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Episode Synopsis:

Welcome to Episode #66 of Habitual Excellence, presented by Value Capture.

meghan scanlon

Joining us today as our guest is Meghan Scanlon, the Vice President of Performance Excellence for Community Hospitals at Duke University Health System.

She was previously with Value Capture for almost 7 years as a Principal and Partner in the firm. Prior to that, Meghan and I worked together at Johnson & Johnson as part of a consulting team there that worked with medical labs and hospital systems. She has a BS in Industrial Engineering from Penn State University.

In today's episode, Meghan shares reflections, with host Mark Graban, about various transitions that she has gone through in her career:

  • Transition from college to the working world
  • Transition into consulting for healthcare organizations
  • Transition to Value Capture
  • Transition to DUHS

Click to visit the main Habitual Excellence podcast page.


Quotes:"I'm not comfortable calling myself an expert in something because I feel like I always have so much to learn.""There's such a gap between what I think is possible and where we are. I just feel that pull to make an impact and do that on behalf of humankind. Not to be so bold and aspirational, but I do think it's an important thing."

"Now I'm trying to think about 'what is the accelerant?' and 'what does it look like to try to build the critical mass?' To get the organization to the tipping point where we get over the hump of 'here's how we used to work' and 'here's what we're trying.'"


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Automated Transcript:

Mark Graban (2s):
Welcome to Habitual Excellence presented by Value Capture. This podcast, and our firm, is all about helping you and your organization. Achieve Habitual Excellence, via one unifying focus, one value based structure and one performance system. In other words, it's about helping you capture dramatically more value through achieving perfect care and perfect safety for patients and staff. To learn more about Value Capture and our services visit Well, hi everybody. Welcome to Habitual Excellence presented by Value Capture. I'm Mark Graban, and we are joined today by Meghan Scanlon.

Mark Graban (44s):
She is the vice president of performance excellence for community hospitals at Duke University Health System. So before I tell you a little bit more about Megan, welcome to the podcast, Megan, how are you? It's great to see you and I'm happy we can have the conversation here today. Community hospitals within Duke University Health System, which, which two hospitals are those?

Meghan Scanlon (1m 9s):
I have the honor of serving both Duke Raleigh and Duke Regional Hospital. Raleigh is located in Raleigh, North Carolina, and Duke Regional is in Durham.

Mark Graban (1m 17s):
And I love the way I look the way you put that. And I know you mean that having the honor to serve those hospitals. That's great. Now, Megan and I have known each other going on it's almost 17 years. If you can believe it. She was previously with Value Capture for almost seven. We'll call it seven years as a principal and a partner in the firm prior to that, Megan and I both worked for Johnson & Johnson as part of a consulting team there that worked with medical laboratories and hospital systems. And Megan has a bachelor's degree in industrial engineering from Penn State University. So we're, we're both big 10 E graduates And proud of it.

Mark Graban (2m 1s):
Yes. So we have a lot of shared background and you know, one of the, the theme for our episode today is, you know, talking about ideas that are shared are transferable across different settings, kind of, you know, the universality of lean and safety principles and practices, you know, the idea of respect for people. And we're, we're, we're structuring today a little bit differently. We're going to talk about some different career transitions that Megan has made and, and what's the learning that, that, that she's experienced. What are the things that are transferable? So we're going to try Kind of an adapted, modified version of a reflection model that we use at Value Capture.

Mark Graban (2m 46s):
So the first, the first question we always ask and what we're going to kind of go through these five and pose them to, to Megan about these different stops in her career. The first question is, well, what did you expect to happen? The second question as Megan knows, is

Meghan Scanlon (3m 4s):
What actually happened.

Mark Graban (3m 6s):
And then thirdly, what, what could you learn from the gap? The difference if there was a difference between expected and actual, and then we ask,

Meghan Scanlon (3m 14s):
What actions will you take now?

Mark Graban (3m 16s):
And then the fifth question is sort of a prediction. So this is different when we're looking back over time, what do you predict will happen when you take those actions? So I guess we're going to start off that first transition was from college into J&J working in manufacturing, right? So I'm going to pair up those first two questions, you know, your recollections of, you know, what, what did you expect to happen when you were doing that type of work? What actually happened?

Meghan Scanlon (3m 45s):
Yeah. So when I think back longer than I'd like to admit on when that was now, I think what I was really expecting from my first role was to learn what it meant to be a professional in an organization. The things that attracted me to my first company were that it had a family feel and there was a real connection and passion with the product and the people who needed those products. And so that was a draw to me, which quite frankly I got from my college internship was when I worked at Harley Davidson. And so it might be an interesting to think about the similarities between a company like Harley and a company like J&J, but the, the heart of the companies was very much aligned with serving customers and people having a passion and belief in the products and what they provided to their customers.

