Creativity in Healthcare: Ideas and a High-Performance Culture | Ep.34

The Healthcare Leadership Experience Ep 34 Creativity in Healthcare: Ideas and a High-Performance Culture

The “Courageous Carol” Icebreaker Brakes Down Barriers at Hospitals.

In Episode 34 of The Healthcare Leadership Experience, Lisa is joined by Carol Turano, facilitator of VIE’s EXCITE! program and a qualified ropes instructor. Together they discuss innovative approaches to solving challenges and the benefits of experiential learning. 

As Lisa comments on the origins of EXCITE! ‘‘I thought, wouldn’t it be unique if we could take this outdoor experience and bring it inside into a two hour workshop, we’ll call it EXCITE! It’s between 12 and 14 people, could we replicate that indoors?’’  

This episode is sponsored by VIE Healthcare Consulting® which has proudly helped hospitals save $772 million since 1999. 

In this episode you’ll hear: 

  • From college athlete to licensed social worker, therapist, ropes instructor and VIE’s EXCITE! Workshops facilitator, Carol’s eclectic career journey. 
  • The adjective name game; how the ‘’courageous Carol’’ icebreaker broke down barriers at one hospital. 
  • The problem solving step of EXCITE! that brings people together; replacing the ‘’put down’’ with a ‘’put up’’. ‘’It reminded me of our use of language. If we want to engage, we have to be positive.’’
  • Successfully transforming a multi-day outdoor concept into a two-hour workshop, exceeding all expectations. 
  • The goals of EXCITE! in a hospital setting; generating margin improvement and cost saving initiatives for healthcare leaders; ‘’…engaging teams, making it fun, challenging, connecting and coming together .. solving a strategic initiative challenge.’’
  • The three ways innovation happens – and why creating workshop time is so important. 
  • The ‘’whip arounds’’ that ensure every hospital employee has a voice at the workshops. 
  • Scaling the heights, one step at a time; how one young woman made a huge breakthrough on the ropes. 
  • The EXCITE! testimonials that speak volumes ‘’…the best training ever received at a hospital.’’
  • Carol’s challenge of 2022, creating a virtual EXCITE! program, and learning from Tony Robbins. 

Watch out for virtual EXCITE! workshops coming from VIE Healthcare in 2022. You heard it here first! 

Connect with Carol:



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Episode Transcripts



Introduction (00:02):

Welcome to the healthcare leadership experience radio show with your host, Lisa Miller. Lisa is an entrepreneur, inventor, advisor, and founder of VIE Healthcare Consulting, the leading healthcare advisory and analytics firm, helping hospitals accelerate their margin improvement goals. Lisa loves to think differently and collaborates with leaders and their teams to solve challenges and to create new innovative approaches that impact the clinical and business side of healthcare. Our show will bring you leaders and innovators within healthcare and across multiple industries. Be a part of the discussion that will give you a unique perspective, deep insights, and roadmaps to successfully help you navigate the clinical, financial, and operations of healthcare. Your show starts now. 

Lisa Miller (00:49):

Hello, you’re listening to The Healthcare Leadership Experience on HealthcareNOW Radio, I’m your host Lisa Miller. Welcome to the show. Today we have a very special guest, Carol Turano who works at VIE, and helps us with a program, or leads the program as a master facilitator we call EXCITE!. And I will share a little more about EXCITE! in a moment, but first welcome, Carol. 

Carol (01:15):

Thank you, Lisa. It’s a pleasure to be here. I’m, I’m happy to be talking with you.

Lisa (01:20):

Great. So as just an entree into what we’re gonna talk about today, which is experiential learning, and the physicality of being on a ropes course, and integrating that into a learning atmosphere, can you give everybody your career, your experience? It’s a little more diverse and interesting, and just how you became to, you know, add experiential learning and being a ropes course instructor into your career? 

