DEFINING STEPS TO BUILDING COMMUNITY AND PURPOSE

Defining Steps to Building Community and Purpose In a Highly Decentralized Employee Population Susan Fleming DePaul University

DEFINING STEPS TO BUILDING COMMUNITY AND PURPOSE Abstract

The purpose of this research is fourfold: 1.) to explore the way that a highly decentralized employee base interacts with and connects with others in the organization to get their jobs done, 2.) to determine what works against the ability to build a sense of community, 3.) to determine what currently does work and 4.) to identify specific areas for change that would help to build a greater sense of community and common purpose. Research includes interviews with a purposive sample. A number of ideas were identified; these ideas will be developed for further refinement through employee focus groups and surveys, with the idea of giving employees the opportunity to have a voice in how they build community and how they relate to the common purpose.

DEFINING STEPS TO BUILDING COMMUNITY AND PURPOSE Introduction and Background

In companies of all sizes and all industries, even the right business decisions sometimes fail to achieve the right results. These failures often are not the product of incomplete business analysis or planning or even execution capability. Rather, these failures often result from a single, powerful, and somewhat invisible source: organization culture. Culture can be an insurmountable obstacle to implementing strategic change. However, when the culture is attended to and guided to support and reinforce strategic goals, culture can accelerate the achievement of desired results (Levin & Gottlieb, 2009). According to Martins work (as cited in Levin & Gottlieb, 2009), culture is defined as the shared beliefs and values of members of an organization that provide meaning and influence daily work life. These beliefs and values affect work behavior in tacit and nuanced ways. The challenge is that culture is not readily changed, especially when there are multiple cultures that are deeply embedded and layered. This is the case for SXC Health Solutions (SXC). SXC is the product of three acquisitions over the past two years. Currently at $1.9 to $2.0 billion in revenue and 952 employees, growth for SXC has been rapid as a result of these acquisitions combined with organic growth. The largest acquisition, National Medical Health Card (NMHC), occurred in May, 2008 and added 500 employees, a significant increase over the core base of 400 employees. Of the current 952 employees, nearly 200 work out of their homes. In addition, there are six regional offices, totaling 352 employees. In the corporate office, there are approximately 400 employees. The acquisition of NMHC marks a significant shift from SXC being a product based IT company to a service organization. Hence, there are two camps within SXC- the legacy IT

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group and the new age service group. For SXC to continue on the path of rapid growth and success, these two cultures must merge and morph into a singular mindset. In an effort to bring a fresh, singular value proposition to the company, a brand identity project was conducted and completed in February of 2010. Out of this project, a new mission, vision and values were crafted to set the stage for a culture change. The ability to realize the full potential of the identity and the mission hinges on the ability to successfully meld and evolve the culture to focus on service. The purpose of this research is fourfold: 1.) to qualitatively examine the effectiveness of interactions between employees and across multiple departments, 2.) to determine specifically where and how connections and communications break down, 3.) to determine what does work and 4.) to identify specific tactics that can be developed into deliverables that can be implemented and/or further tested. The research will focus on employees who are remote and/or must interact extensively with multiple departments in the course of doing their work. Every department will be represented and there will be a mix of legacy and acquired employees. Questions will be aimed at uncovering general feelings about the organizational culture, how employees interact and relate to each other, the level of trust within and between departments and specific ideas on how to build community and common purpose. To date, seven interviews have been conducted. Day to day interactions were explored in detail, knowing that the change process evolves from the daily context within which organizations function. This daily context is directly related to employees reaction to and feeling about change (vanDam, Oreg, Schyns, 2007). Understanding the dynamics of the daily

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context will help to inform the degree to which the community is functional and how likely it is that the organization will be successful in engaging employees to embrace culture change. A number of themes were identified, in terms of what works and what doesnt work. These themes are common across the majority of participants and point directionally toward some big picture needs and some very specific needs. Methodology Because of the complexities of the organization, and the issues related to cultural change, building community and understanding daily context and dynamics, a qualitative approach was chosen. Participants were selected by asking Vice Presidents over each department to identify two people who either work remote or are required to interact with multiple departments when performing their work. The Vice Presidents were also asked to base their selections on tenure; one employee should have between six and twelve months and one should have tenure of three years or more. This was to determine whether the culture and the ability to effectively work were impacted by the length of time in the position. This yielded 34 potential participants. To date, seven employees have been interviewed from the following functional areas: Participant Number/Position 1. Manager, Implementations 2.Manager, Customer Service 3.Director, Integrail Services 4.Account Coordinator 5.Account Coordinator 6.Account Executive 7.Director, Clinical Account Management Location/Tenure Scottsdale / three years Scottsdale / three years Home Office / ten years Home Office / one year Home Office / seven years Corporate Office / five years Corporate Office / three years Location of Interview Telephone Office Office Telephone Telephone Office Telephone