Meghan Scanlon (4m 31s):
And so I think I was just looking to learn what it was like to be a professional, to see the great learning and expertise that I've gained at, through my education at Penn State and to see where it could take me and how I could impact an organization and continue to develop myself.

Mark Graban (4m 49s):
So thinking back, w w was there any sort of gap you think between the expectations you had and the work as it played out?

Meghan Scanlon (4m 58s):
Yeah, so I think it's interesting that the transition between university and work I think is a tough one. And I think, you know, as we mature in life, that's one of the ones we are prepared and expect to be a little harder. But for me, you know, I, I remember thinking that the pace of the working world, if you will, was very different than university, right? So our, our academic lives are so based in spring and fall semesters, and there's a clearly defined start and end with outcomes defined and, and everything else laid out. And, you know, the work world didn't necessarily have the same urgency that you might have when you were doing 15 meets or whatever, the duration of a semester, and then people of all varying levels of experiences.

Meghan Scanlon (5m 40s):
So if you think about cohorts growing up and in school, you're surrounded by people who are sort of in the same life phase and looking to do the same thing. And now you're in a much different population with people from all walks of life, all different backgrounds and experiences working together. And so, you know, there's just learning how to navigate that and to, to use skills, maybe more of the social or interpersonal aspect in a way that you might not have had to grow and use before and learning that, you know, what leadership means is not the, the formal roles that you might aspire to, but it is really about how you show up in every conversation and how you contribute to your work and learn from others.

Mark Graban (6m 21s):
So, as, as you learned about that difference between college and manufacturing use, you got into that, were there adjustments that you remember making and you know, what, in the course of making those adjustments, what did you predict what was going to happen then as a result?

Meghan Scanlon (6m 39s):
Yeah, so I was lucky early in my career to be exposed to lean and operational excellence. And so that mindset and discipline, especially being an engineer was sort of always in me. And so really getting to practice that and get to work with some great leaders and people who shaped and molded my thinking in my career. I think the things that I started to do differently was learn more about how to engage people. I think also something a piece of youth is that you surround yourself more by like-minded folks who are driven by some of the same things. And so, again, just being new and an organization, and I should say that the organization I joined, it had been a while since they had had college hires, right?

Meghan Scanlon (7m 23s):
So their workforce wasn't necessarily there. Weren't a lot of people my age in the workforce that I had just joined. And it's not that they were, you know, crazy older. It's just, you know, even five, 10 years at that point in life is a lot of maturity and experience. So I think just learning respect and what that means to acknowledge others experience while still trying to honor and pull forward your own was a really big learning that maybe I didn't necessarily expect or aim for. And something very important and rich that I got out of in my own development.

Mark Graban (7m 57s):
So it sounds like from those first couple of stops in between Harley Davidson and Johnson & Johnson, that there was a passion around the products, maybe in different ways, you know, Harley is famous for its its following. And, you know, the, the, the, the, it would be fun to make products for people who care so deeply. It's like, it's a lifestyle. It's not just not just a product. Right. And then, you know, at J&J I mean, that was a company with such deeply held values, you know, stated values and stated principles in some ways reminds me of, I think, what you see then in healthcare organizations, or when we talk more about this in a bit, I think within Value Capture, it's a very high, highly principled.

Mark Graban (8m 43s):
It's an organized organization that values its values, I guess, a decent way to say it.

Meghan Scanlon (8m 49s):
Yeah, yeah. And a change I have in the credo be front and center. And, you know, even if we didn't necessarily live it fully as, as we wanted to every time just knowing that it was there and that we were always striving towards living it to its fullest, because the, we really believed in what it was that it said. So absolutely.

Mark Graban (9m 9s):
And I think for what it's worth a lesson or a reflection I had was, you know, having stated values is great, but nobody's perfect. And that includes, you know, whether it's individuals or companies, but I think it, it, it lays up clearly if it seems like an organization is not living up to its values, at least you have the values to point to, to say, wait a minute. We're, we're off track.

Meghan Scanlon (9m 35s):
Exactly. And that's why I love one of the things I think a lot about is sort of how we're using this model, but the simplicity of what is a problem, it's just the difference between what we expected to happen and what actually has happened. And so if we expect those values and we fall short, at least we know we fallen short because it's the first step in trying to solve a problem is actually seeing that the problem is this. So it's really important to have those things be documented and out there, because it really does change your mindset. You build that awareness and you start to see things differently and everything you do.

