Growth and Culture Accelerators: Nimble Planning and Continuous Learning (Doug Morse)

Adopt a nimble strategic planning approach that is actionable and adaptable, and then uncover and overcome learning needs in order to set people up for success

Episode Insights & Takeaways

• A nimble strategic planning process is essential for success.
• Culture plays a crucial role in executing strategic initiatives successfully.
• Investing in learning and development can transform culture and drive growth.

In this episode, Sue and guest Doug Morse discuss the importance of strategy and culture in healthcare organizations, particularly in rural healthcare. Doug emphasizes the need for a nimble strategic planning process that is actionable and adaptable. 

They also highlight the connection between culture and strategy, emphasizing the importance of aligning beliefs and behaviors with strategic goals. 

Doug shares examples of how culture can be transformed through learning and development initiatives, leading to improved outcomes and growth. 

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Hi! I’m Sue Tetzlaff. I’m a culture and execution strategist for small and rural healthcare organizations - helping them to be the provider and employer-of-choice so they can keep care local and margins strong.

For decades, I’ve worked with healthcare organizations to navigate the people-side of healthcare, the part that can make or break your results. What I’ve learned is this: culture is not a soft thing. It’s the hardest thing, and it determines everything.

When you’re ready to take your culture to the next level, here are three ways I can help you:

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Transcript

Sue
Hello there, thank you for joining us for another episode of Culture Change RX. And as promised, we have another amazing guest joining us here today, Doug. And one of the things you'll learn, this is early in our podcast journey and people will get to notice this later on as episode after episode gets recorded and released, but a lot of our guests have backgrounds in rural healthcare. And are very passionate about rural healthcare. And that's one thing I know about Doug. And.

One of the reasons we ask them to be here is related to our common passion in that area. We have other common passions as we've discovered in getting to know each other better in the recent months. So go ahead, Doug, if you would, and just introduce yourself to the audience briefly.

Doug Morse
It's great to visit with everybody. I have the classic story born and raised in a small town and literally educated in a small town family from there. And had my first experience with kind of what it means to be in healthcare in middle school where my family had a contract to help, you know, learn and clean and work in physician clinics. And then had a chance to...

you get exposed to some mentors who were in rural healthcare administration. And for me, it's been a terrific journey of long time involvement in rural hospitals and physician clinics and community developments and was once, uh, more than once probably described as, well, Doug, you're just such a rural zealot. And so it's a proud title I have because.

It's an area of healthcare and of community life that's part of my life, and it's where I've remained by choice for a lot of years. And so, been very, very rewarding journey to work with people, you know, in larger urban centers, but also in rural areas. It's just really been a thrill over the years.

Sue
Yeah, rural zealot. I love that self-proclaimed title there and you should boast that greatly because it's a good one. I certainly support you in that journey for sure. So I know that, you know, right now you're, you know, doing some new and equally important things in the industry to be supportive of rural healthcare in particular, maybe other areas of healthcare too, but I think primarily what are you up to now? Like what's your main focus right now?

Doug Morse
So after a period of decades, frankly, as rural hospital CEO and in various roles, what I do now is I'm a principal with Exec HQ and a healthcare group and spend my days helping rural facilities craft strategic plans, work through a process for continuing in professional development and education.

I did spend some time in the education field as a full-time faculty member. And so those are two very strong marriages of learning new skills, new activities, using tools for the real world to develop strategy so that we can kind of bend the status quo to what's happening in the environment. So I spend my days working primarily with rural critical access hospitals.

both senior teams and boards and people who are department directors trying to bring education and support for new strategies and new activities to take on the things happening out in the environment. And that's been very rewarding and an opportunity to learn from people as well as add to what they already know.

Sue
Yeah.

Yeah, yeah. You know, that's another area where we have kind of a common interest. Um, I wear the hat of strategist you know, in rural healthcare, as you know, uh, and probably many of our listeners do is that in rural healthcare, we wear many hats and somehow I wore that strategist hat or the person that led our organization that where I was at a community hospital for 22 years and didn't matter what role I was in, chief nursing officer, chief operating officer, interim CEO, vice president, probably didn't matter.

