Ep 028: 90 Days to Make or Break: A $60M Leadership Collapse

Welcome back Bridge Builders to Bread to Lead. The podcast transforming leadership across industries. I'm your host Dr. Jake Taylor Jacobs and I'm thrilled that you're here. We're currently ranked as the 30th top business and leadership podcast nationwide. It's all thanks to listeners like you. Bridge Builders, if you haven't already grabbed a copy of my book Bread to Lead on Amazon, it's packed with strategies to elevate your leadership game. Questions or ideas for the show? Visit us at Bread to Lead.com. And if you're finding value here, please take a moment to rate and review us on Apple Podcast. Your support helps us reach more leaders. Now let's dive in and continue breeding excellence in leadership. Today's episode awaits Bridge Builders. Bridge Builders, Bridge Builders, Bridge Builders. If you are new to the show, everyone that's a part of this community is a bridge builder because in some form or fashion, you're taking somebody from where they are to where they could be. And typically if you're in leadership, you're typically leading multiple different generations at the same time. So in order for you to communicate with different generations, you first yourself must be a bridge builder. Somebody who can be a bridge is build bridges of communication that can offer you to get to the step. So if you're new to this podcast, it is a pie class. The whole purpose of this pie class is to make sure you're getting actionable steps. If you're looking for interviews and different type of things, there are plenty of amazing shows on podcasts, platforms all throughout the world that interview. This podcast is solely for the leaders that want to learn, that want to grow, that want to develop and need information that they can take, they can apply and they can move forward. One of the newest things that we added to the pie cast because we always just tweaking it and touching it up just depending on what your feedback is. So if you have feedback, go to breadtalee.com, leave a comment on what you want us to talk about or information that you want us to share on the show or follow me on LinkedIn, a Jake Taylor Jacobs on LinkedIn and it's Jake Taylor, Jacob, J-A-K-E-T-A-Y-L-E-R, J-A-C-O-B-S on Instagram. For those of you that are following on YouTube, we're trying to build our YouTube platform, kind of from scratch, although we have subscribers, which is going to be a fun thing in itself. I'm excited about that. So today, Bridge Builders, we are diving into something that can make a break a leader's success. And it's the first days in a new role. And to illustrate just how critical this period is, I want to share with you a powerful case study that shows exactly what happens when leaders get this wrong. In March 2014, North Adams Regional Hospital in Massachusetts abruptly closed this door. With just three days notice, 37,000 residents lost access to their local hospital. Employees lost jobs, the community lost its healthcare lifeline. And this wasn't just a business failure. It was a leadership failure that began in those first crucial 90 days. What makes this story so important for every leader is that it wasn't inevitable. The warning signs were there. The opportunities to change course were there. But a series of critical mistakes in the leadership transition period set the stage for failure. The episode that we're going to share today will explore how this case study illuminates the four crucial elements of leadership transitions and provide practical strategies for success in new leadership roles. So for some of you that are newer to the podcast, I just want to let you know again, we're always kind of changing and adapting what we do with this podcast. And the reason why we're changing and adapting what we do with this podcast is simply because it's simply because we want to continue to communicate with you. So if you have information that you want to share with us, go to bretilee.com, leave a comment. If you have information or case study that you want us to look into and apply our principles to it, if you have a case study at your facility that you want me to break down, dealing with leadership organization operations, please, I will implore you to send that information to bretilee.com. And then the second thing is if you have specific clinical things that you want us to address, we're starting a new podcast called SPD 911. It's really helping the period of anything in surgical services from OR down to surgical instruments is helping us be able to get together. So let's break this down. What happened at North Adams Regional Hospital? Because it reveals something crucial about leadership transitions. When the new leadership team took over, they made a huge mistake that I see repeated across industries. They misjudged the reality of their situations. Typically, when this happens, everything begins to shift. So when this new leadership took leadership of North Adams Regional Hospital, there are signs, but the mistake happened when they misjudged the reality of their situation. And so many leaders and business owners typically misjudge how long it takes to actually make something stick and make it great. It's because we're in this new once of new information all the time that's telling you in 90 days you can turn it around. Your last opportunity you did it so you can do it again. Just because you did it before doesn't mean you can do it again. This isn't that song. If he did it before, he'll do it again. Yeah. Same God right now. Same God back then. This ain't that situation. If