Sales Enablement Perspectives

Why Effective Enablement Strategies Follow A Two-Step Approach

What’s your focus when designing and creating sales enablement services? What are the sales enablement frameworks you work with? And what do they look like? I’m constantly amazed at how often the customers are not even mentioned, nor included in sales enablement frameworks and approaches that are applied.

“But sales enablement is about sales!” I hear you. However, to be successful in the age of the customer,  salespeople must adapt their strategies, their messaging, their skills and techniques to the way their buyers want to buy. So, sales enablement should always have the customers at the core of its efforts. “But how do I address salespeople’s challenges?” Things will fall into place if you give me a few minutes to explore the matter.

In the digital age of the customer, a high-performing sales force is not optional. It is mandatory. Effective selling requires sales professionals to align their strategies, activities, and behaviors to the customer’s path.

In the age of the customer, salespeople have to deal with well-informed, over-informed, and also misinformed prospects and customers. Also, the specifics of the business challenges their customers are dealing with, matter as well. Is the business challenge new to the buying team, or is it well known? And how risky is the challenge for their organization and their individual careers? Highly successful sales professionals know how to create value at each stage of the customer’s path for all involved buyer roles, based on their specific business challenges.

Creating value means different things at different stages of the customer’s path, but it’s always centered around being relevant, valuable and differentiating to help prospects and customers move forward with their decision-making process:

  • Creating value in the awareness phase is about creating clarity regarding the actual business impact of a challenge, and it’s about providing perspectives as to how prospects and customers can achieve their desired results. In this phase, all efforts are focused on helping prospects and customers to decide to tackle the issue or not.
  • In the buying phase, creating value means providing detailed information about how the customer’s desired results can be achieved with your solutions. It also means providing all the required financial data to be integrated into the customer’s business case. Yes, into the customer’s business case, because cost savings as such are only the door-opener to business impact.
  • In the implementation and adoption phase, creating value could mean providing implementation assistance and tips for successful usage, tailored to the customer’s steps. It also means ensuring that all initial executive buyers know about the value that has been created. That allows you to establish a foundation for additional business.

These examples show exactly why all enablement services have to be aligned with the customer’s path. This applies to not only the content salespeople use but also the training services around skills, methodologies, processes, and product. Even if certain skills are the same (such as value messaging), they have to be applied differently in the different phases.

The two steps: Successful sales force enablement leaders align their enablement services first to the customer’s path and then to the sales force’s specific challenges

Working with an enablement framework that is based on the customer’s path is the foundation of sustainable enablement success. If you design your enablement frameworks around your products or your internal challenges only, you lose the necessary focus on the customers. Your ultimate design point should be your customers and how they approach their challenges, how they want to buy, and how they prefer to use/implement/adopt your products, services, and solutions. The customer’s path is not your only design point, but your first one. Consider your customers and their customer’s path as your “true north.”

Study results show: Dynamic alignment of sales processes to the customer’s path drives double-digit improvement in win rates and quota attainment

The data from CSO Insights’ 2016 Sales Enablement Optimization Study showed a 13.6% improvement in quota attainment (compared to the study’s average of 55.8%.) based on dynamic – formal, responsive and adaptive – alignment.

In 2017, the results from CSO Insights’ much broader World-Class Sales Practices Study showed virtually the same result – 13.5% quota attainment improvement. Furthermore, the 2016 data showed an improvement of 15.0% in win rates for forecast deals with dynamic alignment. In 2017, the results from the World-Class Sales Practices Study showed that win rates for forecast deals can be improved by 10.1%, compared to the study’s average win rate of 51.8%. While there is a difference, both results show a double-digit improvement that cannot be ignored.

As you can see here in the examples and in the data, aligning the sales processes and all enablement services to the customer’s path is key to success. Value messages that are in every single piece of content have to be tailored to the different phases of the customer’s path. What works in the awareness phase is misplaced in the buying phase and the other way around. Once this is done, your sales force’s specific challenges determine how you shape the related content and training services, and the coaching services for the sales managers.

This article was initially written for Top Sales Magazine, March 2018.

How To Cut And Polish Your Sales Enablement Diamond

How To Cut And Polish Your Sales Enablement Diamond

Sales enablement is a very fast growing discipline: In 2013 19% of our study participants reported having an enablement initiative or function. In 2016, it was one-third, and this year it’s 59%. Unfortunately, enablement success is not growing at the same speed. Only one-third of our 2017 CSO Insights Sales Enablement Optimization Study participants reported meeting or exceeding their expectations. It seems that the need for enablement clarity has never been greater than today.

Enablement clarity step 1: Defining the space

With our 2017 CSO Insights Sales Enablement Optimization Study, our definition of sales force enablement has evolved.

Sales Force Enablement — A strategic, collaborative discipline
designed to increase predictable sales results
by providing consistent, scalable enablement services
that allow customer-facing professionals and their managers
to add value in every customer interaction.

We have omitted the list of enablement services (“content, training and coaching services”) and focused on what they need to be: consistent for salespeople and scalable from an organizational point of view. And the target audience has been expanded to “customer-facing professionals and their managers” (it was “salespeople and their managers”). This target audience, including the frontline managers, is also the reason why we call it “sales force enablement.” At the end, we have skipped “powered by technology” because it’s obvious that every single enablement service is based on some kind of technology even if it’s only PowerPoint that has been used to create a training presentation. Instead, we wanted to focus on what really matters: to add value in every customer interaction, which also expresses the remaining design point of sales force enablement: the customers and their entire customer’s journey.

A definition serves as a frame of reference to bring all stakeholders together on the same page. However, no definition is a sufficient guide for creating an enablement practice that allows you to achieve your desired results. This is where our newly developed sales force enablement clarity model comes into play.

Enablement clarity step 2: The Sales Force Enablement Clarity Model

The clarity model builds on the definition and serves as a guide as you assemble your sales enablement discipline step by step. Enablement leaders can assess how they are doing in each enablement facet and make better decisions about how to improve their efforts for better results. Wherever you choose to begin, getting to the next level is easier if you keep the holistic vision represented by the model in mind.

Imagine your enablement practice in your organization as a rough diamond. Leverage the clarity model to cut and polish your enablement diamond based on your context and your particular challenges.

Customer – In the age of the customer, your sales force can only be successful if they approach prospects and customers based on their preferences: how they handle challenges, how they want to interact with salespeople and how they want to work with your products and services. The reason is simple: whatever we automate internally, customers still make buying decisions.

Customer-Facing Professionals and Their Managers – While alignment with customers takes the top facet of our clarity model, your sales force enablement practice has internal customers, your target audiences. These target audiences include not only salespeople but also those roles that are focused on business and sales development as well as the roles that are focused on serving customers after a deal has been closed. Furthermore, we know that reinforcement and adoption of enablement services can only be achieved if sales managers lead and coach their sales teams accordingly.

Sponsorship, Strategy, and Charter – Next, we’ll drop down to the bottom of our diamond and look at its foundation. Of course, you need to start with a strategy, but even the best sales force enablement initiatives fail if the team has the responsibility, but not the authority, to enact their strategy. This includes gaining the all-important executive sponsorship.

Effective Enablement Services – We put effective enablement services in green because these are the services the discipline provides to allow the organization to reach its desired results. If you think about customer-facing roles as your internal customers, this is the only facet they see. If someone outside the organization were to ask a sales or service professional what enablement does, it’s likely that they would talk about how they perceive these services, usually around training, content, and coaching.

The remaining three inner facets focus on the mechanics necessary to design, produce and deliver these services as well as manage the discipline.

Moving from an ad hoc enablement discipline to a more strategic function, the three inner enablement mechanics – collaboration, technology, and enablement operations – are essential to drive consistency, scalability, and effectiveness:

Formalized Collaboration – We talk about sales force enablement as a discipline and not a function or a department because no one team can cover it all. Sales force enablement teams orchestrate the process, enlisting the aid of many other functions within the organization. Imagine that content, training, and coaching services have to cover the entire customer’s journey. Therefore, you have to collaborate with many other functions to ensure enablement services are aligned and consistent.

Integrated Enablement Technology – Sales enablement technology is NOT the same thing as sales enablement, but these days, the right enablement technologies, deployed in the right ways, can extend your competitive advantage tremendously. This facet is all about integrating enablement content management solutions, learning technology, coaching tools, analytics, often supported by artificial intelligence into your CRM system. And, on top of integration, provide mobile access is mandatory.

