Ep 028: 90 Days to Make or Break: A $60M Leadership Collapse

0:01Welcome back, Bridge Builders, to Bread to Lead, the podcast transforming leadership across industries. I'm your host, Dr. Jake Taylor Jacobs, and I'm thrilled that you're here. We're currently ranked as the 30th top business and leadership podcast nationwide. And it's all thanks to listeners like you. Bridge builders, if you haven't already grabbed a copy of my book, Bread to Lead on Amazon, it's packed with strategies to elevate your leadership game. Got questions or ideas for the show? Visit us at breadtolead.com. And if you're finding value here, please take a moment to rate and review us on Apple Podcasts.

0:36Your support helps us reach more leaders. Now let's dive in and continue breeding excellence in leadership. Today's episode awaits Bridge Builders. Bridge Builders, Bridge Builders, Bridge Builders. If you are new to the show, everyone that's a part of this community is a bridge builder, because in some form or fashion, you're taking somebody from where they are to where they could be. And typically, if you're in leadership, you're typically leading multiple different generations at the same time. So in order for you to communicate with different generations, you first yourself must be a bridge builder, somebody who can be bridges, build bridges of communication that can offer you to get to the step.

1:16So if you're new to this podcast, it is a pie class. The whole purpose of this pie class is to make sure you're getting actionable steps. If you're looking for interviews and different type of things, there are plenty of amazing shows on podcast platforms all throughout the world that interview. This podcast is solely for the leaders that want to learn that want to grow that want to develop and In need information that they can take they can apply and they can move forward One of the newest things that we added to the podcast Because we're always just tweaking it and touching it up just depending on what your feedback is So if you have feedback go to bread to lead.com leave a comment on what you want us to talk about Or information that you want us to share on the show or follow me on LinkedIn at Jake Taylor Jacobs on LinkedIn and it's Jake Taylor Jacobs, J-A-K-E-T-A-Y-L-E-R, J-A-C-O-B-S on Instagram.

2:11For those of you that are following on YouTube, we're trying to build our YouTube platform kind of from scratch, although we have subscribers, which is going to be a fun thing in itself. I'm excited about that. So today Bridge Builders, we are diving into something that can make or break a leader's success. And it's the first days in a new role. And to illustrate just how critical this period is, I want to share with you a powerful case study that shows exactly what happens when leaders get this wrong. In March, 2014, North Adams Regional Hospital in Massachusetts abruptly closed its doors With just three days notice, 37 ,000 residents lost access to their to their local hospital.

3:04Employees lost jobs. Communities lost. The community lost its health care lifeline. And this wasn't just a business failure. It was a leadership failure that began in those first crucial 90 days. What makes this story so important for every leader is that it wasn't inevitable. The warning signs were there. The opportunities to change course were there. But a series of critical mistakes in the leadership transition period set the stage for failure. The episode that we're going to share today will explore how this case study illuminates the four crucial elements of leadership transitions and provide practical strategies for success.

3:55in new leadership roles. So for some of you that are newer to the podcast, I just want to let you know again, we're always kind of changing and adapting what we do with this podcast. And the reason why we're changing and adapting what we do with this podcast is simply because we want to continue to communicate with you. So if you have information that you want to share with us, go to breadtolead.com, leave a comment. information or case study that you want us to look into and apply our principles to it. If you have a case study at your facility that you want me to break down, dealing with leadership organization operations, please, I will implore you to send that information to brea2lead.com.

4:40And then the second thing is if you have specific clinical things that you want us to address, we're starting a new podcast called SPD 911. It's really helping the peri-op, Anything in surgical services from OR down to surgical instruments is helping us be able to get together. So let's break this down. What happened at North Adams Regional Hospital? Because it reveals something crucial about leadership transitions. When the new leadership team took over, they made a huge mistake. That I see repeated across industries. They misjudged the reality of their situations. Typically, when when this happens, everything begins to shift.

5:23So when this new leadership took leadership of North Adams Regional Hospital. There are signs, but the mistake happened when they misjudged the reality of their situation. And so many leaders and business owners typically misjudge how long it takes to actually make something stick and make it great. It's because we're in this nuance of new information all the time that's telling you in 90 days You can turn it around your last opportunity You did it so you can do it again Just because you did it before doesn't mean you can do it again This isn't that song if he did it before He'll do it again. Yeah same god right now same god back then this ain't that situation If you did it before if you did it just off sure effort and momentum and luck It's hard for you to reverse engineer and create a success story in every opportunity that you face And so what happened with these leaders with this case study is that they believe that just because they did it before at another hospital That it meant that they can do the same thing at this new hospital without considering the the environment or the space that the hospital was in So so so the new executives looked at the hospital challenges through lens of their past experiences They saw mounting debt, declining patient volumes.

