Healthcare team building

Boost your value in the workplace

By Thomas Davis, DNAP, MAE, CRNA

You are at the end of another work year and it’s time for your annual performance review…what will you learn about yourself? You spent a year delivering high-quality patient care but is that enough to be rated as a high achiever and earn a merit-based bonus? Read on to discover the behaviors that elevate you to all-star status on your team and position you for rewards.

The indeed.com editorial board notes that the most valuable employees are dedicated individuals who use their skills and attitudes to not only improve their performance, but also to positively influence the work environment and elevate the entire team. Clearly, establishing yourself as a highly valued employee requires more than doing your job well; it also involves your impact on achieving team and organizational goals.

So how do you become the cream of the crop and rise to the top of your workgroup? The editorial team at Star Staffing note that high achievers are skilled in the following areas:

Consistency. Be rock solid consistent, reliable and predictable regardless of the chaos that often occurs in the workplace. Respond with reason rather than emotion.
Nurture a positive attitude. Attitudes are contagious. Show up every day with pep in your step, a smile on your face, and anticipate that good things will happen.
Accept change. The old cliché is true…the only thing that is constant is change. Be a leader by accepting and embracing change. Look for the potential good that will arise from the proposed change then leverage and promote the positive.
Grow your personal network. Move beyond your immediate workgroup and connect with others in the organization who are outside of your department. For example, if you work in the operating room, develop contact with people in radiology, pharmacy, and lab.
Hone communication skills. Emotional intelligence is a foundational skill in the modern workplace regardless of the job that you do. How you say it is as important as what you say…delivery is everything.

Writing in Forbes Magazine, author Kara Dennison adds insight into increasing your value in the workplace with the following suggestions:

Build your personal brand. Develop exceptional skills and expertise in a particular area to the point that you are recognized as a content expert and then become a resource outside your immediate department. For example, anesthesia providers can become known throughout the organization as content experts for pain control, particularly non-narcotic, multi-modal techniques.
Never stop learning. Equally important to constant learning is freely sharing your knowledge and skills. Stay at the forefront of your profession and enhance your value by becoming a mentor.
Treat the job as if it is your business. Gain an understanding of the cash flow within the department and actively market the services that your department delivers. Develop and implement ways to improve workflow and cut costs.

Author Scott Mautz identifies core strengths that are shared by the most highly respected workers on the team. Incorporating these strengths into your daily behavior will elevate your value to the team.

Self-confidence. The inner belief that I am competent, capable and up to the challenge at hand. Self-confidence arises from trust and acceptance of yourself and a sense that you have control of your life.
Fortitude. This refers to the ability to encounter difficulty or danger with courage. In the workplace, this is demonstrated when a person stands up for what is right despite being faced with peer pressure to do otherwise.
Boldness. In the workplace, boldness is a willingness to take risks and be innovative in a confident manner that shows no fear. Boldness is demonstrated by setting high goals and then aggressively making them happen.
Decision-making. Quickly consider the options and then take a stand. Base decisions on increasing the good rather than avoiding a loss and then conclusively set a course of action.
Messaging. Take control of your inner dialogue and eliminate negative thoughts, then, use your positive energy to influence and elevate others on the team. Openly share your knowledge and skills with others in a manner that affirms their needs. Make it obvious that you are there for the benefit of others.

Pulling it all together

The collective wisdom of the authors mentioned in this article will position you to be a shining star and win the MVP (most valuable provider) award for your team. Read through the behaviors listed above and pick out two to focus on immediately and then add one per month until you have mastered all of them. It is easy to read an article like this and walk away motivated, however, your commitment to change must be more than a New Year’s resolution that lasts only a few weeks. Rather than making the behaviors in this article what you do, make them who you are. With commitment, over time you will be successful.

