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Why do so many initiatives fail?60%+ of change initiatives fail in North America70%+ of leaders expectations arenot understood by their people about a major change – particularly when down-sizing72% of people hired are terminated within 2 yrs due to lack of alignmentIn the last 12 years, 2 in 3 failure rate has not changed – From Kotter (1996) to McKinsey (2009)

To Err is Human…..10yrs onINQRI observed (12/09): Ten years later, medical errors are still a widespread problem in the American health system. More than 1.5 m Americans are sickened, injured, or killed by medication errors each year. 1.7m Americans battle illnesses due to hospital acquired infections, 99,000 of whom die.The information from INQRI shows that medical error morbidity and mortality is on the rise, not on the decline, despite the attention paid to this vexing issue Copyright PDS Group 2009 All Rights Reserved

How can these quality issues be addressed?Are there best practices that are easily transferable from setting to setting? What taking concrete steps to improve quality by aligning integrated delivery systems?What role can an alignment process play in overcoming cultural inertia?Copyright PDS Group 2009 All Rights Reserved

Non-Financial FactorsValued Most By InvestorsOnly 1 in 10 can consistently achieve their Strategy’s full potential Factors<10%Strategy Execution>90%Management CredibilityQuality of StrategyInnovativenessCompanies Not Delivering Consistently on StrategyAttract Talented PeopleImplementation ChallengeStrategy ExecutionPoor Strategy Execution - Impact95% of employees don’t understand company strategy50% of average employee’s time spent on non-productive work50% more likely to have turnoverSources: “The Balanced Scorecard” David P. Norton; Arthur Andersen estimate: Corporate Strategy Board research;Measures That Matter,” Ernst & Young, LLP, Gates, Stephen, Aligning Strategic Performance Measures and Results

Increased sales 10%-15% in 30 weeksOwnerIncreased Customer Sat.Ratings(4th – 1st)Sales Gross Revenues Up from $20m to $30mResearchAlEx™Prevented Restructuring FailuresClosing RateImproved by 66%Executive TeamEmployeesDelivered Building OTIF & No Legal IssuesCustomer Relations Isolated Hi Performing TeamsFactorsMarketingBusiness PartnersCopyright PDS Group 2009 All Rights ReservedIncrease Revenue14% in 6 months

Signs of misaligned expectations“That’s not what I meant…”“This is not what I asked for!” “My colleagues don't seem to do what I expect...”“They never tell us the whole story!”“I can never do anything right!”“They never send us information, we’re always sending information to them!” Sound familiar? Copyright PDS Group 2009 All Rights Reserved

Aligning Expectations is a Two Way Street – Four BlockerMy Expectations of YouWhat I Think You Expect of MeWhat You Think I Expect of YouYour Expectations of MeCopyright PDS Group 2009 All Rights Reserved

Cliff & Tom’s Four BlockerCliff’s Expectations of TomWhat Cliff Thinks Tom Expects of Him12224 13What Tom Thinks Cliff Expects of HimTom’s Expectations of CliffCopyright PDS Group 2009 All Rights Reserved

Four Blocker ProblemCopyright PDS Group 2009 All Rights Reserved2 People4 People8 People20 People

UnresolvedIssuesPerformanceCriteriaDiscardsNew & Matched ExpectationsAligning Expectations Process (ALEX™)My Expectations of Others(MEOs)What Others’ Think I Expect Them(OEMs)AlignmentDiscussionsCopyright PDS Group 2009 All Rights Reserved

AlEx™ - The Alignment Process2413IntroduceComponents & ProcessDevelopStrategic ComponentsSelect Key Players &/or Focus GroupsMission & StrategyCoach Participants &Collect Their Expectations6Key Component Prioritization& Implications Use CrossHairs Reports todevelop problem definitionsAlEx5798Alignment ProcessBrief, Train, Coach Rapid Improvement Cycles(Based on Tracking TBDs, Discards, Complete & Unresolved Expectations)Integration &TransferCapabilityKnowledgeSkillsCapacityDevelop Metrics & Rewards perComponentCopyright PDS Group 2009 All Rights Reserved

Project SizesRoyal Bank of Canada IMS Health (Canada)Qwest TelecomsGenzink SteelTurner Construction20 participants/6 weeks25 participants/10 weeks – Phase 112 participants/8 weeks – Phase 16 participants/14 weeks12p/8w;86p/1yr; 100+/OngoingCopyright PDS Group 2009 All Rights Reserved

Health Care QualityCopyright PDS Group 2009 All Rights ReservedPatient-Centered CareTeamwork & CollaborationEvidence-Based PracticeQuality ImprovementSafetyInformatics

Key Components ExampleCompetency DevelopmentLeadershipBusiness DevelopmentPerformance AssessmentManagementTeam WorkingDelegatingRisk Management & PlanningValue DeliveryCopyright PDS Group 2009 All Rights Reserved

Component DefinitionRespectful CommunicationUsing all available resources to accurately and effectively relate ideas and positions to associates and colleagues. Manage the tensions created by the conditions, people and conflicting objectives. Respectfully listen to others’ contributions, allowing them to engage and own their contributions. Respond with thoughtfulness, taking into consideration the contributions of others.16Copyright PDS Group 2009 All Rights Reserved

Component DefinitionTeam IntegrationThis is the effective working between one of more team’s so that a team‘s effort adds to the impact of another teams effort. So optimizing resources and maximizing outcomes is a natural outcome. It is based on every one recognizing that "we are all in this together." Welcome the talents and contributions of all members into the team environment. Manage communication, decisions and actions so all are committed to agreements. - Raise the bar by consistently sharing knowledge, advising, mentoring and developing associates and colleagues.17Copyright PDS Group 2009 All Rights Reserved

My Expectations of Others(MEO)What I expect of another person or people during this change process includes:What I expect you to keep doing . .

What I want you to start doing . . . .

Others’ Expectations of Me(OEM)What I think others will expect of me during this change process includes:What things I think others will expect me to keep doing . . . .

What new things I think others start doing . . . .

Expectations (MEO) vs. Assumptions (OEM)LeadCoachPlanCollaborateCommunicateRecognizeValueInfluenceManager’sExpectations(MEO’s)Direct Reports’ Assumptions(OEM’s)By permission Qwest Tel.Copyright PDS Group 2009 All Rights Reserved

Cross Hairs - Targeting on what countsOAC’s as a percentage of total expectations – 11:2489=.44%RFI’s /design issues expectations as a total percentage of total expectations 116:2489=4.6%CO’s as a total percentage of total expectations 128:2489=5.1%Copyright PDS Group 2009 All Rights Reserved

Copyright PDS Group 2009 All Rights ReservedOriginatorPromotesDiscussionOriginatorCoachesReceiverOriginator &Receiver Decide:AgreeDiscardUnresolvedReal AlignmentOriginator Rates PerformanceReceiver Agrees Evidence

The Alignment ProcessAgreeEvidenceRateCoachRate AgainAlEx™ Easy EntryAlEx™ Cross HairsAlEx™ Priority 5AlEx™ Cross HairsNew ExpectationsHold Receivers AccountableCopyright PDS Group 2009 All Rights Reserved

Seven Alignment ChallengesEmbeddingChangeCoachingStrategicallyReplicating SuccessRemovingDistractionsOperationalExcellenceAligningExpectationsRewarding Change39Copyright PDS Group 2009 All Rights Reserved

LearningDesign Performance Contracts Focused

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AlEx - Your Line of Sight to Success

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