you did it before, if you did it just off-sure effort and momentum and look, it's hard for you to reverse engineer and create a success story in every opportunity that you face. And so what happened with these leaders with this case study is that they believe that just because they did it before at another hospital, that it meant that they can do the same thing at this new hospital without considering the environment or the space that the hospital was in. So the new executives looked at the hospital challenges through lens of their past experiences. They saw mounting dead, declining patient volumes. But instead of doing a deep diagnostic of why these problems exist, they jump straight to the traditional cost-cutting solutions. And this brings me to my first principle of in the first 90 days. And let me pause. What you're going to hear me talk about are frameworks. If you're building or if you're a leader, if you're an executive, you should always be operating in certain frameworks. It means like rules to the game of playbook. And when I was in sports, the most successful teams had a plethora of plays, frameworks of what they built their offense or defense on, that allowed everyone to reset in the same way. The reason why a lot of leaders fail is because you're shooting from the hip, but you're not shooting from or building from frameworks. So you're going to hear me reference a bunch of different frameworks that we've created internally so that we can ensure we're at least getting the same similar results every time we turn around a hospital. Okay. So the reality assessment before action, this is what you're doing your first 90 days. You don't just promise you're going to make a change because there's a reality assessment. The information that you received before going into that hospital or before taking that leadership role or before starting that company, you need to make sure over 90 days that that information is accurate before you decide to make changes. So let me share something powerful about assessing reality. Most new leaders, let me share something powerful about assessing reality. Most leaders make the mistake of relying on the information that's presented to them, reports, metrics, and presentation. But here's what I teach leaders. You need three levels of a reality assessment, the paper reality. This is what the data and reports are telling you because there's a saying, right, numbers don't lie. I say bill, you know the other word, it's because numbers do lie because it's all based on the formula that you decide to calculate. So yes, you have a paper reality. The second form of reality is the perceived reality, what people in the organization believe. So you will have a paper data that tells you one thing. You have people saying another thing. And then the third reality is the ground reality, what actually happened day to day. What's happening day to day? So you need three functions of those realities in order to really assess if you have the true grasp of the reality. So you have the paper reality, the perceived reality, and the ground reality. Once I'm able to gather, gather an analysis of all three, then I can decide to start making recommendations on what we're going to do. And typically when you're going into a new industry, a new company, a new environment, a new business, a new organization, a new hospital, is going to take you 90 days to be able to assess what the real reality or the problems are within the organization. So at North Adams, the leadership team looked at the paper reality, the financial statements, the patient volumes, the operational metrics, but they missed something crucial. The perceived reality of their staff and community in ground reality of why patients were choosing other hospitals. This is the biggest thing that we have to consider because this brings us to something crucial about leadership transitions, building credibility from day one. At North Adams, the leadership team made a huge mistake that undermines many new leaders. They failed to communicate transparently about the challenges that they were facing. That's the thing. When you come into a new situation, you want to be the superhero, you want to be the star. But the problem is that when you do not express or show transparently about the challenges you're facing, you're not creating a real reality that can be solved. We'll be back after commercial. Are you ready to transform your leadership journey? Get my book, Bread to Lead, on Amazon now. In it, you'll discover the proven frameworks and strategies I've used to help leaders across industries master each phase of their leadership development. Don't just lead, be bread to lead. Get your copy today on Amazon. Oh, y'all listen. This is hot. This is kind of hot right now. Let it you know. This podcast we're already in the class because we talked about the three levels of reality assessment before I decide anything on anybody. I tell them I need 90 days. If I cannot get 90 days to actually assess the real reality of the organization, there is no way that we can change. And typically when hospitals call our firms to help them stabilize their surgical departments or stabilize or turn them around, we can send our consultants in that are experienced that are specialist that can plug the gap. But plugging the gap and bridging the gap are two different things. Plugging the hole and bridging the gap are two different things. You can plug the hole with anything to kind of slow down the bleeding. But in order to fully slow it down so internally, it can heal, you have to open up the