Hunt down sacred cows—outdated beliefs, policies, practices, systems and strategies.
And stoke creative fires, don’t soak them.

Cows, fire hoses and comic strips. It may not seem to be a likely combination for any reason, let alone for a serious education session on change leadership, but an inspired and appreciative audience confirmed the concept for the Companion Day session “Re-shaping the Blood Banking Industry,” sponsored by CaridianBCT (formerly Gambro BCT). First, renowned motivational speaker Robert Kriegel, PhD, encouraged attendees to toss off dusty traditional ideas about success with an animated discourse about his signature concept, “change readiness.” Individual presentations and a panel discussion followed as three leaders in the transfusion medicine community presented their very different perspectives on change, leadership and what’s really important.

Change Readiness vs. Sacred Cows and Fire Hoses

Despite the variety of messages from the four speakers, consensus could easily be established on the inescapable need for adaptability, especially considering examples such as the current global financial crisis and the challenges of maintaining the blood supply. But in times of flux, the gut reaction to clamp down on risk is the wrong answer, advised Kriegel. “Even if you keep doing what you’ve been doing to achieve success, you’re not going to maintain what you have without change. Change-ready people are not those who respond quickly to change; they are the ones who create it.”

Staying in front of the wave rather than on top of it is reflected convincingly in Kriegel’s own life. A former athlete-turned-Olympic-coach and sports commentator, Kriegel was a pioneer in sports psychology before becoming an advertising executive and Stanford University professor of executive management. A New York Times and Business Week best-selling author, he has also been a regular commentator on National Public Radio’s “Marketplace,” and has produced two public television specials on change leadership.

One exercise Kriegel encourages organizations to perform—and perform often—is a “sacred cow hunt,” discussed extensively in his book Sacred Cows Make the Best Burgers, which was distributed to session attendees. The hunt involves searching out and eradicating the policies or procedures that have been in place so long that the reason for their existence has become obsolete and the “way we’ve always done things” has become a hindrance to real effectiveness and efficiency. Because they are so ingrained, these “habits” and their liabilities are often overlooked.

Kriegel gave the example of a tire manufacturer that originally wrapped its white-walled tires as they came off the assembly line to protect them from smudging until purchase. Many years after the company stopped producing white-walled tires, the wrapping continued. One day, a new employee, who could see no reason for the extra time and expense, asked why. “Why?” is one of the best questions that can be asked, said Kriegel, because such questioning of old ideas and positing of new ones is essential in any organization.

Unfortunately, employee creativity too often meets the “fire hose” response from leadership—that is, the resistant “voice of experience” that protests new ideas before they can develop, saying “it’ll never work,” “don’t rock the boat,” “it’s not in the budget” and “we’ll wait and see.” Kriegel suggested that at meetings where this seems to be happening, water pistols (actually used at one of the organizations he coached) can be great reminders to resist the force of the fire hose.

One sacred cow Kriegel tackled in the session was the traditional work ethic that says the way to advance further is to work harder. He pointed out that new ideas and solutions almost never come when a person is hurried. Rather, creativity and solutions arise during time-outs, when one stops what he or she is doing and takes a step back. “Try easier,” he suggested. “A passionate 90% is better than a panicked 110%.” Clearer thinking, better communication and sharper vision are the results.

Change frightens people. Many times, even though the need for a different approach is clear, fear of losing productivity with new methods is the predominant force. However, big changes need not come all at once, and sometimes they are most successful when they start with small trial modifications. “You don’t have to kill the cow; put it on a diet first… If you round up the sacred cows in your personal life as well as at work,” Kriegel promised, “you’ll end up doing so much more than you ever thought you could.”

Blood Bank Executive Reflects on Significance

Next up, Anne Chinoda, MBA, of Florida’s Blood Centers spoke from the content of her new book (in press) Simply Significant: A Life Fulfilled…A Legacy of Hope, where she draws a personal distinction between “success” and “significance.”

Success, she posits, is often defined by status or monetary measures and, alone, is disappointing. It is often mistaken for significance, which is a deeper inner calling that we are all born to seek, defined (in abbreviated form) as “the state of knowing who you are and aligning your energy with the opportunities and calling in your life that reach beyond yourself to others.” Success is bound to follow when significance is sought first, she contends.