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These participants represent various levels within the organization, with five being at locations away from the corporate office. All of these individuals need to interface with clients and they all need to work with at least three and as many as seven departments to accomplish day to day and long range responsibilities. The interviews were kept fairly structured, rarely straying from the pre-planned questions. The reason for this was to prevent bias from entering the study. The researcher has been part of the organization for nine months and has some pretty strong opinions that could influence the participants responses. Keeping the interviews structured with the researcher interjecting only for clarification or to get back on track, helped to prevent bias. Each interview took between 45 minutes and one hour. The participants were informed that this research will be used to help inform where we are being successful and where we are not so successful with our culture change and to inform the employee engagement plan. Questioning started broad to gain an understanding of the daily context, in particular, roles and responsibilities and requirements in terms of communication and interaction. All participants were asked to describe their roles and responsibilities and how they relate to customers and to the rest of the organization. They were then asked how they feel about the culture. The remainder of questions was designed to uncover what works and what doesnt work in terms of interface with others in the organization. Within these probings, the participants were all asked to contribute ideas about how they can contribute and how the organization can contribute to busting silos and building community and common purpose.

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While responses were fairly consistent, there are limitations with this research. There were no participants from the legacy IT departments. Second, not all departments were represented. Finally, the number of participants was limited. Research will continue in order to round out the sample. Every department will be represented, for a total of at least seventeen interviews. Interviews will continue until we experience redundancy. Internal validity will be established by member checking; participants will be asked to review their transcripts for accuracy and to see if there are comments they would like to add. Internal reliability will be enhanced through use of one additional researcher. Preliminary Results Transformation is a process, not an event (Kotter, 2006). Within this process, its important to understand the magnitude and nature of change required. Very few, if any, culture realignments require changing every aspect of the current culture. Rather, specific cultural attributes that no longer are useful for addressing emerging business challenges need to be identified and targeted for change (Levin & Gottlieb, 2009). In order to be successful in this change, employees must be engaged. Like transformation, engagement is not a short-term initiative. Engagement is simple in concept, but often difficult in execution (Wellins, Bernthal & Phelps, 2009). The key is in creating an environment where employees can focus their attention on their work and drive to do their best. When this happens, less time is spent on wasted activities and resources are used more effectively.

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When asked about the culture at SXC, all seven participants indicated that the organization is silod, with departments sometimes working at odds. Nearly every one of the seven participants used the word silo. One participant talked about teams being very

separate and not everyone seems to know how to go outside their team to get things done. Another said people look down their nose at you if they think youre a second floor person. Only two participants felt that the culture is beginning to move in the right direction. Departments were talked about as being very separate and self-contained. Coming into the organization, its not intuitive where to go or how to cross the boundaries. It was felt that the mindset of many departments and individuals was to focus on creating hurdles or roadblocks to getting things done. For example, several participants indicated that systems and applications developed to serve as tools for managing workflow are being used as tools for pushing back. One participant said If one mistake is made or if all information is not filled out, the request comes back to and your request goes back to the end of the queue. Perhaps the most disturbing phenomenon to several participants was lack of responsiveness. It was reported that sometimes, individuals just dont respond: Why is it ok to just not respond to email? Email is the primary mode of communication and reportedly, does not always get answered. One participant lamented with email you get to hide. The participants talked about an additional phenomenon that exists as a result of hurdles and the lack of responsiveness. There is a tendency to workaround, which means that employees find ways that may be more difficult to get things done, but at least they can figure out a way to get them done. One example given was there was no server assigned to the marketing Macintosh (because IT doesnt support the Mac) and the designer was backing

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everything up to a personal server. When this designer was fired, there was no way to retrieve the back-up documents. Few employees can do their work without the support and input of others. When employees have support and cooperation of their co-workers, they are better able to accomplish more and share ideas to come up with creative solutions (Wellins, Bernthal & Phelps, 2009). This kind of teamwork and collaboration needs to happen not only within work groups, but across work groups. Silos work against the effort to work as a community with a common purpose. It was felt by all participants that there is an us and them mentality that can be pervasive, depending on the department. An account executive talked about the entire department being viewed as the red-headed stepchild. A manager talked about call center people are treated as second class citizens. An account coordinator talked about people just wanting to cya. In general, the participants felt that the silos hurt SXC in small ways every day and believe that they are holding the organization back from working in lock-step. However, it was noted that the two participants with the greatest longevity seem to be able to more effectively maneuver their way around the organization. One said, I know how to get things done; if I need to I go around the problem and go to where I have established relationships. The other commented, I have good relationships and connections. I know where to go to get what I need. Relationships make mot everything happen for me. Another related issue maybe even an issue caused by silos is that employees dont know who does what. Five of seven participants indicated that they felt the department names are not descriptive and, therefore, it is not intuitive to know where to go to get specific tasks done. Additionally, once they found their way to the right place, they could receive two separate

