PART FOUR
Moments of Truth
TEST NUMBER ONE
Jude spent much of that evening preparing for the next morning’s session with Lindsay and her team. By the time he arrived in the conference room at the hospital, he was feeling pretty confident that his theory was more solid than ever. But that confidence was offset by the reality that a new group of executives could change everything.
As soon as the team of eight was seated around the table, Lindsay introduced Jude and succinctly explained the reason he was there. “We need to start working as a hospital, and not as separate departments that happen to share a building.”
Everyone seemed to be in agreement with the goal.
Jude then went to the front of the room and asked the group a series of questions about their behavior as a team. How comfortable were they in being open with one another? How much did they engage in honest debate? That kind of thing.
After an awkward few minutes, the team opened up. Soon enough Jude came to the conclusion, as Lindsay had suggested he would, that there were no blatant personality clashes among the group and that the silo issue was probably more structural and organizational than interpersonal. So Jude moved to his pitch.
First, he asked them for examples of crisis situations they had been in, and for the next ten minutes helped them come to the realization that teams often perform at their best when their backs are up against a wall.
He told the group about his wife’s emergency room experience, which not only was helpful in driving the point home, but seemed to help them come to know Jude as a person rather than just a consultant.
As the lesson was beginning to take hold, out of nowhere Jude asked a rhetorical question of the group, one he decided should be a staple of his workshops in the future: “Why wait for a crisis?”
It was as though he had just told them about electricity.
He continued, with more enthusiasm than he had yet demonstrated to a group of clients. “Why not create the same kind of momentum and clarity and sense of shared purpose that you’d have if you were on the verge of going out of business?”
That set off an outbreak of nods and raised eyebrows from the suddenly engaged audience. Now that he had them where he wanted them, Jude decided to get right to the meat of his session and asked the $64,000 question: “What is the single most important accomplishment that this team needs to make in the next six or nine months?”
The chief medical officer, who oversaw all doctors in the hospital, responded first. “That depends on who you ask. The nursing department is going to have a different answer than administration or marketing.”
Lindsay looked at Jude as if to say and that is exactly the problem.
Jude was happy to be able to address the issue right away. “Okay, I understand that every department has different areas of focus and expertise. Which is a good thing. But what is it that you need to be focused on for the good of the entire organization? Regardless of your departmental role.”
Nothing. It was as though the question had been asked in a different language.
Jude tried another approach. “How about this? Take off your functional hats and think about yourselves as generic leaders without ties to any one department. If I were to come back here next year, what is the most important thing that you would want to be different about the hospital?”
That seemed to spark a few ideas in the minds of the executives.
The chief nursing officer went first. “I’d like to see morale improved. If we don’t have a more motivated work-force, I don’t see how we’re going to be able to sustain the levels of care that we need. And we don’t want any union problems like they had in Stockton.”
No one seemed to disagree, but the chief medical officer countered, “Don’t get me wrong. I’d love to increase productivity and morale too.” No one was quite sure that he meant it. “But frankly, I’d rather see us invest in our clinical technology. If we fall behind in that area, none of the rest of this matters.”
The chief nursing officer rolled her eyes while the chief operating officer, a small man wearing a bow tie, spoke for the first time that day. “Listen, if we don’t fix the infra-structural problems around here then we’re going to lose half my people. Everything from billing to scheduling to e-mail is a mess. But every time the docs say they need a new machine, they get it because we’re afraid they’ll take their business to another hospital.”
Now that it was clear that everyone was firmly entrenched in their own areas, Lindsay was starting to get frustrated.
“Does anyone here still think we don’t have a problem with politics?” She snapped.
The chief medical officer took issue. “This isn’t about politics. It’s about doing what’s right for our patients.”
“And don’t forget our doctors.” The nursing head chimed in sarcastically.
“Yes, and our doctors.” He politely acknowledged. “Without them, our patients aren’t going to be too happy.”
“And the nurses don’t play a critical role in that?” she asked, calmly.
“Well sure, but even a great nurse can’t help a patient who doesn’t have the right equipment.”