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

The Legendary Leadership of John Wooden

Wooden Wisdom:

3 lessons from a coaching legend

By Thomas Davis, CRNA, MAE, DNAP candidate

Follow @procrnatom on twitter

When asked to name the greatest college basketball coach of all time, many would argue that John Wooden has earned the honor. While coaching the Bruins at UCLA (1948-1975), the team made it to the final four 12 times, winning the event an astounding ten times. Even more impressive, he coached the Bruins to four undefeated seasons.

Without a doubt, John was able to recruit and coach talented players, but there was plenty of talent on competing teams. It was The Wizard’s character and leadership that congealed his players into a unified team with a single purpose, setting his program apart from the competition. Knowing that pushing good people to work harder would not deliver the desired results, the coach focused on developing individual talents and taught teamwork that capitalized on those innate abilities.

The legendary John Wooden had 3 rules for his team and they were enforced with integrity every day and in every situation. The same rules that propelled UCLA to basketball fame apply equally in today’s workplace and following them will propel your team to a winning season.

The Wizard’s Wizdom

Rule 1: Never curse. Cursing is an emotional response that results from feeling angry or threatened or when danger is perceived. Wooden allowed only socially acceptable language within his team and taught the players to control their emotions in order to keep “the thinking brain” engaged in the game. Research conducted by George & Dane (2018) affirms that anger undermines good decision-making and must be avoided in the workplace. UCLA’s coach was ahead of the times when he focused on keeping the thinking brain in control. Likewise, applying rules of civility and respect in the workplace eliminates knee-jerk emotional responses and promotes proactive, creative thinking.

Rule 2: Never criticize a team mate. The coach’s ban on criticizing a team mate built an attitude of interdependent collaboration. Nadidah Coveney, of the Forbes coaching council, agrees that collaborative relationships provide a spearhead to success. Tolerating criticism encourages people to see one another as competitors rather than collaborators and, subsequently, to vie for dominance on the team. The superb UCLA teams were expected to see themselves as a single unit in which criticizing a team mate equated with criticizing one’s self. John focused to create teams on which individuals worked to strengthen one another, elevating the entire team. Trust within the Bruins was earned by collaboration, honesty and actively helping one another. Applied in every workplace, a ban on criticizing team mates includes barring gossip and other acts of sabotage that undermine the morale or productivity of the team.

Rule 3: Never be late. Coach Wooden viewed promptness as outward sign of respect for one another. He insisted that practices start on time and, in turn, showed his respect for the group by ensuring that practice ended on time. He believed that sticking with the schedule was evidence of honesty and integrity, both key elements of a trusting environment. Corporate recruiter Chitra Reddy affirms this wisdom by noting that mutual respect enhances collaboration and overall productivity. Team solidarity is created through acts of integrity where members follow through and deliver as promised.

Many work groups are staffed with talented individuals who are competent and capable of doing the assigned job and yet, as with college basketball teams, individual talent may not be enough to win the trophy. Rather than winning with raw talent, the most successful teams win through collaborative team work. Following John Wooden’s three rules of controlling emotions, working collectively, and building trust through respect will enable a slam dunk for success. Now get out there and crash the boards!

Tom is a noted author, speaker and avid advocate

for healthcare leaders.

Mentoring; Connect for Winning Results

By Thomas Davis CRNA, MAE, Lt. Col. (ret)

Follow @procrnatom on twitter

“We make a living by what we get; we make a life by what we give.”

— Winston Churchill

For many healthcare workers, an ideal job includes working within an environment where individuals are valued, creative thinking is welcomed and professional development is enhanced. Effective mentoring addresses those essentials and more. This ongoing cultivation of relationships in the workplace connects less experienced workers who have a need and desire to expand their abilities with more experienced people who have knowledge and a willingness to share. Mentoring offers an opportunity for two people to connect one-on-one in a relationship that promotes personal growth for both individuals.

