Day in the Life at DaVita Academy

Before starting college, I went through a summer of hypochondria that involved multiple blood tests because I was convinced I was dying. I was sure I wouldn't live long enough to graduate from college. Luckily, the ultimate conclusion was nothing at all was wrong with my health. But ever since getting over those neuroses, I've avoided all things medical.

So when an opportunity to spend two days at DaVita Academy, the soft skills program dialysis services company DaVita offers all its employees, was presented to me, I was nervous. The curriculum at the Academy focuses solely on personal and professional development rather than technical training, but I was nevertheless anxious. Would I hear graphic stories of suffering that would make me hyperventilate or obsess over my own health?

The good part, other than the chance for a compelling story to tell readers, was this particular session would be held in Nashville, TN, a place that seemed fun enough to offset any health horror stories that should come my way. At least, I hoped so. After all, I said to myself, how happy can people on dialysis be? And how happy can the people who work with those experiencing dialysis be?

Happier than me on most days, it turns out. When I heard the Academy would be in Nashville, I made plans with a sorority sister to meet for dinner the night before the first day of "class." The Academy organizers who invited me said that would be fine, but they strongly encouraged me to stop by the program's registration area. They said they had a "unique" and "special" way of welcoming participants. So I stopped by the area of the Gaylord Opryland devoted to the conference. Before I rounded the corner, I heard clapping and cheering set to the Gloria Gaynor disco-era song, "I Will Survive." About 30 "Red Shirts," DaVita employees who volunteer as helpers to Academy organizers, bounced up and down, and swayed this way and that, around and behind long tables holding registration materials. Each had on a head ornament of some kind such as the one worn by Dr. Seuss' Cat in the Hat or headbands with sparkly heart "antennas" springing up. I was happy to feel welcomed, but like many of their employees must feel, I also was a bit taken aback, so as soon as I greeted the people I needed to greet, I scurried off, afraid they would force me to dance with them.

I was greeted the next morning the same way—the same Red Shirts bouncing around to music a little too loud and cheerful (to my non-morning-person taste) for 8 a.m. The Red Shirts in the meeting room reserved for the Academy stood in the aisles with yellow numbered signs, directing DaVita employees, or "teammates," as the company calls them, to assigned seats. All DaVita workers, regardless of job function, are encouraged (though not forced) to attend an Academy session as soon as they can. There are several Academy sessions held per year across the country, with participating teammates assigned roommates. All travel costs, including hotel and airfare, are covered. Before my trip, Academy organizers gave me a briefing by phone about what to expect, and told me that for many employees, their participation in the Academy would mark the first time they ever flew in an airplane or stayed in a hotel. As a Manhattanite with a yen for traveling, I couldn't quite wrap my mind around that fact.

But it would be a nerve-wracking experience for many, apparently. "We're about to start a business meeting, but this is probably unlike any business meeting you've ever been to," an introductory video warned. Chief Wisdom Officer Bill Shannon, one of the Academy's lead facilitators, who likes to be called "Coach," presided, noting the jubilant atmosphere at the academy, reflects the need keep spirits upbeat in an industry that has its share of burdens.

Indeed, the cheerful tone extends into the culture of each dialysis center, with "fun" one of DaVita's official company values. At the same time, Coach said the DaVita way also is to scrutinize clinical outcomes on how the company impacts patients. "Clinical outcomes come first," he said, "because we want to be best or No. 1 in everything we do."

Since DaVita is a company that doesn't stand for half-hearted efforts, Coach asked all 366 participants in the room to raise their right hand with their left hand placed on the program agenda to take a participation pledge. He said anyone who didn't think they could commit fully was free to leave with no consequences, but those who stayed were expected to participate as fully as they could.

Communication Credo
The first lesson of the day was communication, and not as simple as "this is how you ask a co-worker nicely to do things he loathes." The lesson, it turned out, cut deeper than that, with a modified Myers-Briggs Type Indicator Inventory the first order of business. The module was led by Doug Vlchek, referred to by all as "Yoda." The nickname comes from the character in Star Wars known for his wisdom. He warned that those who don't like reflection wouldn't like this first exercise at all. Luckily, unlike the buoyancy of the "welcome" routine, I'm at home with quiet reflection, so I felt at peace as I settled down to answer questions such as whether I'm more punctual or leisurely; how my energy levels range at parties; and whether I'm more interested in what is actual or what is possible. My personality, the test said, falls into the introvert/intuitive/feeling/judging (INFJ) category, meaning a party with loads of people is not a favorite place of mine, and I'm prone to daydreaming more than keen examination of facts.