They kept that strategist hat on me and I was the one that kind of led our organization through its strategic planning cycle and now the last 12 years with Capstone, I've done that as well. And I do think that, and maybe you do as well, is see that it is its own specialty in small and rural. It's being a strategist for small and rural. They have unique challenges and opportunities.

and that having that as kind of a specialty and a special interest and you being there for them with that kind of background, I just think that can only add value. One thing I noticed on your bio is you, I think you talk about nimble, nimble strategic planning or nimble strategies. I'm just curious, like I'd love for you to describe that a little bit more of what it means in your words to be nimble.

Doug Morse
Yeah, you know, the word nimble for me is rooted in, frankly, some past strategic planning experiences that ended up with a binder on the shelf. And as busy and with as many duties as we have in rural facilities, the idea is to make this real world actionable, frankly, something that actually even connects with

Sue 
No.

Doug Morse
with your heart and your soul and why you want to go in every day. And that means it has to be able to flex and to change and in my words not take 9, 11, 13, 15 months to do that. So nimble is kind of the way we lead the rest of our lives in rural communities, right? We respond to what's going on.

in the outside world. And so Nimble strategic planning for me has been always the promise to people that the net result candidly is not going to be a five inch binder of data that will look good on the shelf. And others may have had different experiences, but I can tell you, I've gone to facilities in a new role, for example, as administrator and literally in and on the bookshelf is the old binder of what was called that strategic plan. And

When people's starting points are jammed calendars, busy days, three in five single space books full of to-do lists, Nimble has really make it real and give people what I describe as the skills to actually do some of the activities. And so it's the ability to change it, I think, has made a difference for me. And that's what we try to do for people.

Sue (06:48.607)
Yeah, really kind of making it executable, doable, adjustable along the way, kind of that, in our world of transformation, we kind of call that study adjust. You know, like you said, I always like to say, you gotta have a plan so you can adjust it a little bit and tweak it along the way, because we rarely get it right the first time, but it's a process, right? A nimble one.

I'm just wondering from your viewpoint, because we both sat in this role of strategist, either internally in our organizations, guiding the planning and the execution of strategy, and now serving as a helper to others to do that. I'm just wondering, how does culture become part of the strategic conversation? So this is a podcast about culture. So let's connect the dots here. How does culture, how have you seen culture?

become part of the strategic conversation? Or maybe surprisingly sometimes it isn't. I'd just love to hear what you've been seeing out there.

Doug Morse
Absolutely. I, there's a direct line from culture to strategy. And my experience, what I've seen and what I still see, it boils down to strategy is, you know, in our minds supposed to be a set of activities that can create value for the people we serve. And the question then is,

what are the kind of daily beliefs and behaviors we have that will allow us to do those things? And so for me, culture has always been what are our beliefs and therefore behaviors and habits we've always had and do those match what we need to be doing tomorrow and next week? And so finding a way to help prepare and tool up people.

so that they have the skills to behave and act a little differently is the path to strategy. And without that step of focusing on giving people the new skills, my experience Sue is that people are loyal to learning. You know, we know there's a lot of question about staffing and attracting and retaining, but one thing most people are always loyal to is their own learning and the energy that comes.

from actually seeing progress. And so the culture strategy tie is about having the actual skills. Nothing worse than having somebody show up and say, well, here's our new strategy, and we're gonna do X, Y, and Z without talking about your jammed calendar or the fact that maybe nobody's ever shown you how to do X, Y, and Z. So that step is what we try to do to tie.

Sue
Yeah.

Doug Morse
those activities to what we're doing every day as our culture. And so we can become known by that and attract people who want to do that and excite people who are already there, but have learned a new way to do it. And it's a, it's an absolute thrill to be a part of that when that starts to go well. Um, and frankly, as you've seen, I'm sure we both seen, and when that is disconnected.

then you get the dusty binder on the shelf. Cause I'll just do the stuff I've always done. Cause nobody tooled me up. Is that kind of been your experience as well?

Sue
Hmm.

Yeah.

Yes, yeah. And you know, I don't want to like get too common in some of the conversation or words or phrases I hear out there, but it does kind of like make the point is, you know, culture seems like the soft stuff and things like market share and new service lines and new technology and new buildings. And you know, when I'm, you know, facilitating strategic plans and conversations

And when you try to facilitate the conversation around what is the strategic direction you want to take the culture to bring and keep things like our nimbleness and our agility and our, you know, high standards for behavior and performance and, uh, willingness and ability to change and try new things and stuff like that, when you start bringing that up, it does seem like soft stuff. Like the conversation I like, not always.

