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How the University of South Florida Morsani College of Medicine is transforming how students learn

[Music] by this year 2020 medical knowledge is doubling every 73 days every moment we spend with them has to be high-value we have to really be training master learners not master memorizers when we had the opportunity to build this new facility it really gave us an opportunity to rethink medical education we wanted to build a technology platform in a building that would support potentially decades of innovation in the future when you have active learning and you’re engaging their mind we know that they don’t have to study as much later so anything that you can do to make that material easier to grasp I think is really important but it was critical that we knew we were using technological tools that were perfect fits to that pedagogics eerie that educational theory and that led naturally to Microsoft our initial design in this building was actually very traditional we had monitors on the walls around the classrooms we moved away from that we pulled the technology into the room and used a surface hub to’s to really build a platform that could move throughout the building hubs can be used in a conference room they could go up to a director’s office or they could stay there and support the learning in that space the building has been designed in terms of space with lots of small group learning technology infused within those to allow for collaborating around hubs and white boards etc exactly as we envisioned the surface hub is intended for you to interact with and so that a layout of a room is completely different to encourage adoption of that technique we have an experience or learning lab on the third floor of the building where the walls can actually be moved around and you can construct whatever space you need trying to make things more engaged more active technology creates behavior and space enables behavior and so bringing those two things together to really help focus on adoption of technologies students be able to join in into a classroom experience no matter where they are how we selected Microsoft teams for that you can be in multiple small group sessions simultaneously you can be in your lab and teach you a small group it expands and leverages our faculty in a way that makes it much more efficient vision for teams really is to deliberately allow more synchronous and asynchronous learning embedded into our DNA is this concept of continuous quality improvement understanding how the human brain works and understanding how we learn more efficiently and effectively again leveraging technology being innovative is really about how do you simplify delegate to the computer world which should be delegated to the computer world and then what happens is then the human beings have the time-space energy to be doing the things that human beings are really good at [Music] you

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DaVita CEO Kent Thiry on Building a Signature Company Culture

I thought we’d do two main sets of things I want to talk to you about your signature culture because I think it is so interesting to all of us and then at some point we’ll pivot from that into talking a little bit more generally about leadership leadership style and how you approach leadership and then we’ll leave some time for questions from the audience and we’ll wrap up at the end so talk to me about you know some of these signature pieces of the culture that I refer to in my in my opening remarks that the idea of mayor and village and teammates you know the dress-up the chanting that I hope that I heard backstage what’s the story behind behind all of this yeah so we we believe we’re a community first in a company second and hopefully everybody has some communities that they’re a part of in their life could be their family could be the book club could be their church could be the sports team could be their best friends the community basically means that people care about each other respect each other and they care about the organization that they’re a part of that they’re stewards that care about what they give on to the next generation that that’s basic concept of community and and so we believe in that fervently that that given we spend more than 50% of our waking hours as an adult at work and for some of us it’s way more than 50% especially if you travel that to concede that in any way that shouldn’t be central to your life mission and that you shouldn’t be emotionally engaged with the people that you work with all that time we think is a grotesque concession that that some people have to make and and a lot of people don’t have to when people like the ones in this room are going to have a spectacularly big impact on the folks that work for you through the course of your life and so so we we said okay we’re going to be a community alkkagi community let’s call it a village let’s make it the mayor because that raises the bar of expected behavior for us and so we we take it very seriously when we make decisions we consistently use the metaphor if you were mayor of a village how would you decide because if you’re mayor of a village you care about the economy but the economy is the means to an end it’s not the end you want to help the economy so you can have good schools good parks etc yeah so I have to say I mean I alluded to you know what happened in the green room before but it but it is very impressive I mean so here you are meeting up with a bunch of folks from you know the local area who you don’t do this with every day and yet you were able to lead them through a series of chairs which are clearly deeply ingrained and and done as you can see by just looking around the room with you know with this with a sense of passion and buy-in which of course is critical to having called we can talk about culture all we like but but getting it bored in in that way deeply through a fortune 500 company I mean that’s tough so can you tell us a little bit how do you go about that how do you do that it was well first this teammates stand up what the heck we got some teammates here so so I knew I knew they were gonna be a couple here but I didn’t know be a bunch and so there’s a pleasant surprise right before so I will ask them three questions stay standing did what is this company whose company is it and what could it be and if we’re to build the greatest self care community the world has ever seen let it be like this one for all damn straight so that this part wasn’t conscious when we started this adventure and it kind of popped up organically and what we find is that healthy tribes military units religions sports teams places that have strong sense of team strong as its community they do call in response a language means something ritual means something and so we said if we’re going to be a community we should have the attributes of a healthy religion tribe village and it turns out calling responses is what happens naturally in those quarters doesn’t happen naturally most most companies because they’re sort of morally sterile no no value judgment implies there yet I said sort of so um I mean it’s it is it is pretty amazing to watch but how do you how do you know that works I mean I obviously you know it works in that you’re able to perpetuate it but how do you know that you’re