Efficient Enablement Operations – Enablement operations is often seen as a “black box” because it includes the behind-the-scenes functions of the discipline, but this is where all the enablement magic happens. As it is poorly understood, it is also a facet that is often overlooked. Enablement operations cover three areas: enablement governance, an enablement production process that is closely aligned with the collaboration model, and enablement analytics: how do we measure success?

More questions? Download your copy of our 2017 CSO Insights Sales Enablement Optimization Study. As you will see, the clarity model serves as a structure for our 2017 study.

This article was initially written for Top Sales Magazine, December 2017.

Sales Enablement Society’s Conference in Dallas: My Takeaways

Jonathan Farrington interviewed me for Top Sales Magazine to discuss my takeaways from the Experience Sales Enablement conference in Dallas.

JF: You attended the Experience Sales Enablement conference last week in Dallas. What are your impressions?

TS: The #SESociety conference was amazing, inspiring, and transformative, completely organized by volunteers focused on the attendees’ experience. On the first day, enablement was discussed from different perspectives. Bestselling author Ori Brafman shared his wisdom about the power of decentralized networks based on individuals promoting agility versus existing command and control structures. His brilliant keynote pointed out that “the opposite of control is enablement.” Sales Enablement Society founder Scott Santucci alerted the audience that we are living in a completely different economy but that we still apply old paradigms to our current business challenges. Dr. Howard Dover, UT Dallas, pointed out that the sales function as it exists today in most organizations is about to implode.

JF: How fast is the sales enablement movement growing compared to previous years?

TS: The Sales Enablement Society has gathered enablement professionals at the right time. In previous years, when I was myself an enablement practitioner and leader, the movement was rather small and not growing that fast. Based on our CSO Insights data, in 2013, only 19% of organizations had an enablement initiative or function. Last year, it as one-third, and this year, it’s almost two-thirds. That’s a tremendous growth rate. Many new people got into enablement roles in a very short amount of time. And that’s the phase of any movement when the need for clarity is greater than ever before.

JF: What’s different about the Sales Enablement Society compared to established industry associations?

TS: The Sales Enablement Society is by no means just another association. The society’s culture – and that’s what its members have created – is driven by creativity, innovation, and an infectious spirit of trying new things and doing things differently in a highly collaborative manner, following a decentralized and agile networking idea.

JF: That sounds amazing. Could you share an example of that spirit?

TS: Sure. Take the enablement definition project as an example. This project, led by one of the local chapter presidents, analyzed all enablement definitions out there and identified via a member survey the four favorite ones. These were the definitions from Forrester, ours from CSO Insights, and the definitions from Sirius Decisions and IDC. Then, they invited various delegations, such as for example academics, analysts, and vendors, to do the same. Organizations that are competing against each other contributed for the greater good of standards for the relatively new sales enablement profession. In Dallas, the members voted for the suggested definition, created based on the evaluation. This is an amazing, bottom-up achievement.

JF: Did the conference change any of your perspectives about sales enablement? If so, which ones?

TS: It didn’t change but enhanced and enriched my perspectives. The discussion on “who is responsible for growth?” in several sessions was inspiring, as well as the discussion on the future home of enablement teams. Is it executive sales management, is it the CEO or another C-level role, such as the customer experience or chief growth officer? As an analyst, I’m used to talking to many enablement leaders, and each one has a unique approach based on similar patterns and challenges. In organizations where enablement is already established as an accomplished strategic function, the C-level expectations are huge. Consistency, scalability, adaptability, and effectiveness are key success factors. Those senior executives expect their enablement teams to do things like successfully onboard newly acquired sales teams in just a few weeks.

JF: Is there now more acceptance that sales enablement has to be a strategic approach?

TS: Absolutely! The conference definitely contributed to much more sales enablement clarity. There is consensus that sales enablement has to be strategic in nature to drive sustainable results, and that includes achieving growth targets. It’s also consensus that enablement should have an orchestrating role along the entire customer’s journey across various enablement services, targeting all customer-facing roles, which includes for instance service personnel as well as managers. And that scope requires enablement to collaborate with many other functions, not only with sales and marketing; this is a fact that was also confirmed by our data.

JF: As one of the leading thought leaders in the world on sales enablement, how was your session and what do you expect next?

TS: One of the trends that I already discussed years ago seems now to become a mainstream discussion: Will it still be “sales enablement” in a couple of years, or will it become “buyer enablement” or “customer enablement”? In more practical terms: how to evolve enablement to a more strategic function will be THE key challenge. The session I had the pleasure to lead was all about providing a framework, such as our enablement clarity model in the form of a diamond, that allows enablement leaders to perceive their enablement function as a rough diamond that has to be cut and polished based on the organization’s context and challenges, addressing various enablement facets.

JF: Can the implementation of sales enablement arrest the downward spiral in quota attainment (down 10 percentage points in 5 years)?

TS: Yes, there is a downward spiral, according to our research, and the research of many others. However, our 2017 Sales Enablement Optimization Study shows a different trend. Organizations that already focus on sales enablement are not always as successful as they expect to be. But they already show slightly better quota attainment numbers: 57.7% instead of 53.0%. However, measuring a sales force’s performance only by quota attainment does not necessarily reflect their real performance. A set of KPIs including leading indicators provides better insights.

Download your copy of our 2017 CSO Insights Sales Enablement Optimization Study here.

Sales Coaching: How To Get It Right

Sales Coaching: How To Get It Right

Imagine how you are driving now as a skilled driver and years ago when you just got your driving license. There are a lot of specific skills that must be mastered before a driver reaches the level of unconscious competence, e.g., what certain signs and symbols mean, who has the right of way, how to parallel park, and how to master European roundabouts. While all of these skills are important, some are more vital than others because they are critical to success. For sales managers, coaching is such a skill, regardless if they lead a field or an inside sales team.

For most people in sales, coaching is perceived as opportunity coaching even though there are many more aspects of the sales role that must be coached. Furthermore, many salespeople, not only in inside sales, don’t feel “coached,” even if their managers call it that. Let’s start by defining what sales coaching means:

Sales coaching is a leadership skill that develops each salesperson’s full potential. Sales managers use their domain expertise, along with social, communication, and questioning skills to facilitate conversations with their team members that allow them to discover areas for improvement and possibilities to break through to new levels of success.

As importantly, sales coaching is not asking things like, “What’s your forecast this month?” or telling a salesperson, “You need to build more pipeline.” Instead, effective sales coaches consider the salesperson’s personal goals, their style, current strengths and weaknesses before engaging in a dialogue. Then, the focus of such a structured conversation is to discover areas for improvement regarding behaviors and activities that should lead to the desired results.

Coaching areas have to be defined: lead and opportunity coaching, pipeline coaching, coaching skills and behaviors, account and territory coaching

If coaching is reduced to opportunity coaching only, the organization misses out on much of the performance benefits of coaching. At CSO Insights, we separate coaching into five different areas that can be implemented step by step, according to your context:

  • Lead and opportunity coaching
  • Pipeline coaching
  • Coaching skills and behaviors,
  • Account coaching
  • Territory coaching

However, in most organizations, sales coaching is currently focused on lead and opportunity coaching only. It’s remarkable that the majority of sales managers in our 2016 Sales Enablement Optimization Study said they spent less than an hour a week coaching leads and opportunities. Lead and opportunity coaching is a great starting point. But it should soon be enriched by coaching skills and behaviors as a foundational coaching layer. Especially for inside salespeople who are working most of their time on the phone, lead and opportunity coaching should always be enriched by coaching skills and behaviors.

Coaching needs to be formal to be effective

Now as you have defined your various coaching areas, it’s about developing a coaching process that follows the customer’s journey. Ideally, your customer’s journey should be mapped to your internal process landscape. If that’s the case, your coaching framework sits directly between the customer’s journey and your internal process landscape, bridging between both sides.

There are four levels of sales coaching maturity:

  • Random: There is no coaching process defined.  Coaching is left up to each manager.
  • Informal: Coaching guidelines are available, but there is no formal coaching process. Managers are told that they should coach, but there is no monitoring or measurement.
  • Formal: Coaching areas and the coaching process are defined and implemented. Sales managers are expected to coach accordingly, and there is a formal effort to develop their skills. Periodic reviews help optimize processes and guidelines.
  • Dynamic: The coaching process is connected to the sales force enablement framework to ensure reinforcement of sales enablement efforts. Sales managers are required to coach; they are measured and compensated accordingly. Ongoing reviews help to not only optimize the process but also to adapt it to market dynamics and the changing selling environment.

