Staff turnover in healthcare is high, costly, and is causing hospital leadership to panic. Replacing just one nurse, for example, can cost upwards of 1.3 times their salary, so care centers need to learn why this is happening - Are team members disengaged? Do they have the right resources? – and how they can provide top quality patient care while also meeting the evolving needs of their staff. This requires a modern, proactive approach to talent management that will enable them to maximize retention rates and provide an engaging environment for healthcare professionals. Join us for this free webinar sponsored by Cornerstone OnDemand. Dr. Tom Tonkin, Principal Consultant of Thought Leadership & Advisory Services at Cornerstone OnDemand, will share his thoughts and strategies to help identify and reduce the risk of staff departures to healthcare organizations. During this webinar, Dr. Tonkin will provide easy-to-understand insights on: • Current attrition trends and challenges that have disrupted traditional recruiting and retention strategies; • The needs (and demands) of today’s healthcare workforce; and • Talent strategies that create a more engaged, productive, and passionate workforce.

1. Thomas Tonkin, Ph.D. – Advisory Services
This is not why I went to school!
3 ways to Deal with Change with
Clinical Staff

2. Dr. Tom Tonkin
Principal, Change Management and Transformation
Thought Leadership & Advisory Services
Dr. Tonkin is an executive in Professional Services and
Software Sales arena and has over 25 years of business
and technology experience. Prior to joining CSOD, Dr.
Tonkin was the CEO and Co-Founder of the Sales
Conservatory where he specialized in helping sales leaders
that have revenue generation responsibility between $5M
and $1B and are looking for a trusted advisor to guide them
to materially increase revenue . He spent 19 years of his
career at Oracle Corporation as the Senior Director of the
Sales Performance Group in Oracle’s Global Sales
Academy. Dr. Tonkin is also a speaker at leadership and
business conferences where he also presents throughout
the year.

3. Daniel Jacobs
Copywriter
Demand Generation Team
Rehan Mirza
Vertical Solutions Manager
Healthcare and Higher Education
Special Thanks to These folks as well!

4. Thank You To All of Our
Attendees!
4

5. Change Challenges
Organizationally-Centric
• Hospitals employing the least
engaged nurses spend $1.1
million more per year in
malpractice claims than those
with the most engaged nurses.
• Higher nurse satisfaction resulted
in an 87 percent decrease in
infection rate over two years
5

6. Change Challenges
Organizationally-Centric
• Hospitals employing the least
engaged nurses spend $1.1
million more per year in
malpractice claims than those
with the most engaged nurses.
• Higher nurse satisfaction resulted
in an 87 percent decrease in
infection rate over two years
People-Centric
• The cost of replacing a
nurse can be upwards
of 1.3 times their
salaries.
• One hospital reports
that their health care
staff only scored in the
38 percentile in
employee engagement
suggesting that they
were not satisfied with
the work
6

7. Change Challenges
Organizationally-Centric
• Hospitals employing the least
engaged nurses spend $1.1
million more per year in
malpractice claims than those
with the most engaged nurses.
• Higher nurse satisfaction resulted
in an 87 percent decrease in
infection rate over two years
People-Centric
• The cost of replacing a
nurse can be upwards
of 1.3 times their
salaries.
• One hospital reports
that their health care
staff only scored in the
38 percentile in
employee engagement
suggesting that they
were not satisfied with
the work
7
Why?
• “The low engagement levels, survey respondents
said, were primarily due to industry changes
(such as the burden of transitioning from paper to
electronic medical records)”

8. Agenda
• Change Management vs. Transformation
• The Need for a People-Centric Approach
• The 3 Questions you staff asks themselves
everyday
8

9. “Different isn’t always
better, but better is always
different”
(Unknown)

10. Change or Transformation?
" The caterpillar starts to
change“
10

11. Change or Transformation?
" The caterpillar starts to
change“
"The transformation
from caterpillar to butterfly
is one of the most
exquisite in the natural
world"
11

12. Change or Transformation?
" The caterpillar starts to
change“
Canisius College
Website
"The transformation
from caterpillar to butterfly
is one of the most
exquisite in the natural
world"
12

13. Change or Transformation?
" The caterpillar starts to
change“
Canisius College
Website
"The transformation
from caterpillar to butterfly
is one of the most
exquisite in the natural
world"
National Geographic
Website
13

14. Change or Transformation?
" The caterpillar starts to
change“
Canisius College
Website
"The transformation
from caterpillar to butterfly
is one of the most
exquisite in the natural
world"
National Geographic
Website
14
So, Change = Transformation?

