September 27, 2012 § Leave a comment
A nurse, in an Ohio Hospital, accidentally discarded a kidney that was awaiting a transplant and had been provided by a living donor. The nurse had been on break, had been replaced by a different nurse, and was therefore unaware the kidney was submerged in an ice filled sludge. She purposely disposed of the contents into a disposal hopper thinking the kidney was still in the operating room because “that’s what usually happens.”
The hospital suspended the two nurses after the incident; one was later fired, and the other resigned. Furthermore, a surgeon was stripped of his title as director of some surgical services. What a tragedy on many levels.
The nurse who discarded the kidney had walked past a doctor and other nurses carrying the container. Should someone have noticed? Should someone have said something? How was she to know? She was fired! Does that make sense?
In the light of our typical industrial age model of management that focuses on holding people accountable for results it makes total sense. Why? Because, someone must be at fault! That’s the philosophy with which we were raised. That’s the philosophy that dominates our schools and our organizations, i.e. someone must be held accountable for the results.
In 1950 Dr. W. Edwards Deming explained his philosophy of systems thinking to the Japanese leadership. The Japanese proceeded to implement Deming’s philosophy of Profound Knowledge. By the late 1960’s Japan was dominating the manufacturing of electronics including televisions, radios, and stereos. By the end of the 1970’s the gap in quality between Japan and the USA was reaching a crisis. The philosophy of focusing on the improvement of the system was winning the competitive edge. Costs were lower and quality was higher. The age of blaming people for mistakes was dead. At least it was in Japan. Unfortunately it is still very much alive today in America.
Today we still tend to blame people for mistakes. Unfortunately, according to Dr. Deming’s philosophy probably 94% of all mistakes come from the system and processes and only 6% from the people. There were probably a dozen or more hand-offs that occurred in that operating room between the surgery preparation time and the time the nurse returned from her break. Each of those hand-offs was an opportunity to have good quality or poor quality. Information about the location of the kidney was a hand-off. What to do with the slush was a hand-off. Each of those hand-offs was a process that could be improved. To blame her does nothing to improve those hand-offs and therefore, nothing to prevent a reoccurrence.
Today our children are failing to learn reading and math skills at their respective grade levels, yet we continue to embrace standardized testing and performance evaluations for teachers. We continue to attempt to improve the individuals by judging, grading, blaming, and firing them. We fail to fully recognize that our system of grading students destroys their passion for learning and steals their willingness to take responsibility for their own learning progress. We continue with the same flawed processes and hand-offs that make up the entire dysfunctional system. We blame and then expect different results.
If we fired every nurse and every teacher in the country and replaced them all with highly trained substitutes would we improve anything? Couldn’t we expect that the same number of students would fail and the same number of kidneys would be discarded? Unless we embrace a systems view of the world and stop blaming we will continue to see these tragedies. If blame is alive, improvement and systems thinking will take a back seat.
September 22, 2012 § Leave a comment
Employee engagement levels have the attention of many C-Suite executives. The latest research by Towers Watson (2012), a human resources consulting firm, confirms the wide acknowledgement that employee engagement is a critical element for high levels of financial and operational results. Any executive who doesn’t pay attention to employee engagement might be accused incompetence and/or malpractice. This is especially true in light of the Tower Watson research which shows the average percentage of employees who are highly engaged comes in at only 35%. We need improvement. Here are three good ideas that will help us.
There are multiple models about how to achieve engagement. Many of them are very similar. The one outlined here might make some uncomfortable because it requires employees to be trusted. That need for trust will make some executives nervous. It will seem too risky to some.
For purposes of simplicity I name these ideas the Triple “A” Engagement Model
The first “A” is for Anxiety. Anxiety is often considered a negative force (emotion) that causes stress and stagnation. Positive anxiety, on the other hand, is the urgent emotional need to act before an opportunity is lost. Positive anxiety is useful for learning and development. A balance between the challenge a person experiences doing a task and the skills he/she uses to perform those tasks will generate positive anxiety. This positive anxiety is required for engagement and necessary for learning.
Unfortunately feeling comfortable (or satisfaction) usually does not create development. Neither does negative stress. Unfortunately the stress most employees feel today is negative and caused by pressure to perform using threats or bribes. Pay for performance policies and/or performance appraisal ratings are substituted for the required positive stress and results in a reduction in engagement. Positive anxiety is intrinsic (internal), self-imposed, and naturally healthy.
