The Heck with the Middle! Become an OUTLIER!

Are you an outlier? Though this term can carry a negative connotation in the reimbursement and regulatory worlds, here we are viewing it positively. It is an interesting topic to contemplate. Secretly, most individuals seek differentiation and want to be recognized, at least according to Maslow and his Hierarchy of Needs. Or we could cite Frankel in that we all seek meaning and purpose in our lives and would like to accomplish something noble and good. If your organization is not actively becoming an outlier, then I would venture to say that you have a very unattractive organization and that it will never be able to attract and retain highly talented people. Thus the organization will never become world-class. Becoming an outlier is not about being different for the sake of being different, though this is a perfectly fine justification in my mind. Rather, it is about pushing limits and seeing how far you can advance. Although you can also become an outlier by sitting around at the bus stop when everyone else has left!

All organizations that are doing the Model or have done a Model BluePrint Workshop have a goal of becoming an outlier, bare none. One subtle but important shift in thinking is that you must choose to be an outlier as an individual before the organization can become an outlier, as the organization is shaped by the behaviors of individuals within the enterprise. Outlier organizations are usually lead by obsessed and possessed people that are willing to focus uncommon levels of intention towards the fulfillment of a vision or result. They can be crass, tough-driving individuals or they can be highly evolved, soft-spoken spiritual people. However, they are always demanding and relentless in their pursuits, even if they are completely calm and serene in the process. They usually have high energy levels, great capacities for imagination and have a sense of urgency. To put the urgency characteristic bluntly, outliers change the world…often at a pace that leaves the huddled masses in the dust.
Are you an outlier? It is fairly easy to tell if you’re an outlier or not. Look at your numbers. By virtue of your position on a normally distributed bell curve and by definition, an outlier lives in the extremities.  Are your numbers radically different from the majority? In the MVI Benchmarking Application (BA) are you around the 90th or 10th percentiles in the areas of your intention? When you go to networking meetings, do you find that the conversations tend to revolve around the same old topics that you have already refined to the extent possible? Do people scratch their heads when they see your operations and go “WOW!” when they start to catch on to what you’re doing? Do referral sources, ACOs and patients/families comment on the extreme quality and constancy of your meticulously designed care experience and comment that it is UNLIKE anything they have ever seen in healthcare? You can also tell if you’re an outlier by your level of discomfort from pushing outside the norms and measures of central tendency. An outlier organization subjects itself – willingly – to the discomfort and stress of venturing into unfamiliar and uncharted territory.

Where are your opportunities to become an outlier? Most innovation opportunities lie in everyday tasks. They are hidden in mundane work. The innovations that make an organization an outlier come from within as well as from the outside. The key is to be able to recognize an innovation when it is observed AND have a system of incorporating it into practice. This insight is not common or else everyone would be doing it. Can you specifically identify language or a practice that could be used during clinical visits that would decrease On-Call by 50%? Can you get great ideas from John Deere, Apple, Ritz Carlton and Disney or even from horridly run organizations so you know what to do as well as what NOT to do? Also, in the external innovation category, note that some outlier hospices are EXTREMELY CAREFUL in their selection of conferences and educational events for their staff. Why? It is because they do not want to contaminate their cultures. They are not hiding nor are they ignorant of the outside world. They are paying close attention to movements and trends, but are protective of their productive cultures that they have worked hard to create and nurture.   

In a competitive hospice world, the outlier has an enormous competitive advantage. Most hospices are slow moving freighters that take 30 miles to make a turn. It often takes years for an innovation to become common place. A good example is charting at the point-of-care. How many hospice’s still struggle with this situation even though some hospices have mastered it? If we don’t know how to do this, we simply have not been paying attention. This overall glacial speed makes for easy pickings!

It takes guts to be an outlier. It takes confidence to venture into deeper waters. In addition, there is a price for being an outlier. The outlier finds itself alone or with only a few others. Through the course of becoming an outlier, the organization will find itself lost, confused and frustrated at times with failed experiments. The outlier will be mocked and ridiculed by the huddled masses. However, the wins of the outlier are often big and the talent (people) of the organization is inspired as it leads the “industry” back to a “movement.” The outlier will look back one fine day and realize that it is now far removed. You find the “industry’s” conversations strangely bizarre, but familiar. But such retrospection is short-lived as the organization’s intention is again focused on making the intangible tangible. The thrill of progress outweighs the pain and discomfort of being an outlier…and you would not trade it for conformity and the divine feeling of self-actualization, extension and expansion as a distinct organizational personality. Do you walk in familiar, well-worn, comfortable paths? That’s fine if you want to remain in the middle. However, know that you can choose where you want to be on the bell curve!

~ Andrew