“We need to move past the notion of excellence on the basis of reputation, marketing budgets, or size, and expect greatness to be described by broad outcome measures across time, demographics, and sectors of the community.”
“No one’s ego is more important than the well-being of the patients or the staff.”
“What you tolerate, you support.”
Innovation Keys

  • “Get close enough to the work to feel the moral imperative.”
  • “Use structure to improve innovation.”
  • “Maintain a disciplined disregard for conventional wisdom.”
“The more special and protected we treat the executives, the less special and more afraid the staff feel.”
“Holding accountable is looking backward. Being responsible for their success is looking forward. Excellence will be found in the balance.”
“The chain of command is always a weak link in the communication chain.”
“Humble listening builds strong bonds to deeper values.”
“Small-market competition is best replaced by disciplined, values-driven systems that commit to transparent, measurable improvements in the community’s well-being.”
“Without discipline, courageous decisions will do little good, because they’ll go nowhere. Discipline gives courage legs.”
“The ripple effect of under-managed poor performance of leaders is enormous.”
“There is often a big gap between doing something and accomplishing something.”
“Collaboration will multiply your investment faster than the stock market.”
Coalitions of competitors can find common values and common goals.
“The cultures of the partners don’t have to match exactly, but you have to have similar values and similar goals. If you don’t have similar values, then working together is going to be a mess, and if you don’t have the same goals, then you won’t be heading in the same direction, and the partnership will lose focus and disintegrate.”
“We had to ignore the conventional wisdom of the day, which says a choice must be made either between jobs and the environment or between cost savings and the environment.”
“Durability is needed to live your values outside the spotlight despite crisis and hardship.”
“The balance is to celebrate your staff’s successes without developing hubris or complacency.”
“A strong organization with a steadfast commitment to its values will attract partners willing to make long-term investments.”
“The more complicated the lives of our staff, the more they need us to understand those struggles.”
“If you don’t have the courage to implement your values, they are just words.”
“Comparing yourself to your mediocre past or mediocre peers is not excellence.”
“People won’t remember your margins or your awards; they will remember how you treated them.”
“Chaos and confusion—what a perfect place to start. This was an area where we could do the most good for those in the most need.”
Chapter 1 Takeaways
  • Our values define us and provide a constant guide to navigate fork-in-the-road decisions.
  • Values form our personal operating systems.
  • Values-based choices are often hard and have fa-reaching consequences that ripple through the lives of others.
  • Our values are supported by three pillars: courage, discipline, and durability.

