Bridging the Knowledge-Readiness Gap

Bridging the Knowledge-Readiness Gap

Organizations have a lot of institutional knowledge. And, there is no lack of resources to get new ideas, how-to tips, and options to explore. Still, many face challenges in getting ready to embrace what’s new and changing. What’s the recipe to bridging this knowledge-readiness gap?


    • Daniel Gandarilla, Vice President and Chief Learning Officer, Texas Health Resources.

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Top 5 Learning Points

  1. How does an organization bridge the gap between knowledge, learning and applying that learning?
  2. How do leaders motivate the teams within an organization to use their learning to implement change?
  3. Change requires agility, how do leaders induce this agility in their teams?
  4. Even while doing their own job, how to implement that cohesive cumulative effect of the learning, which is going to enable people to move towards readiness?
  5. How would you measure the RoI for learning, and make adoption of learning a holistic process across organizations?

Show Notes

  • A big part of the change is adopting the technology, but an equal part is understanding what to do with it.
  • Individuals need to be made agile as well, to adopt learnings and use them.
  • To implement new systems needs a new approach to communicate to individuals why it’s so important because that helps to drive the adoption of innovation.
  • RoI for leaning shows up in financial benefit of adopting change.
  • Learning should be made into a holistic process that is adopted and implemented to daily work, across the organization.
  • How do you identify resources that will lead the learning process, to take the organization to the next level of market efficiency?


Despite an overload of information, enterprises today have a challenge in displaying the benefits of the learning from this information available. What is the technology-driven as well as the human-driven method is to utilize this data to learn best practices that can be followed throughout the company, adding value to the brand? A discussion on how leaders ensure he value trickles down to each team member, and creates benefit, and helps in making agile, informed decisions.


Sanjog: Our topic today is “Bridging the Knowledge Readiness Gap” and our guest Daniel Gandarilla, Vice President and Chief Learning Officer, Texas Health Resources.

The reason we picked up this topic is that we have an overload of knowledge or information, but when they have to take the initiative, that knowledge that readiness doesn’t seem to exist. We want to explore why that happening is, where are the gaps and how can organizations get better at it? If possible, where technology executives who are our prime listeners can benefit from it or perhaps take charge create the bridge between the knowledge and readiness.

The first question, Daniel is, we have a lot of unknowns, unprecedented disruptions happening. We have to move forward and cannot afford just to keep status quo, or we will perish. In that environment, do organizations invest in learning to ensure it keeps pace with the speed of business?

Daniel: We are at a critical time in business. With new technologies, information and data have almost become like a commodity. It’s how we translate that information and what tools and resources we use to translate that information and make it as effective as possible, that matters.

Organizations are continuing to invest in technology, and one of the things that we often forget is that the technology by itself doesn’t necessarily run the business. We have people that are doing it, so underlying all of this are some elements for humans. A big part of that is change, and another part is understanding and knowing what to do with the technology. One of my favorite articles is the Leaders Framework for Decision Making, by Dave Snowden, really lays out this framework for how we make decisions, which information should really play into. There are four key buckets – simple decisions and the simple notion of the framework, where cause and effect can be determined, so it’s really easy to make a decision. But there’s another part of the framework that’s about complexity, and this is where Dave Snowden has really made an impact on the notion of complexity theory.

Organizations are continuing to invest in technology, and one of the things that we often forget is that the technology by itself doesn’t necessarily run the business.

In this haze of unknown, it really requires experimentation or a mindset for managers and leaders to utilize these tools and the data, to make some decisions that help them reach the point of learning. We need to be able to synthesize that information. In the world of AI, we’re hoping for machines to do that, but right now, we have to realize that our people will have to learn by trial and error through safe experimentation.

Texas Health is one of the trailblazers that relates to the electronic health record implementation. We made its meaningful use a long time ago and implemented fast because we knew we need to this world that uses data. Through different trial and errors, we have learned how to implement and train people. We have taken a stages approach, and learnt from each implementation area, slowly putting a tool that will enable clinical decision making throughout the system.

We know this is the tool which will be used by our staff and on the backend, people will be looking at data and learning from what’s working and what is not.

Sanjog: It is good you brought up the people side because the learning is to be done by people and to be used by people. But even though the audience is information technology leaders, they are there to help business leveraging technology. That means, the way the business is fundamentally shifting, new technologies and even in business models are getting disrupted, the very business ecosystem is getting disrupted, and unexpected things are happening at the business level.

