LONG Tom Peters

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LONGTom Peters Toward Health(care)
Excellence!Michigan Health Hospital
AssociationAnnual Membership MeetingGrand
Hotel/Mackinac Island/0629.2006
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Part 1
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EXCELLENCE. ALWAYS.
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The Irreducible209
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EXCELLENCE. THE MANDATE.
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It is not the strongest of the species that
survives, nor the most intelligent, but the one
most responsive to change. Charles Darwin
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EXCELLENCE. THE WORD.
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SynonymsPurityTranscendenceVirtueEleganceMaj
estyAntonymsMediocrity
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EXCELLENCE. 1982.
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Excellence1982 The Bedrock Eight Basics 1. A
Bias for Action 2. Close to the Customer 3.
Autonomy and Entrepreneurship 4. Productivity
Through People 5. Hands On, Value-Driven 6. Stick
to the Knitting 7. Simple Form, Lean Staff 8.
Simultaneous Loose-Tight Properties
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EXCELLENCE. ALWAYS.
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Why in the world did you go to Siberia?
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The Peters Principles Enthusiasm. Emotion.
Excellence. Energy. Excitement. Service. Growth.
Creativity. Imagination. Vitality. Joy.
Surprise. Independence. Spirit. Community.
Limitless human potential. Diversity. Profit.
Innovation. Design. Quality. Entrepreneurialism.
Wow.
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Business (at its best) An emotional, vital,
innovative, joyful, creative, entrepreneurial
endeavor that elicits maximum concerted human
potential in the wholehearted service of
others.Excellence. Always.Employees,
Customers, Suppliers, Communities, Owners,
Temporary partners
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Business The Ultimate Creative Endeavor.
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Business The Ultimate Personal
Development-Growth Experience.
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Business The Ultimate Transcendent Service
Opportunity.
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EXCELLENCE. YOU ME.
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This is the true joy of Life, the being used for
a purpose recognized by yourself as a mighty one
the being a force of Nature instead of a
feverish, selfish little clod of ailments and
grievances complaining that the world will not
devote itself to making you happy. GB
Shaw/Man and Superman
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Life is not a journey to the grave with the
intention of arriving safely in a pretty and
well-preserved bodybut rather a skid in
broadside, thoroughly used up, totally worn out,
and loudly proclaiming, Wow, what a ride!
anon.
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EXCELLENCE. INNOVATE. OR. DIE.
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A focus on cost-cutting and efficiency has
helped many organizations weather the downturn,
but this approach will ultimately render them
obsolete. Only the constant pursuit of innovation
can ensure long-term success. Daniel Muzyka,
Dean, Sauder School of Business, Univ of British
Columbia (FT/09.17.04)
23
I am often asked by would-be entrepreneurs
seeking escape from life within huge corporate
structures, How do I build a small firm for
myself? The answer seems obvious Buy a very
large one and just wait. Paul Ormerod, Why
Most Things Fail Evolution, Extinction and
Economics
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More than 1 RD spending, last 25 years?
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GM
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Innovation The Secrets
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Parallel universe!
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Venture fund (E.g. Gerstner/Amex,
Dow/Marriott, Grove/Intel, Bedbury/Starbucks)
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This is so simple it sounds stupid, but it is
amazing how few oil people really understand that
you only find oil if you drill wells. You may
think youre finding it when youre drawing maps
and studying logs, but you have to drill.
Source The Hunters, by John Masters, Canadian
O G wildcatter
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We made mistakes, of course. Most of them were
omissions we didnt think of when we initially
wrote the software. We fixed them by doing it
over and over, again and again. We do the same
today. While our competitors are still sucking
their thumbs trying to make the design perfect,
were already on prototype version No. 5. By the
time our rivals are ready with wires and screws,
we are on version No. 10. It gets back to
planning versus acting We act from day one
others plan how to planfor months. Bloomberg
by Bloomberg
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Culture of PrototypingEffective prototyping
may be the most valuable core competence an
innovative organization can hope to
have.Michael Schrage

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Never doubt that a small group of committed
people can change the world. Indeed it is the
only thing that ever has. Margaret Mead
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EXCELLENCE. DRAMATIC.DIFFERENCE.DOABLE.
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798
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415/SqFt/WalMart798/SqFt/Whole Foods
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7X. 730A-800P. F12A.93-03/10 yr annual
return CB 29 WM 17 HD 16. Mkt Cap 48
p.a.