6:41But instead of doing a deep diagnostic of why these problems exist, they jump straight to the traditional cost cutting solutions. And this brings me to my first principle of in the first 90 days. And let me pause. What you're going to hear me talk about are frameworks. If you're building or if you're a leader, if you're an executive, you should always be operating in certain frameworks. It means like rules to the game, a playbook. And when I was in sports, the most successful teams had a plethora of plays, frameworks of what they built their offense or defense on that allowed everyone to reset in the same way.

7:18The reason why a lot of leaders fail is because you're shooting from the hip, but you're not shooting from or building from framework. So you're going to hear me reference a bunch of different frameworks that we've created internally so that we can ensure we're at least getting the same similar results every time we turn around a hospital. OK, so the reality assessment before action, this is what you're doing the first 90 days. You don't just promise you're going to make a change because there's a reality assessment. The information that you received before going into that hospital or before taking that leadership role or before starting that company, you need to make sure over 90 days that that information is accurate before you decide to make changes.

8:00So let me share something powerful about assessing reality. Most new leaders. Let me share something powerful about assessing reality. Most leaders make the mistake of relying on the information that's presented to them. Reports, metrics, and presentation. But here's what I teach leaders. You need three levels of a reality assessment. The paper reality. This is what the data and reports are telling you. Because there's a saying, right? Numbers don't lie. I say, you know the other word. It's because numbers do lie because it's all based on the formula that you decide to calculate. So, yes, you have a paper reality.

8:42The second form of reality is the perceived reality. What people in the organization believe. So you have a paper data that tells you one thing. You have people saying another thing. And then the third reality is the ground reality. What actually happened day to day? What's happening day to day? So you need three functions of those realities. In order to really assess if you have the true grasp of the reality. So you have the paper reality, the perceived reality and the ground reality. Once I'm able to gather, gather an analysis of all three, then I can decide to start making recommendations on what we're going to do.

9:20And typically when you're going into a new industry, a new company, a new environment, a new business, a new organization, a new hospital is going to take you 90 days to be able to assess what the real reality or the problems are within the organization. So at North Adams, the leadership team looked at the paper reality, the financial statements, the patient volumes, the operational metrics. But they missed something crucial, the perceived reality of their staff and community in ground reality of why patients were choosing other hospitals. This is the biggest thing that we have to consider, because this brings us to something crucial about leadership transitions, building credibility, credibility from day one.

10:03at North Adams. The leadership team made a huge mistake that undermines many new leaders. They failed to communicate transparently about the challenges that they were facing. That's the thing. When you come into a new situation, you want to be the superhero. You want to be the star. But the problem is, is that when you do not express or show transparently about the challenges you're facing, you're not creating a real reality that can be solved. We'll be back after the commercial. Are you ready to transform your leadership journey? Get my book, Bred to Lead, on Amazon now. In it, you'll discover the proven frameworks and strategies I've used to help leaders across industries master each phase of their leadership development.

10:46Don't just lead, be Bred to Lead. Get your copy today on Amazon.

10:55Oh, y 'all, listen. This is hot. It's kind of hot right now. Let you know this podcast. We're already in the class because we talked about the three levels of reality assessment. Before I decide anything on anybody, I tell them I need 90 days. And if I cannot get 90 days to actually assess the real reality of the organization, there is no way that we can change it. And typically when hospitals call our firm to help them stabilize their surgical departments or stabilize or turn them around, we can send our consultants in that are experienced, that are specialists that can plug the gap. but plugging the gap and bridging the gap are two different things.

11:34Plugging the hole and bridging the gap are two different things. You can plug the hole with anything to kind of slow down the bleeding, but in order to fully slow it down. So internally it can heal. You have to open up the womb, extract out what's just destroying your organization and then bridge the gap by sewing it closed with strong sutures. Your strong sutures in your organization is your leadership team. If your leadership team is not strong at its core, that can help really develop and turn around an organization. It's going to be hard for you to close that gap too often in the hospital space and in businesses all across America.

12:11There's a bunch of leaders that are just trying to plug the hole, but not trying to bridge the gap. And I want you to think about this. When the hospital finally closed. employees in the community were blindsided. They had just three days notice. This wasn't just a communication failure. It was a credibility killer. But most importantly, it shows us something fundamental about building credibility in your first 90 days. Let me share this framework that I use with leaders. Remember, we're building everything from framework. So every episode, take the framework. Y 'all, we have literally probably 200 pages of frameworks that we build from depending on the scenario or the situation.

