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 Today in health, it we're going to be covering how to avoid misery as a health it leader. I've been writing about the misery index on LinkedIn. Love to share some of that with you. And that's what we're going to do today. My name is bill Russell. I'm a former CIO for a 16 hospital system and creator of this week health, a set of channels and events dedicated to transform health care.

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So I was Charlie Munger was the partner of Warren buffet. For many years, he is a FA. Fantastically smart. Brilliant. Financier, lawyer and as well, he is also witty. And I, it is. Some of his outtakes on YouTube are worth watching. They're just funny. But he I'm reading a book. Where it has 12 of his talks in there.

And it's a really fascinating, and one of them. I was the life mistakes that will cause you misery. It was a talk at commencement address. He gave to students. It was based off of another talk that that Johnny Carson gave to students, that commencement address. And Johnny had three things.

And Charlie built off of those three things and did three additional things. And I started to think, what are the mistakes, health it leaders make that guarantee misery. And so I started a list out on LinkedIn. It's been pretty well received. If if impressions and comments and stuff, or any indication. It's garnered 30, some odd thousand. Impressions and it's only rising.

So let me give you the first five, by the way. I'm not going to do them all, but I was on an airplane and I just started jotting them down. And I had to stop myself at about 23. I'm not going to do all 23. Some of them feel a little redundant I will go through those and just pull out the best stuff.

Maybe I'll get to the top 10. We'll see. But here are the top five that I've given so far, the mistakes, health it leader leaders make that guarantee. Misery number one, not taking action on toxic staff and managers. It's interesting because we all know the quotes, right? The. The quote that people don't leave a company, they leave. A toxic workplace or a manager.

They leave the person they report to more times than not. If you look at the statistics, that is absolutely true. When we come into an organization, I've taken over a lot of organizations. Where I was brought in as the leader in. And a lot of cases, it's a turnaround situation. That's the thing I'm very good at because I can determine what things are very quickly and move very quickly. But one of the mistakes I tend to make. Have made several times in my career. He is not identifying the source of toxicity within the culture of the organization.

Quick enough. And taking action quick enough. I did coach a CIO. I've gotten smarter at this and as I was coaching CEOs I actually interviewed their staff, which is really interesting, especially the direct reports. When they first take me when they first take me on as a coaching as a coach. I will go in there and do an assessment.

I will talk to their peers like the CMIO and CMO and CFO and others. I'll talk to their peers about what they expect from it, but then also talked. To their staff. And invariably in those conversations, I will pick up on a toxic leader and then the comments are pretty obvious. They have not bought into where things are going.

They don't believe in the current CIO. They believe that, the healthcare system is on a downward trajectory. But there's a difference between just negative and toxic toxicity. The person who's toxic actually takes action on that. They continue to build on that. And and if you don't take action on that, it will impact.

And I remember one gentlemen that I coached as a CIO. Told me, you said the first month you told me to get rid of this manager and I didn't get rid of that manager until the month before I left as the CIO, because I didn't want to pass that person on to the next CIO. He goes at that point. I got all sorts of emails from people thanking me for finally getting rid of that person.

I thought. Man, I should've done that when you told me to in the first week or first month. And that is so true and we don't do it for a lot of reasons. The most prominent reason is they're. They're smart. They're capable. They know something, they have some body of knowledge that nobody else has. And you're just afraid.

You're not going to be able to replace them. Trust me, it's a source of misery for you. Take that action. Second one Ms. Handling trust. And this is really interesting. It tends to sometimes when we when we get a little full of ourselves, maybe a little on the arrogant side or prideful side we will think that we are beyond. I don't know, accountability. And so we'll just, w we will. Whatever, just mishandled trust.

We'll tell people, yeah, don't worry about that. This is how much it costs or whatever. We will bend the truth a little bit because people don't necessarily understand. Technology or the contracts that we signed or the budgets that we do. Or the, or. The scale of the projects that we're doing.

And we take advantage of that when you take advantage of any of that. You're mishandling trust. And when they find out it's not good. I remember one of the early meetings. When I was when I came in as an interim CIO at St. Joe's one of the early meetings. More than one. Executive said to me, It is a black hole. That's mishandling trust when they don't understand what's going on.