The head of human resources sighed, and then made a declaration. “I am so tired of hearing about whether nurses or doctors are more important! Who cares? We need both. And for that matter, we need accountants and cafeteria workers and janitors, and yes, even human resource administrators.”
In a rare moment of comedic solidarity, the doctor and nurse looked at each other as if to say, “Do we really need human resource administrators?”
The HR head started to get a little emotional now. “Listen you guys. Every time one of my people comes to one of yours,” she motioned to the heads of doctors and nurses, “and asks them to do something that isn’t directly about a patient, they treat them like they’re a child. They come back to me completely demoralized, which is ridiculous, because all they’re doing is their jobs. If you don’t think we’re doing the right things in HR, then tell me and we’ll take a look at it. But if you don’t think we should be doing anything at all, then please, put me out of my misery and fire me so I can go somewhere where people understand the value of good management.”
She paused, and everyone thought she was finished. Then another thought seemed to cross her mind and she continued, with even more emotion now. “You know, just because my people didn’t go to medical school or cut patients open for a living doesn’t mean they don’t care about patients. It’s just that the way they care about patients is to take care of the people who take care of those patients. It wouldn’t hurt us to acknowledge that from time to time.”
The last statement hit everyone in the room where it needed to. No one spoke for a long five seconds.
Before the next phase in the turf war could begin, Jude jumped in to redirect the conversation a little. “Okay, I want everyone here to take off the departmental hats you’re wearing.” Going around the room one by one he explained. “That means you’re not a doctor, you’re not a nurse, you’re not an administrator, you’re not an HR person, and you’re not a community relations or communications or whatever it is you’re in charge of kind of person.” They laughed at Jude’s inability to remember the external affairs title.
“You’re all now wearing a hat that says ‘Executive of Children’s Hospital of Sacramento.’ That’s it.”
He paused to let it sink in, and then reframed the question for the group. “Which of the things you’ve described so far, or maybe something you haven’t mentioned yet, has to be done in order for the hospital to give itself the best chance of achieving its long-term goals?” He looked down at a piece of paper sitting on the table in front of him. “It says here that your five-year goal is to become the best hospital in Sacramento, and one of the top ten pediatric hospitals in the country. Right?”
They all nodded without hesitation, making it clear to Jude that they were both clear and on board.
“Okay, good.” Jude was relieved to have agreement around something. “So what is the biggest impediment to that happening, in terms of the next year or so?”
Everyone was considering the question when the chief operating officer weighed in. “It has to be patient support services. That’s our biggest Achilles’ heel. I think we’re strong in terms of medical technology and quality of doctors and nurses, but we’re dropping the ball when it comes to old-fashioned customer service and communication. It’s all too confusing and disjointed for patients.”
Amazingly, everyone slowly started to nod.
The chief nursing officer went first. “I actually agree with that. I mean, we can always improve in terms of clinical stuff. But it’s the hand-offs and follow-up that we stink at. And frankly, we’ve all seen the surveys. That’s what people remember most about their experience, whether they’re here for surgery, birthing, or just testing.”
The doctor countered. “I’m just uncomfortable taking my eye off of clinical technology.”
The head of external affairs jumped in. “Are you wearing your doctor hat or your executive hat?”
Reluctantly, the doc admitted, “Okay, it’s my doctor’s hat. But I still don’t want to—”
Now Lindsay interrupted him. “Listen, we’re not going to let this hospital ignore clinical care. But we’re going to have to make difficult decisions and trade-offs sometimes. And I’d prefer it if we could figure out those trade-offs together.”
After a brief moment of silent consideration, Lindsay declared a temporary answer. “Okay, let’s assume that patient service is it. Then what?” The question was directed at Jude.
He wrote “Patient Service” on the board and said, “Everyone write down two or three or four things that we would need to do to turn this situation around.”
The head of marketing raised his hand. “So what do you call that?”
Jude didn’t seem to understand the question, so the marketing VP clarified. “Is that a goal or an objective, or what is it?”
Jude looked at the white board as though the answer were written on it somewhere. “I don’t know. I guess I’d call it a—” he paused, “a theme. Or maybe a thematic goal.”