This learning has to be across the board. But there is a lot of inertia when people are supposed to be going in a brand-new direction which they never thought is going to happen. They need to go very fast, which means organizational learning has to become part of the DNA. Is that even thought of as a critical strategic approach to learning in organizations today?

Daniel: Typically, this is where the notion of the learning function individuals and my role have really been trying to play a larger role of understanding, not just the core competencies of the business, but also what does that mean for individuals. Also, how are we making sure that individuals are capable of agility? How are we reinforcing that agility? Building systems around it, so that people are rewarded for the agility in being able to change. It is that we’re seeking out people within the organization that can guide people down this path. Because 10 years ago, we would never have thought that Amazon is going to be moving into a pharmacy business!

If you’ve read the New York Times, they’re moving into the insurance business; they have got a proposal on to make a purchase of health insurance. So these landmark shifts are occurring that require our senior-most leaders to understand the direction that we now have to take and what these partnerships mean. Then to help convey that message down to the organization so that people understand why. If we are trying to implement new systems and taking a new approach to communicate to individuals why it’s so important, that’s an approach we have to take because that helps to truly drive the adoption of whatever that system is. We need better information to take a new strategic direction. It could be life or death of the business, and we have to make this change because look at the competition that is coming!

We find that the more that we can do that, even down to the local level, and build that understanding in, the easier it is to help steer a massive ship in a different direction. Every organization does that, but here at our organization, we use 10-year strategic sort of plans or visions where we lay out where we’re going. We just completed our last one. To use a mountain metaphor, we were climbing the mountain, and we were able to tell people at the very beginning, what we were trying to do and why we were trying to do it. Then, we made little incremental steps along the way saying, “Here’s what we’re doing now,” and communicating that down, and engaging people in the metaphor of climbing this mountain. Every three years, we’d bring our mountain pictures and have people take them with them.

If we are trying to implement new systems and taking a new approach to communicate to individuals why it’s so important, that helps to drive the adoption of a new system.

They realize, here’s what we’re doing and here’s why and connecting the dots for them so that we can shift. That’s a planned approach, and then on the dime, part of that is got to be, look, here is what we thought and its transparent communication and making some shift along the way. But I don’t know of any organization that really does it extremely well. There’s always some pain in making those quick on the dime shifts, and it really comes down to finding the right people that fit within that organizational model that you’re looking for and developing them to keep that mindset open and to be willing adaptive to change as it comes along.

We need better information to take a new strategic direction. It could be life or death of the business, and we have to make this change because look at the competition that is coming.

Sanjog: The Business case of true learning is not as difficult to make because they understand that without new learning or new capabilities, we will not be able to grow. Humans are learners, and even if you did not say, they are learning somewhere, in pockets in and in piecemeal. But then the challenge is, are they learning, keeping in mind where the business wants to go? That learning not always structured but becomes part of their doing, what they do and even while they’re doing their own job, is it cohesive that that cumulative effect of the learning is going to enable them and move them towards readiness? Because learning is a means to an end. How do you make that learning process even though happening? It’s like a swarm of ants. If you have to move them in a given direction, they have their own antennas, and they’re figuring that out, you want learning to happen in such a way that they all are learning in their own right, but they’re moving towards one direction. What’s the art and the science of that?

Daniel: You mentioned a quite a variety of things in there. One, to your point, that the notion and this is one of these older adult learning principles that’s been out there for a long time, it’s the notion from John Dewey that individuals cannot be separated from their experience. We all bring in these past experiences, and that’s how we’ve identified and understood how the world works. When you think about what’s going on, what happens outside of work and you think about disruption and people with cell phones, and now becoming these mobile devices that are stronger power than other computers existed decades ago. We now have this disruption at home with all that, and it comes into the workplace. People already have this notion of what they can expect.

The goal is to try to bring that experience and say, we need to make work mimic your experience and the rest of your life. We don’t really retain a lot of information in our brains anymore. Lot of times that you probably experience this is, you have your dishwasher breaks. The first thing you do is, you look up the make and model number, you go on YouTube, you search, and you find, and then you can use that information to go ahead and fix your dishwasher because someone else has already done it. It’s really tapping into that collective, but the focus and harness that energy what we’re really talking about, is thinking about what a given role in an organization does and then to illustrate for those individuals whether it’s through a framework or something else what they’re expected to do . Then to start to point them in the right direction of being capable of finding that.