room, extract out what's just just destroying your organization and then bridge the gap by sewing it close with strong sutures. Your strong sutures in your organization is your leadership team. If your leadership team is not strong at its core that can help really develop and turn around organization is going to be hard for you to close that gap too often in the hospital space and in businesses all across America. There's a bunch of leaders that are just trying to plug the hole but not trying to bridge the gap. And I want you to think about this. When the hospital finally closed employees in the community were blindsided. They had just three days notice. This wasn't just a communication failure. It was a credibility killer. But most importantly, it shows us something fundamental about building credibility in your first 90 days. Let me share this framework that I use with leaders. Remember we're building everything from frameworks. So every episode take the framework. We have literally probably 200 pages of frameworks that we build from depending on the scenario of the situation. So just like we had the three triangles talking about building an assessment. In the first 90 days when I'm when I'm seeing this, I want to build a trust triangle. So at the same time simultaneously when I go inside of an organization, I'm looking at the first 90 days, which is our reality, our real reality assessment. This in part with that 90 days, I also have another framework that we're looking called the trust triangle before you can turn around an organization. They first have to trust you. If the organization doesn't trust you, it doesn't matter what you decide or what you recommend it will never happen. So with the trust triangle, the first thing that you need is transparency. Not just about good news, but about challenges. Leaders at North Adams could have built trust by being open about their hospital struggles and evolving stakeholders and finding solutions. Number two, engagement. You need to engage with three key groups in your first 90 days. When you're coming into a new situation as a leader, these are the three groups you need to engage with. Your team, understanding their perspective and concerns before adjustment. When you're coming into a new organization, the very first thing you need to create engagement with is your team. Understanding their perspective and concerns before adjustment. Because adjusting a department or an organization based on past experiences, without first assessing the culture of your current environment is bad news from the start. The second thing, your peers. Building a collaborative relationship amongst those who will be considered equal across departments that you are forced to work with. And then the third thing, your stakeholders. Creating a support network of your upline so that if you're creating an initiative, they will back it. Let me stop here and park parenthetically. A lot of you are in organizations in silos. You barely talk to your team. You barely talk to your peers about growing the organization. And you hardly ever talk to your stakeholders, your upline unless you're in trouble. So when you're asking for something, you don't have a trust bond with the people that can help back you making a decision, get approved. So you have to create this level of engagement amongst your peers, your team, and your stakeholders that can ensure that when you're moving the organization forward, you have an ecosystem or a circle of people who trust you. To get a job done, to strategize the job, to get it done, to get the result and bring it back to them because they know that you're a winner. And then the third thing when it comes to the trust triangle, the first part of the trust triangle was transparency. The bottom was engagement, the other bottom of early wins. But here's the key to early wins. They need to be meaningful to your upline. You coming into a department, saying, man, I got rid of this and we did that. We we stabilized the instruments or we streamlined operations. If your stakeholders, your upline, if that wasn't their main concern, it could be a win for you, but not a win for them. So you need to find out what's meaningful for your stakeholders, your upline, your senior leadership or even your customer, who your customer would be in that space and getting them a win that they find valuable. The second thing in early wins, achievable with current resources. See a lot of leaders like to create a lot of leaders like to complain and want to create early wins with resources that are available. Meaning you come into a hospital, you come into an organization like if we just had this, this, this, this, this, and this, we can do a better but we don't can you fix it. If we had this much staff and we we don't can you still fix it. If we can just get a budgeted a half a million dollars more if we, if we don't can you still fix it. The question is, can you turn around the organization or start getting early wins with the current resource. You win with the current resources staff and things now. That's how they want to know. And then the third thing when it comes to early wins, is it aligned with the long term needs. So when I'm coming in as a leader, I want to know what are the long term wins for the organization? What are what's meaningful to our current leadership? What do they see as something powerful? Cutting costs, getting more efficient, operational work, a workflow optimization. Okay. If those are my three things, I'm not going to come talk to them about anything else, but those three things. And at North