Thanks for the opportunity to be here. I appreciate the chance to connect and hopefully, the time we'll spend today will be valuable for your students and wish them each all the best and much success in their journeys. I've been grateful that I've had a good journey and had much success in it. Certainly had its struggles and challenges as well. So my story, if you want to call it that, I'm just a farm boy from Wyoming. I grew up on a dairy farm in western Wyoming, and as I looked at what I was going to do after high school, I had parents who encouraged me to go to college. I am the first in my family to get a bachelor's degree or a master's degree. And so it was a very unknown journey and wasn't quite sure what that meant or how to go about that and frankly, it was not very sophisticated. So when I embarked on college, it was to go get a degree, in what, I didn't know, what interest I had I wasn't sure, but as I went through that journey, I found that business was very appealing to me. I like the business side of things. I like the computer classes. I like the accounting classes, but frankly, what I like more than anything was the planning and strategy and the workaround business concepts and what businesses could do. And that really led me back to my roots as a farm boy when I was thinking about what job to undertake. So my mother was a nurse and she had gotten an associate's degree in nursing at the time. That was a fairly common degree, and she was a nurse up a little tiny hospital in Star Valley, Wyoming, and we live six miles from that hospital. If you know the geography, the valley's about 40 miles long, and its widest about five miles wide, and there's one highway that runs through the whole valley, and I would watch her as an ambulance whenever ambulance sirens went by, it didn't matter where we were. We were in the house. If we were out in the barn milking cows or if we're out in the field hauling hay, she would immediately go to the phone or out in the field, we didn't have cell phones, she had to get in the car and hustle back to the House and call and see if they needed help. And that suddenly became appealing to me, and I started to pursue discussions with people about business opportunities in health care, and that really led me into the healthcare arena, so that was a background that that got me on the path and then my journey from there when I got done with my bachelor's degree at college, I was married and had a young son and people talked about getting your master's degree. And I didn't have enough money to get a master's degree. I actually needed to get a job and take care of my family. So I looked for job opportunities that would allow me with a bachelor's degree to move forward in health care administration and found that in long-term care facilities, you could go through training programs and be licensed. So I joined a company that offered that opportunity in Colorado. They gave me the chance to be in their training, which was supposed to be 12 to 18 months. Interestingly, though, in Colorado, my college degree qualified me to sit for the exams so two months out of college, I actually had my license to be a nursing home administrator, and two weeks later was given my first nursing home. So, a lot of my training happened just by jumping in and doing, and over the course of time that led me into health care, we can certainly go deeper into that if there are other areas of value. But that's what got me on the course and has influenced me. That's what influenced me to get into health care, and I'm sure these other questions, we'll talk a lot about experiences in health care, and I'm happy to share those too.

The role of a chief operating officer is an interesting one. It's not as well defined as some other senior roles in organisations. A chief financial officer has some very distinct roles in making sure the accounting functions are done right that you have cash to. I operate the organization that you're financially strong and can get the financing via loans, be it stock purchase if you're in the market B of bonds in order to operate and fund your operations on Chief operating officer really is someone who functions at the request and desire of the CEO and each CEOs personality plays out very distinctly in the chief operating officers role. Unfortunate that I work with Mark Harrison and who's very attuned operations, which gives us a great chance to explore things together but is also a leader who charges me with what he needs the organization to be done. And then let's me go and do that and my main responsibilities when you think of operations in an organization as a senior leader first and foremost, I'm part of the executive team who sets the strategy. Secondly, though, in my specific assignment is the chief Operating officer, my job is to make sure we go out and deliver on that strategy and how we run the company. And so we have in my role but significant effort in number one, the organizational design we redesigned in a Mountain Help Cares Organization 2.5 years ago to focus on the realities of healthcare. And we recognize that we were in the traditional hospital business. But we were also in a very different business of community health and that our organizational structure did not support that imbalance, that in the best possible way, our mission is to help people live the healthiest lives possible. And it's about people's journey. And if you need something from a car accident, you're gonna have a baby. You have a heart attack. We're here and want to be here and do a great job in our acute care settings. But we also want to get out and be