Three of the people wrote down his answer and Jude decided it was probably the right label for what he had been previously referring to as the rallying cry.
Jude continued. “Okay, everyone write down the handful of things that need to happen if we’re going to accomplish our thematic goal of improving patient service.”
Then the CFO raised his hand. “You want numbers?”
“No. Definitely not. All I’m looking for are big fat categories of things that need to be accomplished. Keep it as general as you can. We’ll deal with numbers later.”
The executives went to work, completely focused on the exercise now. Jude decided that none of them were evaluating him or what he was doing; they were thinking about the business. Which was all he could ask for at this point.
After three or four minutes, Jude surveyed the room, pointing to each executive for a response. By the time everyone had spoken, Jude had written four different subject areas on the board:
• Better patient throughput
• Integrated clinical information systems
• Improved case management
• More joint planning
As they studied the various areas, Jude asked, “What’s missing? If we did everything on this list, what could still cause us to fail in terms of patient satisfaction?”
“Oh wow, we forgot something huge.” It was the CFO. “What about outpatient scheduling and communication. Isn’t that where we always seem to get dinged?”
He had definitely hit a nerve.
“Yeah, that one will kill us if we don’t do something about it soon,” added the head doctor, much to everyone’s quiet delight.
Jude put it on the list and stood back for a moment to let them soak it all in.
Then he decided not to wait for someone to ask the next inevitable question. “Now, I bet some of you are thinking, What about our day jobs? Rest assured that we’re not forgetting about the fact that we have to continue doing surgery and treating patients and paying bills and collecting insurance.”
The muted laughter and smiles on the faces of some of the executives made it clear that they were indeed thinking the same thing.
“Those tasks are and will always be critical. But if that’s all we’re thinking about, then every month and every quarter and every year that goes by won’t make this a better hospital.” Jude made a note to himself to thank Carter for providing some of the language he was using.
“All makes sense to me,” declared the head doctor energetically. “This is right on target.”
The look on the faces of the people around the table was one of momentary shock. Jude would later learn that the chief medical officer was the team’s cynic, someone who rarely acknowledged a good idea that wasn’t his own. They couldn’t believe he had been so enthusiastic.
DEEPER
“What’s next?” asked Lindsay. “I like it too, but it seems like we need more clarity than that.”
Jude was glad that she was doing the pushing, and not her staff. He didn’t want them to see her as rooting for him.
“The next step is twofold.” He pointed to the white board. “First, figure out how to measure each of these areas. And then come up with a short list of ongoing operational objectives that you need to track in addition to this stuff.”
“How exactly do we track it?” the COO wanted to know. “Do we need an online tool or something?”
Jude shook his head. “I don’t think so. The key is reviewing it during your staff meetings. This should become your scoreboard or your grounding tool for every meeting.”
Lindsay frowned, not quite on board yet. Jude could see she wasn’t getting it, so he continued his explanation.
“Every time you get together for a meeting, you should start by asking yourselves how you’re doing in regard to these areas.”
“You mean, we should go through all the metrics?” she wanted to know.
This was new territory for Jude, so he was going with his gut now. “No, I’m thinking that you should keep it more qualitative than that. It seems like when you start with data people’s eyes glaze over and you lose them.”
The head of marketing agreed. “Either that or they get so wrapped up in the details that they lose sight of the bigger picture.”
Lindsay wanted more evidence. “Let’s try it right now, without the data, and see how it works.”
Jude smiled and turned to the white board. “Why not? Okay, let’s use a simple way of evaluating these areas. How about rating them one through five?”
Lindsay shook her head. “No. Even that gets confusing. If we’re going to keep it simple, let’s keep it real simple. How about green, yellow, and red? Green for ‘on track,’ yellow for ‘not quite there or not quite sure,’ and red for ‘definitely not where we need to be.’”
Jude was happy to try it. “All right, let’s start with the first area. How would we rate our current situation in terms of arrivals and departures?”
