How To Be the Leader Nobody Wants To Leave

Stewart Gandolf

Hi, everyone, Stewart Gandolf. Here again, with another. Podcast and today, in my series of sort of greatest hits in healthcare, Kris Baird is somebody I've known a long time. Kris is one of the leaders in the space, particularly in the hospital side, doing a lot with patient experience leadership, phones, quality, lots of different things. 1st of all, welcome, Kris.        

Kris Baird

Thank you. It's great to be here.

Stewart Gandolf

Yes, and you sound good to do as well. So, your mic is working. That's great, always good on a podcast so I wanted to ask you to start off by just you know I've known you forever, and certainly people that have been following healthcare. You're pretty well known, but for those people who don't know. You tell a little bit about your company and your background and the kinds of things you do every day. Then we'll focus on the specific topic.

Kris Baird

Yeah, thank you. Well, so my background is clinical. I started as a registered nurse, and I transitioned later in my career to being in charge of marketing and business development. And for a lot of people, it seems like, Wow, that's quite a jump. It really wasn't for me. I've always been entrepreneurial. I've always had a real interest in marketing and business development. And so, it was kind of a natural fit for me. I had done a lot of writing had books published already by that time, and then I transitioned into working as a consultant in patient experience. It's what I did my master's thesis on, and I was kind of on the bleeding edge of that patient experience, I mean at the time it was my first book was Customer Service in Healthcare: A Grassroots Approach to Creating a Culture of Service Excellence. I'm.                 

Stewart Gandolf

Customer service nah, nah, nobody cares about that! Haha.

Kris Baird

And back. Then, honestly, people were looking at me like I had 2 heads like customer service and healthcare. So, we've done a lot of changes as an industry. But as I started this business it evolved from me, thinking I could go in and consult to, Hey, wait a minute, despite the fact that every hospital in America has tons of data on patient satisfaction scores or patient experience scores. It doesn't necessarily mean they believe it, right? And so that inspired me to start a mystery shopping division so that we could go in and really do a pulse check on what's really happening, you know, give, give people a slice of the current reality. So, when I describe my company, I say, think of us as a magnifying glass, a mirror, and a map and with the magnifying glass. That's the mystery shopping and the culture assessment. We're going to dig deep, you know. Really, look at your culture, see what's keeping you from making the progress that you want? We're going to hold up the mirror and say, Look, this is what you really look like to your stakeholders. Here are some of the gaps that are keeping you from making progress with your culture and patient experience, and then we co-create the roadmap to get them from where they are to really, where they want to be. So, with that comes a lot of leadership development, frontline staff training, helping them identify what are the elements of the culture that really need to be changed.

Stewart Gandolf

That makes a lot of sense. And you know I was giggling with you a moment ago. It's, you know, the idea of patient experience. I remember doctors not very long ago. Say, I don't care if they like me. I just get them better. It's like, well, it's a little more complicated than that.

So today, when we talked about, you know, getting back together to do a podcast we had talked about various different aspects of all this, and then the leadership part is something we really haven't covered on our podcast at least not since I can remember, it's a very important topic, and we just haven't talked about it a lot. So, I thought, you know, that would be an interesting topic, particularly since you created a course. And so, you know, health care. If you're in healthcare, you believe everything is different in healthcare, and to a large degree it is but like what are some of the common leadership challenges that you address, that you know, that are common to healthcare, that maybe others might miss? What are some of those real tangible issues that come up?

Kris Baird

Oh, definitely you know, communication, culture, hiring, you know, managing difficult situations, helping your team become and stay engaged, retaining them, you know. So those are some of the things we address. But it's not only the what it's the how that makes it unique. And I say that because if you think about the title, be the leader, nobody wants to leave. Okay. Turnover is so high and so costly for organizations. Right now, a new report from NSI came out and it and it said, the updated report said, It's $61,000 to replace an RN. And when you look at the turnover, it's costly. So, we got to do that, you know. So, the reason, the why is, people leave their bosses, not their organizations. You've probably heard that a million times. But the how, is how people learn and retain information is really important. And when I think about adult learners. Oftentimes, when people introduce training in their organization, it's transactional. Not transformational. And so often they're checking a box, you know. Whereas, to really make change and to really retain your staff. That leadership development really needs to be transformational.

