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Politeness, Shmoliteness

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If you can’t say something nice, don’t say anything at all, the adage says. But there’s such a thing as going too far.

Darryl McCormick, senior vice president of human resources and organization development at Stamford Hospital, knows firsthand that politeness can be overrated when senior leaders are trying to create the appropriate leadership tone for their organization. McCormick’s facility was struggling with low patient satisfaction scores, but the issue—among others—was being avoided because management wasn’t willing to point out problems, he says.

When Brian Grissler signed on as new president and chief executive officer of the 212-staffed-bed hospital six years ago, he and other top managers decided a change in leadership tone was needed. “The tone we wanted to set was really a culture of accountability,” McCormick says. “It’s not about blame. It’s about people who are willing to step forward and deal with issues head-on and be passionate for our patients and patient care.”

The upshot: Stamford enjoyed the most dramatic financial turnaround of any hospital in Connecticut in recent years, posting a 4.5 percent operating margin on revenue of $336 million for the 2006 fiscal year, up from a 5.1 percent operating loss three years earlier.

The transformation was triggered by an uncomfortable self-analysis. “We really had to look at ourselves as an executive staff and ask if we were being accountable and if we were creating an environment that would support people being accountable,” McCormick says. “We realized we had some work to do there.”

McCormick offers three tips for setting the right leadership tone:

Speak the ugly. One of Stamford’s values—integrity—is interpreted by this rule: Communicate the good, the bad and the ugly. A CEO must model the behavior he wants from others; Grissler shows staff members that an “avoidance culture” is not acceptable. “He reinforces the good stuff, but when we were going through the turnaround, he was honest,” McCormick says. “He wasn’t hiding things, and people saw that.”

Create a narrative. Every institution has a history and future, and helping staff members understand where the organization—and the staff—are headed is key to setting the right tone. “You have to have a compelling saga, and the CEO has to be able to tell the story,” McCormick says. “You need something to inspire people.”

Stamford employees were recently dispatched to the corridors in search of information, he says. “Each one of us has to go out to 10 other employees as reporters and ask, ‘What should Stamford Hospital be famous for?’ and ‘What does Stamford Hospital have that other hospitals do not?’”

The resulting story will be used in new-employee orientation and as a companion document to the hospital’s strategic plan, helping staff members understand the link between the plan and the hospital’s evolution.

Use positive peer pressure. To reinforce institutional values throughout the staff, Stamford managers developed a training exercise called MAPS, meaning My Accountability for Patient Satisfaction. Vice presidents and department heads are facilitating groups of employees who reconsider the actual experiences—both good and bad—of recent patients.

The employee groups discuss the patient’s experience, think how it could have been better, and fill out actual patient-satisfaction survey forms to capture what a patient may be thinking when assessing an experience at Stamford. Every employee will complete the exercise, which serves to make expectations clear.

“You sometimes see people who will say, ‘I don’t see anything wrong with that patient’s experience’ and then you’ll see the peer pressure to show that there was something wrong,” McCormick says.

—Lola Butcher