Carol (01:50):

Okay, great. So I’m a licensed social worker. So I did therapy with teenagers, and families, and adults for years through a grant-funded program that was based in a school district. It was really an interesting profession ’cause we had the ability to do various things. We were able to implement all kinds of programming that we thought would help families, individuals grow therapeutically. So I did that. I was a college athlete prior to, you know, my work experience, my professional work experience. That’s kind of my background. That’s where I came from. 

Lisa (02:32):

So interesting because I picked up a nuance I hadn’t thought about previously. And I wanna bring it into the conversation. And what made you decide that you wanted to add ropes course to your kind of expertise and your skillset? Since you, since you are a social worker, you know, you’re a therapist, you work with kids really in, um, kind of helping them through their challenges. I think there’s an interesting correlation there. What made you decide to become, uh, an instructor and really also teach and help other people become instructors? 

Carol (03:05):

Right. So it’s an interesting story. I was taking students away for, you know, an experience in the summer. And it was my first introduction to a ropes course. And I was hooked. I was hooked from the moment I started. It kind of grabbed me and, you know, took that part of me, my athletic part. And then it kind of meshed it with my therapeutic part and I said, “Wow, this is amazing.” And from that moment on, in my head, I was like, “Yeah, we’re gonna to do this. I’m gonna do this. This is gonna be a really great therapeutic learning tool for me.” 

Lisa (03:46):

So it’s interesting because you saw the correlation with your students and it being another therapeutic way to have breakthroughs, and for them to learn in an environment, can you just take our listenership through a ropes course experience so they can visualize what that is? 

Carol (04:08):

Absolutely. So the thing about the ropes course is it really melds all the types of learning that individuals have. Like, some people are, uh, kinesthetic learners. Some people are visual learners, and some people are auditory learners. And then some people, you know, we all learn through an experience that connects to emotions. The program begins very lightly with icebreakers, you know, your typical icebreakers, name games and those kinds of things. So as a group, we get to know each other on a personal level via name. 

Lisa (04:42):

So I wanna jump in for one second, ’cause I know this, and I want you to continue. Remember when we did this at one of our hospitals? And I can’t remember the woman’s name, maybe you’ll remember it, but we had a C-suite executive, and then a manager who it really didn’t work well together, but because of the icebreaker, but they would crack up when they saw each other in the hall. And it really embarked for them on a new relationship, a new working relationship. And I can’t remember what her name was. 

Carol (05:10):

I don’t remember her name, but I remember the experience, yeah.

Lisa (05:13):

Yeah. So give the audience an example of the name game. Like for you, uh, you have to, like, an adjective in your first name. So you could be curious Carol, but this name that she had for herself was just so bold and everyone just cracked up and it, it just, it was like a, a mini breakthrough. 

Carol (05:29):

Yes. It’s part of the initiatives of, you know, breaking people down and, and getting a group of people who either work well together, and kinda changing that working relationship, you know — as well as people who don’t even know each other coming together in a very short period of time, and feeling like they have this long term comradery. So one of the games that we would always do is a adjective name game. So if my name’s Carol, ’cause we were on a ropes course and we did crazy things, I would always call myself Courageous Carol, right? And I would always say the more crazy it was or, you know-

Lisa (06:04):


Carol (06:04):

Yeah. The more fun it was, people are gonna remember your name or your adjective, right? So it was always fun to see some people, you know, pick their adjective. And so that was one of the games. And so you would say hello to everybody and you would have to say their adjective as well as their name. 

Lisa (06:20):

And what else do you do beyond that? Now we do the icebreakers, but what else is part of that experience? You know, just as an overview. 

Carol (06:27):

Right. So it’s a step program, basically you get to know each other by name. And then the next thing we do, it’s called a, um, initiative. And it’s kind of like a little bit of a problem-solving game, right? So it kind of moves them into the problem solving, or the brainstorming, or the working together in creating this communication that they need to use. We had rules. You couldn’t say mean things to people. If you said something that was a negative comment to somebody you owed ’em, you know, a put up- 

Lisa (06:58):

What does that even mean? We have a culture of kidding around, but our kidding around is a backhanded meanness, you know? Like, so you won’t even allow that. You don’t even allow, you know-

Carol (06:58):


Lisa (07:08):

… just people in a slight way to do a tear down. You know, everything is, and then you have to owe them a couple of pick me ups

Carol (07:08):

Put ups.