Stewart Gandolf

So how do you do that? Because, you know, I think of today. We're all busy. Well, most of us are busy anyway. So, and it's really easy. I remember once I heard a sales trainer way back, said, Hey, to this frustrated salesperson. You're just a part of the passing parade of their life. And that's kind of frustrating when you think about it. You know, you think like they, you have their rapt attention, and they're really focused on what it is you're trying to convince them to do. And in your case you're trying to convince or train them on what they should do. And then the next minute they're on a different call, completely different topic. How do you keep them engaged? So, they remember any of it versus? Oh, I like Kris. I remember something out about it. I'm not sure. Why, how do you do that?

Kris Baird

Well, there's an art and a science to it, and being raised by educators in my household when we played school, we had the real deal. I mean, I had the Teacher's Guide to everything. So, I was looking at learning objectives and how to do these activities and things like that. And so, when we created the course. We really decided it had to be transformational, not transactional, which is, you're absolutely right. People are really busy. Transactional would be okay. I'm going to watch this video and check that it's done. Transformational is really about more hands-on application, because adult learners want to know, what's in it for me. How is this going to make my life better, easier? You know. How? How is it going to help? So, you know, at having hands on application, giving them a chance to brainstorm or ask questions, problem, solve, reflect. So, using hands-on assignments, you know, they're going to watch videos, of course. But then they're going to give something that they have to try out, right? And then we come together, and we have a group discussion, and then they have private coaching. So, it's that cycle of learning something, trying it out. Talking about it, getting feedback, you know. That's how you create real world readiness for them.

Stewart Gandolf

That makes sense. So, the I thought, I'm glad to hear you have a coaching element in that, because it's 1 thing to watch a course, and it's another to have, you know, follow up coaching to apply to me. Like, Yeah, yeah. But how do I do this? And I'm assuming that happens a lot. Is that generally a critical part of your program, or is it? You know I'm assuming it is. But I don't know. 

Kris Baird

It is, and both the group coaching and the private coaching has been very helpful for the leaders who take the course in the groups. I often get feedback that wow! It's so good to hear somebody else talk about. They're having the same issue. And when I heard you coach them through that problem. It made a lot of sense, and it gave me ideas of what I should do next. Right? So, sometimes they aren't the one being coached, but they're observing it, and then other times. It's a 1 on 1.      

Stewart Gandolf

So, what you know, what are the common? If you, if a leader, is losing a lot of people right more than the sort of average to be expected. What are the things that are you mentioned? A couple of things like culture, or whatever? But are there some typical smoking guns when it comes to turnover. Okay, expand on that for me.

Kris Baird

Absolutely. And a lot of organizations do employee engagement surveys. And so, when they do, the employee engagement surveys, you know, they're going to be able to identify: Where are the problem areas? So that's more of a leading indicator compared to the lagging indicator of this is the turnover they had last year, right.

Stewart Gandolf

Right.

Kris Baird

And so yes, believe me, senior leadership pays close attention in a healthy environment, right in a healthy and accountable environment that they're going to be paying close attention to that. And I say that because not every organization is healthy, with a good culture that's gonna work on retention.

Stewart Gandolf

So? Are there any common blind spots that you see? That? Is it that you know? Is it engagement? And what is? And how do you increase engagement like? Help me understand this.

Kris Baird

Yeah. So, let me let me approach this from kind of 2 angles. There are blind spots for the organization, and there's blind spots for the individual leader right?

