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Why is this Healthcare vision statement wrong?

This is one anonymous Health System’s vision for healthcare quality:

“Our health system is world-leading in delivering the best outcomes across all six dimensions of quality. 

Our healthcare system is just, 

engages patients and families, 

and is relentlessly committed to improvement.”

Yes, it’s the use of the present tense to describe a desired future reality.

So many vision statements do this – express a ‘wish’ as an ‘is’. 

What that does to people working within that system is embed the ‘is’ as … an ‘is’ !! It becomes, in a subconscious sense, their current reality.

It’s Martin Seligman’s positive thinking in all its unrefined, undeveloped ideal form:

Imagine the reality you want. Picture and describe and talk about it as real. Then move your existing reality to become that. 

The problem is that more recent research into how to create a desired future state shows that once you talk about it as if it exists, you fool your brain and the brain of everyone else who works within that system into thinking the desired state DOES exist. 

Healthcare Leadership

Like you, I’m sure, I’ve worked in large organisations with smart people who can’t see the improvement needs in their own practices because of this sense of the vision and values that have been ‘socialised’ in the organisation. 

Any voice of criticism that suggests you aren’t living them is seen as disloyal. Hence the ‘whistleblower’ problem across all healthcare systems across the world. 

This Health System’s report on its vision (from 2015) goes on as follows

Having set out the vision and principles underlying a quality system, the committee working on this project then delved more deeply into how to implement such a system in our health system.

Released in April, this report acknowledges that our province still does not have a high quality healthcare system for everybody, with the health system working well only for some people, with some conditions, treated some of the time. 

The report sets out a number of recommendations for organizations in how to better understand quality healthcare, and how to deliver that care and foster a culture of quality.

Talking about quality across all six dimensions has to involve all stakeholders in the system – from governments, to hospitals and health authorities, to health care providers, patients and caregivers.

These conversations are essential if we are to move forward and make quality care a reality for everybody in the province.

Great. All true. But all totally undermined by the use of the present tense in that vision statement. Which sabotages the thinking of all involved right from the start. 

Healthcare Leadership

That’s just one example of how leadership and quality improvement in healthcare and other systems needs to keep up with advances in the psychology of work and not get stuck in old ‘vision’ thinking that is no longer fit for purpose. 

Leadership Conversations

The ‘leadership conversations’ talked about above have to be honest and reflect reality – ‘brutally confront existing reality’ (Collins, Bossidy etc) while creating and sustaining a sense of realistic optimism that “we can do this” by sharing small-scale real examples of changes happening at all levels. 

That’s what the online communities (that my team builds) do: enable real conversations that “prevent a BS culture of management speak from being the dominant and only acceptable mode of conversation” (in the words of one of the leaders in one of our communities run for one of the largest companies in the world). 

Patient leadership: an ‘Aha!’ moment for me…


A new article by Phil Dourado on patient-led care, a well-discussed but rarely practised tenant of Healthcare Leadership.

What should patient-led care look like in real, practical terms? Here are 3 examples in this 60-second article…

“He feels that he leads the shaping of his own life, rather than having his life led by the illness, mediated by the consultant.”

What we all have in common is the need to lead our own lives.

Patient-Led Care

Patient-led care changes the view of what a ‘successful outcome’ for long-term treatment will look like, letting the patient or their representative describe their view of success. Then the health and social care package is shaped around them to best achieve that.

It empowers the patient, and improves their relationships with the staff by breaking the staff’s assumptions of how the average case works.

“No-one is average. Constructing a care package and expectations from the ‘median’ or ‘mean’ or some other aggregation that leads to ‘likely outcomes’, pushes those likely outcomes to the average; often down from the outcomes you can achieve if you are led by the patient.”

Read Phil’s 60 Second Article in Full >>

Phil’s Picks for May – 9 Components of Social Leadership

Leaders who embody these traits are often the most widely-respected amongst their peers.

