Tag: AANA

What the patient wants

By Thomas Davis, DNAP, MAE, CRNA

Recently we were discussing patient satisfaction at the desk in the pre-op area.  One of the physicians noted that patients assume they will receive top-notch medical care, so the care itself is not notable.  What the patient does remember, he suggested, is their impression of the facility, the workflow process and whether they were respected as individuals. 

My colleague’s comments triggered personal memories of a recent encounter with the healthcare system.  Last year I accompanied my wife to a medical appointment.  The waiting room was filled with heavily worn furniture, magazines were scattered on empty chairs and there was a generally unkempt appearance.  We were moved to an exam room that appeared to need more than a good cleaning.  When the physician arrived, she did a quick assessment and ended the appointment by dictating a plan that did not work for us.  As you can imagine, all the way home we talked about the importance of patient satisfaction.  Having had a negative experience, my wife did not follow-up with their organization nor solicit contact with the physician again.

Because “overall experience of the patient” has become a meaningful component of quality care that is demanded by those who pay the healthcare bill, simple conformance with regulations and standards is no longer enough.  Elevating patient satisfaction, while simultaneously dealing with shrinking healthcare budgets, requires payors to insist that medical providers deliver state of the art treatments that will be remembered positively.

The Center for Medicare and Medicaid Services (CMS) has reinforced this idea by implementing the Hospital Consumer Assessment of Healthcare Providers and Systems (H-CAPS) which ties reimbursement to patient satisfaction.  Simply put, full reimbursement for healthcare services is being tied to the overall patient experience and his/her level of satisfaction with both the individual healthcare provider and the organization offering the care. 

Improve patient satisfaction scores

Moving from the obsolete mindset of “doctor knows best” to the new paradigm of “shared decision-making,” in which doctors and patients work as a collaborative team, requires that healthcare providers learn what patients really want and then commit to meeting their expectations.   Learning about the preferences of the patient requires observing, questioning and listening during every patient encounter.  Discovered through discussions with patients and a review of literature related to client satisfaction, here are a few ways to improve your patient’s overall experience.

  • Patients want to feel respected.  The red-carpet treatment is not necessary but common courtesy is essential. Timetables that are designed to run behind schedule do not respect or value the commitment made by the patient who arranged child care, hasn’t eaten since midnight, has provided the requisite driver and arrived on time. When patients follow the rules and do as told, they expect to receive care as promised.   Likewise, a one size fits all approach to prescribing patient care does not respect the individual needs of each client.
  • Patients want information conveyed in a manner that they can understand.  We work in an environment that has its own language and acronyms.  Terms that are common to us are foreign to many of our patients.  I recently overheard a patient interview.  Nurse: Do you have A-fib?  Patient:  What’s that?  Nurse:  Do you have GERD?  Patient:  What’s that?   Nurse:  Do you take ACE inhibitors?  Patient:  What are those?  Always communicate on the level of the listener and ask follow-on questions to ensure that the person fully understands you.
  • Patients want open communication with every provider.   Hospitalized patients see their doctor once or twice a day and then spend the other 23 hours with nurses and assistants.   Patients expect and need honest, transparent answers from the nursing staff.  The cop-out reply, “Ask your doctor,” is a sure-fire way to kill trust between the patient and the nursing staff and is a trigger for dissatisfaction.
  • Patients want the staff to be collaborative with one another.  Disagreements between staff in a location where patients can observe and overhear must be taboo in the workplace.  Discord between staff members creates anxiety in the patient population and kills satisfaction scores.  When conflicts arise, make sure that they are discussed privately and behind closed doors.
  • Patients want to be included in the decision-making.  The best-practice treatment plan is one that is described rather than prescribed.  The patient must know what is recommended and why; only then are the patient and provider positioned to agree on a plan to provide the recommended treatment in a manner that affirms the patient and his/her family.
  • Patients want a response to concerns and complaints.   Receiving healthcare can spark anxiety in an otherwise intelligent and relaxed individual.  A glitch that’s the size of a pebble to the worker can be viewed as a boulder to the patient.  When a patient expresses concern, listen attentively, immediately fix what you can and follow-up on items that require additional resources.  Leaving the patient with the impression that he/she was not heard will elevate anxiety and increase dissatisfaction.

Assessing patient satisfaction

Your organization sends a survey to every patient and your workgroup consistently scores above the benchmark of 90%.  Does that mean everything is OK? 

Conducting an ongoing survey is an accepted way to gather information and is required in order to obtain full reimbursement under the H-CAPS system.  Surveys are necessary; however, those who truly seek to improve the patient’s experience constantly dig deeper in search of concerns that may not be exposed by the survey.  Rather than boasting about achieving 90% or 92% on the satisfaction survey, focus additional attention on the 8% who were not satisfied.  Seek common themes that generally fuel dissatisfaction such as lack of privacy or excessive wait times and then solicit patients to suggest ways to address the issues. 

The best way to learn about the weaknesses in your system is through the eyes of those who use it.

After working for a year as an anesthesia provider at a busy GI center, it was my turn to be on the receiving end of a colonoscopy.   Wanting to have the same experience as any other patient, I kept things low-key, and it turned out to be an eye-opener.  After following completing a bowel prep and arriving on time, I sat in the waiting room a full hour past my scheduled time.  The room had nice furniture and a TV; however, the room temperature was so cold that I entered the pre-op area shivering.  Despite receiving top-notch care, I felt as if I was on an assembly line and that neither my time nor comfort mattered.   Based on my feedback, the temperature in the waiting area was adjusted.  However, the manager was not brave enough to tackle the sticky issue of intentional overbooking.  In the end, overbooking was not addressed and excessive waiting times continued to be the top complaint expressed by patients at that center. 

The key to improving the overall experience for the patient and family is to engage them in a non-threatening discussion.   Asking pointed questions puts people on the defensive and seldom generates useful information.   Instead, first engage in a friendly conversation and then ask open- ended questions about their experience.   Rather than asking, “What do we need to do in order to improve?” ask, “If your friends were coming for this procedure, what advice would you give them?”   Instead of, “Where did we fail?” ask, “What was your greatest surprise while in our care?”  Finally, ask the patient, “In retrospect, what do you wish that you (or we) had done differently?”   Ice the cake by asking the patient to identify one or two people on the staff who made a positive impact on their experience, and to follow-up by describing the behaviors that made the worker outstanding.

Patient satisfaction IS notable; and it’s not difficult to achieve.  Design a system that values the patient’s time, one that recognizes the patient’s anxiety, that openly communicates information, that develops a collaborative treatment plan and solicits suggestions for improvement; then your satisfaction scores will take care of themselves.

Workplace champions

champion post

By Thomas Davis, DNAP, MAE, CRNA

Follow @procrnatom on twitter

On the sports field, the champion walks away with the trophy; in the workplace, the champion scores high points for being the catalyst that converts an idea into the modus operandi.   When introducing a new protocol or implementing a policy change, having a champion who is all in for the change and works with personal passion can make the difference between success and failure.   The person who champions a cause is not always the designated leader, rather, he/she is a person who has a deep belief that the change is both necessary and possible to achieve.  In contrast, a change agent is a person hired to implement a new policy and often lacks the internal drive and commitment that is found in a champion.

Workplace Champion; a person who voluntarily takes extraordinary interest in the adoption, implementation and success of a cause, policy, project or product.  The person will force the idea through entrenched internal resistance and will evangelize it throughout the organization.

~businessdictionary.com

Speaking on the topic of implementing an opioid sparing anesthetic technique, Dr. Gary Brydges, former president of the AANA was asked what to do when resistance to change came from within the workgroup.  First among his recommendations was assuming the role of champion and then locating and teaming with a surgeon champion and a nurse champion.  Then, move forward as a team of champions to educate all stakeholders about the necessity for and the benefits of the change.

During my tenure as Chief CRNA at The Johns Hopkins, I witnessed first-hand the wisdom of Dr. Brydges’ recommendation to engage champions who are committed to implementing change.   The institution was entrusted to develop and implement an early recovery protocol for patients receiving bowel surgery; a plan that required a radical change to the usual perioperative flow, including the anesthetic technique.   To move the strategy forward, champions, including an anesthesiologist and a nurse anesthetist, joined surgery and nursing champions and formed a united front to overcome resistance and implement the new plan for bowel surgery patients.  Meetings were held, a protocol was developed, and champions from each area aggressively marketed the new plan to their respective groups.  The champions were essential and, with their dedication to the project, the protocol was successfully implemented.

In 1996 John Kotter introduced an eight-step model for implementing change and although he did not specifically use the word champion, several of the steps in his model describe actions that are commonly taken by those who are the driving force for change.   The Kotter model calls for the leader to create a sense of urgency, build a coalition of supporters, create and communicate a vision, and push for buy in from stakeholders…all actions commonly taken by a champion.

Building on the John Kotter’s recommendations, the University of Georgia published a white paper outlining the role of a change champion to include:

  • Streamline implementation/reduce complexity
  • Take ownership and build accountability
  • Enhance speed of project completion
  • Maximize productivity
  • Promote understanding
  • Advocate position change
  • Explain “what’s in it for me?”

So, you want to be a champion…

A key to job security and promotion is becoming the person that the workgroup can’t live without and being a driving force for change places you in the coveted position of being indispensable.  First and foremost, you must believe in the new protocol that you are striving to achieve and then actively work to develop the skills required to create momentum and achieve the goal.  Writing in People Development Magazine, author Julie Gordon lists the essential personal traits of a successful change champion:

  • Willingness to listen
  • Skilled at networking
  • Understanding of the workplace culture
  • Not afraid to take risks
  • Openly markets the positives
  • Solicits help from colleagues and other champions
  • Emotionally intelligent/sensitive to people needs
  • Openly supports the goal, quickly correct misinformation
  • Driven by the value of the change

Recognizing a need for change and having a desire for it to occur is not enough; follow these steps and become the workplace champion who elevates your team and organization.

Be knowledgeable.  Keep up with current best practice guidelines, attend meetings and communicate via social media with colleagues who have a professional practice like yours.  Recognize techniques that produce the best results and then review your current method looking for alterations that could be made in order to improve results.  In addition, keep a keen eye on the culture of your workplace and the receptiveness to change.  Finally, tie your proposed practice upgrade to the stated vision of the organization to increase the likelihood of buy-in from upper level management.

We can do better.  Always work with the mindset that there is room for improvement.   As a change champion, your belief in the new method must be apparent and contagious to those around you.   Be vocal in convincing others that there is a different method that will produce better results.

Team with another champion.   The ultimate outcome is often dependent upon the work done by many parallel workgroups with a common interest.   In the previous example from The Johns Hopkins, implementing an enhanced recovery program affected the workflow of the surgeon, pre and post-operative nursing and anesthesia.  Having champions from each area who were equally committed to achieving a positive result increased the likelihood for success.

Develop a plan.   Work collaboratively and develop a comprehensive plan that works best for all and explain the plan to your workgroup.  Remember, the best plan for your individual workgroup may not be the best for other stakeholders.

Market the change.   Here is where you must have superuser knowledge and exude passion to persuade colleagues that the change is essential.   The first pitch to the team will let them know about the project; however, the ongoing push over the next days, weeks and months will take the plan across the finish line.

“Change does not roll in on the wheels of inevitability, but comes through continuous struggle”

~ Martin Luther King Jr.

Change doesn’t happen in a vacuum, nor does it happen by default.   There must be an apparent need, a belief that it can/must occur, and an individual with the stamina to push the project forward.  The next time you think, “we ought to,” take the next step and commit to making the desired change happen.   Become the champion who looks back and says, “this is what we have done.”

Tom is a noted author, speaker, educator, and dedicated clinical anesthetist specializing in leadership development and team building.  Contact tom@prosynex.com to book a speaking engagement.

Feel the Burn

burnout post

By Thomas Davis, DNAP, MAE, CRNA

Follow @procrnatom on twitter

 

Last week a headline in the Linkedin daily update caught my eye; Millennials are experiencing job burnout at a high rate.  My initial gut response was; “Really? You are too young and it’s too early in your career to be burned out.”  When I stepped back and considered the topic, I realized that burnout is not tied to advanced age or a person’s position in the chain of command.  “The physical or mental collapse caused by overwork or stress” is the full-blown Webster definition of burnout, and it can happen to anyone at any stage of his/her career, including millennials.

 

I recall talented athletes from my youth with parents who thought that with a little more effort, their kid would be wearing Olympic Gold.   Even after Betsy upped her gymnastics practice to four times per week and Jason increased his swimming to two-a-days, neither made it to the Olympics.  Both young people longed for high school graduation, not for the diploma, but for the termination of the unreasonable expectations for achievement.  In short, what began as fun turned into a physical, mental obsession that took its toll and left both individuals flat, weary, and burned out.

 

Employee burnout is real, unrelated to age or years of experience and the affect can be devastating to both the employee and the employer.

 

Young workers are fresh out of college, excited to start a career and eager to pay off student debt.  Most intend to pull their weight on the team and want to earn respect for ability and tenacity.  What they find is a workplace that welcomes their enthusiasm by piling on the long hours, offering advancement by combining two jobs into one, and frequently offering inadequate support.  Many young workers are running out of the energy that got them hired in the first place.

 

 

 

Burnout arises from unrealistic expectations and can happen when production pressure becomes excessive.  Sometimes the burden is placed on the individual by the organization and other times the individual places unrealistic expectations on him/herself.  Either way, as the burden becomes unbearable, the victim breaks internally and does one or both of two things:   He/she pauses to refresh and/or moves on to a different job.  Writers at Workplace Strategies for Mental Health identify the following as personal perceptions or actual causes of professionals becoming burnout victims.

  • Expecting too much of themselves
  • Never feeling that their work is good enough
  • Frequently feeling inadequate or incompetent
  • Feeling unappreciated for their work efforts
  • Working in a role that is not a good fit

 

 

Pushing employees beyond their mental or physical limit has consequences.  In addition to fatigue, stress and anger/irritability, other health issues may develop.   For the employee, high blood pressure, heart disease and type 2 diabetes are correlated with burnout as well as alcohol and substance abuse.    Consequences for the employer include high employee turnover and the financial cost of filling vacant positions.  Overall, there is a loss of productivity and a general deterioration of morale among the work group.

 

Extinguishing burnout is a shared responsibility and there are actions that both the worker and the leader can take to cool the embers.

 

What the worker can do

Ultimately, it’s up to you to monitor your stress level and make changes before falling victim and externally acting out at work or internally developing a physical illness.  The Adult Health Department at the Mayo Clinic offers you these suggestions for assessment or prevention.