Moreover, “once you take a path toward significance, you will become a whole new kind of leader,” fostering others along their own similar paths to significance. Leaving a legacy for others was Chinoda’s strongest point. She used Starbucks as an example of a successful business seeking to infuse significance into its corporate structure. By approaching stakeholders about where they felt a portion of the profits should be donated to make a significant difference, the company has built its reputation as a socially responsible organization.

“We are fortunate to work in an industry of service,” she says, “and it is important to be reminded that service is the reason behind it all because it is so easy to be distracted by lesser goals and, thus, accomplish lesser things.”

Case Study: A Blood Center’s Internal Overhaul

Frederick Axelrod, MD, MBA, used a major revamping of mission, values, goals and even name at LifeStream (formerly the Blood Bank of San Bernadino and Riverside Counties) to describe “How Focus and Accountability Contribute to Change.”

Frequent failure to meet customer demand for blood, a dysfunctional human resources department, neglected employee needs and no real sense of direction were a few of the elements of the dismal picture of the center in 2004. Seeing that action had to be taken, the leadership sought focus by surveying first the stakeholders, to establish five “must wins” as goals for the organization, and then the employees, to focus on fixing the internal hindrances to moving forward. The next step was to build in a system for accountability to achieve the goals set before them, which involved a new performance appraisal system and development of policies.

By refining the center’s mission, vision and values statements (which resulted in the new name), LifeStream was able to set specific, measurable goals, such as collecting 105,500 RBC units to meet projected demands for 100,000 units, and converting 425 whole blood donors to apheresis donors. The leadership focused on making employees feel valued in multiple ways and on implementing a system for measuring their performance, despite protests from some tenured employees who were not used to such transparency and accountability. The 85% turnover in management was testimony that change is sometimes necessary on a large scale.

This year, LifeStream is able to report a success story: the blood shortages that had plagued the center before the transformation have completely disappeared, even as 10 hospital customers were added; 80% of hospital customers signed 3-year contracts; and there was a 90% reduction in citations from external auditors.

Blood Banking’s Future Challenges Likened to Saving Superman

Finally, Merlyn Sayers, MBBCh, PhD, from Carter BloodCare discussed challenges to donor recruitment and testing through clips of a vintage comic strip in his presentation titled “Clairvoyance, Change, and Challenges.” The story line of a 1971 DC Action Comics magazine portrays Superman as requiring blood transfusion. In one scene, masses of people Superman had helped in one way or another line up out of true altruistic fervor. A doctor stands at Superman’s side before the donors, declaring that despite uncertainty about whether blood donated for Superman would eventually help him or kill him, the risk was a necessary one.

This and several other scenes from the episode were presented as strikingly relevant still today, even though many other challenges to blood bankers are new and certainly no laughing matter. Indeed, the lightness provided by the comparison was almost necessary for the spoonfuls of troubling predictions Sayers doled out. Pointing, for instance, to declining civic engagement in younger generations, Sayers felt people who were born in the 1960s and 1970s are much more about “me,” and he wondered aloud, “What has happened to altruism?”

In the Superman comic, a nurse has to refuse Lois Lane’s offer to give more blood because she has already given double the allowable amount, which Sayers humorously played up as a prediction for apheresis. As if current struggles to match blood supply and demand are not challenge enough, Sayers warns a critical time is looming when keeping up will not be possible. This imbalance would have hit the community much sooner, he claimed, if it had not been for the growth of apheresis in the early part of this decade. Apheresis bought some time despite the drop in donors in recent years, but demand has only continued to soar and will soon surpass the capacity of projected blood component availability, predicted Sayers.

Shortcomings in the specificity of screening procedures is another issue whose future effects will compound already existing challenges. By means of a graph using a predictive index, he showed that the more often a person donates blood, the more likely he or she is to be deferred unnecessarily or in error. However, in the question-and-answer session that followed the presentations, Sayers responded to an inquiry that pathogen activation does hold great promise that many donors could be recovered who might otherwise be lost.

The question-and-answer session came to a close as speakers agreed that the area of mergers and acquisitions had provided an outstanding challenge for them. Their advice for such a change:

·          Coach individuals into the place you want them to go.

·          Realize there will always be resistant people.

·          Don’t expect current leaders to do everything at once; use consultants to help lead through the change.