One of my favorite resources to push people to is, we get calls all the time here and from the individual saying, I need help with Excel. Really that doesn’t mean you need help with Excel; there’s a problem they’re probably facing. I direct them to one of my favorite YouTube sites which is ExcelIsFun. You can typically search through there and find just about anything that’s been created on there. It’s really more of curating aligned with what the expectations are in a role. Whether it’s an operations role, whether it’s a right now or Nurse here or whether it’s an IT role or learning, marketing sales, whatever it is, it’s about understanding what are the core components and then putting in front of the individuals in that role. Here’s what these expectations are and the capabilities we need you to have and here are the resources to go and find it.

In this world of commoditizing knowledge and information where it’s out there, it’s more of helping to steer them because we know people are always looking for things whether it’s on Facebook or Twitter, people are sharing videos. It’s directing them to the resources that we think are most important for them to be able to do their job, and that’s getting the business aligned with the role, aligned with the individual so that they’re able to drive success for that business.

Whether it’s an IT role or learning, marketing sales, whatever it is, it’s about understanding what are the core components and then putting in front of the individuals in that role. Here’s what these expectations are and the capabilities we need you to have and here are the resources to go and find it.

Sanjog: Let’s talk about the ROI for learning, which is where if you are just learning and it stays with you or maybe apply it to a limited degree, that’s fine, there is some value-add. But what we don’t measure, we cannot improve. The way we may want to look at the ROI is – how much did a person as an individual or as part of a group, became ready to achieve a corporate objective. Is that a good measure? Is that the only measure we should go after when we’re trying to calculate ROI, because then whatever we do, it will be aligned with the end outcome that we intend to get? Daniel, let’s talk about the ROI for learning because what does not get measured, doesn’t get improved. If you don’t have a numeric measure if, how could we ever say we are truly learning as an individual, as a group, as a department, as an organization?

Daniel: Yes. That’s a really great question because it comes up all the time, especially when we’re looking at in the budgeting process and how we’re making contributions. There are a couple of ways to think about this. The way that I’ve thought about this is, when we present these cases overall, the underlying question here is really valuable, right? What we’re trying to drive is value. There’s a financial value and some other elements that are included. When we are purely focused on training or learning or for an individual or a team or even an initiative, if it’s on its own, it typically becomes something that is highly scrutinized because we’re looking at the value it is going to contribute. Most people in here said, “Well, we want to implement this new initiative. There’s this training.” Then when they’re done, they’re going to be capable of doing this. They want to know what that value is.

It’s got to be in service of the language that we use here in this organization. This training, this education, this is in service of achieving some outcome and that outcome is linked to the organizational outcome. We’ve been on this path to becoming a high-reliability organization and as a part of that journey, what we said is, look, we need to bring out education and training to be in support of that. In year one, we’re going to train managers and leaders because they’re the ones that are then going to train their staff. Year two, and then year three, we’re going to hit physicians who are affiliated with the organization. We’re going to put that path together. But in the end, some very clear expectations on what needs to be done.

At the end of the first year, all of our leaders had to be holding an operational setting, like you’re in one of our hospitals or facilities, you need to be having a daily safety huddle. All of this was really driving to that point; they have to have a daily safety huddle. There also need to be a beginning – starting a meeting with a safety story. There is a new practice of five to one feedback. We had very clear concrete expectations that we could then go and mark, are they being done? Not necessarily to start off with the quality, but just to get started. In this notion of – through the complexity of getting started with unknowns, to some clear concrete behaviors that were new expectations and service of this overall initiative.

When we are purely focused on training or learning or for an individual or a team or even an initiative, if it’s on its own, it typically becomes something that is highly scrutinized because we’re looking at the value it is going to contribute.

By the end of the year, we had all leaders doing this. Then the next year, the expectation is their staff were going to be trained on some very specific tools they needed to utilize to drive safety. It could be presenting information in a certain format, it could be making sure to speak up for safety, and there’s a tool that we use, that’s called CUS, which people really like because it says I’m concerned and that’s how you start the conversation, and slowly escalated up to I’m uncomfortable, and then this is the safety issue. We had some very concrete practices that we could put in place, and this wasn’t supportive, really driving in understanding what those needs were, and then we could visibly see that they were being done. In the end, we have not only the value that we provided was one, financial and then we see that every time we’ve identified a safety issue, and we’ve solved that problem for the organization, but we have also saved, and we can quantify that. But it there’s also this whole the expectation was these things we’re going to be in practice.

