Latest / The Advancing Healthcare Innovation Show / E185: Angi Jennings on Rebuilding Cano Health From the Inside Out

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E185: Angi Jennings on Rebuilding Cano Health From the Inside Out · The Advancing Healthcare Innovation Show

0:10
Hello and welcome back to the Advancing
0:12
Healthcare Innovation Show. I am your
0:14
host, Michael Stamatinos, and if you're
0:17
new to us, welcome. It's great to have
0:19
you here. We're just having some have
0:22
some great conversations with real
0:23
leaders that are uh painstakingly
0:26
reshaping the future of healthcare. And
0:29
we're pretty passionate about a few
0:30
different areas. We're passionate about
0:32
healthcare innovation naturally, uh,
0:34
leadership, um, access, and and and
0:37
transformation. And if it's your first
0:40
time tuning in, let me just sort of take
0:42
a quick step back and just sort of peel
0:45
back some layers of the onion to give
0:47
you a little bit more about what we're
0:48
trying to get done here. So, we're
0:50
focused on bringing real stories of
0:52
leadership and innovation to life, not
0:54
just stuff that you read about. Um, but
0:58
the unsexy stuff that really truly
1:02
matters. And we want to give our guests
1:06
the opportunity to share their stories
1:08
with our community and ultimately with
1:10
the world. So, if you haven't had the
1:12
opportunity to check out any of our
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historical interviews, wherever you are,
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if you're watching this, if you're
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listening to this, please hit the
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subscribe button now so that any of the
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new interviews come directly to you. So,
1:25
before before we get started today, I
1:28
want to talk about a word that
1:29
definitely gets tossed around a lot and
1:31
I mentioned it earlier, transformation.
1:35
You hear it a lot. You hear it in news
1:37
headlines, boardrooms, press releases,
1:40
you know, you see it on slides, I see it
1:42
at conferences that we go to. But if
1:44
you've ever been inside of an
1:47
organization that is really going
1:50
through it, um, you know that the real
1:54
story looks very different.
1:57
Transformation
1:58
is messy.
2:01
um you know when it comes to operational
2:05
friction maybe people were used to doing
2:08
things a certain way now all of a sudden
2:11
you're saying hey um how you used to do
2:13
it like that's not how we're doing it
2:14
anymore u you got to do it another way
2:16
and somewhere inside all of that leaders
2:20
they kind of have to figure out how to
2:22
make things better and inside of this
2:27
chaos they kind of have to distill it
2:28
down and make things super simple and
2:30
clear so they can execute and function
2:32
etc etc. So today's guest has been
2:36
living inside of this chaos and has made
2:39
a career out of thriving in it. Angie
2:43
Jennings is the senior director of
2:47
organizational excellence at Kano Health
2:50
and over the past I don't know call it
2:53
multi-deades she's been deeply involved
2:56
in this kind of work and and I'm excited
3:00
about kind of peeling back behind the
3:02
curtain to see you know what what
3:04
happens after um a turnaround is
3:07
announced or after an acquisition and
3:10
what does it really take to kind of
3:11
align teams
3:12
that honestly really weren't really
3:14
designed to work together. And how do
3:16
you move an organization
3:19
forward from hey, we're just about to
3:21
close our doors and we're barely hanging
3:23
on to survive into like, hey, like we
3:25
got to got to shift gears here and let's
3:27
let's execute. So that is what I'm
3:31
excited about selfishly talking about
3:33
today. I think that revolves around a
3:36
lot of accountability, aligning
3:38
strategy, and a whole host of other
3:39
things. So, we're going to pick Angie's
3:42
brain on that. And I think what I
3:44
respect about her perspective the most
3:46
is that she's actually willing to come
3:49
on to the show and actually share this
3:51
>> publicly. So, thankful in advance.
3:55
>> And um Angie, it's great to see you.
3:58
Welcome to the show.
3:59
>> Thank you, Michael. Thank you very much.
4:02
>> All right. So, you we've kind of talking
4:05
about, you know, your title and all that
4:06
other stuff. I want to start somewhere
4:07
else. So, I want to
4:08
>> Sure. I want to I want you to take me
4:10
inside of the moment Kano Health where
4:15
it's like all right this is either going
4:16
to work
4:18
>> or this whole thing is going to fall
4:20
apart like what was happening
4:23
where were you who was around the table
4:27
and like take me through that because I
4:29
know that you've gotten the band back
4:30
together to kind of re engineer this
4:33
thing. Talk to me about that.
4:35
>> Yeah, it is. Thank you. I I I would love
4:37
to. Um I am privileged in my career to
4:40
have worked with uh some pretty
4:42
innovative and
4:45
foundational leadership and and in my
4:48
process of learning through my career.
4:51
Um you begin in my stage in my career
4:55
learning what you very much enjoy
4:56
working with and working for and what
4:59
perhaps maybe
5:01
>> just not interesting as much anymore.
5:04
And so when you mention where were we,
5:07
what was going on, listen, KO Health is
5:10
um re-energized, is reinvigorated.
