Bred To Lead

YOU ARE A 10,000 POUND ELEPHANT CHAINED TO A SMALL STAKE A baby elephant tied to a wooden stake stops pulling. Years later, fully grown, it still doesn't try. Dr. Jake Tayler Jacobs names the four beliefs keeping healthcare organizations chained the same way, where they came from, and how to break each one. IN THIS EPISODE • Why "SPD will always be reactive" confuses responding to demand with always being behind it • The math on "cost center": a $50 million OR losing 3% to SPD drag leaks $1.5 million • Why the OR's dissatisfaction is a signal, not a character flaw • How "we're doing the best we can" sets a false ceiling, and why you propose a business case instead of a budget ask YOUR CHALLENGE Ask your OR: what would excellent SPD support look like to you, and what would have to be true for you to trust us completely? Then really listen. ━━━━━━━━━━━━ Bred To Lead is powered by SIPS Healthcare Solutions . BredToLead.com SterileByDesign.com SIPSHealthcare.com

THE BELIEFS YOU DON'T KNOW YOU HAVE ARE CONTROLLING YOU How do you know the sky is blue? You just know. Dr. Jake Tayler Jacobs argues that some of what leaders "just know" about their organizations isn't fact at all. It's assumption, and it feels just as certain. IN THIS EPISODE • Why activity metrics like turnaround time and volume can look fine while the OR goes without what it needs • Five belief markers to listen for, including "that's just how it is" and "it's always been this way" • How an invisible belief becomes a self-fulfilling prophecy, and why lean can make a workaround more efficient instead of removing it • Four techniques to surface hidden beliefs, from outside perspective to looking at what you're not measuring KEY TAKEAWAY The discomfort of questioning is nothing compared to the cost of not questioning. Courage to question is the price of transformation. ━━━━━━━━━━━━ Bred To Lead is powered by SIPS Healthcare Solutions . BredToLead.com SterileByDesign.com SIPSHealthcare.com

YOU CAN'T OPTIMIZE DOWNSTREAM WHILE THE CONSTRAINT SITS UPSTREAM Every week the same meeting happens: the CFO sees rising costs, the COO hears surgeon complaints, the CNO watches quality metrics stall, and SPD says the numbers look fine. Dr. Jake Tayler Jacobs explains why everyone is right, and gives the condition a name. IN THIS EPISODE • Why OR improvement efforts stall at a ceiling when SPD, the upstream constraint, goes unaddressed • The definition of operational blindness: leaders can't see dysfunction because measurement and feedback systems don't surface it • The NASCAR picture: the surgeon is the driver, the OR is the pit crew, SPD is the garage • What operational blindness looks like from the CFO, COO, CNO, SPD director and C suite seats KEY TAKEAWAY Fix the people and send them back to the same system, you get the same problem. Fix the system, you fix the problem. ━━━━━━━━━━━━ Bred To Lead is powered by SIPS Healthcare Solutions . BredToLead.com SterileByDesign.com SIPSHealthcare.com

THE SAME PEOPLE LOOKED EXCELLENT ONCE THE SYSTEM CHANGED In 1993 IBM posted an $8 billion loss and analysts said to break it up. Lou Gerstner kept most of the same managers and changed the beliefs and systems around them instead. Dr. Jake Tayler Jacobs opens the Operational Blindness read and teach series with that story and what it means for healthcare. IN THIS EPISODE • Dr. Jake reads "The Elephant Everyone Forgot" from Operational Blindness, word for word, then breaks it down • The three invisible beliefs that nearly killed IBM, including "the culture can't change" • Healthcare's own invisible beliefs: SPD will always be reactive, it's just a cost center, the OR will never be satisfied • What executives, SPD leaders and surgical services should each take from Gerstner's turnaround YOUR CHALLENGE Before you replace another director, ask: do they have visibility into their real impact, the resources to succeed, and a measurement system that shows what matters? ━━━━━━━━━━━━ Bred To Lead is powered by SIPS Healthcare Solutions . BredToLead.com SterileByDesign.com SIPSHealthcare.com