Adams, the leadership focus on cost cutting as their early wins. But these weren't wins at all. They were just delays of the inevitable because they weren't paired with a strategy for future sustainability. The number one thing I see hospital executives make in many executives in every industry, actually. The first thing they do is go cut costs with staff. If your current staff that you believe is overstaffed is inefficient, what do you think your organization going to do when they feel understaffed? A lot of time was in front of you to cut cost. Isn't necessarily the primary move we should be making. But it's easy to say, well, the largest resource here is human resource. So let me cut our staff by 20% and then tell everybody to work more and that should be greater cutting costs. No, no, no, no, no. Cutting costs also means cutting down on errors. Cutting costs may also mean cutting down on mistakes at the assembly. Cutting costs may be also getting efficient. A lot of the ways that people consider cutting costs aren't really just getting rid of the quote unquote inevitable. Cutting costs may sometimes mean we're being too sloppy with our resources. Let's cut down. Let's anchor down on our financial situation. And let's figure out what makes most sense moving forward for the organization, cutting costs. Doesn't always mean cutting people. Now, let's talk about something that trips up many new leaders. And it's the desire to make an immediate impact. In North Adams, the leadership team felt pressure to show quick results. And this led them to make abrupt decisions about layoffs, service reductions, without considering the cascading effects of the organization and the community. And this brings us to a crucial principle. Impact without chaos requires what I call balance urgency. Move fast enough to create momentum. Move slow enough to bring people with you and move smart enough to avoid unintentional consequence. This is balance urgency. But so many people move so fast. Y'all know my favorite song by Indiari. Slow down baby, you go into fast. You got your hands in the air, your feet on the gas. You buy to wreck your future. Running from the past, you need to slow down baby. Listen, you got to slow down. Changing an organization. You got to move just fast enough to create urgency in the momentum at the shift the atmosphere. You have to be slow enough to bring people with you. And you have to move smart enough to avoid unintentional consequence. Because any major mistake or any major mishap in this transition, you'll lose all trust with the people that's which. So we created the impact matrix. Before making any significant change in your first 90 days, you assess it across for a dimension. Immediate effect. What's the immediate impact on operation? Who is directly affected and what's the short term benefit or cost? After the immediate effect, the ripple effect. What are the secondary impacts? How will this affect other departments or stakeholders? What systems or processes will need to change? You see what happened? The immediate effect affects my immediate department, my shift, my low cowl, my operations, my organization. That's the immediate effect. The ripple effect is who else is affected by this one decision that is made? And what processes will need to be changed? There are so many leaders that come in and clean up their department, but didn't clean up the way it's communicated outside of the department with your partner departments, which causes chaos in itself. After ripple effect, we have the culture impact. How does this align with existing culture? What measure does this send? What message does this send? And how would this affect morale and engagement once this decision is made? So if you're changing the culture, does it connect or compete with your upline culture? Is the culture I'm looking to establish? Does it connect with the focus of the entire ecosystem of the business? Or does it compete with? Do you have enough stakeholders that can buy into your idea of changing your organization around? To create a ripple effect that will ultimately change the full organization. And how would this affect morale and engagement? Because when you affect morale and engagement, you affect productivity. You affect productivity, you know efficiency is going down. If efficiency is going down, the business is going to take it. The business take a hit, boom, we got infection rates are really high. Surgery are the all-time low delays are happening. People are dying on the field. People are getting sued. If you're in different industries, you know exactly what that compares to. And then the fourth thing you need to recognize in this impact matrix is how does this impact long-term options? What capabilities are we building or losing? And how sustainable is this change? This is what I'm thinking about. Before I make any changes in my 90 days, remember we have the, we have the reality assessment that's happening your first 90 days. Then we're doing our trust triangle simultaneously. And then before we make decisions, we're taking it through our impact matrix. These are all mechanisms that you can use before you create that change in the organization. And that North Adams, the leadership team failed to set the right tone from the beginning. Instead of establishing a calm, solution oriented environment, they allow a crisis mentality to dominate. This created a self-fulfilling prophecy. When people expect failure, they start acting in ways that make failure more likely. And let me share something powerful about setting tone and pace in your first 