5:13
Um they of course have come out of
5:16
bankruptcy and a new leadership team has
5:19
been put in place uh to regenerate the
5:23
culture to simplify operations and to
5:26
really uh embed the valuebased care
5:29
strategy in the daytoday work when we
5:32
interact with patients. And so I'm
5:35
thrilled to be a part of that leadership
5:37
team again. I missed it uh when I was uh
5:40
venturing on and learning about more
5:42
parts of health care and and doing my
5:45
thing. Uh but I am thrilled to be back
5:47
and and excited to to share any any of
5:50
this with you.
5:51
>> All right. So you kind of let's let's
5:53
just you know I think of you as like you
5:54
know Seal Team Six. you get the team in
5:57
there
5:58
>> and you get you get you're jettisoned
6:00
in.
6:01
>> What what happens in the first like 30
6:04
days? Like can you take me through like
6:07
what's going on inside of your mind?
6:09
Like what are you evaluating? What are
6:11
you trying to fix first? Or do you just
6:13
observe like take me through your your
6:16
thinking when you have to go in
6:17
somewhere and you got to transform
6:18
something?
6:20
>> Uh observation is key. Um, you need to
6:22
get to know the players, need to
6:24
understand the landscape, need to
6:27
respect uh the culture and history that
6:29
they came from.
6:31
>> So, as you begin to create and formulate
6:35
your uh approach, you have clear
6:40
uh operational understanding of where
6:43
they are, what they're doing, and how
6:45
they're going about it. And so some of
6:47
the things that we uh ventured on were
6:50
>> what are the core roles in a clinic?
6:53
>> What are the responsibilities and
6:55
accountabilities of those roles in
6:57
clinic?
6:58
>> What do we have documented about them?
7:01
>> What workflows do they are they involved
7:03
in? Is there some sort of racy diagram
7:07
that shows the interaction of those
7:09
roles together? and let's begin talking
7:12
about it in large leadership groups so
7:15
that we can level set accountability and
7:17
understanding. That's how we began as we
7:21
literally workflow planned and mapped
7:24
out our core service areas.
7:27
>> And so in a multi-sight primary care
7:30
clinic, it's things like an annual
7:32
wellness visit and a new patient visit
7:35
and a same day sick visit and a preop
7:39
visit. There are components clinical and
7:42
administrative that go along in the
7:44
completeness of each of those service
7:47
offerings. And so uh making sure the
7:50
whole group understood what are those
7:52
offerings, what's involved in those
7:54
offerings, how do we do it or more like
7:57
how should we do it
7:59
>> and get consensus and gain understanding
8:02
document and then say how do we roll
8:04
this out? What does this look like for
8:06
us? H
8:09
okay. So you're taking a lay of the
8:12
land.
8:12
>> Mhm.
8:13
>> You're then formulating these into
8:16
standard operating procedures.
8:18
>> You're then communicating this out.
8:21
>> Is there a timeline that you try to
8:23
adhere to when it comes to, you know,
8:26
getting these little wins early? Like
8:28
how soon are you trying to get these
8:30
little wins to build and rebuild
8:34
culture? M momentum is key. Momentum is
8:37
key. Um so understanding the trajectory
8:42
of the momentum because you have to
8:44
understand innovation isn't about an
8:46
announcement. We're rebuilding. We've
8:48
got a new leadership team. It's about
8:50
the sustained execution and all of those
8:53
little wins that you start talking about
8:57
and earning and building trust. Kano's
8:59
gone through a number of leadership
9:00
teams over a number of the most recent
9:03
four to five years and because of that
9:06
the associates that serve our patients
9:09
every single day uh are weary
9:13
>> I don't blame them right they they care
9:15
deeply and that is what I find so
9:18
admirable about our associates is they
9:20
care so deeply about our patients and
9:22
our patient population um but boy were
9:25
they tired of all this change regroup
9:28
group, restart, redo, and that's very
9:31
frustrating for an associate when all
9:33
they want to do is care in our instance
9:35
is for a senior citizen in their
9:36
healthcare journey.
9:38
>> Um, and so I recognized uh clarity was
9:42
the number one issue. And so when you
9:44
come with an inquired group of
9:46
businesses that have operated singularly
9:50
for multiple years,
9:52
>> clarity and were likely competing
9:54
against one another. very likely they
9:57
were competing against one another and
9:59
and so clarity and simplicity is the
10:02
first step in that cultural turnaround.
10:05
>> Um we began first to anchor on what we
10:08
know best which is patient care. We know
10:11
who our patients are. uh we respect
10:13
tremendously the cultural environment
10:15
they come from and that is what we
10:19
anchored our understanding and as long
10:21
as we keep that patient front of mind in
10:23
every decision we make we know we're all
10:26
going to face and and go towards the
10:28
same direction
10:30
>> and so anchoring that first was was very
10:33
important.