  • Evaluate your options both with your current job and finding a new employer.
  • Seek support from co-workers, friends, family or professional counselors.
  • Engage regularly in a relaxing activity such as yoga or meditation.
  • Exercise consistently to help you better deal with stress.
  • Value your sleep and let it restore your well-being.
  • Develop friendships with one or two colleagues at work.
  • Become mindful of your activity, energy, and feelings every moment.

 

 

Creating a culture of burnout is opposite of creating a culture of sustainable creativity…This mentality needs to be introduced as a leadership and performance-enhancing tool.

~Ariana Huffington

 

 

What the leader can do

There several behaviors that can be incorporated into your leadership style to take the fan off the flames and prevent the fire.  Combined, all will elevate team morale, boost productivity and improve employee retention.

  • Provide clear expectations and ensure that they are understood by workers.
  • Make sure that expectations are reasonable and align with priorities.
  • Furnish necessary resources including the training required to meet expectations.
  • Enforce fairness in reasonable work hours including sending people home on time.
  • When overtime can’t be avoided, mandate that those who work extra hours are given time off to recoup.
  • Utilize mentoring and professional development to create a sense of personal value for the worker.
  • Strongly encourage breaks at work away from the workplace.
  • Encourage friendships and social support among the group.
  • Provide a sense of purpose by linking employee tasks to the greater mission of the organization.
  • Encourage physical activity by planning stretch breaks at work, encouraging gym memberships, and arranging group activities away from work.
  • Encourage employees to use rather than save their vacation time.
  • Know your team and adjust your leadership to a style that fosters collaboration.

 

 

Employee burnout is a very real equal-opportunity threat.   Both the high school swimmer doing two a day workouts and an ICU nurse working 4 twelve-hour shifts per week (and being kept over at the end of the shift) can easily perceive that the work is never ending and whatever they do is not enough.  Whether it’s a monster workload, a paucity of resources, or sense of being overwhelmed and isolated, burnout is a constant threat best addressed by frontline leaders who are directly linked to the team.  Sometimes, the quick solution can be as simple as showing you care by providing resources and giving compliments where appropriate.  The long-term remedy, however, must involve an emphasis on physical and mental well-being while instilling a sense of purpose and worth in each worker.

 

 

What was once thought to be the consequence of being in a job too long is now known as a threat to workers at any age or stage of their career.  The cure for burnout starts with self-awareness within the employee and a commitment by leadership to create a climate where the workload is reasonable, resources are available, and employees gain a sense of self-worth from the work they accomplish.  Look beyond the crisis of the day and treat workers today in a manner that leaves them fulfilled and wanting to return tomorrow.

 

Tom is a noted author, speaker, leadership developer and dedicated clinical anesthetist.   Contact tom@prosynex.com to book a speaking engagement.

 

Speak easy; The art of overcoming glitches

speak easy post

 

By Thomas Davis, DNAP, MAE, CRNA

Lt. Col (ret) USAF

Follow @procrnatom on twitter

Recently I was scheduled to be the last faculty speaker on the final day of meetings at Encore Symposiums.  Attendees had various reasons for checking out ahead of my presentation – prior engagements and airline connections among them – but having spoken to this group for several other sessions throughout the weeklong meeting, I felt entirely comfortable with this schedule. Practically speaking, I anticipated an audience somewhat diminished in size and just hoped Leonard’s joke would not materialize.

 

Leonard’s joke:

After the morning coffee break on the last day of the meeting, there were two talks left before the meeting adjourned.  In the meeting room were the speaker and only one other person.  The speaker suggested sitting together at a table and going through the slide set.   The other person replied, “I don’t care what you do, I’m the last speaker.”

 

 

If you’re a healthcare speaker, or a public speaker in any industry, no matter how well prepare you are, the potential for glitches is ever present.  It’s your job as the leader of that moment to “speak easy.”

 

Recover Fast

In mid-September, our local Frederick Art Club, featured the well published women’s rights advocate, Edith Mayo, Curator Emeritus of The Smithsonian to speak to its membership. In anticipation, twenty additional guests were invited to join the audience at a luncheon enhanced by several displays by the iconic clothing designer, Claire McCardell.  This was a “not-to-be-missed” presentation.  According to attendees, Edie introduced herself and quickly announced without apology that her computerized presentation materials had not arrived, and she would be relying on her slides and an old-fashioned, borrowed projector. Without any further mention, Ms. Mayo reportedly immediately launched her spiel while the enhanced audience ate their meal.  Edith gave the audience of art lovers a lot to remember and only a little to forget.  At dinner that evening my wife gave the glitch a scant dishonorable mention, then talked about the pics that had been shown, the new museum being built and other interesting tidbits.

If your props or materials do not arrive, if the sound system fails, or even if the dog ate the homework, recover fast; think on your feet and do what you have to do to move forward, acknowledge the road hazard only if necessary and then get on with it. That’s leadership and leadership makes it look easy.

 

Tough Love

What do you do if it’s a tough audience?  The best advice is to prepare the fall-out shelter.  In addition to knowing your stuff and using cutting edge material, be there ahead of your scheduled appearance long enough to sit in on other speakers with the same audience.  Get a feel for them. What makes the audience laugh, what annoys or bores them, are they text savvy, senior workers, foodies? Where are they from, why are they there, how are they dressed, is the sunny or gloomy weather affecting their attention or attendance? If you can’t be there early or if “sitting in” doesn’t apply or isn’t appropriate, get the answers from others.  As a last resort, be a politician and ask the audience.  “Good evening O-kla-ho—ma-how-are-you?!”  Whatever you do, do not tell these pay-on-demand customers they’re a tough nut to crack. Along with disrespecting your whine, chances are they can get tougher after that. They can walk out.

 

Shift Gears

Nancy LaBrie, founder and owner of Encore Symposiums tells the story of the group of attendees and faculty whose driver delivered them to the Pier AFTER the cruise ship had sailed. Oops! The creative faculty made a seamless transition into delivering their presentations for two hours – outside, – while the ship returned to retrieve them.  The speakers became the Captains of the situation with a truly captive audience! A solid optimistic leader can almost always pull up, even if your ship has sailed.

 

L.O.L

Speakership is leadership and if you intend to make public speaking part of your professional profile, you must handle glitches, tough audiences, unwelcoming venues or schedules along with all other unforeseen events, as part of the routine, with professional grace and aplomb. Indeed, a little humor could be called for.  My wife loves to tell about the wide-girthed MS Vocal Mus Ed candidate back in the day.  The singer, whose half-slip fell to the floor during her graduate performance of O Mio Bambino Caro, kicked it to the side of the grand piano while completing the aria to the roaring applause of the audience. Grace.  Aplomb.  It’s not the glitch you want the audience to remember; it’s the way you handle it.

My last two Encore presentations during the last two hours of an intense four-day schedule went very well. I could have encouraged the down-sized group to gather closer to the podium, but instead I walked out into the group, avoiding reliance on notes and focusing on the individuals in attendance. We communicated interactively with a professional phone texting activity. It was fun, it was professional, they stayed, and the speaking was easy.

Tom is an experienced leader, author and requested speaker.  Contact Tom for an appearance at your next meeting.

Be a social (media) climber

social media climber post

 

By Thomas Davis, CRNA, MAE, DNAP candidate

 

Work completed for my DNAP degree and conversations with colleagues has taught me that just about everybody knows what social media is, and that many people use it in one form or another to socialize with friends, family or colleagues.   What many people fail to appreciate is that social media is a powerful tool that can either enhance or kill your career.  Leveraging the power of social media will position you to be recognized, rewarded and promoted within your profession.

 

Advancing professionally in all industry requires that you are known and respected by your peers for the quality of your talents and interests.  Marketing is essential for the success of any venture and social media is a great launching pad for gaining recognition.  Careerbuilder.com notes that over 50% of employers use social media to recruit the best talent, and that of those entities seeking highly qualified workers, 35% will not offer an interview to a person who has no online presence.  To sell yourself locally and globally, it is critical to be seen online consistently creating a positive professional and social image.  

 

Build your online image

The first step in building your image is discovery and damage control.  Even if you have never used social media or posted a comment online, you may appear online linked to your profession, employer or social group.  Begin by searching yourself on google and click on any link that is connected to you.  If you like what you see, update the content and make sure that others can find it easily by doing little things to ensure that the information is linked to you.  Tom S Davis immediately pops up as CRNA while Tom Davis labels me as a former University of Iowa basketball coach!  Even small changes like adding a middle initial to a common name will help direct readers and save time.  After viewing what others see, take note of anything that is not flattering.  If you don’t like what you see, rebuild or clean up all unflattering content. If you posted a blog years ago that is embarrassing to you or anyone else, take it down. If you posted a less than professional picture or used offensive language, delete it.  A selfie from the college kegger will not score points when viewed by a potential employer.  If some other entity controls the material you have previously posted, contact them and ask that the outdated material be removed. Your profile must be spic and span clean and professional.

After the D&D is complete, continue the rebuilding by making sure that current professional postings are easily linked to you.  If you have completed a degree, published an article, or have recent pictures from a professional meeting, make sure they appear online and are linked to your name. Recognizing the achievement of others, garners their appreciation, elevates both of you in the online community and raises the level of activity on your own site.

 

Use multiple platforms

Because there is not a single best platform for creating a professional image online, gaining exposure requires that you appear on multiple platforms.  Start by opening three essential accounts and update them frequently.  Give time and attention to completing the profile information when establishing an account.

Twitter.  Due to the 280-character limit on Twitter, tweets (posts) are short and to the point.  Open an account, let colleagues know your username, and always being positive and professional when you tweet.  You will earn a reputation for being a “thought leader” by posting URLs for articles that inspire colleagues and elevate your profession.  Be sure to follow other leaders in your profession and “like” or “retweet” as the case may be.

 

Facebook/Linkedin.  Originally, Facebook was designed as a social site and LinkedIn was viewed as a Facebook for professionals.  Both now have user groups specific to just about any profession.  Create an account on each platform and join at least one user group related to your profession. Read what others are posting, comment where appropriate, and when you gain a little comfort and courage, start posting original topics.

 

Professional site.  Many professional organizations have online discussion boards where members of the vocation can share thoughts and debate issues.  For nurse anesthetists, the AANA connect forum is an excellent place to interact with colleagues.

 

Social media is meant to be interactive, so don’t hesitate to add material or continue conversations. As you read other’s comments, your interest may be piqued and your intellect challenged, and you may wish to join the conversation to expand the topic and share your thoughts with the online community.  Regardless of the breadth of your interaction, sometimes all you need to do is like another person’s comments and your name will be linked to the discussion thread.

 

Tips for posting on social media

Update your profile.   Social media sites encourage you to create a personal profile and as you gain followers, your profile becomes your identity.  Post a professional picture, accurate contact information and links to professional work that you have accomplished.  You are creating an online identity so use your real name and get full credit for your contributions to the cyber world.

Be authentic.  Online scholarly articles are not in short supply.  Social media is your opportunity to show colleagues that you are informed in a less academic way.  Be yourself and have a short conversation with your readers, leaving the lectures for the classroom.   If your natural self tends to be academic, work on altering your language enough to sound relaxed and to be engaging.

Set the tone.  Emotional intelligence is a current buzzword and a concept that encourages readers to look beyond the words and sense the emotion tied to the topic.  As you post online, avoid sounding authoritative, dogmatic or robotic.  You are a professional responding in a social climate so choose positive, empowering words with an optimistic tone, even when you’re addressing an industry problem or potentially heated topic.

Involve other posts.  Jumping in to contribute to an ongoing discussion thread, or to comment on a blog post, creates an online presence.  If you don’t have time to develop and post an original topic, make a quick remark or give a thumbs up to something that a colleague has posted.

Stay out of a rut.  Always talking about the same topic is about as exciting as repainting the fence every weekend.   Social media is fast paced and redundancy is guaranteed to turn off and turn away your readers.  Likewise, always talking about yourself, or never talking about yourself, lowers reader regard and should be avoided.  It’s okay to share your personal experience when it’s clearly appropriate to the conversation, but don’t be a prima donna (or primo uomo)  by making yourself the focus of your social media post.

Don’t shoot yourself in the foot.  What you post is out there for everyone in the world to see, including your colleagues and potentially, your next employer.  Keep it professional and avoid trigger topics such as politics, religion or alternative lifestyles.  Your readers have their opinions and you are unlikely to change any minds; however, you will be forever linked to dogmatic rhetoric.  Never forget, bashing or otherwise bad-mouthing individuals whether they are coworkers, political figures or competitors of any kind (and whether or not you refer to them by name), is unprofessional, unbecoming behavior.  Stay about of the mud and be squeaky clean.

 

Having a dynamic online presence does not guarantee employment, promotion or popularity; however, you are invisible without it.  Social media offers many interactive platforms that enable you to create or reinvent a public identity as you connect with colleagues and promote your profession.  If you have earned an advanced degree, achieved professional certification and been granted a license to practice, shine a light on yourself by joining the Global Country Club.  As card-carrying, informed and connected member, you can tweet, blog, post online and harvest the rewards.

 

Tom is a noted author, enthusiastic speaker, committed leadership developer and superb clinical anesthetist.   Contact tom@prosynex.com to book a speaking engagement.

Non-disruptive by design

Disruption post

Thomas Davis, CRNA, MAE, DNAP candidate

follow@procrnatom on twitter

Disruptive behavior cuts a wide swath in the workplace and, left unchecked, it will kill the morale and productivity of a team.  Conduct that is viewed to be disruptive runs a spectrum from minor sarcastic comments to full-blown toxicity of a colleague whose ability to put a negative spin on just about anything is worthy of an Oscar.  A working definition of disruptive behavior is:  Any ongoing personal conduct that disturbs the work environment.  Lainie Peterson, contributing author to Chron, notes that “disruptive behavior kills group morale, drops team productivity, increases workplace stress, increases employee turnover and creates a negative reputation for the employer.”  The effects of disruptive behavior are potentially pervasive, and leaders have a vested interest in drawing a red line.

“An ounce of prevention is worth a pound of cure.”

~Ben Franklin

 

 “Stay Out of Trouble…”

My mother liked to address my youthful indiscretions by saying, “It’s easier to stay out of trouble than to get out of trouble.”  In the workplace, those words of wisdom support the proactive approach of developing a system that attracts and hires workers who value collaboration and congeniality, rather than one that tolerates malignant behavior.

