Tag: Chief CRNA

Emotionally Intelligent Teambuilding



By Thomas Davis, DNAP, MAE, CRNA

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A review of the literature from the business community reveals that having and using emotional intelligence is one of the most important skills of a successful leader, both at work and in the individual’s personal life.  Simply stated, emotional intelligence (EI) is the ability to recognize and control emotions in ourselves and in others.  Writing in PositivePsychology.com, author Elaine Houston notes that EI is the interface between the emotional and thinking centers in the brain.  Having emotional intelligence increases our capability for resilience, motivation, empathy, reasoning, stress management and communication…all desirable traits.

Think back and recall your favorite boss and then ask yourself what made that person stand out compared to others you have worked for over the years.  Most likely, your chosen best boss was a person who was easy to talk with and seemed to understand and accept you as a unique person. This person could probably sense your need for professional development and connectedness with the team.  In short, your favorite boss was most likely a person who was strong in the area of emotional intelligence.

Why emotional intelligence makes a difference?

Writing in the American Journal of Pharmaceutical Education, authors Romanelli, Cain and Smith reveal that those with strong EI skills are better able to make sound decisions, build and sustain relationships, manage stress, and adjust to change.  It is for those reasons that hiring managers across the country are assessing the EI capabilities of applicants during the interview/hiring process in hopes of building a strong and collaborative workgroup.

Recently I had the privilege of teaching a course for an exceptional group of nurse anesthesia students.  In a discussion with the program director, I learned that when evaluating students, the selection committee placed greater value on EI than academic credentials during the interview process and that the class of students was selected based on their emotional intelligence skills. 

Like the savvy program director, Chief CRNAs across the country are placing value on building teams filled with collaborative workers who are empathetic toward one another and resilient when faced with a challenge…emotionally intelligent teams.  Hiring managers have learned that it is better to leave a position open rather than fill it with a “bad apple” who will demoralize others on the team.  Gone are the days when positions were filled out of desperation and those who lack EI are finding it more difficult to find a job.

Tips for building an emotionally intelligent team.

Strong, collaborative teams don’t happen by chance, they are developed by leaders who can visualize what they want, develop a plan to achieve it, and stick to the plan without exception.  It takes foresight, preparation, and follow-through to achieve the desired results.  Let’s get started.

Truth in advertising.

When posting a job opening, include a job description that describes not only the work that is to be done but also the personality traits that you desire.  Weave the core values of the organization into the job description and state up front that you are seeking a candidate with a strong history of collaborative teamwork.

Check references.

Typically, applicants submit three references, forms are sent, and prior work is documented.  Basically, the form documents that the person held the job and was not fired due to incompetence or moral deficiency.   Take the next step by calling the reference and asking questions that would reveal the applicants EI abilities.  Ask “what is the applicant’s greatest strength?” and listen for indications that he/she works well with others.  Ask whether the applicant has overseen projects or mentored others and what was the outcome.  Talking with a reference gives insight into the applicant’s people skills.

At the job interview.

Start your interview with a review of the mission, vision, and values of the organization and clearly let the applicant know that if he/she is not in alignment with the values, this is not their job.  Rather than discussing case management and work schedules, use the interview time to learn about how the person interacts with others.  Ask leading questions such as:

  • Describe your ideal workgroup.
  • Which of the organizations core values do you most identify with and why?
  • Tell me about a time when you disagreed with your supervisor, how did you handle it?
  • Tell me about a time when somebody criticized your work, how did you handle it?
  • How would you resolve a dispute between two colleagues?
  • What was your greatest success in your last job?

These questions will get the ball rolling…add others that fit your specific job situation.  Listen carefully and if you get a superficial stock answer, ask follow-on questions.  “Tell me more about” or “what happened next” are ways to reveal how the applicant works with others.  Listen for we versus I when the applicant answers questions.  Strong team players credit others for participating in success whereas those who lack EI brag endlessly about themselves.

Success.

Strong teams and preferred workplaces don’t happen by accident, rather, they are the product of insightful and effective leadership.  Screening applicants and hiring based on emotional intelligence will produce a highly productive and collaborative team that pulls together during stressful times and is a pleasure to supervise.

Tom is an experienced leader, author, and requested speaker.  Click here for a video introduction to Tom’s talk topics.



Evidence-based Leadership

By Thomas Davis, DNAP, MAE, CRNA

During my four decades as a nurse anesthetist, I have seen many changes in our profession and our day-to-day management of surgical cases.  Back in the day, I was just as proud of my hospital-based diploma as our current doctorate level graduates are of their terminal degree.  Upgrading entry level education first to the master’s degree and now the Doctorate level has mandated that nurse anesthetists be active players in gathering and applying evidence to case management. 

The Johns Hopkins describes evidence-based practice as the integration of research, clinical expertise, and patient values to ensure the safest and most effective outcome for patients.  Throughout our workplaces, policies and procedures have been developed based on scientific evidence obtained through peer reviewed research and patients have benefitted from the upgrade in practice.  Now it is time to apply the same evidence-based activities to the process of leading and managing perioperative teams, including nurse anesthetists.

Leadership matters.

Employee engagement and morale affect patient safety, satisfaction and ultimately the outcome from the treatment that they receive.   Worktango.com notes that leadership is the driving force in determining employee engagement and productivity.  Connecting the dots, effective leadership drives employee engagement which, in turn, improves patient safety, satisfaction, and outcome.  Truly, leadership matters and healthcare leaders at all levels, including Chief CRNAs, must incorporate the principles of evidence-based practice to their leadership style as they interact with their team.  Let’s get started.

Identify your needs.

Improved team dynamics starts with an awareness that the status quo can be changed and that those changes will augment both morale and productivity.  What are the greatest challenges dragging your team down?   Common barriers to high productivity include poor communication, lack of resources, unfair work assignments, production pressure, inappropriate leadership style, or workplace drama.  To address your unique challenges, designate a team meeting to openly identify and discuss the changes needed to improve your greatest needs.  Listen attentively and take notes.

Gather evidence.

Only a scant amount of literature has been published specific to frontline healthcare leadership, however volumes of articles have been written about workplace dynamics.  The Harvard business review, Forbes magazine, and Psychology Today are but three sources of information related to workplace dynamics…many more exist.   Just as you would complete a literature review before updating best practice guidelines, use the same process to learn ways in which businesses have addressed issues like the ones that you face.  A solution to your problem may already exist.

Develop a hypothesis.

Select a workplace issue that could be improved if you were to become a champion for change.  Use the format commonly employed by Doctorate level students and create a hypothesis that includes the planned change as well as the desired outcome.  Writing your theory in the PICOT format will clearly identify what you plan to change as well as a desired outcome that can be measured.  Engage several allies on your team to review your plan and assist the implementation. 

Implement the plan.

The best chance for successful change in the workplace requires buy in from team members.  By including the team when identifying the problem and creating a solution, each member has skin in the game and a personal interest in the success of the proposed change.  Conversely, surprising the team with a plan that they did not help develop is a sure way to provoke passive-aggressive behavior and sabotage.

Gather data.

Establish milestones that indicate progress and track numbers as you implement your plan.  Take a “null hypothesis” mentality and assume that the change will not make a difference in the workflow or staff engagement and then gather data to prove yourself wrong.  Some things such as compliance with the time out policy or postoperative handoff checklist can be tracked immediately whereas indicators of employee engagement, such as reduced staff turnover, may not be apparent for several years.  Regardless, track numbers to document the effectiveness of your leadership.

Share your findings.

As previously stated, there is a paucity of research related to frontline healthcare leadership.   By using a research approach to implementing change, you position yourself to collect data that can be shared with your peers.  What may seem like a simple change in workflow to you can become valuable information to others who share similar challenges.  Publishing in a peer reviewed journal is the gold standard for evidence-based practice however, sharing in a blog format can be equally helpful to other frontline leaders.  Regardless, take an active role in expanding the body of knowledge by sharing your experience with others.