You know, a lot of times the people that hire me to be their strategist or that they have in the past, they know that I come from this really strong background of not just, you know, strategic as in growth and financial strategies, but also people service and quality, which really, you know, has a big, big tie to cultural implications as well. So yeah, that, that idea that when we're strategizing.

Culture isn't part of the conversation because that's kind of the operational soft stuff and it's not really strategy and it has no place here. I've had that experience where I've had to like really sell it as being an important part of the success of the organization and its future. But like I said, most people that call me in to work with them, they don't call me in, you know, not knowing that that's kind of what I do kind of help them with as part of the strategy development. But...

Sue
I've been in situations where it's like, no, that's not part of our strut strategic approach and conversation.

Doug Morse
And it's a challenge as we know for everybody, whether or not you're a CEO or one of the C-suite folks or a department director is strategies a little harder, at least effective strategy to put your arms around. It isn't always a to-do list, one, two, three, four, five. It's insight. It's thinking. It's

asking questions, not always having the answers. And that can be harder for folks. And what I'd offer up is that the flip side is when we're also immersed, for example, in rural hospitals with the day-to-day chaos of to-do lists, that benefits the other actors in the healthcare system, not necessarily our organization and our people. And what do I mean by that? Well, the...

Sue
Oh, yeah

Doug Morse
Insurance premiums continue to go up, the equipment costs go up to the vendors. Everybody that's in that building as a vendor, they're giving their employees the raises, not necessarily happening in our rural hospitals. And that disconnect is because we're creating value, but not keeping enough for ourselves for the facility and the people who work there.

So culture and the learning is the way to get there, has been my experience over a few decades in the rural arena.

Sue
Mm-hmm You know, I was this reminds me of an example recently where I was on site doing some strategic playing I guess it was maybe in the last year or so and the Board Planning Committee that was putting together the strategic planning retreat where we're going to really be working on crafting a three-year plan They asked could we have like an hour long part of the agenda where we bring in a guest?

And we have this presentation and this interview kind of like to take a pause and a break from the activities of, you know, deciding on strategy and streamlining and prioritizing and those kind of things. And I thought, well, that sounds like a great, you know, part of the process and the activities that, and they wanted to take full ownership of making that happen. And so I was like, you know, go for it. I'll do my part. You do yours. And

I was just pleasantly surprised that they brought in a CEO of another health system that was a very strong proponent that culture is everything. All these other things are important to be a great organization, but if anything is going to be number one, it's our culture. We're going to make that a priority strategically and daily. People are going to notice that it's a priority and we're going to take action. It's not soft stuff.

And they spent a whole hour interviewing him on culture. And I was actually surprised. I really honestly did not think that would be what they would use that hour for. And that was their way of bringing culture into the conversation at a whole different level than the activities we were doing to craft strategies around increasing the value. So.

Doug Morse
Yeah, one of the things to your point exactly is the, you know, we work a lot with trying to help people take the steps because there's sequential steps you can take from their starting point and we take the starting point is jammed calendars and long to-do lists. We're getting a lot done. The question is are we getting the right things done to create value? So we use some tools to help people tame the calendar beast and then start to define

what we want kind of out there in the world and then what are some of the focused specific steps and you know see another thing to your point the culture is everything because historically my experience is we haven't done a good job making trade-offs for our colleagues we ask them to do everything at the same time. So a big theme is

We try to create a culture of trade-offs. We know we can't do it all at once. And when we try to, it's, you know, we've both seen it, you know, frankly, and I've lived it, you know, we create an animal that then devours us, right? Which isn't doing anybody any good. So the culture, yeah, we've actually created this thing ourselves to watch it. And so it's so beautiful.

Sue
Yes, yes, yeah, we created that animal ourselves.

Doug Morse
when people start to learn new skills, try different things and have permission to go ahead and change the culture, you can see it, it's something you can feel, and it magnetizes. People wanna be a part of that. We all do, right? If I think of myself. And so that's again, that kind of necessary requisite of culture that we even know what we're gonna have to look like to do what we wanna do. An example I'll toss out is,

you know, recently working with a facility that wants to grow, that's typical, start some new services. And yet, the truth is, in that rural facility, the directors who were in the roles had never once been taught how to do a business plan, any sort of training, because they were just serving in the roles they grew into or were asked to take over. And that's for me a passion point. Where we are today.

where we want to go, but have we really armed folks to get where they need to go? And when we don't do that, we know the culture is where it always was, and it's frustrating to people. And so that's been one of the big joys of this, is being able to really teach people what they now need to know, because again, people are loyal to that learning.

