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Just like any microcosm of society, healthcare organizations mirror the complexity of personage and disparate perceptions that occur throughout our society. We also enjoy and struggle with 4 generations in our workplaces. These disconnects that occur in any group dynamic are replicated throughout the various work units across any organization, and each of these downstream smaller locales become like neighborhoods in cities, which despite sharing the same geography and municipal services, have vastly different lived experiences.

In healthcare organizations such as hospitals, there are minimum wage earners, all the way to multi-million dollar compensated executives, and all too frequently, these co-workers are distinctly segregated from one another, further creating separations in experiences and workplace perceptions. Sometimes there are collective bargaining units competing for the same allegiance. Getting everyone cheering for the home team, can be elusive.

As a former hospital executive, (and therapist), it often seemed that I was living in a completely different world from my C-Suite Colleagues, and in many ways I was. My initial entry into healthcare happened at the bedside. Often, my colleagues shared perspectives about problems that were quite different from mine.

This does not imply that opposing or varying views between team members is unusual or should be muted, but rather this should be acknowledged and used to its’ greatest benefit. These divergent views come from schools of thought in which we were each educated. These resulting beliefs drive our reactions and responses to the same situation. It is sometimes presumed however, that everyone in the senior leadership team has shared the same glass of Kool-aide……big mistake.

Good teams learn to seek out and respect their diversity and rely upon one another’s expertise to help guide decision making. Notice I said, good teams. Sadly, not all teams are high functioning and collaborative. Assuring this kind of interactiveness is the duty of the highest ranking officer or team member. But we all know how hard it is to get 5 or 6 people to honestly express their opinions, convey doubts, or to even appear enthusiastic in the face of dissent, or how to effectively challenge the silent team member who is known for sabotage. These phenomena are part of human behavior and exist regardless of title and span of control. This is particularly challenging when one may feel that their employment is in jeopardy if they are honest, or express an unpopular opinion. As Patrick Lencioni (2002), wrote in his insightful book, The Five Dysfunctions of a Team: “trust lies at the heart of a functioning, cohesive team. Without it, teamwork is all but impossible.”

He goes on to share:

“Achieving trust is difficult because in the course of career advancement and education, most successful people learn to be competitive with their peers, and protective of their reputations. It is a challenge for them to turn those instincts off for the good of the team, but that is exactly what is required. Any less, and misalignment leading to failed strategy execution and lackluster performance will result”.

In my own experience as a leader and a consultant, I have seen such significant misalignment at the Executive level, that it would be completely predictable that any major initiatives to drive large scale change would fail. There were many times as a consultant, that team members would share their reluctances in confidence…… either in suggestion that I would share these feelings with the CEO, or just to offload their own frustrations, and personally – unable to engage in honest, robust, dialog with their CEO. I would submit, that the failure of the CEO to garner and align the support of their inner circle is the #1 risk factor in any new project endeavor.

Tacit head nodding and agreement without passion and commitment is moved downstream to the next level of employee and the splitting has begun. One senior level holdout is all it takes to bring down a stellar idea or project. This same scenario is then repeated throughout the organization, one location/department at a time. Staff who have worked in an organization like this, know how this will play out and they will not invest their emotional energy in the initiative, but rather will enjoy watching the unraveling and flailing that ensues. They are not malicious; they are just tired. (and cynical, right?).

So how can you effectively combat this insidious and destructive low trust environment? Unfortunately, trust is not achieved overnight. It requires shared experiences over time, multiple instances of follow-through and credibility, and an in-depth understanding of the unique attributes of team members. In short, it means that senior leaders, and following their example – the rest of the organization, must commit to putting the needs of the customer and organization above their own, and engage in a reliable and effective process of shared process execution which, over time, results in the development of a high-trust culture. Culture is learned, more than taught.

5 Important Steps for the Senior Executive:

1) Foster Trust and Demonstrate Respect.

This is likely the most important work of a CEO, Department Director, Manager, or responsible leader. This will have to be earned and replicated over time. The starting point for this trust journey is an approach we refer to as the effective communication flywheel or ECF. It is depicted below

2) Share knowledge.

The team that is educated together has a shared and similar exposure, and is more prone to develop aligned perspectives. The effective communication flywheel (ECF) acknowledges this, and has specific steps to develop organization alignment. This requires artful implementation. If this is not your strength, get some assistance. The ECF starts with honest, robust dialog and shared learnings to achieve alignment.

3) Validate the comprehension of the team and establish mutual commitment as to what is expected to assure success, and keep tabs on it.

This represents the next two steps in the ECF process. Commitment is not just consensus or agreement – it’s mutual assurance of shared responsibility. After each person has been given the opportunity to provide their opinion and participate in knowledge transfer, the leader of the discussion calls the question and asks for team commitment. Based upon that commitment mutual accountability is established. You then must have a proven method to monitor results.

4) Role Model

Set a model for how dissent will be managed. Listen, Hear, See, Speak, Act. (versus, the all too frequent……. Ready, Fire, and then Aim). This is critical in the first three steps of the ECF. Model the behavior you wish to see. Multiple examples of follow-through, particularly by senior leaders, builds credibility and drives results.

4) Modify and Adjust, but don’t give up.

Persistence is a virtue, and closely monitored by others. Change is hard but essential if the organization is to survive. As results are achieved trust grows, as does customer loyalty because their needs are fulfilled. Trust encourages more honest, robust dialog and shared learnings – and so the flywheel begins to gain momentum.

Sounds simple, but it isn’t. Not everyone possesses innate abilities in these areas, and some individuals and teams have benefitted from existing dysfunction. So, as the effective communication flywheel demonstrates, work to establish a way to communicate and get things done first before expecting transformation results.

The SOAR Vision Group and The Strategy Deployment Institute (SDI), are poised to assist you and your organization with navigating these complex and worrisome phenomena, establishing an effective communication flywheel process, and assist you with transformational strategy deployment.

Our team of Healthcare experts have crafted related curricula to educate your teams. This education can be completed as a group or individually on-line, and we are also available for on-site guided strategy deployment implementations.

Please contact us for further information at: www.soarvisiongroup.com and www.StrategyDeploymentInstitute.com

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