As a service to readers of Electronic Health Reporter I decided to ask its readers which sessions they most wanted to see at HIMSS13. For the record, I have attended HIMSS more than once so I understand how overwhelming it can be. However, I also understand that there are plenty of great resources available to those in attendance regarding which events to attend. Certainly, what I offer here is by no means authoritative nor is it objective.
Thus, I leave it up to you to decide what you are going to do while in New Orleans. All I can say is thanks for reading. I hope this helps.
One of the must-attend sessions at HIMSS13 will be the Interoperability Showcase, held at ongoing times between March 4 through6. During this showcase, attendees will have the opportunity to see how their personal health data moves securely from system to system. For Nextrials, it’s an opportunity to demonstrate how its clinical trial data and management platform, Prism, intersects with platforms used in hospitals and clinics. This integration can not only improve patient care — it can give patients better access to participation in clinical trials, and help clinics and hospitals contribute to the advancement of medicine.
Roundtable 305 – Proprietary vs. Third-party vs. Standards-based Device Integration: An Update, Tuesday, March 5 at 2:15 p.m., Room 293. Joe Kiani, the chairman of the Masimo Foundation for Ethics, Innovation, and Competition in Healthcare and CEO of Masimo, and I’m alarmed that more than 200,000 patients die each year of preventable deaths in U.S. hospitals. At the recent Patient Safety, Science & Technology Summit, Kiani and friend Bill Clinton issued a goal for zero preventable deaths by 2020. Eight other medical device companies – including GE Healthcare, Drager, Sonosite and Zoll – also pledge to make their data available through open architecture systems. Many other hospitals since have followed with similar commitments. The roundtable’s objectives: “Discuss the advancements and achievements in medical device integration over the last year.” While many are talking about device interoperability and patient safety, the Masimo Foundation for Ethics, Innovation, and Competition in Healthcare are actually doing something about it.
Cheryl Bailey, CNO/VP of Patient Care Services at Cullman Regional, will share her firsthand accounts of using mobile health to improve patient care and show conference-goers how the hospital reduced re-admissions by 15 percent and increased HCAHPS scores by more than 60 percent within six months using Good to Go, a recently launched mobile health platform by ExperiaHealth. Bailey will be presenting at the Nursing Informatics Symposium where she is presenting: “Improving Patient Satisfaction & Reducing Re-admissions with Better Discharge Communication.”
Accenture’s Manuel Lowenhaupt, managing director of U.S. clinical services, Monday, March 4 at 9:45a.m. “Trending Health: Using Information Technology to Deliver Clinical Outcomes.” By implementing a new clinical operating model and engaging clinicians in transformational change, Trinity Health standardized care and improved quality and safety outcomes by using information technology.
Executive Breakfast Panel: Go Big (Data) or Go Home, Tuesday, March 5 at 7 a.m., Hilton Riverside. Three CEOs discuss how the marriage of medical and pharmacy data paired with intelligent analytics will reveal remarkable insights available to all from the cloud. Speak is Atigeo CEO Michael Sandoval.
Emdeon Speaking Session: The Future of Coding is NOW: Maximizing Coding Efficiency and Accuracy Using Big Data and Analytics, Tuesday, March 5 at 11 a.m. Atigeo Director of product management, Manjula Iyer.
“Beyond the Device: A Comprehensive Mobility Strategy” on March 5, as a kick start to addressing mobility needs as they relate to business strategy, security, and infrastructure, beyond the device.
“Leveraging Smartphones to Simplify Communication Across Multiple Systems” will be helpful for organizations planning to implement or already using smartphones to communicate.
Policy and monitoring play critical roles in your information management; you need to develop a governance strategy to drive consistency and adherence to your adopted standards. Governance is essential to ensure that the right decisions and actions in the management of healthcare data are continuously taken. “Healthcare Information Governance: Establishing the Framework for Enterprise Management of Information” on March 6.
Former President Bill Clinton’s keynote on Wednesday, March 6.
“ICD-10 and Administrative Simplification” session (Education Sessions 131) will address the role of ICD-10 in administrative simplification, and the overall objective to lower costs, create uniform electronic standards, and streamline exchanges between health care providers and payers.