13:01So just like we had the three triangles talking about building an assessment, okay? In the first 90 days, when I'm seeing this, I want to build a trust triangle. So at the same time, simultaneously, when I go inside of an organization, I'm looking at the first 90 days, which is our reality, our real reality assessment. This in part with that 90 days, I also have another framework that we're looking called the trust triangle. Before you can turn around an organization, they first have to trust you. If the organization doesn't trust you, it doesn't matter what you decide or what you recommend, it will never happen.

13:41So with the trust triangle, the first thing that you need is transparency. Not just about good news, but about challenges. Leaders at North Adams could have built trust by being open about the hospital struggles and evolving stakeholders and finding solutions. Number two, engagement. You need to engage with three key groups in your first 90 days. When you're coming into a new situation as a leader, these these are the three groups you need to engage with. Your team understanding their perspective and concerns before adjustment. When you're coming into a new organization, the very first thing you need to create engagement with is your team understanding their perspective and concerns before adjustment.

14:34because adjusting a department or an organization based on past experiences without first assessing the culture of your current environment is bad news from the start. The second thing, your peers building a collaborative relationship amongst those who will be considered equal across departments that you are forced to work with. And then the third thing, your stakeholders, creating a support network of your upline so that if you're creating an initiative, they will back it. Let me stop here and park parenthetically. A lot of you are in organizations in silos. You barely talk to your team. You barely talk to your peers about growing the organization.

15:16And you hardly ever talk to your stakeholders, your upline, unless you're in trouble. So when you're asking for something, you don't have a trust bond with the people that can help back you making a decision, get approved. So you have to create this level of engagement amongst your peers, your team and your stakeholders that can ensure that when you're moving the organization forward, you have an ecosystem or a circle of people who trust you. to get a job done, to strategize the job, to get it done, to get the result and bring it back to them because they know that you're a winner. And then the third thing, when it comes to the trust triangle, the first part of the trust triangle was transparency.

16:00The bottom was engagement. The other bottom are early wins. But here's the key to early wins. They need to be meaningful to your upline. You coming into a department saying, man, I got rid of this and we did that, we stabilized the instruments or we streamlined operations. If your stakeholders, your upline, if that wasn't their main concern, it could be a win for you, but not a win for them. So you need to find out what's meaningful for your stakeholders, your upline, your senior leadership, or even your customer, who your customer would be in that space and getting them a win that they find valuable.

16:38The second thing in early wins, achievable with current resources. See, a lot of leaders like to create, a lot of leaders like to complain and want to create early wins with resources that are not available. Meaning you come into a hospital, you come into an organization like if we just had this, this, this, this, and this, we can do it better, but we don't. Can you fix it? If we had this much staff and we don't, can you still fix it? If we can just get a budgeted a half a million dollars more, if we, if we don't, can you still fix it? The question is, can you turn around the organization or start getting early wins with the current resources, staff and things now?

17:29That's all they want to know. And then the third thing, when it comes to early wins, is it aligned with the long-term needs? So when I'm coming in as a leader, I want to know what are the long term wins for the organization? What are what's meaningful to our current leadership? What do they see as something powerful? Cutting costs, getting more efficient, operational work, a workflow optimization. OK, if those are my three things, I'm not going to come talk to them about. Anything else but those three things. And at North Adams, the leadership focused on cost cutting as their early wins. But these weren't wins at all.

18:10They were just delays of the inevitable because they weren't paired with a strategy for future sustainability. The number one thing I see hospital executives make in many executives in every industry, actually, the first thing they do is go cut costs with staff. If your current staff that you believe is overstaffed is inefficient. What do you think your organization is going to do when they feel understaffed? A lot of time was in front of you to cut cost isn't necessarily the primary move we should be making. But it's easy to say, well, the largest resource here is human resource. So let me cut our staff by 20 % and then tell everybody to work more.

19:03And that's, that should be great at cutting costs. No, no, no, no, no. Cutting costs also means cutting down on errors. Cutting costs may also mean cutting down on mistakes at the assembly. Cutting costs may be also getting efficient. A lot of the ways that people consider cutting costs aren't really just getting rid of the quote unquote, inevitable. Cutting costs may sometimes mean we're being too sloppy with our resources. Let's cut down. Let's anchor down on our financial situation and let's figure out what makes most sense moving forward for the organization. Cutting costs. Doesn't always mean cutting people.

19:49Now. Let's talk about something that trips up many new leaders. and it's the desire to make an immediate impact. At North Adams, the leadership team felt pressure to show quick results and this led them to make abrupt decisions about layoffs, service reductions, without considering the cascading effects of the organization and the community. And this brings us to a crucial principle. Impact without chaos requires what I call balanced urgency. You need to move fast enough to create momentum. Move slow enough to bring people with you and move smart enough to avoid unintentional consequences. This is balanced urgency.