Join the movement for evidence-based practice by gathering evidence to support your leadership decisions.  Rather than shooting from the hip, take a scientific approach to implementing change, develop a hypothesis, engage your team to develop a plan, collect data, and share with your profession.  You can make a difference.

Tom is an experienced leader, author, and requested speaker…invite him to your next meeting.  Click here for a video introduction to Tom’s current speaking topics.

Coming june 13th; Tips on using emotional intelligence in the hiring and teambuilding process.

Running circles around patient safety



By Thomas Davis, DNAP, MAE, CRNA

According the USA today, 42,060 people died due to auto accidents in the United States in 2020.  In comparison, Yale University used revised criteria to define death due to preventable medical error and found that 22,000 patients were lost in 2020 due to needless mistakes.   Both the auto and healthcare statistics are causes for alarm and have prompted professionals in each area to develop methods to reduce the tragic and unnecessary loss of life.

For decades, traffic engineers have struggled with developing “crash proof” intersections as a way to improve safety.  Knowing that the two most common causes of highway death are the high impact head on collision and the T-bone type of crash, roadway designers in Scandinavia shifted their thinking away from trying to prevent all accidents and focused on eliminating those that cause death.  Suddenly, traffic circles were installed throughout the region and the results were impressive.

The magic of traffic circles

Traffic circles are unlike traditional intersections with or without stoplights.  The approach to a traffic circle is well marked and traffic must slow before entering the circle. Once at the circle, drivers must observe other vehicles and coordinate with other drivers to safely enter the flow of traffic.  When mistakes are made, the result is a low impact fender bender rather than a full impact crash.   Cars may be dented, and drivers may be bruised but serious injury and death seldom happen in a traffic circle.

Safety circles in healthcare

What would be the result if proponents of patient safety took the Scandinavian approach and developed healthcare safety circles?   What would it look like if our patient flow in the operating room resembled vehicle flow through a traffic circle?

  • We would be alerted when we are approaching an event that is known to have risk to the patient.
  • We would slow our pace and become more attentive.
  • We would communicate and coordinate with others involved in the process.
  • Our activities would merge with others involved in the process and we would share a common interest for getting everybody safely through the event.
  • We might experience fender benders now and then, but fatalities would be eliminated.

Converting the traffic circle safety concept into patient safety circles requires a commitment from healthcare providers to value patient safety above production pressure or maximum efficiency.  Here are but a few areas where we can slow the pace, become more attentive, collaborate with others, and merge our activities to ensure patient safety:

  • Preop handoff from the prep area to the anesthesia provider
  • Preparation of drugs and equipment
  • limiting noise and distractions during induction
  • The surgical timeout prior to incision
  • Postoperative handoff to PACU or ICU

Be an advocate for your patients and control your workflow as if you were driving your car through a traffic circle…we can greatly reduce preventable medical errors.

Tom is an experienced leader, author, and requested speaker.  Click here for a video introduction to Tom’s talk topics.



Cognitive reframing; Reduce stress and increase productivity



By Thomas Davis, DNAP, MAE, CRNA

Healthcare delivery is stressful for both leaders and workers regardless of the title behind the person’s name or their position on the chain of command.   Ever-increasing expectations from patients and their families combined with demands put forth by physician colleagues creates a high-pressure environment for leaders and workers alike.  Chief CRNAs, OR managers and rank and file workers all experience production pressure in a high stakes environment and are all susceptible to work related anxiety and depression.  Rather than succumb to the pressure, a little cognitive reframing creates a different perspective and changes the internal dialogue in the person’s mind.  Here is what you need to know.

What is cognitive reframing?

According to the Wikipedia, cognitive reframing is a process by which a person identifies and then changes the way situations, experiences, events, ideas, or emotions are viewed.   It is a process by which thoughts are challenged and then changed.   Simply put, it is looking at a stressful situation and consciously opting to consider alternative perspectives and then visualizing a positive outcome for the problem.  It is a process that requires changing the internal dialogue in one’s head and replacing negative, fear-provoking thought with options that support a positive outcome. 

Choose your thinking framework

We can’t always control the problems that are thrown at us, but we can control the way we respond to them.  You have choices as to how you mentally react when stressful situations emerge.

Asset-based versus deficit based.  Asset based thinkers step back, assess the resources that are available and consider ways to leverage them to achieve the goal.  In contrast, deficit-based thinkers focus on what is lacking and throw in the towel.

Proactive versus reactive.  Proactive thinkers take control, rally support from others, and implement solutions to the problem.   In contrast, reactive thinkers are at the mercy of others and often view themselves as a victim of the system.

Reframe your thinking

Whether in your personal or work life, the ability to reframe a stressful situation sets you free from being dragged down by the problem of the day.  Start by asking yourself, “If I knew ahead of time that things will work out OK, how would I respond?”  Then proactively assess the situation and intervene as appropriate.   The online resource leadership now offers the following suggestions for actions to take after you reframe your thinking.

Structural changes.  This requires looking at the process, redesigning the workflow, re-writing policies/procedures, and engaging colleagues to embrace the changes.

Coaching.  Assume that you are surrounded by good people, but not all are fully capable in every area.   View the situation as an opportunity for career development and either work with the person yourself or assign him/her to a supportive mentor.

Political.  When discord within the group is causing stress, step in as a peacemaker.  Review the mission, vision, and core values of the group and enforce a code of conduct that includes civility and bans gossip.

Motivation.  Teams function most efficiently when they have a sense of common purpose.  Reduce stress by creating goals and ensuring that the team sees the connection between the goals and the overall mission of the organization.  Generate milestones to assess progress and never miss an opportunity to celebrate success.

Take control

You can proactively ward off some situations however you can’t deflect every problem in either your personal or professional life.  Rather than viewing yourself as a hopeless victim, take charge and reframe your thinking.  Focus on what you can do with available resources, seek additional help, and focus on a positive outcome.  You will be amazed at how your productivity increases and your stress evaporates after you alter your outlook and confidently take charge.

Tom is an experienced leader, author, and requested speaker.  Click here for a video introduction to Tom’s talk topics.



Values-based Leadership



By Thomas Davis, DNAP, MAE, CRNA

The healthcare workplace is fast-paced and often a hectic arena that challenges the skills of leaders and managers at all levels.  Frontline leaders who work at the grassroots level where provider priorities collide with the patient’s needs and expectation are especially challenged daily to keep the train on the tracks.  Values-based leadership brings stability and predictability to the workplace.

What is values-base leadership?

Values-based leadership is a philosophy that teams do their best work when they share common values and apply them to every interaction in the workplace.   Indeed.com career development blog notes that following a shared set of beliefs increases employee collaboration and increases productivity.  Writing in Forbes.com, author Harry M. Jansen Kraemer Jr. notes the four pillars of values-based leadership:

  • Self-reflection; knowing who you are and what motivates you.
  • Balance; the ability to see a situation from different points of view.
  • Self-confidence; knowing that your decisions are based on a solid ethical foundation.
  • Humility; respecting the values of other individuals and of the organization.

Clearly, building a team that knows, embraces, and lives the mission, vision and values of the organization will level the playing field and form a solid foundation for decision-making.

Implementing this powerful leadership style begins with self-awareness and an understanding of the values that most effect the way you make your decisions both at home and at work.  Several values assessment tests are available for free online and offer insight into your personal principles.  Knowing who you are and what you believe will increase self-confidence in all your interactions.   Encourage your team members to gain awareness by also taking the values assessment test.

Values-based team building

The rubber hits the road when the principles of this dynamic style of leadership are applied to the daily operation of the team.  Dedicate a team meeting to discussing the mission, vision, and values of the organization.  Encourage a “what if” discussion…what if we conducted our business in alignment with these values?  Build a consensus within the team that going forward, the core values of the organization will be the norm for the behavior of every team member.

Incorporate values-based leadership into the recruiting process.  Ensure that job advertisements contain verbiage that reflects the core values of the team and re-write job descriptions to include the core values.  At interview, discuss core values with the applicant and have the candidate discuss examples of how they have aligned with the values in past situations.  End the interview by saying, “these are the values of our team.  If this is not you, this is not our job.”  You will be amazed at how applicants are attracted to a job where values are known, and people are respected.