Recruiting.  You are not seeking a warm body to fill a position with your group, you want the right person.  Make sure that your job description touts collaborative teamwork that adheres to the mission, vision and values of the organization.  Use the JD to let applicants know not only what you want them to do, but also how you want them to do it. Making supportive teamwork a job requirement, puts you on solid ground should the need arise to address poor conduct of an employee in the future.

Hiring   Determining the right person for a job must include an interview format that includes a two-way dialogue about job expectations.  An interview technique that I have found to be particularly revealing is to provide the applicant with a list of the organization’s core values and discuss them during the interview.  Conclude the interview by saying, “if these values are not who you are, this is not your job.”  By discussing teamwork and values at interview, you further establish a solid foundation for addressing disruptive behavior should it arise.

Feedback   Schedule a one on one discussion with each new hire at the end of each of the first six months of their employment.  Each month, review the values that were discussed at interview and ask the person to relate their daily work to the organization’s values.  If negative feedback about the person’s behavior has been put forward by co-workers, give the employee a wide berth to answer to the accusations followed by a frank two-way discussion to clarify expectations.  After reinforcing your anticipation of supportive teamwork, ask for a re-commitment to the shared values of the group.

Teamwork.  Those who are already on the team deserve the same opportunity to discuss team values that you had with the job applicant.  Dedicate a team meeting to conversation about the core values of the organization and open the floor for your team members to identify behavior that would support the values.  Decisively tell the team, just as you did the applicant, “if these values do not represent who you are, this is not the right job for you.”

 “Get Out of Trouble.”

If hire-prevention hasn’t kept a bad actor from slipping into the ranks and general morale is suffering, it’s time to roll out the fire-hose.

Look for the cause.  Before you pull out the big guns and start firing, look for the cause of the disruptive behavior.  The person may be suffering unusual stress from satisfying the needs of a sick child or an infirmed elderly parent, or the worker may be experiencing critical financial woes causing internal stress that has been allowed to affect their external behavior.  Counsel your team member and look for options such as flexible work scheduling, or a leave of absence, to enable the person’s resolution of issues.

Give direct feedback.  Workers who disrupt the workplace by lack of personal restraint must be given a clear description of the problems they have created. Again, meet privately with the offender and provide an accurate review of the complaints lodged against the individual and precisely identify the consequences created for the team as a result the bad behavior.  If you are concerned for your personal safety or anticipate passive aggressive spin on your words, have a second person in attendance at the meeting.  Caution: Try not to create an environment in which the accused feels as if the boss is “ganging up.”

 

Be specific.  Giving negative feedback can be uncomfortable and it may be tempting to talk in generalities. …don’t.   In order to ensure that behavior changes, you need to be specific and define your expectations.  Be your confident self as you state, “When you do…, it has this effect…”  If you’re dealing with and angry bird, point out the far-reaching effects on those other than their target. Those who witness the encounter, either patients or colleagues, become collateral damage of the disruptive behavior.

Set boundaries.  After establishing the behavior that is to be eliminated, move on to discussing the desired behavior.  Review the mission, vision and values of the organization and make it clear as to how the behavior did not support the core values.  Challenge the person to describe how they might have handled a situation differently had they kept the core values in mind.  Make it clear that the worker’s behavior moving forward must align with core values and that deviation will mandate dismissal from the team. End the session by setting dates for two follow-up sessions.

 

Follow-up.  If behavior has changed, use the first follow-up session to extend kudos and encouragement. Give feedback from the team to promote a feeling of inclusion. If progress has been made but more work is required, congratulate the improvement and have the person identify additional measures that will continue the momentum.  If no progress has been made, move forward with termination.

A disruptive team member can create a very uncomfortable environment for both leader and co-worker.  Emotions run high in the healthcare workplace inherently and the work environment certainly doesn’t need the friction created by bad behavior within the team.  Rather than avoiding confrontation, see bad behavior as an opportunity to implement decisive leadership. In the process you will eliminate the disturbing personal conduct and earn respect.  Your failure to act with authority will allow the obstructive behavior to weave itself into the fabric of the team, creating a negative culture that will eventually require outside intervention.

Hire congenial, collaborative people and don’t hesitate to deal with disruptive employees you inherited.   Design a system that has zero tolerance for disruptive behavior, and you can stay out of trouble before you get in trouble.  Both my mother and Ben were right.

Tom is a noted author, enthusiastic speaker, committed leadership developer and superb clinical anesthetist.   Contact tom@prosynex.com to book a speaking engagement.

After Halftime

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By Thomas Davis, CRNA, MAE, DNAP candidate

Follow @procrnatom on twitter

 

It’s the first week in July and the half-time show is over. If you joined the throng of hopefuls in January by writing a list of initiatives to accomplish by year’s end, it’s time to revive and resuscitate, or discard and delete.   Here’s how to recover your footing and breathe new life into dead projects.

  • Review your goals. Reflect thoughtfully on the list you generated so enthusiastically six months ago and decide which things are keepers and which ones can go to the bin.  Which items can potentially have a positive effect on your workplace if achieved?  If the team or the organization has moved on and a listed item no longer applies, delete it or store for later; however, if a particular goal remains pertinent or will set you and the group up for future success, leave it on the list.
  • Condense your resolutions. Following your review of goals, shrink the “good list” further to those that will have the most impact. Notate your priorities and commit to accomplishing them within the remaining time frame.
  • Re-write your goals. Your notated priorities must be realistic, specific, and written in a format that is easily understood.  For example, “improving efficiency” is nebulous; but, adding “as evidenced by” provides clarity and focus to the intended outcome.  Rather than having a goal “to improve pre-op efficiency,” you might clarify the goal by adding “to speed the pre-op workflow as evidenced by a 50% reduction in the number of first case delays.”  A goal to ensure that supplies are available could be stated as “ensure the availability of supplies as evidenced by completion of the inventory every Monday, and submission of order form every Tuesday.”  Put into writing both the goal and a quick description of what constitutes success.  Review the list at established and realistic intervals – weekly, bi-monthly, monthly – to maintain your focus on a positive outcome.
  • Change your mindset.   Proactive, asset-based thinking turns your attention to what resources are available and what can be accomplished.  Dismiss all thoughts about what or why goals were not achieved in the past and laser-beam on what can be done in the upcoming months.   You have already reduced your goals to one or two achievable items, now block the extraneous distractions and stick with the plan.
  • Develop the plan. If the majority of your expectations during the first half of the year are still unfulfilled, something needs to change.  Start again by developing and following a realistic, results-oriented plan over the next 6 months. A viable plan should help get you back on track while teaching you valuable lessons about organizing future projects.   Other aspects of a solid plan should ensure that you have the necessary resources available.  It should include modifying your environment to remove clutter and fill the void with items that support achievement of the goal.  Acknowledging that time is a valuable resource, your plan should create a new schedule eliminating activities that sabotage, while adding a block of time for activities that support achievement.  Stay aware that some activities are mutually exclusive; if you have a personal plan to increase networking by engaging in more one on one time with colleagues, you may have to reduce the time you spend answering email or doing other administrative tasks.
  • Work for small victories. Your desired outcome can seem daunting based on today’s new starting line of six months out.   To stay grounded, remember:  Completing a 26-mile marathon is an overwhelming concept for many people; however, celebrating the passing of each mile marker generates an image of progress and makes the goal seem attainable.  Acknowledge each challenge and celebrate each milestone.

 

Among the many benefits of having a personal vision for improving the workplace are two significant ones – improved team morale and elevated respect for the leader.  Being the driver for those improvements should empower you and trigger a thirst for even greater success.  If you have brought closure to your professional initiatives for 2019, kudos to you; start another list.  If you reached halftime with your goals stalled in spam, revive, reboot and get back in the game.  July first is chance to double down after halftime.

 

 

Tom is a noted author, enthusiastic speaker, committed leadership developer and superb clinical anesthetist.   Contact tom@prosynex.com to book a speaking engagement.

Workplace Patriots

Fourth of July

By Thomas Davis, CRNA, MAE, DNAP candidate

 

Following closely on the tails of the summer solstice is the celebration of our day for patriots, the Fourth of July.  It’s the entire nation’s holiday to enjoy summer activities with friends and family while honoring the memory of the dedicated patriots who put country ahead of self and drew a line in the sand, demanding, “Give me liberty or give me death!”   The great experiment of government of the people, by the people and for the people was put into motion by the courageous acts of defiance in 1776 and we are still reaping the rewards from their Herculean sacrifices.

 

As a summer celebration, the Fourth frequently includes having a picnic at the park, out at the lake or right in the back yard followed by fireworks after sunset.  It’s a day of relief from business as usual and an opportunity to kick back, relax and have some fun with friends.

 

For many people, the workplace is an extension of personal life and co-workers are viewed as extended family.  Expanding the holiday celebrations to the workplace is healthy, promotes the development of a sense of community, strengthens teamwork and stimulates creativity. Seize the opportunity to use the holiday theme for teambuilding by challenging your group to create entertaining ways for having some fun at work in the days leading up to the 4th…here’s what others have done.

  • Dress for the occasion. Designate the 3rd of July as a casual dress day at work and encourage workers to wear red, white and blue.  Encourage RWB hair accents, holiday jewelry, or other adornments to add to the festive feeling.   Have a patriotic hat contest with rewards for the creativity of your team. Challenge those with the time and resources to wear full patriotic costumes and have a good chuckle as George Washington, Betsy Ross or Paul Revere walk through the door.
  • Decorate the workplace. Decorate halls, doors and desks liberally in RW and B.   Find a funny holiday poster for the bathroom wall.  If you have personal space such as a locker or a cubby box, decorate it for the occasion.   Don’t forget your patients!  Make their trip to the operating room fun and memorable by decorating the side rails on the cart.  When it’s time to mark the surgical site, give the patients colored markers.
  • Play 4th of July music. Substitute a 4th of July playlist and spice things up a little with fife and drum. You can play Sousa marches, Springsteen, Madonna or Simon and Garfunkel tunes to set a patriotic tone; or take a road trip down the golden oldies lane to generate some enthusiasm worthy of the holiday.
  • Have a Patriotic Workplace Picnic. Workplace potluck lunches are the frequent response to celebrations throughout the year and the 4th of July is no exception; what a great opportunity for decorating the lunchroom and serving a community meal with a theme. Bring hot dogs and watermelon to simulate picnic fare and ask team members to bring their favorite picnic salads and side dishes to augment the dogs.  Don’t’ forget to enlist the bakers on your team to whip up some red, white and blue desserts.
  • Wear lapel flags. Show your patriotic spirit by wearing a lapel flag.  Better yet, supply lapel flags for everybody working during the holiday week.  If you can’t find them, get a roll of flag stickers and make sure everybody has one.  Include patients in the festivities by giving them flag stickers for their hospital gowns.
  • Play games. A picnic just isn’t a picnic without games.  Set up some games for your team members and give prizes.  A workplace scavenger hunt is fun and can be done individually or in teams.  Fill a jar with RWB jellybeans and have workers guess how many are in the jar.   Set up a bean bag toss or a mini nerf ball basketball hoop in the break room and keep a leader board with scores.
  • Engage in a Community service project. Consider sponsoring a community service project in honor of the 4th or any holiday.  A children’s bicycle rodeo or a picnic for the members of a nursing home are two teambuilding activities that are sure to present your organization in a positive light while enhancing community relations.

 

Our nation was united by Patriots who developed a strong loyalty to one another by working hard and playing well together.  Likewise, a good leader can unite a hard working team by offering activities that promote collaboration and that free the people to enjoy themselves.  A great leader creates an environment of loyalty enjoyed with liberty, bound by justice and united by loyal Workplace Patriots.

 

Tom is a noted author, enthusiastic speaker, committed leadership developer and superb clinical anesthetist.   Contact tom@prosynex.com to book a speaking engagement.

Tech Savvy Leadership

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By Thomas Davis, CRNA, MAE, DNAP candidate

 

“The first thing we ought to recognize is that mobile is now part of the fabric — every day in everybody’s life. So, if you’re not looking at mobile solutions, then you’re not really looking at all solutions.” ~Mal Postings, Global CTO

 

The world is wired.   From preschoolers to grandparents, cab drivers to health care workers, our lives are infused with digital technology in both obvious and subtle ways.  We locate directions and connect with friends, we take online courses and purchase real estate, we buy groceries and have them delivered, we organize, strategize, socialize and generally utilize technology to run our lives.  We make business choices based on the company’s online presence and, as noted by PatientPop, 80% consumers search for healthcare information online and 41% say that social media affects their choice of healthcare provider.  Healthcare workers provide a vital service to patients; however, healthcare is a competitive business that must generate a positive cash flow to remain operational.

 

The Harvard Business review reports that the most digitalized corporations see an increase in profits two to three times the average rate of less digitalized competitors.  Likewise, healthcare organizations with a user-friendly digital platform are easy to find, easy to use, easy to forward to a friend, and attract loyal clients.  Your digital presence makes a difference.

 

Writing for Linkedin, product marketing director, Mark Hughes, offers these thoughts about increasing the digital presence in your workplace.

  • Abandon old stereotypes about IT geeks.  Healthcare leaders usually arise from a medical or nursing background and lack sophisticated knowledge about digital technology.  Combine your leadership with a personal relationship and create a techno-partnership with the IT department.    Collaboration enables you to blend your ideas with their technical expertise and develop web-based applications that enhance the patient experience.  The first step to becoming a tech-savvy leader is developing a first name relationship with a skilled person who can create the programs that you need.
  • The customer has the final say. Team leaders must follow hospital policy and remain mindful of the patient’s HIPAA rights.   The patient, however, has no limit to the things that he/she can post on social media.  They can and will rate both the quality of care that they received and the ease of obtaining it.  Part of your job as a leader is to create a client experience that the patient will want to share in a positive way.  The things your patients post on social media can make or break your organization.
  • Understand why a platform works. Rather than becoming distracted about how to use a social media platform, explore the various platforms and figure out why they work.  Why does one platform target a certain demographic more effectively than another?  Select the right platform and then challenge your IT support to make it work for you.  In some cases, you may need to use multiple platforms to target different demographics.
  • Always look to the future. Whatever technology works to connect your team with clients today will be replaced by something else tomorrow.  Never rest on your laurels.  Constantly remain aware of new social media platforms as they arise and always question how they can be used to the advantage of your patients and your staff.