distinctive because of it how do you know that you’re getting superior results because of it yeah so so we were very metric oriented and if you’re if you’re gonna be serious about being community you got to be objective and we certainly not all of our neighborhoods are happy neighborhoods but but our clinical outcomes are superior to our competition that government just came out with a new rating system for example only 30% of all the centers in America and dialysis which is one of our two big businesses can be ranked of four or five and that the percentage of our centers that are in that those four or five categories is twice as high as any competitor so it’s a crushing example in addition we did an acquisition about a three billion dollar acquisition X years ago we pay we do the analysis our wages were the same or salaries are the same we were in all the same geographies across America their turnover was 40% higher so they they they we were then we would had to hire an extra 1200 people a year compared to what we had to do give them the difference in retention at the same pay across America and third there’s some of the big consulting firms Anne’s the Hewitt’s that do standard questions across big companies and our teammate engagement scores are quite high and then I’ll give one anecdote about five six years in a woman came up to me at a big conference and said they’ve been hired by a pharmaceutical company to do focus groups with patients and they had never worked for us they were never going to work for us and and she said by the third city we were playing a game because that’s what you have a facilitator and then and then the sponsors are behind a mirror looking at the people and then the 15 patients answering these questions just like they do with cars and toothpaste and and all that and I said by the third city we played a game that about 40 minutes in since they didn’t ask the question of do you know who owns and operates your dialysis center until the very end about 40 minutes into it they play a game and guess which patients for the divita patients because you could tell that they talk differently and this at this point was across a thousand different locations small locations across America that was for us one of the separate for all those hard metrics that was perhaps the most special one that human beings talked differently so you spoke a little bit about some acquisitions and spreading culture through acquisitions and the one that you refer to is one where it was really a like business model but you would you were taking the culture to that and of course you know a couple years ago you you bought HPC which is in a quite different business related but different business and so have you tried to take the same culture there are they limits to the extent to which you can transfer the culture – yeah well both the big dialysis company when we bought them they were horrified at the notion of being subjected to this weird you know they yet yeah that they said it looks like a call that’s a technical term yes yes a term it’s a just quoting them the that that seems like a cult it seems sophomoric it seems cheesy it seems inappropriate Cavalier and both there and then with this related business three years ago they were similarly worried about about being subjected to a force to try to adopt it we made very clear within rooms like this only not as nice we can’t afford nice rooms like this the make very clear please don’t use our language unless and until it becomes comfortable that don’t don’t don’t talk about I don’t feel like you have to talk about our values or some of our concepts or the village don’t twenty that get to know us watch how we behave watch how we interact and then a year downstream we’ll talk about one night we need to change any of the values or whatever and both the first time in the second time legacy the Vita veterans were appalled that I would say that we might change them but my response was if you’re a village you have to represent the current population and and when you have a lot of new people it’s a new thing and you need to speak for that new community and in the case of this related acquisition that from a business point of view the first two years went very poorly tremendous organizational change we took out half the senior executives so a relatively traumatized organization which exacerbated the fear around you know one hell of a village you know you let half the people go and you’re introducing all this change and so in the second nationwide meeting since the time we close the deal once here we get our top four thousand liters or so together I went off in a room with the two hundred seventy leaders from that enterprise 18 months in traumatic eighteen months and said okay now we’re going to have a debate do you want to go adopt the legacy divita vision mission and values do you want to keep what you have wait another year keep it forever or somewhere in between and it was a very intense debate about about 80 out of the 250 people or so were physicians people from all over America knew somewhere new to the enterprise because the acquisitions have been in post close somewhat been there 25 years they went through it and and about halfway through a woman stood up and was a variant debate a woman stood up one thing we didn’t have on the ballot was go all in to take take the vision mission and values we put you can take these two of these two or just one or none because we never thought it would go all in well this one woman stood up and said you know what you know I’ve been I’ve been now it’s been a year and a half since the deal this we have wonderful people in our company health care partners they have wonderful people in Legacy divita they are living the values that we all agree with with far more intentionality and follow-through and purpose and robustness than we are and I want to be one company I vote for all in I think that should be added to the ballot applause broke out in the room we had another hour of debate both in small groups and big groups and at the end of that two and a half hours the two hundred sixty or so leaders from that enterprise voted 85% to go all in 14 of the remaining 15 voted to go 2/3 of the way in only 1% voted so so they they voted for embraced the village concept themselves much I think to their own surprise no one knew what the outcome was going to be going into that room and therefore there was no one subjected to anything and they went out and told everybody across America that we just you know I’ve sort of taken this stuff more seriously now and in fact I just voted for it and has it taken root I’d say you know the math I use as I think we’re about one third teammates citizens maybe more maybe 33 to 40 percent what about 30 35 percent you know just still watching observing and then whatever number is left are still negative yeah so it’s still on the subject of exporting the culture you’ve taken davido now internationally can you talk a little bit about some of the challenges and in taking this kind of corporate culture to other other national cultures yeah the this has been it’s been very intense the so first when you think about core values some people will look at them on a wall and say yeah it’s motherhood and apple pie who doesn’t believe in integrity who doesn’t believe in team what a dumb pointless list everybody believes in