Values-based daily management

New hires learn the nuances of the workplace very quickly and the orientation process is your opportunity to show that your team lives the values that were discussed during the interview.  Assign the new hire to a team member who role models the values that you desire within your team.

Review your policies and procedures to ensure that they are in alignment with the core values of your team. Where possible, incorporate key words that reflect your values into your written material.

The annual performance review is an opportunity to review the core values with the individual.  Ask the person for examples of how he/she aligned with the core values over the past year and discuss behavior that will reflect core values in the upcoming year.  Occasionally, negative feedback or even discipline is needed to correct bad behavior.  Rather than resorting to accusations or finger pointing, review the core values, point out where the person was out of alignment, and have her/him discuss their plan to re-align with the values.  End a disciplinary session with the statement, “if these values are not who you are, this is not your job.”

Be a values-based leader

Values that are shared by the leader, team and organization provide a sturdy foundation that will withstand the tremors and earthquakes that occur frequently in the workplace.  Dignity, respect, enhanced collaboration and improved productivity all thrive when values are shared and people work toward a common goal.  Increase your value by being a values-based leader.

Tom is an experienced leader, author, and requested speaker.  Click here for a video introduction to Tom’s talk topics.



Halloween Leadership Lessons

By Thomas Davis, DNAP, MAE, CRNA

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“Halloween is not only about putting on a costume, but it’s about finding the imagination and costume within ourselves.”

— Elvis Duran

Halloween is exciting and full of surprises; however, it is no surprise that the festive event also contains several lessons which will enhance team collaboration, staff engagement and the overall effectiveness of the designated leader.  Look beyond gawdy makeup and treats in the lounge and heed the wisdom arising from Halloween leadership lessons.

Identity matters.  At a costume party it is challenging to guess who the person is concealed by the costume and not knowing the identity until the masks are removed.   In contrast, at the workplace, a team must always know who the leader is in terms of the personal values and leadership style.  Honesty, integrity, and consistency must be your hallmark characteristics and they must be apparent regardless of the color of your hair or the funny glasses that you wear.  If you want to scare and demoralize your team, show up as a different person every day.

Creativity generates empowerment.  Policies, procedures, and protocols; they are essential but can leave workers feeling like robots.  Give team members the latitude to decorate the workplace and wear work-appropriate costumes on Halloween.  Reward creativity and then let the spirit of the holiday be a catalyst for the team to apply inventiveness to problem solving.  Not only will the mood of the team be elevated, but the team will also feel empowered to resolve outstanding issues.

You can be whoever you want to be.  Once you decide the character you want to be for Halloween, it is not difficult to find a costume and props to transform yourself into the new person.  Likewise, once you decide who you want to be as a professional, a little time, effort and planning will enable you to acquire the new role.  Halloween is a great opportunity for a leader to learn about the desires of workers and then arrange professional development to take each person to a new level of performance.

Ghosts can only scare you when you let them in.  Do not let your workplace become a haunted house by allowing evil spirits to mingle with your team.  Fear and paranoia are paralyzing and kill staff morale. Behaviors such as gossip, blaming, and passive/aggressive activity are the evil spirits that make everybody leery about scary things that could jump out at them.  Ban gossip, outlaw blaming, and diffuse fear by openly discussing problems; never ignore the elephant in the room.

Collaboration fosters courage.  In the famous scary movie, Nightmare on Elm Street, Freddy Kruger only had power when people feared him, and he always selected a person separated from the group to be his next victim.  In the workplace, collaboration produces a sense of community and knowing that others have their back inspires individuals to address challenges that they otherwise may have avoided.  Team members who work together to plan and pull off a workplace social event will stand united to solve other workplace challenges. Say yes to reasonable Halloween activities, then turn it into a teambuilding event.

Teambuilding is enjoyable.   The purpose of teambuilding is to enhance personal relationships and foster collaboration among team members.   Halloween is an occasion that begs for workers to collaborate by decorating the workplace, donning an altered ego, and planning a festive day.  The best workplaces reward strong performance by planning special days to recognize the effort that the team puts forth daily. 

Halloween is a holiday that can be spooky but do not let it spook you.  The gremlins and goblins who lurk in the shadows are no match for a united group so focus on teambuilding reward your team with a festive day.  While you are at it, plan for celebrations and teambuilding activities for the upcoming Thanksgiving and New Year holidays. 

Tom is an experienced leader, author, and requested speaker.  Click here for a video introduction to Tom’s talk topics.

Core Competency for Leaders

By Thomas Davis, DNAP, MAE, CRNA

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Core Competency: A defining capability that distinguishes an individual or a company from others.  Mastery of an essential skill.

In the business world core competencies identify what an organization can do better than anyone else and why.  Similarly, in healthcare, core competencies validate skills that healthcare providers have mastered; proficiencies that are necessary for the delivery of safe and reliable treatment to each patient.    Likewise, effective leaders must master essential skills and competencies, and, as with professional proficiency, leadership expertise can be learned.

Leadership competencies are specific observable skills and behaviors that are necessary for motivating a team to accomplish goals in a manner that aligns with the company mission, vision, and values.

Throughout the healthcare industry, frontline leaders are often promoted to their position based on demonstrated clinical competency.   Decision-makers in the chain of command assume that workers with exceptional clinical skills will also be great leaders, which may or may not be the case.  Just as mastering core competencies is essential for excellence in clinical practice, mastering leadership competencies is essential for excellence for those who manage a team of workers.  Gaining competency in the following areas will position you for success in your role as a team leader.

Skillful leaders have a vision.  Develop the ability to formulate a picture for your workplace of the future by acknowledging where you currently are related to where you want to be.   Look for areas where minor changes can produce large results moving you toward the workplace you envision.   For example, in my personal experience, I visualize creating a preferred workplace, therefore, I am constantly seeking ways to promote collaboration, mutual respect, and professional development within the team. 

Skillful leaders use communication to motivate.    Communication is the transfer of ideas and highly effective leaders take this skill one step farther.  They share information in an open and transparent way ensuring that the listener both receives knowledge AND is inspired to achieve the goal.  Using good humor, warmth, and civility to create a sense of imperative as you communicate helps establish a can-do attitude within your team

Skillful leaders are fully committed.   Meaningful change takes time and having the capacity for all-in commitment is both convincing and contagious.  Anything less than a commitment to achieving the vision, regardless of the amount of time it takes to get there, will be viewed by your team as a passing fad. An all-in focus on achieving your vision for the team will inspire them to commit along with you.

Skillful leaders resolve conflict.     When humans interact, occasional conflict is inevitable.  The best leaders are not the ones living in a conflict-free zone.  They are the ones who quickly and confidently address issues and achieve resolution. When faced with a disagreement, assemble all the parties, listen to all sides, and discuss behavior/agendas in terms of how the vision and greater goal of the group are affected.  The best solutions involve compromise and align with the vision that the team is working to achieve.

Skillful leaders acknowledge and reward success.    Whether the project is big or small, determine milestones and give recognition to those whose work was important in achieving them.   Plan rewards for the entire team as well as for key individuals and take the time to celebrate.  Public recognition of success is motivating and makes your team eager to take on the next project.

Skillful leaders display personal integrity.   You cannot achieve your goal alone and the quickest way to kill support from your team is to compromise your integrity.   Honesty, transparency, and fairness every day in every interaction establishes trust.  Integrity is both a value and a skill that is foundational to leadership.

Superior leadership is more than wearing a title; it requires demonstrating core competencies, and also requires life-long learning to keep them current.  The best leaders learn from every daily interaction, constantly honing their skills at establishing a vision, communicating a plan, motivating the team, and celebrating success.   The workplace that you create for your team of tomorrow starts with the leadership skills you employ today.  

Tom is an experienced leader, author, and requested speaker.  Click here for a video introduction to Tom’s talk topics.