TRADITION WITHOUT EVOLUTION IS SLOW DEATH WITH BETTER BRANDING When Dr. Jake Tayler Jacobs walked into a 30 year old organization and suggested change, leadership told him "that's not how we do things here." His answer: then how is that working for you, and why am I here? The room went silent. IN THIS EPISODE • The four stages of a slowly eroding industry, starting with losing young talent and ending in irrelevance • Why stagnant and stable look alike but are not, and why stagnant things rot • Five principles of innovative leadership, including building a coalition of the willing before you ask for the yes • Why gumption without systems is chaos, and why you lead with evidence, not just vision YOUR CHALLENGE Identify one tradition in your organization that everyone accepts but nobody questions, and ask why. If you can't get a good answer, start redesigning it. ━━━━━━━━━━━━ Bred To Lead is powered by SIPS Healthcare Solutions . BredToLead.com SterileByDesign.com SIPSHealthcare.com

ONLY BROKEN SYSTEMS SHAKE AT 80 PERCENT CAPACITY Two hospitals in the same city, same patient acuity. One falls apart at 75% capacity, the other runs smooth at 95%. Dr. Jake Tayler Jacobs explains the difference: one was built to survive, the other was built to scale. IN THIS EPISODE • Six signs of survival infrastructure, including daily heroes and knowledge that walks out the door every night • Why "slow is smooth, smooth is fast" and the five step playbook for rebuilding while you keep running • Piloting in parallel: running a new SPD workflow on first shift until second shift begged to switch • A case study: 47 unnecessary steps removed, 20% more volume with fewer staff, SPD turnover from 67% to 8% YOUR CHALLENGE Start this week. Pull six weeks of data and find the capacity where overtime, errors and complaints spike. That is your shaking point. ━━━━━━━━━━━━ Bred To Lead is powered by SIPS Healthcare Solutions . BredToLead.com SterileByDesign.com SIPSHealthcare.com

WE HIRE FOR CREDENTIALS AND HOPE FOR CAPABILITY The best nurse becomes charge nurse, the best tech becomes director, and nobody asks if they can actually lead. Dr. Jake Tayler Jacobs calls it the clinical excellence trap and explains why healthcare's leadership famine is a design problem, not a talent problem. IN THIS EPISODE • Why the skills that get you promoted (reliable, liked, busy) are not the skills that make you effective • The five capabilities leaders need: systems thinking, emotional intelligence, change management, development mindset, strategic foresight • His "three layers down" model for building bench strength, and Xerox's measure of what top people did after leaving • Five fixes, from parallel clinical and leadership tracks to making succession planning a performance metric YOUR CHALLENGE Look at your last five promotions. Did you assess for leadership capacity, or just reward past performance? ━━━━━━━━━━━━ Bred To Lead is powered by SIPS Healthcare Solutions . BredToLead.com SterileByDesign.com SIPSHealthcare.com

WE FUND CHAOS, STARVE PREVENTION, AND CALL IT DISCIPLINE A periop director brought her executive team a $300,000 two year plan to fix workflows, training, and staffing. They said no budget. Six months later, eight people quit in three weeks and the hospital spent over a million dollars on agency staff, overtime, and recruiting. Dr. Jake Tayler Jacobs calls it the trauma budget, and the prevention tax every organization pays for it. IN THIS EPISODE • Why budgets that were too tight for raises suddenly open up when things are on fire • The hardware and software check: financial systems built for widgets, leaders trained in crisis mode • Everything has an ROI: retention, efficiency, innovation, reputation, and outcomes • Five ways to build a prevention focused budget, starting with "can we afford not to?" YOUR CHALLENGE Pull your last three years of financials, total your crisis spending, and ask what 10% of it could have prevented. ━━━━━━━━━━━━ Bred To Lead is powered by SIPS Healthcare Solutions . BredToLead.com SterileByDesign.com SIPSHealthcare.com

