From our founder

Our Story

Like so many of life's journeys, the path that led to the creation of ShareTeam is long & winding.  Some might even say twisted.  And full of stories.

We have to go back in time to the year 1963 to find the beginning of the path that leads to ShareTeam.  This was a year of major events for my family.  I was an unexpected arrival into this world, and my father was diagnosed with advanced renal cancer.  Not only was my mother confronted with the difficult challenge of welcoming a new baby into the world at an advanced age (43), but she simultaneously had to prepare for the probability of raising 3 young children on her own.  I've purposely chosen the word "probability" here, for few people receiving any cancer diagnosis in 1963 had a good chance of surviving beyond a year or two. 

Fortunately, my father remained a part of our lives for another 25 years before succumbing to his cancer.  But the shadow of this dreaded disease was dark and long.  Both of my sisters were initially passionate about pursuing professions in other fields, yet each ultimately chose medicine for their careers (they have their own twisted paths, and reached their destination long before me).  At the sage age of 5 years old (yes, 5 whole years) I was seriously preparing to pursue a career in medical science.  I dreamt of helping to create a world where cancer did not exist.  I had actually memorized the names of all 206 bones in the human body by 1st grade.  That doesn't happen without some serious sh*t reverberating on the home front.  (I also blame my oldest sister.  She originally dreamed of being a teacher, and taught me to read long before I started kindergarten).

It's the last few feet of the journey, however, that catalyzed action.  In 2021 I exited from the last two businesses I'd helped to launch and scale.  I was determined to finally devote my remaining professional life to the realm of social good.  This was a path I'd explored several years earlier, but circumstances conspired to force me down a different route.  In the spring of 2022 a friend & neighbor encouraged me to pursue a "business" role at the local hospital 10 miles from my home (where his spouse is also a surgeon).  Things clicked, and as my sisters were wrapping up their careers in medicine, I finally started mine.

I joined healthcare armed with a unique set of skills and experiences.  For over a decade I'd worked with large business enterprises on a range of matters I will group under the general label of "operational excellence" (from guiding senior leadership on strategy and leadership development to helping these organizations adopt modern project and workflow management capabilities).  I'd served as an entrepreneur-in-residence at Clark University's School of Business and taught an undergraduate capstone course attached to their Graduate School of Business for several years.  So notwithstanding my natural bias toward optimism, I was a hardened realist coming into a large healthcare system.  I expected to encounter a broad range of inefficiencies and dysfunctions (every large enterprise has them), but was excited to bring my talents to bear for the good of my friends and neighbors.  I'm still excited about contributing toward making a difference, but let's just say the patient is in far more serious condition than expected.

Fast forward to the spring of 2024.  Two separate but seminal "events" conspired to launch ShareTeam.  The first was a series of hospitalizations my mother underwent in Ft. Lauderdale, Florida.  The second was a continuous stream of experiences at the health system where I work.  A few details about both should help underscore why ShareTeam is important for the future of healthcare in this country (or anywhere, for that matter).

If a respected authority presents data that says something is so, it must be true.  Right?

My mother recently passed away at the age of 103 years, 2 months, 9 days, and a handful of hours.  She was what the medical community calls a super-ager.  Though she had some physical limitations in the last few years of her life, she lived independently, took minimal medications, and was cognitively sharper than most people half her age.  If you had randomly run into her on the street and struck up a conversation, you would have thought she was 30 or more years younger than her actual age. 

During what turned out to be the last year of her life, my mother suffered 2 separate bouts of sepsis requiring lengthy hospitalizations (both of which nearly killed her).  What actually ended up killing her, however, was an inconsistent quality of care she experienced at an institution that our government's Centers for Medicare & Medicaid Services has consistently rated at its highest levels (5 stars).  Now the CMS Rating System publishes overall quality scores for just about every health facility in our country.  This score is derived from over 40 distinct quality measures and ultimately represented through their single star ratings structure.  If a healthcare system has five stars, it's supposed to be a strong indicator that they deliver a quality of care that is the best of the best.  This kind of data doesn't lie, right?

The institution where my mother underwent her hospitalizations is beautiful, modern, and impeccably maintained.  It's wall of recognition, featured prominently in the main lobby, displays the names of numerous benefactors comprised of a veritable who's who of American "nobility."   The quality of care in this system's specialty units was nothing short of superlative.  Once my mother was discharged out of these areas and into "standard care," however, the quality of that care dropped precipitously.  Life threatening so, in some instances.