Bucket list leadership lessons

By Thomas Davis, DNAP, MAE, CRNA

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I am an avid cyclist to the point of being suspected of having a personal relationship with my bicycle; after all, we have spent over 40K miles together on the road.  In addition, I have a deep interest in healthcare leadership development and last weekend my two major interests collided while doing a bucket list bike ride on the 150-mile Great Allegheny Passage bicycle trail from Pittsburgh, PA to Cumberland, MD. 

As our group of 10 loaded the shuttle van to transport us from Cumberland to Pittsburgh, it was evident that Greg, owner of 2wheel escapes and coordinator for the trip had his act together.  Assisted by his wife Rhona and paid helper Lynn, each new person arriving for the trip received a warm welcome and, with efficiency, luggage, bicycles and passengers were loaded onto the trailer and van, respectively.  In short order, anxiety of the unknown challenge ahead turned into lively conversation among the new group of friends. 

As we traveled toward Pittsburgh, Greg openly shared his vision with our group explaining that the trail is beautiful, but it is the support provided for the riders that converts the ride into a memorable experience worth repeating.  He explained that his goal is to be the number one GAP trail tour organizer and create an experience that people would want to repeat and that they would recommend to friends.  Everything from that point forward was designed to bring his vision to life.   We were told up front that his services were intended to be second to none and that it was up to us to make him even better…please offer suggestions.

Greg put words to action and delivered on the pledge that he made to the group.  Every aspect of the trip was on time and as promised, often exceeding expectation.   The format for our journey included camping overnight; Greg set a high standard and only stayed at campgrounds with flush toilets and hot showers.  Because COVID has closed many restaurants, 2wheel escapes provide an exceptional dinner on site every evening followed by an ample hot breakfast in the morning.  Each day started with a briefing and a printed list of landmarks along the way.   The scenery was different every day and particularly magnificent in the Ohiopyle area, however, riding into the campground each day consistently found Greg and Rhona set up and ready with afternoon snacks for the hungry riders.  They aimed to please and hit the bull’s eye.

As I pedaled toward the Eastern Continental divide, I could not help thinking about the importance of creating a positive and memorable experience and then extrapolated the concept to healthcare.  The outcome of my amazing weekend was much more than rolling along a wooded trail, it was having an experience that I am eager to repeat.  Likewise, a positive healthcare encounter requires more than a nice facility and creates a responsibility on healthcare workers to deliver a positive and memorable experience for each patient. 

Having a positive experience is important in healthcare and this is why

Builds trust   Creating a positive experience requires healthcare workers to connect one on one with each patient and learn about what is important to them.  Taking Greg’s attitude of “make us better” sends the message that what is important to the patient is also important to the provider.  The experience of feeling valued creates trust that the other person has your back.

Enhances confidence   Most patients do not have a medical background and do not fully understand best practice guidelines; they are at the mercy of the healthcare provider.  Those who have a positive experience and trust the provider are more likely be compliant with treatment protocols and achieve a better overall outcome.

Improves patient safety   A solid, trusting relationship between patient and provider creates a bond where both are more vigilant, communicate more frequently and ward off problems before they arise.  Writing in BMJ, Authors Doyle et. al. affirm the connection between the patient’s experience, safety and ultimate outcome.

Job security    Greg knows that to earn a profit in a competitive market, he must deliver the goods reliably and in a manner that generates repeat business.   Similarly, in the past, patients were tied to their local community for healthcare, however, our digital world has broken geographical barriers and opened the door to shop anywhere for medical services.  Healthcare is a competitive market and by creating a positive experience, a loyal customer base is developed.  Patients share their experiences, both good and bad, on social media so the environment that we create will be revealed to the world.  Ultimately, those who create the positive experience for the patient will thrive and those who do not, will not survive.

My weekend ride did a lot more than check off an item on my bucket list, it opened my eyes to the importance of creating a dynamic and memorable experience.  Taking an interest in a patient and placing value on the feedback that you receive is the first step in creating a culture that knows the importance of the patient’s overall experience.  Be bold and create a bucket list experience for each of your patients.

Tom is an experienced leader, author, and requested speaker.  Click here for a video introduction to Tom’s talk topics.

5 ways to get more from your video meeting

By Thomas Davis, DNAP, MAE, CRNA

Follow @procrnatom on twitter

Social changes put into motion by the COVID 19 virus have mandated that we find innovative ways to conduct both personal and professional business, including how continuing education is delivered.  As a result of travel restrictions and limits on the number of people allowed to congregate in one place, providers have either cancelled or moved meetings to an online format.  Although traditional meetings have been put on hold, the requirement for continuing education has not, and those in need of recertification must obtain the required education credits.  Responding to the ongoing need for continuing education, many CEU providers have quickly shifted to an online format with the intent of providing a high-quality learning experiences equal to that presented at live meetings.

A personal conversation with Nancy LaBrie, owner and director of Encore Symposiums revealed a deep commitment to continue service those who have been loyal to her organization for over 20 years.  To ensure the ongoing flow of continuing education, Nancy has temporarily moved to an online Zoom format with live presentations with her faculty covering the identical content provided at in-person meetings.  In addition, she hired a technology expert to moderate the meetings and eliminate technical glitches.  Nancy is not alone in her dedication to provide continuing education in the face of COVID restrictions as evidenced by State and National organizations that have converted to an online format.

The recent AANA annual congress scheduled to be held in San Diego was converted to an online meeting.  On the downside, social networking and renewal of acquaintances was absent, however, the video format enabled every CRNA in the nation to participate if they so desired.  The annual business meeting that previously was restricted to those in attendance at the meeting was offered online to the entire membership of the organization.  Those who chose to participate were able to vote on critical issues and to receive valuable continuing education credit for the online learning sessions.

Likewise, many state meetings have converted to an online format until in-person meeting restrictions have been lifted.   Hawaii and Maryland are but two of the many states that have made the switch.

“Tell me and I forget.  Teach me and I remember.  Involve me and I learn.”
— Benjamin Franklin

Missing out on a well-deserved vacation meeting does not mean that you must settle for second best when obtaining continuing education credit.  Regardless of the effort that the sponsor makes to ensure a top-notch educational offering, participants must actively engage in the process if they are to receive the full benefit of the program.  With a little preparation, you can enhance your knowledge and obtain continuing education credit from the comfort of your home office without sacrificing the quality of the experience.  Here are some tips.

Know the technology.  My recent article, Ace your video interview, stressed the importance of becoming familiar with the video conference platform ahead of time and the same is true when attending a video meeting online.  When you register for an online meeting, the sponsor will send login information which will identify the platform that is being used.  Well in advance of the meeting, take the initiative to google “how to” information about the selected format.   If an account is required, sign up and obtain a password several days before the meeting.  Waiting until meeting time to login to a new platform places you at risk to miss the first part of the session.

Make your own meeting room.  When attending an in-person meeting, you dress for the occasion and expect the facility to be comfortable and inviting.   You expect to see the screen, hear the speaker, and have space to jot down important points.  Attending a meeting via a personal computer does not change those requirements.  Prepare your space by removing clutter including things that will distract you during the online presentation.   If you will be visible to others, position a desk lamp so that it illuminates your face and position your camera at eye level.  Use the selected video conference platform to do a dry run with a friend and make sure to test your camera and microphone.  If your computer has a built-in camera at the base of the screen, consider buying a small camera to plug into a USB port and position it at eye level.   

Do your homework prior to the meeting.   Know as much (or more) about the speakers and content for the video meeting as you would for a live meeting.  Obtain the agenda, objectives and speaker biographies then use the time saved by not traveling to search online and prepare yourself for the meeting.  Know each speaker’s background as well as best practice guidelines related to the scheduled topic.  Prepare a list of questions that you would like to have answered and either submit them prior to the talk or post them to the speaker if there is an opportunity for audience participation. 

Be mindful of social graces.   You would not show up late, chomp on a wad of gum or slurp coffee if you were at a live meeting so hold yourself to the same standards when meeting online.  Mute your microphone when not speaking; I have personal memories of the sounds of toilets flushing, dogs barking, babies crying, and chips being munched during online meetings.  Focus on the speaker and the topic being presented.  Do not do anything in the privacy of your home office that you would not do if you were sitting in a room filled with your professional colleagues.