them as a leader the issue is not belief it’s practice so yeah I believe in all those things if you evaluate exactly how I behave every day some people would say hey Kati I’m not so sure you’re living that core value that you believe in and even harder to create an environment where everybody practices them and and not violating a core value does not equal living it so if I go a month without telling a lie that is not living a life of integrity living a life of integrity is when you tell the truth when it hurts when it’s embarrassing we didn’t have to if I go a month without blaming someone for something they didn’t do I’m not living the core value of accountability living the core value accountability is when someone makes a mistake and no one thinks you had anything to do with it and you realize that you knew the person wasn’t very good about that you could have taken him aside two weeks ago for half an hour they never would have made the mistake and you stand up and take accountability because you said you know what I could have prevented that I know Josh was uncertain or whatever and so there’s a big difference between not violating and living and it’s contagious how that works and so internationally when we decided to go if I was a better CEO we would have gone international ten years ago but I wasn’t so we started four years ago and I went to other CEO I was from prestigious business schools like Stanford and and they all said you know that that weird stuff you do leave it at the airport because you know it’s unusual even in America so don’t you dare try to do it in Saudi Arabia don’t you dare try to do it in China etc etc Poland Portugal Colombia they made all these that India all these other places we are so I took their advice and and then I was giving a talk to a bunch of our Indian teammates X months later as we began to grow and it just felt totally flat and so I went to the boss after I knew enough he was honest he gave me that gift I said well that would’ve really fell flat and he said they they’ve all been on the Internet they if you go walk around their cubicles they’ve got the divita symbols up they’ve got the story of how our neighborhood has grown within the context and now they’re feeling like this village thing that’s just about America and they’re not really citizens they’re just you know foreign laborers and so which I was mailed back we changed we went full on and and in doing that you find out that it’s about human values that everyone wants to have a robust discussion around actual human values and what or not they’re used in making day-to-day business decisions or not it’s not a fairytale thing and and we’ve had uncomfortable moments in some of the cultures as we work through in particular for example because we won’t stand for some of the gender discrimination that exists in a lot of other societies and that leads to awkwardness and then one other moment of awkwardness and then I’ll stop the so you trying to get the right translation is not always straightforward um and and so it turns out in one country the word that we were using for fulfillment basically means masturbation and and so we were saying you know fulfillments very important we think everyone should be fulfilled you know even we hold our leaders accountable for fulfillment and and then someone gave the speaker was not me the gift of so there are speed bumps in the way and you had metrics today back yesterday so I mean probably true of your of your days at Bain but when we teach strategy we talk of course about alignment between between organization including culture and and strategy but then we also talk about alignment between that and the external environment that you find yourself in industry and so on so so the question really is how general do you think this kind of the applicability of this kind of culture is I mean is is this something that works in in mission driven health care mission driven kinds of industries is something that you think could be applied more broadly what are the limits this one this is one where we’re quite intense because a lot of people will kind of go oh they’re nice little health care service people you know I’m sure it’d be very very pleasant to talk to but they probably lose all their football games and in week over the last 16 years they’re in the top 5% of new york stock exchange performers we outperform our competition and clinical outcomes and a lot of our teammates have gone on to be CEOs and CIOs lots of other companies so we we we don’t think there’s any tension between achieving capitalistic and market-based and net worth ambitions and creating a healthy and distinctive community for people to work we think there’s no no tension between those in fact we think they’re in some ways cohabitate very positively and so if I was running an enterprise with 3000 taco bell’s not not medical clinics or a coal mine or any it is all about creating a differentially healthy environment for people to work particularly the people that don’t have the career options and income and flexibility that that most of us in this room have that that that that applies to any business that we a healthy workplace is a gift to that mommy or that daddy that they will take home it is a gift that they will savor at work and it’s about basic ways in which humans behave with one another so we believe passionately that it’s transferable everywhere that’s not to say that there aren’t differences in how one would implement how it manifests itself in a in a Goldman Sachs or a Bain & Company or versus the other organizations that the Democrat that the demographics of the citizenship does affect it but the basic principles have to do with how we behave with one another and what not it’s consistent with them with the values that we allege to hold dear and so I’d like to start to transition to leadership I keep keep one footing culture and put put one foot in in leadership so you know some of the things that we’re talking about village mayor community you know sound sounds soft they sound that sound soft they sound a little bit squishy very GSB esque actually um we’re always going to say it yeah we’re we’re also heavily into into costumes which you call uniforms so see a parallel there as well but at the end of the day you’re the CEO of a fortune 500 company and that’s a tough role that requires tough decision making it requires holding people accountable you know that doesn’t sound so soft and squishy actually and so I’m just wondering how how much of this translates into your your day to day job how do you how do you think about that and and and Elizabeth some point the video is ready we can play it the okay didn’t okay the it’s I think it’s where the metaphor comes in so handy if if you’re the mayor of a village everyone knows the village has to have a healthy economy in order to create jobs for people to have everybody knows you got to pay taxes to support the school system and the police which so and but there’s serious issues of who should pay how much tax how transparent is the deployment of the tax funds that are raised how competent are the organizations that spend the tax money and so we think of profits to the shareholder like that so we’re very open about it that that we don’t get to create the Davidi university that our people love with a tremendous emphasis on personal reflection and introspection not