THIS IS THE FIRST IN A THREE PART SERIES
Deb Spicer, MS, BS, RN
First, let’s agree that if it was easy to be a 5-Star hospital, every hospital would be. The truth is there are many variables in the healthcare clinical setting therefore, it is easy to get some areas right and have no sight on others that drag down healthcare delivery success measures.
Just as champions in industry and athletics are elite in their fields, their extraordinary success comes from their willingness to do what the “low performers” or “only ordinary” will not do; invest in time and training.
The first in this three-part series discusses the role of Ethnography Research and how elite hospitals – and those who strive to deliver superior patient engagement across their enterprise – use Ethnography Research and reporting to amplify the patient’s voice about their care.
Delivering care that is perceived as a true Provider-Patient Partnership from every person who “touches” the patient is fundamental to the elite performance hospital administrators are striving. In addition to the Mission of the hospital, administrators recognize their direct impact on bottom-line financials through the pay-for-performance reimbursement model.
THE ROLE OF ETHNOGRAPHY RESEARCH
Conducting Ethnographic Research by trained researchers outside of hospital staff unveils in non-threatening ways to the patient vital information that can highlight catalysts for change that begins transformation. Researchers ask more open-ended questions than paper surveys and researchers can ask follow-up questions for more robust interpretation or information. Simultaneously, trained researchers can observe caregiver challenges and identify the root of issues of those barriers versus behaviors or personalities.
Revealing and reporting the newly unveiled barriers to operational excellence, together with customized and specific plans and training to improve the variables at issue is the first in three steps and ongoing investment toward extraordinary success – in superior healthcare delivery, in reputation, and financially.
Implementing training and education around physician and provider communications with each patient is the second part in this series. The third of the series, discusses how top-performance hospitals continue to succeed when their physicians, nurses and other healthcare professionals and staff are versed on a “way-of-life” in dealing with patients. These approaches are NOT a program of the day. These approaches are NOT a “flavor of the month ACRONYM”. The “way-of-life” approach focuses everyone on passionate care delivery so that Every Patient, Every Time, Every Day is treated as a central partner in their journey to better health.
While our strategic or personal plan for success looks linear, smooth and tidy on paper, the fact is that trying on new approaches, learning new skills, or practicing new tactics can be awkward, difficult and messy at first. We often flounder through it at first. Our growth to this point, our own journey, likely had many twists and turns, just as a revised or new direction, outside of our current comfort zone may feel difficult. Utilizing Emotional Intelligence tools even with good changes strengthens our self-management skills and personal accountability. Ultimately, when we trust ourselves through this process we will succeed.
Self-management is also referred to as emotional self-control. So how do you deal with an annoying person? You start with yourself! You have a role in the annoying feelings because you “assigned” to that person that they are annoying. Maybe they are, so what is your role in assigning the degree to which that person is bothersome? The Heart of Emotional Intelligence is Self-Awareness. Everything in life is a choice, including how you choose to feel about others. Understand your perspective first, and then take the following steps:
- Show restraint
- Demonstrate patience
- Respond calmly
- Remain composed and positive
- Be proactive vs. reactive
Unless you know yourself, you cannot be free to truly make a difference. Why? Fundamentally, the ability to make healthy choices is based on accurately identifying, understanding and managing YOUR OWN feelings. Imagine you are in a meeting with a dozen team members and someone opens the door letting a lion into the room. Everyone except one is in shock and horror and fear. Yet, the person whose father was a lion tamer in the circus is not afraid because she identifies, understands and manages herself from the experiences of her background. We each bring different backgrounds, experiences and life journeys. Understanding what makes you “tick”, elicits a reaction from you or makes you feel anxious is what helps you grow to make you great! “The more we understand the beauty and the blemishes, the better we are able to achieve our full potential!”(Emotional Intelligence 2.0)
This is the heart of emotional intelligence!
Personal competence is your ability to stay aware of your emotions and manage your behavior and actions. We have been helping companies and hospitals for the past four years…and the HCAHPS scores for hospitals continue improving!
Check out this blog – Company Culture: If You Ain’t First, You’re Last!
The most recent Gallup study, The State of The American Workforce, reported disturbing facts:
- US business are robbed of $450-$550 billion per year
- The reason is internal…in the form of loss of productivity
- The cause is rampant low employee engagement
Hospitals and medical practices are being robbed of billions of dollars in Medicare and insurance reimbursement for similar reasons. Low patient satisfaction scores translate to withholding of reimbursement as the healthcare business model has moved from pay-for-service to pay-for-performance.
Check out this blog – Anchors a Weight http://bit.ly/1XmA8uS
How do you start your day? Mind FULL or Mindful?
While training healthcare leaders in Emotional Intelligence, one facet we explore is ‘how do you start your day or shift’? How do you show up? Mind FULL? Or, mindful?
When tensions get high, your patient goes downhill, or the stress gets rough, the first pulse you check should always be your own! The first drug you give is oxygen – remember to breath!
Practicing mindfulness when not in stressful situations secures the foundations needed when you later need to call on this stress reducer. For more information on mindfulness, see the related article by Dr. Bradberry.
In the first of the recent two blogs, How to Ensure Success During a Major Corporate Change, we addressed the importance of building cohesive leadership teams – those that master the five behaviors: building trust, mastering conflict (around issues or ideas), achieving commitment, embracing accountability and, focusing on results.
In the second blog, Piranha Behavior on a Team, we discussed in more depth that the first discipline we have to master to make our teams great is trust. To build trust, team members need to be vulnerable around one another so that they are unafraid to speak up with honesty. Only team members who trust one another are going to feel comfortable engaging in unfiltered, passionate debate around issues and decisions. Otherwise, they are likely to hold back their opinions.