Follow-up after the meeting.  Ensure that you receive credit for attending the meeting by completing meeting evaluation forms and submitting any documentation required by the meeting sponsor.  Obtain contact information for speakers and follow the session with a personal email with feedback and questions that you have about the topic.  Quick and thoughtful feedback opens the door to a dialogue with the speaker and could potentially expand your network of contacts.  Finally, visit the Meeting review page on procrna.com and complete an online review of the meeting.

Like awaiting the return of flowers in the spring after a harsh winter, participants eagerly anticipate the return of live meetings at fabulous getaway vacation resorts; however, until restrictions are lifted, virtual education is a reality that need not compromise quality.  Although not as fun or relaxing as a trip to a sunny beach, education via computer-based learning provides the safety of your home, eliminates public travel, and saves both time and money.  Virtual meetings are today’s reality so prepare and ensure that the quality of continuing education remains high in our COVID restricted environment.   Stay home and stay well. 

Tom is an experienced leader, author, and requested speaker.  Click here for a video introduction to Tom’s talk topics.

Get wise to the elderly

Get wise to the elderly

Follow@procrnatom on Twitter

“Age should not have its face lifted, but it should rather teach the world to admire wrinkles as the etchings of experience and the firm line of character.”  ~Ralph Perry

Statistics reported by the Population Reference Bureau revealed that in 2016 over 51 million Americans were over the age of 65, and it predicts that the number will increase by over 50% in the next 20 years reaching 78 million by the year 2036.   This precipitously increasing demographic has implications for current healthcare leaders related to how we interact with our customer base and how we prepare our teams to meet the challenges that accompany the aging population.  If there were ever a fertile ground for honing leadership abilities, this is it.  The rapidly expanding elderly population is a veritable gold mine of opportunities for leadership skill development. 

Emotional intelligence

Emotional intelligence remains a buzz word in the human resources/management community. A highly desired skill for leaders at all levels, it has an internal component that requires you to  gain insight about your personal emotional reactions and their effects on others, and an external component that requires the development of social awareness and of skills related to relationship management.  Working with aging patients opens the door for a leader to connect with and gain social awareness about the features that make this population unique.  Learning to relate to one demographic smooths the path and makes it easier to learn about other populations of patients.

Take a sincere interest, ask questions, listen

Older patients are full of amazing stories and will eagerly share if asked.   Expand your listening skills by asking questions and then listening to the stories that emerge.  Your 74-year-old patient who is next in line for cataract surgery may be the one who scored the winning touchdown in the 1970 Rose Bowl; his wife (and designated driver) might have been a flight nurse evacuating casualties from Viet Nam.  You won’t know until or unless you strike up a conversation.  When you have time to chat with boring old people, consider the following:

  • Those now in their 70’s were the students marching for civil rights in the late 60’s and were back in the streets marching for women’s rights in the early 70’s.
  • Senior citizens were born into a world with hard-wired phones and TV sets connected to an antenna on the roof and receiving only 3 channels.
  • Many Seniors remain actively attached to social activism in the form of “volunteer” at hospitals, museums, schools and civic events.
  • Seniors have traveled to your bucket list places and many have interesting hobbies.
  • Those in their 80’s were children during World War II and remember the air raid drills, food rationing, nighttime blackouts and energy conservation.  Some had relatives who did not return from battle. 

Emotional intelligence involves connecting on a personal level and getting to know the other person beyond the information published in their medical records.  Start a chat session by asking your gray-haired patient a general question about events that happened while he/she was a child and be prepared to hear wonderful, perhaps astonishing, stories.  In my daily clinical practice, I regularly discover what is currently important to them by asking, “Tell me something about yourself that is not on your medical record.”  Often, the answer is tied to their personal identity and response you get may take you by complete surprise.  

Establish best practice guidelines based on physiologic changes

Managers typically publish policies and guidelines related to best practice recommendations.  Subsequently, it is incumbent upon leaders to build a team of knowledgeable workers who want to follow the guidelines and deliver the highest quality of care to all age populations, including the elderly.  When working with your team to create best practice protocols, consider these physiologic changes that are common in the elderly.

  • Cardiac   Atherosclerosis is common in the elderly American population and arises from a lifetime of smoking, hypercholesterolemia, hypertension, type 2 diabetes and obesity.  The result is ventricular hypertrophy, with reduced ventricular compliance, contractility and cardiac reserve.  Normal doses of induction drugs take longer to circulate and may produce significant hypotension.
  • Renal   Glomerular filtration is reduced as is the ability to regulate sodium and potassium.  The kidney is less able to concentrate urine and may have difficulty removing free water from the system.   Elderly patients are less tolerant of hyper or hypovolemia. Drugs dependent upon renal clearance have a longer duration of action and smaller doses are required. 
  • Pulmonary.  Like an old rubber band, the lung loses elasticity with age.  Combined with reduced chest wall compliance, one can expect a reduction in FVC, FEV1, and VC as the person’s age increases.  Small airway collapse is common and presents problems with VQ mismatch.  The elderly patient is at a greater risk for atelectasis and impaired diffusion of gases.  Anesthetic techniques that further suppress ventilation put the elderly patient at risk.  Volatile anesthetics require more time to leave the system and should be used sparingly in reduced doses.
  • Nervous system.   Both vision and hearing diminish as the person ages and eye-related procedures are common in this demographic.  Autonomic nervous system dysfunction makes the elderly patient more susceptible to labile blood pressure and postural hypotension.  In addition, thermoregulation is impaired in the elderly patient making him/her more susceptible to hypothermia and less able to mount a physiologic response.
  • Cognitive dysfunction.   Altered mental status is a common fear among the elderly and causes concern for those awaiting anesthesia and surgery.  For many, the fear of mental decline exceeds the fear of death. Slowed drug metabolism/clearance, hypotension, hypothermia, and hypoxemia are all listed as potential causes of POCD.  More recently, neuroscientists have correlated the inflammatory response with cognitive dysfunction.  Attention to detail and strictly keeping the patient within physiologic parameters will reduce the incidence of POCD.  Opioid-free multimodal anesthesia with little or no volatile agent is the technique associated with the least amount of POCD.

Begin with a thorough pre-operative evaluation and then the development of a plan that addresses the specific needs of each patient.  In general, elderly patients do best when the anesthesia provider has a is gentle and provides a slow induction with plenty of time for drugs to circulate.  A regional nerve block with sedation is preferred over general anesthesia, but when general anesthesia is the only option, a propofol based TIVA technique that includes multimodal pain control and anti-inflammatory drugs is the least likely to cause respiratory compromise or cognitive changes.   Opioids and inhalation anesthetics should be avoided if possible, in the elderly patient.

Leadership

Embrace the rich history and learned wisdom of your simultaneously interesting and fragile older patient by tuning in to their special needs.  Conduct meetings with your team to review the physiology of the aging and mentor them to work collaboratively in developing best practice guidelines.  Listen carefully to elder patients and hone your skills at understanding, treating and enjoying the elderly population.   Lead by example and become aware of the fears and concerns, the strengths and the joys that each of your elderly patients brings to the operating room.  Some day you, too, will be older, maybe even wiser. 

Tom is an experienced leader, author and requested speaker. 

John-the-Boss and the Bag of Tricks

By Thomas Davis, DNAP, MAE, CRNA

Follow @procrnatom on twitter

 

I can still vividly remember the day early in my Air Force anesthesia career when Lt. Col. John- The-Boss enthusiastically entered the workroom where our team was setting up the day’s equipment. Like a kid with a new toy, John had excitement written all over his face, wearing a grin indicated that he had something for show-and-tell.  John announced that he had discovered and purchased a tool that would increase our productivity by ensuring that every open project would quickly be brought to completion.  He had our attention and we insisted that he show us the contents of his bag.  John opened the bag and dumped ten round, 4-inch petri dishes on the worktable and then handed one to each person.  With one eyebrow raised and one lip curled, we each opened a glass container and discovered a label inside that said, TUIT.  Ignoring our chuckles and groans, John continued by going down the list of unfinished projects that had been started with good intentions and put on hold until someone got a round tuit.