10:35
anything that you've seen throughout
10:37
your career
10:39
now that you start to see patterns and
10:42
you're like, "All right, seen this
10:43
before. I'm going to go to this
10:45
playbook." Has there been anything that
10:48
you've seen now in this recent
10:49
turnaround that's like super surprising?
10:51
You're like, "All right, kind of in
10:53
uncharted territory right now." Well,
10:56
what's interesting to me in my career,
10:58
it isn't per se the industry or what we
11:00
are doing in the turnaround, but for me
11:02
at my age in my career, I am now
11:05
learning alongside of folks 20 or 30
11:09
years younger than I am. And so the
11:12
learning styles and um approach in which
11:17
you approach an adult learner is
11:19
changing and evolving. And so what might
11:22
have worked me as a generation X person
11:25
might not be as relative or as um quick
11:29
to key into as a different approach. And
11:32
so really appreciating and leaning into
11:35
the generations of your associates and
11:39
what spurs and interests them is what
11:43
I've recognized we need to really put
11:45
our arms around. Hm. You think the
11:48
communication style varies when you're
11:49
talking to Gen Y, Gen Z, um, and how
11:53
they learn, how they speak. How do you,
11:56
>> how do you do that? I mean, do you do
11:58
you kind of have an ambassador of each
12:00
in each of the generations? You're like,
12:02
"Hey, I need to know how to like talk to
12:04
Sally, talk to Joe, get the best out of
12:07
them." Like, like walk me through the
12:08
thinking of that because that's
12:09
fascinating to me. We we're in a work
12:11
environment now where we have multiple
12:14
generations all kind of coming together
12:16
all at once
12:17
>> and then you pile on top of that a
12:19
turnaround.
12:20
>> A lot of pressure.
12:22
>> Yeah.
12:22
>> Like that's that's an interesting
12:24
stockpile of things coming together.
12:26
>> Yeah. I I can give you almost a very
12:28
granular thing that came up today if you
12:30
really want to know a decision.
12:32
>> Let's do it.
12:33
>> A key component of all primary care
12:36
offices is an annual wellness visit. an
12:39
annual wellness visit. Most of us in our
12:41
healthcare journey get those. And as
12:43
folks realize, it's a more comprehensive
12:45
visit. Clinically, involves labs and
12:48
screenings and and other items that the
12:52
questionnaires that you answer over
12:54
time. And we refresh this every year.
12:56
>> Coming from an acquired group of
12:58
businesses, they did annual wellness
13:01
visits a little differently. And what a
13:04
complete annual wellness visit looks
13:06
like might be different.
13:08
So standardizing all the components
13:11
necessary that we'd like to document and
13:13
capture is important. So bringing this
13:16
to a generational standpoint, we have a
13:20
IT project manager who has devel
13:23
discovered for free an app online that
13:28
point andclick walks people through how
13:32
to use our electronic medical record in
13:35
very quick uh and voice over narrated
13:40
um demonstrations. So in 10 clicks you
13:44
can see all of the components and pieces
13:47
necessary for success.
13:50
In my day it would have been printed
13:53
papers with screen grabs where then
13:56
someone in learning and development has
13:58
had to overwrite instructions and then
14:01
I'm fli you it's a little more
14:03
cumbersome maybe perhaps in folks that
14:06
I'm I'm accustomed to learning and
14:07
development here. uh we can express the
14:10
same messages in a very short time frame
14:12
on almost a a a minute bite. And what's
14:16
helpful as health care changes and as
14:19
regulations or codes or responsibilities
14:22
change, we can interchange in a
14:24
plug-and-play environment with modules
14:26
of learning that we couldn't do before.
14:29
>> And how often is this retraining? I feel
14:32
like there's it's not just like, hey, we
14:33
train once, but it's like it's a
14:35
constant cadence.
14:37
>> It is. Can you talk about as a leader
14:41
the um you're doing a lot of the same
14:44
thing over and over and over again? It's
14:46
not like you I mean you're obviously
14:48
problem solving and troubleshooting, but
14:50
can can you maybe hone in on a little
14:52
bit of that because that that might not
14:54
be something that people realize when it
14:56
comes to transformation. You're doing a
14:57
lot of the little things over and over
14:59
and over again.
15:00
>> That's exactly what it is. um
15:02
reiterating workflows, reiterating
15:05
expectations, communicating frequently.
15:09
Two things I think we've done really
15:10
well so far at KO um is twofold. Number
15:14
one, uh we have a very healthy data and
15:17
analytics platform. uh the folks that in
15:21
uh acquired businesses often don't have
15:24
what we determine as clean data or
15:27
something simple to take a look at
15:29
because maybe they've not integrated all
15:31
of the systems to talk to one another to
15:33
provide that environment. uh we have
15:36
taken uh multiple uh locations of data,
15:40
put it into one, display it on a PowerBI
15:43
uh presentation format uh and give
15:46
access to all of our frontline
15:48
associates. And then the first teaching,
15:50
the first iteration when I go around and
15:53
did our CANOA is we begin talking about
15:56
how data mirrors behavior in the clinic.