In our 2016 Sales Enablement Optimization Study, almost 50% of our study participants reported operating based on a random coaching mode. A quarter is working on an informal basis, but only 21.7% have implemented a formal approach, and only 5.3% have made further efforts to align their coaching process with their enablement framework. Our study shows that the coaching approach matters a lot.

Almost 75% of sales organizations waste resources due to random and informal coaching approaches, and only about one-quarter leverage the huge performance potential of formal and dynamic coaching.

If coaching is left up to each manager, sales organizations have a hard time achieving even average performance. Let’s look at win rates for forecast deals as an example. Organizations that use an informal approach end up 4.5 percentage points below the average win rate of 46.2%. That is an actual decrease of 9.8%! Informal approaches start to move things in the right direction, but they lack formal implementation and reinforcement, which leads to a result that’s around average. However, when the approach gets formalized, the win rate improves a significant 5.3 percentage points above average for an actual improvement of 11.5%. The results are even more impressive for a dynamic approach that is based on a holistic sales force enablement program that connects the enablement and the coaching frameworks. In this case, the win rate climbed by 12.9 percentage points, which is an actual improvement of 27.9%.

How could a sales leader ignore a 27.9% better win rate? Investing in sales force enablement to build coaching frameworks and develop sales managers accordingly, especially their coaching capabilities, is the key to achieving the kinds of performance improvements sought by sales leaders everywhere.

This article has been initially written for Top Sales Magazine, September 2017 issue.
Image source: Unsplash Images

For Sales Enablement Leaders: Why Adaptive Competencies Matter More Than Ever

For Sales Enablement Leaders: Why Adaptive Competencies Matter More Than Ever

In an ever-changing world and complex buying environments, traditional selling skills and competencies are no longer sufficient to drive sales performance. The ability to quickly adjust and add skills and to align behaviors to new, changing and complex customer situations is what sets world-class sales professionals apart from the rest. Developing these adaptive competencies is a key challenge for sales enablement leaders to drive sales performance.

“Adaptive” in evolutionary biology

Adaptive competencies refer to the process that organisms follow to survive. The main components applied to sales are to maintain competencies, knowledge, and strategies that are important to be successful, to remove or modify elements that are no longer useful, and to develop competencies that lead to future sales success. As in biology, so it is in sales; it’s evolution, not a revolution. Triggered by changing environments, adaptive competencies become a key differentiator.

Case for Adaptive Competencies

We all know that what products, services, and solutions are and what they do – compared to each other – is no longer differentiating in today’s buying environments. Differentiating, relevant, and valuable for customers is to learn what a provider’s products, services, and solutions could MEAN for them: their specific situation, their challenges, and their results. Working backward from the customer’s specific context and the involved stakeholders’ specific concepts require salespeople to quickly adapt relevant knowledge, activities, and behaviors to the customer’s specific buying situation. And the term knowledge covers both: capability knowledge and situational knowledge. Additionally, the specific decision dynamic how an individual customer network is going to make a decision this time determines the engagement, the selling strategies, activities, and behaviors.
Even within the same account, every buying decision is made differently. And that’s why a situational selling approach matters. More than ever before. This situational dimension requires adaptive competencies that will determine future sales success.

Adaptive competencies enable sales professionals to quickly connect the dots across selling skills and competencies, various knowledge areas and strategies, regarding customers and opportunities.

Being fluent in different customer situations, that’s how we perceive sales professionals with highly developed adaptive competencies. Prerequisites to develop adaptive competencies are two-folded: Fluency regarding skills, knowledge areas, methodologies, and processes, as well as curiosity, open-mindedness, the joy to share and learn and the pursuit to become better every day.

Specific adaptive elements have to be developed to unfold the power of adaptive competencies. These elements are situational awareness, principles, creativity as well as critical and strategic thinking, relevant along the entire customer’s journey:

  • Situational awareness is a salesperson’s holistic perception of a given situation. It’s the ability to quickly catch and realize a situation in a holistic way, and then to focus on the relevant elements and dimensions. This situational awareness enables a salesperson to quickly draw the right conclusions how these elements fit together what’s relevant and what needs to be clarified. Situational awareness combined with a customer management structure boosts salespeople’s ability to quickly explore the customer’s situational context.
  • Principles instead of rules: Applying customer management principles instead of following strict process rules brings the accountability back to the salesperson. Principles require interpretation to be applied accordingly to a particular situational context. Engagement principles such as providing perspectives require salespersons to deeply understand the mechanisms to apply them successfully according to a particular customer situation. Salespeople must have completely internalized those principles beforehand. It requires them to be fluent regarding methods, skills, and competencies. Additionally, principles have the side-effect to widen the boundaries and to open a space that doesn’t exist in the world of strict rules.
  • Creativity: The open space between strict rules and principles should be filled with a salesperson’s creativity to create differentiation, relevance, and value. How to provide perspective for customers, how to tackle their business issues and how to show them that alternative ways may lead to better results for them – the space is wide open for salespeople to be creative on how to develop new perspectives for clients and how to orchestrate a group of stakeholders to a shared vision of future success.
  • Critical and strategic thinking: This ability is highly relevant in complex buying environments that are always changing. Based on a salesperson’s fluency especially in sales methodologies, critical and strategic thinking are the ingredients that allow a salesperson to sharpen the deal strategies. This ability is closely connected to questioning the status quo and asking the tough questions, internally and at the customer. That’s what makes the difference between a thought-through deal strategy and a wishful-thinking approach.

Building adaptive competencies is a journey with several steps. All adaptive elements require specific learning methods. As an example, situational awareness requires exercises that show people what they don’t see but what’s happening combined with techniques how to improve these awareness skills. Creativity requires to understand what creativity really is, and lots of different exercises how to unleash people’s hidden potential of creativity. Critical and strategic thinking requires a focused development approach to unleash this potential and to put it in the context of specific sales situations.

The adaptive elements, based on the prerequisites, have to be put together in context-specific, highly interactive, simulation-based training scenarios. Situational awareness, for instance, to be valuable requires applying principles accordingly, strategic thinking and creativity to sharpen deal strategies and to adjust activities. The potential of all adaptive elements is much bigger than the sum of its parts.

This article has been written for Top Sales Magazine, the July 2017 edition.

What Simplicity Really Means And How To Achieve It In Sales Force Enablement

There is not a single day the topic of simplification, simplicity, or the imperative “make it simple” regarding sales force enablement is not discussed with great passion. And most of the time, it’s a relevant topic. Especially when it comes to sales force enablement. Who doesn’t want things to be simple? Salespeople prefer simple solutions and approaches, simple content assets and training services, simple tools, and simple value messages, etc. There are just a few small details most people overlook in the discussion:

  • First, there is the macro view: The markets most sales organizations sell into are not simple. Most markets are complex environments with many different dimensions impacting them at the same time. Examples are trends and innovations, emerging markets here, saturated markets over there, politics and legal issues, trends, and regional and cultural differences that require tailored approaches.
  • Second, there is the micro view: Our clients’ environments are not simple either. Most customer organizations are complex environments, and each one is unique. Their context is specific, their challenges, goals and desired outcomes are different, and the roles that are involved in the buying decision and the implementation are different as well.

For sales force enablement, this means tons of work, because the complexity of the customer and market environments cannot be “reduced.” We can’t simplify without first understanding this complexity in its entirety. The customer’s complexity cannot be reduced but only navigated.

The focus should be on all the complicated things you can influence and you can simplify. And that means you can reduce the complicatedness in your own organization because that’s a self-inflicted problem.

Making things simple for the sales force is a highly challenging, often difficult, and always time-consuming responsibility for sales force enablement teams! Not easy. But worth doing it.

  • Make the customer’s journey your design point

This may not sound relevant here, but it is. Align all your efforts to what really matters, which is how your potential customers approach challenges, make buying decisions, and implement or use your products and services. That’s the beginning of the move toward simplicity. Changing the perspective within your organization is key to success. For example, it’s not about aligning sales and marketing to each other, but aligning and integrating them both with the customer’s journey. Because the customer’s journey is where your sales force has to be successful at the end of the day.

  • Build a robust, simple process and methodology foundation with the customer’s journey as the design point

A sales process, ideally an integrated process chain from marketing to sales to service, should be as simple as possible, but not simpler. Don’t fall into the “simplification trap” and skip things that are important because you want to make it “simple.” That leads to the wrong results. Examples are, for instance, when organizations try to fix everything with “one” process even if they have very different use cases from transactional to complex selling scenarios. The answer for a simple approach (and this means simple for the salesforce, not easy for the enablement resource!) requires the enablement and ops team to create process variations and a simple configuration that allows salespeople to get to the right process variation with a few clicks.

