Driving Effective Change Management with Paola Arbour | Technovation 540

You know, it's funny because I was going to use some examples that... sitting on both sides or all four corners of the table really, I think has been a little off-putting for some people, but in a good way. So I believe that being able to sit in the chair of one of your audience members, or having sat in the chair of one of your audience members, gives you a unique perspective. So I think that I've got, I believe, a unique ability that allows for some element of empathy, but also a tremendous amount of insight into what good looks like. So I always talk about what good looks like. And so in that envelope, Peter, I would say that that has been a huge asset: just that 360-degree view. So it challenges service providers to be the very best that they can be. And then on the flip side, because I don't know healthcare, I'm actually able to ask questions that maybe a healthcare person wouldn't ask, because they've been in healthcare. So I'm able to ask questions that would challenge the status quo in healthcare that somebody who's always been in healthcare doesn't ask because it's always been that way. So I think that if you wrap that up into a strategic advantage, I think those pieces allow you to drive a cultural transformation that you may not have been able to do if it were somebody else. So then I kind of lean into that cultural transformation. In my book, it's either as important or more important than any type of training or development that you can give within an organization. And I think that it allows a certain amount of humility to occur, so that in again, this is the trickle-down effect: if you allow humility to happen and not everybody has to be right, and there you start to break down the walls of hierarchy, and you start to allow for differences, then you allow people to challenge themselves. And I think that again, if you look at legacy structures, if legacy structures continue to exist, then people stay in their comfort zone, they don't challenge the status quo, they have no perspective of the audience, and therefore they don't actually push themselves to be different, and they don't then have either the humility or the humbleness to go do that and be wrong, because they can't be wrong. They're supposed to be experts in their zone, and because it's always been that way. So I think, and I'd like to say that the subject matter expert goes by way of the dodo bird at some point, because while it's important to have some of that, I think it's actually more important for people to constantly be putting a mirror in front of themselves and saying, 'Was that the best I can do? Is that the very best I can be? Did I push the envelope? Did I cause change? Did I cause people to query and question themselves?' And being able to build that sort of a culture inherently drives innovation and then inherently provokes agility.

My way is: we're going to build opportunities for people to do things that they haven't done before, for people to be empowered in ways they haven't been empowered before, to allow people forums and opportunities to voice their concerns and their ideas and their opportunities. And we're going to build an engagement model, and it's an engagement model that engages customers, it engages employees, and in some respects we're going to blur the lines. And it doesn't matter who you work for or what badge you carry; what matters is the function you perform and who you serve. And once you understand the function you perform and who you serve, then we're going to create the engagement model that says, 'Here's how we're going to go make that consumable, put a road map behind it, and make it a thing.' So I tell you that only because I believe that there is a framework, but I'm just not sure I'm really in on the structure of it. But I really believe it takes an enormous amount of leadership that not everybody is willing to devote the time to. And I'll give you some examples of managing change or running the change management that we did. And that is, I mean, it's literally town halls, it's forums, user forums, user groups, customer groups, feedback sessions. I mean, it is a constant state of generating information verbally, and it's then doing something about what you verbally generated. And it takes, in what we've experienced, it takes an enormous amount of diligence and follow-up. We've set up these command centers, which is a brilliant idea, and it's two days a week where we have customers and employees phone in that actually have an opportunity to speak to people live. It's just a command center; they just dial into the number and people are getting real-time support, where they can ask questions about the services they're getting, the services they're not getting, a bad experience, a good experience, help. So like some of our newer people call in and say, 'Hey, I had a customer and they asked me this question, I couldn't answer it. What do I say?' It's coaching, it's almost like a lifeline. So it's that real-time connection where people, and they, being Tenet people and customers, have said that it's been life-changing for them. They feel so connected that they're not inhibited to speak their mind. And I think that is a huge part of change management. The minute you throw the gauntlet down where you're not available, or you don't respond, or you don't follow up, or you kind of shove people into their hierarchy, or you disempower them, all that organizational change goes away. It won't happen.

And collaboratively, like it again, it should really, I think people still get mired in... forget the title, forget the time commitment. Where can you take my skill sets? Just like I look at you and say, 'Where can I take your skill sets and apply them in the most useful fashion?' And when you have everybody play those positions and you forget about hierarchy and structure, then you actually have a team sport where people are understanding the mission, the purpose, the outcomes desired. They do proper stakeholder management, which I believe is absolutely critical. And if you have stakeholder management and you've got mission and purpose, and people are playing their positions, and you throw down all the other legacy silliness, then I think you have a machine.