Our ‘Hubs’ are designed to magnify the quality of social leadership in an organisation; we build the platform with the leaders, curate lessons from their shared wisdom, and establish a community for fast and flexible problem-solving.

Over the past 8 years, we’ve seen multiple examples of stand-out social leaders sharing their techniques through our communities and having them become essential tools for others in the organisation.

We may even be sharing an example or two of these impressive leaders in the coming weeks.

Infographic created by Julian Stodd.

Click the Image for Full-Size

9 Components of Social Leadership

The Hospital CEO who went Undercover as a Porter

In her book How to Have a Good Day, psychologist Caroline Webb draws on behavioural science to improve our understanding of why we behave the way we do at work.

How to Have a Good Day (Book)

It helps redefine the very tired ‘personal productivity’ canon of business and self-help books, whose main insights after decades and hundreds of books seem to be:

1) Make lists (Dave Allen) and

2) Focus on only a few things and ignore everyone and everything that tries to push you off track (great for collaborative working, dontcha think?)

What Caroline Webb does is recognise that the people we work with are, guess what, people.

How you behave is key

Caroline Webb

Webb spreads the net of personal and team productivity to include not just WHAT you do but HOW YOU BEHAVE.

Of course checklists are useful, says Webb. But then gives us a psychologist’s insight into the little burst of ‘feel good’ chemicals you get when you tick a box, and how that’s addictive and you’ll tick till you’ve finished your list (sometimes) and go home thinking ‘job done’ under Dave Allen-type personal productivity thinking, which is completely self-centred and shallow (that’s me dissing Dave Allen, not Caroline Webb).

Webb introduces the need to inspire yourself and others with reasons, like the ‘personal why’. The neat little story is below as an excerpt. We at the Leadership Hub like this story as it illustrates an aspect of leadership we feel is vital and rarely practised: Leaders need to be where the business is actually done, as often as possible, not shut in their meetings in offices, a distant figure to the rest of the organisation.

(You can be everywhere virtually, by the way, with one of our digital leadership communities that make your top team ‘present’ in all corners of the business, regardless of geography, but that’s just a gratuitous plug).

Here’s the Story:


“….I once heard a nice example of this kind of ‘personal why’ from a community hospital CEO.  David was new to his organisation and still not a familiar face to staff, so he decided to spend a day working under-cover as an anonymous orderly to get some insight into how it felt on the front lines of his organisation.  David busied himself ferrying patients from the emergency room to wards and from wards to operating theatres, learning a little more about his hospital with every step.

At one point, he came across a guy who was prodding a swinging door with a screwdriver.  David asked the handy man what he was doing.  The man looked up and said ‘I’m fixing the hinge so it opens more easily; it’s too stiff so when you’re pushing patients on gurneys through the doors, it gives them a nasty jolt – that’s not going to help them get better, is it?’

Of course, the handy man had been handed a task list for the day by his boss and he was steadily working through it. It could have been dull, a grind, but in his mind the goal was not just to fix the door, it was to reduce harm to patients. Making the connection to something he cared about encouraged him to treat the tasks more like his own, intrinsic goals, giving him more satisfaction and, all the evidence suggests, resulting in better performance too.”

I love the way the emerging behavioural sciences are re-defining productivity for leaders and managers. The further away we move from the self-serving ‘get the monkey off my back and onto someone else’s’, the closer we get to collaborative leadership that serves the organisation, its people and customers, rather than our own career and need to get things off our desks to appear productive and in control.

Because that isn’t leadership. That’s the illusion of control.

Phil’s Picks for March – Morrisons Marketing Director recommends my book

Mike MorrisonsHoban, Morrison’s Marketing Director, has just recommended my Seven Secrets of Inspired Leaders book, along with The First 90 Days. Mike says there are too many books out there and that these are the two books marketers should be reading.