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?
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Its simple, really, Tom. Hire for ?s, and,
above all, promote for ?s. Starbucks middle
manager/field
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1/100 Best Companies to Work for/2005
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Wegmans
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EXCELLENCE. OPPORTUNITY.
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Women are the majority market Fara
Warner/The Power of the Purse
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Forget China, India and the Internet Economic
Growth Is Driven by Women. Headline,
Economist, April 15, Leader, page 14
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1. Men and women are different.2. Very
different.3. VERY, VERY DIFFERENT.4. Women
Men have a-b-s-o-l-u-t-e-l-y nothing in
common.5. Women buy lotsa stuff.6. WOMEN BUY
A-L-L THE STUFF.7. Womens Market Opportunity
No. 1.8. Men are (STILL) in charge.9. MEN ARE
TOTALLY, HOPELESSLY CLUELESS ABOUT WOMEN.10.
Womens Market Opportunity No. 1.
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EXCELLENCE. EXPERIENCE IT.
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Experiences are as distinct from services as
services are from goods. Joe Pine Jim
Gilmore, The Experience Economy Work Is Theatre
Every Business a Stage
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The Starbucks Fix Is on We have
identified a third place. And I really
believe that sets us apart. The third place is
that place thats not work or home. Its the
place our customers come for refuge.Nancy
Orsolini, District Manager
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CXOChief eXperience Officer
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EXCELLENCE. THE STORY.
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Storytelling is the core of culture.
Branded Nation The Marketing of Megachurch,
College Inc., and Museumworld, James Twitchell
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Management has a lot to do with answers.
Leadership is a function of questions. And the
first question for a leader always is Who do we
intend to be? Not What are we going to do? but
Who do we intend to be? Max De Pree,
Herman Miller
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EXCELLENCE. BEDROCK.
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Organizing Genius / Warren Bennis and Patricia
Ward BiedermanGroups become great only when
everyone in them, leaders and members alike, is
free to do his or her absolute best.The best
thing a leader can do for a Great Group is to
allow its members to discover their greatness.
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Leaderships Mt Everest/Mt Excellencefree to
do his or her absolute best allow its
members to discover their greatness.
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The role of the Director is to create a space
where the actor or actress can become more than
theyve ever been before, more than theyve
dreamed of being. Robert Altman, Oscar
acceptance
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In the end, management doesnt change culture.
Management invites the workforce itself to
change the culture. Lou Gerstner
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Our MissionTo develop and manage talentto
apply that talent,throughout the world, for the
benefit of clientsto do so in partnership to
do so with profit.WPP
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DD21M
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A review of Jack and Suzy Welchs Winning claims
there are but two key differentiators that set GE
culture apart from the herd First Separating
financial forecasting and performance
measurement. Performance measurement based, as it
usually is, on budgeting leads to an epidemic of
gaming the system. GEs performance measurement
is divorced from budgetingand instead reflects
how you do relative to your past performance and
relative to competitors performance ie its
about how you actually do in the context of what
happened in the real world, not as compared to a
gamed-abstract plan developed last year.
Second Putting HR on a par with finance and
marketing.
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Leaders do people. Period. Anon.
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AS LEADERS, WOMEN RULE New Studies find that
female managers outshine their male counterparts
in almost every measureTitle, Special
Report/BusinessWeek
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EXCELLENCE. BEDROCK.
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X.Step 1Buy a Mirror!
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The First step in a dramatic organizational
change program is obviousdramatic personal
change! RG
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You must be the change you wish to see in the
world.Gandhi
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EXCELLENCE. STRETCH.
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The greatest dangerfor most of usis not that
our aim istoo highand we miss it,but that it
istoo lowand we reach it.Michelangelo
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Kevin Roberts Credo1.
Ready. Fire! Aim.2. If it aint broke ... Break
it!3. Hire crazies.4. Ask dumb questions.5.
Pursue failure.6. Lead, follow ... or get out of
the way!7. Spread confusion.8. Ditch your
office.9. Read odd stuff.10. Avoid moderation!
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Its always showtime. David DAlessandro,
Career Warfare
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EXCELLE ALWAYS.
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Part 2
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EXCELLENCE. HEALTH(CARE).