Lisa (07:15):

Put ups.

Carol (07:15):


Lisa (07:15):

So, and a put up, can be like, oh, you know, I like your shoelaces. It’s, it’s fun. And people crack up, but I think it’s, that always for me, reminded me of our use of language. And you know, if we really wanna engage in a way we’ve, we’ve gotta be positive. And sometimes we don’t do that so well. 

Carol (07:33):

Right. It recreated the boundaries for the communication for the group to really feel comfortable to share ideas or thoughts without feeling, oh, somebody’s gonna put me down. So anytime there was a put down, we stopped what we were doing, and we waited for the person who did to put down to give that person the, you know, that other person two put ups. And it really stopped it very quickly, you know. 

Lisa (07:56):

Yeah. It did. And people are funny, ’cause then they have to say, like, really, a couple of really nice things, you know, really thoughtful things. And it also is, uh, a state change too. You know, it did stop things right away. So it leads me into really the heart of our conversation today, and my second question. And so about 15 or so years ago, I came to you and said, what if we could bring your outdoor experiential training ropes course inside. Now, we’ve taken some hospitals and we’ve, we’ve done some of those activities and you’ve done it quite a bit. Not just for teens, you’ve done it for businesses, colleges, but I thought, wouldn’t it be unique if we could take this outdoor experience and bringing it inside in like a two-hour workshop, we call it EXCITE! It’s between 12 and four 14 people, could we replicate that indoors? 

And you, at the time you were like, “No, Lisa, this can’t be done. The whole purpose is to be outside. Look VIE, at VIE we’ve done it. We’ve got great stories ’cause we’ve done it. Yeah, I think twice now. And we did it, you did it. Together, we kind of put together EXCITE!, which is, you know, engaging employees for excellence and continuous improvement for their ideas and innovation within team environment. So it’s, it’s a little long, but it, it gets to the heart of the matter. So can you talk about maybe at first, when I said, can you bring this inside indoors? Can we replicate it? And then, you know, your thoughts as really it was successful. It is successful. 

Carol (09:19):

Yeah. I remember that conversation very well. And I remember my internal thinking was, ugh, that just takes away from the whole idea of a challenge course, a ropes course, like, it’s, it’s physical, it’s demanding. It requires you to step up out of your comfort zone and do all these things, and it’s immersion. And those were all the things I really loved about it. And I thought, yeah, this can’t really be done to the level that I would like to do it. You know, in an indoor setting for two hours, we were usually out for a whole day, sometimes two days, sometimes five-day programs. So, you know, you wanna pack that in. And so I thought it couldn’t be done. And then in truly of fashion, you were like, “Well, just think about it, and let’s just try it.” And here we are discussing that it was really a successful endeavor for us. And yeah, we just had to change it. And I had a look at it because people that we were gonna do the program with didn’t know what I knew that they weren’t getting. This was all they knew, so for them it was really exciting and interesting and different, a different way to, to do a team meeting. So I had to get that outta my head a little bit of, you know, ugh, they’re gonna miss out, cause they didn’t know what they were missing. 

Lisa (10:34):

Right. And the whole idea behind doing a site workshop from my perspective was doing all the things that you’ve done outside in a ropes course, which is engaging teams, making it fun, challenging, connecting — and then coming together and solving some kind of a strategic initiative challenge, or, you know, getting cost-reduction ideas from the group, or revenue margin-improvement ideas, or, or circled around a specific strategic goal. We do a lot of this around cost savings, of course. And it’s interesting because, you know, innovation happens in three ways, right? It’s a customer challenge we see and we’re gonna innovate. It’s an internal challenge, a manual challenge we look to innovate, or it’s a facilitated shop approach it’s centered around a specific initiative. And so really taking time, you know, really to look at all three, in fact, but creating this facilitated workshop time is so important. 