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answers, depending on who they talked to. When investigated further, it was found that frequently, there are no standardized processes. As one participant put it, theres no policy or procedure you can get two different answers from two different people in the very same department! Another stated, people are doing their own thing to get stuff done. Additionally, it was cited that, within departments, training is non-existent. The training is left up to us so it never happens, stated one participant. Yet another said, when people without enough knowledge make a request, it hurts the rest of us. They extrapolate that we are all dumb. This lack of training and development more than likely serves to make the employees of SXC even more resistant to change. According to vanDam et al (2007), employees who perceive a strong development climate may be more inclined to consider organizational change as an opportunity for growth and learning and will, therefore, develop less resistance to change. The ability to make decisions is key to having a feeling of job ownership and commitment. This kind of ownership can be built when employees are able to make important decisions about their work. When this doesnt happen, it becomes difficult to develop a sense of purpose (Wellins, Bernthal & Phelps, 2009). Participants felt that decision making is generally in the hands of senior managers. As one participant put it, Im a director directing nothing. A consistent complaint of all participants was that they dont know whats going on. One participant commented, I work on proposals and never knowing whether SXC was awarded the business. According to Kellins et al (2009), leaders need to help employees see the big picture and to understand how their role fits into it. They also need to show how an individuals actions affect other department. This requires employees to be aware and well

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informed about changes that affect their work groups so they arent surprised or confused. When employees are well-informed, they are also better able to manage their time and resources, and to stay on track. The final theme that was consistent across the majority of interviews was a lack of expectation-setting. In general, they felt that there wasnt a clear roadmap and that this contributes to the lack of community and common purpose. Conversely, there were some themes around what does work. Kotter (2006) provides a framework for succeeding at change. He indicates that transformation often begins well when there is a good leader who sees the need for change. He further indicates that when the renewal target is the entire company, the CEO is key. Participants felt that the CEO of SXC communicates in a meaningful manner with the right frequency. Some of the participants have begun to replace email with face to face meetings. They talked about getting out of their chairs and finding the person the need to communicate with. They felt that this in-person approach allowed for more collaboration and creativity. Those who couldnt do this because they are remote, talked about using the telephone in lieu of email when the issue was urgent or complex. One also talked about busting up email strings once they reached a string of three. Again, the two participants who felt that they were able to get a lot done and felt they received adequate help from other departments, were employees who have been with SXC for five years or more. Along similar lines, it was reported that when teams are consistent, work gets done more effectively. Discussion

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The Brookings Institute (as cited in Wellins et al, 2009), people have become the primary source of competitive advantage. In 1982, 62 percent of an organizations value came from tangible assets and 38 percent from intangibles. By 2002, the source of value has flipped. Almost 80 percent of market value comes from the people. Given that the majority of SXCs focus and revenue no longer comes from technology product but from service, there is an overwhelming need to get the employee population engaged and moving with common purpose. SXC has a new identity and should have a new energy and sense of purpose that will make the cultural change begin to work. The core actions for reinforcing new beginnings include: consistency in messages, quick successes that increase morale, applications of symbolism linking the past and the present and celebration of achieved goals (Stragalas, 2010). Values need to be incorporated into everyday work life so that all employees understand that business should be conducted in ways that exemplify these values. Finally, a culture realignment needs to tap into the talent of all employees and needs to move on two primary fronts: leadership and grass-roots (Levin& Gottleib, 2009). As a result of this research and other, existing research around leading change, several big picture and tactical items have been identified to incorporate values, build a sense of community and to foster engagement. These items will be driven by a combination of grassroots and leadership approaches. First, an effective communication approach is critical. The companys current intranet was coined as a wasteland by one of the interview participants. The home page is not much more than forms and fixed content. The organization of the site is not intuitive and its difficult

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to find anything. Some pages were last updated in 2007. If the intranet can be redesigned as the primary communication vehicle, it could go a long way toward building a sense of community. The preliminary design would entirely replace the home page, making it all about communicating, informing and giving employees a voice. There would be a CEO blog, a polling feature to collect feedback from employees on a regular basis, a whats new feature, an award and recognition corner, a spot for stories that would be maintained by the brand ambassador community, to showcase examples of where individuals and departments have exemplified the values and the mission. The intranet design will be shopped with internal focus groups at various levels. Employee input will be used to arrive at a design that employees will find useful because they will have had a voice in how the intranet is constructed. Second, the organization needs more transparency. Employees need to be aware of current priorities and what others are working on. At a very basic level, they need to understand what other departments do, so they can effectively navigate the organization., Specific steps include profiling a department each month on the intranet and the whats new feature reference earlier. In addition, monthly Vice President meetings will be opened to directors to dial in. This is something that was suggested by one of the interview participants. These measures are designed to address the issue that one manager described as being treated on a need to know basis. Other comments about being in the know included not everyone on the second floor knows whats going on up on the executive floor and communication up is better than communication down.

