ask anyone to do something that I can do myself. Being willing to do it and doing everything yourself are two different things. That was my mindset early on, that I don't want to get my stuff anymore work. That mindset led to a failure on my side and zero growth on my steps side -- staff. We have to take a leap of faith, so that. That issue aside, and give this a try.
A few more slides and want to share with you even going down a little more nitty-gritty, this is something that has been super helpful for me and it is to do list in your inbox. When I make those assignments and as I look at all the assignments that I give for follow-up and the monkeys I keep for myself, I do not have a to do list. In my office there is no to do list or sticky notes. All of my monkeys are on my calendar as appointments. This way, I make time for myself
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THAT IS SOMETHING WE MUST INCLUDE ALL staff, so you want to share that monkey and not take that on yourself, quality assurance improvement is huge so don't try to take that one on all by yourself. >> This is your information, if you have any questions you're welcome to contact us at any time. We really appreciate Dave taken the time to take this information with us.
Thank you guys. I hope you have a great afternoon, and thank you for attending.
This concludes your conference, you may now disconnect.