And after our short break, I have a few more questions for you. If you’re just tuning in, you’re listening to The Healthcare Leadership Experience Radio Show on HealthcareNOW Radio. I’m Lisa Miller, your host. Today I’m joined with Carol Turano. We’re having a great conversation around experiential learning. I have a challenge for her soon to answer, and we’re really discussing innovative approaches to solving challenges in this experiential environment.

The show was sponsored by VIE Healthcare Consulting, the leading healthcare advisory and analytics firm, helping hospitals accelerate their margin improvement goals. VIE has collaborated with healthcare leaders and their teams to accelerate their strategic initiatives and improve their financial performance since 1999. If you wanna learn more about VIE visit us at VIE, V-I-E,

OK, Carol, we are back talking about EXCITE! workshop, kind of transitioning from outside to inside. And there’re a couple things I wanna say. And we’ve done these programs over the years throughout the country. And we’ve had some great testimonials or things people have said, and, you know, everything from, oh, it’s the best training I’ve ever received at a hospital. They were so excited to continue the process to, I now understand that I can turn a problem into an opportunity for a hospital. 

I even just have so many of these comments. And I remember, I don’t know if you remember, we did one, that we kind of mix up leaders in different departments, and we make it cross-functional. And I remember the one where we started and she, this woman was a, a leader in the hospital, and she basically came in her arms crossed and, like- 

Carol (10:34):


Lisa (13:09):

… not another one of these trainings. Do you remember that? I was just like, oh my goodness, the vibe is bad. This is gonna (laughs), this is gonna be tough. She’s already showing everybody that she is not in for this experience whatsoever (laughs). 

Carol (13:25):

Right. And so that plays right into the process of experiential learning is you really start it very easily with play and in a, it’s done in a really fun, playful way. And people are like, you know, exactly, they come in and they’re like, ugh, I don’t have time for this. I have a million emails. I have all these things to do. And then all of a sudden through one of the icebreakers or, you know, you step up into one of the playful initiatives, you hook ’em somehow. And part of the process is you debrief after most of the exercises. And the idea is to bring it back to everyday life. Like, okay, that was a fun activity, but how do you bring that back to your daily life. And therapeutically, you know, you’re asking people to see how they’ve problem solved out here in experiential world? How do you bring that back to your personal life, your work life, but in, with hospitals, it was, how do we bring this back to the hospital? This was fun, but really the deeper meaning is what, how can we use this? How can we, you know, use this in a really great way? 

Lisa (14:28):

Yes. And for our listeners, that leader who came in not engaged, ended up grabbing me at the end and saying, “This was fantastic. This was amazing. And uh, it’s not what I expected. And I gained so much value, and everyone here did.” And, you know, she approached me afterwards. So that’s not an uncommon comment. And that’s why I’m so excited to do the EXCITE! programs because you get to see these transformations within two hours. You get to hear people give ideas that you would never get. You just wouldn’t, you get it in that environment. And this is a workshop that really is led by leadership. So they’re seeing the ideas. They’re very, it’s very well implemented. And people feel good. I mean, they want to help, but they don’t have the vehicle. And, and sometimes even the vehicle’s not enough, it’s the governorship, or, you know, the leadership saying, I wanna hear what everyone has to say, ’cause everyone is important part of the process.

So my next question is for you, can you highlight over the years breakthroughs you have seen on the ropes course, it could be whether with the businesses, kids, colleges, and even with our work in EXCITE!, any moments or insights or things that you have that are particularly important for the audience to hear? 

Carol (15:42):

I think every time I run a program, there’s a significant experience that I remember from that program. Somebody faced a challenge or overcame a fear, especially out on the course, doing a zipline through the woods or climbing up 30 feet on a telephone pole when you’re connected just to, you know, a rope and I’m standing at the bottom, and they’re 250 pounds, and I’m 110, and they’re like, “Really, Carol, you’ve got me?” And I’m like, “I don’t have you. The system has you.” You know, I’m just helping the system along. So it was just always an experience watching somebody go past their comfort zone in many ways — physically, emotionally, taking a risk, giving an idea, you know, during one of the workshops, there’s just so many, and I think the idea of people having an opportunity to speak. 