16:01
And then they did something even more
16:03
important that I think is key to our
16:05
leadership success is they tied those
16:07
important uh behavioral metrics to an
16:11
incentive plan and we pay all the way
16:13
down to the associate level.
16:16
>> So when you change behavior, you
16:19
increase your bonus
16:20
>> and we pay it out very frequently for
16:23
bonuses, meaning quarterly. So, I only
16:26
have to do three months worth of work
16:28
and do better behavior to directly see
16:31
in my paycheck how my behavior's changed
16:34
and improved the team as a whole.
16:37
>> What are what are some of those uh I'll
16:39
call them sleep well at night metrics
16:41
that you look at to know that a
16:43
transformation is either on track or off
16:46
track.
16:47
>> Oh, well, what makes me sleep better at
16:50
night is our transition of care metrics.
16:52
Uh it is important in a primary care
16:54
office when our patients go to some
16:57
alternate level of care, emergency
16:59
department, inpatient, sniff, that we as
17:02
their quarterback of their care stay in
17:05
real close communication with them so
17:07
that when they are finished with
17:08
whatever acute issue they're dealing
17:10
with, we come back to us and then we put
17:12
our arms around them and make sure med
17:14
reconciliation's done, we understand new
17:17
diagnosis, new test results, those kinds
17:20
of things.
17:21
>> Okay? We really weren't accurately
17:23
looking at the measurement of of all of
17:26
our patients. Are we calling 100% of
17:29
them to make sure they're doing okay? We
17:31
just didn't have visibility to it. And
17:33
when we first had visibility to it,
17:36
Michael, as with many things, wasn't
17:37
great. Okay? Wasn't great. We we weren't
17:40
as making ourselves proud. But I'll tell
17:44
you, within a quarter's worth of time,
17:47
we are beyond our benchmark that we set
17:50
for ourselves. I think once people then
17:52
understood, wow, when I do this daily
17:55
and document this and this, this ends up
17:57
happening. They're putting those
17:59
workflow very unsexy workflow pieces
18:03
together to go, "Oh, now I get it."
18:07
>> Yeah.
18:08
>> It reminds me of I worked under a really
18:10
awesome operator, a guy named Rick, and
18:12
uh he had a saying, military guy.
18:14
>> He's like, "Okay, what you inspect, they
18:17
respect."
18:17
>> Yeah. That's Yes. Yes. Yes. What only
18:22
you measure improves.
18:24
>> Yeah. Same concept.
18:26
>> The transitions of care. What what other
18:28
any other metrics that you know you were
18:30
really focused on?
18:31
>> Phone metrics primarily. Listen, if our
18:34
patients don't know that we're receiving
18:35
their information and their call and
18:38
responding timely, then they're not
18:40
going to trust us and develop that
18:41
really strong bond that we require in a
18:44
value based care relationship.
18:46
>> And so call metrics were very important.
18:49
uh understanding those um
18:51
>> interesting
18:52
>> access so you mentioned earlier
18:54
>> yeah but you also you said a couple
18:57
times look when we've when we've
18:58
acquired practices I'm curious
19:02
>> do they all move over to similar systems
19:06
or do they stay on disparate systems
19:08
like because that's a huge undertaking
19:11
especially if you're doing a bunch of
19:12
acquisitions and you're rolling them
19:14
into you know one act talk to me about
19:20
the tech aspect of transformation.
19:22
>> Yeah, that's painful. We are going
19:24
through that now.
19:27
And um I can share in our circumstance
19:30
with those acquired businesses.
19:32
Fortunately, they all utilize the same
19:34
electronic medical records, the same
19:36
vendor.
19:37
So with that vendor,
19:39
>> they stacked the various iterations on
19:43
top of it
19:44
>> versus clarifying the needs and
19:48
streamlining choices and workflow within
19:52
the mechanics of the system. So they
19:55
were able to operate separately yet use
19:58
the same system. The same fields might
20:02
not have been the same. I might have
20:03
documented over here. you might have
20:05
documented over there which is then
20:07
makes reporting and analytics very very
20:09
difficult which was their issue. So now
20:12
we are prioritizing and understanding a
20:15
couple fold one fundamentally from a
20:17
configuration standpoint what is
20:19
important to us as a business and is
20:21
that is reflective into our tool that we
20:25
utilize to to execute our our service
20:27
line. Number one. Number two, um, of the
20:31
what are the core pieces in that EMR
20:33
that we need to rectify,
20:37
uh, build consensus around, standardize,
20:41
and hit those methodically. And so,
20:43
we've been doing that over the last four
20:46
to five months, but have probably
20:48
another year's worth of work to uncouple
20:51
things that perhaps might have been it a
20:53
certain way um, right
20:56
>> to make it more optimal.
20:58
You know, you mentioned about the
20:59
momentum of wins.
21:01
>> Yeah.
21:01
>> There's something to be said about
21:04
speed. Um but you know, speed and
21:07
healthcare.
21:10
>> Yes.