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March-June 2006 Sample ofHealthcare PR
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Docs Hospitals
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Doctors/Hospitals53 autopsy studies 24
misdiagnosis rate (The Independent,
06.27)Medical Guesswork From heart surgery to
prostate care, the health industry knows little
about which common treatments really work
(Cover, BusinessWeek, 0529) Dr David Eddy/Kaiser
Permanente Care Management Institute The
problem is we do not know what we are doing.
Eddy 15 of what doctors do is backed by hard
evidence (BW) in general, 20 to 25.What
Doctors Hate About Hospitals (Cover, Time,
05.01) It remains almost a stroke of luck to
enter a U.S. hospital and receive precisely the
right treatment. (Time) No day passednot
onewithout a medication error. The errors were
not rare they were the norm (Don Berwick, on
his wifes treatment) One medication was
discontinued by a physicians order on the first
day of admission Berwicks wife and yet was
brought by a nurse every single evening fo 14
days straight. (Time) Harvard Public Health,
2002 study More than 1 in 3 doctors reported
errors in their own or a family members medical
care. (Time)
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Doctors/HospitalsDr Robert Wachter, Chief of
Medical Service, UCSF Medical Center Internal
Bleeding The Truth Behind Americas Terrifying
Epidemic of Medical Mistakes (Time) Dr Niteesh
Choudry, Harvard Med School More than half the
studies reviewed found decreasing performance
with increasing years of practice for all
outcomes assessed only 4 found increasing
performance with increasing age one study found
that for heart attack patients, mortality
increased 0.5 for every year the physician had
been out of medical school. (Time) My pizza
parlor is more thoroughly computerized than most
of healthcare. (Don Berwick, Time)Teaching
Doctors to Care (feature, Time, 05.29)
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Big Pharma
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Big PharmaPushing Pills How Big Pharma Got
Addicted To Marketing (Cover, Forbes, 05.08)
Novartis 4 best seller, Lamisil, toe fungus,
850 for 3-month treatment, Digger
Dermatopphyte (Forbes) 42 billion on RD, 46
billion on marketing and admin. Salespeople up
100,000 in last 10 years, 1 per 9 docs vs 1 per
18 docs. (Forbes) Clinical trials favor sponsors
drug 90 of the time. The comparative studies
are a joke. Dr Jack Rosenblatt
(Forbes)Psychiatric Drugs Fare Favorably When
Companies Pay for Studies (headline, USA Today.
05.25) 57 of studies paid by drug companies, up
from 25 in 1992. Favorable outcome for sponsor
78. Sponsored by neutral 48. Sponsored by
competitor 28. USA Today /American Psychiatric
Association) Hey, You Dont Look So Good As
diagnoses ofr once-rare illnesses soar, doctors
say drugmakers are disease-mongering to boost
sales (feature, BusinessWeek, 05.08)
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Intractable Problems
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OtherHazardous To Your Health (New York Times
Op-ed on High Fructose Corn Syrup, 04.11)
112,000 deaths/year, 75 billion/per year
associated with too much fat 2/3rd of Americans
over-weight, 1/3rd childrenCall for Switch to
Preventive Measures as 29 billion pound Cost
of Heart Disease is Revealed (headline, The
Independent, 05.15)The Fat Police Obesity
Tests Every four-year-old in the country to be
officially screened (headline, The Independent,
05.21)The Politics of Fat (headline, Time,
03.27) childhood obesity up 3X in 25 years
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STATE OFEMERGENCY
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Funding ........... N.A.Access
N.A.Execution of chosen task
DPriorities ...... FBig Pharma
..... D-
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Funding ........... N.A.Access
N.A.Execution of chosen task
DPriorities ...... FBig Pharma
..... D-Quality FScientific basis for
action C-/D
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Funding ........... N.A.Access
N.A.Execution of chosen task
DPriorities ...... FBig Pharma
..... D-Emphasis on Acute care
CDe-emphasis of WPC/Wellness-Prevention-Chronic
care F (F-??)
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Funding ........... N.A.Access
N.A.Execution of chosen task
DPriorities ...... FBig Pharma
..... D-Me too D-Overcomplexity/Drug
discovery D-Disease creation D-Hiring pretty
girls AHiring lotsa pretty girls A
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BONUSFunding ........... N.A.Access
N.A.Execution of chosen task ...
DPriorities ............ FBig Pharma
........... D-FDA ..