Mark Graban (10m 5s):
Yeah. If there is no standard, there's no comparison point at which to define a problem. So tell us a little bit more your, your transition then of, of working internally J&J manufacturing into the opportunity you had to work out in the field with healthcare organizations, maybe we would start off and, you know, you can share some detail around these questions of how this came to be or whatever you want to share, but as you started getting outside of the J&J buildings, what is you expect to happen in that role and what actually happened?

Meghan Scanlon (10m 42s):
Yeah. I remember that point in my career and really looking to spread my wings a little and have new and different experiences. And I've been looking for opportunities across a bunch of different industries. And I remember having made connections with different people in my own organization, through some experiences that I had had where, and learned about a group where we took what we had learned and tried to work really hard at improvement within our own manufacturing and brought it to the end users of our products. And I, I really love that idea because I, while I thought that I had been great experience in our manufacturing, I knew that, you know, our manufacturing was finite and I wanted to learn more about what it was, and I really wanted to be more connected to our customers.

Meghan Scanlon (11m 25s):
And so I really thought it was a good opportunity to think more broadly beyond the place where I was and think about how we can apply this in real and meaningful ways ever increasing meaningful ways, I should say, because I did find meaning in the work in manufacturing and I wanted to have a bigger impact in health.

Mark Graban (11m 45s):
So do you, and I know you made an impact in that role, so you're expecting to have a bigger impact. I'd be curious to hear more about, you know, what, what some of that impact was, or, you know, how you learned to navigate a different environment.

Meghan Scanlon (11m 59s):
Yeah. So, you know, that was hard. I, again, I still considered myself very young in my career and I'm showing up in places and trying to, you know, share and build your credibility and to have your voice be heard while respecting and learning from others. And that's why I really think that one of the first things I learned was, you know, to pay respect is to go and see. And so I've, I've used that tool and skill my entire career to build my own credibility. So I could speak from the perspective of the people I was trying to learn with and engage and, and doing that in, in translating their work into data. That's the power I think about salvation is it's not just seeing for seeing sake.

Meghan Scanlon (12m 40s):
You can quantify time and you can categorize time, and you can really use that to drive some of those discipline, industrial engineering focus processes, and to make drastic improvements. And I love the model that we used, which was, you know, really following the scientific method and really thinking about, you know, again, I think discipline is a theme that I'm hearing myself say being an engineer. I think that discipline was always something that I needed and craved. And so just the ability to trust a method and apply it and learn still. So wholly from every application of it was a really empowering thing for me.

Meghan Scanlon (13m 21s):
And I think it really, you know, left a trail of a lot of great work and impact from around the places I was able to engage.

Mark Graban (13m 29s):
Yeah. And, and it's just to dig in a little bit around that idea of observing the work and, you know, there's there's methods. And then there's principles that tie back to things like, whether you stated as respect for people or the Shingo model of respect, every individual, you know, part of that respect, I think, involves designing or putting in place or significantly improving processes so that people aren't running around all day dealing with weights, that they can focus on the part of their job that's fulfilling because it's directly serving patients, whether that's running tests in a laboratory or prepping and sending out medications from the pharmacy.

Mark Graban (14m 14s):
And, and I think a lot of times before, you know, you, you come in, you had a lot of people working really hard, but you have to help them see a little bit differently and they can embrace that and work together for the improvement. So I'd be curious if you could just share some more reflections on that model of coming in and engaging people instead of like, I'm, I'm the person here, who's get to tell you all the answers.

Meghan Scanlon (14m 39s):
Yeah. Yeah. And it's, it's funny you say it that way. Cause I've been thinking a lot lately. I, I sometimes hear people use the word expert, like I'm an expert in X and I actually, I'm not comfortable calling myself an expert in something because I feel like I always have so much to learn and I always do learn so much. And that's what I think was really important about the approach that we worked in during those times is that we were there not only to get those results, but we were there to develop their internal capability to continue to get results like that even after we left. So we weren't signing up to be there forever. We were signing up to come in and help develop people to be able to do some of the process improvement methods that we had.