90 days. Most leaders think it's about their words or decisions. But in actuality, it's about your leadership cadence. The rhythm and pattern of how you operate. And the framework of the leadership cadence is the rhythm. What's your regular communication touch points? What's your regular communication touch points? What's your regular communication touch points? What's your regular communication touch points? Before you start making changes, you should get your organization on a rhythm. A rhythm that's upbeat a little bit that doesn't change a lot of what they're going. But we're just getting a rhythm to the organization, getting a rhythm to the organization, getting a rhythm to the organization, getting a rhythm to the organization. And then once you get a rhythm with regular communication touch points, then guess what happens? You get predictable decision making processes. You get predictable decision making processes. You get predictable decision making processes. You see that once you create a rhythm in the cadence, now the predictability of the decision making process becomes a lot more consistent. And then what happens when you have the regular communication touch points? Now you can be predictable with the decision making processes. What I want to do when I'm first getting an organization is change the way that people are making decisions. That's it. I don't want to change too much, but just the way that people are considering making decisions. Because if they can see the value of your value and getting them to change how they see things, it'll be easier for you to actually implement what you need to implement. Hope I'm talking to somebody. I'm getting a rhythm. I'm getting a cadence. Then it's beginning to be predictable decision making. And the next thing of that rhythm, now you get consistent presence and accessibility. So after I get that leadership cadence with that rhythm, now we want to start working on their response patterns. How are you handling challenges? How are they handling challenges? How are you handling challenges? How are they handling challenges? If they're handling challenges inefficiently, your job isn't to scold them. Your job is to just get them into the same rhythm you are in. And I want you to consider this. I'm actually going to look this up. This is not a part of my current script. My training script. How long does it take for ladies to become a coach? Become in sync. I just thought about this as we as we as we're speaking. Because ladies when you work in an environment, you end up becoming in sync with your menstrual cycle. So what I've heard. This is what I've heard. But it said that when you live with someone at least a year, your cycles are likely to happen to occur together more consistently. That's what they say. I don't have to that is all my doctors in here. If it's true, put in the comments, tell me how. But that's going to help. But this is what happens. Those are consistent cadence that happens. You want to get in sync. And getting in sync doesn't happen immediately. You just want to get in rhythm first. Then once you get in rhythm, your response patterns begin to be in sync. How you handle challenges. How you process information. And how you make and communicate decisions. And then you deal with energy management. Have you noticed we do everything in our frameworks and threes? In threes. Where you focus your attention. Is where your energy management. I don't want to focus on everything right now. Your job coming into an organization or even starting a business or running an organization or running a business or running a hospital. Isn't to focus on everything because energy management you burn out. You have to focus on small parts at the same time. You want to make sure everything is on point. So you want to start at the root and not the fruit. If you start focusing on the fruit, you're never going to fix the root. It's always going to seem like you can't catch up. So the best thing is to get to the thing that nobody wants to address, which is the root. Once you fix the root, it immediately fix the fruit. The next thing is how you allocate your time. I'm allocating my time as a leader in the areas that matter most. If I'm an aspiring leader, I want to allocate my time, my extra time to helping my leader in areas that they want to focus on. And then what you celebrate and what you connect correct. You have to have energy management on what's going to make you mad and what's going to make you happy. So you're not always up and down. And at North Adams, the leaders of cadence created anxiety instead of confidence. They're irregular communication, reactive decision making, and crisis-focused energy spread fear throughout the organization. Spread fear. Spread fear. We'll get back to you after this commercial. Bridgebuilders, developing transformational leaders is crucial for the future of healthcare. As SIPS healthcare solutions, we offer comprehensive leadership development programs, designed specifically for healthcare professional. From executive coaching to immersive workshops, we can help you cultivate the transformational leadership skills your organization needs, to thrive in today's complex healthcare landscape. Visit SIPS healthcare.com to explore our leadership development offerings and take the first steps toward transforming your organization. Hey, what's going on, guys? Hey, what's going on? You all listen. Welcome back to the show after commercial. Now, let me share the specific strategies that successful leaders use in their first 90 days. So we're going in their first 90 