D-Kill a few, save a lot D-
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Manifesto
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Healthcare vs Health
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TP Recce 1Dubai Healthcare City to Dubai
Health CityCleveland Clinic and Canyon Ranch
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TPs Healing Wellness Manifesto2006(1)
Acute-care facilities are killing fields.
(WE KNOW WHAT TO DO.)(2) Shift the community
focus 90 degrees (not 180, but not 25) from
fix it to prevent it. (WE KNOW WHAT TO
DO.)(3) There are three primary aims for all
this Wellness-Healing-Health. (WE KNOW
WHAT TO DO.)(4) Im mad as hell and Im not
going to take it anymore. (I KNOW WHAT TO
DO.)
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HealthCentury21.Job 1
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Quality!Prevention!Wellness! Chronic
care!Childhood obesity!H5N1!
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Quality!Prevention!Wellness! Chronic
care!Childhood obesity!H5N1!
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When I climb Mount Rainier I face less risk of
death than Ill face on the operating table.
Don Berwick, Six Keys to Safer Hospitals A
Set of Simple Precautions Could Prevent 100,000
Needless Deaths Every Year, Newsweek (1212.2005)
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2m38s
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Welcome to the Homer Simpson
Hospitala/k/a The Killing Fields
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Quality!Prevention!Wellness! Chronic
care!Childhood obesity!H5N1!
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Childhood Obesity gt Terrorism
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Bust fat docs!
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Quality!Prevention!Wellness! Chronic
care!Childhood obesity!H5N1!
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The Ultimate Culture ChangeHealthcare
vs. Health
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If God spoke to me by saying, Mark, youre down
to your last three words What would you want to
say to your fellow humans that would make the
most positive impact? It would be a close call
between Love Thy Neighbor and Wash Your Hands .
A close third would be Move, Move, Move. Mark
Pettus, M.D., The Savvy PatientThe most
important thing you can do to keep from getting
sick is to wash your hands. CDC/National
Center for Infectious Diseases
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Quality!Prevention!Wellness! Chronic
care!Childhood obesity!H5N1!
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Report Card.
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Re-imagine Healthcare
Reportcard2006Evidence-based/Outcomes-based
....... DPay-for-performance
. DIS/IT (general)
..... C-Use of information
(for decisionmaking-measurement) . C-EMR
(Electronic Medical Records) ......
C-/DCPOE (Computerized Physician Order Entry)
.. C-/DQuality/100K unnecessary deaths
.. D-(kind)Acute care to chronic
care-home care shift ..... D/D-Acute-care
to Prevention/Wellness Obsession..
D/D-Patient-centric/Client-centric..
DDocs acceptance of evidence-based
............ D/D-Revolutionary-intensity
Incentives re evidence ... D- Childhood
obesity epidemic .. D- H5N1
preparedness ... DCorporate
focus on Prevention/Wellness.........
C-/DIndividual focus on Prevention/Wellness
.. DIndividuals health education/self-manageme
nt ..... C-Workforce acceptance of
self-responsibility ....... C-Workforce
transition to Brand You attitude......
C-/D 3 March 2006/Tom Peters
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Wash your hands.Apply 50 sunscreen.Banish
trans fatBanish high fructose corn
syrup.Exercise 30-7.Breathe.Stockpile for
H5N1. (not Tamiflu!)
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Quality COULD IT TRULY BE THIS AWFUL?
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CDC 1998 90,000 killed and 2,000,000 injured
from hospital-caused drug errors infections
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HealthGrades/Denver 195,000 hospital deaths per
year in the U.S., 2000-2002 390 full
jumbos/747s in the drink per year.Comments
This should give you pause when you go to the
hospital. Dr. Kenneth Kizer, National Quality
Forum. There is little evidence that patient
safety has improved in the last five years. Dr.
Samantha CollierSource Boston Globe/07.27.04
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1,000,000 serious medication errors per year
illegible handwriting, misplaced decimal points,
and missed drug interactions and
allergies.Source Wall Street Journal
/Institute of Medicine
111
Dear Mr. Mrs. Smith,XYZ hospital regrets to
inform you .

.Sincerely,A. S.
