[Series 5] How I Used McKinsey-Style Logic to Revitalize a Hopeless Facility with a 60% Turnover Rate [Chapters 4 & 5] Turning Meetings into 'Decision-Making Forums'

Author: Ryosuke Kosaka (Social Welfare Corporation Ichigo-kai)
Recipient of the Prime Minister's Commendation and the Minister of Health, Labour and Welfare's Commendation for Creating a Workplace Environment Where Care Staff Can Work Easily; Recipient of the Minister of Health, Labour and Welfare's Encouragement Award; Recipient of the Grand Prize (No. 1 in Japan) from the Care Work Stabilization Center

👇 Previous article: [Series 4] Chapter 3: The Prehistory of the Ultimate Weapon 'CKP'

Turning meetings into 'decision-making forums'

Until the day a 1.5-hour report meeting opens in 30 minutes

[Chapter 4] Turning meetings into 'decision-making forums'

A room where no one speaks for 1.5 hours

The first meeting I attended after joining was a leader meeting.
A monthly meeting where 15 people gathered.
The scheduled time was 1.5 hours.
I sat at the end of the table and just watched.

Even when the start time arrived, not everyone was there.
Messages came in saying they would be absent because 'the floor is too busy'.
The faces of the leaders who had gathered were exhausted.

Some people were sitting with their legs crossed.
Some people were still wearing their hats.
Some people were sitting with their arms crossed, looking at the ceiling.

The facility director began reading the documents aloud.
The number of residents admitted and discharged last month. The status of infectious disease outbreaks.
Notices of shift changes.

One-way words just flowed by.

'Does anyone have any opinions?'

No one answered that question.
The silence lowered the temperature of the room.

The facility director moved on to the next agenda item.
Agenda items had not been collected from the participants in advance.
Perhaps even if they had been collected, nothing would have come out.

The meeting did not end even when the end time arrived.
1.5 hours. Just listening to reports, and nothing was decided.

It was just a report meeting with the name of a meeting.
I didn't say a single word for 1.5 hours.

There were too many things I had to see before I could open my mouth.

――――――――――――――――――――

In my previous job, I was in 'decision-making meetings'.
In a project led by McKinsey, I reported progress to the Vice President every week as the person in charge on the Taiyo Yakuhin side.
In that room, meetings were mechanisms for decision-making.
Narrow down the issues. Present the facts. Reach a conclusion.

Decide on the next move.

Meetings where nothing was decided were not allowed to exist.

To my eyes, coming from that world, this 1.5 hours looked like a different creature.

'They just don't know how to hold a meeting'

While sitting silently, I kept thinking about what was broken in this room.
Eventually, one phrase settled in my heart.

'These people just don't know how to hold a meeting.'

It's not that they lack motivation. It's not that they have low ability.

It's just that no one had ever taught them what a meeting was. That's all.

This assessment was decisive.

If you diagnose them as 'unmotivated people', you end up blaming them.

If you diagnose them as 'people who don't know how to do it', you end up teaching them.

Blame or teach.

This difference determines everything that follows.

――――――――――――――――――――

First, I asked the meeting organizer.
'What is the purpose of this meeting?'

The answers that came back were two.
'Because it's decided that we do it every month'
'Because we have to convey important things'
With those two, I understood everything.

The first answer means that this meeting has no purpose.

There are meetings that exist only because they have been done before.
That's it.

The content is not questioned.

The second answer means that this meeting is a 'device for conveying from top to bottom'.

The participants are passive.

They are not contributors.

The reason the leaders were sitting with their legs crossed with tired faces was here.

That meeting was not for them from the beginning.

An organization rots from the head

I have one belief that I will not compromise on.
An organization rots from the head.

Executives receive a decent salary. Therefore, they must be a model for their subordinates.

They must work three times as hard as others.

That thought has not changed since the day I joined.

Therefore, before touching the meeting itself, I first touched the head.

The facility director and two nursing care supervisors.

I taught these three people 'what a meeting is'.
A meeting is about making decisions.

'5W1H' Who, what, when, where, why, and how.

Only when that is decided is it a meeting.
The time spent reading reports aloud is not called a meeting.

The three of them had resistance and confusion.

It's no wonder.

After all, they didn't even understand what a meeting was in the first place.

So, I told them this.
'I will teach you how to do it. First, please imitate that.'

Understanding can come later.
First, imitate.

This was the same thing as the CKP (Copy, Keep, Perfect) I wrote about in Chapter 3.

Even if you teach them, they won't change immediately

I prioritized the way I taught. I didn't make them do the real thing right away.
1. First, I demonstrated by role-playing.

2. Next, I gave a lecture.

'Why do we hold meetings?'