Here’s the link >>

Glad to see that leaders are still finding the book useful, as it’s 12 years old now. The community behind that book – the Inspired Leaders Network – brought together leaders who were achieving extraordinary results, from Body Shop founder Anita Roddick to First Direct founding CEO Mike Harris.

That ‘share great and emerging practice’ principle is what underlies our online communities now. >>

Seven Secrets Book

If a book of collated learning from 12 years ago is still invaluable to these senior leaders, it’s just another reminder how powerful emergent peer-to-peer learning is.



How to build an online Leadership Community of Practice

In these short videos, leadership development expert Phil Dourado explains how to build a leadership community of practice.

How the Leadership Hub's current corporate platform works

One-minute Videos

These links take you to the Hub, where you can find the videos.

The problem with existing Leadership Development

What is a leadership community of practice?

How to set up a leadership community of practice

Learning in real-time from each other

Small bites of learning to prompt action

A behaviour-led community

Emergence: how the content is generated

We reversed the time-paradigm for learning

Security & Confidentiality

To ask about setting up your own leadership community of practice: phildourado@theleadershiphub.com

Phil’s Picks for February: Drive for Diversity, and ‘Dyad’ Leadership

1. We recently featured a guest post on the Leadership Hub from a leader we have admired for quite a while.

Dame Stephanie Shirley came to us offering an article for the site and introducing herself, but our team already knew of her since my colleague Zara had pointed us at her TED Talk. We really admire her drive for furthering diversity.

Dame Stephanie Shirley

Worldwide probably the biggest cultural difference between leaders is gender. This has the most profound implications. Because equality will only come when men share leadership equally with women.

I’m an entrepreneur who, back in 1962, started a computer software company of women, for women. Leaders – men and women alike – often start things. They also then invariably determine the criteria for leadership in their own organizations and beyond — and thus who will, and will not, lead in the future.

 Here’s that Hub link again.

2. An interesting approach gaining attention in healthcare: ‘dyad’ leadership

…brought to our attention by this article in Cardiovascular Business.

What is ‘Dyad’ Leadership?

Essentially a leadership partnership.

An administrative or nurse leader collaborates with a physician leader, with the goal to bring out the best in both and to cover what the other is missing. ‘Dyad’ supporters tout that it reduces leader burnout and improves cross-division communication.

Dyad Leadership

And it dispels the core myth of leadership that a single leader is at the top. That alone is promising.

Having written before about the power of co-leadership outside healthcare (here on phildourado.com), I’m interested in the improving results being shown in the US, and whether it’s transferable to the NHS and other countries.

See you in March!

– Phil

A new model for leadership development in large organizations

Head of Global Leadership Development for Specsavers Jennifer Alexander and her team are six months into an experiment that could be a game-changer: a global, online community of practice for her company’s leaders and partners. She explains in an interview with Phil Dourado

Specsavers logo

In this connected world, much of our thinking happens collaboratively and ‘out loud’: it becomes formed during conversations, in real time.

Yet when we get to work, we revert to what we feel are more formal, and therefore acceptable, ways of communicating and working together. For the most part, that means we revert to email.

Our Leadership Hub is partly about bringing connected behaviour into the workplace, and helping evolve work from the assumption that this kind of social connection is informal and therefore somehow invalid or the equivalent of unstructured play.

Social Learning (Leadership Development)

How we started

The concept was endorsed by our Global HR Director and Board Member Pauline Best, who encouraged the exploration of external and internal research around social learning.  We explored a number of papers produced by ‘Towards Maturity’ as well as our own internal white papers.  We knew we wanted the user experience to be powerful from the start and that we wanted to take a people focused technology approach.

We started with 360 members – leaders in the business and store partners (Specsavers is run on a JVP – Joint Venture Partnership – model).

When they go into our online Leadership Hub, the way in is through a Common Room. That’s where general interaction takes place. There are four classrooms leading off the Common Room, for our four programmes – Leading Self, Leading Others, Leading Change, Leading Commercially.