YOU CAN'T BUILD PERMANENT CHANGE ON TEMPORARY HELP Season three opens with a hard look at the traveler dependency crisis. Dr. Jake Tayler Jacobs shares the story of Sarah, an eight year critical care nurse who quit after watching her hospital pay travelers $100 an hour while she made $38: "They can find money for strangers, but not for people who stayed." IN THIS EPISODE • Leadership is the software, systems are the hardware, and hospitals keep crashing when neither gets upgraded • The hidden costs of renting stability: knowledge drain, culture erosion, and broken patient continuity • Four design principles: build your own pipeline, compensation transparency, scheduling as strategy, and leadership that listens • Why leaders who only plan for one term rarely leave lasting change, and why SIPS built Sterile By Design YOUR CHALLENGE Ask yourself: am I managing crises or preventing them? Am I renting stability or building it? ━━━━━━━━━━━━ Bred To Lead is powered by SIPS Healthcare Solutions . BredToLead.com SterileByDesign.com SIPSHealthcare.com

INDECISION IS A DECISION, USUALLY THE WORST ONE At Johns Hopkins All Children's Hospital, the pediatric heart surgery program saw mortality rates three times the national average while frontline staff raised alarms and leadership delayed. Dr. Jake Tayler Jacobs unpacks what he calls prestige paralysis, the trap where protecting a reputation matters more than solving the problem, and the nearly $43 million in settlements that followed. IN THIS EPISODE • The four causes of decision paralysis: the reputation shield, the data paradox, the expertise trap, and the hierarchical filter • The Love Tour at SIPS and what frontline workers said that administration never reported • The 70% rule, the reversibility test, and setting decision triggers before a crisis • Four kinds of decision debt: operational, cultural, strategic, and trust KEY TAKEAWAY Stop asking whether you should act. Ask what it will cost you not to act, because problems do not age well. ━━━━━━━━━━━━ Bred To Lead is powered by SIPS Healthcare Solutions . BredToLead.com SterileByDesign.com SIPSHealthcare.com

YOUR FIRST 90 DAYS DECIDE YOUR WHOLE TENURE In March 2014, North Adams Regional Hospital in Massachusetts closed with three days' notice, leaving 37,000 residents without their local hospital. Dr. Jake Tayler Jacobs walks through how new leadership misjudged its reality, cut costs before diagnosing the problem, and lost the trust of staff and community in the critical first 90 days. IN THIS EPISODE • Three levels of reality assessment: paper reality, perceived reality, and ground reality • The trust triangle: transparency, engagement with team, peers and upline, and early wins that matter to them • The impact matrix and balanced urgency: fast enough for momentum, slow enough to bring people with you • Why cutting costs does not always mean cutting people, and how to find the real power centers YOUR CHALLENGE Make five commitments for any season of change: truth, people, future, learning, and legacy. ━━━━━━━━━━━━ Bred To Lead is powered by SIPS Healthcare Solutions . BredToLead.com SterileByDesign.com SIPSHealthcare.com

STEWARD HAD PLENTY OF PLANS. WHAT IT LACKED WAS FUTURE FOCUS In May 2024, Steward Health Care, one of the largest private hospital systems in the country, filed for bankruptcy. Dr. Jake Tayler Jacobs breaks down how a model built on turning around struggling hospitals failed at the very operational excellence it promised, and what every leader can learn from the difference between planning for the future and leading from it. IN THIS EPISODE • Three failures: confusing expansion with evolution, financial engineering over operations, and no sustainable organization • The now game, the next game, and the after next game, and why you must play them together • Four pillars of future focused leadership and a five point future ready assessment • The phantom tax: why leaders you develop stay loyal and leaders you buy keep moving KEY TAKEAWAY Culture eats strategy, and leadership is about legacy, not a paycheck. Ask what condition your organization will be in when you leave it. ━━━━━━━━━━━━ Bred To Lead is powered by SIPS Healthcare Solutions . BredToLead.com SterileByDesign.com SIPSHealthcare.com