We’re meeting both the financial expectation as well as the expectation of a very visible practice. Those are the things that I think come together. It’s this interaction of we can see it, plus we know there’s a financial benefit. It overall fits with our driving practice of what we’re trying to accomplish. That’s just one example of what we’ve done but again, the return on investment, we might not have calculated that because of the thought that this is really attached to this overall initiative which is about quality and safety, and they’ve identified some things, and through training people, educating them, making sure people are continually learning on these. We know we’re driving those practices.

Sanjog: One is to look at learning by consumption, but it could also be by wondering and experimenting. If you look at many progressive companies, they’re allowing people, the breathing room versus treating them as industrial workers to say, “I will teach you a skill to make a widget.” But that doesn’t automatically result in the best ROI you could get from that worker, especially in today’s information age and suppose in your case, health care is a service industry. Are we limiting our learning approaches? I got this person to consume this much, he is going to retain 18% or 40% of it based on how it was taught or how it was consumed by them, and as a result, they will build some specific capabilities. Are we done or are we actually working towards making them a little more rounded, little more wondering type of individuals where they actually contribute towards innovation also and not just following orders like you would have done back in the industrial age?

Daniel: Yeah. The whole notion of moving from a compliance base, here is what I need to do and here are these expectation and go do them, to this ongoing learning, is one of those things that without a doubt, as a broader society, we need to think about because we have created very – what we call Dependent Learners and that they’re expecting for somebody to tell them what he or she needs to do and to learn and that’s going back to that notion of the framework. This is what we’re working on right now in our organization. I know some others have done this already is to lay out those guardrails around what we’re looking at, for a given role and to then ask people to say, here is what you need to do your job and here these capabilities that will help you to enhance that and to let them learn and set the expectation that they’re continually learning.

One of the great initiatives going on right now that I’ve seen it at AT&T is, they’ve understood and I heard their chief learning officer speak about this is that their landline workers and all the technology that’s been used for the past three or four decades is out and there’s new technology, new role, so they have an initiative where they’re laying out. Here what the new skills are going to be for the types of roles that we anticipate or that we might not even know are available. Here are the key things we want, and they’re asking for employees, not in the work setting time but on their own to really go step into and learn more about what’s going to be that expectation, so they take control of their own career and know what they are going to need to do. They’ve laid out this roadmap, and this vision and here’s skills for the future. People can go do that. These individuals on these roles that are going away can start to transform their own sets of skills if they would like to can continue to at AT&T in a new type of role, so that’s one example.

The other part of your question though is really how much should we expect for retention if someone attends something? I would say that the way we need to flip this is probably as a manager, as an organization, again what are you expecting them to learn, and the formal portion of learning could just be a tip sheet, a performance support job aide to know how to use this tool. Where we really want to invest in this, to your point is around the critical thinking elements and how are they taking this information and utilizing it. Some of that we can send someone off to a course and/or to some event to learn from, they need feedback at the moment from their leaders, “Hey, look, I appreciate how you thought about that, but we need to think about it like this.” This notion of a manager as being a coach or as being a teacher, we’ve adopted sort of the leaders the teachers model here, is going to be critical because we can’t outsource some of those components. They need to be done right there at the moment so the individual truly, truly learns as machines can learn, humans can learn. We’ve taken away that freedom and capability to say, look, I failed, here’s what I need to do next and give them the appropriate feedback so they can learn fast and start to implement things faster and faster.

Sanjog: When you’re looking at this wondering concept of letting people go, give them the breathing room so that they actually are able to assimilate all that was loaded on them. Would you be able to preempt or rather trump other things that they may be doing to say, “Guys, while I’ve used their time this much for training time but there is some assimilation time, so I need to get them the breathing room.” Do you do think organizations are allowing that to that freedom to a learning leader to go and negotiate that with the administrative leader or an IT leader, in this case, to say, give me some time for these guys?