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Third, the right behavior needs to be recognized, celebrated and communicated. Anew award and recognition program will be developed to recognize efforts that reflect the new values and mission. In addition, a new component to recognize daily contextual support of the values will be developed. There is already a name for this award: Everyday Heroes. A brand ambassador community has been defined and there are twenty members across the organization participating, with representatives from every department. They will have a virtual community online with a discussion board and a blog. The blog will showcase stories that serve to illustrate cultural best practices. In addition, they meet every three weeks. Their purpose is to identify early wins, communicate them, and infiltrate the organization to reinforce correct practices and behavior around the values. This is truly a grass-roots effort, as the members are all supervisor or front-line employees. They are directed by the Corporate Communications Director, who facilitates and provides for learning opportunities by bringing in various leaders to bring the brand and the values to life. In this way, they are armed with the knowledge they need to create the grass-roots movement. Vice Presidents will be charged with implementing level, silo-busting efforts. These efforts are about reaching across departments to effect better communication and to ensure that we are marching in the same direction. At the middle management level (directors), a steering committee of opinion and thought leaders is developing tactics that can help make SXC a great place to work. Finally, progress must be assessed to determine whether the culture is realigning. This will serve to keep efforts on track and will tie all of the efforts together. First, metrics will measure the impact of silo-busting. Each department will be required to develop internal service

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level agreements (SLAs) and to routinely measure them. For example, the analytic department may have an SLA that indicates that all client report requests will be turned around in ten days. Initially, achievement of the SLA will be considered success. Over time, they will be required to aim higher with regard to turnaround. Second, a survey will be conducted at the six month mark and again at eighteen months into the cultural realignment. In the interim, the Everyday Heroes award program will serve as a proxy. If we receive a large volume of Everyday Heroes nominations, we will know that behavior is focused in the right direction. Implications and Conclusion As stated earlier, people have become the primary source of competitive advantage. There is an overwhelming need to get the employee population engaged and moving with common purpose. If this doesnt happen, SXC fails. Thus, it will be critical for senior management to commit to making culture change a priority. In order to assist with this, an executive coach has been hired. The coach will be charged with helping executives stay focused on ensuring that their teams are engaging in the right practices and the right behavior. There is no question that there is a great deal of work to be done. This is work that will clearly drive employees out of their comfort zones. The preliminary work is done. SXC has a clear vision and mission to provide direction. Obstacles are being removed with silo-busting, there are groups formed who will identify short-terms wins and expose best practices and there is a guiding coalition being formed and coached with the senior leadership team. Finally, additional research of the daily context (SLAs), employee opinion (around development of the intranet and through general opinion surveys), will provide the guidance to

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ensure SXC stays on track and continues to experience the kind of growth the company and its shareholders have become accustomed to.

References Eriksson, M. & Sundgren, M. (2005). Managing Change: Strategy or Serendipity Reflections from the Merger of Astra and Zeneca. Journal of Change Management, 5(1), 15-28. Kotter, J. (2006). Leading Change Implementation. Harvard Business Review, January, 2007.

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Levin, I. & Gottlieb, J.Z. (2009). Realizing Organization Culture for Optimal Performance: Six principles and eight practices. Organization Development Journal, 27 (4), 31-46. Stragalas, N. (2010). Improving Change Implementation. OD Practitioner, 42(1), 31-38. vanDam, K., Oreg, S. & Schyns, B. (2007). Daily Work Contexts and Resistance to Organisational Change: The Role of Leader-Member Exchange, Development Climate & Change Process Characteristics. Applied Psychology, 57(2), 313-334. Wellins, R.S., Bernthal, P. & Phelps, M. (2009), Employee Engagement: The Key to Realizing Competitive Advantage. DDI, Pittsburgh, PA.: Development Dimensions International.

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Appendix A

Interview Instrument SXC Health Solutions Building a sense of community and common purpose Issues: decentralized, a product of acquisitions, in the midst of a planned culture change, very silod organization, legacy employees vs. new age employees, moving from an IT/product company to a service organization

DEFINING STEPS TO BUILDING COMMUNITY AND PURPOSE 1. 2. Tell me about your role/your work. a. How it relates to customers Tell me how you feel about the culture.

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3. Tell me about your interactions/relationships in getting your job done a. Disconnects/what works against community/common purpose 4. How do you feel about the level of trust between individuals and departments? a. Your ability to make decisions? b. What would empower you to freely express yourself? 5. Talk about what would help you better understand how you can contribute to our mission. How you can directly contribute to client satisfaction and retention?