When you're not forthcoming with information, when you're not transparent, you're mishandling trust. That doesn't bode well, and there's a reason I was in there as the interim CIO. Because things were not going well. So not taking action on toxic managers and staff. Number one, miss handling trust number two. Number three, failing to develop your team. The first budget to get cut is always the training budget. But the mistake we make is thinking that there's nothing you can do to train people when that budget has gotten cut. That's when you have to really be creative. And you have to tap into the things that are readily available to you to make sure that your staff continues to develop. And this is not one that, that kicks you in the bud immediately. It kicks you in the butt over time. Because when you stopped developing your team, the best staff members recognize that they want to advance in their career.

They want to get smarter. They want to work on more challenging projects and those kinds of things. Look for ways to get them trained partner with a university utilize the smart people you have within your health system. Train them on. I don't know on, how finances work within healthcare.

Bring them up to speed on the business by using people internally who understand that. Helping to understand billing, help them to understand. Clinical workflows in different areas and whatnot, utilize the resources you have right there in front of you never stop. Investing and developing your team.

That is a short path to misery. That's number three, number four under resourcing. It. Now I understand we've had a lot of budget cuts. Recently and we haven't had a lot of choice. In terms of, how much money it is going to get. It does not negate the fact that every year you should ask for exactly what you need. The first part of that is understanding exactly what you need. And being able to communicate effectively what you need. We make so many mistakes with regard to resourcing it. And it's probably part of a larger conversation and a larger discussion. But we have to know our number.

What's our number for maintenance. What's our number for refresh. What's our number four projects for pulling off these projects. What's the what's the run rate after the project's done for supporting the technology you're putting in place. There's an awful lot of numbers that we should know and really understand. So that we can communicate it too many times.

We're losing these battles. And we're not even asking for the right number to start with. And because we appear again, it could be a combination of mishandling trust. And and not really understanding the finances of our own organization. We appear to be. People with an insatiable appetite for for money and for budget. And what people want to know is that we're responsible.

So transparency really helps there. And that we have a story that we can link it all to. How is it being spent? How is it moving things forward? How is it tied to the mission and all those things? So under resourcing it and this one, man, it will cause misery, you can do it for a year. You might even be able to get away with it, shortchanging it for two years. But I inherited an it organization. That had a well over 85% end of life equipment. And it was a seven and a half billion dollar health system. If you could imagine not spending money on it for that long. A period of time that the equipment wasn't old, it was deemed end of life by the manufacturers. Okay.

So don't under, under resource. It. For too long, a period of time or. It will cause misery. The final one for today, not managing the flow of work. This is one of those ones that there's a lot of different ways to do this. I found that the really understanding the amount of work. Your it organization can handle and creating a gauge. So that people who are making decisions are part of the governance process can determine whether we can take on more projects.

Look, if you give them a. If you give them a fuel gauge, this is how much we can do from an it perspective. And it's fairly accurate. It doesn't have to be perfect, but fairly accurate. They're not going to just keep throwing projects at you. They're going to know that. We only have three gallons of gas left. Which means we can only go about 60 miles or 70 miles. We probably, aren't going to try to go 20 miles.

That's just ridiculous. But I find that too many. Healthcare leaders don't take the time. Or come up with excuses for not being able to do that math. And providing the organization and accurate. Fairly accurate. Reading. Of what is possible for it to do at any given time. When you do this, man, it is misery upon misery.

Your team is miserable. They're just too much work for too few people. And I know that's the case in a lot of places right now because of the of tight resources. But when they adjust the budget down, That's when you really have to be vigilant on this. One of managing the flow of work into it. And if 80 to 90% of your budget and people are working on maintenance and support, Then you can't do that many projects and your organization needs to understand that.

So there you go. Top five mistakes, health, it leaders make that generate misery. I'm going to keep posting them out on LinkedIn. You can follow me out there and a comment, be a part of the conversation out there. And we'll keep going. We'll see where it takes us. But number one, Not taking action on toxic staff and managers.

Number two, Ms. Handling trust. That's been given to you as a leader. Number three, failing to develop your team. Number four under resourcing. It. And number five, not managing. The flow of work into it. There you have it. That's all for today. Don't forget, share this podcast with a friend or colleague, use it as a foundation for mentoring.

We want to thank Panda health who is investing in our mission to develop the next generation of health leaders. You can check them out at this week. 📍 health.com/panda. Thanks for listening. That's all for now.