Don’t forget to integrate your sales methodology into the process. A process defines the sequence of events, while the methodology details what to do and why. This will take a lot of work for the enablement and operations team. But the outcome for the salesforce will be simple, because a method that’s integrated into the process, and ideally all in one place (one CRM), makes their life more productive. This will be a change they’ll welcome, rather than another time-consuming “add-on.”

  • Assess your current enablement services and throw away what’s no longer relevant:

This is an exercise that doesn’t make a lot of friends, which can make people avoid or overlook it. But it’s a necessary step to throw away all different versions of content and training assets that exist on multiple platforms. Throw away all content assets that are no longer relevant, that are not tailored to the customer’s journey, or that are not valuable for whatever reason.

  • Develop an enablement production and collaboration process to provide enablement services along the customer’s journey:

You have to collaborate with many different departments, not only with marketing. So, defining collaboration goals and defining a simple process (such as “define, create, localize, provide, measure”) for producing the desired services, and identifying which role is accountable for which content or training type, is essential to ensure a scalable and efficient approach.

  • Invest in an integrated enablement content management solution:

For salespeople, enablement is only as simple as they perceive it. And the biggest obstacle is often that they are required to go to different places to find all the content they need. There is a marketing portal and an operations portal, and there is the one from product management and from legal for the contract attachments. And, most organizations (48.3%) still email their content to the sales force or have it accessible on multiple repositories. Only 10.5% work with an enablement platform that is integrated into their CRM. But that’s the way to go if you want it simple. For the sales force.

I could list another five topics to look at in terms of simplicity, but that might “complicate” this article!
So, first things first: Implement a solid, simple, robust foundation based on the customer’s journey.
Only then will the other four steps be effective.

This article was initially written for Top Sales Magazine, May edition.

The Enablement of Women in Sales

Women prefer a collaborative working environment

Getting The Most Out Of Your Enablement Technology

shutterstock_164695367It’s like having a car. You bought it in the expectation of achieving certain desired results. But if you don’t drive it, you won’t get the benefits of owning it. And that’s not the car’s fault.

Sales leaders have lots of expectations when it comes to sales enablement content management (SECM) solutions. Based on our CSO Insights 2016 Sales Enablement Optimization Study, improving access to content for salespeople leads the list with 57.4%, followed by reducing search time (33.1%), sharing best practices, improving sales and marketing alignment and increasing win rates (27.7% each), and reducing the ramp-up time of new hires (24.8%).

Now, let’s look at the adoption rate of those SECM solutions. They are very mixed. Almost a third of study participants have adoption rates lower than 50%, and another fifth ends up between 50% and 75%. In both these cases (which amount to 51% of our study participants), there is no impact on sales performance to be diagnosed. Only adoption rates that are greater than 76% have a significant impact on sales performance. The good news is that 49% reported those adoption rates. So, if you are in the 49% group, you should experience, for instance, win rate improvements by 11.9%, and quota improvements by 6%. But if you did not experience this performance impact, look at these six ways to improve the adoption rate of your SECM technology.

#1 Set up your sales force enablement charter

Enablement charters are highly relevant because if there is no clarity on vision, mission, and purpose, and no clarity on goals and objectives and how enablement services impact productivity and performance, then your efforts will not produce results.

Energy has to be focused to create a movement. And that’s the actual value of an enablement charter. These are the primary areas you should define in your charter: target audience, vision, mission, and purpose, objectives to achieving the vision and the related strategies to get you there, a timeline, and the enablement services you are going to provide for your target audience. And don’t forget to define the metrics for measuring success.

#2 Clean up the content basement

Many sales content landscapes look like a chaotic basement: all sorts of content everywhere – old, new, relevant, and irrelevant. Assets exist in ten different versions and ten different content repositories. So, implementing an SECM solution is like moving to a new house: you don’t want to bring all the clutter with you.

First, make an inventory of what exists, and where. Assess your content assets in terms of quality criteria, and then, be brave and throw away what’s no longer relevant and what didn’t match the criteria. Furthermore, our research indicates that only 39% of all the content salespeople need along the entire customer’s journey comes from marketing. That means you will need a formal cross-functional production process and a related collaboration model to be efficient and effective in the future.

#3 Define and create enablement content services

Only content that’s valuable AND relevant really matters, and that is determined by what’s relevant and valuable to your prospects and customers. As they still make the buying decision, it’s a no-brainer that content should be tailored along the customer’s journey and for the different buyer roles. Dynamic value messaging is a big challenge to be mastered here. Instead of having value propositions only, you will need value hypothesis, value propositions in different levels, and value confirmation messages that have to be developed and integrated into content assets.

#4 Aligning content and training services

For those of you in an enablement role, this may sound familiar to you: “We need this, and we need that, and you have nothing for our role, but we are so special.” It happens all day long. If people don’t know how to use their tools, they will never have enough and always ask for more. Distributing content and tools is not enough; training is also important. So, “no content without training” should become your motto. Create, for instance, a short video about how to effectively use your newly developed playbook, or even better, let a salesperson explain it…

#5 Integrate your SECM into your CRM system

Now, once we have done all the preparation work, where do we put the SECM technology? Stand alone? That’s probably not the best idea. It’s much easier to drive adoption if you provide your SECM solution within the CRM system. This way, it’s a “one-stop shopping” experience for salespeople.

Additionally, such an integration is the prerequisite that you can suggest, which will allow you to recommend sales content automatically within the CRM when a salesperson adds a new opportunity. Make sure that you align your content design criteria, as discussed above, with the selling scenario criteria in the CRM. All the work you have done so far pays off now in this step.

#6 Implement “Be Inspired!”

Now, the salespeople will have anytime, anywhere access to the right content, with the right value messaging, for the right buyer roles, and that addresses their business challenges at the right time. We call a content delivery mechanism like that “Be Inspired!”

Now, your focus should be entirely on a solid implementation, based on senior executive buy-in and their ongoing involvement, in the context of a change story that focuses on why, what, how, and when.

Last but not least: Please make sure that your sales managers coach their salespeople accordingly. Only then can an SECM implementation be successful.

And please don’t forget to measure and to adjust regularly. And use the full analytics capabilities of your SECM solution – but that’s a topic for another article.

Related blog posts:

Three Pillars of A Solid Sales Enablement Foundation

Sales Force Enablement Technology: How to Define the Functional and The Technology Layer

Three Pillars of a Solid Sales Force Enablement Foundation

w_9moguwr08-todd-desantis“You can’t build a great building on a weak foundation.
–Gordon B. Hinckley

That’s exactly the same for a successful sales force enablement function, program, or initiative. The better your sales force enablement foundation, the more successful your results will be. The data from our CSO Insights 2016 Sales Enablement Optimization Study shows the impact of an enablement foundation on sales performance. Today, we discuss the three pillars of a solid enablement foundation. These are enablers for enablement success.

#1: Customer’s journey alignment drives win rates and quota attainment

Proven now for two years in a row: Focusing on the customer’s journey and aligning all internal processes accordingly is not merely a nice-to-have add-on. Instead, the degree of alignment between an organization’s internal processes and the customer’s journey is highly relevant for enablement success.

There is still a group of 9.4% that doesn’t consider the customer’s journey at all. Another 35.2% reported an informal alignment. This adds up to 44.6% who have not purposefully aligned their sales process to the customer’s journey. Then, 55.4% reported having either a formal (27.7%) or dynamic (27.7%) alignment.

An informal alignment means that the issue has been discussed and considered but not formally implemented. But this does not necessarily mean that sales processes have been adjusted or that there is a formal alignment or even implementation. A dynamic alignment goes even further: either deriving the sales process from the customer’s journey or dynamically aligning it to the customer’s journey and implementing modifications as soon as changes in the marketplace are detected.

Our study found an average win rate for forecast deals of 46.2%. With no alignment at all, the win rate went down to 40.5%, which is 14% worse than the average. But with a formal or dynamic alignment, the win rate improved significantly—up to 53%, which is a difference of 6.8 percentage points or an improvement by 15%.

Our study found an average quota attainment of 55.8%. Having no alignment led to a quota attainment of 54.2%, which is slightly below average. Interestingly, the informal and the formal alignment also led to 54.4%, which is also below average and is pretty much the same result as having no alignment. But a dynamic alignment led to 63.4%, which is an improvement by 13.6%.