3. Then, I taught them how to prepare for meetings.

When and how to distribute the agenda to participants.

I narrowed down the rules to follow.
One, always keep to the end time.
One, everyone must be present at the start time.
One, distribute the agenda in advance.
Just that much.

Even so, it didn't change immediately.
Even in meetings after the training, things didn't go well.
That was to be expected.
People don't become capable just by being taught once.

So, I added another mechanism.

4. Every time a meeting ended, I gathered the organizers and gave feedback.

First, I thanked them for their hard work.

Next, I specifically pointed out and praised what they did well.

After that, I gave them areas for improvement, saying, 'It might have been better to do it this way.'

I didn't get the order wrong.

Start with approval, then move to improvement.

This was the same model I used in executive interviews.

Be strict with standards. Be warm with how you deliver them.

――――――――――――――――――――

I kept that cycle going.
The first to change were not the participants.
It was the organizers.

Where there had only been one-way reports, questions to the leaders began to emerge.
Proposals began to emerge.

The meetings gradually moved closer to being a 'place for decision-making.'

The participants' attitudes didn't change.
Sitting with legs crossed, wearing hats... at this point, I didn't dare point it out.

Because there was an order.

There is no point in blaming the participants while the organizers have not yet become role models for the leaders.

The head becomes the role model.
Seeing that, the front line changes.
An organization can only change in that order.

'This is a job that will leave your name in the history of the Ichigo-kai'

In January 2021, I created a draft of the evaluation system.
However, I did not have the management complete and distribute it.

Most evaluation systems in the world do not permeate the front lines.

Why?

The reason is clear.

It's because they didn't create it themselves.

Even if measured by a yardstick decided by someone above, people don't make it their own.

So, I decided on the criteria for the evaluation items together with the 12 unit leaders, the facility manager, and the nursing supervisor.

'This is a job that will leave your name in the history of the Ichigo-kai'

I said that to get them involved.
I don't mind if you say I flattered them.

What is important is the feeling that they decided it themselves and created it themselves.

The first item on the evaluation sheet for general staff was 'Always keeps time and promises.'

Items like these were lined up on the evaluation sheet for leaders and chiefs.

'Subordinates are not pawns. Respect the other party on an equal footing.'

'Do not act with a low posture toward executives and superiors while being strict with subordinates.'

It's not about scolding them to fix it.
I wanted them to read the items they decided on themselves and realize, 'This is bad.'

By creating this evaluation system together, the unit leaders' sense that 'we are building the facility' began to sprout little by little.

Outside the workplace, people show their true faces

In parallel with the introduction of the evaluation system, I tried one more thing.

A club activity system.

This was a CKP of a case study of an excellent company I learned about in EMBA.

I heard a story about a company in Fukui Prefecture that strengthens horizontal connections among staff by activating in-house club activities.

I thought, 'Can this be used in our nursing facility?'

The industry doesn't matter.
Mechanisms for people to connect with people work in any workplace.

The first ones I created were a baseball club and a mahjong club.
Why these two?
To be honest, it was because I wanted to do them.

I have always thought that just because we are in the nursing industry, we don't need to look for reference cases only within nursing.

Translate the wisdom of good companies around the world to the size of our front line. That is CKP.

The baseball club was centered around a staff member named Maeda, a care manager.

With his natural brightness and lighthearted talk, he gathered members one after another.

Monthly practice became a staple, and we even started participating in nursing organization baseball tournaments.

Staff who have worked on the same floor but have hardly spoken to each other naturally converse on the baseball field.

They talk about work, and worries come out too.
If hobbies match, people show their true faces.

Relationships in the workplace are defined by work roles.

But within the club, roles become irrelevant.

That 'role-free' space becomes thefoundation of trustwhen they return to the workplace.

What is important is whether'a place where staff can enjoy themselves'exists.

A room that opens in 30 minutes

It was in 2022 that I made meetings '30 minutes.'
It was the year I went from being an administrative manager to a facility manager.

As an administrative manager, this was as far as I could go.
Teaching. Coaching. Designing systems.

However, I could not force the structural change of 'ending meetings in 30 minutes.'

That is a decision made by the head of the organization.
It was only after becoming the facility manager that I could draw that line.

For reforms that require authority, you need to design the order in which you obtain that authority.

――――――――――――――――――――

Everyone was present at the start time.
Materials were neatly lined up on the desks.

There were smiles on the leaders' faces.
They were accepting what I had to say positively.
Nodding.
Taking notes.

The attitude of listening was clearly being conveyed.
When I spoke, it got through.
I definitely felt that response.

Two years ago, in this same room, I couldn't hear anyone's voice for an hour and a half.