For the next ten minutes, the team went through the five topics, reporting their assessments and then trying to arrive at a general consensus around the final color rating for each area:
| Better Patient Throughput | yellow |
| Integrated Clinical Information | red |
| Improved Case Management | yellow |
| Joint Planning | yellow |
| Outpatient Management | red |
“Shouldn’t at least one category be green?” the CFO wanted to know.
Jude shrugged. “Well, if something is in good shape or on track or ahead of schedule, then yeah, it would be green. And that will probably be the case in some situations. But because we’re just starting out, it makes sense that everything is red or yellow.”
As the team studied the chart, Jude decided something was missing. “You know, let’s go ahead and add the standard operating categories so that we have all the big stuff in front of us.”
“Have we decided what those categories are?” Lindsay asked him.
“No, let’s do it now. We shouldn’t have more than four or five, I would think.”
The team then had a fifteen-minute discussion and settled on the following areas for ongoing measurement:
• Occupancy of Beds
• Clinical Outcomes
• Operating Income
• Staffing Ratios
• Cost per Discharge
Jude wrote them on the board and looked back at the original five categories. “Let’s see. What should we call these things that define the thematic goal?” He looked to the group for a suggestion.
“I like what you called it before,” the head of nursing said. “What was it, big fat categories of stuff, or something like that?”
Jude laughed. “Well, maybe we need something just a little more descriptive.”
The chief medical officer saw an opportunity to come up with an original thought. “Why don’t you call them Defining Objectives? That’s what they do, give definition to the thematic goal.”
No one objected, and Jude liked it as much as anything he could think of. “Okay, so we’ve got a thematic goal, defining objectives, and then the standard operating objectives.” He looked at the board.
With a sense of passion he challenged the team. “Someone tell me why this shouldn’t create the context for every staff meeting you have.”
After a pause, they began shaking their heads as if to say I don’t see any reason not to.
Lindsay spoke next. “Tell us again exactly how this is going to solve our silo problem.”
Before Jude could say anything, the CFO jumped in. “Because now if anyone argues for something that’s good for their department or functional area but doesn’t have a meaningful impact on any of these things,” he motioned to the board, “then we’ll all be able to explain why it shouldn’t be a priority.”
The chief nursing officer added, “And to be honest, now that we’ve clarified this, it would be much harder for me to even think about lobbying for the nurses at the expense of what we’re trying to do overall.”
“I don’t think it’s going to be quite that easy.” It was the COO, in a tone that was challenging, but not bitter. “When we go back to our areas and get bombarded by our people with what they want and need to do their jobs, I think it will be hard not to go back to the way things were before.”
Jude agreed. “You’re right. And that’s why we need to keep coming back to this.”
Lindsay was suddenly fired up, and spoke out with more force than usual. She seemed to be responding to what her COO had just said. “Then let me be very clear to everyone here. You should all go back to your direct reports and tell them what we’re focused on here. We need to help them understand what our priorities are, and why we can or can’t do some of the things they want.”
She paused for a second. “Heck, why can’t we announce this to everyone in the hospital?”
Jude thought about it for a moment. “Well, we’d have to do it in a way that made sense.” He was trying, unsuccessfully, to find a reason why it wouldn’t be a good idea. “But I guess there’s no reason not to. It would create the context for everyone to think about doing their jobs a little differently.”
“And it would connect them to the rest of the hospital,” agreed the head doctor, “instead of just their area.”
There was no doubt in Jude’s mind that Lindsay and her team were, to a person, excited about what they had just accomplished. The CEO called for a break, and asked the CFO and Jude to stay behind.
REVENUE
When the room was clear, Lindsay spoke first. “Okay, this is really good stuff. But we’re going to need help making it stick.” She turned to the CFO. “How much can we afford to pay Jude?”
He hemmed a little. “First, I agree that this is great. And it’s worth whatever it costs.”
Jude could feel the “but” coming.
“But we’ve still got to get the budget approved, and right now, I’m afraid we only have about half his retainer covered.” He turned to Jude. “I’m sorry, but I think that’s the best we can do right now.”
Feeling the need to be more gracious than his checkbook would have liked, Jude reassured them. “I understand. Timing is everything sometimes.”