Meghan Scanlon (15m 19s):
We were there to facilitate them through the achievement of some really impressive and transformational goals within service lines or, you know, smaller scopes within their organizations. And then we were hopefully doing that for a couple of cycles to really build that capability. One of the things I'm proud of is that the places I would leave this was earlier days in healthcare with, with lean and operational excellence. Right? So a lot of the folks that I worked with then became the improvement and professionals full time and didn't necessarily go back to their quilt day jobs. And I thought that was a really cool thing because not only had we done something great together, but you know, they had had a spark lit in them and they wanted to keep pursuing and keep serving their own hospitals and communities and continuing to learn and improve.

Meghan Scanlon (16m 8s):
So I just think that's cool. So the, what you leave back is not just the artifacts of the project or the thing we were doing, but we had built something that was lasting and helping people develop and learn.

Mark Graban (16m 22s):
Yeah. So are there any adjustments that you recall having to make, as, you know, as you went in with that intent and you were navigating that, you know, well, were, were, were there adjustments that you made over time with more experience in that environment?

Meghan Scanlon (16m 38s):
Yes. Oh gosh. So many. And I love the sort of parallel of them. I think as a group, as the group of us, mark, you know, we made so many adjustments and tried to get ever better at how, at what our model and methods were. So there was that kind of adjustment that always happened. And then there was also the adjustment of how I showed up when I was partnering with an organization and did something in that space. And I just remember, I had to learn to seven times seven different ways to be able to describe things, right. I had to develop my own library of stories very quickly so that I could help people understand, because I think, you know, one of the hard things about transitioning organizations so quickly, you know, I might be in three or four different organizations in the course of 12 months.

Meghan Scanlon (17m 26s):
And so I had to continually learn how to build my own credibility, establish what I knew and be able to build relationships and trust so that they would engage with me because we needed to have kind of that safe space so that learning and growth together could happen. And so I think so many adjustments that, that happen along those lines of how I did that, how I was able to convey and connect with people, how I related to people, how I tried to even just articulate what it was that I was learning, because that's, what's hard to write when you're learning sort of on the fly as you're doing, it can be really hard to be clear and help someone else learn. Right. So how can you do that in a way that's meaningful?

Meghan Scanlon (18m 7s):
And to me, those are the things that I think about is, is what I was learning. And another piece about how important leadership and the role of leadership is in this stuff. I know that so often we want to empower and enable our teams to do a lot of great work. And I think a big burden of leadership honestly, is figuring out what their role is in supporting those teams. And I think those roles mature and need to be redefined as the organization learns and improves. So making sure that we're pulling in leaders and allowing them to lead in a way that gets you the results and gets the momentum and, you know, has everything firing on all the right cylinders. A lot of that is what I think about when I think about the different adjustments that were made is just taking a swing at every pitch to try to see how you can make the best connection possible.

Mark Graban (18m 54s):
Yeah. So what I hear you saying is kind of two levels, there was your own Meghan Scanlon iteration of a, as you said, many times a year, getting that day one with a new client, that's a, those are a lot of cycles where in someone's career, if they're changing jobs every five or 10 or however many years, there aren't as many of those opportunities for reflection and learning and adjustment. And then there was that more organizational adjustment trying to, you know, we, we, we, we did our best, I think it was, we do a Value Capture to continuously improve the methods that we're using to help spark whether it's breakthrough improvement or continuous improvement.

Meghan Scanlon (19m 39s):
Yeah, exactly. And I think for me thinking about what I got from my J&J experience into what I wanted to get from my next experience, which brings me to how I, I found in was lucky to be able to join Value Capture is, you know, we had shown proof of concept and proof of method in a lot of, in a lot of places all across the globe in, in pretty defined scopes, right. But service line value stream, connected departments. However you want to think about that. And it really made me want to see what it would take to do a whole house or a whole organization and transform. And that's what it built in me is like, man, like I could see the power and potential of what we could do in a, in a really specifies space.

Meghan Scanlon (20m 23s):
And I wanted to see what we can do. We can unlock unleash and unlock the potential in a whole company, which meant much more exposure and connection to the senior, most leaders of the organization and helping them learn and trying to find the ones who are out there trying to do this to, to connect and learn with them. And so that's really what I started to feel the almost pressure to want to do was to what it would take to, to change an entire organization on a, in a way that would, you know, have a sharp change in what they could do or operational excellence. I never know exactly how to say it. People know what it is. Cause transformation seems like a word we use a lot these days, but yeah.

Mark Graban (21m 5s):
Yeah. So it's almost more than about that transition. So you were doing the consulting work at J&J for nine years, and I think it's interesting to hear you talk about what you were, what you were seeking or what you were feeling pulled toward, you know, if you all share it, share a little bit about then coming into Value Capture and what you expected to happen in terms of meeting some of those needs and desires you have.