Other sessions of note:
#4: The Ins and Outs of Meaningful Use: Understanding Stage 1 Changes & Stage 2 Requirements, featuring Robert Anthony, Policy Analyst, CMS, March 4, 2013, 9:45 – 10:45 a.m., New Orleans Theater C
#23: Stage 1: EHR Incentive Programs, March 4, 2013, 11 a.m. – noon, New Orleans Theater C
#62: Stage 2: EHR Incentive Programs, March 5, 2013, 9:45 – 10:45 a.m., New Orleans Theater C
#81: CMS Town Hall: CMS eHealth: Building the Future, March 5, 2013, 1 – 2 p.m., New Orleans Theater C
#131: ICD-10 and Administrative Simplification, March 6, 2013, 8:30 – 9:30 a.m., Room 294
#138: Views from the Administrator, featuring Marilyn Tavenner, Acting Administrator, Chief Operating Officer, CMS, March 6, 2013, 9:45 – 10:45 a.m., New Orleans Theater C
#178: CMS Quality Measurement, March 7, 2013, 11:15 a.m. – 12:15 p.m., New Orleans Theater C
There continues to be a great deal of talk about the need to marketing a medical practice to patients as a way to engage patients and build a loyal patient following.
However, the strategies that practice leaders can take to engage those they serve seems somewhat elusive.
With Meaningful use reform continuing to bear down and patient engagement ever more important because if it, I decided to ask a few readers of Electronic Health Reporter what tactics they would take to encourage practices to market their practices and, ultimately, engage their patients.
Here are a couple of the responses I received:
Susan M. Tellem, RN, BSN
Physicians need to market their practices using free and easily accessible practices. For example:
Blogging – Content is king. “Tell patients about your new ‘whatever’ and add tags to the post that expands its potential reach. Ask for comments. Re-purpose the content on Facebook, Twitter, you practice website and you have reached your universe.”
Use Facebook – 51 percent of the world is on Facebook. “You can share photos, videos, patient before and afters, conduct surveys, ask questions, hold contests (through a third-party platform) and ‘promote’ the posts. That means for a very small amount of money, you can reach beyond the people who ‘like’ your page to their friends who are like minded and gain new followers and more patients.”
Use Twitter – It’s fast and easy, and you can say what you want in 140 characters and even post photos!
Create email newsletter – “You have an entire email database in your office that is going to waste. Send out a newsletter about what you have to offer. Use it to conduct surveys, promote discounts, special events and new procedures.”
Vicki Radner, MD
Likewise, Radner says. “Get social! Social media can and should be part of each physicians’ marketing plan. Create a blog post, Facebook entry and a tweet that describes your practice and its technology in a client-centered way. For example, ‘Want more control over your medical story? Sign up for the patient portal.’”
Clearly, social is king. I’m not surprised. Each of the responses I received were similar in nature. I would recommend the same approaches to anyone who asked because they are effective and because they are free.
In the current market, we go where those we want to serve are and we capture their attention by informing them, educating them and engaging them. Social media does just that and with a little premeditated thought, a marketing campaign can be quickly and easily implemented.
Like all things done for the first time, there may be some excitement and some fear. This is perfectly normal. Practice and repetition will help, ad in the beginning, while you are building your campaign you’ll be able to practice.
Something else to consider when creating a marketing campaign for a practice is to find people who are conducting successful campaigns and start to follow their example. There are real leaders already doing great things as far as educating and engaging patients. Do a little research and find people you can relate to then use their strategies to build your own program.
I’d love to hear more strategies for marketing a practice to patients. If you feel like sharing yours, feel free to leave a comment below.
In the past decade, academics and industry experts have published conflicting reports on whether electronic health records (EHRs) actually save money. Recent studies based on large, historical data from diverse providers suggest that EHRs haven[i]’t decreased costs[ii][iii] – contrast this with cost benefit analyses published back in 2003 that predicted EHRs would save around $15,000 to $20,000 per primary care physician per year[iv][v]. In addition, multiple vendors, academics and industry experts have published positive case studies on how EHR provides a positive return on investment or saves money in areas such as billing and staffing costs.
So why the divergence? Are providers simply not achieving what we expected in 2003? Are the positive case studies overly selective? Is it a case of what’s true for some is not true for all?
EHRs actually enable more productivity and satisfy more demand, and this is what drives cost. For providers, this also means driving up revenues.
Supply and Demand
One reason healthcare costs have not uniformly decreased is that more (efficient) supply from EHRs leads to more demand.