Lindsay jumped in. “But there is something else I can do. I’m going to call a few of my friends, the CEO of Stockton General and St. Mary’s Hospital in Fresno, and tell them about what you’ve done here. And I know a woman who took over that automobile manufacturing plant in Fremont. And she probably has plenty of budget for this.”
The CFO nodded. “A few of my vendors could use your help, if they’re willing to admit it. Like Hiett Linens, the company that provides our uniforms and sheets. I can probably arrange for a meeting with them.”
It wasn’t money, but it was probably more valuable over the long term, so Jude thanked them enthusiastically.
The second half of the session was spent fleshing out the details of each of the defining objectives. Dates, metrics, specific criteria for determining when something would be finished.
At the end of the afternoon, Lindsay thanked Jude and announced that it wouldn’t be the last time the team would see him. They actually applauded, which Jude found surprisingly uncomfortable. But he’d take it—and use it as a source of confidence during his next sales call, where he’d need every bit of support he could find.
SHIFTING GEARS
When Jude arrived home that evening he told Theresa about the success he’d had, as well as his temporary financial setback at the hospital. All in all, though, he was happy.
Uncharacteristically, Theresa seemed unable to focus on what he was telling her. Finally, she explained why.
“The girls are making progress faster than the doctors thought they would.” Then she started crying, and not in a joyful way.
“That’s great! What’s wrong?”
“They’re going to be coming home more than a week early. In five days.” She paused. “I just don’t know if I’m going to be able to handle it.”
Jude hugged her. “Are you kidding? You’re going to do fine. You’ll be a natural.”
She argued back gently. “I’ve gotten so used to having those wonderful nurses and doctors taking care of the girls that I’m afraid for them to leave there. I almost wish they’d keep them for another week. Is that terrible for me to say?”
Jude laughed, consolingly. “No. It’s not terrible. It’s normal. Don’t worry. I’ll be here to help you.”
“But you’ve got so much to do at work.”
“No. When the girls come home, I’m taking two weeks off completely to be here and help with the transition. And we’ll have your mom around too. Listen, I’ve just got to get a couple more clients firmed up by then.”
Jude was wondering just how he was going to pull that off, when he looked down at his wife and noticed she had fallen asleep. That’s when it dawned on him how tired she must be after almost three solid weeks of uncertainty and intensity. He too was on the verge of exhaustion, but knew that he needed to keep his energy level up for just another five days if we was going to get some momentum before shifting to full-time parenting for a while.
Not that he had any illusions of that being easier. But somehow, at that moment Jude longed for the challenge of all-night feedings and round-the-clock diaper changes. Anything to avoid going back to the Madison.
PRIDE SWALLOWING
Even by the tone in his voice during the initial phone call, Jude could tell that Dante’s feeling toward his consultant had changed since that disastrous presentation. He wasn’t rude or particularly cold, but he was certainly a little more distant.
Still, he agreed to meet later that day, which would give Jude an opportunity to convince the CEO to give him another shot at his team. It wouldn’t be easy.
Dante wasn’t ready to have Jude address his staff again. Not quite yet. “Listen, Jude. Maybe it would be better if you just told me what you’d like to do, and I could relay it to the team.”
Jude was torn. He knew that if given the chance, he could bring them around. But he also wanted to respect Dante’s situation. After all, a consultant shouldn’t be a reason for a CEO to risk losing credibility with his team.
So Jude obliged and dove right in.
First, he talked about the power of a crisis, which Dante found very easy to relate to. And when he said “Why wait for a crisis?” he knew he had him hooked.
Then Jude challenged him to think about what his thematic goal would be. Dante threw out a few ideas. Efficiency. Repeat business. Clearer marketing. None of which seemed like the right idea.
Jude encouraged him to think in terms of broader issues. “What do you want to see happen during the next nine months?”
Then it dawned on the CEO. “I want us to regain the momentum that we once had. I don’t want us worrying about the competition and reacting to them. I want us to have a plan and to be enthusiastic about it. To go on the offensive.” Dante had convinced himself.