People can use positive anxiety to make positive change. A great example of positive anxiety in practice is seen in the process of learning “speed reading.” Many “speed reading” teaching techniques require the student to push themselves to reading speeds 5 or even 10 times faster than their normal pace. This “push” creates positive anxiety and trains the eyes and the brain to adapt to a much higher speed. The push creates positive change even though during this push causes an experience of anxiety.
The second “A” is for Autonomy. Autonomy is the freedom to determine actions and decisions. Autonomy is a higher standard than just empowerment. Empowerment is the act of giving power to someone. Empowerment suggests there must be an authorization by management to perform a task or responsibility. Autonomy is about freedom for self-government or self-management. With autonomy the employee decides when and how to act to solve a problem. No authorization by management is necessary.
Autonomy is best provided when employees understand the principles under which they can make decisions on their own. This doesn’t mean specific processes and/or detailed steps are missing. Toyota, for example, has four principles employees must follow to work toward improvement in their plants.
Principle 1 states that all hand-offs, between internal suppliers and internal customers, must have clear steps in a specific sequence and these steps are defined by the customer. The second principle states that every supplier-to-customer hand-off is direct and unambiguous. The third principle demands that the pathway for these hand-offs must be simple and direct. The forth principle states that improvements can be made by anyone and at any time as long as those changes are done using the scientific method. This final principle is the most influential for allowing employees to demonstrate autonomy. In these principles the decisions are dependent upon what employees want and not on decisions from above.
The final “A” is for Advancement. Employees need to see how their efforts truly make a difference. This advancement must not just be progress for the sake of progress. It must be in context of a higher purpose and vision. In order for advancement to happen the progress seen by employees must be toward a vision and aligned with the values of the organization.
Three elements are needed to achieve advancement. First, we must understand the aim of our actions. The aim is also often known as the mission or purpose. We must be able to answer the question, “Why are we taking this action? What’s the point?” For example, if our task is to clean a table we must know for what purpose the table will be used. Is it a table to clean fish or to do open heart surgery? The purpose will determine the method we decide to use for our task.
Secondly, we must have feedback from our tasks and that feedback should be immediate (or as close to immediate as possible) and frequent. Without immediate and frequent feedback we will lose motivation. The delay between action and information must be as short as possible to optimize engagement and minimize frustration. The other day I planted grass seed. Although I know it takes about 10 days to germinate and to show little sprouts, every day after planting I watered the spots and looked for evidence of progress. It was frustrating for those first 10 days with no feedback.
Finally, we must see progress toward achieving our aim. Without progress frustration will emerge and frustration will damage engagement. The combination of taking action toward a clear compelling purpose, receiving feedback, and seeing credible progress will create the experience of advancement.
The Triple “A” experience generates powerful employee engagement. The three A’s create a recipe for success and will help executive to achieve the organization results they seek. All three elements work as a system. They must all be present. Too often leaders leave out one or more of these A’s. When they do engagement and results suffer.
August 6, 2012 § Leave a comment
According to Gallup and some prominent human resource consulting firms, employee engagement scores continue to hover at inadequate levels. I believe our misunderstanding and misuse of the phase “employee empowerment” exemplifies why these results remain at unacceptable levels.
The dictionary definition of empowerment is “to give power or authority.” If we accept this definition we must assume that managers and/or leaders in organizations own the power and they willingly give it to employees. This suggests that leaders retain the power they just lend it out to employees and this means they can take it away anytime they wish. What impression does that create? For me it is arrogant and controlling. Arrogance and control damage employee engagement. This is why empowerment is inadequate if we want to solve this engagement dilemma and raise the scores.
Our Declaration of Independence clarifies the natural law rights (endowed by the creator) of life, liberty, and the pursuit of happiness. Don’t those same rights apply to all employees? Aren’t they guaranteed by the creator and not granted by the leaders? Why are we not living the same principles in our organizations that we espouse for our society? If we did, wouldn’t that increase employee engagement? Wouldn’t that acknowledgement shift a leader’s job from oversight (the granting rights) to support (the protection of natural rights)? The reason empowerment is inadequate to raise engagement scores is because the concept of empowerment is not aligned with natural law. I believe employees (just like citizens) naturally have the right to life, liberty (freedom and autonomy), and the pursuit of happiness (pride at work). Leaders should not be in a position to grant these. They should instead realize their responsibility to protect them.
