A Guide to Implementation
Introduction
Over the last twenty years we have traveled millions of miles around the world, speaking at thousands of events. We learned a great deal from the innovations of our clients, some of it contrary to widely held beliefs. But we all felt the need for a deeper exploration of how the FISH! Philosophy ignites positive culture change.
We got that opportunity when Steve, living in Australia as a visiting university professor, introduced FISH! to Blue Care, one of the country’s leading not-for-profit senior care providers. He helped them transform from an organization that did good work to a world-class example of service to the elderly and disabled.
The following stages from the Blue Care experience are provided to guide those who would like to accomplish similar goals. In other words, they will help you implement and lead FISH! in your organization. We’re hopeful this helps you, our readers, create your own FISH! Culture.
Stage 1: Connect FISH! to Your Goal
Blue Care introduced a new care model, called Tailor Made, that “tailors” how Blue Care responds to the unique needs of each individual client. In this “person-centered” approach, staff actively looked for ways to provide as much choice and independence as possible. They worked to meet the resident’s emotional and social needs, not just their physical needs.
Blue Care knew Tailor Made would not succeed if it were driven by rules, procedures, or scripts. It would only succeed if employees were inspired to bring their whole selves to work.
One of the Blue Care leaders attended a FISH! workshop and saw a connection. She thought, “What if we built a culture grounded in FISH! that would serve as the foundation for Tailor Made?” The Blue Care manager was bursting with energy to get this done but wise in the way she went about it. She needed allies.
Compelling inspiration begins the culture change process.
Stage 2: Recruit FISH! Agents
In an organization of eleven thousand employees, the fledgling idea for change needs a broad base of support. So Blue Care created the role of FISH! Agent.
This group attracted people from all levels and locations of the organization, natural leaders whose energy and enthusiasm motivated others to take notice.
The FISH! Agents were not ordered to participate; they responded to a request for volunteers. The group quickly became involved in planning and decision making for the FISH! implementation.
The word volunteer is critical for anyone introducing FISH! because FISH! is a philosophy. A philosophy can’t be forced on people. You must invite people to join you because they see value in what you are proposing.
Build a team to guide the culture change process.
Stage 3: FISH! Camps and Blue Swimmers
Employees were invited, not required, to attend FISH! Camps. As a result, those who came were curious and open.
Attendees, called Blue Swimmers by Blue Care, learned the FISH! Philosophy and considered how the practices could help them achieve the Tailor Made vision. They discussed practical questions such as: “How do we transform what we have seen as a task into an opportunity to make the client’s day?”
FISH! Camps put the process of transformation in the hands of the participants. They weren’t given answers. They came up with questions and creatively explored how they could bring the vision to life, as a team and as individuals.
The FISH! Agents had hoped for one hundred people in each camp. Attendance far exceeded expectations. As word spread about the FISH! Philosophy, one camp had eight hundred attendees. Many dressed in fishing gear, adding to the fun atmosphere. By the end of the last camp, five thousand Blue Swimmers had been trained.
Back at their locations, staff felt empowered to take a hands-on role in creating their culture.
Influence culture change through invitation and choice and watch it go viral.
Stage 4: FISH! Master Classes
A few months after the FISH! Camps, the FISH! Agents created two FISH! Master Classes to maintain momentum and reinforce the learning and language.
The classes showcased some fishy workplaces within Blue Care. Employees talked about their accomplishments and shared the impact FISH! had on clients, coworkers, and on themselves personally.
Participants in the Master Class lit up as they heard the stories, saw pictures, and imagined what they could do in their workplaces.
Provide events where the story is told and others are encouraged to join the effort.
Stage 5: Starfish
FISH! needs to become a part of day-to-day conversations to survive in the long term. Blue Care created the Starfish role to support this goal. Starfish are local champions who keep the energy of FISH! alive in their workplaces. They came up with several ideas to engage people, such as:
1. Create an atmosphere at work that employees find supportive and energizing.
2. Listen to those around you and become known as someone who listens.
3. Coach one another to continuously improve by living the practices of FISH!
4. Find and share stories of people making a positive difference with FISH!
5. Recognize and celebrate people when they live the FISH! Philosophy. One team awarded an inflatable trophy to the fishiest person at work every month.
6. Create fun projects and events that keep FISH! top of mind.
7. Remind all who will listen that this is a long-term commitment and a journey, not a destination.
8. Stimulate conversations about FISH! experiences.
9. Always keep one toe in the water, testing the temperature and looking for ways to release energy.
Catch and release your FISH! Culture Champions.