Meghan Scanlon (21m 28s):
Yeah. So like I was saying, I was thinking more about like, what would it take to do this for real quote unquote and then across the whole organization, rather than establishing great pockets of things and hoping for the chance to make those pockets be wider and wider. And so luckily being connected to Ken Segel, at some point we, we had shared values. We had initial conversation and then about six months later, they had an opportunity that, that came about that I, I reached for and put my hat into the ring for consideration. And again was very lucky to be able to be selected to join their group. And there were some things that really struck me about Value Capture that were important to me for where I was and what it was that I wanted to do.

Meghan Scanlon (22m 12s):
And again, it's just how I, I feel a real responsibility to impact healthcare in north America. And on a global scale, I, I feel strongly at the opportunity that exists. There, we are all consumers of healthcare at some point in our lives. And I believe it is a right, not a privilege. And, you know, I just look at all around and I see the opportunity and the chance to do it better and differently. And there's, there's just to me, such a gap between what I think is possible and what I see where we are. And I just feel that pull to make an impact and do that on behalf of humankind, not to be so bold and aspirational, but I do think it's an important thing.

Meghan Scanlon (22m 55s):
And so Value Captures values and the leadership of color meal and learning and studying his career journey and impact he had had. And the people that had learned from him along the way that were the folks in Value Capture. I think I just, there was some, it, it, it connected with me and it was something that I really thought would be powerful because I knew how much I had to learn and I knew the impact wanted to make. And so it just felt like a really good right place, right. Time, right. Work situation.

Mark Graban (23m 28s):
Yeah. I mean, there's, yeah. I love that phrase. You used bold and aspirational because that describes Paula Neal, what he did, what he encouraged others to do to be bold and aspirational would include goals like zero harm. And we'll, we'll come back to this, but I know that's an important commitment and connection there at Duke University Health System. You know, the work we were doing at Johnson & Johnson was, was pretty bold. I mean, you know, if a lot of times people would say our goal for the year is 10% improvement, you know, from the methodology that we were using there, we could often come in and reduce turnaround times by 60 or 70%, or there were big, huge leaps, but I don't remember really that same drive for what Paula Nell would call Habitual Excellence or really, really pursuing perfection, for example, like, like zero harm.

Mark Graban (24m 28s):
So I think you're, you're right. That's a unique opportunity to do that type of work within Value Capture. How did, how did that, you know, I guess the second we'll come back to the second reflection question or the second and the third, you had your hopes and your expectations. How did that play out over the course of what turned out to be about seven years?

Meghan Scanlon (24m 49s):
Yeah, that's when I look back at Megan who started Value Capture and Megan who left Value Capture, I feel like a, a transformed human, a totally new person. It was a huge period of learning and growth for me. I was competent and capable in the methodology. I had been raised in if I could say it that way. And I was really something that was important to me is that I wanted to come in and learn Value Capture from Value Capture and not, you know, come in with as much of my bias, even though it's impossible not to have any right, but I really wanted to learn to do the work the way they did it because I heard their mission and vision, and I shared their values.

Meghan Scanlon (25m 31s):
And I knew that I had a lot of opportunity there, and that was hard because I basically was trying to rewire myself. Right. I was trying to not rely on the instincts I had built and had served me very well for the first, you know, 10, 15 years of my career. And I was trying to learn new ones and it took me probably four or five years before I felt like I could pull back my old bag of tricks, so to speak and connect it with a new bag of tricks that I had been working really hard to board. And so those for the first half, I would say of my Value Capture tenure were really hard because I never really felt like I knew what I was doing or what to do next. And so it was the constant state of kind of vulnerability and, and overwhelm maybe, and a lot of humility to say, you know, I don't know, and I want to learn, and, and I embrace that as best I could and being a person.

Meghan Scanlon (26m 26s):
I know it was, you know, a hard time, you know, that's a lot to try to process and try to do. And so I just appreciate so much who Value Capture is, and the people that are there because they were beyond gracious and supportive of me during kind of that tumultuous piece of my life that I was experiencing. And I hope that as I was learning more and we had those shared experiences together that I have made them proud with the arc of my own development and learning and how I try to espouse the same values and keep putting them into the world. And the same way,

Mark Graban (27m 5s):
I I'd be curious to hear it. You talked about the, the influence, the impact of, of Paula Neil, as many of our guests here, you know, speak to from their direct interactions with them. Are there other principles that come to mind, you know, from Mr. O'Neill that maybe led to other adjustments in, in your actions and in your approach and working with organizations

Meghan Scanlon (27m 33s):
Yeah. As the principles of polonium. And I think about him, I just think, you know, you knew what he would say and do because he told you and he was consistent. Right. And in that discipline again, I always felt it in me and to see someone who had done what he had done in the way he had done it, that shared that same piece was just to me really empowering and inspirational there's comfort in that predictability. And yet it still challenges you because even though you know what he's going to say, you also know that you're probably gonna fall short of what it is that he's trying to get from you. Right. And all of that happened in a way that drove energy and momentum and you, and didn't feel defeated.