According to Wikipedia, an engaged employee “…is fully absorbed and enthusiastic about his/her work.” Mentoring enhances employee engagement which, in turn, increases productivity and job satisfaction. In the still highly-regarded 1996 Gallup Q12 employee engagement survey, 6 of the 12 items on the survey could be improved by an effective mentoring program. From both personal experience as a leader and a review of the small business literature, here are some of the advantages that arise from connecting people in a relationship designed to boost personal and work skills.

Promotes professional development
Connects mentee with someone who is interested in his/her advancement
Stimulates personal/professional growth
Creates a sense of accomplishment
Teaches self-discipline
Expands professional network of colleagues

The Journal of Applied Psychology (2004, Allen et al) published a report identifying additional tangible advantages that were gained by those who had a mentor in their workplace,

Greater overall career success
Increased compensation over the course of the career
More promotions than non-mentored peers
Higher job satisfaction
Greater loyalty to the organization.

Establishing a relationship that benefits both the mentee and the mentor requires preparation and commitment from both individuals. Whether you are the well-informed advisor or the neophyte learner, these two components are essential for the partnership to work.

Start with self-assessment Before entering a mentoring relation, take time for introspection and think about what you have to offer as a mentor, or what you need if you are the mentee. Are you a good match for the other person? How much time can you commit to the mentoring process? Why do you want to be a mentor? Mentoring demands sincere effort to connect with and elevate the other person; it is never a platform for self-promotion.

Establish expectations Having common expectations aligns both people in the mentoring relationship and clarifies up front what each person has to offer and what can be expected from the other. Establish and agree on the amount of time and the level of preparation needed from each person before commencing the mentoring process. To be effective, mentoring is more than casual conversation over a cup of coffee.

Make it personal In addition to sharing information, take a personal interest in the other person and include things that are important to him/her as an individual. A good mentoring relationship can produce a friend for life.

Be a thinking partner All too often, the mentor assumes the role of an authority and eagerly tells the learner how to think and do the assigned task. Avoid being an authoritarian task-master by assuming the role of thinking partner and use your experience to guide the learner to an “aha” moment.

Share your network Those in a mentoring role often hold a more elevated position in the organization than the mentee, and/or have been with the organization for a greater length of time. Introducing your mentee to those whom you trust for advice expands his/her network of connections and establishes resources for future projects. Conversely, the mentee who is lower on the chain of command has a network of trusted colleagues at the grass-roots level. Working with a mentee may give the mentor insight into frontline issues that have not yet made it upward through the power structure.

Mentoring is an opportunity to create a two-way relationship that validates the mentee and provides a sense of fulfillment to the mentor. Having someone in the workplace who cares about you as a person as well as your individual professional development is a win-win in which both parties will grow by becoming more engaged, more creative and better informed . If you are an experienced worker, share your knowledge willingly with those who will become the future leaders in your organization. If you are new to the job, seek a mentor to help you learn about the company culture and provide guidance to ensure your future success. Effective mentoring produces lasting connections and winning results.

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

Right player, Right position; Build a successful team

By Thomas Davis, CRNA, MAE, Lt. Col, (ret)

On January 17,2017, Patriot’s quarterback Tom Brady reached a milestone and reinforced his elite status as a team leader when he appeared on the cover of Sports Illustrated for the 20^th time. Magazines such as SI, Fortune and Forbes regularly feature the super-stars of business on their covers, filling their pages with success stories from the corporate world. What do the elite super-stars of sports have in common with successful corporate CEO’s? Both have received public accolades for combining their natural talent with their ability to effectively lead a team.

The need for teamwork on the sports field is obvious. Every quarterback in the NFL has the credentials necessary to do the job; they know the strategy of the game and have the physical talents to deliver the desired results. Yet, many fail which indicates that success involves more than the quarterback’s arm. The line must block, receivers must run the right routes and the team must work in sync to achieve victory.

Teamwork is equally essential in the business community where success involves more than the CEO’s vision. Victory in the business world requires a supporting team with each person executing his/her role in a confident and professional manner. Assigning the right person to the right role is the first step to the victory dance. Expecting a strategic thinker to balance the corporate books will be equally disappointing as asking a lineman to run the route of a wide receiver. Know your players and their strengths and then put them into the right position to showcase their skills.