To illustrate communication challenges between the personalities, Vlchek asked for a volunteer with an extrovert/sensing/thinking/judging (ESTJ) personality and another who falls within the introvert/intuitive/feeling/perceiving category. Both were asked to leave the room as Vlchek guessed what their response would be to the task of describing a box of markers. He speculated that the ESTJ would be by far the more descriptive of the two. True to his predictions, the ESTJ read the back of the box, described the colors contained within, including counting out the quantity of markers. The INFP, by contrast, had little to say beyond the fact that it was a box full of markers.

With misunderstanding common given personality differences, the Academy recommends following a few basic communication strategies such as approaching a problem from a shared perspective that says to the other person or people, "We're here; the problem's there—how are we going to deal with it?" In addition, the academy's recipe for enhanced communication includes ingredients such as validating the other person's feelings; staying open-minded; and jointly taking control of the communication rather than passively waiting for misunderstandings to occur.

Talking Great Teams
To illustrate for us the difficulty of blending different personalities when working toward a shared goal, we were split into groups and charged with either planning a party or vacation. We each were randomly assigned roles to play such as information seeker, record keeper, energizer, follower, blocker, dominator, deserter, harmonizer, and facilitator. I was assigned the worst of all roles for me (you probably can guess): energizer. Since I'm not capable of jumping up and down and acting excited, I decided to take the enthusiastic-yet-quirky suggestions approach. I think I may have recommended the party include multi-colored animal-shaped balloons, and anything else I could think of that would seem energetic yet impractical (the "energetic" people I've known in my life haven't been particularly helpful). The expected cacophony ensued, with my group deciding to throw the party in Las Vegas and invite an unwieldy number of people.

To avoid a mirror experience at work, Academy facilitators had some "tricks" for us to try when working on a group project. They recommended asking "blockers," for instance, what they proposed to do instead of whatever it is they said they didn't like. The Academy also suggests work groups establish agreements before meetings start, such as agreeing what the end goal will be, and any parameters that will limit what can and can't be done, such as the need to contain the cost to within a specified amount.

Philosophy of Fun
As I mentioned, contrary to the company name, "DaVita," giving life, I had expected a death-fixated organization, and was surprised (but glad) to instead find happy, life-oriented people. To highlight the importance of its "fun" corporate value, the academy showed us a film about Pike Place Market, an outdoor Seattle fish market academy organizers feel epitomizes what it means to create an enjoyable workplace. Those working behind the market's counters call out to customers for a joke or conversation, and sometimes even use the fish as props to entertain passersby. "We don't have to sell them anything," one of Pike's employees notes in the film. "Sometimes they're just stopping by at lunch to get juiced up before going back to work."

What do DaVita's dialysis centers have in common with Pike's? The "Fish" philosophy of fun. Keep it fun, make their day, choose your attitude, and be there (meaning be alert, present, and sensitive to your customer's or patient's needs), this ethos recommends. So what do the dialysis centers Academy participants traveled from do to that end? Bingo in the clinic, one learner said. Another said she focuses on creating a "positive work environment" by "leaving home at home." Another shared that at her clinic, employees sometimes amuse patients with dance competitions in which the patients get to be the judges. Other centers said they give patients cards to mark milestones such as surviving the first year on dialysis, and sometimes bring in treats such as donuts and sugar-free candy (for diabetic patients).

Sometimes having an enjoyable workplace doesn't mean fun so much as support. Another film shown that afternoon pointed out the help DaVita gave its New Orleans area-based centers and staff following Hurricane Katrina, and at one center, the staff-wide effort to get back up and running.

"I try to do anything I would do for my parents for my patients," one employee said.

Game Night
After testimonials of die-hard dedication to patients were shared for inspiration, Academy participants prepared themselves to compete in the "Academy Olympics" for two hours that night. In the interest of full disclosure, I opted out of the "Olympics." As one who made up stories (and even once forged a letter from her mother) to get out of eighth-grade gym class, the thought of running in relay races was too traumatic. But glad to serve as spectator, I sat back and watched as the DaVita employees, divided into groups of 60 people, marked by different colored bandannas, ran, hopped, and passed off various markers to teammates while (what else?) upbeat music played in the background. Some of them even happily twirled hula-hoops around their hips. I have to admit that part looked kind of fun.

I was tired just watching them, but the relay races weren't the end of the evening. After that, game night advanced to a battle of the bands event in which each team was asked to put together a lip-synching performance aided by props such as plastic guitars and costumes such as grass skirts and coconut bikini tops (the chosen attire, surprisingly enough, for more than a few of the men).

