Triple Crown Leadership: Building Excellent, Ethical, and Enduring Organizations

Triple Crown Leadership: Building Excellent, Ethical, and Enduring Organizations

by Bob Vanourek, Gregg Vanourek

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Achieve long-term business success—without sacrificing quarterly profits

Triple Crown Leadership provides a step-by-step model for building organizations that are Excellent (high performing), Ethical (transparent), and Enduring (stands the test of time). It explains how to protect your organization’s values, reputation, and

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Achieve long-term business success—without sacrificing quarterly profits

Triple Crown Leadership provides a step-by-step model for building organizations that are Excellent (high performing), Ethical (transparent), and Enduring (stands the test of time). It explains how to protect your organization’s values, reputation, and profitability by focusing not only on culture, but organizational character; seeking solutions to challenges from all levels of personnel; and skillfully blending a “hard-edged” demand for results with a “soft-edged” spirit of collaboration.

Bob Vanourek has held senior leadership positions at Pitney Bowes, Avery Division, Sensormatic, Recognition Equipment, and Monarch Marketing.
Gregg Vanourek is the founder of Far Horizon, a leadership and personnel development firm with offices in the U.S. and Europe.

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Building Excellent, Ethical, and Enduring Organizations


The McGraw-Hill Companies, Inc.

Copyright © 2012Bob Vanourek and Gregg Vanourek
All rights reserved.
ISBN: 978-0-07-179151-9




What is the use of living, if it be not to strive for noble causes and to make this muddled world a better place ...? —Winston Churchill

It was a quest that crossed generations: finding a better way.

It started with a father, William Worrall Mayo, and his small medical practice in Minnesota in the 1860s. Twenty years later, his two sons joined him. They were obsessed with finding better ways to help patients. Humble and curious, they invited outside physicians into their practice, creating what was arguably the first integrated group medical practice in the world.

Practicing medicine with this kind of team-based approach was revolutionary at the time. Individual physicians were supposed to have all the answers. Rejecting that thinking, the Mayos believed that pooling the knowledge and skills of doctors would lead to better results.

"No one is big enough to be independent of others," said the Mayo father, to which his son William J. Mayo added: "The best interest of the patient is the only interest to be considered." Those were the founding precepts that made what was then called "the Mayos' clinic" distinctive.

According to Drs. Kent Seltman and Leonard Berry in Management Lessons from Mayo Clinic, "Mayo Clinic is the first integrated, not-for-profit medical group practice in the world and one of the largest." It is a global leader in healthcare delivery, research, and education, with a sterling brand in the healthcare industry. With its four main hospitals and additional affiliated hospitals and clinics in the Mayo Clinic Health System network, it serves more than a million patients annually—a spectrum of patients from the international elite to Medicare recipients. With its reputation for excellence, patients from all corners of the globe come for diagnosis and treatment, and doctors come to learn new techniques. Since many people go there only after exhausting all other options, Mayo physicians face some of the toughest medical cases. In today's age of spiraling healthcare costs, Mayo Clinic has been able to maintain high quality while keeping costs comparatively low, according to independent studies. For over twenty straight years, Mayo hospitals have earned top rankings from U.S. News & World Report.

The Mayos' quest for a better way has yielded a stunning record of impacts and innovations, including:

• Influencing the way medicine is practiced throughout the world

• Helping to establish the medical residency education system so prevalent today

• Developing one of the world's first centralized systems of individual medical records for patients (versus previous systems organized by physician)

• Creating a system for numerically grading cancer (still used today), dramatically effective methods to treat rheumatoid arthritis, and innovative tuberculosis cures

• Performing the first federally approved total hip replacement in the United States in 1969, heralding a new era of joint replacement

• Training and employing Nobel Prize–winning physicians and researchers

Mayo's innovations are no accident. Clinic leaders proactively monitor the practices of other medical organizations and study companies like 3M and Xerox that are famous for innovation.

Equally important is Mayo's record of ethical leadership. Its "Spirit of the Clinic" lays out Mayo's ethical commitments: service, not profit; patient first; interest by staff in every other member; willingness to change; excellence; and integrity. According to Dr. Seltman (Mayo's former director of marketing), "Mayo Clinic has built one of the strongest brands in the world ... by preserving the essential elements of what the organization is." Mayo does not take these values for granted. All new hires (from nurses and janitors to accountants) receive extensive orientation in the "Mayo Way," specifically designed to help them understand and appreciate how their jobs affect patients. Mayo employees go the extra mile because they know that together they are helping people and saving lives.

Mayo's values drive day-to-day decisions. For instance, when a Mayo cardiologist faced a choice between two pacemakers for his patient, he consulted with Dr. Robert Waller (then Mayo's CEO), who agreed that he should use the new and less invasive pacemaker even though it was not yet approved for reimbursement from Medicare. Even though it was a bad deal financially, Waller said it was a "no-brainer" because it was the one that was best for the patient.

Through such collaboration and consultation, physicians and leaders make better decisions. According to Paul Roberts in Fast Company, "For all of its prowess in science and technology, the Mayo Clinic owes much of its success to its culture." The clinic has placed on Fortune's prestigious "100 Best Companies to Work For" list for the past nine years in a row.

Perhaps most impressive is how Mayo's record of excellence and ethics has stood the test of time. Mayo Clinic works hard to maintain its reputation as an innovator. In 2010, the clinic invested $790 million in research and education. Its approach is both high tech and high touch—combining the smart use of technology with old-fashioned customer service and attentive care. On the technology side, for example, Mayo makes innovative use of social media, blogs, and Intranet videos; created one of the largest electronic medical record systems in the world; and developed a "Virtual Mayo Clinic" presence on Second Life, an online virtual community. On the touch side, you don't just get a doctor at Mayo Clinic: you get a swarm of physicians consulting with each other about your case (they even call themselves "consultants"), as well as a team of support professionals working to provide you with the highest-quality care and even hospitality and comfort. Meanwhile, Mayo invests generously in more than a hundred community programs, plus energy conservation efforts and sustainability practices.

Of course, Mayo has had problems and made mistakes. Over the years, critics have faulted it for moving too slowly and for being attached to old ways. Experts recently complained that Mayo is spending too much money on costly proton beam treatment facilities due to perverse Medicare funding incentives and competition from other hospitals. Of course, one can also find critiques of doctors, diagnoses, and patient treatment, but Mayo's long-term results, impacts, innovations, and commitment to ethical practices are exceptional.

Mayo Clinic exemplifies the ultimate aim of triple crown leadership: building an excellent, ethical, and enduring organization. See Figure 1.1. We discuss each of these elements in turn below.


Leadership is defined by results not attributes. —Peter Drucker, author and management consultant

Getting results is one of the preeminent tasks of leadership. Triple crown leadership seeks not just any results, but excellent results—compelling and exceptional outcomes. As at Mayo Clinic, it strives for the pinnacle of performance.

In different fields, there are beacons of excellence: for inspired product design, we look to Apple; for brand management, we look to Procter & Gamble; for financial reporting, the Wall Street Journal; for advanced military missions, the Special Forces.

Ensuring clarity about ultimate aims—and measures of success—may sound obvious but is not always straightforward. Harvard Bu

Excerpted from TRIPLE CROWN LEADERSHIP by BOB VANOUREK, GREGG VANOUREK. Copyright © 2012 by Bob Vanourek and Gregg Vanourek. Excerpted by permission of The McGraw-Hill Companies, Inc..
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