15. Change Management v. Transformation
Change
Management
• Reference is the Past
• Efficiency Focused
• Making the current better
Transformation
• Reference is the Future
• Effectiveness Focused
• Birthing a new state
“AS IS”
Urgency
Results

16. Change v. Transformation1
Change Transformation
Past
Present
Future
CHANGE requires becoming familiar with the current situation, and working to make things better, faster, cheaper, or some
other “er” word. The past is the fundamental reference point and actions are intended to alter what already happened.
1"Change vs. Transformation." Change vs. Transformation. The Primes. Web. 15 Sept. 2015.

17. Change v. Transformation1
Change Transformation
Past
Present
Future
CHANGE requires becoming familiar with the current situation, and working to make things better, faster, cheaper, or some
other “er” word. The past is the fundamental reference point and actions are intended to alter what already happened.
TRANSFORMATION is an assertion that our actions today create our future tomorrow. The future can be described and
realized when you free yourself from constraints of the past. In transformation, you design your future and invent ways to bring
it about. Transformation doesn’t describe the future by referencing the past (better, faster, or cheaper); it births a future that is
entirely new.
1"Change vs. Transformation." Change vs. Transformation. The Primes. Web. 15 Sept. 2015.

18. Change v. Transformation1
Change Transformation
Past
Present
Future
CHANGE requires becoming familiar with the current situation, and working to make things better, faster, cheaper, or some
other “er” word. The past is the fundamental reference point and actions are intended to alter what already happened.
TRANSFORMATION is an assertion that our actions today create our future tomorrow. The future can be described and
realized when you free yourself from constraints of the past. In transformation, you design your future and invent ways to bring
it about. Transformation doesn’t describe the future by referencing the past (better, faster, or cheaper); it births a future that is
entirely new.
BOTH require a firm grasp the current state of affairs — the ”As Is”. Without an intimate understanding of our As Is, we’re
delusional about the future from the outset.
1"Change vs. Transformation." Change vs. Transformation. The Primes. Web. 15 Sept. 2015.

19. Change v. Transformation1
Change Transformation
Past
Present
Future
CHANGE requires becoming familiar with the current situation, and working to make things better, faster, cheaper, or some
other “er” word. The past is the fundamental reference point and actions are intended to alter what already happened.
TRANSFORMATION is an assertion that our actions today create our future tomorrow. The future can be described and
realized when you free yourself from constraints of the past. In transformation, you design your future and invent ways to bring
it about. Transformation doesn’t describe the future by referencing the past (better, faster, or cheaper); it births a future that is
entirely new.
BOTH require a firm grasp the current state of affairs — the ”As Is”. Without an intimate understanding of our As Is, we’re
delusional about the future from the outset.
EXAMPLE - A butterfly is a transformation, not a better caterpillar.
1"Change vs. Transformation." Change vs. Transformation. The Primes. Web. 15 Sept. 2015.

20. Common Elements of a Change Plan
20

21. Common Elements of a Change Plan
• Vision (Why)
21

22. Common Elements of a Change Plan
• Vision (Why)
• Strategy (What)
22

23. Common Elements of a Change Plan
• Vision (Why)
• Strategy (What)
• Metrics (How Much)
23

24. Common Elements of a Change Plan
• Vision (Why)
• Strategy (What)
• Metrics (How Much)
• Communications (Who)
24

25. Common Elements of a Change Plan
• Vision (Why)
• Strategy (What)
• Metrics (How Much)
• Communications (Who)
• Execution Plan (When & How)
25

26. Common Elements of a Change Plan
• Vision (Why)
• Strategy (What)
• Metrics (How Much)
• Communications (Who)
• Execution Plan (When & How)
26
This is fine, but what about the people?

