“ Discovering The Keys To Your Business, Professional and

1. “Discovering The Keys To Your Business, Professional and Personal Peak Performance” Michael E. Frisina, BS, MA, PhD Improving the performance of your leaders, your people, and your organization

2. Disclosures • I am the owner/founder of The Frisina Group, LLC. • I am on the Speaker’s Bureau for the American Hospital Association • Michael E. Frisina, BS, MA, PhD

3. Palmetto Health CME Discovering the Keys to Your Business, Professional, and Personal Peak Performance

4. Are You Ready to Learn? • Understand the dynamics of the Semmelweis Reflex • Hand washing QI initiative – what year? • What was the outcome? • What is the current length of time for any QI initiative to become standard practice?

5. Identify the key strategy for managing the changing relationships between hospitals and physicians Describe the fundamental challenge to physician autonomy and patient care safety and quality Discuss the impact of stress on individual physician performance and quality of life List the three essential elements of influential leadership Key Discussion Points

6. Point One • Identify the key strategy for managing the changing relationships between hospitals and physicians

7. Exercise • Describe what the ideal physician “looks” like using one word attributes or adjectives.

8. Technical Skills Behavioral Skills Performance = fx (behavior skill)(technical skill) Know Your Industry Know Yourself and Others

9. Importance of Self-Awareness Knowing yourself and knowing others is critical to managing the relationships necessary to achieve peak performance in the changing landscape between physicians and hospitals.

10. Assertive Focus on results. Faster pace. Tells more than asks Executing Influencing Influencer, Expressive Driver, Directive Goal: Authority & Action Goal: Persuasion & Impact People-Oriented Interactive Uses intuition High empathy Open + friendly Task-Oriented Independent Wants facts Low empathy Formal + cool Conscientious, Analytical Steady, Amiable Goal: Consistency, Being Correct Goal: Cooperation & Support Relationship Building Strategic Thinking Responsive Focus on process. Slower pace. Asks more than tells

11. Behavior Expectations

13. Expressive - Summary Motivation: Applause Loves to: Be spontaneous Hates to: Deal with details Phrase : Big Picture Backup Behavior: Attack Don ’ t … Do … bore me with details be friendly and sociable tie me down with routine be entertaining and stimulating ask me to work alone be open and flexible 22

16. Part of the Problem Highly successful people are protective of the behavior they believe is the source of their success. Many professionals do not see and are not aware of their negative behavior. You cannot change what you do not manage. You cannot manage what you are blind to in your own behavior. Do not forget this – Behavior lapses are painfully obvious to everyone but the person who commits them.

17. Take Away for Point One • Individual behavior is the key predictor to organizational performance. • The success and effectiveness of peak performers in times of change are driven by a set of behaviors that enables them to role model for others, guide operational improvements, and sustain performance excellence.

18. Point Two Describe the fundamental challenge to physician autonomy and patient care safety and quality

19. “Believe me, fellows, everyone from the CEO on down is an equally valued member of the team.” Cultural Barrier

20. Economics, changing expectations, advancing technology, and the accelerating pace of change are transforming the health care industry. • As a result, relationships within the health care community are changing significantly. • Hence there is a great need to effect leadership from the three essential segments of the provider community: governance, administration, and physicians. What We Know

21. The fundamental challenge to sustaining physician autonomy and requisite levels of safety and quality in patient care are organizational culture and structure and the gender and generation differences in attitudes among the workforce. The Fundamental Challenge to Physician Autonomy and Patient Care

22. The Organizational Culture and Structure • The hospital/health system culture and organizational chart remain traditionally top-down driven in knowledge, power, and authority. • Times of rapid and constant change requires a “mutual trust” culture and adaptable structure with an emphasis on horizontal rather than vertical lines of authority with real-time access to data and feedback. • The need for change in culture and structure are inherently the fundamental challenge to traditional physician autonomy.

23. Gender and Generational Differences • The physician community is currently comprised of three generations: • The traditionalist – being a physician is a vocational activity • Baby boomers – focused on work, authority and independence • Generation X – work is a means to quality of life and is not an end in and of itself

24. Creating Unity in Diversity Gender and generational differences pose a significant challenge to traditional physician autonomy. The physician community behaves as an expert culture. There is no one physician with whom an organization can negotiate who can commit others to honor the negotiation. The physician community, seeking to preserve autonomy as a transcendent value, often find themselves defending the status quo in a one person, one vote, majority rules.