Sue
Yeah.

Doug Morse
and they're appreciative when senior leaders focus on culture. It's been my experience, I'm sure the same for yours as well.

Sue
Yes. Oh gosh, yes. I just can see so many examples of what you just mentioned. And I think that's just a really important point of emphasis is just like frontline managers sometimes haven't been given the tools and the education and the development to build a new program. Yeah, they agree it it'll be fun. We can do it and be exciting to do it, but they almost feel like they're set up to fail.

It can be like that too, is when we're trying to create a place where we're a provider of choice or employee of choice, those are two big strategies that speak to culture a lot. You know, culture is kind of the pathway to being those two things. In fact, there are two red indicators I have that if there's a poor reputation of the hospital or the healthcare organization in the community as an employer or as a provider or both.

there's probably a culture answer to that more than anything. But to the line of the frontline manager, again, to elevate the behavior and the performance of their people, to deliver care and services to that level where they're a magnet for patients, to recommend them return, choose them over others.

Frontline managers have a huge role in that. They're closest to the patients, they're closest to those employees doing that work that impacts that reputation of the organization as an employer and as a provider. And just like, yeah, they need the skills. They need the skills.

Doug Morse
No, to your point. Go ahead. Yeah, I was going to say to your point. You can, and you know, one of the readiness questions we'll ask is, you know, senior leaders in a board, we ask a number of questions, but here's one of them. What business are you in? And it's always interesting to see how different those answers are.

Sue
No.

Doug Morse
We lean deeply to the general answer that is we're in the people business. And it is for me always been fascinating to hear the different answers because to your point and to what we're talking about, cultural development, if we don't agree what business we're in, no wonder it's hard to get people excited. And so part of our early assessment is.

Sue
Mm-hmm.

Doug Morse
We're in the people business, which means we're going to invest in people. And that's a, that's the investment in learning and trying some new things in baby steps. You know, one of my personal key messages in the chance to visit with you today, we know there's a better way than jammed calendars and to-do lists that are six pages long.

So there are tools to kind of take baby steps to work your way out of that toward things that show progress, which is what energizes people. You know, I've had those periods, I'm sure you have too, where, boy, okay, I can get up even an hour earlier now at 5 a.m. to check emails and check them till 10 o'clock at night, but I'm not seeing progress. And we're huge believers in

setting strategies that can show some progress and build on those baby steps. And it's great fun when people decide they're in that people business. And so that's what we're gonna build to get where we need to go. And the reverse is also true, but for those who make that commitment, I bet we can both think of a lot of examples of the magic that happens when you make that investment.

Sue
Yeah.

Oh, I know, I know. I think of a phrase that we use a lot when we're working with organizations, in particular on strategy, execution, and in particular, maybe those leadership things. We talked about the wearing many hats and especially those frontline managers, they have to keep day-to-day operations humming, problem-solve the equipment or supply issues of the day, the staffing issues of the day, those kinds of things, but at the same time, they'd be...

have to be working on developing their people and moving projects forward and things like that. But when we're working with them to learn to lead in new ways that elevates the culture and the results and makes that progress that you mentioned that is desired in those baby steps forward, they even in small steps feel like they don't have time for that and energy for that because we call it the whirlwind, very busy and very demanding. And they...

have to have primary ownership and responsibility for that to keep things going. But we like to use the phrase, it's not extra work, it's how we do our work. So to your point of the trade-offs, we have to say, okay, the old way we used to be developing our people to elevate their behavior performance, to get better results and outcomes for our patients that are more satisfying, more safe,

Sue
that it's not extra work, it's how we do our work a new way. So I used to do it this way, you know, it's not getting these top ranking award winning results or at least improved results. So let me stop doing this or change doing this a new way. So instead of that add on, add on, add on, it's kind of a change or replace something else because at a certain point you just can't add on anymore.

Doug Morse
We spend a lot of time with a lot of facilities talking about a strategy around this concept to optimize. That is, let's do well and more efficiently what we're currently doing. Like we mentioned at the beginning of our conversation, Sue, there's always this temptation to go to the new shiny object.

Sue
I know, I know.