 

Ideas flow freely from a creative group and projects that are started with the best of intentions often die from lack of follow through.   The implications arising from procrastination are even greater when it is the leader who fails to follow-through because not only is there a loss of productivity, the leader’s integrity is compromised.  Lack of follow through on commitments is demoralizing, destroys trust, and fragments the team.

 

“Be impeccable with your words and speak with integrity. Say only what you mean…”

 ~ Don Miguel Ruiz

 

Observing for follow through on a commitment is an overt way to measure the personal reliability of another person.  Here are two examples, one negative and one positive.

 

One of my friends has a son is in his early 20s and very talented at wood working.  He can flawlessly design and build cabinets, dressers and chairs.  He is a bright young man and has many creative ideas for developing a business that includes opening a woodworking shop, hiring help and marketing furniture throughout his region of the state.  Unfortunately, to date, he hasn’t done much about it.  He has not consistently followed up on many of his promises to customers, nor on any of his own ideas.  The business isn’t thriving and he lives hand to mouth while telling others about his dreams for dominating the furniture market.

 

 

Conversely, a second friend, and professional colleague, is always available and eager to share ideas when either of us is working on a project.  When we brain-storm, he freely shares his ideas and often says, “I’ll send that information to you.”  Without exception, he follows through within 24 hours on whatever he promises, sometimes sending a document before we even finish the call. In the past three decades, he has never failed to follow-up when he promises action.   To his credit, he quickly says no if he cannot accommodate a request. Yes or no, I have the utmost respect for his honesty and reliability.

 

Following through with commitments is a habit that will elevate your status as a leader, develop self-respect while earning respect from others, and contribute to the overall morale of your team.  Here are some tips for aligning your action with your words.

 

 

  • Define the ask. Requests come in many forms throughout the workday; an email message asking you to update a database, a request for information for the annual report, a need for you to champion a project, a personal request from a team member in need of schedule considerations.  Before giving the quick knee-jerk “yes” response, catch your breath and clarify what is being asked of you.  A database update could be a 5-minute quick click or a 3-day deep dive into archived data files.   A schedule consideration could be an easy accommodation, or it could leave a shift unstaffed and demoralize the team.   Because you intend to follow through to completion, it is essential to define what is being asked and the effect it will have on other work that will be set aside when you tackle the new commitment.
  • Make yes mean yes. As previously stated, integrity requires alignment of your words and actions, and you can only have integrity if you follow through on commitments.   After clarifying the ask, assess your resources, including your available time, and make a reasonable decision about accepting the request.   You will gain respect with an honest “no” and conversely, you will lose respect with a false “yes.”  When you say yes, be prepared to explain when and how the issue will be completed because yes without a plan really means no.
  • Commit with decisive language. Your inner dialogue has a powerful effect on your motivation to follow through. Saying “that’s a good idea” or “yes, we should do that” are not calls to action.  Using words such as can and will are more powerful and indicate a commitment on your part.  Think in terms of “we will do this and here is how we will approach it.”
  • Resolve small things immediately. My high-integrity friend with instant follow-up is the role model I use when the ask is small and easily resolved.   If the resources are at hand and the item can be resolved immediately, do it now.  If your resources are in the office or at home, make it the first thing you do when you get to the location.  From personal experience, I can affirm that I have never awakened in the night thinking about promises that were kept quickly; it’s the unkept promises that keep the stress hormones circulating and disrupt sleep.
  • Establish a timeline on your calendar. The workplace can be crazy and chaotic so it is important to write down your commitments lest you forget.  If a project extends over time, make sure that each of the milestones is on your calendar and that you achieve them.  Calendar and planner apps, readily available for mobile devices, are a good place to enter your commitments.   In addition to the target date for completion, schedule the app to send reminders at intervals to hold yourself accountable.
  • Find a mentor. A mentor is a valuable resource person who will help you develop your plan, identify resources, and keep you on track.  In addition to tapping into the expertise of a mentor, check in at intervals and update the mentor on your progress.  Share your timeline and encourage the mentor to hold you accountable for your commitment.  It’s much easier to make yes mean yes when someone is sitting on your shoulder and offering encouragement.

 

“What you do cries out so loudly that I can’t hear what you say”

 

Lt. Colonel John-The-Boss and The Bag of Tricks is a funny but true story with an elementary lesson about reliability.  And reliability is no joke.  Reliability is just as important as ability and a person of action motivated by integrity always follows through with commitments.  Consistent follow-through directly affects productivity and establishes a positive view of your personal ethics among co-workers, which in turn, opens the door to trusting relationships. High morale, elevated productivity, cohesive team, respect, trust.  Maybe we should all get a round tuit.

 

Tom is a skilled anesthetist, published author and frequently requested speaker.

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.

Encore Symposium: Sedona 2019

post card 1

Meeting Date: November 4-7, 2019

Meeting location:  Hilton resort, Bell mountain, Sedona, AZ

Meeting sponsor: Encore Symposiums

Strengths of the meeting: 

Person #1  Very informative and I really liked the speakers.  Encore staff was very pleasant and helpful.  I would really recommend Encore for future CME.  Sedona was the perfect site; I really liked the outdoor activity and the perfect weather.

Person #2  Great location with lots of activities and perfect weather.  The speakers were top notch and presented a variety of topics.  The information from this meeting will help my case management and has also given me ideas for improving teamwork in our anesthesia group.

Person #3 regarding the CPC review:  I did the CPC Review and the Sedona Red Rock & Grand Canyon Program November 2-7. Sedona is an absolutely beautiful location for a fall conference. While I was there the weather was perfect….blue skies, upper 70’s. The Hilton Resort Sedona at Bell Rock is a beautiful and well kept resort. The Hilton staff were very helpful and accommodating. The meeting rooms were comfortable and spacious. Encore Symposiums provided a delicious breakfast with many choices each morning. The night before the seminars started there was a stargazing welcome reception. It was wonderful to have time to socialize with other CRNAs and their spouses. Nancy and her staff at Encore provide a professional and well run Symposium!!! The the topics were applicable and informative. The speakers were very knowledgable, friendly, approachable, interactive and presented their topics clearly. The CPC review was a well thought out review. Yes, I knew the majority of the information presented, but it never hurts to review the anesthesia information with the CPC examination happening in the next few years. I am looking forward to my next Encore Symposium Program!


Suggestions for improvement: 

Person #1  none

Person #2  I don’t have any suggestions for the meeting itself because it was excellent.  At a place like sedona I suggest offering a group hike or bike ride in the afternoon for those who are interested.

Value for the money:  

Person #1  excellent

Person #2  excellent

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.

Visionary innovation

visionary intelligence post

By Thomas Davis, DNAP, MAE, CRNA

Follow @procrnatom on twitter

Visionary leaders are hot commodity.  How can you go wrong with a leader who can see into the future and position an organization to stay one step ahead of the competition?

In 1995, Jeff Bezos saw the potential of the internet marketplace and visualized a virtual bookstore that would be open 24/7 and could deliver reading material either in print or online with the click of a mouse.  Naming the company after the famous South American river, Amazon books was established and rolled out from the founder’s garage in Seattle.  The Bezos vision expanded via the kindle reader eventually developing into the shopping market that we know today as amazon.com.

The creator of Amazon was not lucky nor was he unique.  There are other leaders in business and industry, including healthcare, who share the traits of a forward-thinking individual.  In working to build a better future for the clients they serve and for themselves, the more successful leaders are able to strike a balance between creative thought and observable action.  They listen keenly to clients and co-workers and use emotional intelligence to learn what people really want.  They establish a desired end point, formulate a plan, and work relentlessly until the goal is achieved.  They favor innovation, accept responsibility, and regard a setback as a learning experience.  “…glad we don’t have to do that again.”  In some cases, new technology must be created to address a need but at other times the leader with an eye to the future finds new applications for existing technology.  Bezos did not invent the internet or the bookstore; however, he did foresee that readers would flock to the convenience of online access to any book in print with immediate delivery to a mobile device.

