Tuesday, March 19, 2013

Tip 17: How does it feel to operate in the dark?

How does it feel to operate in the dark?

Bedside ImageWe wouldn't expect our surgeons to do it, so why would we set up our team members to? Although this sounds extreme, it's a day-to-day reality for many.

Exhibit A: "Just what is a physician leader?"

I started to share this story with you in our last issue of Coach Leader. This question was asked by a physician executive at a medical staff retreat I recently facilitated, which led to a number of physicians in the group suggesting that they weren't sure what the board and administration was asking of them when it comes to physician leadership. One physician said, "We hear this all the time, but I don't see what all this has to do with improving quality." Another stated, "I just don't know why we're doing this."

It's not just this group of doctors that find difficulty in connecting this expanded responsibility of physician leadership to their primary job of caring for patients. It's quite clear that our current context for physician leadership needs to be addressed throughout the industry. While we've discussed physician leadership in-depth in past issues and will continue to define it, it's worth pointing out that this confusion or "lack of context", is the source of accountability challenges reported by many of the organizations we hear from. 

If organizations are serious about experiencing physician leadership, improving patient accountability and strengthening their relationship with their medical staff, we must first start by addressing our "lack of context".  This goes for nurses, staff and administration throughout your organization, because these team members are not immune to this industry wide context deficit. We see and hear just as many questions and comments from staff indicating confusion and insufficient information related to the need for role design:

"I'm just not sure if they know what they're asking us to do?"

"How can they could expect any more from us...they just don't understand what we're up against!"

"That's not my patient."

"That's not my job."

Why should questions and comments like these stop leaders in their tracks? Because these team members are signaling that they are overwhelmed and unaware. They currently operate under a context based solely on their individual jobs. And when your current context is based on job alone, it directs a patient experience that can be best described as "every man for himself". This is a mindset many of us are all too familiar with, and a sure sign that our people are operating in the dark, unable to fully contribute toward raising the level of overall organizational performance.

Where does insufficient context come from and why is it compromising our ability to work more effectively for our patients? It's a bit ironic that in our content over context world, we are missing the key pieces of information that help us identify our role and relate it to a bigger team oriented picture. Consider the workplace environment and how each of us is bombarded daily with overwhelming amounts of content; rigorous continued education, staying up to date with new technology, more and more metrics to track, etc. With all the emphasis on content we begin to lose sight of how it all fits together – context. And so in a content over context workplace, it's quite reasonable that many of us are beginning to ask for more context as we attempt to sift through piles of content and distill what matters most. This directly leads us back to the question, "What does physician leadership have to do with improving care?" And it's why our people are quietly asking these context oriented questions and seeking a more definitive purpose and role.

One things for sure, insufficient context will lead to incorrect assumptions. The most costly assumption we find organizations making is one of defining job and not role. When team members lack context for their role, it limits the degree to which individuals invest in team and organization. We have assumed that because individuals (physicians, nurses, therapists, etc.) are skilled at their jobs, they must understand their team role needed to contribute to the greater mission of the organization. While our individual jobs are necessary for establishing context to identify specific tasks and actions, our jobs alone are insufficient for aligning and engaging the hearts and minds of individuals and teams to contribute to shared purpose... to improve care. If we are going to give rise to context and help our team gain needed perspective of their role, we must start thinking like a coach.

Tip 17: Coaching for Context:

Several months ago we set out to challenge some of our current assumptions about leadership and give rise to new context for healthcare leaders that improves our ability to serve our team and our patients. The goal was quite simple... take some of the unnecessary complexity and mystery out of what being a leader in healthcare really means. Understanding that if healthcare leaders we're a bit more clear on what mattered most to their team, we'd have an easier time focusing our efforts and emphasizing tools that have the most impact on helping them care for patients.

Two issues ago, I shared the personal mission statement of my upcoming book's main character, which is based on attributes of the talented leaders I've worked with throughout my career. This mission statement is in essence an extension of our T.R.U.S.T.E.D. model for improving patient accountability that many of you are familiar with. If you haven't yet had the opportunity to review it allow me to share a few pertinent highlights:

"YOU as a leader have the most impact on care because you help others see the role they play, not because you're better at your job."

"YOU know that a good team needs a good coach and that's what you are."

If we've been successful at anything, we've made the case that to be an effective healthcare leader – providing what matters most to our team and patients – you must be an effective coach.

While many skills and competencies contribute to becoming an effective Coach Leader, simply observing is one of the most fundamental. Yogi Berra said, "You can observe a lot just by watching." I would add that you can learn a lot just by observing. Just as a physician must utilize observation as a key tool to acquire knowledge about a patient; coaches benefit from simple observation and use that intelligence to more effectively  diagnose organizational problems.

Coaches are well positioned to observe the subtle signs, actions and behaviors guided by our teams current context. Chris Osborn, a noted expert on coaching and President of Coach Training Alliance, emphasizes that coaching is a co-creative process that leverages the building of awareness and context. He suggests that following coaching's simple steps can create new behaviors based on what is observed. As Chris says "There is no more powerful process to lead people to greater outcomes." Like all Coach Leaders we work with, observing becomes an essential tool for seeing the questions and comments that demonstrate the need for context. Like all great coaches, you'll quickly discover just how essential setting context is for improved team performance. Lucky for us, coaching doesn't require us to have all the answers; our strength as a Coach Leader relies on tools like observing and asking questions. These are the only tools that will help us lead our teams out of the dark and help to set a more relevant context for them and the patient.

Coach+Leader will be on Spring Break later this month and will return April 10th. We look forward to getting your feedback on how these coaching tips are working for you.

Email me or share your thoughts on our Facebook page.

Brian WongDr. Brian Wong's highly anticipated book,'HEROES NEED NOT APPLY' releases this spring.

Listen to Dr. Wong as he discusses Heroes Need Not Apply: A Unique View on Accountable Culture Click here to listen>>

Brian WongCheck out the new video interview with Brian Wong, M.D.
to access Dr. Wong's Q&A as he discusses "Heroes Need Not Apply," Click here>>

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