Those rooms are where the users go into a deeper dive on one of those topics. Each room is led by a programme sponsor, a Specsavers Board Member who is an advocate for that stream of learning.

Online Learning (Leadership Development)

So, they come into the online community and into the relevant classroom to access the learning materials before and after their programme workshops, for prep in advance and then post-session follow-on work. The classrooms initially acted as a repository for the materials and a place to work with those materials in your own time.

That ‘help yourself in your own time’ element was primary. The social collaboration tool was secondary to that. One thing I’ve observed is that we now have over 550 users and they have used our Leadership Hub predominantly as instructed; to access the pre-work and leadership resources available.

We need to remember that the members are essentially non-digital natives for the most part. So, any assumption that they might intuitively go in and play … well, it wasn’t going to happen naturally for everyone.

What we have learned

Looking back, we should have made the social collaboration side the primary purpose, with the resource access secondary. And for 2017 we are taking that learning and applying it.

Bright Ideas (Leadership Development)

Some cohorts where there is strong sponsorship do collaborate more in The Hub. We learned that strong sponsorship leads to 20% more activity than in groups where the sponsor is not actively leading the collaboration.

That learning about how the users behave and what prompts most participation will help us evolve The Hub: so, for example, with the next generation of sponsors we will make it explicit upfront that part of their responsibility is to lead the collaboration in their group, as we now know that’s what works.

Where we are now

Thanks to the work of some who have taken the lead in the community, I know what good looks like now. This gives us a blueprint to build on.

The sponsors will fill the role of agitators or ‘nudge’ action from participants (nudge theory recently emerged from studies in behavioural economics).

The facilitators – the experts who created and ran the real-world workshops that make up the physical side of our leadership development programmes – also nudge in the community. We give them log in rights and they participate in the community, some more than others.

Sukhwant Bal, for example, facilitated the Leading Others workshop and he recently dropped in a little nudge on self-limiting beliefs and how do you overcome them, to spark off follow-on thinking and action from the workshop itself.

Graham Wilson, who facilitated the Leading Change programme for our Partners, regularly posts short videos with real tips and techniques – they are captured on his phone and are great examples of using technology to share ideas and leadership thinking.

These nudges and prompts create a continual drumbeat to the self-learning journey within the community.  Instead of the usual model of ‘here’s the workshop, tick the box when taken, roll out and deploy’.

Jen Alexander was talking to Phil Dourado. This is an edited version of a fuller article in which Jen goes into more detail with Phil about how in-house leadership communities of practice are the way forward for leadership development in large organizations.

For a copy of the full 3,500 word case study written by Phil, where Jen goes into more detail about how to build a community of practice for leaders, email: phildourado@theleadershiphub.com

Phil’s Picks for January: Growth Mindset resolves a leadership paradox

1. We are not alone!

I have been a bit worried, I have to admit. I mean, 10 years after setting up the world’s first online global community of practice for leaders, and eight years of running one inside a FTSE 100 company, winning awards and all that good stuff, a big bit of me was thinking … If this is indeed the future of leadership development, why are we the only ones doing it?

Growth Mindset

And now we’re not. Phew. I’ve been talking at length with Jen Alexander at Specsavers and they have created a very clever global leadership community of practice. Which has re-convinced me (if that’s even a word) that we are right to have started this.

And the rest of the leadership development world is just taking its time to catch up.

I’m writing an article about Specsavers’ community and the transferable lessons. Watch this space.

2. Authentic means ugly

Wonderful talk on ‘The Ugly Room‘ and how authentic leadership means embracing the ugly, and how to do that, spotted by my colleague, Danny.

3. Nice reminder of the work of Carol Dweck

in this article spotted by another colleague of mine, Clement, ‘The Impact of a Growth Mindset on Employee Engagement’.

The ‘Ugly Room’ and ‘Growth Mindset’ need to be taken together, if possible, as they help resolve a leadership paradox.

