I like to believe I bring insightful perspective when consulting with healthcare organizations and in my speaking, writing, social media and blogging activities. What I bring to the table is insight that spans all organizations. I see how different healthcare professionals approach similar problems, when they succeed and fail, and, with a little luck, can provide some thoughts as to why certain outcomes happen.
What I can’t bring to the table is the first-person perspective. I’m not the person in the hospital working to move that initiative forward. I’m not the one navigating the internal politics, receiving the angry phone calls from physicians, or selling the health system’s brand. It’s been almost 15 years since I’ve worked in a hospital and I’ve used up my war stories.
Fortunately, I work with a truly incredible group of healthcare organizations. The wisdom and depth of experience I find when talking with healthcare professionals is as valuable as the perspective I bring to the conversation. Likely more so.
That’s why I regularly co-present topics with our clients and engage with them when I write. It’s one of the reasons I enjoy going to so many conferences and tradeshows throughout the year.
We’ve been talking about Responsive Design for a long time. In truth, Geonetric was one of the first healthcare Web firms to promote the benefits of this approach in our industry. With the explosion of new devices, form factors, and formats like Windows 8’s touchscreen computers and convertible laptop/tablets, it’s more important than ever to evolve our thinking from “the mobile Web” to a “Whole Web” philosophy.
The initial goal of Responsive Design was simply to deliver all of the content and functionality on our websites to the mobile audience. And it accomplished that. Adobe Flash® features went out the window. Mouse-over menus were outfitted with touchscreen friendly navigation support. And content was prioritized to keep the most important items visible as screens got smaller and smaller.
If you’ve worked in the Web industry for any length of time, you’re painfully aware of how challenging it is to plan for, create, and maintain great content. In healthcare, as in many other industries, there is an enormous amount of informational content. It can easily become overwhelming. However, nothing is more central than content to the success of your online strategy and the overall experience of your audience.
Talk with content strategy experts and you will hear war stories about hours spent manipulating spreadsheets. Dozens of articles and blog posts describe in tedious detail how to combine numerous data files into a single view. All of this cutting, pasting, manipulation, and frustration doesn’t leave much time – or energy – for actually understanding the content or developing a solid strategy, let alone writing anything.
If you’re a regular reader of our blog, you know we’re relentless about measuring Client Satisfaction and posting it here.
Last quarter, and most of 2012, the primary pain point our clients revealed in our Client Satisfaction survey was issues with deployment of our software. So for the past few months we’ve been implementing our new push button automated deployment system, which takes a single click to do, is more reliable, and much faster.
We looked with anticipation to the Q1 2013 survey to see if the changes had any effect. The results are in, and we had the highest overall score we’ve ever gotten: 5.27 on a scale of 1-6.
Yesterday I posted the key takeaways from our quarterly client satisfaction survey. Some questions we hear about it is: where does the data go? Who sees it? How do you use it?
It’s an interesting set of questions, because the answers have evolved a lot in the past few years.
It used to be that we’d collect the data and then just a couple of us would pick some action items to be done and distribute them through the organization. This had the advantage of letting us hide anything we didn’t want everyone to know about, or we didn’t want to deal with yet. But now it’s a bit different. We’ve matured a lot as a company, and we’ve been eschewing top-down management methods and empowering teams to solve problems. Sharing the data widely forces us to face candid feedback even if it’s uncomfortable. Therefore, we share the data very widely within the company, and only in a few cases make it anonymous when we feel it must be.
Who Sees it and Takes Action Based on it?
The data from the client satisfaction survey is:
- Viewed in its entirety, verbatim, by the entire Geonetric leadership team – 12 people – and discussed and debated for a couple of hours. We want to make sure that the team charged with guiding Geonetric forward is 100% clear on whether we’re accomplishing our mission to “Wow!” clients. We identify trends and propose possible ways to address shortcomings or pass along kudos to teams doing things right.
- Client-by-client scores and most client comments are shared with the Account Managers and Project Managers to give them feedback on areas they’re excelling or failing to meet expectations. AMs and PMs tend to have the closest relationships with clients and often can best address issues. In almost every case, the surveys are confirming what the AMs and PMs already know, but the survey helps us stay focused on resolving any outstanding issues, or illuminating exceptional work that might otherwise have gone unnoticed.