A nice thing happened when one of the "bands" went on stage to perform to Bon Jovi's "Livin' On a Prayer" song. The sound system malfunctioned, and when it looked like the group's act would be ruined and/or dispensed with, a few of the Red Shirts asked the audience composed of fellow Academy learners if they would sing the song along with their performing peers. Just as the room swelled with a rendition of the classic '80s hair band tune, the speakers began to work again. Good karma, I guess.

The DaVita Story
The next morning's session began at 7:30 with Vlchek, true to his "Yoda" nickname, sharing DaVita wisdom, which centers on a corporate-wide unity of purpose. "Whether you work in a clinic or in an office, we all do the same thing—we do DaVita," he said. "If someone asks you what you do, you can tell them, 'What I do for a living is I give life.'"

Vlchek pointed out that most people couldn't thrive on, or even survive, the kind of work DaVita's employees do everyday. "Many people go into dialysis care, but the ones who stay are very special," he said. "About 90 to 95 percent would leave."

In addition to the strength of these DaVita employees' character, one of the reasons they stay can, no doubt, be attributed to the livable work environment created by the company. Vlchek says when the company was established approximately 10 years ago, the goal was to create work teams that were effective, caring, and sustainable. The corporate philosophy, intended to be simple and easy to remember (more than an abstract mantra posted near the elevators in the building), includes the values of service excellence, integrity, team, continuous improvement, accountability, fulfillment, and fun. Along with constantly reinforcing these values in educational settings such as the Academy and in employees' daily work at the clinics and DaVita offices, the company upholds its corporate philosophy by screening job applicants for their values. Vlchek says DaVita recruiters ask "value-type" questions during interviews, such as what's most important to applicants, and how they spend their leisure time.

To track employees' ability to deliver on the corporate values, DaVita managers are required to fill out "Mission and Value" report cards on employees, and employees can request the same form to fill out about their manager. The value-fulfillment tracking also includes "Teammate Satisfaction" surveys in which peers provide feedback on one another's demonstration of the DaVita ethos. And perhaps the best marker of all of how well DaVita delivers on its philosophical promises? The judgment of its patients. Employees can be named by patients as "Shining Star Caregivers."

With DaVita's values such an integral part of its work life, the company also wants its employees to think about their "personal credo," says Vlchek. "If you were given an all-expenses-paid vacation, where would you go (no technology, TV, or phone allowed)?" he asked. I'd go to a place with lots of beautiful, fascinating animals to watch (safely ensconced in an way that would prevent me from being eaten by any of them), help, and write about. I wondered how many Academy participants sitting around me were similarly inclined, or whether many of them were just hoping for as-luxurious-as-possible accommodations that met the no-technology requirements.

Next, Vlchek wanted to know the guidance we would give those left behind while we were vacationing at whatever faraway place we chose. "What would you leave behind so people know what you stand for, and don't stand for?" Well, being a journalist and aspiring creative writer, I suppose I have an edge over most of the Academy participants. I would leave behind my leisure-time writing, such as poetry and funny stories about interviewing tulips, and maybe a few of the articles I've written professionally that resonated with me personally.

As to the exact "personal credo" Vlchek suggested we come up with, I'm not yet absolutely positive, but I'm pretty sure mine would be something about "imagination and the natural world first." I guess I should insert something about the desire to help other people, but it isn't the first thing that comes to mind. That's where I'm sure I part company with DaVita employees. I bet most of those sitting around me thought of the quest to help others before anything else.

As I have a flight in the late afternoon to catch, DaVita Academy ends for me with a discussion of linking the corporate values to DaVita's mission to be the "provider of choice" to those in need of dialysis, while also earning that distinction with superior clinical outcomes. Lest anyone jump to the conclusion the emotion-laden values talk engaged in at the academy has nothing to do with efficiency and productivity, Vlchek reiterated the company's approach: "Our core values and efficiency go hand-in-hand," he said. "We want to do the best for our patients."

The "Giving Life" Leader
Leading a company whose mantra (and definition of its name) is "Giving Life," can't be easy. People probably expect you to be better than the average person. Who knows how much better than you or I DaVita CEO Kent Thiry is, but he seems pretty good at upholding DaVita's values, spreading them to employees via forums such as DaVita Academy, and tying it all together to deliver clinical outcomes that meet company goals. Training magazine asks him how he does it, and any tips that can be passed along to other companies.

