Why do we let culture, and dysfunctional teams, impede our progress?
One Example - the Autocratic Department Chair . . .
Eight Division Chiefs told me that their physician teams were struggling. The workload, the constant changes, the new EHR system, new billing processes, a lack of clarity about the Department’s priorities – revenue vs. research, etc…..were killing morale and engagement. They were afraid of losing good people that would be hard to replace.
The Chiefs said they could each use help to develop a strategy for their respective teams, including how to improve communication and engage physicians in finding solutions. Some admitted that their strength is research - not communication!
The Department Chair’s response? “They’re all experienced. They were hired to do a job. They’ve all gone through leadership training. They have the Department’s strategic plan binder on their shelves. If they need help at this point, they shouldn’t be in their role.”
Wow. This is a bit extreme, but not as rare as it should be. This example touches many of the challenges I outline, below. If this is happening in even just one or two Departments in every organization, imagine the potential negative impact…
Organizations assume they have leaders, managers, and teams capable of implementing their plans. Engagement, quality, or other performance programs rarely fail because the strategy is wrong. More often than not, when I’ve been called in to help with a strategy or operations issue – it turns out it’s really a people and culture issue.
Why is healthcare prone to dysfunctional teams?
Silos - We might work in multi-disciplinary teams, but we are an industry built around silos. We create matrixed structures to allow for cross-department work, but we don’t emphasize the skills necessary for this work – or create clear, shared goals.
A Culture of Expertise - Rather than a culture of collaboration and caring, supportive leadership, we have a traditional culture of autocracy, expertise and the need to “be right.”
Distrust - We face the decades-old dynamic of clinicians not trusting administrators (even when they come from their own ranks).
Skepticism - Professions that thrive on healthy, scientific skepticism – This doesn’t always lend itself to positivity, and openness to new ideas.
Team Skills - Individuals often rise to high levels of their own discipline without developing effective emotional intelligence, communication, leadership, and team-building skills – Think about it – you don’t rise to the highest levels of Google without these skills . . .
Culture/Team Neglect - We rarely WORK on any of this!!!! How much energy do you think companies like Google, or organizations like the Navy Seals put into building culture and teams? It’s nearly constant.
The Myth of Collective Intelligence
Healthcare is enamored with the myth of “collective intelligence and talent.” If we create groups of people, each as smart, credentialed, and talented as possible, we’ll succeed. It doesn’t work. Success requires real work on team skills, regardless of the collective credentials, experience. or talent of the individuals in the room.
Every professional sports team who’s tried to win a championship by merely cobbling together the most talented players, without working on the concept of “team,” has learned this lesson.
START with PEOPLE - Think in Terms of Teams, Not Programs…
Rather than thinking about initiatives as a top-down, organization-wide solutions, we should be focused on building effective teams that can successfully implement these solutions – all day, every day.
The teams I’ve worked with rarely lack the necessary, knowledge, or expertise.
The real problems become evident pretty quickly:
The strategy wasn’t effectively communicated or there’s still no consensus on the goals.
Underlying, unaddressed, team conflict
A lack of role clarity
Leaders are inexperienced or lack specific skills (change management, communication skills, team-building, establishing a culture of psychological safety, flexible leadership styles, conflict resolution, etc.)
A lack of praise, acknowledgement, and transparency
No attention to culture, norms, team behaviors, psychological safety, or healthy conflict
Change Culture by Changing the Way You Do the Work
Imagine a football coach who wants to build a winning culture. Once a week the team sits through “culture” and “leadership” training.
Then, his team displays terrible practice habits, poor communication on the field, and a lack of accountability or support for each other. No one corrects the behaviors in the moment, or models the right behaviors. No one sets expectations.
This sounds absurd, but it’s exactly how some organizations approach the concept of culture – and the culture never changes.
You change culture by changing the way you do the work!
You CANNOT simply tell a group of people to function more like a team, to collaborate, to support each other, or to improve how they communicate. These are skills. They come more naturally to some, but they are, indeed, skills that need to be taught, and practiced- by individuals and by the group.
You only change culture by integrating these behaviors INTO the work. People learn while doing the work, and constantly evaluating and improving behaviors, in the moment.
Run better meetings. Make communication and supporting your team a priority, every day. Start your list of tasks for the day with two questions:
“How will I support my people and build a sense of team today?”
“How will I model the behaviors that will build the culture we want?”
This work needs to happen in the C-Suite.
This work needs to happen with Physician Leaders.
This work needs to happen with Nursing Leaders.
This work needs to happen when frontline managers meet with their teams.
This work needs to happen every day.
This is what it means to lead . . .
People WANT to be Part of a Team –
Take advantage of the fact that people WANT to be part of a team, to feel a sense of “connectedness.” Start with this assumption – because it’s generally true.
Make them realize that it will take collaboration to accomplish their shared goals.
Challenge them to do the work to change their behaviors and to support each other.
Give them the structure, and the support, to do it.
A multi-disciplinary team took on the work of improving department performance – by starting with how they functioned as a team. A quote from a nurse in a group ….
“This is amazing to be a part of. I have been here almost 14 years, and this has just never happened before. The process has helped us to grow and pushed us to do and be better – for our colleagues, and, ultimately, for patients.”
Want to learn more about how to integrate people, strategy and operations? Visit us at www.trailheadstrategy.com.
Comentarios