- Teams, like our software development team or design team, are given the scores for their respective areas of influence through the company meetings, where we present the aggregate scores in each of 12 categories in front of everyone. Depending on the feedback, they might choose to take action within their realm of control.
- The monthly company meeting after the survey closes includes a discussion and rank of every client from best-scoring to lowest scoring: everyone knows where every client stands at that point.
We’ve been having a great year at Geonetric and we’re making huge strides in a number of areas. One thing we hold constant is our focus on client satisfaction. In fact, though we’ve consistently surveyed clients every quarter for about five years, we recently updated our mission statement to include “To ‘Wow!’ our clients.” So as you can imagine, we don’t just strive for average. Mediocre survey results simply won’t do.
We share the compiled results every quarter with our entire team. We pat each other on the back for successes and talk candidly about opportunities for improvement. We also share the results with our clients – especially in instances where we changed a process or enhanced a feature due to their direct feedback.
We don’t always post the scores publicly. But every once in a while something interesting comes out of the survey that makes me think… this is blog worthy. This is one of those times.
The primary measure we watch is the overall satisfaction score. This quarter’s overall average client satisfaction improved slightly over last quarter, with score of 5.06, up from 5.00 in Q1. This is on a scale of 1.0-6.0, and our goal is to be at 5.0 or better – intentionally a difficult measure to achieve. For example, we need to be getting a bunch of 6.0s – perfect scores – to keep ahead of our 5.0 mark in the event any individual client ranks us less than 5.0.
In short, the Geonetric team has been working exceptionally hard this year to ‘Wow!’ clients, and the scores reflect that, overall, we’re doing very well by our clients.
Mission statements are usually written early in a company’s history, then put on a plaque and promptly forgotten by everyone.
At Geonetric, we use ours a little differently. For example, the mission statement is the very first slide of every monthly company meeting, because it’s just that important. I put it there to remind us every month why we are here, as a company, doing this – rather than something else.
Up until last week, Geonetric’s mission statement was:
To build an exceptional team of experts to do revolutionary work for our clients.
That may not sound very exciting to you, but we thought carefully about those words and the placement of those words. As you can read in the statement, we focus first on the idea of building an “exceptional team:” amazing, smart people that work well together. It is pretty common for new team members to be a bit dazed the first few weeks as they adjust to the idea that there are so many brilliant people under one roof. The people here care about where the company is going. They’re engaged. They want Geonetric to succeed. If the new hire just arrived from the typical corporate world, it’s a bit shocking, actually – and that’s the point. Building an exceptional team is hard, and it’s the most important reason we’re here.
Every company has them. At Geonetric, we call them “huddles” – a chance to sit down, one-on-one with your manager to discuss your performance, your role, your goals, and areas for improvement. They usually happen every few months, or in some cases, annually. Overall, they foster great conversations, and often bring about resolutions to problems that have festered for a while. They’re the perfect time for managers to deliver a “thank you” for a job well done.
And that’s why we’re getting rid of them.
With about five years of consistent data from huddles across the company, I can say pretty confidently that they don’t directly improve organizational performance. In fact, I would argue that performance appraisals are detrimental to a high performance culture. They’re a crutch for managers, and an enabler of poor communication.
Let me tell you why.
Since I pontificated yesterday about the problem with relying on managers for improvement, I thought I’d share an example of a self-improving team: the software engineering team at Geonetric.
This image is the output of the retrospective done by the team, in this case, at the end of the regression period just before we release the next version of our software to our clients. Retrospectives are a critical component of Agile software development and at Geonetric, they happen every two to three weeks.
I belong to a number of CEO peer groups, and I have the opportunity to learn from some brilliant small business owners, and they learn from me. Last week we had a fascinating conversation about a fairly well-known concept called The Saltshaker Theory, which apparently inspired a book called Setting the Table.
The Saltshaker Theory goes something like this: it is the role of the business founder/CEO to apply constant, gentle pressure on the organization to set the standard and vision for the company. The author illustrates this point by clearing a table, and asking his friend to put the saltshaker in the middle of the table. The author moves it slightly off-center. The friend must move it back. Again, the author moves the saltshaker, and gives this sage advice:
“Your staff and your guests are always moving your saltshaker off center. That’s their job. It is the job of life. It’s the law of entropy! Until you understand that, you’re going to get pissed off every time someone moves the saltshaker off center. It is not your job to get upset. You just need to understand: that’s what they do. Your job is just to move the shaker back each time and let them know exactly what you stand for. Let them know what excellence looks like.”