And, and part of the process, I don’t think we even said this was… throughout the process even from the start, we kind of do these fun little activities, what, that we call whip arounds that require everybody to speak. And they don’t even realize they’re actually giving input, and they are and then all of a sudden as the program goes on, the process just takes over, and everybody’s just used to giving information. So where in a regular session or learning session, say with a hospital, you have people that sit there and don’t open their mouth for two hours. In our program, they do, they, they’re kind of required to do it.  They don’t even realize it, cause it’s in a playful way in the beginning. And then as you get into the more difficult challenges, they’re comfortable and they’ve already spoken multiple times throughout that experience, and it just happens. Yeah, and you don’t have that person that doesn’t speak. We just don’t really allow that during the program. 

So, it’s interesting too that you’ve mentioned a lot of other things, but I would say probably one of the things that sticks out the most was this young woman that was there with us. She played on a college team. She was on a full athletic scholarship. So everybody would assume that climbing, you know, all over a ropes course or a challenge course and all that would be easy for her. And she got about six feet off the ground and just froze. Just couldn’t do anything. You know, we talked her through it. We let her take her time. We gave her all the time she needed. And we were like, “okay, this is your limit?” She was like, “Yes, yes, yes.” We were like, “All right, go one more step. Just go one more step.” And finally she went one more step and then she froze there. And then we were like, “Can you take one more step?”

And then before we knew it, she was at the top of the pole and actually did the activity, did the element. It was a high element. And when she came down, it just was this huge breakthrough. And, and we were like, how do you take that back to the basketball court? You know, you play for a division one basketball team, you know, this was something that you stopped 6 feet off the ground. You, you continued to go another, you know, 25, and then walk across a wire, you know. 

Lisa (18:44):

…one step at a time. 

Carol (18:45):

One step at a time. I, I think she exploded after that, and they ended up having them an amazing season, the team.

Lisa (18:53):

Mm-hmm (affirmative). Yeah. I remember that. 

Carol (18:54):

During that season that year-

Lisa (18:55):

Mm-hmm (affirmative).

Carol (18:56):

You know, they came back and the coaches were just, they were just like, wow, we used all the things we learned, you know, all those activities and icebreakers, we would start our practices that way. And we would do some looking around and find some really new activities, but you guys just catapulted us to really look at our basketball practices differently as well. That was big. 

Lisa (19:17):

That’s a great story. I had one in mind, but I’m not gonna tell it because that one is so great that I want everyone to, to hear it again and think about it. It’s so extraordinary. And so, we have one final question as we wrap up, but I do want everyone to know, you know, the reason why I felt like bringing it in the hospital was so important. It was that there is a certain physicality on the ropes course. And, and not to say that everyone can’t do it, but I think there are limitations. So I thought, well, how could everybody gain the value and the experience of doing a workshop like this, but not having the physicality. And so that was a secondary reason not that we couldn’t offer this outside to hospitals, but I think there are some limitations. So I think the indoor EXCITE! program really allows that to not have that elements of the high, the zip and all these other things that probably might limit some people, you know. 

Carol (20:10):

Yeah. I agree. And we just gave them the different challenges — challenges that really affected them, their organization.

Lisa (20:18):

That’s right. 

Carol (20:18):

It was still challenging, but in a different way. 

Lisa (20:21):

Exactly. So the final question is, and of course I’ve already somewhat pitched this to you. And so you’ve had some time to think, but it’s a challenge and the audience will hear us kind of talk through this in the last few minutes. Now it’s 2022. And we’ve all been through COVID, unfortunately, you know, still going through the challenges in the pandemic. So I I’ve now asked you a different, what if question, and you know, what if, or how can we bring EXCITE! workshops virtually, right? How can we create this experiential experience via a virtual Zoom or otherwise setting? And the floor is yours, Carol. 

Carol (20:57):

So I’m sure the audience knows my response. It’s the same as it was in the beginning. No, it’s probably, you know, you lose, I felt like so much, but again, I’m gonna have to come back to the fact that the audience that’s stepping into a virtual learning experience doesn’t know what they’re missing. 

