In previous blogs we highlighted Leadership Practices that achieve exceptional healthcare outcomes. Rather than separate lists of behaviors – one list for safety, another for patient experience, or joy in work – literature and lessons from the field reinforce that essential behaviors consistently exhibited in daily practice can have significant impact on all key outcomes. Our intent is to decrease the noise of change for leaders and offer an integrated, practical approach to generating results in joy, safety for patients and team members, excellent quality, patient experience, population health, and lower costs.
Previously we described the first of four leadership practices – Purpose: Eye on the Prize.
In support of and intended as a supplement to the Joy in Work White Paper, this blog describes Leadership Practice #2: Partnerships – Create a Common Fire. The White Paper clearly illustrates partnerships in action. Effective leaders build and sustain healthy, trusting relationships with the healthcare team and community members across boundaries as part of their daily work. They show, through an emphasis on collaboration and teamwork, that the healthcare team and patients/families/community members are full partners. The commitment to “nothing about me without me” is evident in improvement and design activities where the team includes patients.
Step 1 of Four Steps for Leaders in the White Paper shows the intent and ability to engage in conversations with team members in understanding What Matters to them in their work, and then addressing the barriers to achieving those outcomes is a superb example of partnerships. Conveying a sense of teamwork and camaraderie is an essential need in thriving work cultures. Without camaraderie, joy and meaning are absent. Partnerships modeled by leaders set the stage for creating an engaging work environment.
So what does partnership look like in action? What do leaders do that makes a difference? While not an exhaustive list, below is a sample of additional ideas to aid leaders in developing partnerships.
- Leaders model the way1. Leaders reflect on when they have experienced great partnerships, analyze which specific behaviors were present, then examine their opportunities to model those behaviors in every encounter, every day.
- “Doing With” colleagues rather than “Doing To”. Engagement and internal motivation develop when team members have choices and are respected in their daily work. Leadership actions that rob people of choice and respect (“Doing To”), diminishes commitment to work and are a source of burnout. Leaders who Do With make sure colleagues are always treated with respect, have choices in how their work is accomplished and improved, are able to contribute to something larger than self, and have the systems, skills, and materials to accomplish what is expected of them.
- Effective conversations – which are different that communicating information – are essential for partnerships. It is frequently assumed that leaders know how to engage in conversations, which is the ability to listen to learn with others. What we have found is that this is an under-developed skill. Leaders are often stuck in an expert model – needing to be the one with the answers – rather than committing to learning together. Listening to learn is a skill that, like any other, requires learning and practice to do well. We developed a Listen to Learn Guide to provide practical steps to build conversation skills. Portions of the Guide are also incorporated in the White Paper.
- Regular huddles. Rather than relying on meetings, leaders tap into frequent, brief opportunities to spend time with colleagues, understand systems that enable or get in the way of outcomes, identify bright spots or successes, share stories that illustrate being at our best, and convey a caring connection. Look for opportunities for informal huddles to connect.
- Label & Link. Leaders help colleagues to see how their actions (label) contribute to larger outcomes (link). For many team members, the demands for frequent changes can seem like a series of random acts of goodness not a coherent path forward.
Leaders can use any opportunity to label and link when talking with team members. For example, building camaraderie and trusting relationships are the foundation of psychological safety – the ability to speak up when one is unsure, actions seem unsafe, or to try new actions. When a colleague “speaks up” regarding a concern, gap, or opportunity, leaders can positively reinforce their contribution to the team by linking speaking up to aiding in achieving best care outcomes.
Joy in work is closely linked to safety for patients and those who care for them. Helping others seem the link helps to make sense of the changes underway.
We will be addressing this link in detail at the 2017 IHI Forum in a session: Leaders Igniting Joy in Work and Creating Safety with colleagues Jennifer Lenoci-Edwards and Patricia McGaffigan from IHI/National Patient Safety Foundation.
- Improve daily. Nothing unleashes hope, optimism, and a sense of choice more than the ability to see and solve problems quickly. Leaders must intentionally set a tone of continuous learning and improvement. The White Paper emphasizes this step as vital to joy in work and offers specific examples of how some organizations made progress quickly.
As you can see from the White Paper and above suggestions, to generate joy in work often requires that leaders spend their time differently. Identifying how leaders currently spend their time and taking steps to assure they have capacity and capability to achieve these new outcomes is essential to achieving joy in work.
1 Kouzes, J., Posner, B. (2012). The Leadership Challenge: 5th Ed. San Francisco: Jossey-Bass; Kouzes, J., Posner, B. (2003). Encouraging the Heart: A Leader’s Guide to Rewarding & Recognizing Others. San Francisco: Jossey-Bass.