 

Becoming a tech-savvy leader is a great way to connect with existing clients and attract new business to your organization.  However, technology can become impersonal and create a buffer between you and your team.  Author Inger Buus, leadership developer at JP Morgan, offers suggestions for solidifying the connection with your team as you add technology to your workplace:

  • Value human connections. The best teams are those that value interaction and collaboration between the team leader and team member. As you increase your digital presence, make sure that personal relationships are maintained.
  • Embrace change. Adding technology to the workplace requires that the workflow be altered to adjust to the change.  Take the lead and set the example for your team to follow by willingly modifying your routine to accommodate the technology upgrade.
  • Encourage diversity of thought. A recurring theme in Leader Reader 1, Authentic Lessons in Leadership is “The best idea arise from many ideas and yours may not be the best.”   Review your goal with the team and listen as they describe the ideal app that would best accomplish the goal.  Not only will the final concept be stronger, team members will have a sense of inclusion and will be more likely to participate in bringing the project to life.
  • Ask for help. Patient safety advocate Dr. Peter Pronovost notes that everybody is fallible, including the leader.  The best leaders acknowledge that they don’t have all the answers and rely on a working relationship with team members to help find solutions to challenges.  When developing new technology, rely on your team to identify and correct glitches.  Have a goal, create a vision and then ask the team to help develop the plan.  Active participation shows trust and builds engagement.

 

Patients and their families are hungry for technology that will enhance their healthcare experience.  They desire appointment scheduling similar to booking seats on an airline and appreciate GPS based assistance when navigating the halls of busy medical centers.  Families want to connect to nurses via mobile device rather than pushing a call light and wondering when it will be answered.

 

User-friendly digital connections produce impressions and influence decisions to do business with the vendor.  Confusing or cumbersome technology is quickly abandoned leaving you to look elsewhere for goods and services.   Bond with IT specialists and develop cutting edge technology in a user-friendly format that you would enjoy using.  Chances are that your patients share your expectations when using web-based sites, including those related to healthcare.  Be a catalyst for digital technology and keep your organization a step ahead of the competition.

 

Tom is a noted author, enthusiastic speaker, committed leadership developer and superb clinical anesthetist.   Contact tom@prosynex.com to book a speaking engagement.

Micromanagement; A lens on leadership

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By Thomas Davis, CRNA, MAE, DNAP candidate

Follow @procrnatom on twitter

 

“Train people well enough so they can leave, treat them well enough so they don’t want to”      ~Richard Branson

 

Control is a funny thing.  It’s necessary and can improve results when the boss wields it, but it is oppressive and demoralizing when you’re on the receiving end of the heavy-handed version.  Keeping the boss informed as a project is tackled is one thing but having all the small parts directed is quite another.  Unfortunately, many well-intended supervisors become over-zealous while attempting to produce exact results, crossing the line from coach and encourager to micromanager.

 

Micromanaging is the enemy of both collaborative empowerment and creative thinking and can have devastating effects on a team.  Writing in Careeraddict.com, author, Chris Leitch lists the following as consequences of micromanagement.

  • Employees develop more health problems
  • Staff turnover is increased
  • Productivity is reduced
  • Personal relationships suffer
  • Job security is questioned
  • Progress is slowed
  • Teamwork is destroyed
  • Morale is lowered

 

Clearly, micromanaging blocks any attempt at creating a preferred workplace and must be avoided; yet Market Watch reports that over 50% of employees feel as if they are micromanaged.  Keeping out of the micromanagement swamp starts with self-awareness and a sincere desire to release the creative energy in team members.  Not sure whether you are a micromanager?   Try the online self-evaluation offered by The Workzone.

 

Managing by “control patrol” is a sign of insecurity and often originates from fear; fear of losing control, fear of project failure and fear of not being viewed as the authority figure in charge of the team.   To escape the fear, a leader must develop a keen sense of self-security that is clearly evidenced in the way he/she interacts with the team.  Leaders who are secure in their position seek to gain stature through the empowerment of others.  Author Goeffrey James offers the following insight for those who want to abandon the micromanaging style of leadership:

  • Rethink your role as a leader. Visualize yourself as a leader who is meant to guide and develop your team rather than a boss charged with controlling behavior.  View your team members as the capable and competent people they are and individuals who desire is to meet your requests and serve the organization while developing their own personal skills.
  • Delegate projects. Assigning responsibilities to others eases the burden of leadership and sends an important message that you trust your team.  When you delegate, make sure that the assignee understands the goal, the parameters within which he/she must work, and the timeline for completion.  Agree on checkpoints that keep you in the loop then set the boss’s binoculars aside and trust that the team will come through on the project.
  • Ask how he/she plans to proceed. As the project or assignment takes off, remember that the goal is to go from point A to point B.  Anticipate that someone else may solve the problem differently than you would, allow the individual to select the route and be okay with it.  The intent is to bring the project to closure, not to dominate the process.
  • Establish reasonable check in via email. Check in must be appropriate for the complexity of the task and the experience of the person assigned to complete it.  Requiring a person to check in more than necessary does not convey trust in the person’s capability and implies that you don’t trust your own decision to assign him/her the job.        Limit yourself to checking in once a week by email so as not to intimidate the person you delegated for the project.  Keep the tone cordial and collaborative.
  • Focus on developing others and giving them credit for their work. Micromanaging and empowering are polar opposites and mutually exclusive.  The best and quickest way to change your reputation as a micromanager is to re-direct your attention to developing others.  Be a thinking partner as well as a support system for team members who seek additional responsibility and have the desire to learn new skills.

 

Many people describe the “worst boss I ever had” as the controller who managed everything and everyone through a telescopic lens.  If your team has trouble with high turnover, low morale or other consequences associated with micromanagers, consider the possibility that you may be one.  Turn the lens on yourself, loosen your white-knuckle grip, embrace the concept that there is more than one way to achieve a goal and more than one person who can do it.  Ironically, by releasing authoritative power, you strengthen personal power and emerge as the recognized leader of a loyal and productive team.

 

 

Tom is a noted author, enthusiastic speaker, committed leadership developer and superb clinical anesthetist.   Contact tom@prosynex.com to book a speaking engagement.

The family friendly workplace

 

 family friendly post

By Thomas Davis, CRNA, MAE, DNAP candidate.

 

The United States is currently experiencing economic growth that has created a record low unemployment rate and increased the competition for skilled and motivated employees.  The 2016 census reports that 32% of the active workforce have children (per: Bureau of Statistics).  Among those who have graduated from college in the past 20 years are men and women with advanced degrees who are eager to participate in the workforce but must balance the demands of the job with the responsibility of raising children or caring for elderly parents.  In order to capitalize on the talents of those who wish to work, corporations are taking steps to make the workplace more friendly for those with family obligations. The intent is to attract highly qualified people to join their team and to provide incentives to retain those already filling key positions.

 

Every year Fortune magazine posts its list of the 100 Best Workplaces in America and, no surprise, those at the top are known for their family friendly approach to developing human resources.  This year, Wegman’s, a food market headquartered in New York, moved into the #2 position on the list partly because they offer many perks to help those who are juggling career and family. Wegman’s management puts an emphasis on building a preferred workplace for every employee and then provides incentives that boost their family-friendly rating.  Special benefits offered by Wegman’s include lactation rooms, fertility treatment, and paid leave to care for a sick child.   Family-friendly at Wegman’s includes measures to make the store kid-friendly for customers.  The store in St. Louis boasts of 15 kid-friendly features in their store.

 

A blog posted on care@work rates Edward Jones as #5 on the short list of top ten family-friendly employers.  At EJ, families can opt for a baseball tickets overnight family retreats at company expense.  And new moms “can take up to 120 paid days off for maternity leave.”

 

Attracting and retaining highly skilled workers is just as important in healthcare as it is at the supermarket.  Like the workers on Main street, many who work in healthcare must balance personal and professional lives using multi-dimensional equilibrium that ensures quality patient care and meets personal family needs.   Frontline healthcare team leaders are seldom able to implement sweeping changes in corporate benefits; however, there are things that they can do to make an individual workgroup more family friendly.

  • Listen and connect. Connecting with team members on a personal level is a key element of good leadership and is especially important when building a family friendly workplace.   Take an interest in things that are important to those you supervise and learn the names, ages and interests of their children.  Be sensitive to the coordination that the worker must do daily to ensure that children are able to attend activities, eat meals, do schoolwork and keep a reasonable sleep schedule.  Having empathy will elevate your understanding of the workers needs and open your eyes to ways to help the person meet his/her obligations.
  • Flexible time. When it comes to a work schedule, one size does not always fit all.  Workers coordinate with their partners for delivery and pick-up of children and the timing may not always fit your traditional schedule.  For example, Ana is a valuable team member but can not deliver children to school and be at work promptly at 7am.  Her creative manager shifted Ana’s work schedule to have her arrive at 8am and then be the person to stay an hour later than the others in the afternoon.  With the flexible schedule, Ana’s needs are met, and the workplace has a reliable person who ensures the afternoon shut-down process is done correctly.
  • Job sharing. All-star workers who have just become moms may not have the stamina to work full time and meet home obligations.  Rather than losing highly effective workers, offer the opportunity other team players to combine and cover one full time position collectively.  For example, at our workplace a young mom-to-be does not want to quit her job, nor does she feel able to work full time and care for her baby.  Another person on the team who is toward the end of her career feels the need to cut back and work only a few days per week.  Encouraging them share a position retains skilled workers and leaves the manager with one position to fill rather than two.
  • Switch to part time. Building a flexible part time schedule for a worker whom you don’t want to lose is another key to maintaining a cohesive team.  Often, the request to convert to part time comes from a worker who has obligations caring for an elderly parent, or grandchildren or who has earned his stripes and wants to cut back.  Accommodating the cut-back request sends a message that you value the person and want him/her on the team, even if only part time.
  • Remote work. Although working from home is not possible for a person delivering hands-on care, there are behind-the-scenes jobs that do not require the person to physically be at the workplace.  For example, a busy GI center makes two pre-procedure calls to each patient to ensure that they understand the bowel prep and know when and where to report the day of the procedure.  In addition, every post procedure patient receives a phone call.  The process requires two nurses to spend the entire day on the phone; calls that could be made from home just as easily as from the GI center.   Other tasks such as ordering supplies, building work schedules or revising policies/procedures could also be done from a home computer.
  • Healthy family days. Think beyond the traditional workday and offer family friendly days for healthy activities.  Schedule a Saturday morning day at the playground or a Sunday afternoon picnic in the park and have activities for children of all ages.  Adults will network, children will play, and a fun time will be had by all.

 

Does family-friendly matter?  Ask a colleague who has been challenged with a special family need.  Those who were supported by their employer feel a bond of loyalty with the organization and become highly committed to the job.  In contrast, those who were treated as #1 Nuisance feel no loyalty and become disgruntled employees.   Here are a few examples that I have personally witnessed:

  • An anesthesiologist friend of mine reinforced the importance of supporting family needs by sharing the story that his wife required 6 weeks of bedrest prior to the delivery of their first child. His employer told him immediately that his wife was his top priority and that the team would work around whatever schedule was needed to accommodate his wife’s care.  Following a successful delivery of a healthy baby, he is a loyal employee who continues to sing praises for the employer.
  • A member of our small perioperative team had a child with a special event at school at 7:30am.  All members of the team agreed to start the room at 10am that day and stay late if needed to complete cases.
  • A member of our team suffered a severe burn that required ICU and follow-up surgery. He was on the low end of the pay scale and could not afford his $5000 medical deductible.  The team rallied and in short order raised the required money to ensure that our colleague received the best possible care.

 

Teams that go the extra mile to take care of colleagues with family needs are rewarded with a team member who is totally committed to the group and ready to step in when others are in need.  The return on investment is high.

 

When it comes right down to it, blood is thicker than water.  Water is important, of course.  It nourishes the family, even makes the family possible.   But, as a leader, never forget that family will always be the first concern of all workers; the reason they work extra hours when needed, the reason they agree to imperfect contracts, and the reason they are loyal to a family-friendly workplace.  When you hire a worker, you are hiring his/her family and it behooves you and the entire healthcare industry to listen, to learn and to lead accordingly.  The time and effort that you put into creating a family friendly workplace will reap benefits for decades into the future.

 

Tom is a noted author, enthusiastic speaker, committed leadership developer and superb clinical anesthetist.   Contact tom@prosynex.com to book a speaking engagement.

Perception; The first step to success

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By Thomas Davis, CRNA, MAE, DNAP candidate

 

“All our knowledge has its origins in our perceptions.”

~Leonardo da Vinci

 

John is an experienced, highly motivated worker who is frequently assigned important projects with a short timeline.  Regardless of the demands that are placed upon him, John can hunker down and gitter-done to complete projects on time.  MaryAnn, John’s colleague, holds him in high esteem and respects his tenacity and ability to focus on a project.  Kevin, another colleague, views John as aloof, hidden behind his computer in order to avoid interaction with others. He judges him with disregard.

Mary Ann and Kevin have witnessed the same person and the same behaviors and draw opposite conclusions. Yet, in their own minds, both colleagues have developed perceptions that are fair and accurate.

Perception is reality to the observer and how you are perceived by others will have a lasting effect on your career.  People who create a positive memory of themselves tend to advance while those who project a negative image do not.   Stephanie Ketchum, contributor to fairygodboss.com, agrees that the memories created through observation have a lasting effect noting that “…a positive perception generated by visibility is a key factor for earning a promotion in an organization.”  Ketchum offers four suggestions for creating a positive image that others will remember.

  • Get assigned to important jobs. Let you boss know that you are ready to step up by asking to head a project or join a team working on a vital issue.  Once the assignment is made, deliver more than is required in a timely manner to demonstrate your effectiveness.
  • Gain face time with leadership, make personal contact. Being in the presence of people at all levels of the chain of command makes you a known commodity and a person to be considered when projects are assigned.  Gaining personal interaction with those at the executive level is more difficult but possible.  Attend receptions and participate in community projects that are endorsed by your CEO.  Upper level leaders of your organization want a positive public image and often will put on the gloves and spend a day working on a service project…hopefully, next to you.
  • Speak up and share ideas. Those who do the job are the experts who best know areas in need of change and have ideas for improving workflow.  Trust your observations and share your ideas.  Frequently, those who identify a problem and propose a solution are the ones who are put in charge of the project and earn recognition when the job is brought to completion.
  • Become known. Creating a positive image within the organization requires that you expand your boundaries and become known beyond your workgroup.  Actively seek to participate in projects that involve collaborating with people from other work teams.  For example, a perioperative safety program requires people from pre-op, intra-op, post-op and anesthesia to work together to achieve a common goal.