Doug Morse
But the experience I've had is that is what leads to the jam calendars and long to-do lists. And instead, really have a conversation at the senior level and at the leadership level, how do we deliberately give permission to make some trade-offs? And my own passion point is that is very effective when we even start talking about the word trade-off.

It changes the culture. And it's hard for folks because our traditional definition is yes to everything. I've been a CEO for a long time in rural communities, and I know there's this urge to say yes to everything. I also know what that does to the culture. And by that I mean, you know, when people are so busy, they're on the run and can't think.

Sue
Uh huh.

Doug Morse
There are paths forward to slow that down through these trade-offs. There are specific tools. There's this thing called the Eisenhower Matrix. There are calendar management tools that are born in this trade-off. We can have everything we want, just not at the same time. That's how we start to slow down and create time in our strategic process that we use with facilities.

Sue
Yeah.

Doug Morse
By being very careful, we start where people are today, not 10 steps ahead, and make sure that we understand how we'll get people there with baby steps. That's been something that's worked very well in my career and it's worked well in this latest phase where we try to help other hospitals go through the journey to set the right activities going forward.

Sue
Mm-hmm, yes, yes. Now I was thinking, given your experience in rural healthcare and being a CEO in your career as well, is can you think of an example where there was kind of like a before and after story where you're like, wow, the culture was part of what changed. It wasn't just like.

a new tower, a new building, or a new service line, or robotics or something. There wasn't something like that, but it was like, maybe it was some of those things, but also you'd say there's a before and after that the culture used to be this and now it's that. Do you have any of those stories or at least one that kinda is top of mind?

Doug Morse
Yeah, I'll tell you one that's related to what I mentioned before and that is, and I've lived this both myself as CEO and now helped other organizations. But one theme that has come up repeatedly is when the normal is

directors who sometimes are maybe a little early in their role or haven't been blessed with some mentoring or seasoning or education and suddenly you're running departments. And I'll give an example where in our case, yep, we need to grow. We need financials to improve. We need quality. All the usual pressures people hear. And as an example...

Sue
Mm-hmm.

Doug Morse
the facility I'm referring to, you know, we also didn't have tax support and we had to live on only what we brought in. So it was a very high need to be efficient. And so that was kind of a normal. Well, the event was it's sort of this until one day, some of the leaders said to me at dinner or at lunch, because, you know, we were always eating and people could be relaxed. You know, you want me to grow and start that new service. I...

Sue
Mm-hmm.

Doug Morse
I don't have any idea what you were talking about. And it hit me like a ton of bricks, which is in my mind, I knew what I was talking about, but you know what a learning for me that this person was very willing, this person was doing everything, but had never been afforded the support and someone to show how to get there. And

that particular facility, the joy was, as people learned some of those tools, as CEO, I didn't have to dream up the new services. People were actually bringing business plan summaries forward to work on with us. We got actually more ideas, not fewer Sue because people knew how to spot opportunities. Then I had stories speaking of culture.

Sue 
Mm-hmm.

Yeah.

Doug Morse
Well, gosh, I showed my son how to do this because he wants to start a pizza restaurant in town. Fantastic. Now we're all better off because we're learning about how to launch a new venture or some new skill that we forget, it impacts people's lives and their families, not just them. And so we were locked in the classic, boy, grow, find a way to grow.

Sue
Mm, so.

Doug Morse 
until again that day which was let's do something different and that's become a perennial top 20 facility now with its marks and its growth because of this demonstration of look at the magic when we actually tool people up with what they need for the new world and really one of the most exciting needs and you can repeat that this the fun part is this is doable you know we got this

Sue
Yeah.

Doug Morse
If we put our minds to it in a world that's very, um, what's the right word, It seems like a lot's out of our control. In, in my experience, if we choose these things are in our control, and that's very exciting if we give it a try.

Sue
Yeah.

seems very empowering, right? To one, be taught and supported to learn and grow in this way, but then your example of what happened after was they felt very empowered to then not just use it in the very specific situation in which it was taught to be used probably initially, but then to say, now what? What else, you know?

I now have a new skill, and not just internally, but externally, I find that in rural healthcare, maybe because it's small enough, we can wrap our arms around our community. We can see more evidence of how our community healthcare systems ripple of impact from the employees to their families or their other businesses or stuff. But remember in our local community, when our hospital really went from being one that was kind of spiraling downward to one that was then.

kind of really known as the employer of choice, the provider of choice, great service, great quality, great reputation, growing, flourishing. I remember other businesses looking at that as a model and saying, wow, we need to step it up. Like if our local hospital can be a shining star for service and quality and growth, like maybe we can too.