At first blush, this seems elegant and obvious. Of course the leader’s role is to define the level of excellence for the organization and continually demonstrate it by nudging the organization back toward the target.
While I concur that the leader’s role is to articulate the vision, there are two things subtly wrong about the analogy:
- It reinforces a cynical view of the team and treats them as children. Apparently, it is the “law of entropy” that your team will fail to live up to your expectations. “That’s what they do.” Always. Without you, as the magnificent leader, to put the saltshaker in the right place, your team will clearly perform poorly.
- It perpetuates a culture of reliance on the leader to define and continually reinforce the standard. Why is it that you must move the saltshaker back? Is your team apparently incapable of understanding your intent – that the saltshaker should be in the middle of the table, and move it back there, should it somehow get off center? They must rely on you to tell them it’s not right.
So, in my view, the Saltshaker Theory is an interesting concept, but ultimately it doesn’t work for a high performance, professional team.
In fact, I think it’s completely wrong.
In addition to celebration, our monthly all-hands company meetings focus on incredible levels of transparency.
We’ve been very deliberate about weaving transparency across the company in ways that are rare in corporate America. In my view, that reflects our belief that we treat our team members as responsible professionals. Most companies keep even basic data about performance a secret – as if executives are the only people qualified to hear and understand it, or do something about it.
There are six categories of information we share at company meetings:
- Client satisfaction survey data. Every company pays lip service to the importance of their clients or customers, yet most companies don’t even ask, or care, about feedback from them. And of the ones that do ask, how many share the results with the entire company? Client satisfaction is so important to Geonetric that every quarter we survey all clients – either electronically or by phone, for feedback on how we’re doing. The cumulative scores and summary comments – good or bad – are then shared with the entire company. Sharing this information makes it crystal clear to everyone that our jobs are ultimately focused on meeting our clients’ needs and making them happy. Without that – profitable or award-winning as we may be, we’ve failed. It also reinforces the idea that we’re all in the same boat together – our clients’ success is dependent on everyone at Geonetric performing optimally.
- Employee satisfaction survey data. Twice a year, we ask our team members for feedback and input on what’s going right, and what’s not. The survey gives us a way to push team members to effect change by identifying areas that need attention. Being a fairly outspoken group, the feedback we get is often enlightening and eye opening! I would like to think that, as a small business CEO, I have my finger on the pulse of the company every day. But sometimes the survey identifies areas that I might not have realized were in need of attention. Or maybe something I don’t want to acknowledge is an issue. Sharing the aggregate results of the survey publicly reinforces accountability for me – I can’t exactly duck an issue I’m not comfortable with if it’s presented publicly for all to see.
- Financial data. Some executive leadership teams seem to think that it’s OK to incent employees to accomplish financial goals (e.g. profitability) but then hide all of the pertinent information from them of how to get there. Especially when it’s bad news! In my view, this is a failure of typical American management. At Geonetric, every month we’re pretty much doing Open Book Management, sharing revenue and EBITDA information with the whole company. And yes, everyone is expected to know what EBITDA is – not necessarily how to calculate it, but what it represents to the business.
- Sales data. Because we’re growing so fast, it is critical for us to keep everyone on the same page. We find that we need to regularly scale up new processes as new clients or types of work are added. Keeping everyone apprised of the various “waves” we might hit is one way we’ve absorbed a constant growth rate and maintained excellent client satisfaction rates and a 94% client retention rate for the past 13 years.
- Process improvement metrics. Sometimes we’re working on challenges with a particular process, and so we focus on “what hurts” by highlighting an appropriate measure in front of the whole company – a painful exercise! For example, two years ago, we had significant challenges in having too many defects in the software released into the finished product each quarter. We undertook a painful but very successful effort to utilize Behavior Driven Development and other techniques to eliminate defects; we showcased defects per release in company meetings – until the number got so low it wasn’t important enough to include any more. In other words, acknowledging and focusing on problems company-wide works to steel the resolve of the team and keep problems front and center until they’re gone. It also forces accountability – we don’t have the option to simply ignore difficult problems when they’re publicly known and visible.
- Community efforts. Unlike many large companies, we have our entire staff headquartered in one location: Cedar Rapids. So we take our Cedar Rapids community outreach efforts very seriously. We donate to local charities, we sponsor local events, we marshal teams for fundraising efforts, and we even knit hats for babies in local NICUs. We highlight these efforts in our company meetings to reinforce that – like our clients – supporting our local community is a goal at the highest level – as worthy as EBITDA or client satisfaction.