Jackson, AdministratorT. D. Jones, M.D., Chief
Medical OfficerL.S. Donald, CFOW.N. Arnold, CIO
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Purchasing Officer Thrust 1 Cost (at All
Costs) Minimization Professional? Or/to Full
Partner-Leader in Lifetime Value-added
Maximization?(Lopez Arguably Villain 1 in
GM tragedy/Anon VSE-Spain)
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YE GADS! New England Journal of Medicine/
Harvard Medical Practice Study 4 error rate (1
of 4 negligence). Subsequent investigations
around the country have confirmed the ubiquity of
error. In one small study of how clinicians
perform when patients have a sudden cardiac
arrest, 27 of 30 clinicians made an error in
using the defibrillator. Mistakes in
administering drugs (1995 study) average once
every hospital admission. Lucian Leape,
medicines leading expert on error, points out
that many other industrieswhether the task is
manufacturing semiconductors or serving customers
at the Ritz Carltonsimply wouldnt countenance
error rates like those in hospitals.
Complications, Atul Gawande
114
In a disturbing 1991 study, 110 nurses of
varying experience levels took a written test of
their ability to calculate medication doses.
Eight out of 10 made calculation mistakes at
least 10 of the time, while four out of 10 made
mistakes 30 of the time.Demanding Medical
Excellence Doctors and Accountability in the
Information Age, Michael Millenson
115
20 not get prescriptions filled50
use meds inconsistentlySource Tom
Farley Deborah Cohen, Prescription for a
Healthy Nation
116
In health care, geography is destiny.Source
Dartmouth Medical School 1996 report
117
Without being disrespectful, I consider the U.S.
healthcare delivery system the largest cottage
industry in the world. There are virtually no
performance measurements and no standards. Trying
to measure performance is the next revolution
in healthcare.Richard Huber, former CEO, Aetna
118
A healthcare delivery system characterized by
idiosyncratic and often ill-informed judgments
must be restructured according to evidence-based
medical practice.Demanding Medical Excellence
Doctors and Accountability in the Information
Age, Michael Millenson
119
As unsettling as the prevalence of inappropriate
care is the enormous amount of what can only be
called ignorant care. A surprising 85 of
everyday medical treatments have never been
scientifically validated. For instance, when
family practitioners in Washington State were
queried about treating a simple urinary tract
infection, 82 physicians came up with an
extraordinary 137 strategies.Demanding Medical
Excellence Doctors and Accountability in the
Information Age, Michael Millenson
120
Most physicians believe that diagnosis cant be
reduced to a set of generalizationsto a
cookbook. How often does my intuition lead
me astray? The radical implication of the Swedish
study is that the individualized, intuitive
approach that lies at the center of modern
medicine is flawedit causes more mistakes than
it prevents. Atul Gawande, Complications
121
Dr Larry Weed/POMR (problem-oriented medical
record)/Etc Its impossible to keep up with
the avalanche of knowledge. Therefore its
essential to use a valid diagnostic-decision aid
like Larrys Neil de Crescenzo, VP Global
Healthcare/IBM Consulting There is no other
profession that tries to operate in the fashion
we do. We go on hallucinating about what we can
do. Dr Charles Burger (using Weeds software
for 20 years)
122
About Time!100,000 Lives CampaignDon
Berwick/Institute for Healthcare Improvement
123
You must be the change you wish to see in the
world.Gandhi
124
You Your Calendar
125
The Necessary IS/Web REVOLUTION
126
We all live in Dell-WalMart-eBay-Google World!
127
Some grocery stores have better technology than
our hospitals and clinics. Tommy Thompson,
former HHS SecretarySource Special Report on
technology in healthcare, U.S. News World Report
128
Our entire facility is digital. No paper, no
film, no medical records. Nothing. And its all
integratedfrom the lab to X-ray to records to
physician order entry. Patients dont have to
wait for anything. The information from the
physicians office is in registration and vice
versa. The referring physician is immediately
sent an email telling him his patient has shown
up. Its wireless in-house. We have 800
notebook computers that are wireless. Physicians
can walk around with a computer thats
pre-programmed. If the physician wants, well go
out and wire their house so they can sit on the
couch and connect to the network. They can review
a chart from 100 miles away. David Veillette,
CEO, Indiana Heart Hospital
129
Health
130
Sanitary revolution mortality in major cities
down 55 between 1850 and 1915Source Tom
Farley Deborah Cohen, Prescription for a
Healthy Nation
131
Our mistake is not that we value medical
carebut that we have misunderstood what it can
and cannot do.Source Tom Farley Deborah
Cohen, Prescription for a Healthy Nation
132
Gwen former healthcare exec has wonderful
health insurance and an abundance of healthcare.