#2: Create an enablement charter to improve revenue attainment

Looking at the data on how organizations approach enablement, it’s interesting to see that 49.1% of all global study participants still treat enablement in a one-off project manner (9.6%) or on an informal basis only (39.5%). Then, 35.7% reported having a formal enablement vision in place, and 15.3% have actually created a formal enablement charter that covers, for instance, vision, mission, purpose, target groups, enablement services, programs, roadmaps and how to measure success.

Our CSO Insights 2016 Sales Enablement Optimization Study shows that formality matters. If enablement is approached in a one-off project manner, sales performance suffers. Revenue attainment ended up at 84.2% (compared to the study’s average revenue attainment of 90.1%), and that’s a difference of 5.9 percentage points or an actual decline of 6.5%. Win rates ended up at 45.0%, which is below the average win rate of 46.2%.

Instead, if enablement was treated with a formal enablement charter, sales performance results were much better than average. Revenue attainment climbed up to 98.8% (compared to the average of 90.1%), which is a difference of 8.7 percentage points and an actual improvement of 9.6%. Win rates showed a positive impact as well. With a formal enablement charter, win rates climbed to 53.6% (compared to the study’s average win rate of 46.2%). That’s a difference of 7.4 percentage points or an actual improvement of 16%.

Improving the revenue plan attainment by almost 9.6% and the win rate by 16% show a performance impact that ambitious sales leaders cannot ignore.

#3 Getting cross-functional collaboration right to achieve enablement goals

Cross-functional collaboration does not exist for its own sake. The purpose of collaboration is achieving better results, ideally in a shorter amount of time. Sales force enablement is always a cross-functional discipline because no enablement team can provide integrated content, training, and coaching services throughout the entire customer’s journey for different user groups and powered by technology, alone. That’s why cross-functional collaboration is mandatory for three reasons. First, to provide the defined enablement services. Second, to achieve the enablement goals regarding sales results and productivity. And third, to keep enablement as cost-efficient as possible.

Informal and ad hoc collaboration (the least desirable forms) are still the leading approach (a combined 68.8%), but this is better than last year (83%). While there is overall good news, let’s be aware that 43% of all study participants, like last year, collaborate on an informal basis, and almost 10% don’t collaborate at all.

With increasing enablement maturity, enablement leaders have to define which functions they need to collaborate with, and why. This step is often overlooked, but it is essential. If we can achieve our goals on our own, we won’t collaborate in the first place. We collaborate because we need others to help us provide our services and achieve our goals. How other functions can help has to be specifically defined for each enablement area and with each involved function.

The data in our CSO Insights 2016 Sales Enablement Optimization Study shows that cross-functional collaboration has an important impact on enablement success. With ad hoc collaboration, only 36% could achieve all or most of their enablement goals. With formal collaboration approaches, 59% could achieve all or most of their enablement goals. So, an effective cross-functional collaboration process is an important pillar for enablement success.

Questions for you:

  • How did you design your enablement foundation?
  • How mature is your customer’s journey alignment?
  • How did you set up your cross-functional collaboration?

This article was initially published in the November edition of Top Sales Magazine.

Getting Serious About Sales Force Enablement

tsw-october-coverThis interview, conducted by Jonathan Farrington, CEO of Top Sales World with my colleague Jim Dickie and myself, was initially produced for the October issue of Top Sales Magazine.

Jonathan: Tamara, may I begin by asking you to share your definition of “Sales Enablement?”

Tamara: Yes, of course. At CSO Insights, we define sales force enablement as a “strategic, cross-functional discipline designed to increase sales results and productivity by providing integrated content, training, and coaching services for salespeople and frontline sales managers along the entire customer’s journey, powered by technology.”

Jonathan: Why is sales enablement such a growing discipline? Is enablement now growing up?

Tamara: B2B sales is in a period of transformation. How to sell becomes more important than what to sell. In the age of the customer, old product centered selling formulas don’t work anymore. Modern selling is about creating value at each stage of the customer’s journey for all stakeholders to influence their decisions along their customer’s journey. And successful salespeople involve more stakeholders (5.8 on average) at the customer and also internally than mediocre performers. Our data shows these transformational challenges. Quota attainment is decreasing since 2012, from 63.0% down to 55.8% in 2016. But trying harder doesn’t work anymore. Instead, sales forces need smarter support. And this is where sales force enablement comes into play, orchestrating all efforts across functions to equip salespeople and their managers with the necessary training, content and coaching services in an integrated and consistent way so that they can be more successful in an ever-changing world.

Jim: An interesting trend the CSO Insights 2016 Sales Enablement Optimization Study found was where sales enablement fits within the organization structure. In 52.5% of the cases, the discipline reports to executive sales management, another 25.3% of the time it reports to sales operations. So this is not being seen as a marketing, HR, or training responsibility; this is truly something linked directly to the sales organization. While we are clearly seeing growing interest in sales enablement, how companies implement this discipline varies. The study found that 12.1% of the participants surveyed said that their company viewed this as a series of one-off projects, 39.4% said they had an informal vision of what sales enablement could or should be, and the remaining 48.5% told us they had taken the time to define a formal vision for sales enablement’s role within their organization.

Jonathan: That’s interesting; the organizational aspect underlines enablement’s growing up. Now, what are the major goals they are focusing on achieving?

Jim: Study participants reported two top objectives for sales enablement programs: increase not just sales efficiency and but sales effectiveness as well. But how to do that comes in a lot of flavors. Key areas of focus the study surfaced were increasing new account penetration, increasing sales to existing accounts, optimizing cross and upsell, improving margins, minimizing customer churn, improve win rates of forecast deals. The key to success is what you do after you prioritize the specific challenges your sales enablement organizations needs to address. Work needs to be done to clearly define the causes of suboptimal performance so you can then craft a comprehensive sales transformation vision, which in turn can be broken into management steps so that we can engineer evolutionary change that doesn’t overwhelm the organization.

Tamara: All these various goals that enablement leaders are pursuing cannot be achieved all at once. Some of the goals depend on an organization’s current state of enablement maturity; others on an organization’s context and priorities. But wherever you are on your enablement journey, effective cross-functional collaboration is always an essential key to success. And it’s not just marketing you have to collaborate with. Instead, there are, for instance, sales management, sales ops, product management, HR, L&D, and also IT. According to our data, 66.8% of the participants collaborate in an ad hoc or informal manner. Only 21.7% have a formal collaboration approach. So, getting cross-functional collaboration right leverages a huge productivity potential. And that requires to defining collaboration goals with each other function. Setting up a collaborative production process and defining the relevant roles for each enablement service (e.g., content types and training services) is a prerequisite for productivity. With other functions such as sales management or IT, collaboration should be formalized to ensure executive buying, exchange, and structured decision making.

Jonathan: In the age of the customer, what’s the role of the customer’s journey in sales enablement?

Tamara: As buying decisions are still made by customers, the entire customer’s journey has to be the main design point for sales force enablement. Aligning the internal processes, namely the sales process, to the customer’s journey is still a challenge for many organizations. There is still a group of 9.4% that doesn’t consider the customer’s journey at all. Another 35.2% reported an informal alignment. This adds up to 44.6% who have not purposefully aligned their sales process to the customer’s journey. Then, 55.4% reported having either a formal (27.7%) or dynamic (27.7%) alignment. Our data shows that the better the customer’s journey alignment, the better the sales performance: win rates, for example, can be improved by 15%. With no alignment at all, the win rate went down to 40.5%, which is 14% worse than the study’s average of 46.2%. But with a formal or dynamic alignment, the win rate improved significantly—up to 53%, which is an improvement of 15%.

Jim: Many companies seem to struggle with mapping the customer’s journey. That doesn’t need to be the case because to really understand what that journey entails all we have to do is ask the customer. To do that, we have long been advocates of doing buy cycle reviews. This starts with taking a group of past opportunities – wins, losses, and no decisions – and interviewing the customer about what happened from their side. What issues caused them to consider doing something, who was assigned to the project team, what tactics did they go through to assess alternatives solutions, how did the cost justify the investment, etc. You also want to know what happened after they bought something and started using it. We have outlined in detail a process for how to accomplish this in our ebook, The CSO’s Guide to Transforming Sales, which anyone can download.

Jonathan: Enablement services: What’s the state of training and content services and how do they impact performance?