21:10
>> They don't always they don't always mesh
21:12
well.
21:12
>> Yeah.
21:12
>> Uh is that
21:15
>> how do you kind of keep you cool around
21:16
that? Do you get frustrated when things
21:18
aren't moving along as quickly as you'd
21:20
like them to? I mean what gets you kind
21:22
of
21:23
>> when strategy connects clearly to
21:26
frontline actions
21:28
>> meaningful progress happens
21:31
and so having participated in these
21:34
types of transformations in my past I
21:36
have the experience to understand
21:38
there's a period of time when it feels
21:41
like things or appears as if things are
21:44
very shock and and and unstable
21:48
>> that is everyone's internal change
21:50
device trying to zone in and reconcile
21:54
like wh new way to go. We're going to
21:56
have to do things differently. And and
21:59
>> once we provide an atmosphere of
22:02
psychological safety
22:04
>> um and express what accountability
22:07
really means, that's when traction
22:10
begins to occur. And so let me share
22:12
with you what I mean by accountability.
22:14
>> Yeah. Tell give me an example. Give me a
22:15
story. I think that'd be awesome. Yes.
22:17
To me, accountability is not a manager
22:20
or a leader pointing their finger,
22:22
shaking their finger at an associate
22:24
telling them what to do. Matter of fact,
22:27
if any of our managers do that, I smack
22:29
their finger. That's just not what we
22:31
do. Okay.
22:32
>> That's right.
22:33
>> Ability is the associate conversation
22:35
with each other about what is the
22:38
optimal patient experience that we want
22:41
to achieve. And it might be, "Hey,
22:44
associate, we're not doing this
22:47
consistently like we should be. Can I
22:50
help you understand why we're not doing
22:53
things similarly?" Or, "Hey, did you
22:56
realize when you're doing things
22:58
differently, it affects how I do my
23:00
job?"
23:02
If we can't provide an environment where
23:04
our associates can communicate clearly
23:07
and respectfully and have courage to do
23:11
those things, um then we failed as
23:14
leaders. Um that that that's my biggest
23:16
role is to provide an incubator during
23:19
change for that psychological safety.
23:22
Now that doesn't mean correction doesn't
23:24
occur. Correction occurs because
23:27
correction has to occur. But it's not
23:30
because anyone has bad intent or doesn't
23:32
want to change, they forgot, they didn't
23:35
understand, or it wasn't clear enough.
23:37
So, we double back and we figure it out
23:39
thankfully because we have data and
23:41
analytics that look at leading
23:43
indicators and not lagging indicators.
23:45
So, we can course correct pretty
23:47
quickly.
23:48
You know, I love that you brought up
23:49
psychological safety a couple different
23:51
times because I'm familiar with Amy
23:52
Edmonson's work
23:54
>> and I remember sitting in a um she
23:58
lectured senior lecture and she talked
24:00
about look psychological safety doesn't
24:02
is not about being nice.
24:06
>> It's like it's like you can be kind to
24:09
someone and still have really high
24:11
standards.
24:12
>> Of course. Yeah. So, I I think that's
24:16
something to be said about having real
24:18
talk.
24:18
>> Yeah.
24:19
>> About being like, "Hey, we're not we're
24:22
not hitting the mark here."
24:23
>> Yeah.
24:24
>> If if a transformation
24:27
is not going as well, and I'm sure
24:29
you've been a part of some that haven't
24:31
gone well.
24:33
>> Is it usually a strategy problem or is
24:37
it more of a leadership like issue? I
24:42
find it at a clarity issue. Clarity is
24:44
my word for 2026. I know you and I have
24:47
spoken in the past about words and
24:49
meanings and intention around words
24:51
before. Clarity is my word for 2026. And
24:55
I often find when we are going astray,
24:58
we've got to pull that leadership team
25:00
together and clarify our understanding.
25:02
Hey, we thought we were doing this. Do
25:05
we need a change of direction? We need a
25:07
change of direction. We could pivot.
25:09
Nothing wrong with pivoting,
25:11
>> but are we all on the same page? And
25:13
then is how is that echoed down to the
25:16
associate
25:17
>> and really immerse yourself out? We
25:20
encourage our leaders at KO to get out
25:21
in those clinics. You're not going to
25:23
know how this business runs. And unless
25:25
you are out in those clinics watching
25:27
and participating in how we take care of
25:30
patients, that's what's
25:32
>> How many How many clinics are there now?
25:34
>> 67. 67.
25:36
>> Okay.
25:36
>> Yeah.
25:37
>> Yeah. I mean you got to you got to and
25:39
you know what's interesting you know
25:40
because you mentioned about sort of u
25:42
just spread across a wider range.
25:47
>> Do you feel like there's sometimes in
25:48
some of the clinics there's like a micro
25:50
culture inside of these areas and you go
25:53
to one region and there's a micro
25:55
culture but they all kind of roll up to
25:57
the larger culture.
25:59
>> Is that is that all contingent on you
26:01
know that that clinic manager and
26:03
localized leadership?