YOU CAN ONLY HAVE WHAT YOU ARE Dr. Jake Tayler Jacobs comes back from his first real vacation in eight years with a lesson from his mentor: you cannot become a millionaire until you are worth a million. Success happens before the moment of opportunity arrives, and life gives you what you have prepared and trained for, not what you wish for. IN THIS EPISODE • A leader who rehearsed crisis scenarios for years and found the real crisis easier than the ones she imagined • His three part framework: mental simulation, physical practice, and integration • Why generic affirmations fail and visualization has to be specific enough to feel real • Leadership labs and readiness rhythms: recorded practice, real pressure, and specific feedback built into the week KEY TAKEAWAY Hope is not a strategy. Build your career and your company on the worst happening, and practice for it, so the best is icing on the cake. ━━━━━━━━━━━━ Bred To Lead is powered by SIPS Healthcare Solutions . BredToLead.com SterileByDesign.com SIPSHealthcare.com

POSITIONAL POWER GETS COMPLIANCE. INFLUENCE GETS COMMITMENT. A senior executive with every title and all the formal authority couldn't get his initiatives off the ground. A mid-level manager with no authority over most of the people she worked with kept getting things done across departments. Dr. Jake Tayler Jacobs explains the difference, and why the bigger your scope, the more you need influence instead of your title. IN THIS EPISODE • The four elements of real influence: credibility, connection, contribution, and consistency • Why "I do my job" is not contributing to your organization • Value-first leadership: the leader who spent her first weeks learning what each department head needed • The three C's of scaled influence, and why he hands his own ideas to others so they get the credit KEY TAKEAWAY Your title might give you authority, but your impact comes from influence. Start building it now, whatever level you are at. ━━━━━━━━━━━━ Bred To Lead is powered by SIPS Healthcare Solutions . BredToLead.com SterileByDesign.com SIPSHealthcare.com

AN OPEN DOOR NOBODY WALKS THROUGH IS NOT AN OPEN DOOR One leadership team prided itself on its open door policy, yet almost no one walked through it, because frontline ideas kept getting dismissed. Another had every report and metric and was still blindsided by problems any employee could have named. Dr. Jake Tayler Jacobs breaks down how leaders drift away from the front line one logical decision at a time, and what it costs. IN THIS EPISODE • The elevation effect and the filter effect, and how bad news gets sanitized on the way up • His four-part framework for staying connected: presence, process, people, and proof • The leader who blocked two hours a week to work, not observe, alongside frontline teams • Why good habits have to be modeled, not told, and what teaching his kids taught him about it YOUR CHALLENGE Will you be a bridge builder who stays connected, or a manager who drifts away? Put frontline time on your calendar as a meeting you cannot miss. ━━━━━━━━━━━━ Bred To Lead is powered by SIPS Healthcare Solutions . BredToLead.com SterileByDesign.com SIPSHealthcare.com

IF YOUR PEOPLE DON'T BELIEVE IN CHANGE, NO PROCESS WILL STICK Watching Coach Prime rebuild Colorado football, Dr. Jake Tayler Jacobs saw what he has taught leaders for years: real transformation starts with belief and culture, not metrics and process maps. He walks through why "we've tried that before" is a symptom, not an excuse, and why new systems fail when the culture underneath them never changed. IN THIS EPISODE • The three phases of transformation: cultural reset, technical evolution, and sustainable excellence • Why resistance during technical change usually means your cultural reset isn't finished • How one organization that had failed three system rollouts rebuilt belief through small, visible wins • Why your company should run like an internal university where learning never ends YOUR CHALLENGE Before you touch a process or a metric, find out what your people truly believe is possible or impossible in your organization. ━━━━━━━━━━━━ Bred To Lead is powered by SIPS Healthcare Solutions . BredToLead.com SterileByDesign.com SIPSHealthcare.com