 

As healthcare workers, we are skilled professionals who provide vital services to the patient population. In the process, our activities and attitudes are constantly under surveillance by both co-workers, patients and leaders.   As such, our careers will be advanced or broken based on the perception we create as we do our jobs.  MaryAnn is impressed by John’s efficiency and ability to complete a task; however, Kevin is put off by John’s lack of people skills.  Although John’s expertise and commitment to timelines is a magnet for significant assignments, he doesn’t appear to work collaboratively and make personal friends with others who can participate in the project.  Consequently, the vital work that John does to advance his team remains unknown to others in the organization.  It’s each emerging leader’s responsibility to be a magician who can create the image of being the person who can take an idea, develop a plan and engage others to bring the project to completion.   Combine hard work, self-confidence and collaboration to create a perception that the team cannot function without you.

 

Tom is a noted author, enthusiastic speaker, committed leadership developer and superb clinical anesthetist.   Contact tom@prosynex.com to book a speaking engagement.

Encore Hilton Head 2019

 

HH post 1

Meeting Date: May 2019

Meeting location:  Hilton Head, SC

Meeting sponsor: Encore Symposiums

Strengths of the meeting:  Great speakers, timely topics and an attentive group of participants.  As always, Encore picks the best hotels and provides the best breakfast of any meeting that I have attended.


Suggestions for improvement:  None


Value for the money:  Excellent

Atlas Shrugged again

Atlas post

By Thomas Davis, CRNA, MAE, DNAP candidate

 

Follow @procrnatom on twitter

 

In 1957, author, Ayn Rand, released the powerful novel, Atlas Shrugged.   Over 60 years later, the book continues to provide insight for creative entrepreneurs and fodder for heated debate between capitalists and socialists.

 

The storyline of the novel showcases business tycoons who use only objectivism, rather than faith or emotion, to obtain evidence, ascertain the truth and set the best course of action.  The courageous Atlas characters who use evidence to gain insight and then act rise to the top, and the compliant, under-achieving sycophants become dependent upon the government for protection.  As the story progresses, the most creative minds and bodies vanish one by one until, finally, their previous importance/value to national socioeconomics is revealed.  Readers who doggedly complete the 1168-page book until Dagny departs, will gain a new appreciation for the value of logic and individualism in the creation of success both in business and one’s personal life.

 

“What greater wealth is there than to own your life and to spend it on growing? Every living thing must grow. It can’t stand still. It must grow or perish.”   ~Ayn Rand

 

Today’s workplace continues to have leaders with insight who can create a vision, look at reality and develop a plan to achieve a goal.  Author Robert Tracinski applied the principles from Ayn Rand’s classic novel to modern business leadership in his article published in The Federalist (2017).   Building upon Trancinski’s work, allow me to take the 7 lessons that he identified in Atlas Shrugged and apply them to healthcare leadership.

  • Know the business from the ground up. The quickest way to fail is to lead people who know more about the business than you do.  A grocery store chain in Texas is known for requiring every manager/leader hired by the company to spend the first 6 months stocking shelves and running cash registers before moving on to their intended position.  Likewise, healthcare leaders at every level must know more than how to do their job; they must also know the culture of the organization.  A Chief CRNA or an OR manager must know the overall workflow of the perioperative process and then follow up by appreciating the jobs done by other members of the team.
  • Earn respect. Entry level respect is earned by bearing the title of “designated boss,” whereby, authority is based solely on position.  True respect is earned over time and grows from personal relationships based on honesty, transparency and integrity.  Recognizing and rewarding excellence while mentoring those in need of improvement shows that the leader knows the difference between high and low quality work – an insight that will earn respect from the entire team.
  • Always take responsibility. Crisis management is an important aspect of leadership that comes with the job.  You might not be responsible for creating the state of affairs, but when a worker presents you with a problem, don the mantle of leadership by finding a solution.  Your title places you in a position to deliver like Dagny, and when you’re asked, “Whose responsibility was this?” there is only one answer; “Mine.”
  • Deal with the best talent. When you’re hiring personnel, look beyond technical skills by recruiting and hiring only people who are competent and who share your vision/values.  You can teach skills that are needed for success however you can’t teach work ethic, honesty and integrity.  Hire for values and teach the skills.  When seeking a mentor or expanding your professional network, “play up” and associate with those who have a proven record for success.
  • Set an innovative vision. Focus on the work at hand and insist on excellence in all you do, but never stop looking over the horizon and planning for the future.  You can break the monotony of status quo by having a vision, sharing it and motivating your team to achieve it instead of creating a Groundhog’s Day  Every today is another step toward a better tomorrow.
  • You are not a leader unless you have followers and gaining support is essential. A vision that enhances your personal profit and someone else’s loss is doomed for failure; however, a shared vision that encourages others to gain in tandem with you is likely to be achieved.  It’s OK to reap personal gain but not at the expense of others.
  • Don’t prop up the losers. When a new leader inherits a team, not every member is a high achiever, and some people are dead weight.  With mentoring and professional development, the low achievers will either come to life or they will sink further into being parasites and hangers-on who drain the whole team’s energy and resources.  If the less productive members of The Team do not respond promptly with a change of attitude, cut them loose quickly and cleanly with serving leader civility.

 

The fact that Atlas Shrugged continues to be discussed and debated decades after its publication underscores the impact of the lessons put forth in the book.  The characters who made an impact were the ones with a vision; they used solid personal values, they dealt fairly with others and, collectively, they elevated society.  Modern Hanks in healthcare are NOT building railroads or marketing Reardon steel.   They ARE leading the medical industry into the future using the lessons from Atlas Shrugged to build a new paradigm; one that is patient-centric; one that ensures safety and guarantees better outcomes for each client.  Hop aboard the Taggart train and ride the Rearden rails over the horizon to a healthcare system that is built upon the lessons put forth by Ayn Rand: The assurance that Dagney Delivers.

 

Tom is a noted author, enthusiastic speaker, committed leadership developer and superb clinical anesthetist.   Contact tom@prosynex.com to book a speaking engagement.

Uncommon Courtesy

courtesy post

By Thomas Davis, CRNA, MAE, DNAP candidate

Follow @procrnatom on Twitter

 

I arrived at a clinic to sign in for a medical appointment as the receptionist at the check-in window was having an energetic headset phone conversation with a friend.  While continuing planning the food and entertainment for a big birthday party, she handed me a clipboard stacked with forms, indicated with her finger that I should fill them out, and air-pointed toward a chair without missing a word of animated conversation.  Not one word was exchanged between us.  My first encounter as a patient left me feeling as if I were a distraction in her life rather than the reason for her job.

 

Driven by me-centered technology, civility is more and more frequently replaced by indifferent, disrespectful behavior, even in our benevolent healthcare industry.  Common courtesy has become uncommon.  While focusing on the medical task at hand, healthcare workers often ignore the value of using common courtesy to build a relationship with each patient, thereby, improving outcomes and solidifying a client base.  In writing about courtesy in Pharmacoeconomics review, author, Megan Dubina agrees, noting that common courtesy is essential when building positive patient relationships.  In a courteous environment, patients are more trusting of their healthcare providers and more likely to comply with treatment that promotes better overall outcomes.

 

Integral to courtesy is respect.   Though most of us have never had a face to face argument with a patient, there are many less obvious ways in which we may have been unintentionally rude and disrespectful to them.

  • Respect for the right to know. Healthcare providers are very efficient at obtaining informed consent prior to doing a procedure but fail to fully inform the patient about other things related to their care. Introducing yourself and your role in the process opens the door to dialogue that will enable your patient to clarify other questions that he/she may have.
  • Respect for ability to understand. Those with healthcare concerns frequently consult Dr. Google prior to a medical visit and arrive loaded with information from renowned institutions, but the new knowledge is only valuable if the healthcare team listens. Patients may not have medical terminology at the tip of the lip or understand advanced physiology, but they do know their own bodies. They do know how they feel and the changes that have occurred.  On several occasions my non-medical friends have told me that they will never see a certain doctor again because he/she “does not listen.”  They did not feel as if their insight into their own condition was respected.
  • Respect for time. The most common way to generate negative feedback at our ambulatory surgery center is failure to follow a schedule. Patients who sit in the waiting area several hours beyond their scheduled procedures feel as if their time is not valued and they are just another job for the provider to accomplish when he/she gets around to it.  The patient may be losing wages. Their designated drivers may be losing wages.  They all feel inconvenienced and disrespected.

 

Courtesy matters

The Disney corporation and others in the entertainment industry exist at the will of the client.  Since its creation in 1955, Disney has built an empire on four key principles; Safety, Courtesy, Show, and efficiency.  Regardless of the job, each Disney employee is viewed as a cast member and extensive training during orientation is focused on building a culture founded on courtesy. From front office executives to grassroots workers, courtesy in the form of respect is expected during every interaction with a client.  Disney’s loyal customer base is the best evidence for the importance of courteous behavior in the workplace.  In his book, If Disney ran your hospital; 9.5 things that you would do differently, Fred Lee underscores the importance of courtesy, civility and respect for every client and applies Disney’s key principles to healthcare.

 

The culture of courtesy and civility starts at the top and is job one for every member in the organization.  Dr. Reuven Paternak, CEO of Stony Brook University Hospital, sets a high standard with his emphasis on the importance of courtesy and respect as tools to improve the overall patient experience within their system.  His message to the organization includes the following points, equally applicable across the healthcare industry.

  • Introduce yourself. Start conversations by asking open-ended questions about the other person.  Show interest in the person and ask follow-on questions to increase your understanding of the individual and his/her concerns.
  • Listen carefully. Patients can sense changes in their bodies that may not be apparent in tests that have been performed.  Listening attentively adds to your pool of information regarding the symptoms as well as any fear or anxiety that may accompany them.  Avoid interrupting, cutting off or rebutting the patient.
  • Be considerate. Accept what the patient tells without discounting their observations or concerns.  Academic arrogance or dismissiveness will be perceived as rudeness and block the establishment of a collaborative relationship with the patient. Practice saying, “I understand,” and use a demeanor that shows you do.
  • Be on time. Show that you value your patients by valuing their time.  Intentionally overbooking your schedule may make the productivity numbers look great, but it also mandates that patients spend prolonged periods of time in the waiting area.
  • Use basic manners. Saying please, thank you and asking the patient’s permission before starting a procedure are all ways to show your respect for the person on the receiving end of your treatment.
  • Be honest and transparent. Delivering a diagnosis is not always easy, but it must be done openly and with respect for the person receiving the news.  Be empathetic while avoiding false optimism.
  • Take the extra step. Every day there are opportunities to do small things that make a big difference to the patient.  Follow up quickly with anything that is promised to the patient and make referrals immediately. Look beyond your patient and help others in the system who appear to be lost or confused.

 

Several positive consequences emerge when courtesy permeates the workplace.  First and most important, the overall outcome of the medical treatment improves as satisfaction increases. Second, because payors are beginning to link reimbursement to patient approval, the bottom-line financial status of the organization improves. Third, the morale of the staff is elevated due to conscious civility, high quality outcomes and satisfied patients. Finally, a culture of courtesy and collaboration is created that supports the concept of a preferred workplace, a major tool for recruitment and retention.

 

Building an environment that promotes courtesy as an essential element will ensure long-term viability of the organization.  People want to visit the Disney parks, stay in Disney hotels and eat at Disney restaurants because they know the Four Keys will be practiced – they will be treated with courtesy in every respect and the total experience will be amazing.  Families leave their vacation fantasyland wanting more and anxiously awaiting the time when they can return and build newer, greater memories.  As a healthcare leader, you should know, likewise, the value of creating a happy and loyal customer base by building positive memories for each patient and his/her family.   Establishing courtesy as a top priority in your workplace creates the only place that a loyal patient would ever consider going for treatment.

 

Tom is a noted author, enthusiastic speaker, committed leadership developer and superb clinical anesthetist.   Contact tom@prosynex.com to book a speaking engagement.

Take charge of change

change management

By Thomas Davis, CRNA, MAE, DNAP candidate

Follow @procrnatom on twitter

 

“Somebody ought to…” “If they were smart, they would…”  Workers frequently discuss the management flaws during small talk in the lounge and call on those in charge to fix the system; however, it is common for the very people who criticize and call for change to adamantly resist any disruption of business as usual.  Whether it arises from the front office or from a grassroots movement, and regardless of the merit of a new plan, variation of routine can be intimidating and evoke both active and passive resistance from the same people who are essential for putting a new strategy into action.  Successfully guiding a team through a revision process is a multi-faceted task requiring a leader to unite the workers; a demand that will challenge the skills of even the most experienced boss.

 

“The world hates change, yet it is the only thing that has brought progress.”

~Charles Kettering

 

 

Writing in The Balance Careers, Susan Heathfield connects effective leadership with managing change by emphasizing the importance of the leader’s commitment to implementing the new policy.  She suggests 5 essential elements for the leader to put in place if modification is to occur smoothly:

  • Have a vision
  • Communicate the vision
  • Be involved in planning
  • Provide structure to support the change
  • Designate an executive champion

 

 

At the core of implementing change is effective communication of both the proposed plan and the reasons that drive the need for adjusting current procedures.   Author Steve Weber (Speakinggump.com) affirms that most people will accept workflow alteration if they understand the vision, are allowed to participate in development, and feel ownership during implementation.   According to Weber, transparent disclosure of the plan and its necessity will have the following effects:

  • Defective systems will adjust
  • Redundant systems will be eliminated
  • Major flaws will be exposed and eliminated
  • Minor flaws will be tweaked

 

Leadership is essential for change implementation and management (CIM) regardless of its scope.   In a recent conversation with a patient, Joe, an executive level consultant for managing change at USAA insurance provided additional insight about the importance of leadership by sharing actual stories from his work. According to Joe, meaningful and lasting change is difficult to impossible without Active Invisible Management (AIM)  Like a duck that appears to be peacefully floating on top of the water and whose legs are churning below the   surface, effective leaders display calm confidence in public while churning out some hard work behind the scenes to push the project forward.  When I asked Pete about obstacles to anticipate when asking workers to set a new course, he noted two things that can derail implementation.

  • The first signs of success  Most of us assume that signs of success are a good thing, but Pete noted that top leaders are busy people and as soon as it appears that success is on the horizon, attention gets diverted to other areas and the project loses its AIM.  Having a designated executive champion who actively works until the new way becomes part of the team culture is essential, particularly when things appear to be going well.
  • Recognition and reward achieved under the old system High achievers who were rewarded under the old system have a vested interest in maintaining the status quo.  Leadership must be sensitive and ensure that the most productive people under the old system can also anticipate gaining recognition and reward with the new system.

