Members make their way into the converted garage gym and spread out to stretch and prepare for the workout that’s about to begin. Dumbbells, kettlebells, and barbells line the walls and half a dozen rowers are staged just outside the rolled up garage doors with pull-up bars across each opening.

On a whiteboard on the wall is the WOD (workout of the day).

W.O.D. May 12, 2011

Power Cleans 5 X 5

21 – 18 – 15 – 12 – 9 – 6
DB Power Snatch L
DB Power Snatch R
Pull ups

It’s the end of the week, so there’s a focus on lifting heavy things. Each session will include a warm up that exceeds most people’s traditional workout, plus five increasing sets of power cleans – aiming to achieve your personal best, followed by a timed workout that includes dumbbell power snatchs and pull ups. Finish the workout and you’ll do 81 of each! Just another day at CrossFit Central in Austin, Texas.

For a taste of CrossFit, enjoy a short (01:31) video by Paul Scheider called “Breathe”

Background

CrossFit Central is an Austin, Texas affiliate of the International Method of Fitness – CrossFit. Co-Founded by a brother/sister team – Jeremy Theil and Carey Kepler – in 2005, it has grown to be one of the largest CrossFit affiliates on the planet. It now runs two gyms in central Austin, bootcamps held in public parks around the city, and corporate programming on location at the workplace. Their corporate program at Sherry Matthews Advocacy Marketing was where I first heard of CrossFit. You can read about their story here.

Building Community

While people join gyms for a host of reasons, there is a 60-80% dropout rate. There are many reasons for this, but one is the lack of community found in most traditional gyms. One of the unique attributes of CrossFit is strong focus on building a community of friends pursuing fitness. This starts with coaches that get to know their clients and who build fellowship among their class members. In addition to regular classes, coaches and clients also get together for special events, picnics, and community workouts. For example, tomorrow is the Spring picnic for members and their families.

Use of Social Media & Storytelling

CrossFit is largely led by a young crew who grew up in the era of the Internet and social media and that’s clear from their approach to business and marketing. The CrossFit Central website is a running stream of content chronicling the daily CrossFit activities around Austin, promoting upcoming events, sharing videos, and profiling the success stories of real people (not just athletes) who have achieved great results through consistent hardwork. Coaches also have their own blogs and many are sharing updates on the Facebook fan page or via Twitter.  All this adds to the presence CrossFit Central has online.

Collaboration and Friendly Competition

A unique quality of CrossFit affiliates is a focus on friendly competition and collaboration. Affiliates frequently host other gyms and welcome CrossFitters to jump into class when they are visiting from out of town. Affiliate leaders swap stories of what they’ve found works and doesn’t work in spreading CrossFit and growing their membership base. In addition, competitive workouts are hosted locally, regionally, and nationally for teams to compete against others. This collaborative and friendly competition model builds the CrossFit community and aids in spreading the common goal of living a healthy lifestyle.

A Greater Mission

While their motto is “Building a Fitter Community”, coaches and members also strive to give back to the community in other ways. This includes hosting events that benefit charities like the Livestrong Foundation and the Wounded Warrior Project. This month, coaches and members are bringing their strength to Habitat for Humanity to build a home in East Austin.

Focus on Steady Hard Work & Personal Best

Coach Michael Gregory

When people discover I’m a CrossFitter, I get a wide array of reactions. Many have driven by the gym or a bootcamp and see it as an intense fitness program. I’m quick to point out that I am holding up the rear in my cohort, but that’s okay. My coach, Michael “Big Mike” Gregory says, “CrossFit is for everyone, but not everyone is for CrossFit” and that’s very true. While groups workout together and there are a lot of competitive events, the real challenge is within each of us. We are constantly competing against ourselves and doing better than yesterday. By pushing yourself, each WOD brings you a step closer to your goal and everyone walks a little taller after a session knowing they did something tougher than most and are getting better and better by the day. Success stories are all around and the feeling is addictive.

Final Thoughts…

We share the story of CrossFit not just because I’m a member, but because many of the attributes of its business model and mission are rock solid and applicable to many of the organizations we work with. A lot can be learned from a collaborative organization with a clear mission, measureable results, evangelist clients, and a sense of purpose beyond the boundaries of the core business. Go discover a CrossFit gym in your community. For a list of affiliates, go here.

Until recently, corporate road warriors, distributed small companies, and freelancers were stuck working out of hotel rooms, coffee shops, or home offices. This was okay occasionally, but not sustainable for the longterm. Plus, people longed for a sense of community, collaboration, and networking. Enter coworking. Now, in cities around the country, coworking spaces are opening their doors and redefining the concept of the workplace. The trend has even been noted in Fast Company and the New York Times. For many, these spaces and communities offer the best attributes of a “workplace” with all of the freedoms and flexibility of being independent. Whether you are a traditional organization or an independent entraprenuer, coworking may be for you. Check it out. Now, back to work.

