Tom Peters

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Tom Peters The (My) Search for Excellence
ContinuesFrom Institutional Healthcare to
Humane Healing and WellnessNAHC/Seattle/10.24.2
005
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Slides at tompeters.com
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Life, circa 2005 .
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If you dont like change, youre going to
like irrelevance even less. General Eric
Shinseki, Chief of Staff. U. S. Army
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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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The most successful people are those who are
good at plan B. James Yorke, mathematician,
on chaos theory in The New Scientist
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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)
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In Toms world, its always better to try a
swan dive and deliver a colossal belly flop than
to step timidly off the board while holding your
nose. Fast Company /October2003
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This (NAHC) is personal
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I, Boomer (Geezer, Class of 42), do hereby
declare, on this the 23th day of October2005,
that I want to die at home on my Farm in
Tinmouth, Vermont, with my wife and kids
nearby. I thank NAHC and the D.C. Nine (the
Supremes) for helping make this possible!Im
not in a hurry!And ponds, birds, flowers,
dogs, geese, donkeys, barn cats, alpacas, mice,
skunks, porcupines
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This is professional
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What is In Search of Excellence all about?
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What is In Search of Excellence all
aboutPeople. Emotion. Engagement.
Empowerment. Caring.
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What is In Search of Excellence in Healthcare
all about?Especially Home Care
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What is In Search of Excellence in Healthcare all
aboutPeople. Emotion. Engagement.
Empowerment. Caring.(Safety.)
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TP/RHW Hard is soft.Soft is hard.
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Hard Science/Technology abetted by the soft
Human/Healing Touch?
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Hard Science/Technology abetted by the
Human/Healing Touch? OrThe Human/ Healing
Touch abetted by Science/ Technology?
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Home care Only about Emotion Healing. (The
Missing 95)Tom World biz strategy,
customer service, people, etc.
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This I believe
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TPs Healing Wellness
Manifesto2005(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 two
primary aims for all this
Wellness-Healing. (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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Experience it!
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2/50
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Experience Rebel Lifestyle!What we sell is
the ability for a 43-year-old accountant to dress
in black leather, ride through small towns and
have people be afraid of him.Harley exec,
quoted in Results-Based Leadership
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798
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415/SqFt/WalMart798/SqFt/Whole Foods
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4
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?
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Wegmans 1100 Best Companies to Work for84
Grocery stores are all alike46 additional
spend if customers have an emotional connection
to a grocery store rather than are satisfied
(Gallup)Going to Wegmans is not just shopping,
its an event. Christopher Hoyt, grocery
consultantYou cannot separate their strategy
as a retailer from their strategy as an
employer. Darrell Rigby, Bain Co.
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Experiences are as distinct from services as
services are from goods.Joseph Pine James
Gilmore, The Experience Economy Work Is Theatre
Every Business a Stage
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The Experience LadderExperiences
ServicesGoods Raw Materials
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Beyond the Transaction/ Satisfaction
MentalityGood hotel/ Happy guest/ Exceeded
Expectationsvs. Great Vacation!/ Great
Conference!/ Operation Personal Renewal!
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One companys answer CXOChief eXperience
Officer
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The Ritz-Carlton experience enlivens the
senses, instills well-being, and fulfills even
the unexpressed wishes and needs of our guests.
from the Ritz-Carlton Credo
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Design it!
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With its carefully conceived mix of colors and
textures, aromas and music, Starbucks is more
indicative of our era than the iMac. It is to the
Age of Aesthetics what McDonalds was to the Age
of Convenience or Ford was to the Age of Mass
Productionthe touchstone success story, the
exemplar of all that is good and bad about the
aesthetic imperative. Every Starbucks store is
carefully designed to enhance the quality of
everything the customers see, touch, hear, smell
or taste, writes CEO Howard Schultz. Virginia
Postrel, The Substance of Style How the Rise of
Aesthetic Value Is Remaking Commerce, Culture and
Consciousness
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We dont have a good language to talk about
this kind of thing. In most peoples
vocabularies, design means veneer. But to me,
nothing could be further from the meaning of
design. Design is the fundamental soul of a
man-made creation.Steve Jobs
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Brand it!
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WHO ARE WE?
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WHATS OUR STORY?
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WHATS THE DREAM?
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EXACTLY HOW ARE WE DRAMATICALLY DIFFERENT?
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Sell it Women!
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Thanks, Marti Barletta!
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The Perfect Answer
Jill and Jack buy slacks in black
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(No Transcript)
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Women dont buy brands. They join
them.EVEolution
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Sell it Boomers!