 

Even after clearly communicating the proposed plan and its necessity, you may still need to address a question from your team; “what’s in it for me?”   Answer the question in a confident manner with a focus on benefits for both the individual and the organization with emphasis on the following:

  • Achieving personal / professional growth
  • Developing adaptive flexibility
  • Challenging old beliefs and accepting alternative methods
  • Showcasing strengths
  • Mastering the stress associated with the unknown
  • Breaking ho-hum routine
  • Opening the opportunity to create a fresh future

 

“Change has a bad reputation in our society. But it isn’t all bad – not by any means. In fact, change is necessary in life – to keep us moving, to keep us growing, to keep us interested. Imagine life without change. It will be static, boring, dull.”
–~Dr. Dennis O’Grady

 

Successfully guiding a team through the process of change is a multi-faceted process that can cause trepidation from even the most experienced leader.  Rather than cowering in fear of the lunchroom nay-sayers, clearly communicate the new plan and engage high-achievers from the old system to assume a prominent position in the new scheme.  Confidently position yourself and your team to be the trailblazers within the organization and be the first to reap the rewards that accompany successful implementation of change.

 

Tom is a noted author, enthusiastic speaker, committed leadership developer and superb clinical anesthetist.   Contact tom@prosynex.com to book a speaking engagement.

Find the right boss

hire your boss

By Tom Davis, CRNA, MAE, DNAP candidate

Follow @procrnatom on twitter

The blog-o-sphere is clouded with management and leadership articles about how to attract fabulous applicants, how to build an elite team and what it takes to retain the top performers.  On the flipside, there is a paucity of information to guide workers who are searching for the right job with the best boss.  Unfortunately, highly qualified workers are sometimes wooed into joining a team only to find that they have hitched their wagon to the wrong horse.  The Balance Careers writer Susan Heathfield affirms the importance of finding the right boss, noting that that working for a poor boss is the most common reason given by a person who leaves a job.  People don’t leave jobs, they leave bad leaders. In fact, having the right boss may be the single most important factor related to happiness and success in a position.  When you hit the job market, be an informed shopper who avoids chasing pay and benefits. Focus your search on finding the right boss.

 

Chief Technical Officer at Dailymail online, Oleg Vishnepolsky writes, “Choose a boss, not a job. A boss that supports you, trusts you and believes in you will make a great difference in your career.”  That sounds simple and would be if only you could go online and click “order” and “submit.”  Ordering a boss from Amazon is not possible, yet, there are a few things that you can do as you apply and interview for your next job.  Adopt the mindset that you are interviewing them just as they are interviewing you and take responsibility for your future.

 

Start your search by doing your homework and reading blogs regarding the common traits of a great boss.  From the articles, make a list of traits that satisfy your own requirements.   If your list parallels the essentials identified by others, it will include some of these items:

  • Communicates effectively with a pleasant personality
  • Has a vision
  • Makes decisions based on shared values
  • Sets expectations and provides resources
  • Provides timely feedback
  • Demonstrates honesty, transparency and respectfulness
  • Cares about each worker on a personal level
  • Values the perspective that each person adds to the group
  • Is focused on team development
  • Has your back, cuts you slack while maintaining standards
  • Is a working partner who provides mentoring and professional development
  • Makes the workplace enjoyable
  • Recognizes and rewards superior performance

 

The list is followed by the search.   Stumbling on Happiness author Daniel Gilbert gives a comprehensive, evidence-based review of how people perceive and react to various situations. Based on solid research by behavior scientists, he concludes that one of the best indicators of whether you will like something are the reviews of others whom you trust.  So, ask questions of someone who knows your next boss.  Is the person happy at work, fulfilled by his/her job and would he/she recommend the job to a best friend?  According to Gilbert, it is likely that your experience, good or bad, will parallel theirs.

 

After talking with people who know your next boss, your quest continues during the application/interview process.  If you detect a heavy presence of red tape and bureaucracy as you apply, don’t expect it to be any different once you are on the job.  Be certain to read the job description carefully, looking for key words related to teamwork, collaboration and professional development.  Read the mission, vision and values of the organization and determine if they are reflected in the job description.  If not, they are just words on a web site and are not part of the corporate culture.

 

At some point during the interview you will be asked whether you have questions and that is the opening that will allow you to learn about the leadership style of your next supervisor.  Have a list of written, open-ended questions that will get your next boss talking about him/herself and your future colleagues.  IMPORTANT: Word your questions in a manner that does not make the person defensive.  Asking, “How do you…?” or, “Why do you…?” is personal and may generate a cautious answer.  Instead, “Tell me about…,” or “How does the organization handle…?” gives a platform for the person to spill the beans without being put on the spot.  NOTE: if someone other than your next boss does the interview, it is a red flag that you will have a supervisor who is isolated and does not connect with workers.  Listen carefully as the person answers.   Dialogue that is “I” oriented with the leader describing all the wonderful things that he/she has accomplished is a red flag.  Empowering Leaders who elevate their workers and create preferred workplaces will respond in terms of “we” while crediting the team for accomplishments.  It is a particularly good sign when your next boss names people on the team who played an important role in implementing a plan or achieving a goal.  Here are a few questions to ask when you interview

  • Why is this position open? This is a question to ask “trusted others.” If it is due to expansion or retirement, that is fine and you will be told; however, if the void was created by people jumping ship, after you sign on, you will quickly learn why they left.
  • What is the greatest achievement of your team in the past year? This indicates whether the job is ho-hum, day to day routine or if there is a vision and shared goal.  It also gives you one more opportunity to listen to the leader taking credit or giving it.
  • How does the organization handle staffing shortages? A supply of local per diem workers that cover vacations can be healthy; however, if a significant number of shifts are filled by expensive locums who were imported from other parts of the country, it indicates that the team is having difficulty hiring new members locally and leadership may be the reason.
  • What is your favorite part about leading this team? Listen and you will learn about the person’s basic leadership style.  Is the focus on command and control or is it on empowerment and professional development?
  • A year from now I’m at my first annual performance review and I have had an exceptional year; describe it. Listen to the response and discern what is most important to your new boss.  Some will emphasize compliance with policy and high production numbers.  Others will talk about professional growth and the important contribution that you make to the team the organization.  In the middle are those who describe managing the status quo.  You know which to choose.

 

Some people go through an interview and get lucky, happening into an job in a supportive workplace; others roll the dice during the process, hopeful that the job works out but ready to move on if it doesn’t.  A lot of preparation is required for both interviewer and candidate in the process of learning about each other. As part of the prep, acquiring the attitude that you are choosing your chief will position you to weed out poor bosses and sign on with a real leader who wants to hire and promote the best and is the best.

 

Tom is a noted author, enthusiastic speaker, committed leadership developer and superb clinical anesthetist.   Contact tom@prosynex.com to book a speaking engagement.

Artificial Intelligence: The future is now

AI post

By Thomas Davis, CRNA, MAE DNAP candidate

Follow @procrnatom on Twitter

 

“It’s likely that machines will be smarter than us before the end of the century—not just at chess or trivia questions but at just about everything, from mathematics and engineering to science and medicine.”

~ Gary Marcus, Professor/scientist, New York University

 

 

“Son, be smart and plan for the future. Get job security and land yourself a job as a conductor on a train, a great career job that will never go away.” The year 1899 was an exciting time for people who needed fast, reliable transportation and rail service appeared well up to the task of carrying its passengers into the 21st century.

Fast forward to 1999 and the same conversation suggested the child enter the field of healthcare.  After all, as long as there are people, there will be a need for healthcare caregivers.  Today, nearly two decades into the 22nd Century, though the need for caregiving remains high, the healthcare train circa 1999 has long left the station and a new train has pulled in powered by an engine called Technology.

Just as train travelers in 1899 could not imagine the 1903 debut of the flying machine, those of us in healthcare today, especially those on the frontline delivering hands-on patient care, view our future workflow through the lens of today’s practice and can’t imaging things that have not yet been invented.  Although new hardware, software and devices are continually being developed, the awesome advance in technology that will have a monumental effect on healthcare will be artificial intelligence (AI).

Take an Exciting Glimpse Into the Future…

Artificial intelligence is defined as, “…machines that respond to stimulation consistent with traditional responses from humans, given the human capacity for contemplation, judgment, and intention,” says Darrell West, Director of the Center for Technology Innovation.  Stated another way, artificial intelligence involves data bases and algorithms that think, respond as humans would, and do it faster and with more accuracy. Here are some current uses of AI in healthcare.

 

Sepsis

  • Duke University actively uses an AI based sepsis watch protocol in the emergency department. The program feeds vital signs, lab tests and patient histories into a database and opens it to digital scrutiny for analysis.  Emergency room workers are alerted when the computer detects patterns suggestive of the early onset of sepsis.
  • The Johns Hopkins has its own life-saving sepsis alert program called TREWS. The miraculous protocol is being used in the many ICUs on the Baltimore campus simultaneously tracks 27 factors related to sepsis.  Like the Duke protocol, when signs of sepsis emerge, ICU workers are alerted an intervention is initiated.
  • University of Tennessee Children’s hospital is equally committed to eradicating infection and has implemented AI in the ICU with a program like those utilized by Hopkins and Duke.  Using digital insight to analyze multiple real-time factors identifies children in the earliest stages of distress and allows healthcare providers to initiate treatment early in the process.

Disease prediction

  • Mount Sinai Hospital has explored uses of AI going back to the deep dive project of 2018. Rather than looking for a specific condition such as sepsis, the project uploaded over 700,000 medical records into a database and gave the green light for the computer to “learn as you go.”  Deep dive gave latitude for AI to assess the information in a “learn as you go” manner and report the findings.  The program was able to accurately identify individuals who were most likely to develop hypertension, diabetes or other common diseases.  An unexpected finding was the ability to predict those who would develop schizophrenia.
  • Case Western Reserve University has programmed a robot to use AI to detect emotions in people. The robot quickly detects the mood of the person at the moment as well as changes in mood and personality over time.  Currently, the robot is being taught to respond with music, video or conversation to elevate the person’s mood when depression is detected.

Diagnostics

  • Ophthalmology The British Journal of Medicine reports that AI will continue to have a vital and expanding role in the future of ophthalmology. Digital analysis is particularly useful in diagnosing diabetic retinopathy, age-related macular degeneration and glaucoma.
  • Radiology The use of AI in radiology is predicted to be so successful that it will threaten the existence of the profession. The blog diagnostic imaging forecasts that AI will be able to read radiology images faster and more accurately than a radiologist.  A digital radiologist has the additional advantage of being available 24/7 to a worldwide population.
  • Pathology Similar to radiology, AI is revolutionizing the field of pathology.  Sophisticated programs are being taught to correctly identify the existing disease and will also be able to predict which cells will progress to a serious disease.

Anesthesia

  • Pharmacogenetics Webster defines genome as the complete set of genetic material found in every cell of a person. Pharmacogenetics is the relationship of an individual’s genome to their response to pharmacologic agents.  After genetic mapping, a person’s genetic composition can be reviewed by AI to forecast their exact response to drugs.  The anesthetic of the future will be based on the ability of AI to assess the genome and then provide a detailed prescription of the best combination of medications, the exact doses, and the re-dosing interval customized to the person’s genetic profile.
  • Ventilation Ventilators are being developed which allow AI to guide mechanical ventilation. Smart ventilators will analyze physiologic data and self-adjust to provide optimal exchange of respiratory gases.  When used in an ICU setting, AI ventilators will also prescribe appropriate sedation to complement the ventilation.

 

Encouraging adolescents to enter the healthcare field is still solid advice, however preparation for a career on the frontline of patient care delivery will go beyond science and chemistry and will include preparation in basic digital technology.  Moving healthcare into the future will require the C-word – collaboration between physicians, nurses, technicians and artificial intelligence experts.  Designing a career path that establishes job security into the future does not involve punching tickets on a train.  It requires boarding Starship Enterprise and “going where no [human] has gone before.”

Tom is a respected author, speaker leader, and clinical anesthetist.

Contact tom@procrna.com to book a speaking engagement.

Debrief, learn and excel

Debriefing post

By Thomas Davis, CRNA, MAE, DNAP candidate

Follow @procrnatom on twitter

 

All too often, opportunity knocks on the door and nobody is home.  Despite our desire to have everything go smoothly and safely with each patient interaction, glitches occur and when they do, opportunities emerge for improving the care that every patient deserves.  Rather than reprimanding the individual involved, insightful leaders respond by opening the door and welcoming the event as an occasion to debrief the entire team and develop a plan to ensure that the incident is not repeated.

 

“When a test pilot comes off a flight, typically there is another pilot to take it up and he believes in the debriefing.  You don’t keep something to yourself.”

 ~Wally Schirra, NASA astronaut

 

The act of debriefing has been an important part of military teamwork for decades.  Timely analysis of an event as it is occurring enables soldiers to address mistakes and make changes while on the battlefield.  Debriefing encourages novel approaches to critical situations and has the additional benefit of fostering relationships that promote team learning.  Similarly, the healthcare battlefield must address a never-ending flow of patients with unique needs that require addressing in a timely manner.  Writing in the British Medical Journal, authors Freytag et al. note that teamwork is the key to reducing medical error and recommend regular team debriefing as avenue for proactively developing a collaborative plan that will reduce or eliminate future medical errors.

 

Debriefing a team does not need to be a punitive or daunting event, rather, it is a format for understanding why the current protocol failed and exploring ways to patch holes to prevent future recurrence.  Leadership and strategy consultant Doug Sundheim proposes a simple four-step process to follow when conducting a team debriefing.  His advice to business leaders is equally applicable in the healthcare community.

Specify a time and place.  Emotions run high when an event occurs or a medical error is made, and knee-jerk responses seldom address the root cause of the incident.  Having a one on one talk to reprimand the person involved destroys morale and does not address the foundational issue.  A better solution is to designate a time and place for the entire team to review the glitch and collaboratively propose a solution.

Create a learning environment.  For the first half of my healthcare career, our department had a monthly morbidity and mortality conference to present a bad outcome and roast the person involved.  Over the years, the M&M conference morphed into a learning experience with the intent of process improvement based on the philosophy of Dr. Peter Pronovost, “every system is perfectly designed to achieve the results it gets.”  Addressing a problem as a system error rather than a personal failure opens the door for the team to find novel ways to design a new system that does not allow the mistake to be repeated.

Gather information.  As the leader, you are privy to information about what happened, however don’t assume that you have all the details of an event.  Those on your team who provide direct patient care are the most knowledgeable about flaws in the system and have insight about correcting them.  When the team assembles, use the time to clarify the following:

  • What was the goal?
  • What was the outcome?
  • Why did we achieve the results that we got?
  • What will we do differently in the future?