Daniel: Yeah. That’s one of the issues that we continually face is, it’s really tough to want to build things because I know that things change fast so we want to be able to implement as fast as possible and people do need the time one to learn. What I mean by that is through that experimentation process, as well as be educated and trained know what the whole approach and purpose are. It is a constant battle. It needs to be set up effectively for a change management approach. We’re working on an initiative right now in our organization to implement a palliative care solution which is more, more holistic towards the end of life as well as to eliminate unnecessary pain and sufferings through treatments.

One of the things that we’ve done is able to get in on the front end of this and to say, “Look, how do we want to roll this out, such that it sticks?” Which may mean, in the first year, we only do this much, and the second year, we can only do this much. We’ve been really strategic and how we’re coming up with this plan to make sure that if we believe this is the right approach, then it’s going to be an intentional effort to get it up and running and make sure it’s one 100% successful. That’s the biggest thing is – initiatives fail, and we know this. We know the research says that the majority, the far majority – the vast majority of initiatives ending up failing, and a big chunk of that is because we don’t give the time and resources needed to do that, so it is a constant battle and something that the individuals like me and I know others in the organization try to push on because we’re just hitting employees from all sides. It makes it tough to understand where to prioritize their time.

Sanjog: Let’s take a quick break listeners, we’ll be right back. Let’s talk about a holistic approach to learning across the organization because you could have the squeaky wheels which get the most attention, so they get the most learning but when you’re talking digital, and this digital age literally everything shifts. That means the learning needs to be touching all areas for the final outcome that we may be looking at from a people process technology across different departments, to create the most value or the optimal value. Is there something we can do or is this something being done where we say, we’re going to do the learning, but we will rethink it so that people learn and become capable and become ready at the same time versus one waiting for the other. How do you make that juggling happen so that the outcome that you’re looking for is achieved? Please stay tuned listeners; we will be right back and explore.

Welcome back. We’re talking about an environment and digital where everything has to be touched from capability development, from learning and any other resources to be provided. Coming to learning, how do you negotiate with different business unit leaders, how do you build the necessary expectations and provide the resources so that learning happens holistically and also calibrator so that it happens somewhat at the same speed? For readiness purposes, as a full organization, we’re not waiting for some people at all times.

Daniel: This is one of those things, back to the point of – these are really difficult because what we’re talking about is a change effort. Anytime we’re either implementing a new system, asking for people to do something differently. What we are really fundamentally saying is, we need you to change. The hard part of the efforts is, we want to change everything extremely fast because we can see the end game. It’s a skill set that’s really hard to think about, what’s the scope, what’s the sequence through which we do things. I’ll tell you; we have some plans that have worked really well. One of those was our high-reliability plan, where we got things tied in, and we have this promise packet and  messages were tied there. We connected messages about high reliability in there as well as the training. We immersed everybody in it and made it so they couldn’t run.

Other types of approaches as we go up is like what we’re going to do with this new implementation with the revenue cycle system that we’re using. We’re going to go up by one site and then up by two or three more and then two or three more, and in each one, we’re going to capture the learnings and adjustment and make some changes. One of the elements that we need to keep in mind really is, we expect that everybody by the end of the implementation or when it starts, will have that same level of capability. But there are a variety of things, and it gets really down deep into the organization to that front-line manager role or supervisor or whomever the team lead is.

Understanding what’s going on with their staff, knowing why we’re making this change and being able to translate some of that change to the individuals because I think most people inherently want to do a good job today. They come to work; they want to do their best, they want to understand how they’re connected to the organization’s mission, vision, purpose, the reason for existence.

The more those things can be tied into how what you’re doing in that role is driving it better. We have good examples like I mentioned with HR where we clearly did this with high reliability. Even though we’ve been a trailblazer on our implementation of our Electronic Health Records system, there are still a variety of difficulties and pockets of people that just don’t quite grasp it and have difficulty utilizing the tools and understanding what the purpose is. That’s just one of those expectations. I don’t know if we will ever get away from that and be able to eliminate it, but I think we can mitigate it by thinking through how we create that change in the first place.

Sanjog: I wish if we had a readiness dashboard for an organization where we are also able to plot the learning initiatives, and as learning happens across the organization, we show movement upwards hopefully in the readiness. Do you think such things are tried?