I maintained a journal of interesting experiences from time I spent visiting my mother during her hospitalizations (here's where "stories" start to come into the picture).  For example, one experience is about how it literally took over 1 hour and 45 minutes on one occasion for staff to come into my mother's room after we pressed the nurse's call button.  Another is around how one physician refused to place an order that was the right medical choice in deference to "professional courtesy."  You see, another physician had placed a different order that just didn't make sense (perhaps because they had not been fully briefed on the circumstances).  But the attending physician who rounded that morning was not comfortable with the notion of countermanding the order of a peer, even though he agreed a different course of action was a better choice.  This situation actually prompted me to track down the Chief Medical Officer via his personal e-mail.  To his credit, he actually intervened and the right decision was acted upon. 

Yet another entry in my journal relates to how frequently my sister and I had to undertake basic nursing care that should have been routine for the floor staff.  Far too often staff would fail to respond to nursing station calls.  Far too often they would fail to return as promised after learning of a need to address potentially life-threatening conditions to a medically compromised centenarian (5 star service apparently allows for a patient to stew in their urine and fecal matter for hours on end).  My family was fortunate enough to be in a position to hire private aids to attend to my mother after such clear and continuing patterns emerged.  Let that sink in.  My family was hiring private staff to essentially do the work this hospital's staff should have been undertaking all along.  What of those who don't have such a privilege, however? 

Though my mother was miles away from this institution when she passed, there's good reason to attributing the cause of her death to the incredibly poor level of care she experienced during her hospitalizations.  This is because of the considerations she had to make long after her second discharge.  During rehabilitation following her 2nd bout with sepsis, my mother developed breathing complications from an accumulation of fluid around her lungs.  After attempting several different approaches to alleviate this issue, she was informed the best remaining option would be to return to the hospital for a minor procedure to remove the fluid.  It would be actually be a relatively simple and straightforward procedure.  The procedure itself wasn't the issue.  My mother was done with the "5 Star" experience she would have to endure at this "quality" institution following the procedure.  She chose comfort over misery, entered hospice care, and died peacefully in her sleep surrounded by family in June 2024.  At over 103 years she didn't need to live longer.  But she could have, and probably would have chosen to, had her experiences earlier in the year been different.

There's a reason for the starkly different staff attitudes and behaviors we experienced at this institution.  Those reasons can be derived from stories the patients and care team in this system all have to tell.  Good and bad.  But those reasons will remain hidden, and these challenges will persist, until this system puts itself in a position to do discover the patterns that expose the why behind these stories and then do something about it.  Helping healthcare systems like this put themselves in a position to eliminate the kind of things my mother and family experienced persuaded me to write the first check to get ShareTeam started.

We don't know what we don't know.  And that's often a problem.

As my family was experiencing patient-centered challenges and frustrations with one healthcare system, in another system thousands of miles away my colleagues were being continuously assaulted by a stream of "calls to action” on 15 or more system-defined “priorities.”  

Consider this:  the medical providers who work in our system are called upon every day to triage medical care. Put another way, they’re identifying and prioritizing who to care for first and how to first render care. These are risk-based determinations based on current conditions. The administrative side of the house, however, is surprisingly ill-equipped at applying equivalent levels of risk-based decision-making to business operations.

Just like I maintained a journal of interesting experiences around my mother's care in Ft. Lauderdale, I've maintained a journal of interesting experiences since joining my employer as a member of its workforce.  I have countless entries highlighting the folly of those 15 system-level prioritizations not only being afforded equal importance, but deemed equally important in all contexts -- even where actual performance meets or exceeds targeted measures. I attribute this apparent inability to effectively “triage” business operations to large organization mediocrity. And I say this not from a place of scorn, but of understanding.

Business leaders want to believe that every person on their roster, every team within their walls, and every capability within their toolbox, can and should be high-performing.  This is neither true nor realistic.  Believing in such a landscape is not just misplaced optimism, but the organizational equivalent of the Dunning-Kruger Effect.  A true high performing organization embraces the reality of mediocrity within its ranks, makes intelligent choices about where excellence in operations is truly necessary, and then takes pointed action to create excellence in those areas.  My employer is not at this level of operations.  Yet.  (There's that optimistic bias of mine poking through).

