What you Permit, you Promote


    StuderGroup – Conversations with Quint Studer

    Another great discussion from Quint Studer's management blog (I hate to call it a “healthcare blog” because that might keep you manufacturing leaders away). Here is a direct link to a post called “What you Permit, you Promote” (or you can use the top link).

    I've heard the same concept explained as:

    “You deserve what you tolerate.”

    If you tolerate people not wearing their safety glasses in a factory, you deserve to have leadership or the government come down on you when a preventable accident occurs. If you tolerate leaders treating employees badly, you will deserve the poor morale and business problems that will come with it.

    Quint provides some excellent examples on his blog, often framing it in terms of “respect.”

    When I became president of a hospital in 1996, 23 percent of employees had late evaluations. I became aware of this issue when I mentioned to some employees our organization's value of respect. An employee said, “If we are so respected, why is my evaluation late?” Thus, my search led me to find that 23 percent of our employees were waiting for an evaluation to be completed and some had been waiting for weeks and months. If an employee's evaluation was late, nothing happened to the leader who did not complete it by the deadline.

    I guaranteed all staff that in 60 days there would no late evaluations. I put in systems and consequences, positive recognition to leaders with no late evaluations, and connected the dots on why an on-time evaluation is crucial to show staff respect and retain employees. Sixty days later, there were no late evaluations nor were there any while I was there. I believe the system of on-time evaluations and results is still strong.

    He decided, as a leader, to no longer permit late reviews. Some other examples from Quint.

    Allowing a physician to intimidate staff. We know from research that if staff are scared, they may not address patient issues with the physician. By allowing intimidation, we are not providing staff or patients the safest environment.

    A leader keeps blaming the data for results. We are permitting, thus promoting, excuses.

    I agree with Quint's call for leaders to ask themselves and their organization, “What am I permitting, thus promoting?” At your next senior leader meeting, put on the agenda “What are we permitting, thus promoting?”

    Such good common sense leadership tips.

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    Mark Graban
    Mark Graban is an internationally-recognized consultant, author, and professional speaker, and podcaster with experience in healthcare, manufacturing, and startups. Mark's new book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation. He is also the author of Measures of Success: React Less, Lead Better, Improve More, the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean. Mark is also a Senior Advisor to the technology company KaiNexus.


    1. Let’s not forget that Dr. Deming was against “evaluations.” For one thing, annually or even quarterly opportunities for feedback are too few. How can a person make a correction a if feedback is separated so long from when a problem occurred? And why are evaluations late? I once read that receiving an annual evaluation was only slightly more stressful than giving one. Could there be an emotional aversion to doing someone’s evaluation?

      Deming said to drive out fear. When a management policy calls for evaluations, it’s because there is no culture of daily feedback, focused on events and processes, not ability or attitude.

      So, yes, it’s more respectful to provide evaluations on time, but we should be seeking to eliminate the paper pushing and rating systems that constitute “evaluations.”

    2. Great point, Karen. The root cause of “late” reviews might be to avoid the annual review process altogether and to “substitute leadership”. From Quint’s book “Hardwiring Excellence,” he promoted an approach of giving direct feedback to people so they could improve immediately, not waiting for an annual cycle.


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