Daniel: That’s a real trailblazing idea there. We are in the process of bundling up a variety of initiatives in our organization because I’m sure all of your listeners were very similar in that. Everybody has their own initiative, and we’re all trying to push things forward, but we don’t quite have our oars all going the same direction. So we’ve created a new model where we have a group of individuals, a sort of decision-making model for the organization that will decide at Texas Health what we’re going to do. There’s a committee that makes these decisions, and there’s a group that helps to plan and prioritize and think through when these things need to happen, so that we can have a broader organizational change management plan and initiative, so that we know again, so here’s what we’re trying to do and then underneath that we’re not there yet. But underneath that, individuals like myself partner with the business and say, here are the capabilities of these units that will drive the success of adoption of these initiatives to move us forward.

Then, I think the next measure is what are the critical competencies required to achieve that and who in these areas already has them. If they do, let’s leverage them to move us forward, and if they don’t, that’s where we want to focus our time on being able to support those individuals to move them through the change, to build the capability and then to advance quickly. That’s a great concept. We’re slowly working in that direction with this initiative dashboard. I’ve seen a variety of other organizations, and it depends on the centralized or decentralized notion of the organization where a lot of the decisions may be held locally. That’s the way we’ve been prior to the past two to three years. The business leader was making those decisions and driving them forward, and it just required a different expectation of thought around it. I hope that answers the question a bit.

I think the next measure is what are the critical competencies required to achieve that and who in these areas already has them. If they do, let’s leverage them to move us forward, and if they don’t, that’s where we want to focus our time- on being able to support those individuals to move them through the change, to build the capability and then to advance quickly

Sanjog: Definitely, it does. The very next one is, the times we are in also pose another challenge. We have unprecedented security challenges. You’ve got official intelligence coming in in your space, telehealth or other IoT based initiatives that are starting out for you to be able to take health care to the next level. There is no one who could claim expertise for them to come and train your people. What do we do? Do we just say one blind is going to lead another blind or someone who is less of a blind is going to lead the other blind? How are we getting the resources in the first place, wherever they come from, or whosoever claims that they know it all or they know enough to train others, may be kidding themselves or us? What do you do for such cutting-edge areas to establish learning and with an outcome for readiness?

Daniel: The question, it makes me think back in our industry. The history of medicine and you go back to the Greeks; there was once this theory that there were four humors. There are black bile and yellow bile and phlegm and blood, the imbalance of those is what drove wellness or illness. When you think about this, it’s a revolution in terms of what technology is capable of doing and what we’re required to do for security or analytics or whatever it might be. What you’re really speaking to here is back to the very first question is this notion of complexity.

If you look at the pattern, it’s a series of tests where you have a theory you test and then say whether it’s correct or not. We probably have very few experts, and so we have to look to those who are doing ongoing research, probably in academic institutions, to help them test some of their theories around this and to use the business for that. If we don’t have time to be able to partner with them, then it really becomes us having to work through it, learning what’s working and not working. We’ve done the same. I wouldn’t say with AI analytics security, we have some processes and we’re bringing on board a lot more capabilities in our organization to create even a chief data officer. We want to structurally put that in place for the organization because it’s about really having to keep the focus on that. It is to have someone really driving that, someone who probably has some expertise – maybe not complete experts when things are changing. But then at the same time, to partner with them across different business units to figure out what are the small incremental pilots that we want to be capable of doing, to make sure that we’re learning how is this working.

What we’ve done before, not with data but as we opened up some small clinics. They were targeted for very specific purposes and different neighborhoods to see how they worked. Ultimately, we learned that it did not work as well as we thought they were going to be, so we closed them. But we didn’t put a lot of investment into it in terms of financial capital; we did enough to see if it would be successful. We tried the approach, these clinics that were local did not work so we close them down, and we catalog that as learning, moving to the next thing, and try our next pilot to see if this will work or not. Taking the same approach and small safe increments in these areas of analytics, AI, security to make sure we understand some of the high-risk things in there, we got to find out what are the right pilots to be capable of doing and partner with academic institutions who have some theories about this that we can test and learn from.

