Managing with a focus on trust Create Learning Team Building and Leadership


Working with a medical office of 150 employees that had grown rapidly.  In 4 years their size, contracts, and income had tripled. Rapid growth from 1 location with quick communication and a start-up mentality.  To a sustainable organization with policies, procedures, processes, systems, compliance, separation of management, and growth requiring middle managers was proving to be a struggle for everyone in the company. The company was noticing more fighting amongst staff and management, plus suppliers.

This struggle was creating:
  • Decreased quality
  • Decreased on time completion of work
  • Increased complaints from external customers and suppliers
  • Loss of credibility in the public leading to declining customers
  • Increased turnover


Consulting and Coaching this entire organization we knew that a solution was possible.

Examining the organization and customers we found:
  • They had a great product
  • People liked the services offered
  • Sufficient talent was in the organization to succeed
  • 83% of the employees wanted to stay & to improve things

From a NOISE analysis, looking at the current state of the company we identified “Fear” as the main topic. In a meeting, I asked, “What would people in this company be doing when they were not fearful? How will we know that fear is no longer an obstacle to progress?

The response was Trust

We started to focus internally with the medical office staff. We sought responses from all 150 employees, aggregated replies to the following question.

What is the behavior of a trustworthy employee?

We came up with two lists, one describing the trustworthy employee, another the untrustworthy employee.

Trustworthy Employee Untrustworthy Employee
  • Responsible adult
  • Desires to contribute ideas, energy & effort into their work
  • Desires to do their best work
  • Cares about the company
  • Cares about co-workers
  • Cares about community
  • Wants to see the company, co-workers, community succeed
  • Follow through on commitments
  • If cannot follow through on commitment informs others
  • Takes advantage of the company & others
  • Completes the bare minimum
  • Is passionless about the work
  • Doesn’t give a damn
  • Watches & enjoys others failure
  • Overtly apathetic to most things
  • Feels that management “owes” them something
  • Fails to follow through on commitments
  • Blames others for their direct failure to follow through on commitments


Now that we have list the management team and I tried to estimate how many of the current employees fit the Trustworthy List & how many fit the Untrustworthy List.

We found that close to 95% of the people matched the Trustworthy List.

The management team thought about the Company Culture plus Current behavior of management within the company.

  • Who are the policies and procedures written for? The 5%
  • Who is the focus of much of their organizational change efforts? The 5%
  • Where is most energy being focused? The 5%
  • Which employees are leaving the company? The 95%

Managing a company with a focus on Untrustworthy people builds fear.

Guiding the team from the abstraction of data to day to day work we created an “Impact Project Team” to head a year-long process of policy revision, education and learning.


  • 86% of Policy & Procedures were re-written with Trust-Attracting in mind
  • The Impact Project Team changed members as needed to focus on increasing trust within the organization
  • The company went from 5 to 3 layers of management (keeping all employees and pay at current levels) this led to more autonomy and visible trust to complete great work
  • Within 1 year the amount of sick days and calls off shift decreased by 47%
  • Within 18 months turnover decreased from 23% to 14%
  • The Medical Office contracted with 3 large HMO’s bringing in more business.
  • A  re-evaluation of the employees showed work satisfaction & perception of trust increased at all levels.
What do you think?

How are your policy & procedures written? Are you creating a trust attracting company? In what ways might your work be better with higher trust?

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