26:04
>> It is. It very much is. And you you can
26:07
tell a discrepancy on uh some districts
26:11
and territories do some things very very
26:13
well, others do other things very well,
26:16
but getting them all to show their
26:18
strengths at the same time uh is really
26:21
our secret sauce. And so h teaching the
26:25
why. Uh the our big first um educational
26:29
effort uh road show that I did around to
26:32
all of the clinics is for them to
26:34
understand a we have a big job ahead of
26:37
us.
26:38
>> Time is not our friend.
26:40
>> Okay, we have to uh standardize and
26:44
simplify our workflows so that we can
26:47
all easily get on the page. Now I tell
26:50
our team very ca candidly this is going
26:54
to be a long and painful process. I I
26:58
share with them very candidly you should
27:00
ask many of them uh when we started
27:03
coaching and doing our training back in
27:05
November. I said to them, give me until
27:09
August or April rather. Give me to
27:11
April, six months.
27:14
>> It's going to feel some kind of way at
27:17
Cano.
27:18
>> When we reach April, you it's almost
27:21
like a light switch goes off. Uh in my
27:24
experience watching these
27:25
transformations, associates then go, "We
27:28
should always done it this way." or well
27:31
this is a lot simpler than we used to do
27:33
it but it takes time and I share with
27:36
our leaders
27:38
>> please don't get discouraged right
27:40
because this takes time it didn't get
27:43
this way overnight okay so it takes time
27:46
for us to do bite-sized pieces so that
27:49
it makes sense uh to be able to handle
27:52
this change
27:53
>> I mean look transformation it puts
27:56
enormous
27:58
pressure on leaders
28:00
It does.
28:00
>> Uh
28:02
how do you deal with pressure?
28:05
>> Well, I share uh you have to fill your
28:07
own cup. You have to know what brings
28:09
you joy. Uh I I share with our
28:11
associates and I take the uh advice
28:13
myself. Uh this is hard. This is hard
28:16
work that we do. It is consistent and
28:18
it's monotonous.
28:20
>> Figure out what brings you joy. Go see a
28:22
movie. Play with your kids. Play with
28:24
your grandkids. Uh you know, paint. Do
28:27
do take a walk. do some exercise, all of
28:30
the things. But to remember when you're
28:32
going through this change, drink your
28:35
water, get your sleep at night, take
28:37
your vitamins. All of those things are
28:39
important because this will wear on you.
28:41
Change is tough. Um, and you can't have
28:44
associates not feel strong emotionally
28:48
to endure this because the frontline
28:51
folks, boy, they're they're going to
28:53
spin out of control here and there and
28:54
everywhere. Uh, we we have that uh in
28:57
clinics. So, you got to take care of
28:59
yourself. As the uh uh airline industry
29:02
says, put your mask uh on first, right?
29:07
>> What's been Yeah, totally. Oftenimes
29:10
people don't.
29:11
>> Yeah.
29:12
>> Um I'm curious what what's been the
29:14
hardest um leadership moment for you,
29:17
you know, personally during this this
29:20
journey at Kano? Um, I'd probably say in
29:24
every organization I've worked in, the
29:27
toughest journey is saying goodbye to
29:30
well-intentioned associates
29:33
that might not fit the paradigm of where
29:35
we're at today and where we need to go.
29:39
Um, sometimes despite your best training
29:42
and despite your best efforts of
29:44
coaching and counseling, um, sometimes
29:47
either the role has advanced beyond
29:50
somebody's capability or perhaps we're
29:53
going a different direction and that
29:55
might fundamentally be different than
29:56
what the associate thought. Um, and
29:59
having to say no when you've built and
30:02
created valuable personal relationships,
30:04
that's tough.
30:05
>> It's tough for the team.
30:08
necessary but tough.
30:10
>> So you you said a couple of things that
30:12
just I've got a dear friend of mine and
30:14
he uh you know runs a sizable business
30:17
and he when he was sort of sharing he's
30:19
like well look I classify people in
30:20
three buckets. First is
30:24
they don't know their job
30:27
>> or they don't know how to do their job.
30:30
>> He's like and the third is they just
30:31
don't care. It's like the first two are
30:33
fixable.
30:34
>> Yeah.
30:34
>> They're totally fixable. He's like the
30:36
third one is unforgivable,
30:38
you know. So, like you said, it sounds
30:39
like, you know, people are weeding
30:41
themselves out and it doesn't make it
30:42
any easier on their leader because
30:44
that's never an easy conversation
30:46
situation. People's livelihoods are on
30:48
the line. I guess who who helps you get
30:50
through those moments because I feel
30:52
like leadership is a lonely job.
30:54
>> Well, we rely on each other. Uh I'm glad
30:57
to be a part of a leadership team that
30:59
can call each other and be like, "Today
31:00
sucked. Today I had to let two people go
31:03
and I I hate it. I don't like it.