And one of the big blind spots that I see is that we keep talking about breaking down silos. But it's not really happening right. That can be a huge blind spot for the organization, you know. And let me just give you a marketing example. There are so many times we go into an organization to work on patient experience. And I will ask, How is marketing going to be involved in this culture transformation? They look at me like—why would we have marketing involved? And to a marketer? You chuckle because you're thinking it's all about, you know the consumer experience. But we've created even more silos. Patient experience. You know now that we have chief experience officers or experience managers. That's 1 more silo. We've created and so, you know, patient experience is siloed again. So then, leaders don't relate to the brand promise right. You know, and of course they're well versed in quality safety. But when we come to connecting the dots with service and you know, preventing patient attrition, you know they're not as focused on that and the blind spots for the individual leaders. I think the biggest blind spot that we see when we're coaching is seeing them make the transition from being an individual contributor, like me, I was an RN. At the bedside, right? I was an individual contributor. And then the next day, one day I was made a director. I skipped the supervisor and manager and went right to director. And leadership is a skill set, not a title, right? Huge blind spot for organizations. And I cannot begin to count for you how many people have been promoted because they're very good, clinically or technically, and now they're a leader of sometimes 80, 90, 100 people, right? And so, they haven't been adequately prepared. So that is a blind spot.

Stewart Gandolf

That makes a lot of sense. And it's funny, even in a much smaller way with our agency. If I bring somebody who's been a good technician to supervising a team of 3 or 4. That's a different world, and not everybody wants to do that, and not everybody can do that. Not everybody is really set up for that. And you know you get into those things like, well, if it's what has to be done right, I'll just do it. It's faster for me to do it myself. And you've heard that like how many thousands of times. So, that's certainly common. So, turnover is a big problem in healthcare. But so is burnout like, you know how you know. Like, do you mentioned engagement and leaders? And you know their team is burn out all the time. It's going to be hard to be effective and hard to retain them like, how can you help leaders, you know, deal with burnout as a real issue. 

Kris Baird

Yeah, and it's 2 prong for leaders. One is they have to be cognizant of their own burnout, right? Or, or, you know, tendency toward burnout, but then they also have to be cognizant of their staff and the potential for burnout. So, one of the first most powerful prevention elements for burnout, for preventing burnout is staying connected. You know, active listening, a leader actively listening to their people rounding, and I know leaders hear about rounding all the time. I'm not talking about drive-bys right? It's not about being seen. It's about seeing, right? And so really staying, connected, active, listening, doing rounding, doing stay interviews and stay interviews are one of the most important things for a personalized retention plan, but they do a lot to prevent burnout, too, because they can reveal a lot about what's going on in the organization. But the other thing that cannot be slighted—is recognition. Helping people feel valued. You know, I was just reading a post by a group of nurses where they were having a discussion about. Look. I don't mind working the extra shifts. I don't mind doing this, and this. All I want is to feel valued right. And so, I think that that recognition, you know, a general sweeping. Hey? Thanks, everybody. Good job, you know. Okay, that nice. But coming up and saying, You know, Stewart, I want to thank you for you know, staying and taking care of Mrs. Jones yesterday, and her, and talking to her family. I know your shift had ended, and you were on your way out the door when you stopped to connect with them, and honestly, that that is truly living, our values of respect and dignity. So again, recognizing the individual, and then tying it back to who we are as an organization.

Stewart Gandolf

Yeah, it just has to be purposeful. I think it's really hard again. We're all busy to make that a habit versus. And you know I'm still learning as a leader. I've been working on this actual issue more lately, because, you know, Aren't you all happy, anyway?! Like no, no like, we're all still humans, we need nurturing, especially for us in an agency environment where everybody is virtual. It's even harder. You have to be really purposeful and try to remember that you also mentioned that you had strategies for helping to bridge communication gaps. What kinds of things are helpful there?

Kris Baird

Well. Communication is something that is woven throughout the course. I mean, from the very 1st module of hiring for fit. We're talking about the importance of good communication. And you know, bridging gaps between, let's say messaging that you're getting from administration, and you know, hire somebody get somebody in there, you know, and saying we need to protect our values. So, hiring for fit means, you got to take the time to actually ask the questions that are behavior-based. They're going to help you get at those. So, teaching those communication skills, really is woven throughout the entire course. One of the areas that we find is so important and so widely appreciated, is on managing expectations. And somebody had said to me once, ‘You know, you don't realize you weren't clear on expectations until somebody fails to meet them,’ right?                          