Cultures of operational excellence allow organizations to step out of the shadow of their version of the "Dunning-Kruger" effect.  I've purposely highlighted the word culture here.  Excellence is not a function of standardized processes, of the latest management fads, or of vision, mission and value statements that show up in pretty posters on office walls.  Excellence is the product of the right thinking and the right behaviors.  In my experience, cultures of excellence emerge when executive leadership actively prioritizes the continuous development and reinforcement of key thinking and behaviors.  Talented people across almost every large organization end up being assaulted by and forced into mediocrity because of  "anti-behaviors" that arise when the right thinking and behaviors aren't being sufficiently emphasized.

One particularly egregious "anti-behavior" that keeps organizations mired in mediocrity lies in the pursuit of vanity metrics.  Like so many other large enterprises, my employer chases a lot of vanity metrics.  These are hollow measures that make an organization, a business unit, or sometimes an individual senior leader look good to others.  They do absolutely nothing to help us understand actual performance in a way that intelligently informs business strategies (of course, this assumes working in an organization that has defined meaningful strategies, but that's another story for another day). 

There's a good three-prong test that can be used to distinguish valuable metrics from vanity metrics.  If we can't answer yes to all 3 of these questions, there's a good chance we're dealing with a vanity metric:

1. Can a meaningful business decision be made from the metric?  

2. Can you manage cause and effect from the data?  (if the data doesn't help you consistently replicate good outcomes, then it's not helping you perfect processes to sustain success)

3. Is the data a real reflection of the truth?  (and as a corollary, if you can't ascertain the "why" behind the data, then it's probably impossible to assess whether your data is a reflection of reality).

One of the metrics my health system chases every year is a numeric "grade" around "employee engagement."  This grade is generated from a single, annual "employee engagement survey."  Now there are over 23,000 people employed by this organization.  Our human resources division owns the survey process and contracts with the Gallup organization to facilitate and support this survey (plus all the ancillary work around it).  There's a significant expense to contracting with Gallup for the platform and resources it provides.  There's significant time, effort and expense devoted every year to aligning both management and employee understanding around questions contained in the survey.  There's significant time, effort and expense devoted every year to deciphering the reasons behind the scores generated from employee responses.  The perennial objective is to increase scores year over year because of correlations that have been established between "engagement" and desirable outcomes like staff retention, quality work, and other things.  I won't go down the rabbit hole of the risks inherent with confusing correlation and causation. 

The intentions behind this survey are good.  But this survey, and all of the ancillary work around it, comes at a huge cost (and by my back of the napkin math, one that approaches several million dollars per year in the case of my employer).  Moreover, the continuous prioritization of survey-related work means less focus, less time and fewer resources devoted to other important work.  Work that actually has significantly more value.  The annual survey measure we chase also fails every single prong of the vanity metric test.  There's a reason the challenges these measures are intended to solve never go away.  This is the epitome of a wicked challenge.

Connecting the dots

I’ve shared and connected a number of experiences to illuminate cause and effect between those experiences the the actions taken to create ShareTeam.  Now if you've explored this website to familiarize yourself with ShareTeam, you no doubt realize the methodologies and technologies associated with our work are fundamentally about using stories to expose meaningful data that can drive better informed decisions and lead to better experiences (more desirable outcomes).  I initially made a substantial effort to  undertake the work ShareTeam delivers inside the organization for whom I work.  This effort came to a grinding halt recently for a variety of reasons, most of which I attribute to that large-business mediocrity referenced earlier.  I didn't join healthcare to do mediocrity.  So the floodgates opened, and another check was written to pursue a full-scaled launch of Shareteam (after all, launching and scaling new business ventures is the one thing I've excelled at for the past 15+ years).

What's the most important common denominator to these two catalyzing events?   Neither of the healthcare systems in my "stories" are close to achieving a level of operations that allow them to extract value from the things they don't know that they don't know.  They're both wasting a lot of time, talent and treasure in pursuit of vanity metrics and believing in the illusion of excellence these suggest.  ShareTeam is a way to help change this.  And to help these systems finally solve the wicked challenges their staff is confronting year after year after year. 

Founding this social good enterprise is my way of accelerating progress.  But it's going to take a lot of help from others along the way to turn our vision into reality.  I hope you'll consider coming along for the ride in some fashion.

Jack

Jack Speranza
Founder & Chairman of the Board