Here are three essential leadership roles to play when you develop and implement an action plan for your team.

Innovator The innovator is the creative thinker who constantly sees a better way to do just about anything. Tell this person what you would like to accomplish and he/she will quickly identify several ways to complete the task. The keen insight of the innovator considers both short and long-term implications and formulates a plan to maximize success while minimizing unintended consequences. The innovator sets the course and provides the spark of energy necessary to get the project rolling. An innovator on the team introduces possibilities however, a team with only innovators becomes a think tank producing concepts but no results.

Enabler The enabler is the essential person on the team who has a network of contacts and knows where to obtain the resources necessary to transform a vision into a reality. Whether the project needs supplies or support, the enabler knows where to turn. Essential resources include not only things, but people and the enabler is a master at fostering collaborative teamwork. In short, the enabler buys into the vision, obtains the resources and motivates others to make it happen.

Implementer The implementer takes pride in actually doing the hands-on work required to give life to a project. This hard-working team member can understand the goal, capitalize on the resources provided by the enabler and do the labor necessary to achieve results. On some teams, the implementer is also referred to as a go-to person, someone who always seems to be able to do just about anything. When an implementer is charged with completing a task and given the resources to do it, the sky is the limit.

Just as sports teams need skilled players at every position, the most successful business leaders build teams where each position has a skilled player. A baseball team doesn’t recruit a generic baseball player; it recruits for a specific position, i.e. pitcher, catcher or infielder. Likewise, insightful leaders recruit innovators, enablers and implementers and then make sure that every project has people from each category on the team. Your ultimate success is dependent upon leveraging your natural abilities by creating a team that will bring reality to your vision.

Thomas Davis is a noted leader, educator, speaker and clinical anesthetist.

Build a preferred workplace. Join Tom and a group of healthcare leaders for the values-based leadership webinar. Click here for information.

Infuse the Holiday Spirit

By Thomas Davis, CRNA, MAE, Lt. Col. (ret)

Follow @procrnatom on Twitter for leadership tips

The Christmas season is a time for family and friends to gather and share the excitement of the season. With store fronts decorated, neighborhoods lit up at night and jingle bells in the shopping malls, children start squirming with excitement while adults develop a sense of kindness and generosity. For the savvy leader, the holiday season is a golden opportunity to build the team. And there’s no better place to start than by building a workplace of choice.

Think of your team as your extended family and give them a gift they will enjoy throughout the upcoming year – the workplace of choice. Make a commitment to create a preferred workplace and start today by leveraging the spirit of the holiday season. In your ideal workplace, team members will:

Feel as if they belong
Sense that they make a difference to the organization and the team
Have a spirited team spirit
Know that their work is recognized and appreciated

Exude the mood of the season then commit to carrying the new attitude into the upcoming year. Team collaboration and production will soar as your workplace gains a reputation for being the best in the organization. Here are a few ideas to make the season memorable for your team.

Make it fun and festive

A team that has worked diligently for a full year since the last holiday season has earned the right to feel good about themselves and their accomplishments. Break the monotony of business-as-usual and usher in the joyous season by changing the face and the tone of your work area. Try these ideas to lighten the mood and unite your team.

In the break room

Encourage team members to post holiday pictures of family and pets.
Post a joke of the day and encourage team members to post funny holiday stories.
Post a riddle of the day and encourage team members to work together to solve it.
Bring treats several times in the week leading up to the holidays.
Bring a nerf basketball and small hoop. Have a contest for the most buckets in 1 minute.
Set up a new challenge every day such as counting red jelly beans in a jar and provide a prize for the winner.