Lisa (21:16):

Or what the other opportunities are, right? Or what the others look like, right? 

Carol (21:20):

And so, you know, I would initially say no, but now seeing other people do virtual immersion experiences, uh, one being, like, like, a Tony Robbins, it’s hard to say, you know, how do you do a Tony Robbins’ seminar? A 5-day seminar virtually and, and really get the full experience. And I think it’s possible. I just think- 

Lisa (21:42):

So I have a question for you. So that’s a great example. So Tony Robbins now, you know, is doing these virtual workshops, which he swore he would never do. He said, absolutely no, I’ll never do it. So when he, his business is really, one of his businesses to be out engaging with people in large stadiums and large venues. And so when 2020 happened, he said, okay, I’m gonna go to Vegas, they’ll never close down Vegas, Vegas closed. I’m gonna go to movie theaters and I’ll have the virtual experience, they closed movie theaters. Okay, I’m gonna take it to churches. They’ll never close churches, they closed churches.

So it forced him, just like I’m saying to you now to think of something different for those who don’t know, I would check it out. Tony, does he created a whole new area, an office, or I would really say a building where he could have literally hundreds of thousands of, of people in this very experiential Zoom room. And he has people come in to keep the energy high. And he has recreated a virtual event that has the same energy as if you were in a regular Tony event. And it’s remarkable. And you’ve experienced it so have I, and until you experience it, you wouldn’t think that he could maintain that energy and the connections, and everything he does, what he does, it connects with the audience, and now he’s able to connect with millions more people than he could ever connect with. 

Carol (22:59):

Exactly. And I had been to seminars live and thought, you know, it’s almost impossible. I just didn’t think it was possible. And he did it. He was able to do it. It’s a different experience, but it’s still a really great experience. And he really was able to get people totally immersed. And it was amazing. So I think it’s possible. Yes. I’m gonna say yeah.

Lisa (23:23):

Okay. So you have to say yes. So everybody’s listening now in 2022, Carol will be creating, or recreating our EXCITE! program, our EXCITE! workshop. It’s gonna be a virtual EXCITE! Workshop. And we’ll be working on that in the next 90, 120 days, probably ready for second quarter. And we’ll be hearing more about that.

Carol, this was fun. I really enjoyed you being on our radio show. And if you wanna learn more about Carol’s work at VIE with her EXCITE! workshop, you can reach out to me to learn more about the workshop in general, but, um, available on LinkedIn or And if you’ve got suggestions on future programming or topics you wanna talk about, please let me know. This radio show is for you. And we wanna continue to bring innovative conversations and people onto the show. And you know, people can collaboratively learn together.

So thank you for listening to The Healthcare Leadership Experience Radio Show on HealthcareNOW Radio. I’m Lisa Miller, the host, please join us for other radio shows and you can listen to The Healthcare Leadership Experience on other podcast apps. Thank you. 

Outroduction (24:33):

Thank you for joining Lisa Miller for this episode of The Healthcare Leadership Experience Radio Show sponsored by VIE Healthcare Consulting. If you enjoyed the show, subscribe so you can automatically get notified when new shows premiere weekly. Don’t forget to leave us a review, some more healthcare leaders like you can discover us. This show is on HealthcareNOW Radio, Apple Podcast, Stitcher, Spotify, Pandora, and other major podcast platforms.

To reach out to Lisa personally, you can join the conversation on LinkedIn where Lisa continues to have discussions on the business of healthcare.

You can find links to Lisa’s other social platforms in the show notes or at The Healthcare Leadership Experience Radio Show is the think differently communication for healthcare leaders. And we are honored to have you tune in. Join us next week for another episode of The Healthcare Leadership Experience Radio Show. 

Leah (25:27):

Hi, this is Leah. You are listening to my mom’s podcast, The Healthcare Leadership Experience. 

Fernando (25:34):

Hi, this is Fernando. If you would like to speak with my mom, just email her.

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