just applied stuff we don’t get to grow and create career opportunities we don’t get to grow and create profit sharing Awards and unless we are allocated capital which is just like a mayor’s got to collect tax money in order to do all the things that citizens want to exist the parks and the summer programs and so you and we find that that it doesn’t matter wave 18,000 folks out of our sixty five thousand if not been to college and never will they understand the concepts totally about what real life is like if they feel you’re honest and transparent about what reality is and are willing to have real debates so I’ve gotten up in front of thousands of our teammates and talked about my compensation an executive compensation with people making $17 an hour and then they get the right to ask questions or send send messages so so first there’s there’s an issue of the of just basic straightforward honesty and transparency and explanation to kind of loop things together in a way that that otherwise doesn’t work and then second when we talk about tough to say we we will discuss them in the context of the metaphor give one example we made that big acquisition referred to well the government was appropriately going to requires to do some divestiture z’ and when you do divestiture z’ but the FTC requires is that you either either divest all the defeated legacy to be dissenters or all of the new companies you can’t pick and choose because you would cherry-pick all the best market positions and so you can’t do that it’s it’s a reasonable federal policy everybody assumed in the I mean everybody assumed that that I would decide to divest all centers from the company we were buying and some of these folks would have been in in this part of this and and I said no if if the other company that we’re buying has got a group that’s on the ascendancy that is the clear long-term winner then we will divest the divita legacy to be dissenters people were appalled that you know this is a violation we love the village we’ve been good citizens the village of excellent clinical outcomes and you’re going to sell us too you don’t even know who you’re going to sell it to and we can’t even switch and work because the way the FTC rules work you can’t you know take all the employees you got to add a certain hands-off period and our case teammates on employees they call them employees and so people are livid and I got up in a room a bigger room with 3,000 of our leaders and explained that that job one of a mayor of a village is to make sure the village is sustainable for the long term because every single one of us talking to them is going to leave the village at some time because we get a great job offer because we retire because their spouse gets transferred and so we are all stewards for the next set of people in these chairs and for maintaining an environment where we can provide superb care for our patients that’s job one and just like if you’re mayor of a village and you know you got to put a highway in or your downtown’s going to deteriorate and you’re going to lose to some other village you know you got to rip down houses to put in that highway and some of those people will have lived in those houses for 25 years love their neighborhood and you’re gonna rip down their house to put in a frigging highway but that’s the right thing either that or the place goes dead in 30 years got up and and explained why I had decided what I decided and about 70 percent of the people being divested came up after most of them crying saying that they they accepted the logic that the decision was best for the village and it was consistent with my responsibility and they were very sad but understood so so we it’s we put it together because life life yeah it’s hard sometimes and and how much of this translates to decision-making with your core team I mean are you’re talking about the the village at large but when you bring this back to core management II mater what are some of the tough decisions you made are they are they times where you’ve had to go against the wisdom of the core team and say yeah you know I am the mayor and this I think this is the this is the right decision yeah they’ve been a couple we do a lot of votes compared to most organizations votes with thousands of people involved sometimes hundreds of people involved but I always retain the the right to overrule the vote I mean it’s the discussion that matters and the data is very useful for me and for others but in the end I have the job I have that should come with differential inside and and should carry with it a differentiated experience some people would question that it’s and and so we had one one business that that I wanted to buy and the entire team voted against it so I hired Vayne and then they came out and recommended against it so we stopped that project and and I told I pulled out of the process and then I went on that weekend and I just said our alleged vision at that point because we were just kidney care at that point was to transform kidney care in America which were halfway there and this was 13 years ago and we cannot get that we cannot seriously try to do that unless we buy this thing even though right now it’s little and broken and there’s no pro forma you can do that makes sense that we have to change a bunch of laws to do a lot of things and I went back on on Monday and and all the team we’re going to buy it and I respect all the reasons but it’s not it’s not inconsistent with our construct and then I guess the other part if it was implicit in the question about core team if the I am sensitive to the fact that that there are times that I behave in ways that are inconsistent with our mission and values and particular with my core team when you say bring it back to that mm-hm and and that is where one hopes that you’ve scored enough points in terms of intentionality that people forgive you for your behavioral transactional shortcomings do they call you on it do they feel comfortable enough to call you on it dude you apologize for it how do how does that go I’d say that’s a big curious but some of the teammates say the I think we’re we’re seriously above average and people being willing to call us on it I get scored in the core values every year an independent consultant goes out and talks to a lot of folks my scores are made public to the board and to the teammates as well as a bunch of comments I don’t get to change them IND and then we’ll talk about high and low scores we we take as it sort of self-evident that that that we all have bad stretches that we all have faults and and that if you can’t create an environment where you talk about them each of our personal growth journeys are going to be stunted and so we do a lot of introspection a lot of reflection a lot of discussion and in the second part of every executives review is after I for example when I’m reviewing others the first part is the most important message the second part is to go through each core value and talk about how other people’s experience you with respective integrity how do they experience to you with respect to fun how do they experience you with respect to service excellence real words and so and then I get the same back so I think we we help me and we help each other grow as human beings and so I think we’re we’re reasonable on that so where most of the first years have been taking a course