My step son and his 7 year old daughter went to the lake for a swim. A raft is situated approximately 50 yards off shore and he and his daughter decided to swim out to it for a relaxing sun bathe. The life guard stopped them because my step son was swimming out to the raft with his daughter clinging to his neck. The life guard explained that, for safety reasons, policy stated that everyone must be able to swim to the raft unassisted. The life guard asked them to go back to shore.
My granddaughter was very upset and started to cry. She wanted to go to the raft but she was not sure she could swim on her own. She thought for a moment and told her dad, “I think I can swim it. Will you help me?” Of course he agreed and she was successful. She felt great e and happiness. It was not because he made her do it and it was not because he granted her the right to try. It was because she exercised her rights and he supported her.
Leaders must get over these thoughts of omniscience and omnipotence related to employees. They must realize instead that they are servants in charge of protecting the natural rights that already exist. Unfortunately we have been taught to run our organizations with control and arrogance. Both are inconsistent with natural law. If we shift that thinking we can shift employee engagement. The idea of empowerment must be discarded. The idea of support for natural rights must be embraced.
July 26, 2012 § Leave a comment
Employee engagement is the hot topic today. More and more leaders today are beginning to recognize and appreciate that engaged employees are more productive and do higher quality work. Engagement is an emotional response to work such that employees willingly exert extra voluntary effort in their jobs. Unfortunately, every measure of employee engagement remains at a dismal level between 21% and 31%. Is the root cause of these dismal scores in the employees or in the leadership?
Apparently there are an entire series of quotes that take the form, “There are no bad [something], only bad [something else].” For example, “there are no bad dogs, only bad owners”; “there are no bad foods, only bad diets” etc. I want to add a new one, “There are no purposely disengaged workers only leadership malpractice.”
I hope it is clear that I am not suggesting employees should be treated like dogs. My point is dogs are naturally motivated and happiest when they are treated consistent with “pack mentality.” Dog trainers who treat dogs consistent with pack mentality have the happiest and best behaved dogs.
Similarly, people are naturally motivated by “engagement psychology.” Leaders who understand engagement psychology and create an environment consistent with it will have engaged employees. Unfortunately, most leaders have not been taught the correct engagement psychology thus many organization (if not most) consistently have high disengagement, poor productivity, and poor performance.
Leadership malpractice typically takes the form of sophisticated ways of blaming employees for poor results. Leadership malpractice uses phrases like “a leader must drive performance” or “we must drive results” because, the assumption is, employees can’t do it without the leader pushing, pulling, driving, supervising, overseeing, and evaluating.
There are many policies that emerge from this way of thinking but I want to address them one at a time in a series of blog posts. This post will deal with the very popular pay-for performance policy. This policy is consistent with malpractice because it’s designed to control employee behaviors in order to achieve specific results.
People want to be rewarded for their hard work and they should be but when leaders make the individual rewards contingent on specific individual goal achievement it crosses the line into malpractice. Leaders think this policy will increase employee engagement but it instead violates the engagement psychology. The use of contingency pay-for-performance to achieve organizational results is akin to the use of bloodletting leeches by physicians in the 1700’s to cure heart disease. The typical pay –for-performance policies violate employee engagement natural law and therefore they:
• Attempt to control behaviors (e.g. they limit options)
• Send a message of distrust (i.e. employees would not work on the right things with the right effort without a reward)
• Limit innovation (there may be a better result employees could work toward)
• Ignore interdependence (achieving a goal in one area of an organization might cause waste in another area)
• Increase the probability of dishonesty to achieve a specific goal to receive a specific reward (e.g. people often cheat if they think they need to do it to achieve their individual goals and if they think they can get away with it)
An alternative reward system consistent with systems thinking and aligned with engagement natural law will instead:
• Align with a larger purpose and or the compelling mission of the organization and not just the individual needs of the single employee
• Allow for choice in methods for completing tasks and accomplishing the individual goals
• Give employees opportunities to be challenged and to optimize the use of their strengths
• Enable employees to track their own progress with control over their own feedback without dependence on the biased ratings usually issued by managers
• Demonstrate clear progress toward a win-win set of outcomes for both the individual and the organization.
