It is new month, the flowers are blooming, the grass is growing and golf season has started. It is a time of change. But when isn't it a time of change? The most successful companies are always changing, yet most of us have a habit of procrastinating. We even procrastinate those things we know will make us feel better or help us grow our businesses. Before tackling how to stop procrastination, we need to look at why we procrastinate. Here are seven reasons:

1. Fear of rejection-We fear that if we try something, we will be turned down. No one likes to hear the word 'no.'
2. Fear of success-We worry what will happen if we become successful. We might feel like an imposter waiting for someone to discover the truth about us (see Lack of confidence).
3. Fear of the unknown-We always worry about what we don't know and how people will react and this causes us to freeze up.
4. Complacency-We get comfortable with our routines and are hesitant to change because we know change is difficult, so we take the path of least resistance-status quo.
5. Lack of confidence-We have low self-esteem and don't believe what we are doing will be valuable to others.
6. Not knowing where to start-We think of things in such a broad sense that we get over-whelmed and don't know where to begin.

Often there is a simple solution to breaking through the reasons mentioned above: just start moving. If we spend some time breaking down the initiative into digestible chunks, it becomes more manageable. Once we actually take the first step towards that goal, we can overcome all of our fears.

Right now, many hospital systems put an inordinate amount of pressure on hospitals. Patients are staying for long periods of time because they have nowhere else to go, doctors are required to perform minor procedures that nurses are trained to perform and many governments don't want to admit that there are other options for those that can afford it. In Canada, approximately 7,500 people are living in hospitals (living is defined as having been there longer than 100 days) because they have nowhere else to go. That costs the system approximately $7.5m every day!!! Does that sound like an efficient system? We need a system where these people have a place to go where they get better care that is more cost effective. The hospital is the most expensive place they can be.

We need to develop local clinics and providers who can take much of this pressure off of hospitals. Hospitals should be a place where people go for emergencies and specific kinds of specialty care, not a catchall where patients stay because they have nowhere else to go. Develop local communities and homecare facilities to support those that need a place to go and be cared for, provide for better home care and give people options when it is time for them to be discharged from hospitals.

Like most businesses, much is lost in the transition from one system process to another. However, in most businesses this leads to lost money and profits. In healthcare, this leads to lost money and lost patients. There are lives at stake here so let's make a better effort to fix the problem.

When you take over a new business or step into a new management position, there are a few areas you need to assess before you can take advantage of new opportunities. And you need to do it quickly. Many people refer to this time as the first 100 days. Here are a few of the areas you should look at:

·       Talent - What are the current capabilities and potential of your employees, especially those in management  and other leadership positions? If you see any leadership deficiencies, can training or development help address them?

·       Processes - Are the operating processes of the company focused on adding value through every activity? Can they be standardized across business units? Are you providing your products and services to customers in the most effective way?

·       Technology - Is the technology you are using appropriate for the business you are running? Are there opportunities to automate repetitive and/or manual activities? Is the technology supporting business decisions instead of driving them?

·       Business Partnerships - Are you partnering with the right suppliers and getting treated as an important customer? Are your business partners coming up with ways to help you improve performance in your business?

·       The Numbers - Are you profitable in certain product or customer segments but not in others? Are there sacred cows that used to be important to the business but are now unprofitable or in decline?

·       Culture and Flexibility - Does the organization have a history of adapting well to changing industries and environments? Is there a culture of change and empowerment? How is change managed within the organization?

If you are able to quickly assess where your company stands in these areas by talking with employees, business partners and advisers and reviewing and observing the operations, you will quickly be able to develop a priority list of the biggest opportunities for improved performance and profitability.

Yes, I know the stock markets had their worst day in two years. Yes, I know the US economy is in trouble. Yes, I know that most international currencies plummeted. Yes, I know Tiger Woods is back playing on the PGA Tour. But it is only one day. The sun will rise again today (actually, I already checked and the sun is up). Today is a new day and things will get better. Don't panic!

Don't let the stock market determine how you run your business or how you run your life. Businesses are doing well, customers are feeling good and this too shall pass.

Many business executives are feeling good about their businesses depsite all of this. You must also remember that even if there is a slow-down in the economy, there are lots of industries that thrive in those times, so things are not going to be all that bad.

Look for opportunities, take advantage of them and go about your business. Try not to worry what others are doing. That is how you can be successful in uncertain times.

Building strong relationships has become more important than ever in today's world. Building strong relationships helps us in our personal lives, in our business lives and everything in between (which for me is nothing, since I view my life as one whole entity). There are so many options out there for goods, products, services, advice, etc. that how do we know where to turn? How do we know who to choose as a business or life partner? Here are some of my thoughts on the keys to building strong relationships:

• Go with your gut - sometimes you cannot rationally justify why you feel a certain way about another person, but there is usually a good reason for it. Invest time with those people to whom your gut says "yes."
• The principle of reciprocity - if you are constantly giving, then the universe usually finds a way to reciprocate.
• Be respectful - regardless of who the person is or at what level of the organization they reside, be respectful. If someone is disrespectful to you, stand up for yourself and then walk away.
• Provide value - leave people saying "Wow, he/she is such a great source of information and really helped me out." Clients will want to work with you and personal connections will want to be around you.
• Appeal to self-interest - try to view things from the other person's perspective - what do they need? What would make things easier for them? How can I help?

There are many other keys to building successful relationships, but the ones above are essential to any strong, trusting relationship.