25. Take Away for Point Two • The current challenge to physician autonomy has a direct impact on patient care. • The physician community behaves as an expert culture – beholding to only legal, ethical, and professional constraints. • Compelling physicians, by any means, to alter their behavior from an expert culture to a collaborative or affiliate culture is a threat to individual autonomy.

26. The B-17 Factor? • Medicine today has entered its B-17 phase. Substantial parts of what hospitals do—most notably, intensive care—are now too complex for clinicians to carry them out reliably from memory alone. I.C.U. life support, for example, has become too much medicine for one person to fly. • Read more http://www.newyorker.com/reporting/2007/12/10/071210fa_fact_gawande#ixzz1XxTedRij

27. Point Three What is the impact of stress on individual physician performance and quality of life?

28. How do you Feel about the work you are doing? Sisyphys (1548-1549) by Titian, Prado Museum, Madrid

29. Managing Stress • Dr Karl Albrecht, a management consultant and conference speaker based in California, is a pioneer in the development of stress-reduction training for business people. He defined four common types of stress in his 1979 book, "Stress and the Manager."

30. #1 Time Stress • You experience time stress when you worry about time, or the lack thereof. You worry about the number of things that you have to do, and you fear that you'll fail to achieve something important. You might feel trapped, unhappy, or even hopeless. • Common examples of time stress include worrying about deadlines or rushing to avoid being late for a meeting.

31. # 2 Anticipatory Stress • Anticipatory stress describes stress that you experience concerning the future. Sometimes this stress can be focused on a specific event, such as an upcoming presentation that you're going to give. However, anticipatory stress can also be vague and undefined, such as an overall sense of dread about the future, or a worry that "something will go wrong."

32. # 3 Situational Stress • You experience situational stress when you're in a scary situation that you have no control over. This could be an emergency. More commonly, however, it's a situation that involves conflict, or a loss of status or acceptance in the eyes of your group. For instance, getting laid off or making a major mistake in front of your team are examples of events that can cause situational stress.

33. # 4 Encounter Stress • Encounter stress revolves around people. You experience encounter stress when you worry about interacting with a certain person or group of people – you may not like them, or you might think that they're unpredictable. • Encounter stress can also occur if your role involves a lot of personal interactions with customers or clients, especially if those groups are in distress. For instance, physicians and social workers have high rates of encounter stress, because the people they work with routinely don't feel well, or are deeply upset. • This type of stress also occurs from "contact overload“ or “compassion fatigue.” When you feel overwhelmed or drained from interacting with too many people.

34. Take Away for Point Three • While everyone experiences different physical and emotional symptoms of stress, it's important to understand how you respond to each one. When you can recognize the type of stress you're experiencing, you can take steps to manage it more effectively.

35. Point Four What are the three essential elements of influential leadership?

36. The Three Elements of Influential Leadership • Self-Awareness • Collaboration • Connection

37. Self – Awareness • Discover and establish your inner core • Create your personal mission statement • Accept responsibility and ownership of self • Discover your primary behavior domain • Collaboration • Change Your Thinking – Change Your Performance • Behavior Intelligence and Managing Emotions • Creating and Sustaining Highly Effective Relationships • Connection • Dedicate Yourself to Continuous Learning • Priority Management and Pay-off Events • Effective Communication Skills

38. Look at the list of the ten Behavioral skills. Where are your natural strengths? Where do you need to improve?

39. Self – Awareness • Discover and establish your inner core • Create your personal mission statement • Accept responsibility and ownership of self • Discover your primary behavior domain • Collaboration • Change Your Thinking – Change Your Performance • Behavior Intelligence and Managing Emotions • Creating and Sustaining Highly Effective Relationships • Connection • Dedicate Yourself to Continuous Learning • Priority Management and Pay-off Events • Effective Communication Skills

40. Take Away for Point Four • Self – awareness is the competency of influential leadership. Far too many leaders are unaware of how they are perceived by their peers and subordinates. • Collaboration is the duty of influential leaders. They rely on collaboration knowing that people not processes strengthens the organization’s pursuit of performance excellence. • Connection is the strategy of influential leaders. They know that when people are emotionally disconnected from their leaders that performance suffers. Hence influential leaders value and welcome an authentic connection with people.

42. Thank you! Dr. Michael E. Frisina, PhD michael.frisina@gmail.com