• Share profit increases (because of the collective accomplishments) with a clear specific method and without biased judgments about individual performance e.g. who is more responsible for a winning no-hitter baseball game, the pitcher who throws the ball, the catcher who reads the batters and calls the types of pitches, or the teammates who field the grounders and fly balls?
This alternative reward system optimizes intrinsic motivation and increases employee engagement. It minimizes the controlling extrinsic motivation created by contingency based policies.
Leaders who want to increase employee engagement must design their pay-for-performance policies consistent with employee engagement psychology. Otherwise, regardless of their good intentions, they are undermining the very thing they are trying to accomplish i.e. engagement and sustainable improved performance. They will be practicing leadership malpractice.
Leadership malpractice will be a series of blogs. Please email me with any ideas or comments.
July 13, 2012 § 1 Comment
We have been taught the wrong way to lead. We have been taught a top down authoritarian model of management that damages three important organizational competencies. This model makes the typical manager irrelevant in the current context of global business. One might even claim that the current management model is damaging results in immeasurable ways. Managers need to be supportive facilitators not bureaucratic overseers.
There are reams of data about the current quality of managerial skills. Employee engagement levels are stagnant even though most research confirms it plays a critical role in performance improvement. Change efforts fail at least 70% of the time (some research says it’s 90%). A recent leadership survey revealed how the most important skills of dealing with and developing people were not only underdeveloped but undervalued as well.
Ask yourself, what grade would you give the quality of the job the typical manager does now? The rating is probably below average. Why is that? How can this be? How is it I predict that almost anyone will rate management performance below average? It’s because they have become irrelevant.
They unintentionally damage employee engagement
Employee engagement is one of the hottest Human Resources topics today. Study after study demonstrates that when an employee feels a positive emotional connection with their team and organization they consistently contribute toward increased productivity, customer service quality, and they are more loyal.
The typical manager damages this engagement and they can’t help it. Their responsibilities and way they have been taught to carry them out clashes with what employees need for engagement. To optimize employee engagement a work environment should have these five elements: a clear understanding of how their work contributes to the benefit of the whole organization and the customers it serves, a sense of autonomy in their decision making, a sense of challenge that matches the employee skills, consistent feedback, and a sense of progress toward a desired result.
The typical environment is set up so that the manager is the only conduit for these elements. The manager is the parent and the employee is the child who cannot be fully trusted to act on their own. These manager dependent environments prevent the achievement of these five engagement elements.
For example, employees are most often assigned tasks. They have little or no choice in them. If they are lucky they are told the strategy of the organization. More likely they are merely told what their goals are and they have little choice in their creation. Their feedback is dependent upon when a manager wants to give it and often it is delivered poorly.
They unknowingly stop innovation
The manager dependent environments send subliminal messages about the difference in status between an employee and a manager. The message is “the manager is the parent and the employee is the child.” Naturally if you treat someone like a child it increases the probability they will act like one. Organizations need adults who are innovative not children who comply. The typical manage stifles risk taking and innovation because they are responsible for evaluating their employees. Manages are also evaluated by their managers and so on all the way to the top.
This hierarchy of criticism makes the reward for being truly creative small in comparison to the damage one mistake might make to a career or reputation. Furthermore, that mistake will go in the file and everyone who considers that employee for a future position will be able to read it and know how and why they messed up. This fear of failure, and the label the employee might carry, stops innovation in its tracks.
Managers are told to evaluate employees. They do it and unknowingly damage the very thing that could improve the organization’s competitive advantage.
They accidentally impede adaptability
Today increasing the capacity for change is necessary to match the the speed of change in the global economy. For example, just a few years ago Research in Motion dominated the cell phone market. Today they are dwarfed by Apple and Google. The ability to adapt is probably more important than ever before yet our managers accidentally slow the pace because they are focused more on themselves and less on the elements that create adaptability.
The war for talent contributes to this inability to adapt. Focus is given to improving the parts of the organization (the top talent) while the adaptability of the organization’s system suffers. In the war for talent managers compete with each other for attention and success. These intelligent individuals are often able to manipulate their own success while creating unintended negative results in another part of the organization, e.g. selling more than the operations can deliver or over promising to meet a performance goal. Usually the setting of numeric goals that must be achieved to receive either a pay for performance bonus or a “results oriented reputation” are the root causes of this behavior.