6. Talk about what you think would better connect you with others. a. What can you do? b. How can you break down silos? c. What about our culture works against building a sense of community? d. Specific ideas e.g., internal web site, town hall meetings

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Appendix B

Interview with Customer Service Manager, location: Scottsdale I = interviewer P= participant

I: Can you take a few moments to describe your role?

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P: Well, I cam from QVC. I have been an executive at other corporations and this place is different than Ive ever seen before. Its very silod. Structurally, teams are very separate and they dont seem to work very well together. I: Can you tell me about your role? P: Anyway, I manage the call center group in Scottsdale. Ive been here for about two years. I: Tell me how you feel about the culture at SXC. P: The culture here is very silod. I was here for two weeks for training and attended different meetings. I was all over the building on different floors so I saw a lot of people. I noticed that nobody says hello, nobody smiles. Its really weird anytime I was on the elevator with other people and got off on the second floor people looked at me like, oh youre one of those 2nd floor people. Last week someone from HR called me and said, oh it must be one of your people I saw in the elevator wearing sweat pants. I mean, why would someone assume that it was one of my people? Just because, like, we are customer service people and were second class citizens? Si I say tell me how you know it was one of my people did they get off on the second floor? So then the HR person says never mind and goes down on the second floor looking for the person in sweatpants. She made an assumption and on top of it didnt even trust my word. Call center people are looked down upon. I: So how did that issue get resolved? P: They never did find the person in the sweatpants, but it was a really annoying thing to have to defend an assumption. I think thats especially telling coming from HR. I: How so? P: Well, if HR treats us that way, imagine how the rest of the company looks at us. I: Tell me more about the culture. P: Well, in Scottsdale everyone is approachable. Here, when youre walking around, nobody introduces themselves.. In Scottsdale, people take the time to introduce themselves and say hi. Here, nobody even says hi on the elevator. A couple of supervisors from Scottsdale who have been her brought it up, as well. People seem less approachable. Mark Thierer seems approachable. Jeff Park gives the attitude of do it my way or the highway. And Kristen DeLay is feared in Scottsdale. I asked Kristen about putting stuff up on the walls because, you know, there was nothing on the walls. Maybe some motivational pictures or words stenciled. Can you believe she said I will make that

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determination if and when Jeff Park says its ok. Im in charge here. I was just trying to get some motivational stuff on the walls I want to have some fun. I: Tell me about how you interact with others in the company to get your job done. P: A lot of work is done on same time and email. I try to get up and walk around. I share stories with people to motivate them. But, you know, we spend more time at work than we do with our families. I couldnt work in Lisle. Do you know that every supervisor we hired to start this place up two years ago is gone. There has been zero turnover here in the past 15 months. There are people on the waiting list to be temps cause we do temp to perm. There arent enough slots. We surveyed our tema they love it the think this is a great place to work. I: So whats your secret? P: We have what we call the FISH philosophy. It involves team building and recognizing people when they do a great job. We have a board where we have everyones pictures and little blurbs about what theyve done to support FISH. We put their profiles up there. We need to roll our more groups of people like the brand ambassador team or roll out the FISH philosophy. We need team building and interdepartmental teams. We need to figure out how to pull every level of the organization together. It could work if someone could figure it out. I: Do you use the telephone? P: I try to go voice to voice whenever its a hairy issue or I just want to see the other persons eyes. You know, I also have to talk to clients some times. But mostly, I talk to members or to my staff. Its a hard job for my people. Basically, people are calling mostly with a mad on, not just to tell us hi. It sort of disarms them when youre nice to them. I: What works against good interactions? P: There arent enough smiles. Also, some people arent responsive. I dont get it. The other issue Ive had lately is getting things at 7 pm on a Friday just so other people can get stuff off of their desks. We need a sense of team across the company. I: How do you feel about the level of trust between individuals and departments? P: Trust is bad. Theres too much email. We need to start looking at a program to get people talking. Maybe lets shut down email for an hour a day. A great place to work starts from the top. We have some executives that dont do anything. Its a perception so why try? They dont understand what other departments do. We dont make it well known. I: Who do you work with really well?