31:06
>> And have that safety in in your friend
31:09
at work to be able to go, you know, I
31:11
hate when I have to do that, too. It
31:12
does suck. And,
31:14
>> you know, but tomorrow, tomorrow's a new
31:16
day. And and we not not as if we don't
31:19
pay homage to what just happened, but
31:22
this is a business and we've got to
31:23
continue to move forward because the
31:25
longer we can turn this around, the
31:27
better we can be for our patients and
31:30
the better we can be a large employer in
31:31
South Florida for a number of healthcare
31:33
workers.
31:35
When do you know that like things have
31:39
been healed?
31:41
>> Turn around.
31:42
>> Healed. Listen, I could tell you when I
31:44
first met the associates out in the
31:46
clinics, when I met those front desk
31:48
people and those medical assistants,
31:50
those referral coordinators and our
31:52
drivers,
31:54
>> I knew KO had something special. I kn I
31:56
knew we could do it. I their
31:58
>> infectious enthusiasm, they they just
32:01
were like, "Tell me the right way. Just
32:03
I can do this. Just we can do this. Just
32:06
quit giving me conflicting information.
32:08
I mean in so many words. My words, not
32:10
their words.
32:11
>> Yeah. Yeah. Yeah. Yeah.
32:12
>> Yeah. I I knew then we could turn this
32:14
around. Again, time is not our friend,
32:17
right? Everyone wants results. When
32:19
you're part of a a larger organization,
32:22
you don't own it yourself. You are uh
32:24
responsible to uh reporting to a larger
32:27
group. And time is not our friend. And
32:30
so we we gotta we got to hustle. um but
32:33
maybe might have had a little more time
32:35
for some jogging and getting that muscle
32:38
memory in shape. We're sprinting. We got
32:40
to sprint. Uh come on. We're going to
32:43
drag people along with us. We got to do
32:45
it.
32:47
>> So, if you could sort of anonymously sit
32:50
in a breakroom in one of the clinics.
32:53
>> Yeah.
32:53
>> For a day.
32:54
>> Yeah.
32:54
>> What What would you want to hear the
32:57
staff saying?
32:59
>> I'd want to hear joy. I'd want to hear
33:03
um development of interpersonal
33:05
relationships. I'd want to hear them
33:07
talk about their kids, their dogs, their
33:09
outside life. Um I'd want to hear them
33:14
being the supportive human and kindness
33:16
that we should extend to everyone.
33:19
That's what I want to hear because in
33:22
that atmosphere
33:23
change and positivity flourishes when
33:27
there's that amount of psychological
33:29
safety that that's I know then there it
33:32
is unstoppable at that point
33:36
>> you know for the majority of this
33:38
conversation this whole transformation
33:39
it's about it's about people.
33:41
>> Oh well
33:42
>> it's it's it's 100% about people.
33:44
>> It is
33:45
>> you know the other stuff usually sorts
33:46
itself out. You're talking about
33:47
aligning systems and technology and
33:49
there's a time and a place for it,
33:51
>> but it sounds like foundationally what
33:53
you're doing is really alignment around
33:55
people
33:56
>> and change is difficult.
33:57
>> It is.
33:58
>> It's really difficult. It's just not
33:59
changing is terminal.
34:01
>> Correct. Unfortunately. That's right.
34:04
That's right.
34:06
That's
34:07
>> um who do you look to for like
34:11
inspiration? You know, are there other
34:13
industries that you look at outside of
34:15
healthcare where you kind of get ideas
34:17
and bring them in? Like talk to me about
34:20
your mental model of thinking and going
34:22
through transformations.
34:24
>> Uh the hospitality industry is probably
34:27
the first place I look to specifically
34:30
about patient uh engagement, patient
34:33
experience, customer service, uh team
34:36
dynamics. uh was fortunate uh to have
34:39
worked at a company called Blumen
34:41
Brands, the parent company of a lot of
34:43
our uh founder-based chains in this
34:46
country. And what I learned from those
34:49
people is that you can have fun at work
34:51
and do meaningful things.
34:54
>> And so hospitality people are great. I
34:58
love their attitude. I love their
34:59
energy. And I think a lot of other
35:02
energies can uh energies industries can
35:05
reap benefits from understanding what
35:07
motivates these people. How how do they
35:09
get so great and positive uh and do hard
35:13
work? I think that's great.
35:15
>> Yeah. I mean you mentioned energy.
35:18
Energy is
35:19
>> and enthusiasm and infusing that
35:23
>> and that's hard to do for a long stretch
35:25
of time by yourself. What I find is that
35:28
when you kind of have this compound
35:30
effect of you can get one and then all
35:33
of a sudden now not two are enthusiastic
35:34
and like and those two remain
35:36
consistent. It's that can change the
35:40
entire feel of a whole organization.
35:44
>> We've had a few folks that have come on
35:47
the show and um Michael uh Craftsman and
35:52
Jeff Elman a company called Urban Bound.
35:54
Shout out to Urban Bound. um they said
35:57
something in one of our conversations
35:58
where they said, you know, culture is
36:00
caught. It's not taught.