And I thought about that. And I thought, Oh, my gosh, that is painfully true. And so, we spend a lot of time talking about. How do you manage? Expectations? And communication is huge in there, and that is where you find so many major communication gaps. What you think you said and what they actually heard, you know, are two different things. So, there are gaps, and so learning how to communicate more clearly and to validate what they heard, and then to follow up to make sure that you know they did understand that they're following through and things like that, and then, of course, back to coaching again. Coaching is all about communication.

Stewart Gandolf

Yeah, I would say, another line I heard from somebody, spacing on her name. Years ago, is, how can you expect people to make expectations you've never set, or how can you expect to make us have expectation the client has never set like you really have to be on the same page, and I think the fallacy is, you know, you tell somebody once in a meeting you expect them to remember it, and that's really that's one of my flaws like we talked about this 6 months ago, and we haven't now talked about it again. It's like people just don't retain well, especially in today's world, everybody is, ADD, you have to hit them with a message over and over and over again, simplistically to hope for it to stick. And I've been in meetings where somebody's complaining about a lack of process like, wait, you were part of that, you documented that. So, it's like they it's really easy for people to forget and stuff we've all agreed on. It really does need constant, at least in my experience, a lot of reinforcement. It's like talking about it once is not the same thing for sure. So, you know, like you the staff engagement and patient experience and outcomes. How do you connect all that together?

Kris Baird

Yes, I mean, and there is strong evidence of those links between, you know, staff engagement, patient experience, and clinical outcomes. You know, there have been some really good studies that have done. You know, there, transformational leadership is one area, too, that is so important in bridging that gap.

I was reading an article about nursing and talking about how, in nursing transformational leadership is so important because it helps people connect to purpose. It's all about relationships. It's about feeling heard, and then they can transfer that to other people. So, when people feel cared about, they're more likely to care right to give care to be caring. I like to think of it. As you know, we all run a kind of emotional checking account, right? And you need to have deposits made in order to be able to give that emotional, you know, capital away. And so, as leaders, you know, we've got to be really mindful about maintaining that. But Press Ganey did a really good study. I think they published it last year. They were analyzing like almost 2 million employees from over 500 location or organizations. And what they showed was when you measure staff engagement, those in the top 25% of employee engagement, the organizations who score in the top 25% on average have 38 percentile, not just, you know, mean score, but percentile points on the patient surveys, indicating likelihood to recommend, I mean. And so, you know, at the end of the day, as a marketer, you know, that's the big question. How likely are you to recommend? And that is, you know, that's really important. And so, there's also, you know, trust comes in there too. Right? Patient trust happens as you forge a relationship right? So, the relationship builds trust, trust builds compliance, and compliance improves outcomes. And people are much more likely to listen to and comply with somebody that they like and who feels cares about them, you know that's the bottom line.

Stewart Gandolf

That totally makes sense. So, two more questions as we wrap up here. One was about just leadership behaviors, you found, have the strongest, strongest sort of ripple effect to employees and to engagement.

Kris Baird

Yeah, I would say, rounding that, and then not the drive-bys, but really interacting. Rounding. The next one, I would say, is recognition, meaningful, personalized recognition. And when I talk about recognition, I talk about 3 P's, it needs to be prompt, personal, and plentiful right. And when people go in to measure just how often recognition is happening. It's not happening as much as it really should. And so, you have to have systems in place to make that happen. So, rounding recognition and one-on-one coaching are all really big.         

Stewart Gandolf

So, I have to ask a bonus question here. The, I still have another question I want to ask at the end of this, but like, when you have a sick organization where it's just like, you know, they're leapfrog score is suffering. They're not super safe. They've got no culture, and you know there may be, I would guess like, if you get into a place like that, you know, who would dismiss the other cultural issues that are inherent, but it all kind of ladders up to the same stuff. So, when do you ever get engaged by where they just really have a lot of work to do. And then are there anything special that you can do to help? You know? Sort of triage that to get them onto a baseline.