Chapter 2 Takeaways
  • Courage is not the absence of fear.
  • Courage means not allowing fear to make your choices.
  • Making a courageous decision puts vision and virtue ahead of your own interests.
  • Courage is called the “first virtue” because it is the foundation for all other virtues.
Chapter 3 Takeaways
  • Values statements mean nothing unless you follow them.
  • You need courage to take the stand and discipline to follow through.
  • A disciplined approach to living your values makes you, your staff, and your organization more effective and efficient.
Chapter 4 Takeaways
  • Durability provides stability to your values, enabling them to withstand change and hardship.
  • Sometimes our toughest critics are ourselves. Durability means staying true to your values and vision, even in the face of doubt.
  • What we tolerate, we support.
  • Courage and discipline require durability to ensure stability; together they form the three pillars of support for our values.
  • No one’s ego is more important than the well-being of the patients or the staff.
Chapter 5 Takeaways
  • Living your values requires more than polite respect for others; it requires reverence.
  • The more special you treat executives, the less special everyone else feels.
  • Reverence places people over profits, people over egos, people over convenience.
  • Reverence for others takes humility—but it results in deeper connections, deeper wins, and a greater organization.
  • The more complicated the lives of our staff, the more they need us to understand those struggles.
Chapter 6 Takeaways
  • Establish early on that there is a two-way responsibility when it comes to practicing and honoring your values.
  • Staff from the front lines and senior executives can and should be participants.
  • Be courageous to tell the truth in the most-supportive but clearest way possible.
  • Consistently express your values through actions and words.
  • Get close enough to the work to enrich your connections and communications.
  • Be open in rounding, listening, speaking, and writing to gain insight and learn from your staff.
Chapter 7 Takeaways
  • To live our values, our goals must be bolder than mediocrity.
  • Hope is a weak strategy for improvement. Staff will be inspired by big, bold goals aimed at the well-being of others.
  • No one’s ego is more important than consistently living the values.
  • Measure, don’t guess. Use common tools that build, not limit.
  • Embed the values into every orientation, communication, evaluation, and goal.
  • Have the discipline to build and use a system that supports those that live the values.
  • “Holding accountable” is looking backward. “Being responsible for their success” is looking forward. Excellence will be found in the balance.
Chapter 8 Takeaways
  • Innovation is not just for small teams or Silicon Valley garages.
  • An organization can improve innovation by investing in leadership training that gets them close to the work and provides great tools.
  • The management system should support, not thwart, innovation.
  • The keys to innovation are: Get close enough to the work to feel the moral imperative.
  • Use structure to improve innovation.
  • Maintain a disciplined disregard for conventional wisdom.
Chapter 9 Takeaways
  • Great organizations live their values despite inconvenience or cost—they find a way.
  • Staff will follow an organization’s lead to live their values.
  • Tackling obesity was a problem bigger than any single organization or program, requiring partnerships across the community, diversity of approach, and the discipline to follow through.
  • Our values would require we act when there is a need, not just when it is convenient.
  • Find the joy and value in improving the health and well-being of one person at a time, even if the whole system is in need of change.
  • Use your assets of consistency and a commitment to a higher cause to bring like-minded partners to the table.
  • The best way for an organization to motivate a community is to live a motivated life among them.
Chapter 10 Takeaways
  • Explore multiple paths to find the resources you need.
  • Investment in the community can pay large dividends, often financial.
  • Long-term, disciplined investment beyond the usual avenues is a great strategy for organizations and communities.
  • Find your gold, use your assets. Partners with the same values are one of those available assets.
  • Facilities and finances are tools—important tools, but tools.
  • Innovation and discipline can work past conventional wisdom to serve the mission.
  • A commitment to your values means remaining committed all the time, not just when it is convenient.
Chapter 11 Takeaways
  • Set extraordinary goals to accomplish extraordinary achievements.
  • Conventional wisdom is often an impediment to progress.
  • You can improve the economy, the environment, and the bottom line at the same time.
  • Measure and change; measure some more, and change some more.
  • Take responsibility for your impact on your community.
  • Build plans to accomplish multiple goals.
Chapter 12 Takeaways
  • Communities have huge untapped capacity; our job is to inspire and unleash it.
  • Cast a broad tent to find partners with similar values.
  • Partnerships with common values and agreed-upon goals will be much more efficient.
  • Learning will go both ways, and benefit will go both ways.
  • These partnerships can have an impact on your staff that will serve you and your community far beyond their immediate involvement.

Tom Peters

“Unless you walk out into the unknown, the odds of making a profound difference in your life are pretty low.”

“Organizations exist to serve. Period. Leaders live to serve. Period . . . Leaders don’t create followers; they create more leaders.”

Jim Collins

“Greatness is not a function of circumstance. Greatness, it turns out, is largely a matter of conscious choice and discipline.”

“Great vision without great people is irrelevant.”

Patrick Lencioni

“Not finance. Not strategy. Not technology. It is teamwork that remains the ultimate competitive advantage, both because it is so powerful and so rare.”

“Success is not a matter of mastering subtle, sophisticated theory but rather of embracing common sense with uncommon levels of discipline and persistence.”

Stephen Covey

“Above all, success in business requires two things: a winning competitive strategy and superb organizational executions. Distrust is the enemy of both . . . High trust won’t necessarily rescue a poor strategy, but low trust will almost always derail a good one.”

John P. Kotter

“We learn best and change from hearing stories that strike a chord within us.”

Dan Heath

“You want to invite new ideas, not new rules.”