Well, I just think it's been hard, you know. And I think it's been hard because, especially with IT people, IT people tend to want to have an exact science. You know, so they're very focused on go/no-go decisions, testing processes, QA, gate checking. So it's like it has to be a thousand percent perfect before you go to production, right? That's how we've been raised. So to allow people to say, 'You know, even if you say 80% is good enough, and then let's give it a shot,' they're scared. It's scary because it's totally not in their comfort zone. And so we've had to be able to allow people to think out of the box and allow themselves not to be discouraged if it isn't perfect, and simultaneously not to be discouraged if it doesn't get adopted. And I think that's been really tough for some people because, as we were building this innovation and people were coming up with some pretty cool ideas, and they were starting to feel kind of refreshed about their capabilities and what the art of the possible was out there, but when their idea didn't get adopted, their feelings got hurt. It was harder than I thought it was going to be. However, I think that if I'm less pessimistic about how hard it was and I'm more optimistic about the lessons we learned from it, I think people then started to gain strength in their own courage to bring ideas forward. In again, I'll say this to someone like me or to a member of my peer group, but things that are happening over the past few months: we launched a telemedicine solution during COVID-19 that we had been talking about and we had run a couple of sprints on telemedicine, but it was hard. You know, there's security issues, there's adoption issues, there's training issues, there's all kinds... we could throw up a million reasons why telemedicine is hard. Well, we just decided to, because of COVID, we bit the bullet and we're going to do it. We did it. We launched it. It wasn't perfect, but it worked. We did the same thing with some security access stuff. I mean, this is big stuff. We had a call yesterday on something we had pulled together at every single hospital. We did exactly the same thing, and it again wasn't glamorous, it wasn't pretty. Every hospital CFO, all 67 of them, are on board. We've got a great database filled with information that we've never had in the history of the company. And we had one guy who is the worst of the worst when it comes to 'I must be a thousand and ten percent perfect or I will not move forward with my solution.' And we had him present it. He rose to the occasion, and he was so proud of himself. And I thought that this is the kind of stuff that builds energy in a company for thinking differently, doing things. And it was validation for him that it wasn't perfect. Everybody poked a bunch of holes in it, but in the end they were like, 'Wow, we've never seen anything like this before.' And that's what it took. It's that kind of stuff that then makes people go, 'You know what? I'm going to do that again. And you know what? I'm going to do that again.' And then they just, in its momentum, because you've engaged the field. And if you have a culture of innovation and not a program of innovation...

Don't overthink it. I think that the things that cannot be taught, or the things that are inherent in a person's character, are the things that you should focus on first. And I usually do, and I tell you, I trust my gut. I really do. And I don't know that I've often been gut wrong. But you know, when you're recruiting, it's okay to take a chance. I took a chance on our data and analytics person. I spent a long time headhunting a VP of data and analytics. There were a couple of people that I'm like, 'Oh, they'd be really strong candidates for the role.' So that was very scientific, and I'd say, 'Yeah, they'd be very strong candidates for the role.' But I knew in my heart of hearts they might not have culturally fit in. They might not have been across the business. I always looked and said, 'Can I put them in front of the CFO? Can they gel with my team?' And I got to tell you, I'm sitting at 100% change in my leadership team. 100%! Wow. So that's why I say now, effectively, it's 100% different. And it's people who fit well together, and they hold each other accountable. And over time, and this is happening, they require less and less and less of me. And that's really important to me. And because I'm meddlesome, as long as you let me, I will meddle all day long and make sure that it goes the way I want it to go. And as they figure that out, they'll start to figure out that they do need me less and less and less. So that's why I say I really think you want to recruit based on the things you cannot train or teach. You know, you can't teach someone to be accountable; they either have it in them, in my opinion, or they don't. You can't teach someone to have humility and integrity. And sometimes you have to look at it from a leadership capability; sometimes you can't teach people to be leaders. I think you can do a really good job of coaching and developing, and then those are the people that you say, 'I'm going to take a risk on that person.' You know, there are lots of... and of course, I mean obviously you have to recruit for people that do have that subject matter expertise. You don't want to have somebody run your applications who doesn't even know what an application is; that would be a problem. Yeah. So anyway, I just really do believe that the focus has to be on the things you can't teach, yeah, because if they can't pass that test, you must move on.