here which we call leadership labs one of the things we talk to them about in the labs is is being active learners and being active learners they hold their whole lives their whole careers you constantly learn from what went well what didn’t go well become become a better manager leader your spoking about some of the ways you’re getting feedback but but what are some of the other ways that you personally have worked on your own leadership and management skill over time well so so one of our pitter patters is management is a business skill it’s really important so you should study it and think rigorously about it leadership is a human thing not a business thing and if you want to give better at leadership learn more about humans starting with yourself and so virtually every W University class has elements of introspection and self-reflection and and particularly if you have as have as many behavioral deficiencies as I have you we try to make sure not just through 360 process but through using other tools and outside coaches that you’re continuously forced to reflect on your self and and and that combined with having to discuss yourself publicly is a is a tremendous spirt thing that can spur your your growth for me to work on some of my behavioral things I have done things like give myself a score every day so when I took this job 16 years ago is 43 when you still have serious behavioral issues which many of you will have it doesn’t mean you’re a bad person and overall I got some good scores but I had things I had to work on when you’re 43 you better see yo already for eight years this means there’s some stuff going on I mean you’re not just going to get their feedback and then suddenly the next day stop entirely and so for some of those things I use the metaphor of it’s my brother’s is an alcoholic he’s now 11 years sober and he talks about the early years he said you know I had to win that battle against alcoholism everyday and so for some of my behavioral deficiencies like getting angry with people I started giving myself a daily score and tracked it on a spreadsheet because I I had to build the muscle memory to to catch myself first after I did it and then I could go apologize if I had the courage and then catch myself while I was doing it and and then catch myself right before I was going to do it and and after about two years I was doing it a lot less but if I had not kept the daily score to confront my reality while it was still fresh and I couldn’t then just sort of consistently dismiss it as you know as a bad day or the person you know has been bugging me for a while then all the rationalizations get stripped away when you score yourself every day did you have a drink or not did you have too many drinks or not it just is the reality it is you it’s not the external world fascinating I want to go back a little bit in your career because I think it’s of interest to the student bodies they’re thinking about you know where to go way to go next from from the GSB you did spend a good spell at Bain there’s there’s a lot you learn in in a gig like that and I’m wondering about the transition from that to being CEO of an operating company what did you learn at Bain that was helpful other some things you you learnt at Bain that you that you had to unlearn you can talk a little bit about better transition first of all as to ideas for where you should go after Business School I have have one they have but we’ll come back to that the on the Bain versus operating company thing back when I graduated which was a long time ago there at that in that decade in my mind there weren’t really a lot of operating companies that had thoughtful programs for growing general managers and leaders and that’s that’s what we’re about and that’s what I wanted to become I knew my dream was to become of competent general manager and leader of people that’s I knew that’s what I wanted to become proficient at and and I did not I did not see stuff like there were jobs out there but they they weren’t about that they were they were just about learning the business and and then and consulting more generally in my way I would advise young people is if if you want to be a general manager leader in the long term that and you find you’re the sort of person who’s super super bright you figure out the case faster than other people you can you can be very verbally adroit connected to your brain that but you’re not a natural team leader you’re not an actor you’re not a natural team builder you’re not naturally establishing trust well you got to stare at that very realistically because if you want to be gym a leader and you have that mix relative to the world doesn’t you know there’s no good or bad in this and you go to consulting or vessel banking that you your existing muscles get way way stronger and your pay goes up and these other muscles stay weak and then you want to make a shift and it’s a nightmare because you got to take a huge cut and pay and work on your remedial capabilities and so you don’t do it and I got a lot of friends who are 59 and wealthy and not happy because they they went too much they didn’t have a good strategy similarly if if you’re graded that project management and team leadership and the rest which I felt for me that was of some of my natural natural sport for me a lot to learn but a natural sport but you need help and more strategic discipline more analytical discipline we need to just be exposed to a lot more then it goes the other way that you know you’re going there and getting that incredible exposure in learning those disciplines and then you transfer over to a sport you were sort of born to play and and so I think it’s very there’s no generic answer it’s very person specific and it requires incredible intellectual honesty about your strengths and weaknesses and and where you want to end up and so for me I needed I needed exposure I needed to to run with that that sort of intellect with people for a while to make me sharper help me grow I needed to become more disciplined analytically I needed all those things and I got them big time and then went to play where I always knew I mean the sport I wanted to play thank you I don’t want I don’t want to hug all your time let’s let’s instead open it up for for questions from from the audience I have the first question from Twitter how do you distinguish company as community from company as a family how does one for instance fire a community member oh yeah actually when you asked about tough moments firing a friend and in some cases someone you literally love is a brutal thing to have to do in ticki if they love the village and you have that personal relationship and then you tell them they have to go and and and we use community which of course is made up of families very explicitly because the family thing while there that level of intimacy exists in some of our neighborhoods and some of our smaller teams for us some of the my senior executive team we we love each other as we love our oldest dearest friends and we talk about it and and so we are almost like families but for the bear community that’d be an overly aggressive word it would just be inaccurate to say the entire 65,000 people across 12 countries is a family it just it would be an appropriate metaphor the dislike a village has families within it that’s that’s that’s just more accurate we’re serious about