What Gwen does not have is health. And there is
nothing our health system can do to give it to
her. The battle cry is always health, but in
fact the struggle has always been over
healthcare. For all its inspiring, high-tech
cures, medicine is just not very effective at
curing our eras major killers. Medicine
doesnt do much chronic disease. When the
most common killers of our era are mostly
incurable and our preventive treatments pretty
feeble, you have to wonder about medical care as
a whole. There is a widely held view that
medical care contributes little to health. (John
Bunker/ Journal of the Royal College of
Physicians) Source Tom Farley Deborah Cohen,
Prescription for a Healthy Nation
133
Curve ShiftingSource Tom Farley Deborah
Cohen, Prescription for a Healthy Nation
134
Bump into factor Extra-size portions, eat
more. Higher shelf space snacks, more
obesity. More liquor stores, more crime. High
vs low fat Japanese who emigrate to U.S. suffer
3X increase in heart disease.Source Tom Farley
Deborah Cohen, Prescription for a Healthy Nation
135
Sprint/Overland Park KS Slow elevators, distant
parking lots with infrequent buses, food court
as poorly placed as possible, etc.Source
New York Times
136
Determinants of HealthAccess to care
10Genetics 20Environment 20Health
Behaviors 50Source Institute for the Future
137
Wellness
138
Obesity/-79(-36) BP (140-85 to 90-60) Blood
sugar (180-87) Blood chemistry (normal)
Cholesterol (140-58) Metabolic rate/RMR (250)
Mental state (dramatic improvement)
139
Off Univasc (lt1/2)BextraLipitorToprolPropra
nolol
140
Aging reversal!!!!Why wasnt I informed
until age 59?
141
FixesDietExtreme exerciseMeditationSuppleme
ntsEliminate all alcohol(Meds)
142
Planetree A Radical Model for New
Healthcare/Healing/Health/Wellness Excellence
143
The Nine
Planetree Practices1. The Importance of Human
Interaction2. Informing and Empowering Diverse
Populations Consumer Health Libraries and
Patient Information3. Healing Partnerships The
importance of Including Friends and Family4.
Nutrition The Nurturing Aspect of Food5.
Spirituality Inner Resources for Healing6.
Human Touch The Essentials of Communicating
Caring Through Massage7. Healing Arts Nutrition
for the Soul8. Integrating Complementary and
Alternative Practices into Conventional
Care9. Healing Environments Architecture and
Design Conducive to HealthSource Putting
Patients First, Susan Frampton, Laura Gilpin,
Patrick Charmel
144
1. The Importance of Human Interaction
145
Press Ganey Assoc/1999 139,380 former patients
from 225 hospitals0 of top 15 factors
determining Patient Satisfaction referred to
patients health outcomePS directly related to
Staff InteractionPS directly correlated with ES
(Employee Satisfaction)Source Putting
Patients First, Susan Frampton, Laura Gilpin,
Patrick Charmel
146
There is a misconception that supportive
interactions require more staff or more time and
are therefore more costly. Although labor costs
are a substantial part of any hospital budget,
the interactions themselves add nothing to the
budget. Kindness is free. Listening to patients
or answering their questions costs nothing. It
can be argued that negative interactionsalienatin
g patients, being non-responsive to their needs
or limiting their sense of controlcan be very
costly. Angry, frustrated or frightened
patients may be combative, withdrawn and less
cooperativerequiring far more time than it would
have taken to interact with them initially in a
positive way. Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
147
3. Healing Partnerships The Importance of
Including Friends and Family
148
When hospital staff members are asked to list
the attributes of the perfect patient and
family, their response is usually a passive
patient with no family. Putting Patients First,
Susan Frampton, Laura Gilpin, Patrick Charmel
149
Family members, close friends and significant
others can have a far greater impact on
patients experience of illness, and on their
long-term health and happiness, than any
healthcare professional. Through the Patients
EyesSource Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
150
4. Nutrition The Nurturing Aspect of Food
151
Meals are central eventsvsThere, youre
fed. Irony Focus on nutrition has
reduced focus on food and serviceSource
Putting Patients First, Susan Frampton, Laura
Gilpin, Patrick Charmel
152
KitchenBeautiful cutlery, plates, etcChef
repSource Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
153
Aroma therapy (eg smell of baking
cookies)Source Putting Patients First,
Susan Frampton, Laura Gilpin, Patrick Charmel
154
8. Integrating Complementary and Alternative
Practices into Conventional Care
155
Griffin IMC/Integrative Medicine
CenterMassageAcupunctureMeditationChiropracti
cNutritional supplementsAroma therapySource
Putting Patients First, Susan Frampton, Laura
Gilpin, Patrick Charmel
156
CAM (Complementary Alternative Medicine) 83M
in US (42)CAM visits 243M, greater than to PCP
(Primary Care Physician) (With min insurance
coverage)W-Educated-Hi incDont tell PCP
(40)And lt30 procedures used in conventional
medicine have undergone RCTs (randomized clinical
trials) Source Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
157
Conclusion Caring/Growth Experience
158
Care!Control!Connect! Engage!Grow!