Firstly, consider the Jevons Paradox: energy efficiency leads to greater consumption (e.g. as air conditioning becomes more efficient and affordable, more air conditioners are purchased.) Taking a healthcare analogy, data center capacity has grown exponentially and EHR functionality has improved in recent years. In response, providers are storing larger amounts of detailed patient data and accessing greater capabilities. For example, providers are integrating IT and medical devices for real time patient data monitoring, storage and beyond. Additionally, a 2012 study supports this theory in that physicians ordered 40 percent to 70 percent more radiology exams with EHRs than with paper records. The efficiency and capability of EHRs (supply) have driven up the demand.
Secondly, I’ll paraphrase Parkinson’s Law: work expands to fill the time available. Demand for services in (public) healthcare will always outstrip the supply. This is because there is a backlog of patients waiting for currently available services and once this backlog is cleared, expectations of what should be provided will increase. It is therefore important to recognize that current health care reforms may not automatically decrease costs with EMRs in place, as demand will then increase too.
Increased demand means increased cost.
Productivity
So if cost doesn’t uniformly decrease with EHRs, does anything improve? Productivity does. A 2009 Wisconsin Medical Journal Study[vi] found that physician productivity increased about 20 percent and remained at that sustained level of productivity following EHR implementation. This means that more patients were seen on a given day. Not bad, considering the average wait time to see a physician in the U.S. is 20 days.
Increased productivity, however, leads to increased costs.
Payers vs. Providers
Another way to explain the divergence may lie in who we’re actually talking about. Do we mean payers like Medicaid/Medicare or providers like primary care physicians or hospitals? Studies often reference cost but fail to discuss revenue increases that an EHR system delivers to providers. Seeing more patients means more revenue to providers. In addition, providers with integrated EHR and billing benefit by eliminating billing errors and enabling better revenue protection. Payers, however, don’t share these financial benefits as more procedures means their costs are rising. Indeed, payers may not realize the full cost savings of EHR until providers move away from pay-per-procedure to quality based payments. Quality based payments of course, are next to impossible without the enabling reporting capabilities of EHR systems.
So when we talk about the cost of EHR systems, it’s important to distinguish who we’re talking about. In addition, when comparing pre- and post-EHR situations, instead of simply asking: “What’s the cost?” we should also be asking “What do we get for this cost?”
David Farrell is an IT strategy specialist at PA Consulting Group, focusing on project management and strategy for healthcare providers. He has worked with accountable care organizations and county-run hospitals on both U.S. coasts, assisting clients in building business cases, managing project benefits and forecasting the long term infrastructure impact of EHR.
[iii] Electronic Medical Records: Lessons from Small Physician’s Practices, iHealth Reports, 2003 http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/E/PDF%20EMRLessonsSmallPhyscianPractices.pdf
Guest post by Steven Jackson, chief operating officer, ExperiaHealth.
Every patient story is unique with engaging plots, complicated characters, emotional twists and turns, but more often than not there is a recurring theme. Somewhere in the healthcare narrative there are gaps in communication. In fact, according to the Joint Commission, an estimated 80 percent of medical errors are caused by breakdowns in communication.
Whether the disconnect is between internal and external care teams, a patient and a nurse, or in my case, a family member and a physician, any missed or misunderstood care directives can leave the patient and the health system vulnerable.
I was certainly feeling vulnerable when I arrived home after taking my son to the doctor and met my wife immediately at the door asking, “What did the doctor say?” As I recollected the physician visit and details of my dialogue with the doctor, I quickly realized I wouldn’t have all the answers she wanted to hear. I remembered most of the instructions, which I paraphrased quite succinctly. However, my wife, who is a very caring mother with a fondness for details, wanted to know exactly what the doctor said.
A similar story was told by a colleague. He described how his father was discharged from a local hospital after suffering a heart attack. At discharge, while tired and stressed from being in the hospital, his father and mother were given 30 minutes of clinical, complex information detailing his post-hospital care and medication needs. Later, when the couple tried recalling the discharge instructions to relay to my colleague, they each remembered the directives very differently – a misunderstanding that put his father at risk for an adverse event.
The CDC reports that nine out 10 adults who receive medical advice find it incomprehensible and do not know what to do to take care of themselves – creating a revolving door for institutions.
Stats and stories like these, as well as looming penalties for performance, are driving the development of innovative healthcare applications and patient portals that improve patient and family engagement, understanding and compliance of discharge instructions and other care directives. These same technologies are also improving patient safety and satisfaction, ultimately driving HCAHPS scores up and avoidable re-admissions down.