Meghan Scanlon (28m 17s):
Right. So you knew that, you know, there was support there and you knew that whatever he knew and could impart on you, he would. And so, yeah, I just think that that is the power of it. And I was very fortunate to have him help me at a few of my early clients sites. And he came and spoke and I, you know, I, I love a good speaker and I love somebody who can inspire. And I was definitely inspired by and tried to be a sponge as much as possible with the, not just what he said, but how, and then most importantly why. And so it really is, you know, simple, there is a bit of black and white to this. There is right and wrong, right.

Meghan Scanlon (28m 58s):
There is harm and no harm. And, and having that clarity is a really empowering thing. And it's also sometimes a really hard thing because so much of the world feels squishy, you know, it's in the gray. And so how do you take all of the yes. And or yes, buts as most likely people say and change them into no, there there's a, there's a right and a wrong, there is a best and a worst. And how do we always aspire to be in that direction? And so it really does. I mean, I feel this relentless pursuit, which is something else we talk a lot about, but, you know, I, I can't rest. We're not done.

Mark Graban (29m 37s):
Yeah. Well, again, I think, you know, there's, there's a high standard when comes to principles and behaviors that may or may not line up with those principles. And there there's a high standard on performance. As you know, Mr. O'Neil would say striving to be the best in the world at everything we do, that is a really high bar, but I, I appreciate, I have less direct exposure to him than you did, but there was that sense of these aspirational goals and the, the whole package of the principals and leadership behaviors were inspiring as opposed to being defeating of like, oh, well, we can never get there.

Meghan Scanlon (30m 16s):

Mark Graban (30m 17s):

Meghan Scanlon (30m 18s):
Yeah. Yeah. I think, you know, that's what I gleaned from the stories from Paul is that, you know, he could give you very specific examples that weren't as aspirational or big, but really just in the course of day to day, you would show you this was the chance we had to get it. Right. And then he would share very frankly, and here's the times we did. And here's the times we fell short and what we learned and what you would do next. And so, I mean, I feel like every single thing we do is a chance to do it the best way we know how, and I really love the spirit of that and the permission that it's okay if we don't do the best, cause we're going to get another chance right behind it to do it better next.

Meghan Scanlon (30m 58s):
And so I just, I think that's a really important mindset to have as a leader and really as a person, because otherwise life can be, it can be a lot sometimes, but knowing that you're always going to have another chance to do, to do the best you can is really important. And, and it gives me the energy and the hope I have about what we can do.

Mark Graban (31m 19s):
So let's, let's talk now about the hope and the actions and what you're helping people do at Duke University Health System that, that transition from Value Capture to Duke almost a year and a half ago. So a shorter stint there, you know, before we have the reflection questions to think of again, but one of the things I wanted to ask first is I'm curious as your role in your role as a leader, as a, as a vice-president and with people working for you and working with others, you probably hear Mr. O'Neil's famous three questions in your head fairly often, As you're now in a leadership role, what are your reflections?

Mark Graban (32m 4s):
Because this is a different mode of operating than being an advisor or consultant to others. Now you're in a, a formal leadership role and we know not all leadership is based on formal title, but I'd be curious to hear some of your thoughts about that aspect of your, your new opportunity.

Meghan Scanlon (32m 23s):
Yeah. Well, first I think that right now is the biggest opportunity I have is what does it mean to be a formal leader, as you just said, my career hasn't, I haven't had a lot of that direct status is the wrong word, but it's the one that's in my head in my life. I haven't had that role be clearly defined before for me. And Paul's three questions I actually do ask my team on a regular basis. And I've incorporated that into how I, I tried to leave. And it's interesting, I think learning to assert myself or, or understanding that how my voice can be best heard.