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P: The account management team is really important to us because they have the clients, you know? The PA area is good. We have just started meeting with them to come up with process improvement. We have a lot of members calling about status of PAs so I wish they would find a way to do status for members to see, but they are responsive. Mail order has gotten a lot better lately. It is great when they system goes down. They are really responsive. Data Center Operations and TAC have to help us a lot. HR and recruiting down here in Scottsdale is awesome. Our relationship with HR works really well. We have good rapport. They go to bat for the team, they give us options But once it gets outside of this site with HR it becomes more difficult. I feel like its sometimes not about whats good for the employee, but just whats good for the company. I think sometimes people feel very expendable and thats not a good way to feel. Mail order has really broken the silo, but thats because of Rebecca. She forced them into it. She established best practices. Account management in the past three months has really turned it around. They are being held to timeliness. We send them 100-150 escalations a day and we need them to get them resolved for the members. Sometimes we were waiting for like two weeks and now we get it back sometimes the same day. Weve gotten amazing results over the past three months by talking to people we work with. Things very rarely get escalated anymore. I: Can we talk about some specific ideas to help us better connect with each other? P: I love the idea of using mySXC as a communication vehicle. You know, nobody knows what other people do around the company. We should use mySXC to let people know the contributions of each team within the organization. Maybe profile a department each month. Like I know what the implementation department does, but not the HCIT implementation. In orientation they should spend two hours going through each department. They dont even talk about other departments during orientations. Then because were so silod thats why nobody knows who to go to for what and nobody knows what other departments are doing. The brand ambassador thing is so great. Im really glad I have the opportunity to be part of that group. Im talking to everyone about it and trying to spread the word around. I know I sounded really negative while we were talking, but its just that I had that weird week in Lisle and it seems like such a foreign place. You gotta get people to smile over there. I: How about breaking down silos? P: Weve really tried to talk and meet with other departments we work with. We never used to do that and its made a night and day difference. Just the talking and trying to work together to solve problems had made a huge difference. There are still departments that just do their own thing. I think if we lead by example and they see how good its working when we talk to each other then they will eventually get on board with it.

DEFINING STEPS TO BUILDING COMMUNITY AND PURPOSE I: Any last words, thoughts?

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P: Not really, I just want to thank you for taking an interest in this and for leading the brand ambassador group. Im looking forward to learning a lot from this. I: Thanks, Kelli. This was insightful and gave me a lot of really good information. Ill see you at the next brand ambassador meeting.

Interview with Director, integrail, work location: home I = interviewer P = participant

I: Describe your role.

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P: Well, my role is one of a kind its unique. Its entirely around a product thats not core to anything. The clients we service its a small world. I have been supporting integrail for so long I know how to do it with my eyes closed. But now we have the new piece the integrailRx, so now I have to work with just about every department in the company. Its account management or sales - can you give me info? Can you do a presentation? Can you meet with my client? I work with Finance. I work with Marketing. I work with legal, trying to develop contracts. I spend a huge amount of time with IT on infrastructure. Theres a direct tie to clinical with integrail so I spend a huge amount of time with them. I also have to deal with customers directly. I have really good relationships and good connections you know, account management doesnt understand my product so they actually like me to talk directly with clients. I: So what are some of the challenges you have? P: Well, Ive been here for ten years so, as I said, I have really good relationships and I know who to go to - to find out stuff. But coming into the organization its not intuitive where to go. You need to cross boundaries that arent intuitive. So, me trying to get this product up is like someone coming new into the organization. Even after being here for ten years, I had to figure out some of the places I needed to go to try and stand up this product. I was flabbergasted after all this time that I didnt know some of the corners of this company. I: How about communications? P: Communication falls down at different levels. Like, as an example, you work on a project then you wonder hey, what ever happened with that? Like, I worked on about ten proposals over the past year and I never hear whether we got the business or not. We never find out what the outcomes are. A lot of things fall into a black hole and youre like, what ever happened to that? Now, Marks communications are really good. If everyone communicated as well as Mark it would be great. And I know you know this because you work with him, but my boss sometimes makes decisions for me he talks to people and doesnt even tell me. It seems like were treated on a need to know basis instead of trusting. Some more senior people tell me things that others may not know because they trust me. Its sort of like working with you you showed me some of the brand stuff before a lot of other people saw it thats great, but not everyone gets that chance. I: Now youre touching on trust. P: Yes, we can probably trust a lot more people than we do. It makes people feel isolate, you know? We should be more transparent. As part of the GPTW group we are studying about ways to improve trust. There are some really cool things we could do. Like, at Boston Consulting Group you can listen in on senior management meetings. Why not make the monthly VP