I start with a partnership orientation that is empathetic at first, that says, 'Hey, listen, I've sat in your chair before. I know how painful sitting in your chair can be. Between us, here's what I would suggest that you do, and here's... and I'm going to tell you really directly the things that make me happy and the things that make me upset. Now let's go figure this out.' I don't think my asks are unreasonable. It's got nothing to do with the contract, it's got nothing to do with pricing, it's got none of that. It's all about structure and relationship and proactivity and escalation and, you know, just all the... again, we call them behaviors. And I can tell you a dozen suppliers... you know, because we don't do any... we can't do this stuff ourselves, so we use a lot. 1,100 partners we have out there. I pay 1,100 partners to do stuff to support me, and I am going to micromanage many of them. And so I really... and none of them are dumb, and they know that I've sat in that chair before. So I think they've kind of... in the beginning, I think they wanted to see how much they could get away with. And then the last one came around in January, and I called him out on it. And again, I think they don't mean to, but I think they're... you know, there's just a behavior of this tunnel vision that until a customer speaks out and says, 'Here are my expectations, here are my hot buttons, here's what makes me upset, and here's what makes me happy. Now you go off and do what you think you need to do with those pieces of information.' I personally think that's fair, because you're basically giving guidance to the people that you work with on how to operate with you. And at the end of the day, I am the paying customer, and what I say does go. Now, if I'm wrong, or if you think that you have a better way than what I've just shared with you, I'm all ears. But then you better be ready to actually go do something with it and make sure that it's the right something with the right outcomes that meet my objectives. But I use that as... because I mean it is... I do run the risk, and that's why I'm saying this, I run the risk of probably I could do their job maybe more than I should. I have to remember, I have to remind myself that I'm the customer. Yeah, I'm not sitting in their chair. So I can have empathy, and I can give them purpose and mission and vision and some direction, but I can't sit in their chair and do their job. Yeah, and that's where I draw the line.

That is a fabulous question. I would say first and foremost, a return on value or return on investment mentality. I think, and we had talked about this previously, when people just get really focused on budget and departments, which is a legacy company... legacy companies are mired in budgets and departments. And if you can eliminate budgets and departments and focus on return on value or return on investment, then it becomes again purpose driven. So I think that in that envelope, that drives a nimble company, that drives you into a more nimble... because it's there, you can see it. You're going to get improved quality, you're going to get reduced duration, you're going to get less downtime, you're going to get more opex savings, whatever the return is, you can qualify and quantify it. And it very quickly tells you whether or not it's a good idea. So that in and of itself. Then the second thing I would say is very much focused on making sure that you have the transparency, or I'm going to say transparency, the transparency and the level of knowledge of what happens in the organization so that you can make decisions. I think there are too many decisions that get... it's a double-edged sword. If the only way you're going to make a decision is based on the data, then you may not make any decisions. But if you have enough data in order to make the right decisions at the right time, and you can use that data to make good decisions or change your decisions, that's what you want. And that was the point I was trying to make with the TBM team: forget about the tool for a second. For the first time ever, my organization actually knows how much money we spend on what. So we know the how much, we know the what, and now we know the where, and now we know the with whom. When you have that amount of data... I mean, IT never had stuff like that before. It was just black box and allocations and a bunch of silliness and zero the cost out. So that transparency, and it's not transparency just for your team, but it's transparency to the customer to allow customers to make decisions, because then decisions get made faster. So you have the data and you can use the data to help you make the right decisions. You have the return on investment mentality. And then basically, if you collapse your verticals and you actually look at it as a workflow to execution or a workflow to decision making, because there is no one team that can ever do anything anymore. It absolutely does take a village. So you either take a village and you get 50 people from 20 departments and then you'll never get anything done, or you get your core set of stakeholders, five or six people, and then you use that cross-functional mentality because everybody says, 'As long as that guy's at the table, I'm good. They can make the decision.' So you get a real strong group of stakeholders, and you manage that set of stakeholders, and you put that governance in place. And again, people say, 'Oh, governance, that's going to slow everything down.' I attest to you right here and now, it absolutely does not. It speeds things up, and it makes people accountable. And that would be the last thing: you have to have accountability. And now we can say, 'Huh, we made a decision in 2018, and we have the data. We know exactly why we made the decision, who made the decision. Now we'd like to retrofit that decision, and we can because we can see it, and we can bring the same group of people, and we can now take a different outcome that we're trying to achieve, and we can now make a different decision.' And it's just like... I said I didn't give the numbers when I talked to the TBM panel, but we were able in three weeks' time to take almost a third of our cost out. And we never would have been able to do that before. But we had the data, we had the right amount of information, and we had the right people at the table to go make the decisions. And it wasn't hard. Didn't take us any time at all, and it wasn't emotional. You know, so I think that in and of itself told me, 'Wow, we have come a long way, a long way as a team.' So anyway, I don't know if that helps or what, but that's what I... and I truly think that drives, you know, outside of the behavior and having a sense of urgency, but I think that if you get certain mantras underway, Peter, I really think that people adopt those.