De-stress!
159
Access to nurses stationHappen
tovsHappen withSource Putting Patients
First, Susan Frampton, Laura Gilpin, Patrick
Charmel
160
T.T.D./Healthcare27
161

Healthcare27 1. Fully utilize Physicians
Assistants to do routine work in a timely
fashion. (Doc in a Kiosk at WalMart is
great!) 2. Maximize Outpatient services! 3. Short
hospital stays work! 4. Support home care to the
max. (E.g., Declaration of IndependentsBeacon
Hill/Boston) 5. STOP THE 100K NEEDLESS
DEATHSmuch/most of the quality stuff is
eminently fixable. (Don Berwick for President!
AHA for Hall of Shame!) (Strong, vicious insurer
incentives!!!) 6. FLIP HC 177 DEGREES TO
EMPHASIZE PREVENTION WELLNESS. (Steps are
being taken but not enough. Med schools Awful!
Insurers Little better. Support for
appropriate-proven alternative therapies is an
important part.) (HUGE INCENTIVES FOR EFFECTIVE
WELLNESS-PREVENTION PROGRAMS-MEASURABLE
SUCCESSES.)
162
T.T.D./ACTION.NOW.
163
Visible Signs/Measures (Creech)TRAIN. TRAIN.
TRAIN. (P.S.)Med school, Nursing school
cirriculum (P.S.)BOLD!/Big change EASIER than
modest change (P.S., etc.)EXCELLENCE. ONLY.
ALWAYS. DAMN IT.EVP/Patient SafetyP.S.O.sFund
the living hell out of it (P.S.)CEO (etc)
REFLECT IT IN CALENDAREMERGENCY STATUSH.M.O.s
Big/Enormous (/-) incentives for docs,
hospitals, etc, etcBOARD Patient Safety
CommitteeBOARD WPCC CommitteePatient Safety
BALDRIDGE (POTUS?)CERTIFICATION/RE-CERTIFICATION
for One All (P.S., etc)
164
WPOCC Rules!!!!!!! (Wellness/Prevention/Obesity/C
hronicCare)WPOCC N.G.A. (AK)Dramatically
higher involvement in WPOCCINSURANCE COMPANY
VISIBILITY/SPONSORSHIP/MEGA-INCENTIVESAwards
Galore P.S./WPOCC)BOARD Committee
H5N1GovtHHS Split HC PWO (Ontario)Write off
½ of med school loan if pay with 3-5 years
service in Public HealthGlamorize Family
Practice, Public Health Service, etcFAT
legislation?? (Almost certainly) (Density, HFCS,
Trasfats, etc, etc) (A FIRST FOR TP)SUE the hell
out of One All re Obesity (Cigarettes II)
165
Research LEAP _at_ N.I.H. (Etc, Etc, ETC)INCENTIVES
_at_ SCHOOLS (BIG!!)EMR Intensify!!!!!!!!!!!!!No
leadership position in AHA (AMA?) (DEANs?)
(Etc?) without Safety tourNo Medical Chief
(gt150 beds?) without Safety tour)FORGET ABOUT
ME!!! (Except Wellness, ChroniCare)VIGOROUSLYSUP
PORT Home CareAmerican OBESITY African AIDs
(??)ELIMINATE/OBLITERATE HIGH FRUCTOSE CORN
SYRUP!ELIMINATE/OBLITERATE TRANSFATS!(HFTC/TF
The Real WMDs)FDA Kill! Kill! Kill! (Please)
166
STATE OFEMERGENCY
167
EXCELLENCE. ALWAYS.