Jude then pushed him to think about the defining objectives and the standard operating objectives, but Dante’s head was starting to spin a little. Finally, he said, “Okay, let’s have you come back tomorrow to take us through this.”
Jude should have been ecstatic. He would have his chance at redemption after all. But once he’d accepted the reality that it wasn’t going to happen, he’d actually felt relieved to be off the hook and let Dante make the presentation. The resurrected thought of having to stand in front of the Madison staff again was suddenly unwelcome to Jude.
But I’m his consultant, and I guess this is what consulting is all about, he thought to himself as he booked the meeting for the next day.
THE LIONS’ DEN
In addition to agreeing to do the meeting, Jude went so far as to suggest to Dante that he not say too much about what they had talked about the day before. He didn’t want to bias the group, and he thought it would be better if they learned about the theory from the beginning.
Thankfully, Dante did kick off the meeting by saying, “Jude is back today, and he has some very interesting ideas to go over with us. He’s been a helpful member of our advisory board for the last few years, and I think we’d be crazy not to fully utilize him now as a consultant.”
Even without mentioning the previous week’s debacle, everyone knew what Dante was talking about.
Jude went to the front of the room feeling like a convict standing in front of a parole board. “Okay, I’d like to talk to you about that silo problem again.” He swallowed hard. “I still believe that the responsibility for those silos lies in this room.” He paused, letting the comment sink in, then continued. “But I think I’ve figured out exactly how you can address it.”
The front office VP didn’t even give Jude a chance to go forward. “So you’re coming back here to tell us what we’re doing wrong again?” She was as bitter now as she had been before, as though no time had passed since the last session.
Jude was conciliatory. “No, I didn’t mean it that way, and I’m not saying that you guys are doing something uniquely wrong. And I admit that I made some mistakes last time, but I’m learning. I just want to show you something I’ve discovered recently that I think most organizations can do to reduce politics and interdepartmental conflict.”
She wasn’t about to accept his apology. “But you’re saying that we’re political. What makes you think—”
Dante interrupted. “Hold on a second, Mikey. I’ll tell you right now that I do think we’re political. Maybe not in the overtly manipulative way that most people assume politics works. But we’ve certainly got different agendas. I don’t know what it was like for you in high tech, but every hotel I’ve ever run had politics. And now I’m starting to realize we’re the only people who can put an end to it.”
Mikey was tough. “Yeah, but when someone comes in here and tells me that I’m being political, I just think that—”
Again Mikey was interrupted. But this time by the head of operations. “Come on, you’re the most political person here. Everything is about your department and your people. Whenever anything goes wrong, it’s never something that you or your staff did. It’s always our fault. Just once I’d like you to admit that you screwed up.”
Jude was feeling a strong mix of emotions. First, he felt bad that the session had already drifted out of control. But he also felt a sense of relief that he wasn’t the center of controversy for the time being, and that some semblance of truth seemed to be seeping into the room.
Mikey looked as though she was about to explode, and then she just shut down. Nothing. She folded her arms and turned back to Jude as if to say, Go ahead. Which he did.
“Okay, I think that the challenge at the hotel is completely avoidable, and that it’s not a matter of personalities but just a lack of shared direction.”
The looks on the faces of some of Mikey’s colleagues seemed to suggest that personality was definitely at play, but Jude had a point to make and didn’t want one person’s issues to cloud his lesson. So he pushed on with his planned talk.
By now, Jude was pretty comfortable with the silo lecture. He explained the power of crisis. He asked the question, Why wait for a crisis? He introduced the concept of the thematic goal and the defining objectives and the standard operating objectives.
Oddly enough, everyone seemed to get hooked by different parts of the model. The head of facilities immediately clicked with the crisis analogy. Most of the others were convinced by the thematic goal and the defining objectives. The CFO wasn’t quite on board until the standard operating objectives were included. Everyone, with the exception of Mikey, had been won over.