36:02
>> It's caught. And that has always
36:04
>> stuck with me.
36:05
>> Yeah.
36:05
>> I'm curious for someone that's coming in
36:07
from the outside initially
36:10
>> and you're trying to re-engineer
36:11
culture,
36:12
>> what do they want? What do you want them
36:14
to catch from you?
36:17
>> Authenticity.
36:19
I think that's the element that people
36:23
bond to initially.
36:26
I I very much am a curious human. Uh
36:30
I've been my whole life a curious human
36:33
and I'm curious about what has gotten
36:35
these people to this point. I respect
36:37
their journey. Um I respect the lessons
36:40
they have learned. They know a lot more
36:42
about what they do than I certainly do.
36:44
Um, and so listening and appreciating
36:47
um, what they do and then sharing and
36:51
trying to share back to them how a maybe
36:55
a change in strategy or a change in
36:57
direction truly supports what they
37:00
already were thinking all along. It's
37:02
just now a different way to reframe it
37:04
or reposition it.
37:06
>> That's right. That's right.
37:09
How can people follow along your story,
37:13
the journey? Give us um a little bit of
37:16
a of a take on how people can stay
37:19
connected and stay in contact and learn
37:21
more about KO and what you guys are
37:23
doing.
37:23
>> Uh well, we are launching new our new
37:27
website. Hold tight. We're get we're
37:29
getting a new one there. Um, I I'm
37:32
always welcome uh folks that have
37:34
questions or or interest about Cano
37:36
Health or valuebased care. Uh, I I love
37:39
talking about operations, as you could
37:41
tell, it's just a part of who I am. Um,
37:44
and so, please feel free at any time to
37:46
reach out to me directly, but but KO's
37:49
going going in big places. We are uh
37:52
fundamentally changing how we operate
37:54
business uh while really focusing on
37:57
that patient. And so I'm excited to be a
38:00
part of it.
38:01
>> That's awesome. Uh just my last question
38:04
is like what what do you see
38:07
like where do you see hope for
38:08
healthcare?
38:10
>> Where do you see it going? Like you know
38:11
if we're looking back or looking ahead
38:13
rather 10 years from now?
38:15
>> Yeah.
38:15
>> And somebody's that's worked with you
38:17
during this I'll call it this period of
38:19
transformation and they're yeah
38:21
>> reflecting on that chapter of their
38:23
career. What what would you hope that
38:25
they say about how you led, you know,
38:28
during this time?
38:31
>> Um,
38:33
what I hope people realize, um,
38:42
change is necessary. Um, a lot of people
38:46
understand valuebased care strategy,
38:49
>> but when you um translate it into daily
38:54
clinic operations and behaviors and
38:57
document document it and explain it in a
39:00
simple uh and clear way, um, every
39:06
associate then becomes their own
39:08
ambassador for the type of culture and
39:10
care that we're doing. So I think it's
39:13
leadership's responsibility to make this
39:15
as clear and simple as possible so that
39:18
they can move this message forward uh in
39:22
alignment to what we're doing that
39:24
that's as closely as you can get the
39:27
message to the front line is what I hope
39:29
for health care uh happens long term.
39:34
>> I think first off this has been an
39:36
amazing discussion. got there was uh
39:39
several writer downers. I would like to
39:41
call several.
39:43
>> And I think one of the things that stood
39:45
out to me during this conversation was
39:47
>> um how different
39:50
>> transformation looks when you're inside
39:51
of it.
39:52
>> I think there's a there's a perception
39:54
from the outside of what it is. And um I
39:56
think from the outside you could say
39:57
it's it's strategy. It's slides. It's
40:01
like hey we're doing these memos and
40:02
announcement. Uh and I said it just you
40:05
know momentarily just earlier it's from
40:08
the inside it's really all about people
40:10
>> and it always has been about people and
40:13
it's about culture. It's about having a
40:14
cadence of accountability and
40:17
>> a thousand of these small decisions made
40:19
every single day by teams.
40:21
>> That's right. you know, trying to move
40:22
in the same direction and that creates
40:24
this flywheel effect
40:25
>> and um yeah, this has been a really
40:28
meaningful discussion. So, if if you're
40:31
listening to this and you found this
40:32
conversation helpful,
40:34
>> um would you mind sharing it? Honestly,
40:36
sharing it with your network, sharing it
40:38
with uh people that you care about that
40:39
are allstar operators. And if there is a
40:42
topic that you would like for us to
40:44
explore or even a leader that you want
40:47
to hear from, feel free to drop me a
40:50
note, leave a comment. We do read them.
40:51
We pay attention to them. So remember,
40:53
this this is a platform that's that's
40:55
it's not just content. Like this is
40:57
about community. And if we want to kind
41:00
of a rising tide raises all ships, like
41:03
we all got to work together. So thank
41:05
you for listening. Keep building with
41:07
purpose. And we will see you next time.
41:10
by the Advancing Health Cotivation Show.