Tamara: Sales training is still the top enablement service for salespeople, followed by sales tools, process improvements, onboarding, and content services that are actually the foundation for almost every other enablement service. For sales managers, enablement analytics and coaching are most important. The quality of enablement services impacts sales performance. Content quality, for example, impacts quota attainment in two ways: Content that meets or exceeds expectations drives quota attainment up to 59.3%, which is an improvement of 6.3% compared to the study’s average of 55.8%. Content that requires major redesign or improvement impacts quota attainment negatively: 53.1%, which is a decline of 9.5%. The same patterns apply for training. Training services that meet or exceed expectations improve quota and revenue attainment and win rates in a remarkable way. But if these services lack quality, the consequence is a negative impact on performance. Examples for onboarding and social selling with exact data are included in our 2016 Sales Enablement Optimization Study.

Jim: W. Edward Deming’s observation that “You can expect what you inspect” has a lot of applicability to training and content management services. Providing training and content to sales teams needs follow-up with analyzing how they are leveraging those skills and sales tools when they are actively selling. Are salespeople really trying out new sales techniques with customers, or falling back to old habits? What content are they actively using when engaging clients, and what materials are effective and which are not? And also, what content have salespeople created themselves? How do we find those materials, synthesize them into best practices, and share them across the sales force? We need to put together the processes and technologies to get answers to these questions. If we do, we can significantly increase the impact that sales enablement has on performance, because we can ensure the services are really being used.

Jonathan: Enabling salespeople is not enough. What does sales manager enablement mean and what’s the role of coaching?

Jim: Too often when we have discussions around enablement, the focus is on what salespeople need to be doing differently. That is only half the equation. Sales management needs to evolve as well. If you have a Sales 2.0 sales force reporting to Sales 1.0 managers, you are setting the stage for conflict. We need to bring a whole new level of science to the art of sales management. The CSO Insights 2016 Sales Enablement Optimization Study found that the average win rate of forecast deals is only 46.2%. Think about that. The odds of winning on a “pass bet” at the craps tables in Las Vegas are 49.3%. The forecast is created by sales management, with input from their salespeople. Nothing gets into the forecast unless management puts it there, and we are wrong more than half the time! That is indicative of a broken, or at least suboptimal, coaching process. So optimizing sales management performance needs to be part of the sales enablement charter from day one.

Tamara: I always recommend that companies enable sales managers first, based on my own experience and our data. Investing in sales managers impacts, for instance, revenue attainment by 18.4%. And the specific impact of developing the managers’ coaching skills can improve, for instance, win rates by 27.9% and quota attainment by 10.2%, if the coaching approach is a dynamic one. Yes, the coaching approach itself makes a huge difference. It’s still the biggest challenge that 47.5% of the study participants reported that coaching is left up to each manager. Such a random approach is not scalable and has no positive impact on performance at all. The abovementioned results can only be achieved with a formal, or even better, a dynamic approach. That means the coaching areas and the coaching process have been defined and implemented, and the sales managers are up to speed and are required to use it. In a dynamic approach, the coaching framework is connected to the enablement framework to reinforce the initial enablement efforts and to drive adoption.

Jonathan: Now, let’s look forward: What are your top three recommendations?

Tamara: My first recommendation is to create an enablement charter. With buy-in from the senior executives, such a charter is a very powerful internal selling tool for enablement leaders. The charter has to be based on a clear vision, mission, and purpose statement. It defines the enablement target groups, goals, strategies and activities to get there. The provided enablement services and how to measure success also have to be defined.

Second, content and training services have to be aligned. It’s still a challenge, especially when sales training and sales content services are created from different departments. In that case, enablement should establish an alignment process to ensure that the messaging is consistent. No content without training. No training without content.

Third, social selling is an enablement issue. Marketing’s social strategy and the social selling strategy have to be aligned. And enablement services involve more than training on how to use LinkedIn. Instead, social selling methods have to be integrated into the sales process and powered by technology. And social selling requires shareable social content that salespeople can use to connect and engage with prospects and customers.

Jim: You need to establish a sales culture that embraces change. That means that the first sale you need to make with any sales enablement initiative is an internal sale. Everyone who is going to be impacted by the changes you are making to training, process, technology, coaching, etc., needs to understand what is happening and why.

Second, realize that that sales enablement is an investment, not an expense. If you take the time to figure out the cost-of-doing-nothing associated with sales ineffectiveness, in terms of low revenue attainment, poor margins, high customer churn, and so on, you will quickly find that the cost of fixing these problems is orders of magnitude less than letting them continue.

Finally, understand that sales enablement is an ongoing journey of continuous improvement, versus a single event. Adapting to changes in the marketplace will require unending changes in how you engage customers.

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When two CF carriers have a child, there is a one in four chance that the child will have CF. Abnormal uterine bleeding is the most common symptom of a fibroid If the tumors are near the uterine lining, or interfere with the blood flow to myosure non surgical fibroid removal the lining, what do fibroids feel like during pregnancy they can cause heavy periods, painful periods, prolonged periods or spotting between menses. A leiomyosarcoma can be difficult to distinguish what is what do fibroids feel like during pregnancy a fibroid on ovary from a benign fibroid and this possibility should always be considered in a patient with a rapidly growing uterine fibroid. Conventional treatments for fibroids include waiting to see if they will shrink on their own, medication and surgery. Success depends on the degree to which the fibroid is deprived of its blood supply. When coding for an outpatient hospital observation stay, it is appropriate to code the current medical condition as the first-listed diagnosis. I just remember seeing different doctors and they were shocked that my fibroids were so large and they recommended to take out my uterus.

I went to see my Dr. I also have uterine fibroids and a bladder infection. Laparoscopically treated small bowel obstruction due to internal herniation through the broad ligament. A blood transfusion before surgery may be necessary because of anemia or during surgery for blood loss. A large fibroid on the back surface of the uterus is more likely to cause back pain than a small fibroid within the uterine wall. All women fibroid pain management 2017 going for myomectomy must also be consented for hysterectomy as haemorrhage is the main complication and myosure non surgical fibroid removal hysterectomy may be life saving when done early enough. Avoiding certain foods when uterine fibroids are a problem can also help lessen symptoms and promote shrinking. The numbers may prove even greater when considering both direct medical costs as well as hidden costs of the fibroid treatment process.
This procedure is minimally invasive and may be performed in an office or outpatient setting.

Excessive monthly blood loss during menstruation results in anemia If symptoms are present they will depend on the size and position of the fibroid within the uterine tissue, thus pain is often felt during sexual intercourse and irritations in the bladder or the bowel often occurs, this produces an increased urge and a rise in the frequency of urination and other conditions such as constipation can also follow. The video has been edited to 5 minutes and shows two fibroids being removed, suture closure of the uterine muscle and the use of Seprafilm adhesion barriers. Keep in mind that while supplements and diet may help control fibroids for many women, others may require medical treatments what is a fibroid on ovary to experience relief. Oral contraceptives may cause various irregular bleeding patterns, particularly in the first what is a fibroid on ovary few months of taking them. Normal fibroids don't grow when estrogen is low, as it would be after menopause. The doctor told me not to be alarmed about it but will monitor its progress. We have shown that gynecologists and interventional radiologists can successfully partner together to provide women with fibroid-related symptoms the widest variety of treatment options possible.

Many other women are taking surgery to remove fibroids in uterus lot.

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There are many ways to cure these conditions including fibroid natural treatment options as well as natural methods that can cure endometriosis. Certain growths within vagina, cervix or uterus could cause post coital bleeding too. With a myomectomy, there is a risk of scar tissue formation in the uterus, which could lead to infertility. Please, see if you are eligible to demonstrated that tumor cells produce more collagen. Recognizing the signs helps to reduce the risk of future fibroids growing out of control. You should therefore know more about fibroids and whether you need to 'treat' them, or leave them alone, before making an informed choice. During the consultation, the interventional radiologist will review previous physician notes, laboratory tests, imaging studies, review all fibroid treatment options, and fibroid tumors for ovarian surgery explain and discuss uterine fibroid embolization with the patient. Castor oil packs can help with every feminine health issue, when there is congestion or lack of circulation, which there most generally is. If she has no other complaints like uncontrolled menses or bleeding per vagina, and not much pain or such, this finding of bulky uterus is not very significant. The only possible issue is where extensive surgery was carried out to remove large tumors. Pain during sexual intercourse - The additional masses inside the uterus can cause pressure on the cervix or uterine walls. However, there have been multiple reports of successful pregnancies following uterine fibroid embolization.