your partner in your journey in life. We want to make health care accessible, affordable. We want to keep you healthy and provide your resource is to stay healthy and live the way you want to live. And frankly, there aren't many of us who really want to spend time in the hospital. The only time I've been excited about going to the hospital in my life was have a baby and toe be with my wife. What? She had a baby. I'm not sure she was quite as excited as I was, but other than that, the hospitals are times of stress and concern and worry and times when your second don't feel good and we do that well, frankly, it's our roots from one Intermountain started. But the community side is probably more important because those are the things that actually lead us to staying out of hospitals, to being healthy, to enjoying our life journey. And we want to be a partner there. So we reorganize the company to recognize that and in some ways actually separate out enough that people could be, um, focused in the right areas for the jobs that they they have, or the services that they lied. So that was one area. Another is. We launched an operating model, and, uh, when I was a regional vice president, had seven hospitals, and I had someone asked me if I would know today if an M. R I was down in one of my seven hospitals, and the answer honestly was no. I wouldn't know unless a doctor was mad enough that he called me directly. The operations happen they move through. But as faras awareness on a daily basis is a senior leader, you're dealing with the macro issues. And how do you make sure that you're deploying? The resource is to the micro needs today so that people can do their jobs. And so we launched an operating model. We have over 3000 huddled boards in our system. It creates. We focus on clarity, alignment, accountability. What does the organization want to accomplish? How does your team connect to that work? What is it that's important for you to then achieve to help us accomplish that work? And where do we stand? And if we're not where we want to be, how do we support a process to get back on track? And so we have a huddle every day at 10 a.m. And I know now in our entire system 22 hospitals, 40,000 caregivers stretched from southern Idaho to Nevada. I know if any piece of equipment is down, that's impacting patient care. And the question is, Do you need help from the system side to address that and get that back operational? And we can now deploy resource in real time to address those needs. Those a couple of examples, but it's really about It's the chief operating officer. How do we engage in defining strategy with the CEO of the company, the board of the company? And then how do I through my teams, deploy that and make sure we deliver?

Yeah, there's a lot of experiences that influence leadership style, and the first thing I would say is a lesson that I, it took me a little while to learn, the best leadership style is your leadership style, leadership should be authentic, and we get taught a lot of things in school. We listen to a lot of executives, a lot of leaders. We look at their examples. We try and emulate those things that we like and all of that is really good, but at the end of the day, as a leader, your job is to actually touch the hearts and minds of the people you're leading. It's to be able to influence them, to deliver on whatever it is your organization is attempting to deliver on. In health care, that's pretty clear about taking care of people in times of need. If you're in other industries, other businesses, then that purpose might be different, but that's okay. A successful leader is still going to have to focus on connecting the hearts and minds to that purpose and helping people through it. So I have found that we're most effective in doing that when we can bring out our own authentic leadership style and be ourselves, and so as leaders, I think it's important to take all those lessons you learn, incorporate them into who you are, but also let who you are come out as a part of that, and in that process, I think we've become better leaders, and I think we become more impactful leaders. When I think about my journey then, over my style, I like to think of myself as someone who assembles teams, gives them clear charges, and then gets out of the way and lets them do their job. Now there's a lot of nuances and caveats to that, and one of which is as a leader, I like to understand my operation in enough depth that I can actually understand if it's going well or not. I have to apply different leadership styles in different situations, and I do believe in some situational leadership on top of that authentic leadership we talk about. My core go-to is to get good people, stay close to them often enough that I can stay on top of what their needs are, and let them do their job. I don't want to micromanage, I don't like to micromanage, and frankly, if I need to be micromanaging what you're doing, then I have the wrong person in that role. But sometimes, there is a demand to be a little more in the details, and I think it's important as leaders that we step into that. I'll share an experience in just a moment, but one of the things that I learned early on that helped formulate my leadership style too was around clarity, being really clear in what we expect of people. I do believe Demings, teachings, and studies as he talked about business in general and really said, businesses, as they get in, about 85% of the time, if something isn't working right, it's because of the process and system isn't designed right. And then out of the other 15%, 14% of the time, it's because people