That room, where people sat with their legs crossed, wearing hats, and looking sullen.

In 30 minutes, it opened up.
People change when they know how.

If you know that, there is no need to blame them.

Meetings were no longer just reporting sessions.

People were no longer just pawns.

How many minutes do your meetings last?

'Meetings where nothing is decided' kill organizations.

Just by setting a single rule of 30 minutes, the nature of meetings changes.
If you have the authority, I want you to start tomorrow.

In the next chapter, I will write about another site that supported this revitalization.

It is a record of the dialogue with the executives and my father, the board chairman.

――――――――――――――――――――

Chapter 5: 'I'm counting on you,' my father said

The redesign of the organization began with a dialogue with the top

The archives existed

When I decided to rebuild the organization, the first thing I tried to do was not reform.
It was understanding.

I still knew nothing about this corporation.
You cannot change what you do not know.

Work rules, management policies, building blueprints, procedure manuals for each task, and so on.
I asked my father, the board chairman, where the documents that form the foundation of the organization were.
And I also asked the facility manager.

The answer that came back was the same from both of them.
'I don't know.'
'I have no idea.'

Neither the father who founded the corporation nor the facility manager entrusted with its operation could answer where the foundation of their own organization was, or even if it existed at all.

I thought, asking these guys is useless.
And I also thought that the staff working under such a leader were pitiful.

After that, I stopped asking them.

I searched the archives all by myself.
I pulled them out one by one and investigated.

――――――――――――――――――――
Work rules, management policies, blueprints, and procedure manuals.
They were properly inside the archives.

This was a heavier fact than an organization without documents.
The foundation had existed from the beginning.

It was just that the head of the organization was completely disconnected from it.
They didn't even know it existed.

An organization rots from the head.
Soon after joining, it was proven right before my eyes.

In the board chairman's office

A few days later, I entered the board chairman's office. It was just me and my father.
I asked him directly.

'Why are you keeping someone like that as the facility manager?'

My father explained the circumstances.
The previous facility manager had been guilty of severe power harassment, so he was let go.
At that time, he had no choice but to ask the person who was a counselor then to become the facility manager.
Because there was no one else who met the requirements for a facility manager.

It made sense.
It was a painful personnel decision made after being backed into a corner.
I understood that.

So, I asked what came next.
'That aside, why didn't you, as the board chairman, develop that facility manager?'

If you appointed them out of necessity, it is even more the job of the head to develop them.

The problem is not the constraints of personnel.
It is the subsequent absence of development.

My father could not answer.
That silence was the answer.

――――――――――――――――――――

'You are the head of this corporation. Please fully understand that you are the one causing this current situation.'

I didn't yell.
I called him 'you,' not 'Dad.'

I directed my words not as a family member, but toward the position of responsibility that is the board chairman.

And one more thing.
'You want to manage in a way that values people!'
'If you say that, you have to lead by example.'

That was my father's own dream.
It was the reason he said 'Can you help me?' in that phone call that night.
I was throwing my father's dream back at him as a demand.

My father got half-defensive.
'I know that!'

He says he knows.

But he couldn't answer earlier.

There was a deep chasm between 'knowing' and 'doing.'

That chasm was the very reality of this corporation.

I posed the final question.
'Can you do it yourself? Or can't you? If you can't, I will do it. In exchange, I will do it thoroughly, so please don't complain.'

It was a binary choice.

A question with no escape.

My father was silent for a while, and then he said,

'I'm counting on you.'
It was one word.

The 'Can you help me?' from that night's phone call had stripped away all the cushioning in the board chairman's office and became 'I'm counting on you.'

My father completely entrusted his life's work to his son.

Every reform I write about in this book—meetings, evaluation systems, hiring—
became possible starting from these two words.

'What are you struggling with?'

I had been given full authority.
However, I didn't use that power to go and fire anyone.

First, I had a meeting with the facility director, who was at the top of operations. I asked only one thing.

'What are you struggling with?'

If you attack, people get defensive.

If you grill them, you get excuses in return.

That is why I did not blame them.

I simply asked about their troubles.

After a while, the facility director said quietly,
'I can't do it.'

In truth, I had been looking at this person critically.
Even so, this statement would never have come out under interrogation.

It came out because I gently asked, 'What are you struggling with?'

It was the same structure as my father's 'I'm counting on you.'

The facility director wasn't a bad person; he was just drowning.

'I will do everything I can. So, will you entrust this to me?'

The facility director said,
'Please, I'm counting on you.'

My father said, 'I'm counting on you.'
The facility director said, 'I'm counting on you.'

Two people at the top, pushed to the brink, entrusted things to each other with almost the exact same words.