 

CRNA inventor

Diane Miller is a pediatric CRNA and inventor whose life was changed by her inner drive to develop a playful way to initiate general anesthesia for pediatric patients.  Motivated by an experience inducing anesthesia on Zeke, a 4-year old “frequent flyer” with PTSD from previous anesthetic inductions, Diane felt compelled to develop a lighthearted induction technique.  Rejecting the decades-old tradition of “cyclo-brutane” used on fighting children, Diane developed the Pedia device for induction of anesthesia.  Widely accepted by young children, it resembles a balloon with a whistle and makes induction of anesthesia entertaining for the pediatric population.  Pedia has been awarded a patent and has been cleared by the FDA.  The Pedia device is a game changer for pediatric induction of anesthesia and I predict it will quickly become the standard for our industry.

Diane’s story and device are featured on the pedia web site

 

Point of care ultrasound

Ultrasound imaging can identify the gender of an unborn child, determine the size and shape of a tumor or locate nerves prior to placing regional anesthesia.  However, the device comes in size extra-large and it frequently isn’t available where the patient is located.  These handicaps opened the door for Dr. Jonathan Rothberg to introduce an ultrasound system that did not require transport of a cumbersome machine to the patient’s bedside.   Rothberg selected a team with whom he shared his vision and together they worked tirelessly to create the butterfly point of care ultrasound device.  The device uses a standard sized ultrasound probe with quartz crystals and, uniquely, connects to a smart phone, pad or other mobile device to display the image.  The probe can be carried in a holder on the individual’s belt and literally anyone with a modern phone can keep a personal ultrasound system at their fingertips round the clock.

You don’t have to be an inventor to foresee uses for existing technology as evidenced by anesthesia leaders who have quickly adopted the butterfly system to enable immediate ultrasound images of their patients.  In addition to the obvious use of facilitating nerve blocks, the system is being used to assess gastric volume, vascular access, ventricular movement, pulmonary fluids, bladder retention or other conditions where an image could alter the anesthetic plan.  Those boarding the butterfly bandwagon appreciate the flexibility that comes with having immediate access to ultrasound images and forecast improved patient outcomes due to information gained by this creative device.

More information can be found on the butterfly web site.

 

Some think of visionaries as having a crystal ball while others picture the mad scientist busy inventing things in the workshop.  Although there may be a touch of truth to each stereotype, the truth is that most visionaries are ordinary people visualizing extraordinary things in order to solve both ordinary and extraordinary problems.  Their mantra is, “We can do better!” and their work ethic is indefatigable.  Sometimes, a new product will emerge, and other times new uses will be found for existing technology.  Jeff Bezos developed an online marketing system that has changed the world economy; Diane Miller developed a playful way to induce pediatric anesthesia, and Dr. Jonathan Rothberg put real time ultrasound imaging into the hands of every healthcare worker.  Now it’s your turn.  Use your visionary skills to discover resourceful ways for making the new technology a standard of care in the workplace.   Identify a need, imagine the best possible outcome, develop steps to get there, communicate your plan and work relentlessly until your goal has been achieved.  When the new standard has been set, you will join the ranks of visionary leaders.

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

Be a social (media) climber

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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.

After Halftime

halftime post

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.

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.

By Thomas Davis, CRNA, MAE, DNAP candidate

Follow @procrnatom on twitter

revitalize post

Are you capable, competent, committed to the job and yet feel like your daily routine has you mired in a muddy rut?  You are not alone.   One thing that business, industry and healthcare have in common is that each has a cadre of talented people who feel imprisoned by the status quo and are ready to break the bonds of mediocracy.  Take control of your destiny, shake things up, and gain the recognition/promotion that you deserve.

Both those who are in leadership roles as well as those who are frontline workers must act to position themselves for advancement in the organization.    Cameron Chapman, staff writer at skillcraft, says that it is foolish to wait to be “discovered” at your workplace when there are things that you can do to revitalize your career and increase your value to the organization.   Chapman suggests that you start with self-evaluation and do an honest review of your capabilities compared to your actual work performance.  Begin to resuscitate your career by taking action to close the gap between your current performance and the maximum potential that you are capable of putting into the job.  Here are some simple ways to advance yourself in the pecking order of most valued employees:

Be more assertive.  Confident extroverts infuse energy into a group and are catalysts for productivity, whereas introverts blend in with the environment and go unnoticed.  Take the initiative to up your energy level and set a positive tone for your team.  Even those who are not natural extroverts can be more outgoing by giving every colleague a friendly greeting and engaging in conversation. Be brave, set ambitious, attainable goals and have high expectations for yourself and colleagues.  Positivity is contagious and as you increase your performance, your team will follow suit.

Learn new skills.  Instead of arriving every day with a flat attitude and stagnant skill set, enhance to advance.  Visualize the job that you desire, the skills required for that position, and then find a mentor or take the classes necessary to expand your capabilities.  Taking a course in accounting, personnel management or team development will enhance your existing position as a leader. Mastering the use of new equipment or learning to perform new clinical techniques will advance you as a healthcare provider.

Ask for responsibility.  Meet with your supervisor and ask about the most pressing needs in your workgroup or the organization.   Better yet, identify an existing situation where your team could improve safety or efficiency and offer to head a project to strengthen the team in that area.  For example, the patient handoff between the operating room and recovery room did not include all the basic information required for continuity of care.   Alice, a nurse anesthetist talked to the supervisor and proposed a project to team with a recovery nurse and revise the handoff procedure.  Completion of the project improved patient safety and having a defined format made the process more efficient.

Align yourself with the company culture.  What does your company stand for, why do they exist, and how does your behavior enhance or detract from the greater goal?  Read the mission, vision and values of the company and then assess/modify your behavior to ensure that your action supports the purpose of the organization.  Behavior that is observable by others and supports company values will ensure that you are noticed when people are being considered for promotion.

Increase your networking.   Progress, to include revitalizing your career, happens based on relationships at all levels.  Solidify your relationship with others on the team and then expand your horizon by getting to know the people outside your immediate workgroup.   Never miss an opportunity to extend your hand to meet new people regardless of their title or role in the organization.  As you take on projects, it will become increasingly helpful to know others who can support or mentor your activity.

Eliminate deal breakers for decision makers.   Attitude and physical attributes are components of the perception that you create for others to consider when they are selecting the next person for promotion.  Characteristics that are unwritten, not discussed but affect the final decision include personal hygiene and habits such as a wimpy handshake or a boring communication style.  Clean up your act, literally, interact with confidence and put yourself at the head of the line for the next promotion.

We are each known by our reputations, good or bad.  Breaking the bonds of the status quo, increasing your status in the organization, and positioning yourself for advancement are all tied to the reputation that you build for yourself.  Everything you say and creates a memory and it’s your job to make sure it is a positive picture.  Master new skills, align behavior with company values, and connect with decision-makers to ensure that your name is the first one that comes to mind when your boss is asked to name his/her top performer.

 

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

Better habits through science

By Thomas Davis, CRNA, MAE, DNAP candidate

follow @procrnatom on twitter and retweet to a friend

Resolutions

 

Men’s natures are alike; it is their habits that separate them.

~ Confucius

 

Resolutions are intentions related to the changes that we desire in our personal lives and are often based on notions and emotions.  Being “a better person” is a nebulous term that means different things to different people.  Habits, by contrast, are observable behaviors that define us as individuals.  The transition to each new year encourages people to make resolutions; however, the reality is that good intentions come up empty when theoretical concepts about the person you want to be do not change the behavior of the person you are.  Resolutions seldom work because they are simply ideas, and ideas do not change behavior.  It is actual behavior in the form of habits that define us as individuals.

 

The key to personal change is in transforming the abstract concept of a better you into     observable, habitual behavior that will define you in the future.