MANAGERS PUT OUT FIRES. EXECUTIVES MAKE SURE THEY STAY OUT. Three months after a promotion to executive, Sarah was working longer hours than ever and things were still slipping. In the first live episode of Bred To Lead, Dr. Jake Tayler Jacobs explains why: she was still managing what she should have been overseeing. Managers own the how and the what. Executives own the why, the when, and the where. IN THIS EPISODE • Why "I can do their job" is how managers burn the bridge to their executives • The operations leader whose firefighting strength became his weakness, and the questions that fixed it • What King David learned as a shepherd, a harp player, and a warrior before he ever became king • "We make 10 million a year, why can't I get $1,000?" and the business fundamentals behind the answer YOUR CHALLENGE Name one shift you can make this week to start thinking like an executive: stop solving the fire and ask what system would prevent it. ━━━━━━━━━━━━ Bred To Lead is powered by SIPS Healthcare Solutions . BredToLead.com SterileByDesign.com SIPSHealthcare.com

THE HIGHEST PAID POSITION IN THE WORLD IS NOT A TITLE Closing a conference in Delaware, Dr. Jake Tayler Jacobs told the room that too many people want leadership roles before they have mastered where they are. Using the story of King David, who was the best at every role he held long before he became king, he lays out why playing the promotion game instead of the mastery game gets leaders exposed. IN THIS EPISODE • The four phases to master in order: skills, people, the business, then scale • Why he would have a new director of periop spend three months in SPD before taking the role • How one department head got full funding once he stopped pitching passion and started speaking ROI • Self-check questions to tell which phase you are actually in YOUR CHALLENGE Be honest about which phase you are in right now, then pick one area to strengthen this week before you ask for the next promotion. ━━━━━━━━━━━━ Bred To Lead is powered by SIPS Healthcare Solutions . BredToLead.com SterileByDesign.com SIPSHealthcare.com

YOUR BEST EXPERT MAY BE YOUR WORST CHOICE TO LEAD Picture a hospital that promotes its top surgeon to run perioperative services and its most experienced technician to run sterile processing. Six months later, OR efficiency is down, costs are up, and both new leaders are drowning. Dr. Jake Tayler Jacobs calls this the leadership paradox, and explains why deep expertise and transformational leadership are rarely found in the same person. IN THIS EPISODE • Subject matter thought leaders own the what and how. Transformational leaders own the why and who • Why he estimates only about 1 in 10 professionals truly have both skill sets • A case study where pairing experts with operational leaders cut OR turnover 20% and instrument delays 50% • His answers to "we can't afford it" and "outsiders won't understand our challenges" YOUR CHALLENGE Take a hard look at your leadership team. Are you building both technical expertise and transformational leadership, and giving them room to work together? ━━━━━━━━━━━━ Bred To Lead is powered by SIPS Healthcare Solutions . BredToLead.com SterileByDesign.com SIPSHealthcare.com

TEMP STAFFING SHOULD BE A TOOL, NOT YOUR WHOLE STRATEGY Picture flu season: the ER is overflowing, periop is surging, and two of your most experienced sterile processing techs just retired. Dr. Jake Tayler Jacobs explains why calling in temps feels like a lifesaver in that moment, and why a pressure bandage left on without real treatment never fixes the wound. IN THIS EPISODE • The pros and cons of temp staffing in the ER, periop and central sterile processing • Why a new hire needs about three months to get comfortable and 24 months to master a system • Four scenarios for choosing temp staffing, integrated management, or a hybrid of both • How a community hospital cut sterile processing errors 40% in six months using just two experienced temp techs YOUR CHALLENGE Look hard at your staffing and ask: are we just filling gaps, or are we building for the future? ━━━━━━━━━━━━ Bred To Lead is powered by SIPS Healthcare Solutions . BredToLead.com SterileByDesign.com SIPSHealthcare.com