20:45But so many people move so fast. Y 'all know my favorite song by Indy Irie. Slow down, baby. You're going too fast. You got your hands in the air and your feet on the gas. You're about to wreck your future. Running from the past, you need to slow down, baby. Listen, you got to slow down. Changing an organization. You got to move just fast enough to create urgency in the momentum. Got to shift the atmosphere. You have to be slow enough to bring people with you. And you have to move smart enough to avoid unintentional consequences. Because any major mistake or any major mishap in this transition, you'll lose all trust with the people that's with you.

21:45So we created the impact matrix. Before making any significant change in your first 90 days, you assess it across four dimensions. Immediate effect. What's the immediate impact on operation? Who is directly affected? And what's the short term benefit or cost? After the immediate effect, the ripple effect. What are the secondary impacts? How will this affect other departments or stakeholders? What systems or processes will need to change? You see what happened? The immediate effect affects my immediate department, my shift, my locale, my operations, my organization. That's the immediate effect.

22:32The ripple effect is who else is affected by this one decision that is made. and what processes will need to be changed. There are so many leaders that come in and clean up their department, but didn't clean up the way it's communicated outside of the department, which are partner departments, which causes chaos in itself. After ripple effect, we have the cultural impact. How does this align with existing culture? What measure does this send? What message does it send? And how would this affect morale and engagement once this decision is made? So if you're changing the culture, does it connect or compete with your upline culture?

23:23Is the culture I'm looking to establish, does it connect with the focus of the entire ecosystem of the business? Or does it compete with? If it competes with. Do you have enough stakeholders that can buy into your idea of changing your organization around? To create a ripple effect that will ultimately change the full organization. And how would this affect morale and engagement? Because when you affect morale and engagement, you affect productivity, you affect productivity. You know, efficiency is going down. If efficiency is going down, the business is going to take it. If the business take a hit, boom, we got infection rates are really high.

24:06Surgeries are at an all time low. Delays are happening. People are dying on the field. People are getting sued. If you're in different industries, you know exactly what that compares to. And then the fourth thing you need to recognize in this impact matrix is how does this impact long term options? What capabilities are we building or losing and how sustainable is this change? change. This is what I'm thinking about. Before I make any changes in my 90 days, remember, we have the reality assessment that's happening your first 90 days. Then we're doing our trust triangle simultaneously. And then before we make decisions, we're taking it through our impact matrix.

24:50These are all mechanisms that you can use before you create that change in the organization. And at North Adams, the leadership team failed to set the right tone from the beginning. Instead of establishing a calm, solution-oriented environment, they allow a crisis mentality to dominate. This created a self-fulfilling prophecy. When people expect failure, they start acting in ways that make failure more likely. And let me share something powerful about setting tone and pace in your first 90 days. Most leaders think it's about their words or decisions, but in actuality, It's about your leadership cadence.

25:32The rhythm and pattern of how you operate. And the framework of the leadership cadence is the rhythm. What's your regular communication touch points? What's your regular communication touch points? What's your regular communication touch points? What's your regular communication touch points? Before you start making changes, you should get your organization on a rhythm. a rhythm that's upbeat a little bit, that doesn't change a lot of what they're going, but we're just getting a rhythm to the organization, getting a rhythm to the organization, getting a rhythm to the organization, getting a rhythm to the organization.

26:15And then once you get a rhythm with regular communication, touch points, then guess what happens?

26:25you get predictable decision-making processes you get predictable decision-making process you get predictable decision-making processes you see that once you create a rhythm in the cadence now the predictability of the decision-making process becomes a lot more consistent and then what happens when you have the regular communication touch points Now you can be predictable with the decision making processes What I want to do when i'm first getting in the organization is change the way that people are making decisions. That's it I don't want to change too much But just the way that people are considering making decisions Because if they can see the value of your value And getting them to change how they see things It'll be easy easier for you to actually implement what you need to implement Hope i'm talking to somebody I hope i'm talking to somebody I'm getting a rhythm.

27:21I'm getting a cadence. Then it's begin to be predictable decision-making. And the next thing of that rhythm, now you get consistent presence and accessibility. So after I get that leadership cadence with that rhythm, now we want to start working on their response patterns. How are you handling challenges? How are they handling challenges? How are you handling challenges? How are they handling challenges? If they're handling challenges inefficiently, your job isn't to scold them. Your job is to just get them into the same rhythm you are in. And I want you to consider this. I'm actually going to look this up.

28:03This is not a part of my current script. My training script. How long does it take for ladies to become in sync? I just thought about this as we're speaking.

28:28Because ladies, when you work in an environment, you end up becoming in sync with your menstrual cycle. That's what I've heard.