The focus by senior leadership on attracting and retaining talent can accidentally damage the organization’s ability to adapt because the focus is on those individuals and not on encouraging the cooperative effort to detect the subtle important changes that need to be made to continuously respond to changing customer needs and wants. Focus on the wrong things accidentally damages adaptability.
Managers are consistently rated poorly by employees and employee engagement scores are stalled. Why? It’s because managers are being asked to play a role that is irrelevant for the current needs of employees and the needs of the organization. The typical manager unintentionally damage engagement scores, stops creativity and prevents adaptability. Senior leaders need to recognize that the typical manager must be replaced with a facilitator who understands how to lead people to greatness while optimizing a system. Managers need to be supportive facilitators not bureaucratic overseers because bureaucratic overseers are now irrelevant.
June 19, 2012 § Leave a comment
The coaching industry has enjoyed explosive growth over the past decade. Even though the recession of 2008 has caused a flattening out of its growth as companies cut “non-essential” services, coaching remains a very popular service for business executives.
Why is coaching needed?
According to a professional Human Resource consulting company 2008 survey of 4,700 executives, two critical organizational capabilities need to be developed:
• The ability to manage talent
• The ability to improve leadership
The shift in our economy from local to global and from industrial age to knowledge age has created pressure on leaders to improve these competencies quickly and coaching is seen as one way to accomplish this.
The purpose of coaching is to create innovative solutions to problems through a specific process of cooperative dialogue between the individual and his/her coach. This relationship is unique and requires a high level of trust along with a specific process and a sense of accountability in order to generate desired results.
But, are we missing something? The aim of this article is to point out two possible opportunities to improve the way we view coaching and therefore improve our ability to increase performance for the entire organization and not just the individuals being coached. There are two questions I recommend we ask our coaches to be sure they will help both the individual being coached as well as the organization within which they work.
I want to ask these two questions because I believe we cannot separate the behaviors of the individual from the context within which they work. The interaction between the individual being coached and their work environment (or the system) is a major influencing factor and cannot be overlooked or ignored during the coaching process.
Ask them their theory: “Please tell me the theory behind your coaching process?”
A coach’s theory will determine their process and therefore determine their advice. Coaching is a process (according to all three of the largest coaching associations) and a process comes from theory, “if you do this action, this result will occur.” According to Gary Hamel our mental models are out dated and need an upgrade. We are now operating in the knowledge economy where we need optimum trust and there is a deficit of trust. Leaders need to know the most effective theory and align their actions with it for them to achieve optimum results.
A shift in thinking provides a whole new universe of ideas and solutions. Without the right theory coaching will be stalled because the ideas created will be stale or outdated.
Two ways to ask this question include: “please explain why your process works? Or…tell me the theory behind your process?” These questions will reveal how the coach thinks about people and problems.
I personally prefer and embrace the Theory of Profound Knowledge created by Dr. W. Edwards Deming. Deming helps me to understand the impact of the interactions between the work environment (the system) and the individual. This environment (or context) influences actions and decisions of the individuals being coached.
One of the most important parts of Deming’s theory is “appreciation for a system.” A system is a series of interdependent processes that attempt to achieve the aim of the system. Deming believes that this system has an enormous impact on the individual behaviors. A coach that does not recognize and/or embrace this idea may miss major opportunities for improvement for the individual.
Ask if they know how to study a system: “How do you help individuals who are impacted by the system in which they work?”
If a coach appreciates a system he/she probably knows how to study it. But, you better check. Without this skill the coach will limit his/her advice to actions only the individual can take and it may avoid actions others can take to influence the system.
Sr. leaders have the most influence over the system policies and procedures. If these policies or procedures are ineffective or dysfunctional they will impact the individual being coached and may be some of the most significant barriers preventing that individual from achieving his/her goals. If the coach knows how to study a system he/she will probably be able to influence others in power. The chances for improvement are increased exponentially.
Coaching that is limited to individual behavior change may not be enough to create significant improvements in behavior or performance. Without appreciation of a system and without the skills to study that system a coach’s effectiveness can be significantly reduced. It’s better to ask them specifically what they know before you put all your trust in their competencies.