Stage 6: Vision Moments
A clear vision makes it possible to “see” examples of the vision in action, and opportunities to create more. Blue Care’s vision of Tailor Made, supported by FISH! practices, helped staff see new ways to deliver “person-centered” care.
When the staff focused on being more present for each person and situation, they chose an attitude of being open to play with ideas that might make the resident’s life happier and more meaningful. (See how the FISH! practices work together?)
This led to creative, person-centered solutions. For example, one resident became increasingly agitated and difficult to care for. Staff learned he had been a plumber, so they arranged for him to help maintenance (his “tinkering” was safe and supervised). He was calmer, happier, and easier to help.
When a former musician became agitated at meals, instead of simply offering medication, the staff offered him an MP3 player and headset. The transformation was incredible. He ate with a smile on his face, tapping his toes.
When staff learned a distressed memory unit resident had been a skilled cook and homemaker, they purchased aprons, children’s clothing, and a duster. Each morning the resident helped staff make her bed, hung clothing on a clotheshorse, and cleaned. She was happier because she was engaged in an activity that had a purpose.
To help residents dealing with dementia, Blue Care brought more play into their lives. Visiting performers used props and musical instruments to engage residents. Residents who had been unresponsive often joined in by singing or dancing. An analysis of “mood charts” showed they were happier after the visits. Residents had fewer falls and the use of antipsychotic medication dropped dramatically.
Culture change becomes embedded when people personalize the vision and live the vision in their daily activities.
Stage 7: Who Are You Being?
The FISH! language is now the language of Blue Care. Every day in hundreds of different Blue Care locations, there are conversations about how to better serve clients. Most of those discussions are related to the FISH! Philosophy. This is the new normal.
The primary lesson in the new normal is a concept that supports the vision. No matter what we are “doing,” we also are “being” something. Being is about the way we show up. There is what we do—the tasks we perform. The other side is who we are being while performing those tasks. Why be stiff when you can choose to be loose? Why choose impatient when the opposite is also a choice and much more gratifying?
A key practice of the FISH! Philosophy is consciously choosing the attitude you bring to your life’s ventures. The positive impact of that choice was especially apparent in one Blue Care respite center.
Though the outside of the building appeared old and worn, inside you were met with a wave of fishiness! The feeling of inclusiveness, fun, laughter, and friendship was palpable.
This was notable since the staff, which had been coming to this building for twenty years, was moving to another location. You would expect the clients and staff to be anxious. That was not the case. They brought the FISH! Philosophy with them.
Since embracing FISH! in every facility, conversations have changed for the positive. Old and deeply ingrained patterns have lost their grip on many staff. FISH!-based changes were followed by a major decrease in staff sick leave, work cover claims, bad team dynamics, low morale, and staff and residents’ complaints. The number of staff attending meetings and the amount of staff collaboration have increased dramatically.
When we choose our attitude about who we are “being,” we can achieve dramatic results.
Stage 8: Create Vision Moments
A clear and important vision makes it possible to “see” examples of the vision in action. Blue Care’s vision of Tailor Made, supported by a FISH! culture, helped staff identify better ways to deliver “person-centered” care.
For example, a staff member asked an elderly woman what would make her life better. She replied, “Can you just sit with me a little while longer?” The simple act of being present made the difference between her feeling lonely and feeling cared for.
This is an example of one of the thousands of interactions between residents and staff that occur each day because of the FISH! transformation.
As time passed FISH! took on a life of its own, so much so that it became more difficult for FISH! Agents to find these stories. They came to realize the stories were hard to find because FISH! had become a way of life. It was the new normal.
Conversations between staff and residents and between staff and families also changed. Frequently the FISH! memorabilia and decorations ignited conversations about what the practices were all about. Every time a staff member explained the purpose of the FISH! Philosophy to a client or family member, it strengthened the staff’s commitment to the vision.
A sharp vision allows staff to identify behaviors that support FISH!
Stage 9: Celebrate
Celebration is vital for keeping the spirit of FISH! alive. We all want to be appreciated and valued. When we celebrate one another, not just for what we did but for who we were being when we did it, it makes us want to do it even more. It reminds us of our shared commitment.
It feels just as good to recognize someone as it does to be recognized. It builds trust, equipping the team to handle challenges with confidence and common purpose.
Celebration and recognition drive and deepen FISH! culture change.