27. “The best ways to encourage out of
the box thinking is to draw the box
correctly in the first place”.
Paul Gibbons, (2015).

28. Standard Change Curve

29. Population Characteristics
Population Characteristics
• Innovators (2.5%) Highest Social Status
Highest Social Capital
Close Contact with Innovators (Sensitive to Scarcity)
Rogers, E. M. (1962). Diffusion of innovations. New York: Free Press of
Glencoe.

30. Population Characteristics
Population Characteristics
• Innovators (2.5%) Highest Social Status
Highest Social Capital
Close Contact with Innovators (Sensitive to Scarcity)
• Early Adopter (13.5) High Opinion Leadership
More discreet than Innovators (Greater levels of Judgment)
More judicious to maintain control
Rogers, E. M. (1962). Diffusion of innovations. New York: Free Press of
Glencoe.

31. Population Characteristics
Population Characteristics
• Innovators (2.5%) Highest Social Status
Highest Social Capital
Close Contact with Innovators (Sensitive to Scarcity)
• Early Adopter (13.5) High Opinion Leadership
More discreet than Innovators (Greater levels of Judgment)
More judicious to maintain control
• Early Majority (34%) Above Average Social Status and Capital
No Opinion Leadership (Sensitive to Social Proof)
Do have direct contact with early adaptors
Rogers, E. M. (1962). Diffusion of innovations. New York: Free Press of
Glencoe.

32. Population Characteristics
Population Characteristics
• Innovators (2.5%) Highest Social Status
Highest Social Capital
Close Contact with Innovators (Sensitive to Scarcity)
• Early Adopter (13.5) High Opinion Leadership
More discreet than Innovators (Greater levels of Judgment)
More judicious to maintain control
• Early Majority (34%) Above Average Social Status and Capital
No Opinion Leadership (Sensitive to Social Proof)
Do have direct contact with early adaptors
• Late Majority (34%) Adopt after the average end user (Looking for more than 50%
adoption)
High levels of Healthy Skepticism
Average Social Status and Capital
Rogers, E. M. (1962). Diffusion of innovations. New York: Free Press of
Glencoe.

33. Population Characteristics
Population Characteristics
• Innovators (2.5%) Highest Social Status
Highest Social Capital
Close Contact with Innovators (Sensitive to Scarcity)
• Early Adopter (13.5) High Opinion Leadership
More discreet than Innovators (Greater levels of Judgment)
More judicious to maintain control
• Early Majority (34%) Above Average Social Status and Capital
No Opinion Leadership (Sensitive to Social Proof)
Do have direct contact with early adaptors
• Late Majority (34%) Adopt after the average end user (Looking for more than 50%
adoption)
High levels of Healthy Skepticism
Average Social Status and Capital
• Laggards (16%) Little to no opinion leadership.
Aversion to change-agents, “tradition“
Contact with only family and close friends.
Rogers, E. M. (1962). Diffusion of innovations. New York: Free Press of
Glencoe.

34. “Communicating” the Chasm
34

35. “Communicating” the Chasm
35
Maloney’s 16% Rule:
Once you have reached
16% adoption of any
innovation, you must
change your messaging
and media strategy.
Your message must
change from scarcity to
social proof. Use this
media type available to
you to communicate.
This is how you
accelerate past the
chasm to the tipping point
of adoption.

36. 36

39. Standard Change Curve

40. Standard Change Curve
Again, this is fine, but what about the INDIVIDUAL people?

41. GLOVES

43. “People change what they do less because they
are given analysis that shifts their thinking than
because they are shown a truth that
influences their feelings. This is especially so
in large-scale organizational change, where
you are dealing with new technologies, mergers
and acquisitions, restructuring, new strategies,
cultural transformation, globalization, and e-
business – whether in an entire organization, an
office, a department or a work group”.
Kotter and Cohen, 2002).