When the session ended, Jude gladly and graciously accepted a little ribbing from Dante’s team. “Hey, this was a little better than last time,” was how the CFO put it. Jude knew that his standing at the hotel was on firmer ground. More important, he felt strongly that even if Dante didn’t extend his retainer, his work might lead to real progress at the hotel, and that it would work in other organizations too.
For the first time since starting his company, Jude felt certain that he would be a consultant for the rest of his career.
LOOSE ENDS
Afew days later Carter called to say that his trip had been extended and that he wouldn’t be able to meet with Jude for another two weeks. He assured him that he had every intention of following up, and he even mentioned thematic goals by name, which gave Jude confidence that he was serious.
For the next few weeks, Jude stayed home with his wife and baby girls, losing himself in the trials and joys of early parenthood. Admittedly, he checked e-mail between late-night feedings, but he didn’t worry about his business. Not that the financial arrangements had been completely ironed out. But Jude knew that his business depended less on his convincing his current clients to sign on for a long-term engagement and more on the effectiveness of his ideas.
Within a month, Jude’s client list included Batch Technology, Children’s Hospital, the Madison, the automobile plant in Fremont, and another hospital in Fresno. Each of them encountered meaningful though varying degrees of success in eliminating their silos.
Batch had the greatest level of success, propelling the firm back up onto the technology wave that it had caught early on. Carter and his team finally put the merger behind them, and then used the skills they had developed to rapidly acquire and integrate two additional firms. And when occasional signs of territoriality arose, Carter always went back to the thematic goal and the defining objectives to refocus the team on its collective, common interests.
Children’s Hospital struggled at first to bring doctors, nurses, and unions together, but with Lindsay’s persistence, it would become one of the twenty best pediatric facilities in the country. Eventually, Lindsay would move on and establish a name for herself as a turnaround specialist.
The CEO of the Fremont automobile plant would become Jude’s favorite client. Kathryn Petersen was a hard-working executive with a modest background. She had a knack for building teams, and would provide Jude with an education in that area that would prove to be useful in his work with clients, as well as in the consulting firm that he would eventually build.
The Madison overcame its short-term problem with the front desk and housekeeping teams, part of which could be attributed to Dante’s firing his difficult head of services. However, his diminishing patience with the day-to-day challenge of managing interpersonal issues would finally lead him to sell the hotel to one of his chain competitors and buy a series of smaller bed-and-breakfast inns in the Napa Valley.
One of Jude’s greatest challenges and most rewarding experiences would be his work with Father Ralph at Corpus Christi Church, where he would learn that silos in churches can be particularly difficult to dismantle, but that the clarity of mission there can be a powerful motivator for doing so.
JMJ Fitness continued to be successful under Brian Bailey. From time to time Jude took on a small project there, but more often than not, he felt he was learning more than he was contributing. Nonetheless, the relationship between client and consultant remained strong for many years.
FAST FORWARD
By the one-year anniversary of the founding of Cousins Consulting, Jude’s practice was as varied as ever, allowing him to be the generalist he wanted to be. Still, every engagement seemed to involve, in some way, the idea of rallying executives and their employees around a thematic goal and destroying silos.
Jude’s business grew rapidly through word of mouth and strong client references. Over the course of the next three years, the firm had grown to seven consultants and two office staff. Jude leased a small office over a bank just three miles from his home, and went home for lunch with Theresa and his three daughters as much as possible.
On the eighth anniversary of the firm’s founding, Cousins Consulting had grown to more than fifteen consultants and five staff members handling marketing, finance, and client support. Vertical markets had been established in health care, technology, education, and nonprofits.
And then one day it happened. It was during a staff meeting.
Jude asked for input about how to allocate marketing dollars for the upcoming year. One of his health care specialists responded first. “We think it’s about time that we received our fair share of the budget.”
Jude frowned. “Excuse me?”
The consultant started to repeat himself. “We think it’s—”
Jude interrupted him. “Who is we?”
“Me and Fred. We think that the health care vertical deserves more money this year.”
And there it was. The first real silo to sprout at Cousins Consulting. Though he was tempted to dive in and crush it immediately, Jude decided to let it sit there in the open for a moment so he could appreciate it in all its destructive glory.
Then he crushed it.