the metaphor if you’re going to if it’s going to if it’s going to help you make decisions and help you talk about decisions and help people understand how you want to behave it’s got to be real it’s got to make sense has got to be internally holistically consistent and so the ones there we I’m much better at this I used to be bad at giving people bad reviews and bad at terminating because that was too intent on proving I was right I’m right about the way he underperform I’m right about it’s the right decision to terminate you and then and then one of my executives to work for me a guy named Tom muscle ttan taught me what I thought about conceptually but had never applied to that area which is the whole issue of intentionality until I got to the point where I intended to be helpful to that person in the review or in the decision helpful I could never become very good at doing it and as I went through my year two of learning that from this gentleman I there were times I cancelled the meeting because I knew I was still going in with my old tendency to want to prove I was right and and and take care of respond to any rebuttal and so if you go into it with the right intention in your heart your head will do just fine by itself and in a in a village you got to maintain the health of the village and doesn’t mean they’re going to be destroyed there’s there are their jobs there are their villages in many cases they’re people who won’t take a demotion and so in that case it becomes their own decision to go it turns out a majority of successful executives have a really hard time with a demotion I think that’s totally philosophically inappropriate and shallow the but it’s where most human beings come from shell is not the right word but I think in many cases they would have been happier but but I think putting in the right context having the right intentionality and then being respectful inhumane okay my name is fernanda i would like to hear a little bit more about the intentional parts of the culture so in the beginning here you were saying or what we just did that was not my intent when we started off and I’m sure a lot of things evolved through the years but I would like to hear about your vision in the very beginning and your role as a leader and making that vision come true yeah I mean let me take a stab at it and then you come back if I don’t hit it right an intentionality is is fundamental and we just for exam for ten people last night in Denver who just went through something that I’ll describe as part of our intentionality and that was the first word they used there a couple big groups that are thinking of joining us and and when that happens we just invite them to come to our big meetings so so a Part A and A Part B first when I showed up and they were in for reasons we can go into later perhaps it was a big big big family decision I did announce to the to the groups like this that that number one I wanted to create a differentially healthy place for people to work and I have an unusual percentage of people say that it was the best place they ever worked not perfect not easy but the best place ever worked and number two is willing to build the greatest dialysis company the world ever seen that that that’s what I said and we were on the verge of bankruptcy we’re being investigated by the SEC we’re being sued by shareholders we had no CEO no CEO and the CFO we were in six weeks of missing payroll on 9,000 people and and and so when I said those words in that situation a lot of people thought it was inappropriate emphasis given where we were and in my mind if you care about that stuff that time to start working on it is right now you never delay doesn’t mean you don’t know you have to do all the other stuff there’s no such thing the leaders lead they don’t wait for the right time to lead second when I did that yeah we use this room the 1/3 of the people thought it was just you know manipulation superficial marketing you know hoity-toity MBA wants us to stay looks like we’re going to go bankrupt so this is like you know what he would if he wants us to stay you shouldn’t give us you know superficial football speeches like that he should give us retention bonuses and then maybe a third of the group obviously don’t know the right numbers we’re thinking well that’s very nice he seems sincere but that’ll last about a month and then maybe a third of the group said wow I would like to work in a place that’s differentially healthy place for human beings to work and has a dream of actually making a significant impact on the world I would I’d like that I’m hoping he’s sincere and he’s competent and and if you have not done it yet given a speech in room where two-thirds of the people think you’re full of it it’s not fun it’s not fun but it demonstrates intentionality and then and then you say and by the way I know most of people in the room think this is not pragmatic or not sincere or naive or whatever and then they go look at like so he actually knows that a bunch of us think its BS and he’s still saying it now that’s interesting because at first we just thought he was dumb or naive now we see he actually knows and he’s still saying it and and then and then people of course say how it’s okay that’s what we had to figure out together yeah here’s some ideas about about our policies around 2vd University here’s some our policy about helping teammates in need here’s some are here some of our here’s some brainstorming here and there on personal professional development and impact on communities and and and and so we started to demonstrate by having regular meetings where the only subject was how do we make this notion of being a differentially healthy place to work come true and and just like if you had a marketing problem or a manufacturing problem you it was the agenda item you would generate ideas you would allocate resources you would have programs you would monitor the execution so we we respected the challenge and we demonstrated that we were damn serious about it and and we used to get the phone as we still do every eight weeks for a voice to the village call they’re just on one yesterday about five thousand people across the world and in those days every call I’d say what is the incremental evidence since the last call to suggest we’re serious about this mission and values stuff and so and so put it way way out there and then at some point you call the question and say okay you know that we call it crossing the bridge and we have a bridge in every neighborhood I walk across the bridge every morning and if you after you’ve been with us six months we ask you to stand at that bridge and and decide you never have to tell us and if you decide to walk across it it means that you’ve declared that you share accountability for creating a differentially healthy place to work having us be a community first and trying to have a differential impact on health care in the world and so and so it was very explicit it was very much reinforced by actual actions actual intellectual investment actual project management operating follow through actual honest discussions about how we were doing because back then we had nine thousand people across 450 locations if you didn’t get way intense it’s not like being able to call everybody in a room it had to be much more serious so I think those are some of the things that really hammered