44. The Process of Change and Adjustment
Elisabeth Kubler-Ross (1969)

45. Three questions every employee answers
everyday
• Do I want to stay?
• Do I need to stay?
• Should I stay?

46. What is this?
This addresses the positive
emotional connection that
the employee has to the
organization. For example,
working at here, whether the
people or the work itself,
makes them happy.
46
Do I want to Stay?
Most employees formulate their long-term organizational commitment in their first 30 days

47. What is this?
This addresses the positive
emotional connection that
the employee has to the
organization. For example,
working at here, whether the
people or the work itself,
makes them happy.
Where does it come from?
This feeling is induced from
positive work experiences at
your organization.
47
Do I want to Stay?
Most employees formulate their long-term organizational commitment in their first 30 days

48. What is this?
This addresses the positive
emotional connection that
the employee has to the
organization. For example,
working at here, whether the
people or the work itself,
makes them happy.
Where does it come from?
This feeling is induced from
positive work experiences at
your organization.
Proposed
Action/Curriculum:
• Testimonial videos
• Professional Development
Classes that coincides with
employee's career
aspirations.
• Reoccurring team
meetings at every level (i.e.
regional or national)
48
Do I want to Stay?
Most employees formulate their long-term organizational commitment in their first 30 days

49. What is this?
This is when an employee is
calculating the cost of
leaving the organization and
questions what they need to
do.
49
Do I need to Stay?
Most employees formulate their long-term organizational commitment in their first 30 days

50. What is this?
This is when an employee is
calculating the cost of
leaving the organization and
questions what they need to
do.
Where does it come from?
Leaving is more difficult
when the employee invests
more and more into the
company. How vested are
they in the company.
50
Do I need to Stay?
Most employees formulate their long-term organizational commitment in their first 30 days

51. What is this?
This is when an employee is
calculating the cost of
leaving the organization and
questions what they need to
do.
Where does it come from?
Leaving is more difficult
when the employee invests
more and more into the
company. How vested are
they in the company.
Proposed
Action/Curriculum:
• Exposure to all of the
organization through cross
line of business training.
• Have employee invest in
the organization and be
visible about it like filling
out their profile page.
• Special internal projects
that makes the company
better.
• Increasing employee
engagement
51
Do I need to Stay?
Most employees formulate their long-term organizational commitment in their first 30 days

52. What is this?
The feeling of obligation to
stay with an organization.
What the employee ought to
do.
52
Should I Stay?
Most employees formulate their long-term organizational commitment in their first 30 days

53. What is this?
The feeling of obligation to
stay with an organization.
What the employee ought to
do.
Where does it come from?
When employee is socialized
into the organization and the
company invests in the
employee.
53
Should I Stay?
Most employees formulate their long-term organizational commitment in their first 30 days

54. What is this?
The feeling of obligation to
stay with an organization.
What the employee ought to
do.
Where does it come from?
When employee is socialized
into the organization and the
company invests in the
employee.
Proposed
Action/Curriculum:
• Early investments in the
employee, for example
during on-boarding
• Help employee build a
personal network
• Job satisfaction and career
advancement surveys
54
Should I Stay?
Most employees formulate their long-term organizational commitment in their first 30 days

55. Putting it All together
Organizationally Centric
• Vision (Why)
• Strategy (What)
• Metrics (How Much)
• Communications (Who)
• Execution Plan (When & How)
55

56. Putting it All together
Organizationally Centric
• Vision (Why)
• Strategy (What)
• Metrics (How Much)
• Communications (Who)
• Execution Plan (When & How)
56

57. Putting it All together
Organizationally Centric
• Vision (Why)
• Strategy (What)
• Metrics (How Much)
• Communications (Who)
• Execution Plan (When & How)
People Centered
• Do I want to Stay?
• Do I need to stay?
• Should I stay?
57

58. Conclusion and Wrap-up
• We must:
58

59. Conclusion and Wrap-up
• We must:
• Understand the difference between a change
management effort and a transformation
59

60. Conclusion and Wrap-up
• We must:
• Understand the difference between a change
management effort and a transformation
• Be sensitive to the needs of the people effected
by change
60

61. Conclusion and Wrap-up
• We must:
• Understand the difference between a change
management effort and a transformation
• Be sensitive to the needs of the people effected
by change
• Plan for both organizational change as well as a
people-centric change
61

62. Thank You!