Cullman Regional Medical Center in Alabama recently reported a 63 percent increase in HCAPHS scores for questions related to discharge communication and a 15 percent reduction in re-admissions after re-engineering its discharge process using the Good to Go solution by ExperiaHealth. Good to Go blends multimedia technology with healthcare best practices to engage caregivers, patients and families in the care plan during and after a hospital stay.
During hospital discharge, Cullman Regional caregivers use smart devices and the HIPAA/HITECH compliant Good to Go application running on the deviceto capture “live” care instructions at the patient’s bedside. After the discharge session, the nurse asks the patient to listen to the captured communication, and a dialog between the caregiver and patient occurs to clarify any confusion. This conversation is also captured by the application, adapting discharge instructions in the patient’s own words and breaking down health literacy barriers. The recorded audio instructions are then made available 24/7 for the patient, family or a subsequent caregiver to listen to and review from any landline phone, mobile device or computer using unique login credentials.
In addition to audio instructions, caregivers use the solution to attach instructional videos, images and documents and post those educational resources on the patient’s personal Good to Go website to improve compliance and reduce risks. For example, if a patient has congestive heart failure, a caregiver can use the solutionto capture images of baseline swelling in the patient’s leg to help him or her monitor and manage their condition. Follow-up appointments and medication lists can also be managed in one location via the patient’s personalized Good to Go website.
With access to live care instructions and multimedia education, a couple can leave the hospital feeling secure about the discharge plan, and a father can be confident replying to an inquiry by his wife after their son’s physician visit. Hospital caregivers can also feel better because they can use the solution’s monitoring tool tracks if and when patients access their instructions, allowing Cullman Regional to gauge compliance and identify potential risks for bounce backs. This valuable information also plays a vital role in performance analytics and patient follow-up call management available via the Good to Go solution, which helps unify quality, safety and satisfaction initiatives.
By taking advantage of technology already in use and at the fingertips of caregivers, patients and families, hospitals like Cullman Regional are creating impressive last impressions and extending care beyond the hospital walls. And while technology cannot replace human interaction, it can certainly help enhance the exchange and create market differentiation as well as lasting loyalty – especially for those patients whose journeys were safer because there were no communication gaps along the way.
Healthcare stories with seamless transitions are the ones with the best endings.
Guest post by Jordan Battani, managing director of CSC’s Global Institute for Emerging Healthcare Practices.
There’s a sea change underway in healthcare in the United States, an effort that’s focused on addressing the challenge to improve healthcare quality and outcomes for patients and the population at large, while at the same time controlling and reducing healthcare cost inflation. It’s no small task, and there is no shortage of opinions about how best to make the changes that will be required.
At the core of the discussions, however, is a general understanding that a fundamental change in the traditional orientation to healthcare, and healthcare financing is required. Episode focused, fee-for-service medicine has led to a systematic bias against coordination and collaboration.
The need for change is particularly acute in a world that is increasingly defined not by acute episodes of illness and injury, but by the constant demands placed by the burden of managing the impact of chronic disease. Transformation requires an expansion from the traditional focus on patients and episodes to include populations and the entire care journey experience from wellness, through illness and back again.
In short, an expansion:
From the needs of the patient to include the needs of the population
From the support of the individual provider at the point of care to include all providers across the spectrum of care
From the activities in a particular care setting to include the activities in the entire continuum of care
From the discrete episode of illness and care to include the activities that promote wellness and prevent illness and recurrence
From the treatment of chronic disease to include its management
From islands of automation to integrated information access across the entire continuum of care
The core competency in this new orientation is the ability to practice coordinated care and to manage the financial arrangements that support it. Medicare, and many commercial health plans, refer to this competency as “accountable care.”
Practicing in this new environment requires the ability to expand care beyond the traditional boundaries of a linear provider to patient interaction during a discrete episode of acute illness or injury. In a healthcare landscape characterized by long-term chronic disease, healthcare must include the patient’s lifestyle, environment and long-term personal health risk factors in care planning, delivery and management.
Delivering that care plan cost effectively using complex clinical technologies and innovations requires coordinating and integrating the activities and information from multiple care settings and many different providers. Financing a coordinated care delivery system requires expanding payment for activities beyond fees for the services rendered for a discrete episode to include compensation for the effort and the value delivered from collaboration, coordination and integration across the continuum of settings and providers.
Not surprisingly, the tools and capabilities required for practicing in the era of coordinated care are more complex and far reaching than those required in the traditional episode-based fee-for-service model.