Kris Baird

Yeah, so we typically start with a culture assessment. When we're working with organizations. And during that culture assessment we are able to look at. Okay, just how toxic is this, that we're dealing with? And I pride myself in delivering the kind truth. And that means being able to say to that, CEO, privately, ‘Look, do you want to change this organization? Because this is going to be hard work. And this is what your role has to be.’ And there have been times where I've needed to walk away, because I know that they are not going to be willing to do the work, right? And that can be tough because you look around. And you think, Oh, my gosh! On the front line they have these wonderful people that are so dedicated they just don't have the support right.

Stewart Gandolf

Yeah, well, I could see that. I mean, like, I said, there are some organizations are healthier than others. I think some organizations, you know, view themselves differently, like, I remember, that Dr. Jim Molino has been a friend and guest on this, podcast a lot, as you know, he's a leader in patient experience, and when he went over to the private sector with Press Ganey, I said, what is the thing that surprised you most? He said, ‘How many times the safety is not even in the question.’ That's not even on the on the topic. Right? Like, that's sort of fundamental. And so, you know. Some organizations, I'm sure, have a much longer way to go, and some organizations, for example, view themselves, as you know, protectors of health in their communities. Some view themselves as leaders and innovators, but others really don't have that. And so, it's, you know. I can see it being challenging. As we wrap up, we talked about marketing just a little bit. Anything else on the strong connection between leadership or the connection between, you know, strong leadership and marketing. Anything you can expand on there?

Kris Baird

Yeah. A favorite topic of mine, actually, because if a brand is a promise. Then the question is, how are you delivering on that promise at every encounter, with every customer, every single day?

So, you know, think about how marketing and organizations works tirelessly to bring in business to the organization to, you know, acquire new patients, think about the cost of patient acquisition. And when that consumer becomes a patient there are multiple touch points where the patient is deciding if you are what you say you are, right? And what are you saying? You are. You put out your mission, your vision, your values your tagline, right? And nobody's putting an asterisk or a footnote on the mission, saying, you know, we put the patient at the center of all we do asterisk. Look at the footnote that says, except for when we're busy or having a bad day, you know, and God help you on the weekends and holidays, right?

Stewart Gandolf

Yeah.              

Kris Baird

So, nobody's putting that footnote in. And so having leaders really embrace that they're the ones who are the keepers of the culture. They're the ones who are helping deliver on the brand promise at every touch point. You know, are the behaviors aligned? Does the staff know what's expected of them? Have the staff been coached? Are they tolerating bad behaviors that don't align with the promise, you know, because what you permit you promote.      

Stewart Gandolf

Yep. So, it's funny a couple of thoughts on this. So, I recently interviewed Doug Flora and Dr. Doug Flora. He was talking about how it is hospital to look at marketing as part of the cancer fighting team like they really do look at it that way, like as opposed to being sitting at the kids table or not even in the room at all. Right. They're not like there. Go get your lunches on your own. Go to the school cafeteria.

So, I think marketing historically, and it's a little better now, but has always been at the kids table in many organizations. And it's tough. And you know, we're marketing, not just to attract patients. Today, we're marketing to our own constituencies, right? Our own doctors or referrers our donors, our employees, and people forget that. And you know clearly, if we're talking about a brand promise and culture extending all the way through is important. You know, we are working on currently we're just engaged with a group that has provider groups and an IPA and a bunch of different entities. And there's some challenges in there, because some are you know, are unknown, others have were known and aren't as much of today. So, there's always thinking through, like, how does this stuff all fit together, and how do we align on a brand promise? And how do we live? That right? It's not just lip service. But how do we actually live it. So, I think it's an important topic. Anyway, Kris, any final thoughts before I let you go. This was awesome, as I expected it would be. Anything else?

Kris Baird

I mean just that if people are interested in learning more about be the leader, nobody wants to leave they can always find more information on my website, Baird-group.com, and we start new cohorts every 9 weeks for that course. But, then we also offer it to organizations so that they can have private cohorts as well.      

Stewart Gandolf

That's awesome. Well, Kris, it was fun. I will see you in Orlando in a few weeks, here.

Kris Baird

Yeah, that's great. I'm looking forward to it.

Stewart Gandolf

Yeah, we'll see you there. Nice seeing you again. Have a great day. Thanks.

Kris Baird

Thank you.     

Stewart Gandolf

Bye, bye.