At your team meeting

Have a non-business meeting and encourage your team to identify ways to have fun…then follow-up.
Have a laughing contest…it’s contagious.
Create a New Year fun committee and plan quarterly events.
Ask each person to name another team member and state something that they appreciate about the person.
Discuss team accomplishments from the past year.
Finish the fun meeting with a holiday “shift exchange.”

One on one

Show an interest in each team member’s holiday plans.
Focus on positives and point out things that the person does particularly well.
Give each member of the team a hand-written holiday note and that expresses thanks for something specific that they did for the team in the past year. Deliver it in person or mail it but DO NOT leave it in their box at work.

Creating the ideal workplace takes time and commitment. Holidays are a special time of the year for each person on your team regardless of religious beliefs or family heritage. Use the season as a platform for building a team, one that everybody wants to join in an environment where people want to work. Haul out the holly and have some team-building fun.

Tom is a skilled anesthetist, author, speaker and leadership coach.

Leader Reader 1, Authentic Lessons in Leadership. “The book that goes beyond theory and provides hands-on leadership skills.”

Connect Through Recertification

By Thomas Davis, CRNA

Follow @procrnatom

Nurse Anesthetists practicing in the United States are required to be certified and then recertified at intervals throughout their career. The recertification process is an opportunity for leaders to connect one on one with each member of their team, ensure that the person is qualified for recertification and improve employee engagement.

Management literature is filled with articles about the advantages of employee engagement and corporations pay millions of dollars every year on programs for improving it. Very similar to other types of employment when it comes to the advantages of engagement, healthcare organizations depend upon effective leadership within the organization to inspire and motivate employees. Among the advantages of having an engaged staff are the following:

Improved Safety Engaged factory workers are up to 5X less likely to be injured on the job. In healthcare not only are the workers less likely to be injured but they are less likely to make mistakes that injure others, including patients.
Improved health Engaged employees are less stressed, more relaxed in their interactions with others and are less likely to miss work due to illness.
Improved happiness Engaged employees look forward to coming to work and interacting with co-workers who they are more likely to view as friends.
Improved Performance Engaged employees tend to be more creative, have a better attitude and work at a higher level. Their high-end work is more likely to be reflected in a salary bonus than that of a less productive peer.
Improved sense of community Engaged employees tend to have the backs of their co-workers which is reflected in increased safety for the entire unit.
Improved retention Engaged employees are easier to retain. Costs of recruiting, hiring and orienting new employees can be significant and employee engagement saves time and money for the organization.

Although many crash courses and gimmicks exist to improve employee engagement, the one piece that is essential for success is a trusting one on one relationship between the employee and the supervisor. Whether you are the leader or the employee, developing the relationship is foundational to being a workplace of choice.

For several decades the Gallup organization has worked with employers to survey their workforce, assess engagement and make recommendations for improvement. The current Gallup engagement survey has been refined to 12 essential questions which give an accurate estimate of employee engagement. Three of the 12 can be addressed when the proactive leader uses recertification as an opportunity to connect individually with the employee.

Question 6 Is there someone at work who encourages your development?
Question 11 In the last 6 months has someone at work talked to you about your progress?
Question 12 In the last year have you been given opportunities to learn and grow?

The recertification process is a gold mine for the proactive leader committed to building a fully engaged team. Schedule a private, face to face meeting with each member of your team and discuss the following:

Determine eligibility for recertification Whether the person recertifies this year or is mid cycle, determine where they are in obtaining the required continuing education.

Review the professional education that the person has received over the past two years. Discuss ways in which they can share their knowledge with the group.

Plan professional education for the next two years. Make note of any special interest that the person may have and discuss ways in which developing the interest will benefit the group.

Explore enrichment opportunities beyond the required continuing education. Many organizations offer in-house learning opportunities that do not award continuing education credit. Discuss ways in which the individual can pursue interests and grow professionally regardless of the credit that is awarded.

Elevate your leadership by connecting with your team and motivating them to grow professionally. By encouraging team members to enhance their individual skills, you will address issues that have been identified as essential by the Gallup survey and you will improve the engagement of your team. Savvy leaders don’t wait for a stroke of luck to elevate the status of the team. A highly effective leader connects and engages with each individual by making use of a great opportunity like recertification.