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meeting one that people can dial into. Another tech company, I cant remember who, needed to make a major decision about the direction their company needed t take. They made it an open debate. That way everyone knew what was going on. GPTW has really been enlightening. It has proven to me that we really need to make communication available to everybody. I: Tell me about GPTW. P: Well, you know, because youre involved, but we were charged with developing a program that would make a big difference at SXC. We landed on this notion of great place to work and found an expert on the subject, Dr. Robin. Dr. Robin has been guiding us in our efforts and, as you know, you have been helping us figure out how it could become connected to the overall corporate change effort. I: Can we dive deeper into getting things done and how that works? P: I know what I need to do to get my job done. I know all of the other decisions that are being made that would impact my job. Not everyone knows what else is happening that might impact their job. Sometimes is a surprise and sometimes they find out by happenstance instead of good communication. Generally, I would say that people arent working as a tem and are fighting over resources. People get bitter over other people getting resources. But theres a lot of people thinking we already have a good company. We need to focus on the good. We should find out who works well and see if we can replicate it. Find a team like that and figure out what we do right. There are things that work well. We should use the steering committee to figure that out. Figure out whether its a structure or a process and what makes it work. Lining that up with GPTW makes a lot of sense. Back on how difficult it is sometimes, a department that I dont normally work with mad e me do a pulse ticket for a task I needed done. Well, I kept filling it out wrong and instead of helping me they just kept kicking it back to me. I kept losing a place in the queue and it took six tires before I got it moving. They were basically using the pulse ticket as a barrier to not have to do their work. You know, I never did a pulse ticket before and didnt have a template. Nobody picked up on my need to better understand the process. Relationships make most things happen for me. Because Ive worked to build relationships. Thats why Im in Lisle more than most. Also, having been here as long as I have, Ive had to figure out how to work the relationships. Ive also visited almost all of the satellite offices. It makes a big difference. One of the strange things about Lisle is that not everyone knows what goes on up on the 6th floor. I: Ive heard that people are nervous about coming up to the executive floor.

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P: Yeah, sometimes when they come to the 6th floor they actually check in with the receptinis instead of just going like to HR> Weird. I: Can I get some more detail on communication? What about communication doesnt work for you, for us? P: Communication up is better than communication down. Like I said before, sometimes my boss just communicates with others and does my job without telling me. Another example, its shocking to me that not everyone completed the survey you and Mark sent out after the NBC. We should find those people. They cant have their heads in the right place. We have tried to make this cultural change before there has to be real change to make it stick this time. Something that says we hear you to the employees, not just the status quo. We cant just take all of this information and not make changes. Perception is that nothing ever changes. Mark made allusions to getting rid of people who got in the way of cultural change. It hasnt happened. There needs to be promotions, demotions, getting rid of people anything that would make the environment better. I: Tell me about your ability to make decision. P: Ive been told by certain senior people that I need to make decisions around integrail. Well, sometimes I make decisions that have an impact on resources and I dont control resources. Ive talked about my boss making decision over my head. I feel like I have a title with no ability to direct. You know, all the meetings are VPs and me. The advice I get is to step it up and direct. Theres always somebody else with an opinion who has more authority. Everything I do I have to do collaboratively. Carl creates negative relationships because his style is to barrel through to get to his date. On the other hand, I can get around the process with relationships. The best way to get things done is to support, not push people under the bus. Sometimes I feel like there is too much pushing under the bus by people to make themselves look better. We need to get to a point where we are all working for the same thing. I: Have you seen anything meaningful in terms of change? P: The perception is that there has not been much action. Maybe its just not transparent. Theres a perception that theres too much focus on the stock price and not enough focus on employees. We need to walk around more. We need to take control. Executives are too busy running around. Im not meaning to imply that theyre not doing their jobs, its just that theres a lot of talk and no action. I also get the sense that decisions are made very slowly. The company is too bureaucratic. Its structured way too much by department. The whole HCIT informedRx divisions just create a greater chasm.

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Account management can spend hours getting one little thing done. Its like ten phone calls, twenty emails. Our systems dont support anything beyond claims processing. We may be really good at that, but we are definitely not enabled by technology. We have to get everything from five different places. Everything is cobbled together from acquisitions, our own developments and outside vendors. Nothing talks to each other. Ill tell you everyone has their own workarounds and theres a million examples around the company. That is proof that things dont work as they should. We get it done, but not efficiently. So, clients are requesting medication possession ratios. Analytics isnt doing it because our systems dont talk to each other and we cant get at it. They are having to grab resources from my unit to be able to get it done. We need our systems integrated. And we need to get scaled up way up. I: Were out of time. Any closing thoughts? P: Like I said, I think we should find out where we are doing it right and replicate it. To me, that would be the biggest thing. Showing how, showing best practice. I: Thanks for your time. Im going to give you the transcript so you can look it over. P: Thanks, Susan.