home the intentionality and and got a lot of people thinking about what not they wanted to cross the bridge and then I’ll throw out one other thing that was powerful part of it a bunch of managers in the first year across the bridge they said whoa we we believe this and we’re we’re psyched it would be great to retire and say I tried to build the greatest dialysis company we’ll ever seen and have a different idea I’m on board but when I go back to Tulsa or New York or whatever and talk to the 25 people in my little Center I can’t bring that alive and we’re open six days a week three ships a day I can’t even put my team together much less convey at all and the video is help but they’re not enough and so we’re like you know that the village concept is sort of stopping at the manager level and so we hit town halls and their managers saying this to me and the other senior leaders and I said okay how can we break through that and then somebody had the you know temerity to say well you know we couldn’t actually fly all our people somewhere like to go to meetings like we do and discuss this stuff and you know of course no you can’t because it’s expensive and because it’s really hard to get substitute staffing and all the local centers and and then we said okay but it appears we can’t we can’t do it we say we want to do the dream is not feasible unless we’re willing to do something that we don’t know of anyone else that does and so ever since that time we have academies or two days long every teammate in America and now increasing the world is invited to come for two days we have people who’ve never been in a business trip lots of them some never been on a plane don’t have credit cards never checked into a hotel and then the vice president’s right next to the doctor is right next to the they the tech who’s right next to the secretary and it’s two days with no applied training it’s all about our mission our vision our language our rituals people go through things like Meyers bread and we have thousands of people have never done that and the second day we asked everyone to write their personal credo which is essentially a statement of life purpose and then think about how are they living a life consistent with what they would say their values and life mission is and then do we fit in it and so when we started doing that when we when we told people across America we will fly you for two days of discussion and have senior executives there to help interact that was a huge piece of data for people that we were that we were serious and and still all along the way you know you’re just you had to go through waves of skepticism cynicism fatigue you know you set a tough budget and does that mean it’s not a village that it was that reasonably responsive I think we have time for for one more okay you can a none citizen call you Katie yes it’s a pleasure having you Katie it depends what words are in front of after it can you speak a little bit more about the disadvantages to having that stronger the culture specifically for your leadership role and on a more personal note for you and for your citizens how does it how does it having your daytime job being that touchy-feely how does that impact your life at home and your relationship with your own family whoo I’m the first one which I think was how does the the strength and nature of the culture constitute in it it where’s where’s it a disadvantage you know I I can’t I’ve not been asked that specific question and thinking spontaneously I really I’m coming up empty I think it’s I think it’s a it’s always a good thing now sometimes it makes some stuff harder because you have to explain really delicate things that are uncomfortable but that’s sort of like the bridge you have to pass if you want a special cultures that’s inevitable so I think it forces uncomfortable human behavior it forces you to do stuff and me to do stuff I might not have the courage to do otherwise but once you one of things we tell young leaders is get out there and talk about your values out loud to the people that work for you and it’s in tech as a bunch of them will be looking and saying oh well you think you live that value you know I’m not so persuaded and and the power of speaking out loud so so I think it forces moments of serious discomfort but it’s never a disadvantage would be my my pretty strong reaction although I get the question I’m not trying to be dismissive and then on the second one yet second one is I particularly thought provoking giving my my son my little munchkin is in the room the but but I believe that that the divita village has made me a better human being and and I think you know I’ve said my kids have limited memories of because I was they were ten and eight when we started this adventure but but other people who know me throughout would talk about how its fostered it’s fostered forced encouraged motivated growth as a human being and I love most the letters we get from people that have left or when we give core value words which we take very very seriously one of the rituals of our village the annual core value words and then they happen throughout the most of the year are very very serious events there’s no recognition in our night of honor for business accomplishments it’s all human behavior that that often I mean for me the most special ones and often the remarks of the people who get it will say that I’ve been at 2v2 six years and I am a better daddy I’m a better mommy I’m a better daughter that’s that’s what we’re about it’s is it for us our culture is not a part of our business strategy our culture is about our dreams of what life should be like and it just happens to be inserted into a capitalistic enterprise so so I feel it’s it’s why I’m still as my son will a highly imperfect I think it’s made me way more mindful at at home and and it’s been demanding as some of you know back 16 years ago when I took the job I had just come off a private equity back thing I ran a company it got taken over was very neat financially and really sad because we thought we were building something special then I did a private equity back thing with TPG and Bain Capital and it failed and it failed largely because the mistakes I made strategically in otherwise and I had friends who moved their families across the country to join this company with me and then a year and a half later I had to tell them their job was being eliminated and and we ended up selling the piece of the company losing half the money and in the face of that and I was so I was working very hard to try to save it and didn’t and and so when I when that was over I told my wife and kids that I was going to take six months off and and spend time with them and get healthier and the rest and so when search firms a call I would say you know I’m call me in six months I’m I’m gonna take some downtime I was within eight weeks of being done and then then they called for this company and since I had run one other caregiving company before I was the most professionally fulfilling time in my life and and so I went through a hellacious month with my wife Denise who was also at HBS grad was one of America’s first female venture capital partners about how much of my taking this job was ego you want to make some more money want to prove I can turn on a company want to run a bigger company even though it was in another city it was a total