Training: How does DaVita Academy help your company meet its business goals?

Kent Thiry: It's part of the overall DaVita Village concept. Early on, we adopted a strategy of training and caring for our teammates as a way to truly live our mission and values. Patient care is our first priority, and it starts with caring and growing our teammates. The Academy brings teammates together, provides an environment to learn about themselves, the DaVita story, our mission—and, of course, to have fun along the way. If you take time to care for the people who do the good work, and provide a positive work environment, it usually leads to improved patient care, decreased turnover, and a high level of teammate fulfillment.

Training: The enthusiasm and energy at the Academy was palpable. For companies that are skeptical that training and corporate events can be enjoyable, what is the business case for "fun?"

KT: First, we don't think we need to make a "business case" for fun. We think a distinctively fun work environment is a superior way of life, and that is what we are trying to make possible for and with our teammates. Second, our core values were chosen through a series of elections, by the teammates themselves. So it is impossible for us to assess how many of them had a business case in mind when they voted for fun. But third, if the question is, "Does our fun have an impact on the business?" we think it does, namely in terms of improved quality of care, increased friendliness of care, and lower stress and turnover in our team.

Training: As you look at the evolution of the Academy since its inception, what are some important points of progress?

KT: The attendees rate every individual session and speaker, and we kept revising things until we were getting uniformly high scores on every topic covered. Separate from that process, we probably have seen the most innovation in the area of increasing the "take-home" value—[asking ourselves] what we need to do differently so there is a more sustainable impact on how each teammate works and lives with others. I think the most significant change in the Academy over time is the growth of the program. We started with only 44 teammates at our first Academy, and now have an average of more than 400 in each class. This larger setting allows us an opportunity to touch a greater number of teammates, who, in turn, go back to their facilities and have a greater impact in sending forth ripples of citizen leadership to patients, teammates, and others in their personal and professional lives.

Training: Most companies, it seems, think of personal development as something employees do on their own time with their own resources. From a business perspective, why does incorporating personal, in addition to professional development, into a program such as the Academy make sense?

KT: DaVita is a community first, a company second. Because DaVita is not about dialysis. DaVita is about life. And in a Village, as we are, there would be opportunity for everyone in a community to grow. The Academy is an opportunity for teammates to familiarize themselves with the DaVita Village and with other new teammates. For many of our teammates, their development as members of the Village leads to an increase in confidence, empathy, and fulfillment. This can have a positive impact on their maturity and professional growth, as well. And in the end, that kind of growth helps teammates do what matters the most—provide the best patient care possible.

Training: What is the importance of corporate culture to a company's success, and what tips can you offer other companies on making values substantive rather than something that exists only on a poster stuck to the wall?

KT: We do many things to make our core values materially relevant, even in the hectic and demanding rigor of day-to-day life in an intense dialysis center:

• All executive candidates are evaluated explicitly for mission and values fit, in writing.

• All annual professional development reviews done by the CEO for his direct reports include a written section on the mission and values and how other people experience the executive with respect to each of the values.

• The company and the top 3,000 leaders get scored by their teams on the values once every year or two.

• We have extensive nominating processes for Core Value Awards, which then are publicly awarded, to honor teammates who are role models for one or more of the Core Values.

• We pay out millions of dollars in bonuses, not based on superior business results, but for being a role model for our mission and values.

Training: Has the attention you pay to creating a winning work environment paid off in employee retention?

KT: Our turnover was in the high 30s, percentage-wise. We cut it in half. Then we bought a large competitor that had turnover 40 percent higher than ours. It took a couple years, but we are back down to where we were before the deal, and striving to achieve new lows.

Training: I noticed DaVita makes a point of getting involved with community charities, such as those aimed at finding a cure for kidney failure. What tips can you pass along to other companies about creating and implementing a social responsibility initiative?

KT: We suggest holding a few brainstorming sessions with some of your teams, executive or otherwise. This way, you get ideas people are excited about and have shared ownership of. Then make sure you give some of the enthusiasts responsibility for making them happen, as opposed to turning it over to a staff. Then spend as much time designing the implementation as you did coming up with the idea. Many good civic ideas die not because they are bad, but because implementation is tricky and often under-invested in.

Training: What's next for DaVita's training program?

KT: We are undergoing a "blank page" process right now. This means we are pretending we are starting over to provoke more creativity and objective thinking. One decision we made is to re-start our Academy II, which was stopped when we made a big acquisition. In Academy II, we shut down centers to facilitate focused teambuilding sessions with all of the centers' teammates.