Interview with Account Executive, location: Lisle

I = Interviewer P = Participant

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I: Tell me about your role. P: Ive worked on the same account the entire time Ive been here I: Whos that? P: Prescriptions Solutions they are our largest Part D client. Im a senior account manager (laughs) Im the only one in the company. My role is to train and mentor people who come in Im a resource for them. I also assist the informedRx side of the business. I deal with a lot of enhancement requests so I work with Amy in product development and Jim in IT development. There are existing perceptions about account management that are really disturbing. It happened all because of a restructure we did three years ago. We used to be grouped into Commercial, Operations, which was ASP clients and Part D, which was Medicare Part D and claim. So there were three sections. There was a group of account managers who couldnt grasp RxCLAIM so we restructured. There was a perception that we were cutting and pasting when we put in IT requests, because we didnt know what we were talking about. There is now three levels of technical knowledge. The people like me serve as mentors and take the most difficult and high profile clients. The people who have mid level knowledge have clients. The people who really dont have enough technical knowledge do the internal grunt work to support the external account managers. But its still bad. Some account managers dont have enough knowledge. When they make requests the people in development extrapolate that we are all dumb. I have to combat that every day. Theres a task force getting together to figure out how to fix it. I: Talk about the culture at SXC. P: There are three things that contribute to the bad culture. The first one is that theres an inability to communicate on the same technical level. If I call a developer I know what Im talking about. Some dont. They cant speak the same language. Second, theres incorrect perceptions about people and departments. Nobody knows what other departments do. Its a big problem because we dont know whats happening thats going to impact our jobs. The third thing is that theres a lack of humility and being teachable. It starts with upper management. They need to be patient enough to teach us. Take the time to whiteboard it. That never seems to happen. Its all about getting tasks done. All of the communication revolves around the task at hand. It doesnt help us become stronger or more capable. Its just more of the same. It may take more time up front, but it pays off, you know?

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Theres simple things, like look up from your keyboard when someone walks up to your space. Overall, it just seems like we are too busy and crazed about getting the task done. Communication is just way too focused on tasks instead of being global or strategic. I know that Bill tries to get it done but he gets busy, too. I started when there was 200 people. Its different now with so many people its very cliquey and hard to break into a group. Account managers are viewed as the redheaded stepchild. We always get blamed for stuff that goes wrong. It becomes save the client or yourself. Truthfully, I make decisions knowing Ill take a hit internally. Ill make the right decision on behalf of my client every time and worry about how pissed people get later. The view is always that we are too client oriented and not enough SXC oriented. At the end of the day Im always going to be a client advocate. I: Talk to me about communication what works, what doesnt? P: Well, theres always room for improvement. My manager is good at passing along information between and within teams. But I dont really know what other departments do. But I dont really have time to sit in a session and listen. Politics get in the way of a lot. I: What do you mean by politics? P: People are concerned about their own necks. Or theyre concerned about making sure they fall in the favor of important people. They want to make sure they, well, they make decisions based on what other people would think of them. I: So what do you think gets in the way of our mission. Youve seen it, right? P: Of course. You guys have been talking so much about it how could you miss it? I think its having to go up the chain to get things done. If someone doesnt like me they make me suffer and the client suffer to teach us a lesson. The big issue doesnt get dealt with and thats the people who put up barriers and dig in their heels. Theres a level of protection around that person. If there are some good attributes they look past the bad behavior. They sweep the bad stuff under the rug. I have to take my client at face value. I know how to get things done. If I need to, I know how to go around the appropriate area to get things done. I can go to where I have an established relationship instead of going through channels. People use pulse for buying time. They use missing data, sending to the wrong place, whatever. Anything to avoid doing work. We lose our place in the queue and we get the runaround. It sucks. Expectations arent set on turnaround time. I wish people would let me know what to expect. Because all of the communication is email or sametime, its hard to set expectations.

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Email is another big black hole. Half the time I dont even get a response. I dont get why its ok to not respond. Lately, if there is more than three emails in a string, I stop it. There are just too many channels to go through. Because everything is disconnected, its really complicated to get things done. Silos dont make it any easier. I used to do a lot of things for the relationships. Like bring in cookies and stuff. I want people to give me their best so I try to give them my best. One of the biggest issues for me is career path. It doesnt really seem like theres an opportunity for growth. We need motivations and incentives that make you feel like you have the right opportunity. I feel like I am tapped out. And because we are the redheaded stepchildren, nobody wants me. Every time I try to scope out a position in another part of the company, I feel like because we are labeled as being stupid, I dont get the opportunity to branch out and do anything different. But I dont want you to think its all bad. On a scale of 1-10 I would give it a 7 in terms of lining it. I love the work, the issue I struggle with the most is career path. I: What works well for you? P: Well, I know youll find out. I date Scott Canavan, but his department is the best tech support (laughs) I know what youre thinking. I: No, I trust that if thats where you get the best service, then thats what works the best for you. P: I say that because theyre finishers. When you need something done you know they will get it done for you. They are smart people and theyre good about not trying to differentiate whos important or not, irrespective of the client. All clients should be viewed as important. Also, they dont play favorites within account management. There are favorites and it makes it hard for some people to get things done. I: Do you have any specific ideas on what could be done to change culture or make it easier to communicate? P: I think we have a behavior contract its what we commit to. It needs to include what we commit to in terms of respect, how you behave and to respect the values of others. Theres a lot of professional immaturity that needs to be dealt with. Thats why I think we need a contract. We need to understand that everyone views their work as important. I think if leadership would model some of these things we would follow. I: We are out of time. Any last thoughts? P: No, Im really happy that you asked me to participate in this.

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I: I will be giving you a copy of the transcript so you can make sure its accurate and to add any comments you may have.