Successful coordinated care requires:
Clinical information and point-of-care automation to ensure that information about the patient’s entire experience of health and healthcare is available at every patient encounter – and that decision support is available to the provider who is engaged in care plan activities and adjusting the care plan based on outcomes.
Data management and integration to ensure that the healthcare data assets that are required for practicing coordinated care are rationalized, useful and consumable at all the points in the care continuum.
Health information exchange that delivers useful and consumable information across the continuum of care and enables the participation of care providers in multiple disparate care settings, systems and locations.
Patient engagement strategies and technologies bringing the patient into the care planning, delivery and management process, enabling them to act on their own behalf and to use their energies and insights to promote improved outcomes, adherence and quality care.
Care management and coordination process automation informed by information assets generated across the care continuum, supports the work of care providers in disparate locations, settings and organizations on behalf of the patient.
Performance management systems and strategies for clinical, financial and administrative processes that ensure that goals of quality, outcomes, patient safety and financial sustainability are achieved and exceeded.
In an environment characterized by multiple, conflicting and interlocking mandates and transformation requirements it’s a difficult task to take on a new set of organizational and technology strategies, and tempting to focus instead on meeting the deadlines and details of the individual programs and requirements.
There is no single road map to success and the timeline, priorities and projects for each organization will vary based on their circumstances. The only certainty is that under the current set of clinical quality, patient safety and financial pressures and requirements, organizations that fail to develop and demonstrate coordinated care capability risk long-term clinical and financial failure.
Jordan Battani is the managing director for CSC’s Global Institute for Emerging Healthcare Practices, the applied research arm of CSC’s Healthcare Group. Battani has a strong professional track record in leveraging technology solutions to deliver business value.
Guest post by John Sung Kim, CEO of DoctorBase.com.
As been reported here and many other industry publications – patient use of mobile health apps is skyrocketing. So why can’t we email our doctors yet?
Early statistics
Since 2010, vendors of patient communications applications have seen a gradual uptick in healthcare providers who accept email from patients, but they are often for special circumstances and providers generally do not make their email address available to their entire patient tablet. When asked in an informal survey of 500 small to medium sized practices (SMB defined here as one to seven doctors in a single location) the top three reasons for not accepting patient email in 2011 were:
1) Lack of reimbursement
2) Potential to divest the practice of traditional in-office revenue
3) Security issues
In the same survey when asked how many doctors offered their email address to their patients the respondents indicated –
1) All my patients – less than 3%
2) In special circumstances – more than 22%
3) Rarely – more than 74%
4) If they were paid for their email response time – 46% said they would accept email from their general patient tablet if the reimbursement came direct from patients and bypassed payer paperwork.
That same survey in 2012 yielded as the top three reasons for not accepting patient email —
1) Lack of reimbursement
2) Potential to divest the practice of traditional in-office revenue
3) Security issues
When asked how many offered their email address to their patients the respondents indicated –
1) All my patients – less than 6%
2) In special circumstances – more than 37%
3) Rarely – more than 56%
4) If they were paid for their email time – 66% said they would accept email from their general patient tablet if the reimbursement came direct from patients and bypassed payer paperwork.
Findings
The lack of reimbursed time continues to be the primary concern for providers as they wrestle with the increasingly mobile and digital world of communications, with divesture of traditional in-office revenues as a close second. One thing not mentioned in the stats above was that “HIPAA compliance and security concerns” was a distant third behind economic factors in both annual surveys.
While we saw the explosion of smartphone sales from 2011 to 2012, the number of doctors offering their email address to their general patient tablet grew very little (about 3%) while the biggest gain was in doctors who offered their email in “special circumstances.”
From this sampling we can potentially infer that economic forces – not security – is the primary driver in doctors offering their patients email services. And who can blame them – would we work for free?
Sampling limitations
Most of those surveyed were small to medium sized (SMB) group practices that ranged from specialties such as OB/GYN to Internal Medicine. As such, the statistical significance is more relevant to this segment of the provider market. As well, the patient communications industry is in its infancy and coming regulatory changes with HIPAA Omnibus 2013 and Meaningful Use Stage 2 may affect provider behavior in the next 24 months. Surveys conducted using Surveymonkey.
The inventor of the first Cloud-based contact center and founder of Five9.com, John Sung Kim is the current CEO of DoctorBase.com – the leading provider of mSaaS (Mobile Software as a Service) that allows healthcare providers to easily monetize mobile communications with patients.