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2000-2010 Stats18-44 -155 21(55-64
47)
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44-65 New Customer Majority 45 larger
than 18-43 60 larger by 2010Source Ageless
Marketing, David Wolfe Robert Snyder
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Possession Experiences /Desires for
things/Young adulthood/to 38Catered
Experiences/ Desires to be served by
others/Middle adulthoodBeing
Experiences/Desires for transcending
experiences/Late adulthoodSource David Wolfe
and Robert Snyder/Ageless Marketing
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Tom Peters State of Healthcare10.23.2005
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TPs Healing Wellness
Manifesto2005(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 two
primary aims for all this
Wellness-Healing. (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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Toms HealthCare2
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• 
  Healthcares 1-2 Punch
• Hospital quality control, at least in the
  U.S.A., is a bad joke Depending on whose stats
  you use, hospitals kill 100,000 or so of us a
  yearand wound many times that number. Finally,
  they are getting around to dealing with the
  issue. Well, thanks. And what is it weve been
  buying for our Trillion or so bucks a year? The
  fix is eminently do-able which makes the
  condition even more intolerable. (Disgrace is
  far too kind a label for the condition. Whos
  to blame? Just about everybody, starting with the
  docs who consider oversight from anyone other
  than fellow clan members to be unacceptable.)
• 2. The systemtraining, docs, insurance
  incentives, culture, patients themselvesis
  hopelessly skewed toward fixing things (e.g. Me)
  that are brokennot preventing the problem in the
  first place and providing the Maintenance Tools
  necessary for a healthy lifestyle. Sure,
  bio-medicine will soon allow us to understand and
  deal with individual genetic pre-dispositions.
  (And hooray!) But take it from this 61-year old,
  decades of physical and psychological self-abuse
  can literally be reversed in relatively short
  order by an encompassing approach to life that
  can only be described as a Passion for Wellness
  (and Well-being). Patientslike meare catching
  on in record numbers but the system is highly
  resistant. (Again, the doctors are among the
  biggest sinnersno surprise, following years of
  acculturation as the man-with-the-white-coat-who-
  will-now-miraculously-dispense-fix
  it-pills-for-you-the-unwashed. (Come to think of
  it, maybe Ill start wearing a White Coat to my
  doctors officeafter all, I am the
  Professional-in-Charge when it comes to my Body
  Soul. Right?)

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Excerpt from Tom Peters Presentation to
Healthcare CIOs Quality COULD IT TRULY BE
THIS AWFUL?
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CDC 1998 90,000 killed and 2,000,000 injured
from nosocomial 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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This should give you pause when you go to the
hospital. There is little evidence that
patient safety has improved in the last five
years.
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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
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As many as 98,000 Americans die each year because
of medical errors despite an unprecedented focus
on patient safety over the last five years,
according to a study released today Journal of
the American Medical Association. Nationwide
the pace of change is painstakingly slow. USA
Today/05.18.2005
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Hospital infections kill an estimated 103,000
people in the United States a year, as many as
AIDS, breast cancer and auto accidents combined.
Today, experts estimate that more than 60
percent of staph infections are M.R.S.A. up from
2 percent in 1974. Hospitals in Denmark, Finland
and the Netherlands once faced similar rates, but
brought them down to below 1 percent. How?
Through the rigorous enforcement of rules on hand
washing, the meticulous cleaning of equipment and
hospital rooms, the use of gowns and disposable
aprons to prevent doctors and nurses from
spreading germs on clothing and the testing of
incoming patients to identify and isolate those
carrying the germ. Many hospital administrators
say they cant afford to take the necessary
precautions. Betsy McCaughey, founder of the
Committee to Reduce Infection Deaths (New York
Times/06.06.2005)
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Various studies 1 in 3, 1 in 5, 1 in 7, 1 in 20
patients harmed by treatment Demanding
Medical Excellence Doctors and Accountability
in the Information Age, Michael Millenson
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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 industries simply wouldnt
countenance error rates like those in
hospitals.Complications, Atul Gawande
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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
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Welcome to the Homer Simpson Hospitala/k/a
The Killing Fields
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Toms HealthCare2.5
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We all live in Dell-WalMart-eBay-Google World!
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We almost all live in Dell-WalMart-eBay-Goog
le World!
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Some grocery stores have better technology than
our hospitals and clinics. Tommy Thompson, HHS
SecretarySource Special Report on technology
in healthcare, U.S. News World Report (07.04)
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Were in the Internet age, and the average
patient cant email their doctor.Donald
Berwick, Harvard Med School
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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 (HealthLeaders)
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Toms HealthCare3.0
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H5N1Tom Peters/23October2005
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We may not be interested in chaos but chaos is
interested in us. Robert Cooper, The Breaking
of Nations Order and Chaos in the Twenty-first
Century
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H5N1
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3D/350M
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Grim tail of the distribution of outcomes 3 days
to circle the globe up to 350,000,000 deaths
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Kroll/SARS dont over-reactKroll/H5N
1 devastatingSource Newsweek/10.24.05
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Sample ActionsBrief self (CEO)Project Manager
as Asst to CEO/Attends all Exec Team
meetingsPlan ASAPRisk Management job elevated
(min RM consultant)Discuss with Board (on every
agenda?) non-Exec Board designee?Medical
Officer on Exec Team?Info Dissemination strategy
explicit, reviewed regularly (update 100 of
employees regularly)Engage Clients/VendorsReview
JIT issues/impactDiscuss with Banker/sKey
person/first responder planCommunity
involvement
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TPs Healing Wellness
Manifesto2005(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 two
primary aims for all this
Wellness-Healing. (WE KNOW WHAT TO
DO.)(4) Im mad as hell and Im not going to
take it anymore. (I KNOW WHAT TO DO.)(5)
H5N1 preparedness is Healthcare Priority 1 for
the foreseeable future. (WE DONT KNOW WHAT TO
DO.)