days. That's our learning and assessing. So I gave you the frameworks of learning and assessing. The deep diagnostic of the organization, stakeholder mapping and engagement, cultural and capability assessment. That's where we're focused on in that first 90 days. We're really trying to figure out what the cadence of the organization is and then start slowly just shifting it to your tick. You shift it immediately, it messes up everything. But if you shift it slowly, they get consumed in it. Perfect example is the example of the frog. If you put a frog in boiling water, it's already boiling, and it'll pop and jump right back up. If you set the frog in room temperature water that it's used to, and then slowly begin to heat up the water, it begins to be what? Comfortable in their water and eventually burn up. Same thing goes with when you're in the shower. During that water, slow warm, but you stay in it longer. Your body adjusts. You start to slowly raise the temperature until it gets too hot. And then it's death. Like ladies always like to have their water on scorching hot. I don't understand that. The second 30 days, you're going to focus on strategy and alignment. Vision and direction, setting. Team alignment. Quick wind identification and execution. And then the final 30 days is momentum and sustainability. System and process refinement, capability building, long-term planning initiation. Those are how I'm breaking down my first 90 days. I'm boom, I'm boom, I'm boom. Okay? Now let's drill down into these phases because this is where most leaders either set themselves up for success or failure. In the first 30 days learning and assessment, you need to resist the urge to take immediate action. This is harder than it sounds because there's often pressure to show quick results. But the premature action without proper understanding can be devastating. And then we just look at what happened to North Adams. Here's the assessment framework I teach leaders to use in their first 30 days. With the deep diagnostic, when I'm doing a deep diagnostic, remember we're not just looking at the financial health. Looking at financial health, operational effectiveness, people in culture and market position. It's only all four of those that you can take the analysis of all the information to truly decide what the health of the department organizations in and how to really fix it. So you're coming in in the beginning 30 in that first 30 or in that first moment. You're coming in just to just to plug the holes. Plug the holes that people know you there, but no real changes. They're just getting used to the consistency of you. The second thing you're focusing on is the stakeholder mapping. Who are the power centers? Who really influences decisions? Now, which I'll say the CEO of the boss, no, no, no, no, no, no, no. In every organization, there is that person that doesn't have any title, but everybody comes to for their advice. That's what you need to find. Okay. That's what we need to find. Who really influences decisions? Who does everyone gravitate to positively or negatively? Everybody always looks at titles for who influences a department. If you get caught up in titles, you'll miss influence. Because two people that influence don't care about titles. They just care about the work getting done. So what do you call me CEO, boss, him, her, doctor, or the man downstairs? As long as I can control the environment or the space, the position in title doesn't matter. So find the power centers and build from the power centers. Why? Think about it like an electrical current. If you're not plugging in to the power centers, how can you be powered up to change the organization? So plugging into those who truly have the influence, look past the position, look past the title, really look at the core of the organization. You have a nurse that's been there 40 years. She may not be the CNO. She may not, but she's seen everything in the organization and everyone comes to her mother him for all of their decisions, even the CEO. But if you talk crazy to her and you don't plug in with the power center because you feel like your ideas are better, guess what happens? You miss out on everything great that you wanted to do because you didn't plug into the source. The second thing is stakeholder mapping. Information flow. How and where decisions are made. There's so many leaders that come inside of hospitals and organizations that don't know how and where decisions are made. How can you expect for your upline to find a way to sign off on something that you want to change if you don't know how and where decisions are made? If I know where the decisions are made, I know who can back them and how to present the information. To get them to back me. The third thing is stakeholder mapping. Resistance points. Where change might face obstacles. What are the resistance points? Why are they existing? Why are they there? You need to get background on that. Then the support networks. Potential allies for change. Those who have been there long enough, got a strong enough influence that want to see change but just doesn't have a real strategy. That's how you do your stakeholder mapping. Quick win assessments. We want to identify problems that can be solved quickly. When I'm looking at the assessment of that first 30 days, quick wins identify problems that can be solved quickly, find opportunities for immediate impact, spot low hanging fruit, and that builds credibility. You want to do what my coach is just saying basketball. Just put the ball in the hole. Get a layup, get a free throw. You