Watch for the release of Tom’s book, Leader Reader 1, Authentic Healthcare Leadership scheduled for release on Amazon Books March 15, 2017

Effective Listening

Keys to Effective Leadership: Listening

By Thomas Davis, CRNA

Nurse Managers and other frontline healthcare leaders want to be known as the boss that everybody wants to work for. It is only natural to want to set goals that build your personal reputation and the success of your workgroup. Being a good listener is foundational to achieving your goal and here are 2 guaranteed ways to increase your listening skills

Listen to understand
Listen to emotions

Listen to Understand

People want to be heard and understood. When asked about the traits of their best boss, people will frequently say that it was a person who listened and at least tried to understand them. Conversely, when asked about their worst boss, they describe a person who was distant, isolated and out of touch with the needs of the individuals in the group.

The key to effective communication is effective listening. Leaders often put two barriers between themselves and effective listening: the hectic pace of the workplace and the demands on time. Both factors place the leader at risk to be distracted while talking with a member of the team. Just like the raffle at church, you have to be present to win. Somebody on your team finally has the courage to open up to you with a problem and your mind is elsewhere! Whether you’re in the hallway or in the office, value the information that each member of your team offers and give them 100% focus when they talk to you.

The second and more difficult barrier to overcome is the tendency to prepare your response while the other person is talking. I call it agenda listening. You can’t fully appreciate the message the person is delivering if you are focused on your rebuttal. Serious listening is like drilling into the mother lode. By listening to learn, you will gain insight that will elevate you as a leader. Forget about your reply and listen carefully and hear everything that is said. You don’t have to agree but you will benefit from knowing their point of view.

Points:

Learn from listening. Appreciate the gift you are being given.
Restate the other person’s position to ensure you both agree on what has been said.
Encourage the person to tell you more. Build on what they say with replies like, “Tell me more about…”
Encourage the person to clarify by asking how questions. “How can we do that?” “How will that benefit the group?”
Avoid questions that put the person on the defensive. Asking “why did you” puts them on the defensive and looking for an explanation.

Listen to emotions

As educated professionals, we listen with an academic ear. As team leaders, we must listen to both content (actual words) and the emotion that drives the words. We like to think that we are rational beings and that the argument founded in fact will win. Not so. We also have an emotional side and emotions frequently trump logic when interacting with troubled team members. In a famous study, Albert Mehrabian noted that only 7% of what is communicated comes from actual words. Tone of voice and body language make up the other 93% of communication. Maybe that is why so many email and text messages are misinterpreted. As an effective leader, listen not only to the words but also listen to the tone and watch the body language to pick up on the emotion behind the message.

Points:

Allow people to feel how they feel. Telling them how they should feel ends communication.
Make open-ended statements about the emotions that you observe and listen to responses.
- “I sense that you are uneasy with this proposal”
- “You appear concerned about….”
Welcome and encourage team members to suggest solutions.

As a leader, your greater goal is to have a cohesive and effective team where each member is valued not only for the work that they do but also for the person who they are. Listening is the foundational element to build a one on one relationship with each team member.

Thomas Davis is an experienced clinical anesthetist, leader, speaker and the owner of Frontline Team Development and Leadership.

Building Common Purpose

By Thomas Davis, CRNA

Follow @procrnatom

This is the third in a series of blog articles applying political quotes to frontline leadership. Previous articles have applied the words of Hillary Clinton and Mike Pence to frontline healthcare management. There is no intention of supporting or disparaging any candidate or party but rather learning from their words of wisdom. We will have to wait and see whether or not politicians and parties can turn words into action.