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I was also on birth control pills but this made no difference with the pain or the bleeding. The great news is, you can find healthy fibroid fighting foods in some of the most unlikely places. This process causes the exchange of some platinum and titanium ions that makes the water more alkaline in its pH. There are a number of different surgical alternatives cystic polycystic fibroids on ovaries for the treatment of fibroids if they become a problem. Sometimes fibroids may cause excessive bleeding which can cause other complications. Castor oil packs when used properly can help to improve various components of the immune system.

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Ultrasound uses sound waves to create an image of the uterus and the surrounding structures can provide further information about the fibroid in addition to detecting its presence. The question of fertility following fibroid embolisation and questions revolving around the procedure in patients desiring fertility is explained in much more depth in our internet site within the Fertility Section and anyone who has fibroids and is thinking of either surgery or embolisation should read that section. Hurst and his team determined that young women with otherwise unexplained infertility in cases in which a fibroid distorts the uterine structure have the best prognoses for future fertility. Among the benign masses, most are only an inconvenience and of no threat, but some are associated with increased long-term risk of breast cancer. Women taking contraceptive pills, therefore, have higher levels of estrogen and are more likely to develop fibroid s. The standard Pap smear is obtained from the cervix and only screens for cervical cancer. As 80% of the cholesterol is generated by the liver, if the liver is not functioning well there will be abnormalities in the level of fats in the blood like elevated LDL cholesterol and reduced HDL cholesterol and elevated triglycerides. Han MX, Zhu ZS, Liu F. Unfortunately, there is no known way to prevent fibroids either from growing or recurring. African American women have fibroids two to three times more than Caucasian or Hispanic women. The fibroids are removed through a smaller incision and hence surgical removal of what are fibroids in the uterus is faster. In most cases fibroid-induced symptoms such as excessive menstrual bleeding, incontinence, and urinary frequency resolve within a month or two of receiving the correct homeopathic medicine. Prevention is usually achieved through promoting hormonal balance and preventing an estrogen dominant state since fibroids thrive in an estrogen dominant environment. This may benefit those experiencing chronic inflammation related to a fertility issue such as endometriosis, uterine fibroids, PID or ovarian cysts. On the horizon are several promising, new drugs that will treat the fibroids themselves not just the symptoms.

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Your employer wants productive people, and especially since you work with public, they don't want you crabby. Over 137,000 women in about 131 countries have used this treatment approach to successfully heal their uterine fibroids in the last 7 symptoms of fibroid cysts rupture They also reduce heavy bleeding and may protect against uterine and ovarian cancers. The cause of fibroids is unknown, but as many as 20‐25% of women over the age of 35 may develop fibroids.

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But several studies and theories point to a number of probable and possible factors. And I know that as The American Cancer Society writes in their report on thyroid cancer,most benign and cancerous nodules look the same on ultrasound and they said thats why you can't tell by ultrasound alone if they are benign or cancer. Imaging natural remedies for subserous fibroids the uterus with a pelvic ultrasound scan will rule out the possibility of structural abnormalities such as fibroids or polyps. She had 5 fibroids.2 were the size of lemons and the rest were the size of grapes. Therefore, its prolonged, estrogenic direct action on the my Underactive thyroid Symptoms Checklist you may not and progesterone during the normal menstrual homeopathy. Another possibility would be to compare pregnancy rates between infertile women with and without myomas in whom other infertility factors have been excluded. DAY2: Being worried that we had not seen a scan of the baby, we booked an appointment for a internal scan, this showed the Fibroid at 6 cm the GC suggested she take 1 paracetamol and 1 Co-Codamol 4 times a day. Breast fibroids can cause breast cancer as the cells that make up the fibroid do not respond correctly to commands from the body concerning growth and multiplication. Embolization can cause the stalk to deteriorate and allow the fibroid to float around the abdominal cavity. An excellent trend that has pretty much carried forward to this day with myomectomy. My uterus is back to its normal size again, only a teeny little bit of scar tissue in the wall where the fibroid was removed. If this were the case then the rise in testosterone could increase DHT and the anti-estrogenic effects of the iodine would aggravate the condition. Tiny particles are slowly infused into both uterine arteries to enclose the fibroids cutting off blood supply, while maintaining blood flow to the uterus as a whole. We performed a HIPAA-complaint, IRB-approved retrospective study of women seeking second opinion for management of uterine fibroids at our multidisciplinary fibroid treatment center in a tertiary care facility from July 2008 to August 2011. Research clearly shows that fibroids cause a slight increase in miscarriages, premature labor and delivery, abnormal fetal position and placenta separation. Other women had to wear larger clothes and said that they looked bloated and pregnant. We suggest that greater intake of fresh fruits and cruciferous vegetables may be able to reduce the incidence of uterine fibroids. So be sure to cut back on high iron foods before including blackstrap molasses in your diet. This allows some women to take their time to prepare physically and emotionally for surgery.

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In the recovery room, your care team monitors your condition and gives you medication to control any nausea and pain. Just because they are present, however, does not mean the uterus or the fibroids must be removed. She had almost every severe side effect listed on a drug website that we looked at after her admittance to the hospital. You also need to know that fibroids are not something to panic about - and you should not feel unnecessarily pressured into choosing one type of treatment over another. The researchers found that BAE participants lost an average 5.9% of excess weight in the first month after the procedure. We have fibroids in uterus in pregnancy treatment centers conveniently located in Newark, Linden, and Elizabeth, NJ.

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For any queries you may write back to us. Their effort not only showcases high-quality science but also the possibility of treating a neglected, small patient population with scarce resources; in this endeavor they were generously helped out by funds from the Cystic Fibrosis Foundation. Testimonials are not science, so you really have to take all those reports that dietary changes made fibroids go away with a calcified fibroid in breast of salt. Benefits: As a therapy for both endometriosis and fibroids, it can reduce pain, shrink current lesions or fibroids, and reduce the growth of new endometriotic growths.

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Traditional myomectomy will only address superficial tumors without entering the endometrial cavity. After carefully weighing several options presented by Dr. Please come for your biopsy with a responsible adult who can drive or accompany you home. Pulsatilla 200 was given two doses at 15 minutes interval, which relieved the pain. The high-frequency energy emanating from sounds heats up the fibroid growth and destroys small areas of the fibroid tissue. Hormonal imbalances such as estrogen dominance or low progesterone can cause pink discharge or spotting as your low progesterone levels mightn't be able to support your endometrial lining which could begin to shed and cause spotting before your period. It's important to note that uterine fibroids are generally not treated when they are small. I'm still taking ACV hoping it's shrinking the fibroids and will definitely let you know when I go for the next scan. In 2013, thanks to an explosion in high technology and medical breakthroughs in new diagnostics and drug therapies, women suffering from heavy menstrual bleeding have a full range of treatment options that do not necessarily end in hysterectomy. Which i think would help and avoid fibroid is bigger uterus need for stool softener and avoid bloating. The younger the woman is and the more fibroids she has before a myomectomy, the more chance she has of fibroids returning. As a patient, we urge you to find peace of mind in the form of the expertise and care of our surgical experts. Common in every 10 women over age 35 years.Fibroids occurs most often in women between 30 and 50 years. Using Focused Ultrasound Treatment of uterine fibroids modality in conjunction with image guidance, the physician directs a focused beam of acoustic energy through the patient's skin, superficial fat layer, and abdominal muscles to thermally coagulate the fibroid tissue, thereby destroying it without damaging nearby tissue or the tissues that the beam passes through on its way to the target. White spots that show up on a mammogram are called microcalcification, and may also require a biopsy.

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If asymptomatic, as most women are, a physician may first feel a knot on fibroids fast in uterus how do grow the do babies uterine wall during a routine pelvic exam. Turmeric has been found to heal uterine fibroids through its anti-inflammatory properties and its ability to induce cell death in the tumour cells in the uterus. While most of these have no symptoms, they can cause pain, particularly with strenuous exercise or intercourse. Until more is known about the potential link between fibroids and hair relaxers, my advice is to stay away from the chemicals and to instead try the natural approach; it's safer, plus your hair will be more versatile. Severe menstrual pain can be caused by other conditions, including fibroid tumors. If you only have two submucosal fibroids, they can be removed through a hysteroscopic resection which is an outpatient procedure. There is a small associated risk of hysterectomy, most often due to excessive intraoperative bleeding. If carried out adequately, debridement may allow preservation of the uterus without posing further risks to the woman. The UCLA Uterine Fibroid Treatment Program recognizes that this approach is valuable for many patients and may decrease the need for medical, surgical and radiological therapies. The few studies that have looked at long-term pain relief after an epidural steroid injection have shown that 50% of patients who initially responded to the injection will have recurrent pain after 12 months. Basically my doc told me exactly what yours did, either leave it in and risk a high risk pg or try to remove it but worse case scenario I might bleed out during the op and lose my whole uterus. The second bout was degeneration of two 2.5cm subserosal fibroids and the pain was very much localized peritonitis like right where the fibroids were. Ten million women in America currently experience fibroids, and over 250,000 women annually undergo a hysterectomy in response to fibroids. Saravelos and colleagues found that women with fibroids distorting the uterine cavity had a total miscarriage rate of 76.7% and a live birth rate of 23.3%.