 

Develop a plan.  Theory and intellectual understanding are great but they don’t repair a defect in the system.  Take notes as the conversation progresses and use the insight of your team to change the existing system.  The objective is to develop a plan that eliminates the possibility of anyone else repeating the error.

 

The purpose of debriefing is to modify a system, change behavior and improve outcome.  Until the knowledge gained at the debriefing session is put into action, it is only an academic exercise.  Apple CEO, Steve Jobs knew the importance of follow-up and assigned a designated responsible person for each agenda item prior to a meeting.  Corporate trainer Paul Axtel affirms the importance of after meeting action as an essential part of the process for continuous improvement and makes two recommendations:

  • Summarize the meeting notes and distribute them to each person on the team. Written notes creates a document trail and serves as a reminder to each team member regarding the origin of the problem and the consensus for solution.
  • Clarify the plan and expected behavior of team members. When items need additional attention, designate who will be responsible and establish a timeline for completion.

 

The best leaders learn from every experience positive or negative, and constantly seek ways to improve results while promoting individual professional growth.  Medical errors might have devastating consequences or they may create a “near miss” scenario where nobody was injured…but they were at risk.  Glitches represent opportunity knocking on the door and perceptive leaders seize the opportunity to create a learning situation that fixes a defective system, improves safety, and preserves the self-esteem of the team member.  Open the door and welcome a friend.

 

Tom is a clinical anesthetist, noted author and requested speaker.

Evidence Based Leadership

 

evidence based post

By Thomas Davis CRNA, MAE, DNAP candidate

Follow @procrnatom on Twitter

 

Dr. David Sackett, an epidemiologist from McMaster University in Canada, is credited as being one of the early individuals most associated with evidence-based medicine.  “Evidence based medicine,” in the words of Sackett, “is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.”  The intent of using data to guide care is to move patient care beyond traditional lore and personal experience to a level of treatment based on solid evidence authenticated by research.

 

Building upon the success that evidence-based medicine created in healthcare, insightful business leaders are actively seeking ways to apply evidence-based management in the business community.  Writing in the Harvard Business review, authors Jeffrey Pfeffer and Robert Sutton note the importance of gathering and using information to support leadership and management decisions.  Their insightful article, Evidence based management, gives examples of business leaders, like GE and Adobe, gathering information in order to revise policies/procedures founded upon documented validation.

 

Examples of evidence-based management in the business community include GE and Adobe making the bold move to eliminate the dreaded annual performance review.  Evidence revealed that APRs focused on the past, caused anxiety and impaired rather than improved performance.  With the clear intention of building a collaborative culture, those same companies now require managers to have frequent one on one talks with employees instead of the APR.  The new system requires managers to discuss ways in which workers can enhance their future performance.  Inherent in the process is listening to employees suggest ways to improve the workflow and efficiency.

 

Communication, mutual understanding, respect, and ability to work together are four essential pillars that support highly effective workgroups.  Gathering and using evidence to implement those essential items builds a foundation for solid management decisions.  Managing a group of frontline healthcare workers is much different from directing a division at IBM, however the same principles apply.  Taking the time to accrue information will position you as a solid thinker and will earn you the respect of your team and your chain of command.

 

Implementation of evidence-based management within your healthcare team is a 4-step process

  • Ask questions. What are the policies and procedures that make the least sense to you or cause the most stress and anxiety in your team?  Ask further, “Why do they exist, are they effective, and are they necessary?”
  • Search for evidence. Review the literature, survey or interview other leaders, develop a questionnaire for your team and gather real information from every possible source.  Often, similar management issues exist in the business community as in healthcare, and data is available online to guide your leadership decisions.
  • Evaluate the data. Following the collection of information, set up a process to evaluate the data.  A survey with interval and ratio data can be scrutinized with statistical analysis.  Qualitative information collected by the interview process can be coded into themes that identify strengths and weaknesses of current policy.
  • Act on the evidence. Develop a plan to implement the new data and roll it out with a pilot plan.  Agree up front that the pilot is a trial that will be carefully assessed and modified before permanent changes are made to existing policy. Specify a period for the pilot and assess the results to determine if goals were met.  Modify the plan to address deficiencies identified in the trial period and introduce the final version of the new policy for implementation by the entire team.

 

For example, a healthcare team was not satisfied with the results achieved by their current one size fits all bonus system where each person received the same amount of money regardless of productivity. Using the four-step process, the system was questioned, and team members agreed that the system was not fair, nor did it reward high achievers.  Literature was reviewed and other leaders were questioned in the process of gathering information about alternative applications of bonus money.  With fresh information in hand, a new plan was developed with defined metrics that when achieved, moved the person to a higher bonus level.  Under the new system, everybody had the opportunity to receive the highest bonus, however benchmarks were required in order to earn the reward.  Some on the team were driven by the money and others were driven by the status of achieving the upper tier.  Regardless of the personal motivation, the productivity of the team soared under the new system.  At the end of the first year, a committee of peers reviewed the process, updated the benchmarks for achieving the highest reward and rolled out the plan for year two.

 

Evidence-based thinking that is currently being applied in the business community emerged from the concept of evidence-based medicine and now has come full circle as it is being applied to healthcare management.  The shift to data-driven decisions breaks the burden of being tied to tradition and opens the door for you to guide your performance and the dynamics within your team in new and insightful ways.  Applying evidence makes healthcare leadership healthy.

 

Tom is a noted author, speaker, clinical anesthetist and is a strong advocate for nurses in leadership roles

Older workers strengthen the team

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By Thomas Davis, CRNA, MAE, DNAP candidate

We respect our elders. There is wisdom that comes from experience, and I am not going to stop learning from wise counsel. ~Marcia Fudge

 

Our baby boomers are aging, our healthcare needs are increasing, and our shortage of nurses and other healthcare providers is expanding…an unhealthy situation.  Concurrently, many highly qualified healthcare providers who have reached retirement age are not quite ready to throw in the towel.  Keeping experienced, qualified people on the job adds depth and diversity to the team and reduces the shortfall of workers needed to meet the expanding demand for healthcare services.

 

Arlene Donovan, Forbes.com contributor, confirms that seasoned workers add value to a workgroup. “They possess years of experience, have industry knowledge and are committed collaborators.”  In addition, many older workers have a calming and unifying attitude based on their ability to withstand the battle-scars of past achievement. Blending the wisdom and experience of older workers with the knowledge and enthusiasm of younger workers creates a diverse workgroup uniquely positioned to meet the challenges posed by the expanding patient population.

 

Efforts to broaden the age range and retention in the workforce must go beyond making all capable workers welcome to remain.  It must include active recruiting to bring experienced people back into the workforce.  Many who have recently retired are having second thoughts and would welcome an opportunity to rejoin a team, even if part time, but feel too old to apply for a job.  Reaching out to mature workers opens the door for their return to the job.

 

Glassdoor.com, author, Jacqui Barrett-Poindexter, highlights several characteristics of mature workers that make them valuable team members.

  • Problem solving  With decades of experience, veteran workers have overcome challenges and deadlines, have a network of connections in place, and know the most efficient way to bring a project to completion.  Along with adding insight, in stressful situations they have a calming influence that that generates confidence.
  • Perspective  Seasoned workers know that not every project is urgent and not every deadline is firm or realistic.  By drawing on experience, they are able to discern the difference and when to focus on urgent tasks prior to addressing other issues.
  • Knowledge  Older workers may not have the same knowledge base as younger workers who recently completed advanced degrees, but, as described in the March 24, 2019 procrna.com blog, there is a big difference between knowledge and wisdom, and both are important.  Where older workers lack textbook knowledge, they win the prize for perceptive common sense.
  • Capacity to grow/learn. It is a myth that older workers are set in their way and resist change.  To the contrary, older workers have spent a lifetime implementing change and know how to do it.  Today’s workers who are in their 60s and 70s were the activists of the 1960s and 1970s who spearheaded the civil rights movement and attended Woodstock.  The hair may be gray, but the spirit remains.
  • Mentoring.  Older workers want to share their stories and ensure that those who follow in their footsteps have the benefit of their experience.  Older workers tend to be willing mentors who are eager to leave a legacy through the work of the next generation.

 

Attracting older workers to apply for a position in your organization should not be a daunting task.  It is a myth that the long-serving people who join, or rejoin, your group will try to steal your leadership position or demand a higher level of pay.  Experience from the business community has revealed the opposite; older workers want to share their experience, but they do not want the responsibility of being the boss nor do they expect top dollar in the pay check.  Whereas younger workers are attracted to pay/benefits, school districts and flexible hours, older workers are working because they want to and are attracted by things that make them feel valued.   When recruiting older workers, appeal to the following:

  • Competitiveness Senior workers who wish to remain in the workforce have been the innovators of change throughout their careers and even though they are no longer leaders, their competitiveness remains.  Their desire to achieve will lift the performance of the team.
  • Wisdom The transfer of knowledge into action requires the judgment, foresight and prudence that older workers have accumulated over the span of a career.   Your elders know how to get the job done.
  • Place in life Mature workers are at a place in life where they are neither harried by the schedules of their children nor encumbered by leadership responsibilities.  Appeal to their needs by offering flexible work schedules that allow them to travel, visit their children and grandchildren or pursue the other activities that keep them in shape for continuing to work.
  • Flexibility Appreciate and place value on the flexibility that older workers offer the collective welfare of the team as they fill schedule positions that are difficult for younger workers who are raising young children. You’ll find that the grandparents on your team who have been there, done that, will help out where others cannot.

 

Baby boomers ARE aging, and their health needs ARE changing; and, they bring balance to the ever-expanding need in health care.  Engage with the gray-haired and tie-dyed who still want to work and you’ll rediscover what, sooner or later, you will experience…decades of wisdom based on experience, a wonderfully collaborative spirit, and the dedicated dependability of those who truly want to help build the bridge to a healthy situation.

Tom is a clinical anesthetist, noted author and requested speaker.

Prevail over office politics

politics post

By Thomas Davis, CRNA, MAE, DNAP candidate

Follow @procrnatom on Twitter

When experienced leaders are asked to list things that they like the least about their position of authority, “office politics” will be high on the list of annoyances.   Similarly, when rank and file workers are asked to name several things that they dislike about their work environment, “office politics” makes their list too!  Disruptive sub-agendas in the workplace cause trepidation among leaders and create conflict among workers, yet politics is accepted as a natural component of the environment.

Webster and Wikipedia both agree that office politics involves the use of power and authority to gain and keep an advantage over co-workers or business competitors.  The concept is simple; those with P&A constantly use politics to expand and solidify their position.  Strong, designated bosses can use authoritarian power that goes with the position to enforce compliance however, savvy leaders know that using a touch of politics will create a team that wants to follow rather than a team that must follow.

In contrast, where strong leadership is absent, quasi leaders emerge to shape the opinions of co-workers and undermine the agenda of the designated leader.  Opinion leaders claim power by controlling the emotions of their peers, often by starting rumors that generate fear and anxiety.  In dysfunctional workgroups that are void of effective leadership, the quasi-leaders often have more power than the person with the title.   Workers who want to be loyal to the organization are stressed by the conflict of choosing between the designated leader and the opinion leader.  When left unchecked, opinion leaders gain power and can ruin both morale and productivity.

 

“One of the penalties for refusing to participate in politics is that you end up being governed by your inferiors” ~Plato

 

Politics in the workplace may arise from many different sources.  Harvard Business Review contributor Michael Jarrett identifies several dynamic forces that fuel office politics, including the following.

  • Grassroots politics – generated by the buzz that exists just below the radar screen of the designated leader or organizational administration. Opinion leaders spin and spread enough fear to undermine just about any initiative put forth by leaders.  Because gossip and rumor are the vehicles for spreading discord, there is seldom accountability for instigators.
  • Authority politics – linked to the official title or role of the individual. The designated leader or a person appointed to head a project may use her position to coerce others into obedience.
  • Policy politics – wielded by individuals who memorize the rule book and quickly report anyone whose behavior is suspect. Rather than addressing an issue with the offending person, the rule mongers quickly file a complaint with HR or any authority who will listen and act.
  • Status quo politics – emerging from established norms, assumptions and unspoken routines. “We have always done it that way,” rules the day and those in the cocoon of comfort generated by routine will fight any disruption to workplace habits.

 

Stop the shaking at your knees and lead with confidence.  As the leader, you have an opportunity to view workplace politics as a dynamic source of energy that can be tapped and directed to produce impressive results.  Put the harness on runaway politics and channel team energy into more productive activities by adopting and practicing the following leadership behaviors.

Learn the office culture.  Be confident of your ability and agenda while discovering who the opinion leaders in your group are.  Identify your sources of support and use positive politics to ensure that they are allies.  Assess the status quo of your workplace and consider that many elements of the daily routine serve a positive purpose and enhance the workflow.  Before implementing change, evaluate the level of support for the new policy, and be politically aware by fully informing the team of the need for change well in advance of implementation.   “Knee jerk” policy implementation fuels the furnace of political rivals and ensures sabotage.

Don’t burn bridges.  Divide and conquer is an established military strategy and those who would steal your political power are energized whenever you have a rift with another person.  Avoid emotional responses that poison personal relationships and consider that today’s foe may be tomorrow’s ally.  Don’t turn a blind eye to bad behavior, instead, address every issue in a mature manner that addresses the problem while maintaining a positive relationship with the individual.

Never allow gossip.  The undercurrent of gossip that is ubiquitous in many workplaces only serves to empower opinion leaders and may be used to sabotage you.  Do not participate in gossip and cut it off immediately by dispelling rumors.   As a leader charged with improving the morale of a group, I gained political respect by publishing a weekly update which included the “rumor mill”.  In that space I directly addressed any current rumors by transparently informing the group of the truth.  In short order, rather than gossip, people came to me unswervingly to clarify rumors.

There are no unimportant people.  Display charismatic politics by connecting with everyone on the team on a personal level including, and especially, the opinion leaders.  Be professional and remain on alert that they will try to control you.  Take responsibility for your relationships and give the loyal opinion leaders on your team additional responsibility and then recognize/reward them when they are productive.

Be strategic.  What is your long-term goal for the team and what are the steps that must be taken to get there?  Start with small projects and put others in a logical sequence so that you can build momentum as you go.  Again, give appropriate recognition to your all of your high achievers whenever possible.

Be collaborative.  The positive use of politics augments effective teamwork, unites individuals, enhances morale and eliminates power struggles that fuel office politics.  Creating interdependence and a sense of shared responsibility puts you clearly in control as the leader and strips power from those who would take yours.