Sanjog: Utilizing learning means, someone has to impart the learning, people have to learn, he or she have to apply that learning, he or she have to experiment, he or she should have feedback to what the experiment it, is it working or not and what additional learning is needed. Then finally, bring it to a point where we are confident that we can operationalize. That’s called readiness. Can learning be imbedded in this whole readiness creation process or learning all along traditionally or even today, is just considered as the starting point and then you’re on your own? Please stay tuned listeners; we will be right back and explore what should be the level at which learning and the related leaders should be embedding themselves in the whole readiness development process. In this process, can learning be embedded? Who should all be leading this effort? Not just the leader but also the department head who is allowing that experimentation and line of sight is created through and through so that we actually are able to see the readiness happen. If not, clearly able to see the challenges and then find solutions, apply them and see what works what doesn’t work. Do you think we are in that Star Trek mode of learning and bridging that knowledge to readiness yet?

Daniel: No. We’re working our way towards there. This is where a lot of these information systems can really help us because we are trying to create a line of sight to understand how the organization has identified that we’re going to achieve success. One of our KPIs here is HCAHPS Survey, which is the survey that people got when you had a visit to our hospital, or there’s a version for if you visit a physician practice. Based on that, we get a score that does this analysis for us. They are able to tell us since these are tied to reimbursement, how well we score and what the satisfaction is that that’s going to drive some revenue for us ultimately. How does that goal, line of sight get trickled down then to a target measure which we have for a hospital or for the physician practices which then get targeted down to an individual unit or practice? We can drill down there, on that specific initiative to get down and understand, here are these things. If they’re not quite going very well, that’s the point at which we can look at individuals and their own performance evaluation and link that to the broader KPIs that we’re trying to drive and the systems underneath that they can provide them data.

One of the things we’ve been talking about a lot with our IT folks is, how we do some of these things for other initiatives that we have. Our quality team is looking at sepsis. For our sepsis effort, then how do we get that data from our own documentation, cascade that down to units and organization, being able to share that, so we know and then can make adjustments and understand at this unit. Identifying the issue, and if it’s a knowledge gap, provide them that knowledge or education or training on these things. So then we’ve closed that, and we’re able to see then the link to our previous conversation of, we’re trying to drive this initiative or this unit base issue forward. We close that gap, and then we should see the performance improve. It’s a mini hypothesis, we test it, and we advance it, and we realized that. The knowledge was helpful, but they’re still not doing it, and we realize they can’t because some other system is in the way, so we need to move that.

Again, I think that whole vision is where we’re trying to go, and we have some initiatives and some KPIs where we can drill down. We have others that we’re working through and trying to make information. Not only readily available because sometimes we can get to it, but quickly available -within 24 hours as opposed to a week, and that helps us to make those rapid cycle adjustments. To get to readiness, we need to understand whether or not there is truly a knowledge or education gap and what’s driving that.

Sanjog: Very quick, two questions. First is since you are working towards helping an organization get ready or individuals get ready, how an organization should create benchmarks so that they’re not just chasing a ghost and they never get there, and everyone gets bad marks for not trying hard enough.

Daniel: Yes. Again, with the end goal is to implement a new process, there’s a new initiative that we’re working on related to this and success is following. Once you’ve identified what that success looks like, we’ve just oriented our new leaders to the way that the organization works. That fundamentally provides some knowledge that we can test, and they have that understanding. See if that is helping to drive and then the outcome of being able to implement the change a little bit faster.

We probably have to first start with what the end is and then work our way to what do we think will help them be ready and to set that as a benchmark. There is always both a technical component to it, as well as more of this human-related understanding of the change.

We probably have to first start with what the end is and then work our way to what do we think will help them be ready and to set that as a benchmark.

Sanjog: 15 seconds, what would you say is your message to the business and technology leaders who are trying to get this – trying to bridge this knowledge and readiness gap, what should they be doing something new more or different so that they are able to achieve this objective?

Daniel: The conversation has really focused a lot of change and human. Think about whatever it is that we’re doing, what’s likely to be the impact for the individuals that are doing this work and what is that really going to change for them because the whole notion of a change by itself is complex. But then, what are the new knowledge skills, abilities, competencies, things that they will be doing differently that will be required of them because that will help to drive the success.

Sanjog: Thank you so much, Daniel, for sharing your views.

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Daniel Gandarilla

Daniel Gandarilla, Vice President and Chief Learning Officer, Texas Health Resources

Daniel Gandarilla, M.B.A., M.Ed., FABC, serves as vice president and chief learning officer (CLO) for Texas Health Resources. In this capacity he is responsible for the strategic oversight of leadership and management development initiative... More   View all posts
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Daniel Gandarilla


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