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The (Obvious?) Fix(es)
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About Time!100,000 Lives CampaignDon
Berwick/Institute for Healthcare Improvement
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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 (HealthLeaders/12.2002
)
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Oh Canada!Ontario To Split Health Ministry
Headline/Globe And Mail/06.05 (New ministry will
focus on Prevention/Wellness/Eldercare)
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Companies Step Up Wellness Efforts Rising
health costs provide incentive to promote
healthier employee lifestyles headline/USA
Today/08.05
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Home Care Hospices!
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Planetree A Radical Model for New
Healthcare/Healing/Wellness Excellence10.23.200
5
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Much of our current healthcare is about curing.
Curing is good. But healing is spiritual, and
healing is better, because we can heal many
people we cannot cure. Leland Kaiser,
Holistic HospitalsSource Putting Patients
First, Susan Frampton, Laura Gilpin, Patrick
Charmel
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Determinants of HealthAccess to care
10Genetics 20Environment 20Health
Behaviors 50Source Institute for the Future
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The 9 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
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1. The Importance of Human Interaction
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Planetree is about human beings caring for other
human beings. Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel (Ladies
and gentlemen serving ladies and gentlemen4S
credo)
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2. Informing and Empowering Diverse Populations
Consumer Health Libraries and Patient
Information
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Planetree Health Resources Center/1981Planetree
Classification SystemConsumer Health
LibrariansVolunteersClasses, lecturesHealth
FairsGriffins Mobile Health Resource
CenterOpen Chart PolicyPatient Progress
NotesCare Coordination Conferences (Est goals,
timetable, etc.)Source Putting Patients First,
Susan Frampton, Laura Gilpin, Patrick Charmel
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3. Healing Partnerships The Importance of
Including Friends and Family
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The Patient-Family ExperiencePatients are
stripped of control, their clothes are taken
away, they have little say over their schedule,
and they are deliberately separated from their
family and friends. Healthcare professionals
control all of the information about their
patients bodies and access to the people who can
answer questions and connect them with helpful
resources. Families are treated more as intruders
than loved ones. Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
98
4. Nutrition The Nurturing Aspect of Food
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Meals are central eventsvsThere, youre
fed. Source Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
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5. Spirituality Inner Resources for Healing
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6. Human Touch The Essentials of Communicating
Caring Through Massage
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Massage is a powerful way to communicate
caring. Putting Patients First, Susan Frampton,
Laura Gilpin, Patrick Charmel
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7. Healing Arts Nutrition for the Soul
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8. Integrating Complementary and Alternative
Practices into Conventional Care
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Griffin IMC/Integrative Medicine
CenterMassageAcupunctureMeditationChiropracti
cNutritional supplementsAroma therapySource
Putting Patients First, Susan Frampton, Laura
Gilpin, Patrick Charmel
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9. Healing Environments Architecture and Design
Conduciveto Health
107
Planetree LookWoods and natural
materialsIndirect lightingHomelike
settingsGoals Welcome patients, friends and
family Value humans over technology .. Enable
patients to participate in their care Provide
flexibility to personalize the care of each
patient Encourage caregivers to be responsive
to patients Foster a connection to nature and
beautySource Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
108
The most basic question we need to pose in
caring for others is this Is this a loving act?
Leland Kaiser, Holistic HospitalsSource
Putting Patients First, Susan Frampton, Laura
Gilpin, Patrick Charmel
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Lead Loud!
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Ninety percent of what we call management
consists of making it difficult for people to get
things done. Peter Drucker
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People want to be part of something larger than
themselves. They want to be part of something
theyre really proud of, that theyll fight for,
sacrifice for , trust. Howard Schultz,
Starbucks (IBD/09.05)
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G.H. Create a cause, not a business.
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Leaders do people. 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,
Business Week
115
Execution is the job of the business leader.
Larry Bossidy Ram Charan/ Execution The
Discipline of Getting Things Done
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We have a strategic plan. Its called doing
things. Herb Kelleher
117
Nothing is so contagious as enthusiasm.
Samuel Taylor Coleridge
118
What creates trust, in the end, is the
leaders manifest respect for the followers.
Jim OToole, Leading Change
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The deepest human need is the need to be
appreciated.William James
120
You must be the change you wish to see in the
world.Gandhi
121
The First step in a dramatic organizational
change program is obviousdramatic personal
change! LH
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Avoid Moderation!
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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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TPs Healing Wellness
Manifesto2005(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 two
primary aims for all this
Wellness-Healing. (WE KNOW WHAT TO
DO.)(4) Im mad as hell and Im not going to
take it anymore. (I KNOW WHAT TO DO.)