 

The fields of neuro science and behavior science merge when addressing the issue of changing behavior.  Scientists affirm that when behavior is repeated, neural pathways (grooves) develop in the brain, and when new behavior is repeated frequently, it becomes a habit.  Christine Comaford, a behavior scientist who specializes in coaching CEOs to be more effective, states in Forbes.com, “First it’s key to know that neurons that fire together, wire together. This means to learn something new, to set a new habit in place, repetition is required. When you practice something deeply, intentionally, and with some element of struggle, a neural pathway is formed. Neurons are now firing together in a new sequence, and thus are wiring together as a collective.” This statement is great news for those who are willing to learn by repetition because the behavioral patterns we repeat most frequently are etched into our neural pathways. Neuro science presented in Psychology Today affirms that through repetition, it’s possible to form and maintain new habits.

 

Applying the wisdom of the neuroscience community allows you to convert the abstract concept of a New Year’s resolution into observable new behavioral habit.  Show your commitment to changing your behavior by signing a personal contract to follow three rules for 30 days.

  1. Bring the desired change to mind and repeat the new behavior at least 5 times per day, every day, without exception.  You may not be able to go to the gym 5 times per day but you can bring fitness to mind and take time to stretch.  The change you desire must be etched in your brain at least 5 times per day.
  2. Prioritize the repeated behavior, especially if it’s difficult or inconvenient. Let nothing deter your effort.
  3. Repeat the new behavior with intensity, constantly visualizing yourself as successfully practicing the desired behavior.

 

Rather than seeking a total overhaul of yourself, select one behavior and use a 30-Day Challenge to make meaningful change.  Every time you duplicate the new behavior, the neural pathway becomes stronger and over time the new behavior will become your default action. When the new behavior becomes a habit, do a self-assessment, then select a second behavior that you want to change and start another 30-DC.

To get started, below is a list of categories and possible resolutions that are crying out to be included in a 30-day challenge. Select one, follow the rules above, faithfully complete the challenge, realize the results and celebrate success. If none of these bullets hits the mark, come up with your own idea and pull the trigger.  The goal is to implement the 30-day plan, alter neural pathways and build a new habit.

  • Personal health
    • Exercise 20-60 minutes per day.
    • Commit to a healthy, plant-based diet.
    • Restrict/eliminate one negative food such as sugar, caffeine or alcohol.
  • Professional development
    • Learn a skill that will enhance your work performance.
    • Learn key words in a language spoken by your international clients.
    • Write in a journal daily.
    • Select a topic and read one pertinent blog article per day.
  • Time management
    • Limit social media to 30 minutes in the morning and 30 minutes in the evening and SET A TIMER.
    • Make a daily list of realistic “must do” items and don’t stop doing until they’re done.
    • Set a personal boundary, ie turn off electronics at a specific time in the evening and go to bed at a time that ensures a minimum of 7 hours of sleep.
  • Workspace at work and at home
    • Organize and keep everything in its place.
    • De-clutter and do not leave the workspace until clutter is cleared
    • Set aside one item per day to donate and do it.
    • Give away or trash one item daily.
  • Social interactions
    • Speak to at least one stranger daily.
    • Once a week, extend an invitation to an acquaintance to meet for coffee with the intent of learning new things about the person
    • Send a thank you email or text to at least one person per day.
    • Give a sincere compliment to at least one person per day.
  • Financial
    • Stop eating out.
    • Log all money that is spent during the month…no exceptions.

 

We are counting down the days until we count down the final seconds as the ball drops.  Rather than experiencing another year with good intentions in January that end up as February failures, try a using a new method for building new habits.  Combine the wisdom of the neuro and behavior science communities with your personal tenacity to commit, and follow through and enjoy lasting results that improve your leadership and last a lifetime.  Using your new neural grooves, get into a groove that will set the stage for a successful 2019.  Happy New Year!

“You can do anything you decide to do.  The most difficult thing is the decision to act; the rest is merely tenacity.”

~Amelia Earhart

Tom is a noted author, frequently requested speaker, and leadership consultant

Team strength through diversity

By Thomas Davis, CRNA, MAE

Follow @procrnatom on twitter

“Diversity: the art of thinking independently together.”

~ Malcolm Forbes

 

Diversity

The combination of digital technology and the availability of dependable travel has linked people in distant areas of the globe and opened the door to blending cultures through unusual partnerships.  With the click of a mouse, executives in the United States can have a video conference with just about anyone, anywhere in the world.  People who were previously separated by geographical boundaries can now interact freely with one another thus creating the opportunity for diversity of thought within their organization.

 

In addition to connectedness created by technology, immigrants fleeing terrorism or seeking opportunities for employment are flooding across borders both in Europe and America, changing the ethnic makeup of the population, and contributing to diversity in host countries.  Clearly, demographics are changing in many areas of the world and organizations on the cutting edge of their industry welcome and capitalize on opportunities that accompany diversity.  Cultural diversity in the workplace is promoted when employers actively seek to hire employees from every religious and ethnic background and then capitalize on the variety of experiences that they bring to the workplace.  Building a diverse team strengthens the organization and here is why.

 

A member of the Q6 customer service team in Perth, Australia, R. Heryati documents the following advantages that arise from a diverse workgroup:

  • Increased productivity
  • Improved creativity
  • Increased profits
  • Improved employee engagement
  • Reduced employee turnover
  • Improved company reputation

 

Writing for Entrapraneur.com, author Kim Abreu adds to the list of advantages to having diversity on a team by noting that diversity correlates with improving innovation and recruiting.  From blogs to books, authors evaluating the relationship between diversity and productivity affirm the importance of having a diverse team when seeking creative answers to workplace challenges.

 

Two types of diversity are commonly found in the modern healthcare workplace; cultural and interprofessional.  

Cultural diversity refers to a person’s family heritage. Do people at your workplace have different skin color, facial features and hair color? Do they speak a second language?  What religious holidays do they celebrate?  The greater the variation between individual workers, the more diverse the workplace.

Interprofessional diversity arises from the mix of professions that must work collaboratively to render evidenced-based care to the patient.  Doctors, nurses, technicians and support staff are only a few of the professions that combine their efforts in a busy hospital environment.  Each sub-group has a different purpose, has received different specialty training and brings a different perspective to the table when discussing issues and developing plans.  In an ideal situation, every sub-group will have equal say and be given equal respect when interprofessional teams are formed to address issues or create policies.  The term abrasive collaboration is used to describe diverse professional groups working collaboratively to find a mutual solution while, at the same time, ensuring that their individual professional needs are met.

4 ways to promote diversity in your workplace

Educate yourself.  Connect one on one with people on your team and learn about their family’s country of origin and family traditions that carry over to today.  If members of your team have different religious beliefs, learn about their traditions.  Adjust your work schedule to enable team members to attend important religious or cultural activities.

Solicit different perspectives.   In personal conversations and at team meetings openly encourage each person to voice their point of view.  Seeking a variety of opinions is especially effective with reference to interprofessional groups.  To be effective, the hierarchical “doctor knows best” attitude must be replaced by a commitment to collaboration where each person has an equal say.

Develop diversity activities.   Include dates on the team calendar that recognize the culture or religion of your team members.  Encourage people to share their traditions with the group and schedule ethnic food days to celebrate the various cultures represented on your team.  When team members celebrate one another’s heritage, they respect for the contributions that each person makes to the team and become more receptive to their ideas.

Be the leader.  You are the leader and set the tone for the workplace.  If you are dismissive of diverse thoughts, your team will follow your example.  Conversely, if you welcome and openly solicit diversity, your team will follow your lead.  Openly welcome both cultural and interprofessional diversity in your workplace.

The best ideas arise from many ideas combining ideas from people with different cultural and professional background strengthens the team.   First, assemble the right group and then be inclusive of their ideas when making decisions.  Doing so will position you and your team for success.

“When we listen and celebrate what is both common and different, we become a wiser, more inclusive, and better organization.” ~Pat Wadors, Head of HR at LinkedIn

“If you hire only those people you understand, the company will never get people better than you are. Always remember that you often find outstanding people among those you don’t particularly like.”

~Soichiro Honda, founder of Honda

 

Tom is a noted author, speaker and mentor.  Contact tom@procrna.com for information about the 4-part values-based leadership webinar series.