Meghan Scanlon (33m 4s):
So I'm looking at things that are, you know, on my computer I have, because I am a person that's driven and inspired by the words of others. I've got some things written that I, that I try to always do. So it's, I have hold the principles, the method, the discipline, and PTSA, I have be humble, curious, be kind and show respect, and I have owned my expertise and speak up and use your voice. And I think those are things that I try all the time and the speaking up and using your voice piece can be hard. And I don't know if that's just hard for me or just where I am right now, but you know, having a different path and a different set of experiences that have led you to a place, it can be hard to, to assert your voice in a way that others will hear it.

Meghan Scanlon (33m 51s):
And to say that differently is it can be hard to have a shared mental model or to, to find thought partnership when you don't have shared experience together. And I think that's, what's hard about the first parts of new transitions is that you haven't yet had a lot of shared experiences that allow you to come back to a common, common place, right? So we're still sort of like two pieces growing together. And the good news is we're growing and the challenging parts are, how do we can grow faster if you will, or how do we learn more together? And that's just part of, you know, I'm relying a lot on some of those earlier transitions that you're actually helping me think about right now.

Meghan Scanlon (34m 31s):
And what I used to do in rapid cycle is now I'm like, oh, I'm here and I'm trying to continue to do it. And to me, relationships are so important. I like to build relationships first and, and build that trust. And then you can do a lot of things. And so that's, that's what I'm trying to do. And, you know, the relationships are early. I'm still, even though I'm in one organization, I still am in two different hospitals within that. And so, you know, I do still have half my time. So there's still sort of like a, a delay if you will, and how the relationships can form. So yeah, the, the stability for me is my team and they're amazing and they're awesome learners and it's, I'm so proud to see them grow and to see the things that they want to tackle and just how hungry they are.

Meghan Scanlon (35m 18s):
And I've always been for new knowledge and they are a great source of stability for me, as I'm trying to get my feet under me and be the leader that I think the organization needs and the leader I aspire to be.

Mark Graban (35m 33s):
So back to joining, you know, joining Duke in your other steps, you've talked about like, what was pulling you, what you were looking for. So I'd love to hear what some of your thought process was in joining Duke University Health System in terms of what you were expecting and then what you've experienced in the first, almost 18 months.

Meghan Scanlon (35m 54s):
Yeah, that's a good question. I think, you know, I'm very proud of the work I did with Value Capture, which includes the last couple of years of my time there, which was supporting Duke Raleigh. It was really to me the, the best work that I was able to do in my life. And it wasn't because I was doing something crazily different it's because of the people that I was fortunate enough to work with and learn from. And there's just something there that is a really special place, willing partners, willing to try and learn, wanting to just get going and start as opposed to figuring out what it is that we need to do to start just being just a very willing learner culture.

Meghan Scanlon (36m 38s):
And so that experience, I, you know, I just, I wanted more of that. And then thinking about my ultimate goal, which is to change the face of north American healthcare, therefore the globe, or, and then also the globe. I think that an organization like Duke is a really important role within north American healthcare being a large academic institution. And I think that having Duke be a place where these ideas can take deep root and show dramatic improvement and change, I think will really be a good proof or test of case, if you will, that can then be used to accelerate and teach others what we can start to do together.

Meghan Scanlon (37m 19s):
And so that, to me, it was again, just right opportunity, right place, right time. And it's exciting to think about promise and talk a lot about it at work is the promise of potential is why I'm here. And I'm excited about what that can mean for not just my local community, but for the community at large.

Mark Graban (37m 40s):
Yeah. And when he's talking about promise and potential of a little bit of exposure I've had directly with Duke university of health system, is this aim for zero harm or language around committing to zero commit to zero. I wonder if you could elaborate a little bit more on, you know, how that is an inspiring goal, even though it sets the bar really high or in terms of the measure of really low.

Meghan Scanlon (38m 5s):
Yeah. Well, I think I do think it's inspiring because I think that it's this idea of setting that expectation that, you know, any harm is a problem. And so we want to learn from anything that doesn't go the way we want or any harm that's created. And I think what's exciting is how we're expanding the definition of harm. Right? We started in maybe the classic way of thinking about those hospital acquired infections and physical harm of, for our employees, which we would like to eliminate and the organization learns and thinks about this. Now we're considering that harm means, Hey, we didn't get your first paycheck, right. New employee, or, Hey, you know, your vacation time didn't translate or Hey, your computer wasn't fixed in the appropriate amount of time.