turnaround my family wasn’t going to move versus how much of it was was virtuous and had to do with having a positive back to the world and I wasn’t sure about the answer I knew it was a bunch of both and and clearly we decided what we did and it was sort of pivotal in the end was was saying it’s Indians the fact that was going to be difficult was highly relevant but it’s one thing to be home five nights a week with your kids and talk to them about leading a purposeful life and a whole other thing to be there fewer nights lead one and and that’s the gift that the village gave me and so and so while it’s pulled me away and certainly there’s times I’ve been distracted that I think my kids know that I’m doing my best to lead a purposeful life and become a mindful person and I think that counts for something with them I don’t know well we’ll check that out with a munchkin later yeah all of they all of the students who are here in order to get in to the GSB how to answer a question which has become customary for us to ask our guests which is what matters most to you and why I hate questions like that the divita people sometimes say well what matters more you know that keeping the profits up in the stock price up or the village and I say as mayor that’s a false dichotomy it’s like what’s more important to you air or water you have to have both I mean to say one’s more important than the other is I think a paradigm that defies reality and so so I would say three one is there there is nothing more special than the people you love and love you and the older you get I’m a couple months from 60 the more significant that that that is and what you sow so shall you reap you know by the time you get to my age a lot of stuff is locked and loaded in terms of the depth and breadth of your friendships and the texture of those friendships and your relationships and your family and your kids and your spouse second is to try to become more mindful each day you know to tread gently on the planet and the people in it this is a particularly difficult one for me but but there’s there’s a Buddhist saying that’s strictly strictly speaking there are no spiritual people there’s only spiritual practices and people who act in a humane mindful gentle way every day all day send amazing cumulative ripples through the course of their life and so for me that’s a it’s a particular challenge and I’m proud of the progress I’ve made because it’s so important and then third is the more macro of what impact you have on the world and particular people in this room you know spectacular capabilities spectacular experiences and and spectacular luck and getting to come to a place like this with people like you’re sitting with and so I certainly hope that many of you take on the incremental responsibility on top of the first two of trying to have a significant impact on the world great great Ansan on all three points yeah did you have any closing thoughts you’d like to share with with this crowd well for me I mean honor to be here I mean when I was when I was in those seats of in 1981 to 83 maybe was my dream that maybe one day I get to come back and talk to excuse me kids like you about important topics so for me getting to be here and be here with Garth and Charles O’Reilly and Joel Peterson others is like a dream so I I really encourage young people think about your dreams and don’t give up on them because sometimes they come true they are rarely easy they’re rarely linear to go after but for me many of the dreams I had when I was your age have come true and I feel so so lucky and the second thing I would say is just too with all the ambitions and the pressures of two career couples and having babies and you know been through all that to really savor the adventure of life there’s a was a French author Colette who who said I had a wonderful life I only wished I’d realized it sooner please join me well thank you

Read More: DaVita – A Kidney Company That Cares

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DaVita – A Kidney Company That Cares

and one of the things I like best about the Vita is that everyone in my Center feels like family my philosophy is actually treating the patients as though it was one of my family members or if I was on that chair ever since the first day I kind of didn’t either these people have treated me so great it’s hard to explain how great they are they do everything for the rational life but then they seem to take everything personally and when they say family they mean it hi I’m Dave and I’ve been with the Vita four or five years now my name is Kay I started with hemodialysis in September of 2006 and I switched over to peritoneal dialysis approximately the middle of December 2006 my name is dr.

Robertson I put my trust into beaded teammates to give my patients the very best care then coming here since September the third will be two years my name is Sally and I’ve been a teammate at the Vita since June of oh one I enjoy you know helping people who you know experience that is not so pleasant and trying to make it as pleasant as possible for them we have to develop close relationships with our patients because you know we see them three times a week for hours at a time you know when dialysis takes takes a toll on your physical and mental strength so try to be there for our patients the PD nurse Jay who is my right arm right now I can call him anytime anywhere and I have I was on a plane and it was like a month ago in Las Vegas and I was delayed and I was in I can and I got a hold of him and he told me how to work through everything I mean you’d have to have people divita is committed to you know making sure that patients can get quality care no matter where they go we’ve got thousands of divita teammates working with approximately one out of every three dialysis patients in America also we have locations everywhere serving 42 states we try to cater dialysis to the individual patient needs and desires when I say Davi Toulouse its core values that means we’ve actually very much care for each individual patient we’re able to learn and unique approach to dialysis and the skills and the tools and the values so that we can provide the highest level of care to our patients we also want to make sure that our patients are keeping their health up and a big part of that is diet so we have dieticians that provide nutritional counseling to teach our patients ways to eat properly one of the other things that they really do that’s very good is I met with their insurance person because this is a catastrophic illness and insurance is a major thing and they handle a lot of that which is very impressive divita offers people who are experts in everything and they just cut through all of it our commitment here at divita is the quality of care to get our patients back out into life and the clinical care outcomes surpassed the national average the best outcomes are provided by the best providers and for me that has been davina patients have a choice in health care I would advise patients to visit it to Vita Center the Vita has proven to me to be an effective partner provides the best care if I could say one thing to the people of De Vita is I wanted to thank them from the bottom my heart for giving my life back to me

Read More: Thanking Davita Kidney care, God’s Angels -an update

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