A tremendously interesting and probably important experiment has been taking place at the University of California, Irvine since 2010.
Since then, the university has been using iPads to improve student learning and the program is successful. Specifically, the med students that are part of the program that is using the mobile devices are getting better results, developing apps for the technology and even working to improve healthcare.
Named the “iMedEd Initiative,” all of the students enrolled in the college’s med school received iPads with their textbooks already loaded on them. According to the report, as featured on TabTimes, “The iPads offered access to lecture podcasts, patient records and recorded data from digital stethoscopes, bedside diagnostic ultrasound units and a variety of other medical devices.’”
“UC Irvine reports that students taking participating in the program scored on average 23 percent higher on their exams than previous UC Irvine medical school classes, but such has been the success of the roll-out that some students are even hoping to utilize the iPad to improve healthcare across the globe,” the site reported.
One group of medical students at the school formed the “iMedEd Innovators Group” to discuss which new technologies that could be used at the medical school, and even partnered with the Donald Bren School of Information & Computer Sciences to hold a “Med AppJam” session in the aim of building iPad apps specifically for healthcare, resulting in 19 specialized iPad healthcare apps being developed by more than 100 participants at the school in just 10 days.
Other students are now looking at how pairing the iPad with a portable ultrasound unit could improve healthcare and medical education in other countries where the technology is not so readily available.
The results of this program, however, are not unique. In fact, the site Mashable recently reported that students who use touch technology, like an iPad, in the school setting advanced more quickly than those who did not use them and pair this with the fact that there are more than 2 million tablets being used in schools – a number that will increase dramatically as the technology becomes more accessible and affordable.
Clearly, it’s time for more of us to embrace the technology like they have at UC Irvine. It’s certainly a valuable tool inside the classroom, and as many of you know, it’s a valuable solution in the practice setting as well.
As technology moves, so do we and the world as we know it. With the benefits we’re seeing here, it’s clear to see that we’ve only just begun.
When my wife forwarded me the following heartwarming link to a tender, but powerful presentation about leadership and teamwork, and later in the day I came across a piece titled “5 Facts that Top Teams Learn From Geese,” I figured it was some sort of sign so thought I’d share with the readers of Electronic Health Reporter.
The link to the presentation is here, and it’s worth a look. Even though it’s a slide show, I understand if you don’t have the time or the desire to follow a link. As such, I’ve included the piece, from HR Pulse (thanks to writer Charles Lubbe for compiling this post, his in full below).
Is it about health IT? No. But, it’s about leadership and taking common sense steps to help improve your teams and your organizations. These are simple tips that apply to every business and should be embraced by every leader — and, who doesn’t like an animal story?
Fact #1: As each bird flaps its wings, it creates a “current” that lifts the bird following it. By flying in a V formation, the whole flock adds 71 percent more flying range than if one bird flew alone.
Lesson learned: People who share a common direction and sense of community can get where they are going quicker and easier if they travel on the strength of one another. The clearer the vision or certainty of a team, the more courage they demonstrate in achieving their results and the less they concern themselves with individual effort.
Fact #2: Whenever a goose falls out of formation, it suddenly feels the drag and resistance of trying to fly alone and quickly gets back into formation to take advantage of the lifting power of the bird immediately in front of it.
Lesson learned: If we have as much sense as geese, we will stay in formation with those who are ahead of where we want to go and be willing to accept their help and give ours to others. Top teams encourage discipline and look forward to opportunities for positive criticism, ensuring that the entire team reaps the reward.
Fact #3: When the lead goose gets tired, it rotates back into the formation and another goose flies at the point position.
Lesson learned: It pays to take turns doing the hard tasks and sharing leadership. Teams that are focused on their vision understand situational leadership and don’t need to be micro managed.
Fact #4: The geese in formation honk from behind to encourage those up front to keep up their speed.
Lesson learned: We need to make sure our “honking” from behind is encouraging, and not something else. Teams that place a value on regular check in and feedback hold their shape.
Fact #5: When a goose gets sick, is wounded or shot down, two geese drop out of formation and follow it down to help and protect it. They stay with it until it is able to fly again, or dies. They then launch out on their own, with another formation, or they catch up with their flock.
Lesson learned: If we have as much sense as geese do, we too, will stand by each other in difficult times as well as when we are strong.
I’d love to know your thoughts and if you think the previous points are worth the read, and more importantly, if they are worth implementing.