Paul Levy, CEO & Blogger - Running a Hospital

One of the first banners I saw as I entered the IHI Forum had a blue Twitter bird logo with instructions to “follow” the hash tag #IHI09. By placing this hash tag in messages posted or “tweeted” on Twitter, your messages shows up in a search of folks communicating about the Forum and its content.

Over the last year or so, we’ve seen a rapid emergence of the use of social media like Facebook and Twitter. We’ve also seen it become an interesting communication tool for businesses and real people to share ideas and information. It feels as if we are only beginning to see the potential of these relatively new mediums.

Today, I sat across from Hospital CEO & Blogger Paul Levy (Running a Hospital) as he shared with an interested group of faculty “this thing called Twitter.” In addition to providing real time blog posts and tweets about the Forum, Paul is delivering a session on Wednesday on Using Social Media to Pursue Quality and Patient Safety. Sarah Fraser is also doing a mini course on Monday on Using Social Media to Improve Health: Techniques and Applications. Who would have guessed a year or two ago, these topics would be on the agenda?

In addition to scheduled sessions, IHI Forum participants are self organizing for informal “tweet ups” around topics like patient safety. For the first time, attendees can quickly network with people with like interests, from around the world, that they might not have ever met in year’s past. Fantastic!

I’m still testing and learning to use these tools, but am intrigued. When Paul finished his Twitter demo, one of the faculty asked him something along the lines of: “What’s the point?” He replied, “I’m not sure yet, but for now, it’s kind of fun.” I agree. What do you think? Where do you think this social journey will lead us?

Screenshot of IHI Improvement Map

This morning’s Faculty/Staff Mindwalk at the 21st Annual National Forum on Quality Improvement in Health Care, included an introduction of the IHI Improvement Map by Maureen Bisognano, Executuve VP and COO at IHI. The map is a free online resource for hospitals to sift through the best available knowledge on key process improvements to enhance care. With a few clicks, users can access information based on criteria like cost, time, evidence, and difficulty. The tool is quite amazing and what’s even more impressive, it’s free. The intent is to get the information to those that can lead change.

Check out the improvement map and learn more here.

Commonwealth Ambulance, Springfield, MA (1996)

As the health care debate continues, political pundits, as well as hacks, talk in sound bites about insurance reform without understanding many of the challenges that face the system and add to its cost. Imagine if the discussion was about solutions to real problems instead of hot button, polarizing topics. What if we were truly using the Pareto Principle to identify the vital few improvements that would really enhance health care in America?

In a former life, I worked as an urban street paramedic. Few people realize that, in addition to responding to heart attacks, shortness of breath, elderly falls, and fender benders, much of EMS work involves serving those who are uninsured and plagued with chronic health problems. EMTs and paramedics are the street level primary care and public health safety net for many.

A select segment of these patients are very high utilizers of ambulances and emergency rooms for their health care. Labeled, “frequent fliers,” they can sometimes call multiple times a week. Most paramedics see them as just a part of the job. Some systems have viewed them as a nuisance and have developed programs to deny them service or even have them arrested for 9-1-1 abuse. Few have looked at helping them.

A colleague today sent me a great article in the Washington Post about a “frequent flier” in the DC Metro system. The journalist did one of the best jobs I’ve seen of profiling these people, explaining the reality of the problem, and talking about programs like San Francisco Fire Department’s HOME Team. The San Francisco Chronicle once estimated just 362 patients resulted in $11.6 million in ambulance and emergency department charges during an 18-month period. It’s a big issue and one I firmly believe is a wonderful opportunity.

What if health care improvement was focused on helping them too? Please read the full article here.

Image: Lisa Jarvis

I recently returned from the Pinnacle EMS Forum, which is the leading conference for leaders of prehospital emergency medical transport services (i.e., paramedics). The keynote speaker was my friend Robert Lloyd, PhD, executive director of performance improvement for the Institute for Healthcare Improvement. Dr. Lloyd led fantastic plenary and breakout sessions presenting a pragmatic and action-based approach for using data to test changes, improve process, and enhance performance. He was very well received.

The concept of quality in organizations, especially health care, is freely thrown around, but rarely do we get to witness it in action. On my flight out to St. Pete Beach, FL, I reached into my bag for the magazine I had packed for that brief period between takeoff and 10,000 feet, when I can “turn on approved electronic devices.” On this particular trip, I mistakenly packed an old edition of Fast Company, which I had read months before. As I flipped through the pages, I came across a story I had forgotten about that really impressed me. It was about Geisinger Health System in central Pennsylvania.