 

Think of politics as a use of power.  The politics of the 60s united a nation and landed a man on the moon whereas the politics of the 70s divided a nation and mandated the retreat from Viet Nam.  Workplace politics are less sensational but equally control the mood and productivity of a team.   Capitalize on the collective strength of your team, take charge, and use the political capital that comes with your position to build a cohesive and productive workplace.

 

Tom is a clinical anesthetist, noted author and requested speaker.

Boost your credibility

 
credibility post

By Thomas Davis, CRNA, MAE, DNAP candidate

Follow @procrnatom on twitter

Would you have faith in the information that you received from a person for whom you had little respect and trust?  Even if you gave the person the benefit of doubt, you would be likely to view the information with skepticism and validate the report before fully it.  That is because respect and trust go to the heart and soul of being believed.  Whether you are starting to climb the professional ladder, or reaching down to assist others with their ascent, when you’re dealing with others, your personal credibility will either enhance or kill the results you achieve.

Business is conducted at the speed of relationships and credibility is the gatekeeper that will makes or breaks the deal.  Forbes.com contributor, Victor Lipman, reinforces the notion that credibility puts spurs to the process of making a deal.  For example, at one point, Warren Buffett’s company sought to make a 23 billion-dollar deal that normally would take months, or even years, for lawyers to complete.  Based on the personal credibility established during previous deals between Mr. Buffett and his counterpart, both parties felt secure that the other was working honestly and in good faith.  As a result, the monumental deal was completed in a few short months.

In the movie The legend of Bagger Vance, Rannulph Junuh, played by Matt Damon, is the local favorite locked head to head in competition with the two greatest golfers in the world.  Having trailed for much of the match and now tied with the pros, Junnuh hits a ball into the rough.  “He has a chance to win the match on the final hole but has the integrity to call a penalty on himself when his ball moves after he tries to remove a loose impediment.” (wikipedia).  A young boy and eager fan implores him not obey the mandate, saying, “But nobody saw it move.”  Junnuh replies, “I saw it.”  Honesty and integrity provide credibility, and Rannulph Junnuh had both. Sometimes personal integrity leads to an immediate loss, but it always creates a long-term winner.  You will have to watch for yourself to see who finally wins the match; however, the young golfer’s high ethical standards set a precedent that would build a foundation for honest dealing beyond the golf links.

Follow the example from Bagger Vance and build relationships like those of Mr. Buffett by focusing on behavior to boost your credibility.   Incorporate the following behaviors into all your interactions and establish yourself as an honorable trusted person in all that you do.

Be honest. The call for honesty appears so often in self-help articles that it is almost a meaningless cliché; however, without honesty there can be no trust and without trust, there is no credibility.  A retired used car salesman whom I’ll refer to as Pompous Patient, told me, “If a used car salesman told the truth, he would never sell a car.”  Do you want to do any kind of business with a person who is a professional liar?  In your leadership transactions, move beyond mostly honest and establish a goal of totally honest.  Admit your mistakes and assess yourself a penalty when needed.  Total honesty also involves refusing to turn a blind eye and proactively holding those around you responsible for following established standards.

Deliver results.  It’s easy to volunteer and say yes when someone is needed to tackle a project; however, saying yes puts your integrity on the line.  Credibility is established when the task comes to fruition in a timely manner and achieves the desired outcome.  Protect your reliability by refraining from over-promising and treat all tasks, large or small, as opportunities to deliver results.  When you agree to perform, keep your word and deliver.

Be transparent.  Credible people have the courage to share information, both good and bad, to those who have a need to know.  Trying to shield those around you from bad news is a losing proposition. When you’re the messenger of bad news, put it into context by discussing the reasons behind the decision. Eventually, people always learn the truth and if you have not been forthright, they will have good reason to doubt you in the future.

Be consistent.  Human beings, including your colleagues, thrive on routine and are more relaxed and trusting when the behavior around them is predictable.  By making certain that policies, procedures and rules are known by all and equitably applied, predictability is reinforced.  When administering discipline is required, it must be appropriate for the offense and be meted out evenly to every offender.

Be principled.  Situations change but guiding principles remain constant.   What are the principles that you stand for and guide your deciaion-making?  If you need your consciousness raised, go to jamesclear.com to review a list of values, select 5, and practice, practice, practice.   Your credibility is enhanced when others observe that consistent, principled behavior is who you are and not just something you do.

Lead by example.   Imagine yourself with impeccable credibility and then be the person you visualize.  It’s easy to want or intend to be honest, trusted and credible, however intentions do not change reality.  Personal credibility can only be present when people know your integrity not by what you say, but by what you do.  Your behavior is being observed and will determine the reputation that you create for yourself.

Credibility is a visualized, rehearsed, observed, taught, role-modeled behavior that, lucky for leaders, can be learned. It is often said that we are who we are when no one else is watching. If you consistently set high standards for yourself no matter who’s in the audience, you will earn the reputation of a straight-shooter with whom people want to do business.  You will garner respect and trust, the key components of credibility.

 

Tom is a noted author, speaker and team builder

Compelling messages get results

email post

By Thomas Davis, CRNA, MAE, DNAP candidate

follow@procrnatom on twitter

 

“Effective communicators make great friends. They’re open to many things and are able to translate their thoughts into meaningful words and actions.”   ~Patrick Cogen

 

E-mail is an amazing and vital byproduct of the digitalization of America.   At present, it is attractive, affordable and essential for communication between leader and team.  Group messages are an effective way to update and inform an entire team about policy change, workflow alterations or any other topic that affects the group.  Individual messages provide an avenue for private, two-way dialogue related to a specific issue.   The electronic message platform is so familiar that an important message may blend in with the volume of junk mail and go unnoticed and unopened.  Therefore, it is incumbent upon the writer to create a recognizable topic for the subject line, and a compelling message inside that catches the attention of the recipient and demands to be opened.

 

Caution

There are two important cautions to consider before delving into the finer points of writing effective email messages.   Caution #1 Do not use email to avoid personal interaction. Relationships are essential and often make the difference between success or failure of a project.  Janice Nadler Ph.D. published a study revealing that people who introduced themselves with a brief phone call were four times more likely to reach agreement when negotiating via email.  Email used as a time-saving means of communication is a supplement, not a substitute.

Caution #2 Don’t send emails that pose the risk of creating an unwanted paper trail.  Always consider that your messages may be stored or shared so check your amygdala at the keyboard and avoid writing emotional, unkind or nasty rhetoric.  Assume up front that anything you publish thoughtlessly can and will be forwarded in mere seconds to the receiver’s support network.

 

Preparation is key

Before you shoot out a quick message, take a moment to consider the purpose.  What is the single most important concept that you want the reader to remember?  Recipients tend to remember one or two main points and if you shotgun too many topics in the same message, they may remember the one that affects them the most while overlooking the others.  Combine and condense subjects to support a single concept and clearly state the desired respnse of the reader at the end of the message.

 

Identify your target audience and tailor the language of the message to make it easy to understand.  Whether you’re sending a message to a single person or to an entire workgroup, never talk up or down to your reader.  If you are implementing a policy change and notifying people at different levels on the chain of command, develop a separate message for each group.  For example, a workflow change will affect technicians and nurses differently than physicians and APPs.  Developing a message for each group ensures that the information is presented appropriately.

 

Capture the reader’s attention

You can control the words you write and who initially receives it; however, you have no control over whether the receiver opens and reads the message.   Hubspot writer, Olivia Allen, suggests creating a subject line that piques interest, stimulates urgency or is personalized to the reader.  For example, “Vendor sponsored dinner” sparks less interest than a subject line “Dine and earn CME at the Steakhouse.”  If your goal is to get people to read a draft and offer feedback, a subject line “XYZ policy draft, reply by Friday” will stimulate both curiosity and urgency.

 

Power Words make Power Mail

 

Impactful messages begin with a powerful opening and your first two sentences will either win or lose your reader’s attention.  Review your goal and write several versions of the first two sentences making sure to include a few power words.    Blog author John Morrow offers 595 power words that can be incorporated onto your messages to compel the message recipient to continue reading.  Words like amazing, fabulous, remarkable, spectacular, exciting and tremendous might be used to describe an opportunity or an achievement.  Power words like frightening, revolting, toxic, scary staggering or scary can be used to give warning or to describe challenges. Regardless, your message content must be related to and flow from the subject line.

 

“Fools talk because they have to say something whereas the wise talk because they have something worth hearing.”    ~Paul Bowden

 

Once the message is opened, remember, less is better.  One or two short, concise paragraphs will be read attentively, whereas, a rambling message will be visually skimmed over before joining the trash barrel.   Transparency gives the sender credibility, builds trust and maintains the writer’s integrity. If you’re sending a message that will alter the status quo, briefly state the reasons and the benefits.  For example, an ambulatory surgery center required workers to copy two pages from the patient record at the end of each case and submit them to the billing department.  Without prior notification by the employer, the usual copier was removed and workers had to walk down the hall to a different copier. The workers did not welcome the change and gave pushback.  Had the leader sent the group a message informing them of the impending change, openly revealing that removing the extra copier would save $15,000 per year in ink costs, there would have been little dissent.

 

When the purpose of the message is to implement change, there must be a clear description of the next step for the reader.  Workers are comforted when the leader takes charge and has the foresight to state clearly and without ambiguity the exact behavior that is expected from the reader.   Soft messages that only imply but do not specify action will be misread and cause confusion.  After giving a powerful opening to capture attention, a transparent description of the problem, and a clear directive to the reader, summarize the message in 1-2 sentences.   Unless the message is urgent, save a draft and re-read it before it whooshes out to all.

 

Electronic communication is not the wave of the future, it is the reality of today.  Like the junk mail delivered by the postman that you transfer quickly from the mailbox to the trash can, bland email messages go to the electronic trash can with one click. Communication is an essential component of leadership and email is currently the platform of choice for sending electronic messages.  Honing your skills to use current and future digital technology wisely and well, will ignite your leadership and unite your team.

 

Tom is a clinical anesthetist, noted author and requested speaker

Build a Bridge

teambuilding post

The Team Is The Trestle

By Thomas Davis, CRNA, MAE, DNAP candidate

 

Great leaders know that even the most brilliant plans fail without the support of members of the team.  Motivating workers to leap on board to work collaboratively toward a common goal is a challenging yet important part of being a leader.   Don’t be daunted or intimidated by the collective roll of the eyes when you introduce the topic of teambuilding.  Instead, appreciate the importance of inspiring team spirit by doing projects outside the scope of normal work.  In addition to uniting team members, they will experience the reward of creative collaboration and the energy generated from the project will be carried back into the workplace.

On teambuilding.com, Samantha Mc Duffee identifies several essential benefits from teambuilding activities and puts improved communication/collaboration at the top of the list.  When a group who works together daily is removed from the normal workplace and given an open-ended challenge to solve a problem, an amazing spirit of collaboration emerges.  Take for example a teambuilding activity that was used with a group of nurse managers during a leadership course.

  • The large group of eager participants was divided into 5 groups of 5 people; each group was given 25 pieces of uncooked spaghetti, a string, a role of scotch tape and a pair of scissors; the individual groups were challenged to build the tallest tower in 15 minutes.  The simple rules were to use only the materials provided and to work collaborative with a positive focus on what is possible with the available resources.  During the first 5 minutes each group quickly constructed a tower and each tower collapsed; then each group spent the next 10 minutes collaborating to create a better design and re-build the tower.  At the end of the allotted time, each group had a standing tower; however, two tables opted to combine resources, work as a larger group and constructed the tallest tower.  Remember, they were told to work collaboratively and seek the best use of available resources and there was no rule about working across group lines.

Brian Scudamore, founder and CEO of O2E brands, took another avenue toward teambuilding by treating his team to a country music concert at a local dance hall.  They enjoyed sharing the evening together with music, adult beverages and learning the two-step and taking advantage of the relaxed venue outside the workplace to appreciate each other as individuals.  Brian encouraged the team to continue the networking within the workplace and to share personal interests with one another.  From interaction developed during the two-step, a book club emerged. You might not be permitted to treat your workgroup to a night out; however, you may be able to arrange a group discount at the ballpark or reserve a park pavilion for a barbecue.

Community service is important to the image of a company and opens another opportunity for teambuilding.   By serving the community outside the scope of normal business, a bond is created between the organization and the people it serves.  Employees’ hidden talents are revealed and, as well, the community receives support for projects and events important to the local area.  Here are two examples of teambuilding projects that solidified ties between the organization and the community.

 

Example 1   While on faculty at the University of Kansas Medical Center, I participated in the annual KU community service day.  Over 100 energetic volunteers from the hospital assembled in a cold parking lot at 7am on a Saturday morning and were greeted with hot coffee and pastries.  We were told ahead of time to wear work clothes and bring a few basic tools.  The Medical Center had identified a two-block area within the city with run down homes that were inhabited by elderly indigent people and pre-arranged permission for us to do basic repairs on their homes. We went to the neighborhood, divided into teams and went to work.  Some raked, some cleaned gardens and others did inside repairs.  We re-attached cupboard doors, fixed locks, patched cracks and even fixed some plumbing leaks.  At the end of the day the residents of the area were all smiles as were the UKMC volunteers.  I spent my day working with one person from radiology and another from the lab and from that day forward had a point of contact in each area.

Example 2   A group of nurse anesthetists, at The Johns Hopkins was actively seeking a teambuilding activity that would serve the community and arranged to do a craft night at the local Ronald McDonald house.  After scheduling the activity, the team set a goal of providing the most amazing “craft night” ever for the children and families staying at the facility.  Planning sessions were held where creative ideas were shared and then supplies were assembled.  On the big night, children cautiously entered the craft room and quickly became energetic as they engaged in the numerous projects provided.  Parents and siblings jumped into the fun and none were ready to quit at the end of the evening.   As with the experience at KU Med, when the evening was over it was difficult to tell whether the residents of the Ronald McDonald house or the volunteers were the happiest.

Workgroups across the country routinely participate in community service teambuilding activities.  Use the comments box below to share your project with other readers.

Successful teambuilding is evidenced by the momentum that is brought back into the workplace following the event.  Whether joining in a social interaction event or a community volunteer enterprise, those who work collaboratively outside the workplace are more likely to work well together on projects serving the organization.  Encouraging people to enjoy one another’s company and appreciate creative ideas carries innovative vitality forward and becomes contagious.   A collaborative environment is the bridge to elevated productivity in a preferred workplace.  A collaborative team is the trestle linking the organization to the community.  Teambuilding activities strengthen both.

Tom is a clinical anesthetist, noted author and requested speaker.