don't understand what their role is, and therefore they're not successful. It's rare. It's 1% less where people actually are not trying to do a good job and incapable of doing a good job. I really believe that that's true. And as we get people engaged when you run into challenges as a leader, how do we help people be successful and really looking at what we've wrapped around them to do that? One of the early examples I had or experiences. So I mentioned that I quickly went from college into this training program and from the training program immediately into a leadership role. And by the way, is there, when I talk about understanding in that training program, the very first thing I did when I arrived at the job was I was asked to get a white cotton shirt, white cotton pants and report the next morning and find Kathleen. This was in a nursing home and Kathleen was a certified nursing assistant. And I spent my 1st 2 weeks working in administrator training, actually following around a nurse assistant and helping to care for patients. We changed their bedding. We took care of the patients, we rolled them, we moved them. We took them to activities. We fed them, we changed her clothes, we bathed them. And that was a phenomenal opportunity for me to understand what my teams would do, and even today. Just this morning I was rounding in one of our ICUs where we have the CoVid 19 patients to visit with our staff and talk with them, but just having that experience along the way to know some of the details they deal with every day is helpful as a leader. So I would certainly encourage you to, whatever circumstance you're in, to do what you can to connect and understand what people are dealing with and going through. Now that the experience I had, I got into this nursing home and was named the administrator. I'm here less than three months out of college, and now I'm in charge. It's a small facility out in eastern Colorado and it was part of a corporation and as I took over the reins, I was informed that there was a leadership issue in our dietary area that had been brought up by our consultants, our corporate consultants who come in, and there's a lot of regulations that have to be met and that progress was not being made there, and we're going to have to deal with it. So I reviewed the file, got out all the information, went down and met with this manager, and talked with her about the deficiencies and challenges, and she assured me that she understood and was working on some of those things. And the corporate consultants came back a few weeks later and did another detailed review and found that she had failed in her work. Further, we did one more intervention, and then the next time they came back and she'd failed, we terminated her. And so this was the first person that I actually fired from employment, those are traumatic things for leaders to do and by the way, I believe if that ever gets easy for us, we should quit being leaders. It's something we should be worried about and be very concerned about making sure we do it right. Well, I was sure that we had done the process right. I was sure that we had laid out all that we needed to layout in the file to document that process. And this individual filed for unemployment, and in the location I was, we had a company that helped us actually defend unemployment claims if they were rightful terminations. So we ended up in court. I ended up with the hearing officer and here, this lady, let me paint the picture. This is a lady in the tiny town of 1500 people out in the middle of the Plains between the Rockies and Nebraska in her late fifties, who was leading a small dietary department in a little 60-bed nursing home, and she has now just been terminated from her job. She filed for unemployment benefits. We challenged that, and I'm in this with the hearing officer. And as she's giving her testimony, she says this looking at me, she said, the hearing officer asked her, "Did you know there were problems?" And she said "Yes. I knew there were problems", And the hearing officer said, "Had you been talked to about these problems?", and she said "Yes. I was talked about these problems and we were working to correct them, and then she made this statement, that will forever be seared in my brain. She looked at me and she said, but if only Rob would have told me how serious this was, I would have responded differently, and it was like a dagger to my heart, and I felt horrible. I still think she had lots of opportunity to correct what she needed to correct. But I made a vow to myself that day that never in my career would anyone else be able to look me in the eye and say they did not understand how serious an issue was because we weren't clear how serious it was before they were terminated, and that has moulded my leadership as well, and although I want to let people get in, do their work when it comes time to have candid conversations, I am very direct with that. I want people to understand that this is something that may put you in jeopardy, and at times I have people who feel that my counsel might be a little harsh, a little direct. But I would much rather do that and help somebody get the message so they can succeed, then let them fail because they didn't understand. And that was one of the early experiences that I've had and experiences build through your career, but that was helpful for me to know how important it was for leaders to be very clear with their teams and especially when it comes time that they might be in jeopardy so that they have the understanding and really have a true opportunity to correct and succeed where they are.