Creating Joy in Work: What Effective Leaders Do
This is not surprising news to team members in healthcare. Which is why a frequent request from team members is “how do we engage senior leaders?” This question is often posed by core leaders – the mighty middle leaders in healthcare organizations. Core leaders are essential sources of ideas and energy for change – and they are not enough to accomplish and sustain large scale change. Systemic results will not change without aligned leadership behaviors at all levels, especially by the most senior leaders.
We are not advocating top-down leadership practices – doing ‘to’ team members – but are advocating doing ‘with’ others to co-design, implement effective learning systems, and sustain ongoing improvement for those served and those who work in healthcare.
Literature describes the behaviors of effective leaders. One source we consistently rely on is the work of Kouzes and Posner1. Their three decades of studies define five practices of exemplary leadership:
- Model the Way
- Inspire a Shared Vision
- Challenge the Process
- Enable Others to Act
- Encourage the Heart
Model the Way
Assume good intent
- Rather than assume senior leaders are opposed to or not interested in Joy in Work, Senior Leaders:
- May lack information on Joy in Work (JIW) or other topics you are advancing. There is a myth that senior leaders are expert in all healthcare issues – false! As prior healthcare executives and in our current work, we can verify that no one is capable of knowing all the content required in the vastly complex work of healthcare. The path forward to improving joy in work may not be known to them.
- May want to engage in joy in work but are not sure what needs to be done or how to take effective action. They may lack core content about the rationale and benefits – what exactly JIW is and why is it important. For example, those who lead patient safety can relate to this gap. Deep skills in the science of safety is frequently lacking in senior leaders.
- May be concerned with how to integrate strategies vs. adding “one more thing”. They may not be sure where joy in work fits with all the other competing demands.
Get a plan:
Identify which senior leaders may be the most receptive to a dialogue regarding the importance of JIW.
- Clinical executives are frequently the biggest champions of JIW since they see the impact directly
- Other senior leaders who are often great champions are:
- Safety executives
- Human Resources
- Be authentic, clear, concise
- Start with reiterating your shared purpose about the organization’s mission
- A clear purpose or Shared Vision: why this is important and what it means for the organization
- Use organizational data – particularly stories of impact and stats, especially the cost of turnover, patient experience results, and the impact of safety culture surveys on outcomes
- Link to evidence of how important their role is: the evidence shows that senior leader behaviors lead to results – or not
- Describe the benefits for the organization, the link to other strategies, and to areas of interest of senior leaders
- Link to existing strategies: “I want to talk about our goal of _______. I am fully committed to achieving that goal”.
- Ask for what you believe is needed to create JIW – do not ‘hint and hope’ for action
- Briefly describe long-term and short-term actions (2-3 items to get started)
- Make a specific request with clear behaviors and actions (small tests of change) – some examples might be:
- Have a conversation with 1 other senior colleague about what, why, and how of JIW
- Have 2 What Matters to You? conversations with senior leader peers and direct reports
- Offer help: practice and coach on what you and others have learned on having these conversations; offer a few questions from the IHI Conversation Guide as aids
- Identify problem-solving paths for boulders – big problems beyond one department/site that require senior leader sponsorship to resolve
- Identify specific commitments you will make to drive the work forward
- Specific request and rationale: “What I believe would drive this work forward is _______, because it will____”.
- Share specific ways in which you will commit to ensure success of efforts
- “I will gather a group of colleagues to talk about this idea and gain their feedback and additional ideas within 2 weeks and share that feedback with you”.
- “I want you to know that you can count on me to_____”. “Does this make sense to you, or do you have other ideas?”
- End conversation with clear commitments on both sides, a timeline for reconnection and feedback to one another, and gratitude for the conversation
Recognizing others’ contributions is a powerful and frequently overlooked leadership practice to support colleagues in the long journey to better outcomes. Recognition is one of the nine components in the JIW White Paper. Steps you can take when engaging senior leaders are:
- Remember that all leaders, including senior leaders, benefit from recognition for the steps taken to achieve JIW outcomes. Sharing bright spots already seen in the organization is one form of recognition
- Recognize individual and collective contributions by all leaders through celebrating small wins
A wise colleague used this advice “Ask for what you need, it ups the chance you’ll get it”. We have found that leaders have found surprising and positive success with using some of the above steps.
1Kouzes, J., Posner, B. (2012). The Leadership Challenge: 5th Ed. San Francisco: Jossey-Bass