Geisinger is an interesting case of the commitment to continuous improvement and serving patients. In Peter Carbonara’s article The Cure: How a small network of hospitals in Pennsylvania is defying convention, cutting costs, and improving health care, he tells how the CEO, Glenn Steele, and his doctors and staff have put providing the right care, on the first try at the forefront of all their focus. It’s all part of their ProvenCare program.

The components of ProvenCare are:
•    Patient-centricity
•    Appropriate care
•    Evidence/consensus-based best practices
•    Highly reliable care
•    Optimized work flows
•    Explicit accountabilities
•    Packaged pricing
•    Performance-based reimbursement
•    ”Warranty”

So, how effective has this one health system been when they focus on patient centric, evidenced-based care, with continuous process improvement? Patients receive nearly 100% of the generally accepted treatments for their condition – compared with 55% found in one New England Journal of Medicine (2003) Study. An example of how they achieve this aim is in surgery; each surgery case involves 40 documented steps to confirm all of the right treatments are performed. A study of CABG patients in the Annals of Surgery (2007, February) found patients had 16% shorter hospital stays and that the end patient bill was 5% less. Other benefits included a 45% reduction in readmissions and a 60% decrease in neurological complications. Geisinger’s CEO is so serious about the system’s mission, he’s quoted as saying they ”should’t get paid if we don’t do the right thing.” More than just a slogan, it’s actually a guarantee. If you end up back in the hospital in 90 days as a result of a preventable complication, the hospital will take care of the bill.

In a time when politicians are arguing over health insurance versus improving health care, it’s important to not loose sight of real and tangible examples of getting it right. Geisinger Health System is not alone as a best practice, but it reflects a strong will, a focused aim, and a pragmatic, daily approach to enhancing performance, controlling costs, and keeping attention on the core business – the patient.

Image: Creative Commons License by jsmjr

Ding! “Flight Attendants take your seats,” came the
announcement from the cockpit. As one who flies quite a bit, this is nothing
unusual – maybe some unexpected turbulence.

Maybe not! The flight attendant in the front reached into an
overhead compartment, grabbed an oxygen cylinder, and darted to her seat
behind the partition. Her colleague was briskly making her way down the aisle
to the back of the plane signing something with her hands to the other
attendant with a focused facial expression. Not good!

No announcement…nothing. Then, an usual and load noise
started and the plane felt like it was making a rapid descent.  The plastic water bottle tucked in the
seat pocket in front of me began to cave in – pressure change! I
waited……..still no news. I’m getting less comfortable. And then, things seem to
smooth out, flight attendants reappeared, and the captain came on the intercom.

“Ladies and gentleman,
you may have noticed we made a rather quick descent. We had a warning light go
off indicating we were loosing pressure somewhere. We opted to bring the plane
down to a lower altitude so those pesky oxygen makes wouldn’t drop out of the
ceiling and scare you. All is okay and we are being cleared to be the next to
land in Birmingham.”

As we landed, airport rescue crews were standing by and
Southwest Airlines management were hovering with clipboards and radios. Just
days before our flight, another Southwest flight flying from Nashville to
Baltimore had to make an unscheduled stop in Charleston, WV when it too lost
pressure, so this event was more than just routine for everyone there. Read story here.

The flight ended without issue. Southwest staff did their
usual fabulous service – the captain even helped carry my gate checked car
seats up so we could get headed to Grandma’s house (I was on a family trip with
my wife and two small children). Other than a brief scare and a good story, it
was just another day of air travel for me.

But the story doesn’t end there. The next day I received
this email from Southwest Airlines’ Proactive Communications.

The email explained, in detail and in plain english, what had happened on our
flight the day before and included facts only someone on the plane would have
known (i.e., low volume of the captain’s announcement). It was more than a form
letter. The next day, I would receive three $50 travel vouchers as well for our
troubles. I was a little surprised by the unexpected follow up.

As customers, most of us have become far too used to being
treated as less than valuable by many of the companies we frequent and “issues”
have become an expected norm rather than the exception. Addressing service problems
is critical to any organization’s success. Quickly identifying something didn’t
go well, communicating with customers, and reinforcing a commitment to quality
says a lot about an organization.

Sure, Southwest already had one related event that week and was
on high alert. But, Southwest also knew it wanted to be the kind of company that
is customer focused and their actions were very reflective of that corporate
value, which I’ve encountered many times. While it’s continually leadership’s responsibility to improve
quality and reduce errors and defects, it’s also important to be ready to
respond when you are not perfect. Only then, can you create devoted customers
and vocal fans.

The flight home was
uneventful (other than the kids) and I’m boarding another Southwest flight to
Oakland on Sunday. Southwest Airlines remains truesimple consulting’s corporate
air provider even if they haven’t profiled me yet in the back pages of Spirit
Magazine as an A Lister!

