Walking onto the grounds of the University of Virginia last month felt both new and familiar. I was there for the two-day Enduring Excellence executive seminar, my first “go see” with the firm. And while it was my first time at UVA Health, the experience took me back more than a decade to my ThedaCare days, when leaders walked the floors, stood shoulder-to-shoulder with teams, made daily management a living habit, and then regularly opened their doors and hospital hallways for others to learn.
Attendees were healthcare executives from California, the Midwest and the East Coast. We began with stories that grounded the why. Mike Bundy reminded us that doing the routine tasks routinely well – like consistently placing syrup on patient trays when they order pancakes - gives staff more time to do patient care. Bill O’Rourke shared memories of working alongside Paul O’Neill at Alcoa, showing us what habitual excellence looks like and how organizational values such as safety must be focused on 100 percent of the time. And Dr. Tracey Hoke and her team opened the door to UVA Health’s 12-year journey with a daily management system, hard-earned progress, discipline, leadership support, and the constancy of purpose needed to sustain improvement.
The discussions had a huge impact on the attendees but the gembas literally showed how the organization walks the talk. We went to inpatient and outpatient floors, stood in front of visual management boards, and saw how UVA teams track what matters most: bed availability, patient flow, staffing needs, and even space for kudos. These boards weren’t just tools; they were living systems of problem-solving at the source. They answered our questions with openness and pride. We also joined two virtual updates with system leadership.
It reminded me of my 17 years at ThedaCare. Daily huddles, PDSA cycles, value streams and standard work were new, energizing, and sometimes messy, but they were real. Leaders committed to going to the frontlines, not just staying in conference rooms. Teams owned their improvements, learning together and believing they could make things better.
I left Virginia grateful. Grateful for the graciousness of UVA Health in opening their doors, sharing tools, and having candid and honest conversations. Grateful for the reminder that habitual excellence isn’t built overnight. It’s built through discipline, transparency, and countless daily choices. And grateful for the chance to reconnect with practices that shaped me deeply years ago, and that still matter today.
Executives attending Enduring Excellence leave with a checklist of tools, and perspective, seeing what’s possible when people commit to the long game of improvement. They will remember why it matters to stand where the work happens.
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