While conflict is often considered taboo, especially at work, people may spend inordinate amounts of time and energy trying to avoid the kind of passionate debates that are essential to any great team. Yet, conflict is the second discipline we must embrace in order to be a highly-effective and successful team. Teams that engage in productive conflict know that the only purpose is to produce the best possible solution in the shortest period of time.
Teams that avoid conflict – speaking their views, debating their perspectives and voicing unfiltered opinions – turn to unproductive and sometimes destructive measures. In these cases, team members are not listening to one another’s ideas and considering their own points of view; they are figuring out how to manipulate the conversation to get what they want. Or, they don’t even engage their colleagues face-to-face; instead, they vent about them in the hallway after the meeting is over.
Teams that fear conflict:
- Create environments where back-channel politics and personal attacks thrive
- Waste time and energy with posturing and politics
- Fail to tap into all the opinions and perspectives of team members, and
- Ignore controversial topics that are critical to team success
These behaviors are team distractions, and are powerful destroyers of team success.Even among the best teams, conflict is at least a bit uncomfortable. It is unrealistic for a team member to say, “I’m sorry, but I don’t agree with your approach to the project,” and not expect the other person to feel some degree of personal rejection. If team members are not making one another uncomfortable at times, if they never push one another outside of the emotional comfort zones during discussions, it is extremely likely that they are not making the very best decisions for the company.
The best teams are made up of people who are comfortable passionately arguing for their ideas. No one holds back their opinions – and everyone embraces conflict as the discipline necessary in the pursuit of truth or the very BEST possible answer for the organization.
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Posted by Deb Spicer Certified Cultures That Work Coach
and Five Behaviors of a Cohesive Team Facilitator
No one can dispute the power that strong leadership teams deliver to an organization. Therefore, when a major change takes place in a company – such as the appointment of a new CEO, a strategic restructure of an organization, a major acquisition, or a turnaround – it is time to take action.
To get the company on board withcorporate change requires putting into practice a new approach that focuses the leadership team on the new vision, measurable improvements and results.The leadership team’s commitment and their success in driving achievable, measurable, and bottom-line results in light of the major change, is fast-tracked when together cohesiveness, collaboration, commitment, and accountability are put into action.
With as much energy as it takes to build a cohesive team, the process does not have to be complicated. Quite simply, a cohesive team needs to master five behaviors: building trust, mastering conflict (around issues or ideas), achieving commitment, embracing accountability and, focusing on results.
“Team members have to be focused on the collective good of the team. Too often, they focus their attention on their department, their budget, their career aspirations, their egos. When people come together and set aside their individual needs for the good of the whole, they get more done in less time and with less cost.” — Patrick Lencioni (Author of the national best-seller, The Five Dysfunctions of a Team)
Teamwork does not just happen, particularly when the leadership team is inherited or cobbled together bringing different cultures, different operating processes, and different perspectives about customer service delivery.
There are many reasons why teams fail. There is one proven way to help them succeed. Taking this focused approach your company can dramatically accelerate the process and build the leadership team in relatively short order. In this series, The Five Behaviors model is designed exclusively for intact teams and work groups. To download The Five Behaviors of a Cohesive Team brochure click here. For more information or to request a proposal to help you build productive, high-functioning teams click here.
One of the most difficult and destructive team personalities to deal with in an organization is one that I refer to as the “Piranha.” Like the South American fish that eats other fish it perceives as a threat, this personality type sabotages team success by manipulating and coercing others for personal gain.No matter how strong your team leadership skills, how charismatic your personality or how fluidly you negotiate, a “piranha” behavior on a team sabotages every effort toward the success of the team as a whole.
Why? Because the fundamental and most important behavior in creating a successful, high-performance team is trust. Trust is about vulnerability. Team members who trust one another can be comfortable being open, even exposed to one another regarding their failures, weaknesses, and fears. Vulnerability-based trust is predicated on the simple and practical idea that people who are willing to admit the truth about themselves are not going to engage in the kind of political behavior that wastes time and energy, and more important, makes it difficult to achieve real team results.
While the advantages of being a high-functioning team are enormous, they can only be achieved if every member of the tam is willing to invest the time and emotional energy in the process. For example, team members that lack trust often exhibit the following behaviors…
- Waste time and energy managing their own behaviors for effect (a “piranha” behavior)
- Find reasons to avoid attending team meetings
- Contribute very little, even when specifically addressed
- Dismissive and caustic in responding to other members’ ideas and inputs
- Conceal their weaknesses and mistakes from one another
- Jump to conclusions about the intentions and aptitude of others without attempting to clarify them
- Fail to recognize and tap into one another’s skills and experiences
- Hesitate to ask for help or provide constructive feedback
- Don’t offer help to people outside of their areas of responsibility
The first behavior we have to master to make our teams great is trust. To build trust, team members need to be vulnerable around one another so that they are unafraid to honestly say things like, “I don’t know the answer,” “I need help,” “I made a mistake,” “I’m not sure.” When one member is not vulnerable, it spreads like a disease and the team can be left in shreds. Unless each team member can readily speak these words when the situation calls for it, they will waste time and energy thinking about what they should say and wondering about the true intentions of their peers.
In order for a team to establish real trust, team members, including the leader, must be willing to be vulnerable around one another. Everyone must be committed to getting there. Every team member must be willing to take risks without a guarantee of success. They have to be vulnerable without knowing whether that vulnerability will be respected and reciprocated.
I have seen first-hand that once the piranha personality or team member unwilling to commit to the team is changed out, the team transforms immediately. In fact, while the rest of the team remains the same, it looks and behaves like an entirely different team. And, as these team members are now genuinely transparent and honest with one another, they are able to build the foundation to their long-term success: vulnerability-based trust.