I’ve stuck 2. and 3. together here, as they help resolve the apparent paradox between positive psychology (where you can end up ignoring the blemishes in the drive to keep everyone motivated and upbeat) and negativism or over-criticality of individuals, team or organization, which can go under cover as a ‘sub-culture’ for lack of any other outlet, and/or can undermine the team or organisation

Jim Collins’s Stockdale Paradox and Gramsci’s ‘Pessimism of the Intellect and Optimism of the Will’ are, neither of them, a solution to the tension between optimism and pessimism or positivism and negativism. Confront reality, as Larry Bossidy said. Warts and all. But remain inspiring and keep people inspired.

Hey, no-one said this leadership stuff was easy: it involves taking apparent opposites and reconciling them in many cases.

Phil Dourado

Phil’s Picks for December: New articles for HR Director, and an impressive leader…

1) Online leadership communities: where are we at?

I’m writing a series of three articles for HR Director on the state of play in using in-house online leadership communities to develop leaders in a ‘community of practice’, as an alternative to, or to supplement, existing leadership development.

The articles are based on eight years of running such a community of practice for one of the largest companies in the world.

Article One: Open Source Leadership – The Future of Leadership Development?

Article Two: The Problem – And Possible Solution – With Leadership Development

2) A leader who really impresses me

One of the joys of running an in-house leadership community is you get to spot wonderful leaders who may not be known as such to the outside world.

These are every day leaders who do it right, in the moment, consistently, and lead by example.

After eight years of running IHG’s Leaders Lounge – their leadership development platform that we built and facilitate for them – I am so impressed by this leader and want to quickly share, as I think she models 21st century leadership for the rest of us.

Emily Chang, Chief Commercial Officer, Greater China, IHG

Emily Chang

Here’s what her colleagues said about her in the community when I asked them to identify great leadership within IHG and describe what it looks like:

“I would like to nominate Emily Chang, the Chief Commercial Officer of Greater China.

I think she is the only female CCO in our company as well.

Five reasons why Emily is an example of how to lead at IHG:

1. She is a smart learner. She joined IHG China from another great company (Apple) last year. She has worked for P&G before but IHG is her first hospitality experience. She learned very fast not through others but her own first hand experience. For example she went to “sleep with the enemy” herself for our competitor hotels. She set an example of how we can develop insights quickly from doing ourselves, not only listening.

2. She is a bold change agent. The first task when Emily started her current role was to tackle the decline RGI/market share challenges in July last year. She has implemented a new organization structure in sales marketing and put together an integrated action plan. She is daring to implement the changes under the performance pressure. The result? The whole team has turned around the RGI after 4 months in November. No risk, no gain. Courage is the first step to build a high performance team.

3. She is a great teacher. Despite her busy schedule, Emily organizes regular “Lean in Lunches” with the women in the office to talk about various topics on how to help them advance their career and life. She will collect the topics and put together the content by herself. Some topics cover, for example, “how to manage your energy to achieve work life balance”, “How to enter the boy’s club?”etc. She shared her knowledge and experience and I was often inspired by the conversation. She also set up a little library beside her office to share great books with us.

4. She brings energy. Energy is the new leadership. I was amazed often by how she can be a caring mother for 2 babies while managing such a big team and responsibility. She brings laughter and injects energy into every single conversation. It takes energy to inspire, motivate people during the change process.

5. She is a creative storyteller. Emily communicates in a very effective way. She can make complicated things simple, make simple things meaningful, and make meaningful things fun. She can not only explain well, but also draw well!

What I appreciate about Emily: she will always make the efforts to share her thinking from those senior meetings with everyone in her team (normally it’s live broadcasting as she does it right after the meeting; see below for example).  She prefers to build a flat, transparent communication instead of following the hierarchy.”


Here’s a link to Emily’s micro articles on LinkedIn, which are brilliant. You can find them here.

Look at how simple drawing can be used as a powerful leadership tool, not just words, in Emily’s micro-articles.

Congruency: Do you experience this every day? >>