Meghan Scanlon (38m 50s):
Right. So, you know, that idea, that harm, even though it resonates so well in healthcare, because it is a people focused industry that harm really is a gap in what we want to happen and what actually happens. And we want to close all of those gaps. And so I think, whereas what I'm seeing now is, you know, we're, we're in this journey enough that we're thinking about harm and a lot of different ways. So that's exciting because I think thinking about Value Capture with the, another big thing I got was how I expanded my definition of what safety is, right. It isn't just physical safety, which is what we think of most. It's the idea of professional, psychological, emotional, whatever words that we want to use, but the idea that people aren't at root of the problem, people aren't to blame and that there should be no repercussions or punitive action for me being able to pull the end on cord or call out an issue.

Meghan Scanlon (39m 40s):
And so I think this is an important time for where we are in the journey is how we're expanding our definition of harm and realizing that we want to drive the harm out, which to me just translates so nicely to drive the waste out and make sure that we're, we're doing the right thing at the right time for the right person in the right way.

Mark Graban (39m 59s):
Yeah. So maybe a final question for you, Megan is, you know, the last two questions of the reflection cycles. So here's the chance as we've been trying to use that model, here's an opportunity for you to now look ahead and make a bit of a prediction, which is what happens in those, those fourth and fifth questions. You know what, looking ahead, whether it's this year or the next couple of years, what actions we be taking now that are different and what do you predict will happen when you take those actions? Just one example, maybe it's a big question.

Meghan Scanlon (40m 32s):
So it's interesting as I'm building my team and I've been thinking a lot, and even just the past few weeks, I've been having a lot of reflections for what I want to do differently with my team. And I think, you know, to me, the biggest opportunities in front of us are how do we get even more clarity and discipline around the design of our systems and how do we make our systems much more visual? Our systems need to live and breathe in a way where we can bring people to them and share them and have them feed them. And so I'm just thinking about that a lot. And so, whereas before that might've been something I would try to help another leader do. Now I'm excited at the idea of like, wait a minute, I'm a leader who can start to try to do these things.

Meghan Scanlon (41m 14s):
And I'm starting to learn more about who are the people in the organization that, you know, are connect, I'm connecting with and who I can use this to gain some momentum. And so that's where my head is about what I can do differently. And that's honestly another big part of why being here was important to me is because I wanted to have some of my own responsibility and discipline to hold myself to what I was trying to help others do. And so now I'm in the thick of it and it is hard. And I love having that perspective now. And I love the opportunity to keep trying and to get ever better at it and to try to continue to bring others into it with me.

Mark Graban (41m 53s):
So final question back to the prediction. What, what do you, what's your prediction? What do you expect to happen as you get more clarity around the design of systems as you put it?

Meghan Scanlon (42m 4s):
Yeah. I think that what I expect to happen is that we're going to build more towards critical mass. I think where I am right now is I'm thinking a lot about, okay, so we've, we've done a few things very broadly across the organization. Things like tiered huddles and things like just contextual awareness about harm and problem solving. And then we've spent the last year thinking of how we show more of the totality of where we want the organization to go in a very small area. And so now I'm trying to think about what is the accelerant and what does it look like to try to build the critical mass, get the organization to the tipping point where we get over the hump of here's, how we used to work. And here's what we're trying.

Meghan Scanlon (42m 45s):
And we get that groundswell of here's where we're going, that will then unleash and allow us to really accelerate to new Heights. And so that's, that's where I am. I think that the better we can do at making our work visual and designing the systems and making some of the connections, we might not see our missing yet connections within our organization, connections to our customers and our patients, connections in the work I think. And what I hope and expect is that we will build more critical mass of people engage more people in the process and help people understand and just, you know, reach more people than we have so far and get more people rowing in the same direction.

Mark Graban (43m 27s):
I think that's a great vision and great goals. So thank you for sharing that with, with, with all of us here today, Megan. So again, our guest has been Megan Scanlon. She is the vice president of performance excellence at Duke University Health System, the community hospitals, but Megan, thank you so much for being here today and for sharing with us.

Mark Graban (44m 10s):
Thank you for going through that experiment with the reflection model. Maybe we'll, we'll get a chance at some point, you and I will reflect on how that use of the reflection model went. But thank you for giving that a try. I think it drew out a lot of great stories and reflections from you. So thank you for that.

Meghan Scanlon (44m 25s):
Yeah. Thank you, Mark. It's been great talking to you as always. I appreciate the opportunity.

Mark Graban (44m 30s):
Thanks for being here. Thanks for listening to Habitual Excellence presented by Value Capture. We hope you'll subscribe to the podcast and please also rate and review it in your favorite podcast, directory or app. To learn more about Value Capture and how we can help your organization on this journey to Habitual Excellence, visit our website

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