just need to see the ball go in to build that confidence to say, okay, I'm ready. But in this crucial phase, you're not just gathering information. You're building relationships and credibility through how you gather it. The questions you ask, the people you talk to, the way that you listen. It all sends signals about your leadership style. The second 30 days is strategy and alignment. This is when you start making your moves. You set directions, articulate your understanding of the current reality. Share your vision for the future, define the path forward. Then you build alignment. Create a shared ownership of the challenges. Once you find it, you get everyone involved in creating the change. When they feel involved in creating a change, change happens faster. When they feel like you're another leader coming in trying to tell them what to do, you're going to be in and out three years and they're not going to wear. The staff becomes like bad students. This teacher's not going to make it. This sub ain't going to be here long. So we're going to do whatever we got to do to get you out of here and get out out of here. You want to develop that in a collective solution and establish your priorities. See when you build from frameworks, you can teach your team how to use the frameworks to come up with the right answer. But if you're only coming up with an answer and not teaching them how to think, as a leader, you are crippling your organization. My biggest function is always in frameworks. If you can make your decisions in this framework, it'll be easier for us to be on the same page and communicate a result. But if I'm just asking you, hey, do this, do this, do this. And I'm going to say, okay, give me a result. They can't regurgitate. One of your best skills or the best job responsibilities that you have as a leader is the art of developing leaders. Your job in true leadership is people management, not task management. So I want to learn how to manage people and get us to collectively move together. You may say, Dr. Jake, I don't have a team right now. I'm kind of like a team lead, but I don't really have a team. How can I do this? You practice collective solutions before you manage people. And if you have, if you need somebody to explain to you how to do that, maybe you're not the leader that you think that you are. And you want to establish those clear priorities. Third, with those quick wins, don't forget. You want to implement solutions to identify problems, not problems that you found. Demonstrate progress, build confidence, release your listen. I'm always an advocate of marketing and branding the changes that you're making. Too many leaders are quiet with the changes that they're making and mad that people don't recognize them. Everyone is inundated in their world, their department, their space. If you don't market and brand and sell yourself, and the changes that you're making, nobody's going to know the changes are occurring. That's your job as a leader to make sure that everyone in the organization knows about every single thing that you're helping or a part of and changing that department. So let me share something crucial about the phase that North Adams missed, the power of inclusive problems solving. When they faced financial challenges, they made decisions in isolation instead. They could have engaged staff and finding efficiency improvements, involved the community and solution development, and created partnerships with other health care providers. North Adams leadership team, I don't know them personally, I'm looking at them as a core, I'm saying failed and dropped the ball with their lack of transparency. When you don't give your staff that are doing the work the time to help you solve those problems, you don't build a camaraderie. When the team is only focused on the stars and not the power of the team, what good is a team sport? Okay. So strategy alignment that's second 30 days and then final 30 days, this one you said enough for long term success. And this is where so many leaders make the critical mistake. They think the hard part is over. North Adams by this point, the leadership had already made decisions that were approved failed to the organization, largely because they didn't build sustainable systems for the future. Now I'm not saying it only takes 90 days to do it. What I'm saying is this is the mindset you should be in. By the time you get to your last 30 days, you should be trying to start putting these things into place. System and process refinement formalizing what's needed, adjusting what needs improvement, building and accountability measures. Listen, you cannot lead without transparency. Accountability is only through transparency. If people in your organization are hiding small mistakes or hiding communication or hiding, there's no way that you can build an organization of accountability if the information needed to be accountable to is not transparent. If you're not showing me how you're judging me, how can I know to do right? Number two, capability building, identifying skill gaps, developing training programs, creating leadership pipelines. Let me stop at the creating leadership pipeline. People say we don't have enough leaders. How many organizations are developing or investing in leadership development? You say, man, well, it's because if we invest into it, then they leave us, then when they leave us, we use all that money, or you can think of it that, if I invest into developing them as leaders, I get the most and the best of them when they're most excited. So our organization grows the more we