Reader Request: If you liked this post or any others on the truesimple blog, please use the links below to share it with others. Thanks for reading.

Lighting

Compact Fluorescent Light Bulbs – It’s estimated lighting accounts for more than a quarter of an office’s energy consumption. Switching to efficient fluorescent light bulbs may reduce energy consumption by as much as 75% and last 10 times longer.

Occupancy Sensors – Imagine a single individual office where lights are left on for just two hours a day when not needed; for an average worker, that’s $2,500 worth of waste per year. Occupancy sensors are a cost effective way to make sure lights are only on when somebody is working in the space.
Office Equipment

Computer Choices – Office computers are a large draw on the energy grid. Setting your computer’s power settings to go to sleep when inactive and powering it off when you go home can greatly reduce consumption. Did you know laptops are more efficient? With the reduction in laptop prices, it may be worth the investment and your staff may appreciate the mobility benefit.

Paper Savings – The City of Los Angeles estimates paper use at 1.5 pounds of paper per person per day. There are several ways to reduce paper usage. Whenever possible, stick to electronic formats for reading, filing, and editing documents. If you must print, use recycled paper, print with smaller margins, and reduce spacing. You can also print double sided or reuse single sided printed documents by printing on the backside.

Temperature Control

Heat/Air Conditioning – Temperature regulation is a frequent place for waste. By using a programmable thermostat, you can ensure the temperature is comfortable during work hours, but use less energy when uninhabited.  Consider adjusting the temp a few degrees cooler in winter and warmer in summer. As long as workers are comfortable, a few degrees can mean big savings.

Shade – One simple way to control temperatures is by creating shade. Consider awnings over windows or planting trees that shade the office. Blocking the sun can keep inside temperatures cooler. Solar shades and tinted windows can also help.

Water

Drinking Water – In our pursuit of healthy drinking, we are actually creating waste every time we crack open a bottle of water. Replace the disposable water bottles with a water cooler. Instead of paper cups, provide reusable cups or sports bottles. See Brita's Filter For Good efforts.

Facet Water – Most small offices have 50-gallon water heaters made for large homes. A smaller capacity water heater is sufficient for most offices; even better go for a tankless water heater. Lastly, reduce water waste from facets by installing water flow aerators and timed fixtures that automatically shut off (think the airport).

Toilets – Toilets and urinals account for a lot of wasted water. Newer toilets reduce consumption; some even allow the user to decide the flush based on what is being evacuated.

Transportation

The Commute – The average American commutes 25 minutes. In many cities, employees are biking to work to reduce their environmental footprint and get exercise at the same time. Employers are assisting with bike racks and shower facilities. Other workers are car pooling or taking public transit to reduce their carbon footprint.

Hyrbids & Alternative Fuel – The city of Austin is working hard to transition every possible vehicle in its fleet to plug-in or hybrid vehicles. The new energy efficient cars reduce pollution, operate cheaper, and there’s even a plan to have the plug-ins return energy to the power grid during the business day. Another emerging trend is an increased use of bio-diesel to fueled vehicles.

Telecommute – With rising fuel costs, the pollution associated with the commute, and the power, water, and paper consumption that occurs at work, what would happen if employees didn’t come in? Some communities have implemented programs encouraging working from home to reduce their carbon footprint and the costs associated with the employee commute. Telecommuting can be a win-win for both the employee and the employer.

Carbon Neutral

So you’ve made all the adjustments, increased the energy efficiency of the office, and reduced waste. No matter how hard you try, there remains a carbon footprint you have no control over (i.e. airline flights). What do you do? One option is to invest in carbon offsets that allow your organization to invest in clean energy and other projects that result in equal reductions in carbon emissions. Fly to a conference; invest in wind power – carbon neutral.

Educate & Inform

Educate – The first step in making a difference is understanding the challenges we all face and learning how individuals and organizations can make a substantive difference. Organizational learning through groups like Ecosphere Net aid in facilitating a shift in perspective and appreciating how single actions can make a real impact.

Talk with Customers – Many organizations are sharing with the world and their clients the steps they are taking to be more sustainable. Annual reports, website information, and deliberate conversations with clients and customers about individual and corporate values related to corporate responsibility and the environment are becoming more common. Starting the dialogue opens the doors for new opportunities.

Organizations create a significant carbon footprint, but have many opportunities to make a measurable environmental difference while saving money in return. Your organization can make sustainability part of its values and cultural practices. The choice is up to you.

Reference:
Office of Sustainable Development (n.d.). Green office guide: A guide to greening your bottom line through a resource-efficient office environment. Portland, OR: City of Portland.

Re-purposed from an article originally published in Best Practices in Emergency Services