Doug Morse
exact

Sue
I remember seeing those examples and it reminded me of that when you said about the pizza business.

Doug Morse
Yes, it's exactly that. This whole idea of what it can do for a culture clearly shapes the community. And that's, I think, what brings people alive. Because that's why people got into this. People want to serve and have an impact. And I don't mean to sound naive about this, but

I deeply believe that makes a huge difference in attracting talent and retaining talent because I've seen it with my own four eyes year over year that when people are learning and people are trying new things and they're safe in doing it, they will work their hearts out and you feel like you're part of something.

Sue
me too.

Doug Morse
And that's the difference, this kind of strategic approach, you know, rather than, you know, there's a lot of ways you can develop a plan so you feel great about it and put it up on the old shelf. But this notion of really helping people see where they are and where they can go can be remarkable. In fact, some folks have to...

Sue
Yeah.

Yeah.

Mm-hmm.

Doug Morse
see it to believe it. There are facilities doing this very well, as you know, the facilities you work to help. Helping people see a spirit of the possible is a big part of my role now that I can only say it because I've lived it and I can say it over time things happen.

Sue
I know.

Yeah.

Sue
Yeah, yeah. You know, I think one of the things that you've said today that really resonates with me, but I know it will with others is that once you have a strategy in place, when you go to execute on it, one of the things you need to consider beyond budget and funding it and what resources are gonna be needed is what learning is going to be needed. What are the...

things that we don't know. So let's say you have a big strategy to be top ranking, award winning in the patient experience and to be a high reliable organization. A lot of that's cultural more than it's buying widgets or building buildings and stuff. And there's learning needs involved with that out of management and staff and other level. And so really then to execute on it, you have to say, what do we need to learn?

to succeed at executing this plan and have a learning culture where it's just like, instead of it being the first thing we cut in the budget is our education budgets, you know, which are usually less than, you know, the amount of money we spend to, you know, ensure our equipment or the maintenance contracts on some of our equipment, you know. But yeah, the learning needs of, if we're gonna succeed at this,

What do people need to learn?

Doug Morse
Well, I'd offer up some discussion questions right off the bat from this conversation. If you're working in a facility right now in a senior leader level, here are some of the questions I'd offer you to consider. Number one, are the colleagues in your building an expense or an asset that can grow? And that is a.

Bottom line fundamental because rather than being interested in reducing expense, when we know this is an asset that grows, that's where we want to invest. So my starting point assessment question for people often is, assume we're in the people business for a moment, doesn't additional investment help us get where we want to grow? And people will say, well,

There's a lot of things around that, but I would offer our experience. Then, you know, get where you want to grow. You'll have to invest in the asset. And it's a winning investment over time, 100% of the time. So that's a, to your point, kind of those first things for strategy is taking an assessment of where you are philosophy and then allocating the resources and making the tradeoffs.

Sue
Yeah, but.

Doug Morse 
That's the beginning of the journey is just acknowledging we're going to start making some trade-offs and investing to work on the things maybe we do now. Maybe we get our best growth, however we want to define it by optimizing what we do now. And I tell folks, I'll bet you a pizza. What has always happened with me is more and better ideas come from...

the frontline colleagues because they're there. And it always relied on just a few of us to come up with these new ideas. Imagine the whole building having more skills at opportunity recognition and that's culture. That's what in our minds that path forward is rooted in investment in that level of culture to get to the execution we need.

Sue
Thanks.

Mm-hmm. That deference to expertise that's spoken about and high reliability, it applies beyond, you know, and to other things than high reliability is, you know, the front line and truly to be able to have a culture that not only acknowledges that, but truly, truly makes it part of their approach. That there's knowledge there, there's answers there, there's solutions there.

We call it do it with them, not to them. It's way easier. You know, a lot of the stuff that we need to execute right on the front lines that change how people work daily, whether it's the processes or the behaviors of how they work daily with patients or with each other to make that happen, you know, that's just, that's happening on the front lines. And if that needs to change in any way to get a better outcome or more value,

they know the answers and if it needs to change, they can shepherd that change easier than a leader saying, hey, we're gonna do it a new better way. That usually is like a lead balloon as you know.