develop leaders. And if they go into the world, and they go work for other organizations, or they go in work for other hospitals, guess what? They can never take away that they got their development from you. But when we, as hospitals or organizations, when you're not developing it to leadership, when you're not developing in the training programs, you're not allocating money and resources to actually develop the talent within your organization, and you leave it only up to them to go get it on their own, they believe that you did nothing for their growth. If you did nothing for their growth, what good is their loyalty to your organization? The more you invest into somebody, the more they feel enthralled to give back. You have the very few that use and abuse the system for their own game. But that's in the few, not the many. And the last thing I'm doing in my final days is long-term planning. Setting strategic priorities, establishing metrics for success, and creating feedback loops. I want to share something powerful about this phase. It's not just about what you build, it's what you make sustainable. In the North Adams, any improvement that they made weren't sustainable because they hadn't built the underlying systems in culture to support them, think about this. When the hospital finally closed, it wasn't just because of their financial situation, it was because they had no systems in place. To identify and respond to early problems, to adapt to changing market conditions, to build and maintain community support, and to develop alternative solutions. All four of those need frameworks. If you want your organization to help you, and as a leader, you don't want to bear the weight of holding everyone together, you have to give the organization frameworks of how to do everything. So at least with the framework, you're building the skill set of problem solving that will allow for you to come up with the best most innovative solution that is cost-efficient and help your organization remain profitable. So by the end of your first 90 days, you should be able to ask yourself a couple of questions. Do you truly understand the organization's reality? Not just the surface levels issues, but the root causes of problems in the real capabilities of your team. Have you built true genuine credibility? Not just through your decisions, but through how you've made them and how you've engaged with the stakeholders. Have you created meaningful impact? Not just quick fixes, but sustainable improvements that set the foundation for future success, even if you were to leave abruptly. And have you established the right tone in pace? Not just for immediate results, but for long-term cultural health and organizational success. Let me leave you with something crucial about leadership transition. The first 90 days isn't just about what you do. It's about who you become to the organization. Every decision, every interaction, every response, shapes not just your immediate results, but your long-term ability to lead effectively. Think about North Regional Hospital. Their closure didn't just happen on that day in March 2014. It happened through a series of decisions or lack of decisions that started in those critical first days of new leadership. The community didn't just lose access to health care overnight. They lost it through a gradual erosion of trust, capability and sustainability. And here are five commitments I want every leader listening to me right now to make. The first commitment, the truth commitment. Commitment to seeing and speaking the truth about your organization's reality. Not just the comfortable truths, but the difficult ones that need to be addressed. Number two, the people's commitment. Commitment to engaging with your people, not just managing them, understanding their perspectives, leveraging their insights and building their capabilities. Number three, future commitment. Commitment to building for the long term, not just solving immediate problems. Every decision should serve both present and the future. Number four, the learning commitment. Commitment to being a learner first, then a leader. Your first 90 days are as much about understanding as they are about acting. And five, the legacy commitment. Commit to building a building something that lasts. Your decisions in these 90 days will echo long after you make them. And listen, the 90 days isn't just you being new to this space. The 90 days is anytime you decide that you want to create change in wherever you are to. Remember Bridgebuilders, your first 90 days of creating change are being new into a space to create change, set the trajectory for everything that follows. The habits you form, the relationships you build, the tone you set. These create the foundations for your entire leadership tenure. This is Dr. Jake Taylor, Jacob signing off. Thank you for tuning in to another episode of Bread to Leader until next time. Keep leading, keep building, and keep breeding excellence in everything you do. Remember Bridgebuilders, your first 90 days aren't just about you making your mark. They're about you creating the conditions for lasting success. Make them count. Listen, leadership. This is what we do here. If you truly find value in what we do, please share it. Please like it. Please comment. Please send this to 10 other leaders that need to hear this right now. Our goal is to make sure that in healthcare, we have the best leaders on the planet. Because we're in the business of saving lives. And if we're going to be in the business of saving lives, we need the best people to help us do it.