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NOTE: The first couple of weeks you use the pack you will have to apply a tablespoon or so of oil about every 3 to 4 days. I found out I had fibroids when I was trying to get pregnant and it was taking some time. Those who are looking for a quick start type embolization of the fibroids Uterine Fibroids program, might be a bit intimated at first. If you're taking birth control pills for years at a time, as are most American women, you're creating nutrient deficiencies. Uterine Artery Embolisation for Symptomatic Adenomyosis - Midterm Results - Bratby MJ, Walker WJ - European Journal of Radiology - February 2008.

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If both T4 and TSH are low, this may indicate a pituitary problem with a low TSH secretion resulting in the lower production and secretion of T4. Clinical observation of mifepristone alone or in combination of Chinese medicine for treatment of uterine fibroids. I contacted him,and he promised to prepare his herbal mixture and send to me,that the only money that i will pay is the material money which i did.after 3days i received the herbs with the prescription and i started taking it intermediately. If you've been diagnosed with HNPCC, ask your doctor what cancer cystic fibroid ovarian disorder tests you should undergo.

fibroid tumor and lower back pain

Oestrogen is a mitogenic, excitatory, inflammatory hormone and fibroids are directly related the the foods that can cure fibroids environment. When we eat, sleep and exercise in constantly fluctuating and disturbing patterns, the body loses its natural balancing cycles and cannot cleanse or heal itself as effectively. Grace specializes in obstetrics, infertility, minimally invasive surgery and uterine fibroid surgery. Because of the minimally invasive approach, women recover in 7-10 days, with less complications and pain. Pregnancy may also protect against them due to uterine changes after childbirth. A 33 year old nulliparous married lady presented with mass per abdomen and pain in abdomen since last five months. Some studies have identified an increase in some complications of pregnancy after UAE.


Pronunciation of Cue

English Meaning

  3. A queue of hair.
  5. Games To strike with a cue.
  6. To braid or twist (hair) into a queue.
  7. To form a line or queue.
  9. A reminder or prompting.
  10. A hint or suggestion.
  12. Music A gesture by a conductor signaling the entrance of a performer or part.
  13. Psychology A stimulus, either consciously or unconsciously perceived, that elicits or signals a type of behavior.
  14. Archaic One's assigned role or function.
  15. Archaic A mood; a disposition.
  16. To give a cue to; signal or prompt.
  17. To insert into the sequence of a performance: cued the lights for the monologue scene.
  18. To position (an audio or video recording) in readiness for playing: cue up a record on the turntable.
  19. cue in To give information or instructions to, as to a latecomer.
  20. The letter q.

Malayalam Meaning

 Transliteration ON/OFF | Not Correct/Proper?

× എങ്ങനെ പെരുമാറണമെന്ന സൂചന - Engane Perumaaranamenna Soochana | Engane Perumaranamenna Soochana
× സൂചന - Soochana
× സൂത്രം - Soothram
× സൂചകപദം - Soochakapadham
× കുറിവാക്ക് - Kurivaakku | Kurivakku
× എങ്ങനെ പെരുമാണണമെന്ന സൂചന - Engane Perumaananamenna Soochana | Engane Perumananamenna Soochana
× കുറിവാക്ക് - Kurivaakku | Kurivakku

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What is Al-Jazeera English for?

AJILogo.jpgWe have recently witnessed a huge growth in the number of transnational English-language television channels. This workshop led by Prof. Marie Gillespie of the Open University and Dr. Ben O’Loughlin of Royal Holloway, University of London, focused on the purpose of these channels. Given that Qatar, France, Russia, Iran and China have all recently launched English-language TV stations, does this mean countries only feel they count as a ‘power’ if they have a voice alongside the BBC and CNN in the emerging ‘Anglosphere’? Are governments institutionalizing a new phase of public diplomacy in an attempt to influence other governments or publics? Or are these channels simply professional news providers, part of profit-making organizations?

Debate was anchored around two presentations. First, Dr. Mohammed El-Nawawy of the Queens University of Charlotte and Shawn Powers of the University of Southern California introduced their new study, Al-Jazeera English: Clash of Civilizations or Cross Cultural Dialogue? In the next year they will examine the impact of Al-Jazeera English in five countries, asking whether such media can have peace-making effects in world politics, acting as ‘conciliatory media’. Al-Jazeera English is an interesting case because journalists have an explicit mandate to give a ‘voice to the voiceless’ and produce news that does not offer casual demonisation, lack of context, or reduce debates to simplistic binary stand-offs. But why would the Emir of Qatar sanction this TV station alongside its Arabic version? And why recruit journalists from the West rather than from ‘voiceless’ regions? Debate focused not only on the purpose of this channel, however, but also on how researchers might ascertain its impact. For instance, few viewers have access to Al-Jazeera English at present, and those likely to reply to surveys or interviews about the channel are likely to be a self-selecting bunch: viewers who already approve of the journalistic ethos of Al-Jazeera English. How transnational media channels attempt to measure any ‘effects’ on audiences – conciliatory or otherwise – is a critical challenge in the coming years, and it remains to be seen how these channels will prove their value.

The second presentation drew on findings from the recent New Security Challenges Shifting Securities project by Marie Gillespie, Ben O’Loughlin, Prof. James Gow, King’s College, London and Dr. Andrew Hoskins, University of Warwick. The project explored how cultural and religious diversity affect news reception and the specific responses of British Muslims to media and security policy. It has also highlighted how changes in the technologies, ethics and practices of journalism shape the security stories and how they are interpreted. The study has been pioneering by connecting news producers, texts and audiences over time in ways that illuminate how audiences’ use of news contributes to their shifting perceptions of security and belonging. Insights from the Shifting Securities methodology will feed into several projects funded by the ESRC and AHRC in coming years, including in the New Political Communication Unit. An understanding of news consumption as a ritualised, social and situated process, not a matter of transmission of isolated messages to atomized viewers, can offer greater analytical purchase on questions of news credibility, the legitimation of security policy, and the ‘impact’ of media diplomacy around the world.


Juan F Granada, Mark Stenoien, Piotr P Buszman, Armando Tellez, Dan Langanki, Greg L Kaluza, Martin B Leon, William Gray, Michael R Jaff and Robert S Schwartz

Background The efficacy of paclitaxel-coated balloons (PCB) for restenosis prevention has been demonstrated in humans. However, the mechanism of action for sustained drug retention and biological efficacy following single-time drug delivery is still unknown.
Methods and results The pharmacokinetic profile and differences in drug concentration (vessel surface vs arterial wall) of two different paclitaxel coating formulations (3 µg/mm2) displaying opposite solubility characteristics (CC=crystalline vs AC=amorphous) were tested in vivo and compared with paclitaxel-eluting stents (PES). Also, the biological effect of both PCB formulations on vascular healing was tested in the porcine coronary injury model. One hour following balloon inflation, both formulations achieved similar arterial paclitaxel levels (CC=310 vs AC=245 ng/mg; p=NS). At 24 h, the CC maintained similar tissue concentrations, whereas the AC tissue levels declined by 99% (p<0.01). At this time point, arterial levels were 20-fold (CC) and 5-fold (AC) times higher compared to the PES group (p<0.05). At 28 days, arterial levels retained were 9.2% (CC) and 0.04% (AC, p<0.01) of the baseline levels. Paclitaxel concentration on the vessel surface was higher in the CC at 1 (CC=36.7% vs AC=13.1%, p<0.05) and 7 days (CC=38.4% vs AC=11%, p<0.05). In addition, the CC induced higher levels of neointimal inhibition, fibrin deposition and delayed healing compared with the AC group.
Conclusions The presence of paclitaxel deposits on the vessel surface driving diffusion into the arterial tissue in a time-dependent fashion supports the mechanism of action of PCB. This specific pharmacokinetic behaviour influences the patterns of neointimal formation and healing.