――――――――――――――――――――

I continued to use this question, 'What are you struggling with?', long after that.

In executive meetings, leader meetings, and individual 1-on-1s with general staff.

I start with one question.
1. 'Please tell me what you have been working hardest on lately.'

I start with validation.

2. Then I continue with, 'Is there anything you are struggling with or finding difficult right now?'

This is a question that draws out true feelings.

3. I then ask, 'If you could change just one thing, what would you want to change?'

This converts dissatisfaction into a request.

4. Finally, I close on a positive note: 'Is there anything you would like to try doing next at this workplace?'

I never change the order.
Start with validation, and end with improvement.
True feelings only emerge in this order.

5. And, I always respond to the voices that emerge.

I do not use the phrase 'I will consider it.'

I give a clear yes or no answer on whether it can be done.
If it cannot be done, I explain why.

The despair of 'nothing changes even if I say something' kills an organization.

The track record of 'they actually took action when I spoke up' brings an organization back to life.

Bowing my head and saying, 'Please teach me'

The remaining executives were the two nursing care supervisors.

Just like with the facility director, I met with them individually, one by one.

True feelings do not come out in a group.
People only tell the truth one-on-one.

The reaction I got was the exact opposite of the facility director's.

'What can this guy who just showed up do? He doesn't even know nursing care.'

'We are the ones who built this facility. I just hope he doesn't do anything weird.'

They didn't say it out loud, but I could tell from their expressions and attitudes.

The facility director was drowning and said, 'I can't do it.'

The nursing care supervisors braced themselves as if to protect their territory.

I did not fight that territory head-on.
I said this:

'Look, I'm full of questions because I don't know anything. I'm going to ask you a lot of things, so please teach me. I'm counting on you.'

I did not deny their attack that 'you don't know nursing care.'

I admitted that they were right.

And then, I bowed my head and said, 'That is why, please teach me.'

What they wanted to protect was the pride that they had built this place.

Therefore, I entered their inner circle not as someone who came to take away that pride, but as someone who came to learn from it.

――――――――――――――――――――

The effect of bowing my head was greater than I expected.

By continuing to say 'Please teach me,' the supervisors gradually began to talk to me.

They told me about the reality of night shifts.
The harshness of one person being responsible for 20 residents at night, the exhaustion on days when the nurse call keeps ringing, and the reality of having to work the day shift the next day anyway.

They told me about their relationships with the residents.
The meaning of building trust, where even as residents with dementia repeat the same things every day, you still learn their faces and names, and build up the relationship of 'you came to see me again today.'

In the world of nursing care, countless hours that cannot be seen in numbers were piling up.

If you talk about 'efficiency' without knowing those hours, the staff will push back.
That is only natural.

Conversely, if it is conveyed that the attitude of 'please teach me' is genuine, people will teach you.

Do not fight pride with force.

Accept it, honor it, and utilize it.

It was the same approach I used when I called the staff 'lights' in Chapter 2 and decided to become a 'translator' in Chapter 3.

Redesign rises from the voices we hear

In this way, I gained full authority from my father, the facility director entrusted me with it, and I also gained the trust of the nursing supervisor.

From here, the organizational redesign began.

However, the blueprint was not something I pulled out of my McKinsey-trained mind.

It was provided by the nursing supervisor, who had bowed her head and said, 'Please teach me.'

We are short-staffed.

They said they were at their limit in running the floor.

That pain became the first pillar.

Recruitment reform.

One more thing.
Ms. Kawamura, who left me a LINE message on the first day in Chapter 1.
I had been continuing to help with her work.
From that assistance, the second pillar emerged: labor reform.

The redesign did not rise from my blueprint, but from the pain expressed by the staff on the front lines.

From the voices of those I had crushed.

From the tasks of those who were drowning.

Listen first, then design.

Whether in meetings, evaluations, or here, my approach never wavered.

――――――――――――――――――――

'What are you having trouble with?'
The first time I used this question was during an interview with the facility director.
But before I knew it, this question had become the core of my 1-on-1s with every staff member.

To listen is to give.

People are moved more by being listened to than by being told the answers.

That conviction never wavered throughout the entire organizational revitalization process.

Have you asked your subordinates, 'What are you having trouble with?' lately?

You don't need to blame them or evaluate them; just listening is enough.

That alone will change the words that come back to you.

Once the words that come back change, you will see what you need to do next.

In the next chapter, I will write about how we changed that first pillar: 'recruitment'.
This is the record of how an organization with a 60.3% turnover rate began to attract people and stop them from leaving.

＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿
▶ Next article: [Series 6] Chapter 6: 'You hired good people'