At Geonetric, we have had all-hands company meetings every month for about 10 years. These meetings are a linchpin in reinforcing our award-winning Geonetric culture. The constant, rapid change of our company and the open, transparent culture we have makes it almost impossible to not hold them.
Meetings that pull together 70+ employees for an hour (or more) to hear the CEO drone on for awhile cost a lot and takes people away from directly productive work. But they’re worth it to us, because celebration is a key aspect of our culture.
At every meeting we have the opportunity to celebrate in five ways:
- We celebrate our clients’ incredible successes. Our company meetings showcase the latest site go-lives, show off major projects that we recently completed, and talk about what exciting things clients are doing with Geonetric. We truly are blessed to have smart, innovative clients with great ideas. This is our chance to showcase how, together, we turn those ideas into reality.
- We celebrate our clients’ results. We’re here to do revolutionary work for our clients – and that work only matters when our clients are successful. We happen to have the ability to see across all of our clients’ efforts and the results of our collaborations in aggregate. We’ve started tracking the total impact we’ve had for our clients – an astounding $275 million in total downstream revenue for them as of June 2012 – and we’re excited to watch our impact grow.
- We celebrate our teams’ successes. Not everything we do is as high profile as a new site launch or a million-dollar client savings. The “behind the scenes” projects are just as critical to Geonetric’s (and our clients’!) success. Sometimes it’s celebrating a new process improvement. Sometimes it’s celebrating a new idea that was implemented.
- We celebrate each other. Geonetric’s culture puts a lot of emphasis on peers providing feedback to each other. When was the last time a coworker told you that they appreciate something you did, publicly? Our company meetings give team members the chance to “kudo” a peer (yes, with a Kudos bar) by telling everyone how they live the Geonetric values, and do revolutionary work for our clients. We go through about 40-50 Kudos bars at every meeting!
- We celebrate particularly notable efforts. One team member is publicly acknowledged as being “Spot On” in exemplifying Geonetric values, and gets recognized by proudly displaying Spot, our stuffed dog mascot, on his/her desk for the month.
I try my best to avoid singing any song from Disney’s High School Musical, but it seems quite appropriate that this particular song keeps resounding in my head as I contemplate the dynamics of what makes great teams. What does it take for a team to be truly successful? Is it possible to have successful teams? I believe truly successful teams are hard find, but as one pointed out, teamwork is the “ultimate competitive advantage.” You can have players on your team that are smart, have killer strategy ideas and instinct about the marketplace, and are the best at what they do. But if they cannot work together as a team, nothing will be accomplished. When people of all types are thrown in together and asked to be a team, most teams don’t stop to analyze if things are working. They just keep pulling along. If they do sense the dynamics of the team are a bit off kilter, they often do not bother to dig deep and discover why.
In his book, The Five Dysfunctions of a Team, Patrick Lencioni presents readers with a fable about a team that is far from functional. Throughout the course of the story, the team, which has been working together for some time and thought they were “successful,” finds out how truly dysfunctional they had been. Lencioni’s main premise is very simple: without trust, teams will have a fear of conflict, which will lead to a lack of commitment, which will lead to an avoidance of accountability, and which will finally lead to an inattention to results. Trust, therefore is the primary foundation on which great teams are formed.
If you are reading this now and know your team is not working as well together as they could be, get them together and ask, “Do you trust the people in this room.” If your hands don’t shoot up, then it’s time to get your shovels out and start digging. I might suggest a team retreat away from your regular meeting time and location. You don’t have to go to Napa Valley to build trust, but it just might help. Don’t be afraid to be creative! Remember…great teams take care and time to build, and trust is not going to form overnight. It is a process that will require many baby steps, and maybe even some adjustment of personnel.
Ta Daa! Geonetric’s blog is officially unveiled.
If you know the culture here at Geonetric, you’d know that we like to share ideas, participate in stimulating discussions, and we’ve even been known to get in heated debates about the benefits of writing in .NET versus ColdFusion.
So a blog fits us perfectly!
I’m really excited about sharing the brainpower we have here at Geonetric with the world. We’ve got fresh ideas, expert opinions and a lot of personality. We hope you’ll find the same in our blog.