Doug Morse
Exactly. And you know, the other thing for people to think about is what are the other alternatives? More of the same. The part that's kind of ignites passion for people, the other part of strategy we work very hard on is it has to show some new insight. Doing a new way is what will actually generate some energy.

if we are simply doing what we have gotten to, to this point, we're perfectly designed for our results, right? So if we can make some changes, we change the culture, and that's then what we build on. And it's a snowball effect. Baby step and let it sort of snowball. And if you compare that to what it currently is, that's kind of a nice place to be as a rural facility, or any facility, really, in health care.

Sue
Yeah.

Doug Morse
rather than letting all the other actors do those culture changes, frankly, kind of at our expense, you know, they benefit from the value we create. We're trying to create value and keep a little more for ourselves. That's the exciting part of good strategy and effective strategy over time, frankly.

Sue
Yeah.

It is, it is. This has been such a great, meaty conversation. There's just some gems in here from your years of experience and wisdom on this topic. And I would love to kind of close out this wonderful conversation and very helpful conversation with maybe just maybe another gem from you, Doug, about maybe a clean.

a key message, a key tactic, a key lesson. We've already talked about several and I'm sure people will be able to pull those out, maybe even wanna listen to it more than once to make sure they capture them all. But is there maybe one more thing that when we were planning to do this, you're like, I've got this message or I've got this thing that I know works. Is there anything like that you wanna add to our conversation before we close it out here today?

Doug Morse
Well, I appreciate the opportunity. My own experience was, I was overwhelmed, frankly, in whatever role I was doing in a rural hospital with the daily tasks and the jam calendar and didn't feel like there was progress. So my overarching message is there is a better and different way. Personally, there are opportunities to tame the calendar. There are opportunities.

to get the right things done that don't require more early mornings and later nights. And so my first message is, there are proven paths forward to tame that beast. And what one could do now, in my view, what's a step you could do even after listening to this podcast, is to take a piece of paper and a pencil, the old fashioned way, and...

Sue
Nah.

Doug Morse
Write down what it is you as a leader, whatever your role is in that facility, what do you want or think you need to learn? Write your own learning plan. It could be a simple handwritten plan because most of us know the gaps between what we're being asked to do and what we frankly can do easily. So write out what it is you think you need to learn with a development plan.

and then present that to try to get resources toward it. I think that's a good solid first step that, you know, fundamentally you got this if you're given the tools. So let's tame the calendar and let's see what we need to learn. And that is transformative over time and accelerates better results. That's my two cents after about three decades in the business.

working in rural areas as a zealot, a true rural zealot by the way.

Sue
true rural zealot Yes, yes. Well, this is

Doug Morse
Good for us personally, good for the organization, good for town. Yep.

Sue
Yes, you know, there's a quote I use often is when we strengthen a community hospital, we strengthen the community. And I truly have seen example after example after example of that where that is true. My own community, we added more than 500 jobs in a community, you know, from 307 employees to 900 plus. That's a big impact on a small community.

And that's done through great strategy and execution. And culture was a major part of that plan that got patients to be loyal and increase the volumes so that we could add new services, grow and optimize our current services because people would use them and they'd recommend them to others. And so, some people are gonna listen to this, Doug.

you know, later than the date of when this is published in March. But you and I are going to collaborate together again on event coming up, a discovery discussion event, a two-part series where we're going to talk about, you know, your major, you know, passion of right now strategy planning and me, strategy executions. So we're going to be doing a two-part series. So in the show notes under today's podcast, I'm going to be putting that in.

It's coming up real soon. So after the release of this, so if people haven't registered yet or missed the first one and there's still time to get into the second one, um, but, uh, that's coming up real soon. I wanted to put a plugin for that cause I've enjoyed this conversation and I'm really going to enjoy our upcoming co-presentation, um, to dig in deeper specifically on some of the tools that we couldn't talk about today that leads to great planning and great execution.

and from our background, primarily in rural healthcare, because you're a rural zealot. So, yes, well, thank you for your time, Doug, and I appreciate your contributions to this amazing industry called healthcare. It's been something that we've committed a lot of our lives to, and it's nice that we can use this forum to share some of our lessons. Thank you so much for being willing to do so.

Doug Morse
That's right. Absolutely. Looking forward to it Sue, very much. Thank you.

Doug Morse
Thank you. Thank you very much.

Sue
You're welcome.