May 14, 2012 § Leave a comment
I often ask seminar attendees to rate the current quality of their leadership on a scale of 1 to 10 where 10 is excellent and 1 is poor. I have done this for the past 5 years and never have I seen an average rating above 5. Is our leadership quality really that poor? It is if we give credibility to the followers who are doing the rating. Furthermore, why is our leadership so poor? How can this be when there is such a need for quality leadership? I believe this consistent set of low ratings is due to a kind of “leadership insanity” and there are three main reasons this insanity is so prevalent.
Perhaps you don’t believe my rating data. Perhaps you think your leadership is effective. If so, consider this additional data. According to Watson and Wyatt only 39% of employees trust their senior leadership; only 31% of employees rate internal communication effective at their companies; only 52% of employees can see the connection between their jobs and the company strategy; only 25% of employees think their rewards system is effective; only 29% of employees are considered fully engaged. According to Bersin Associates, only 18% of mid-level leaders and only 37% of senior leaders are rated excellent by their direct reports. I could go on.
We all know the typical definition of insanity namely, doing the same thing over and over again and expecting a different result. Although this definition is memorable I offer a different definition from the dictionary: foolishness or lack of good judgment. I believe many leaders are acting foolishly with their actions and decisions about policies that no longer make any sense. I believe there are the three major conditions that cause this insanity.
An inability or unwillingness to understand and appreciate “Systems Thinking”
Systems’ thinking is the art of looking at the world as a whole and avoiding the analysis of the parts. A system is a set of interdependent processes that work together cooperatively to achieve an aim. We have not been taught effectively how to think deeply about systems. Our public schools systems are competitive and attempt to improve the parts of that system (the students and/or the teachers). Our organizations search for talent as if that talent exists separately from the whole and will create organizational success just by being present.
Systems’ thinking requires a focus on the quality of the interactions between the parts of the system and avoids evaluation of the performance of the parts. Systems’ thinking takes into account how the system can impact the performance of that individual when looking for solutions to problems. Systems’ thinking requires a synthesis of parts and not a separation of them. It helps answer questions about why people behave the way they do and not just analyze what and how they do it.
Leaders today tend to ignore systems’ thinking and this hurts their ability to solve problems quickly and for good. This lack of effective problem solving hurts their leadership ratings making them look foolish.
An inability or unwillingness to understand and improve trust
I believe every organization must understand how to continuously improve trust. Trust is the oil in the pistons of innovation, performance, and adaptation to change. A lack of trust results in fear, poor learning, an inability to adapt, and stagnation in improvement.
In their book Credibility: How Leaders Gain and Lose It, Why People Demand It, James Kouses and Barry Posner describe the key characteristics of a credible leader. They list the top four characteristics as honesty, the ability to be forward-looking, the ability to inspire others to action, and the ability to be competent. These top four characteristics were chosen by up to 87% of the 1,500 survey respondents who were asked to define the characteristics crucial to leadership.
Coincidently, there is an alignment between these four characteristics and the four elements of trust included in the International Association of Business Communicators definition of trust. The IABC define trust as the willingness to be vulnerable with another due to the presence of integrity (honesty), concern and respect (inspiration), shared objectives (inspiration and the ability to be forward looking), and competence (ability to be competent).
Leaders lack credibility and this is why they receive low ratings from their followers. Managing the key elements of credibility and trust would provide improvement and healing. This lack of focus on the key elements of trust causes followers to mistrust their leaders and make them appear foolish.
A senseless and foolish embrace of the past
Frederick Taylor’s Scientific Management influenced everyone’s belief system about management. His beliefs about people and work are still embraced today and we can see examples in our school systems and organizations. Unfortunately, his beliefs, and the controlling policies that follow from them, have reached their limit in their ability to improve productivity and performance in the knowledge age. Taylor methods do not create employee engagement and that is one reason why we are doing so poorly on that front.
Many leaders (if not most) still embrace policies and practices that are consistent with Frederick Taylor Scientific Management thinking. Contingent pay for performance and the typical performance management system are examples of those policies. These polices prevent employee engagement and act as barriers to improving leadership credibility. These policies place leaders in a dominating position over employees. They rob employees of autonomy and create victims. Victims will not rate leaders highly. Victims will not willingly follow leaders because they feel controlled. Victims are created in environments of leadership insanity.
Healing our leadership insanity is essential to our future success. We can’t continue to be led by foolish and senseless policies and procedures and expect a significant improvement in results. To heal we must acknowledge our insanity and shift our focus and our behaviors.