“You are the director of your own movie; if you aren’t enjoying what you are doing, change it.” “Stand up for principles and offer a real alternative.” Gary Johnson

Same stuff, different day. Is that your experience as a frontline leader and manager? Going back a few years, the basic murder mystery was the backbone of evening television. A crime was committed, several suspects were identified, surprise evidence emerged, and the bad guy was caught. The format was predictable, however in 1971 “Columbo” reversed it. A crime was committed with the perp identified up front. Viewers were kept on the edges of their seats while alibis melted away until justice prevailed.

To enable your group to achieve excellence and to keep the job interesting, rewrite your daily script. Engaging your team to edit the script creates a common purpose and becomes the cement that binds the team

Develop a common purpose. If you think you have problems building consensus and motivating a team, consider the challenge faced by Coach Mike Krzyzewski when he agreed to coach the Olympic men’s basketball team. Taking a group of millionaire all-stars and asking them to give up their summer vacations in order to play even more basketball was not an easy task. To be successful, the team needed a common purpose. Coach K took the team to Arlington Cemetery and the tomb of the Unknown Soldier and talked about people giving their lives for their country. He then took the team to the area of the cemetery where recent casualties are buried and they viewed gravestones of people younger than they. He arranged workouts at the military academies where young people were preparing to give all for their country if necessary. When all was done, the team was no longer playing summer basketball; they were playing for the honor of their country and all those who have given their lives to defend it. They had a common purpose.

As a frontline healthcare leader, you most likely will not be able to take your workgroup on a field trip to a National monument. Therefore, you must find common purpose within the environment where you live and work.

Create a common purpose

Focus on patient safety and satisfaction when rewriting the way you conduct your business.
Openly discuss concerns and explore remedies
Actively listen to each member of the team as they offer fresh ideas
Have a former patient or family member talk to your team and tell their story

Change the Script. As a leader, the team looks to you for guidance and wants you to motivate and provide direction. Be bold and confident when interacting with your team. Meet regularly and link the new script to each member personally. Tie common purpose to a sense of urgency and role model the new behavior that is expected of the group

Implement Change

Display competence and confidence when sharing expectations
Clearly outline expectations as you role model the desired behavior
Actively listen to and address concerns of team members. Ask what it would take for them to be fully on board.
Establish benchmarks to document progress toward achieving the larger goal
Recognize and reward desired behavior.

Some tasks have to be repetitive, but no one enjoys watching the same movie day after day. As a frontline leader, you will improve the workplace for both patients and workers by making a new script that infuses energy and improves outcome.

Thomas Davis is an experienced clinical anesthetist, leader, speaker and the owner of Frontline Team Development and Leadership.

Effective Leadership

Follow @procrnatom

By Thomas Davis, CRNA

For centuries, leaders in both the Military and civilian world have attempted to identify and define the perfect leadership style. As far back as 500BC Lao-Tzu wrote in the Tao Te Ching, “The highest type of ruler is one of whose existence the people are barely aware….when the task is accomplished and things have been completed, all the people say we ourselves have achieved it.” On a grassroots level, people are empowered, engaged and have the self-satisfaction of a job well done.

Leaders in both business and healthcare are modifying their management style to encourage employee engagement. As noted by Edward Hess in the Washington Post, “leaders of the most successful companies do not have a top down style of management”. Collaborative management to encourage employee engagement is the key to success regardless of the type of business to include healthcare. In reviewing leadership literature a common thread is advocating leadership through shared responsibility. Collaborative Leadership is a sharing of power which recognizes the contributions of each individual and helps them develop and perform at their highest level.

Over the past 3 decades, I have observed many styles of leadership described with many different names. Without exception, the most efficient organizations with the highest employee engagement and morale were those in which the leaders followed the principles of Serving Leadership and shared governance. Use the principles below to establish yourself as an effective manager of an engaged workgroup.

There are no unimportant jobs or people in an organization that embraces shared governance. As a manager, develop a one on one relationship with each individual. When people are respected and their views heard, they become empowered and will seek excellence. Both managers and front line workers recognize that mistakes will be made. By treating a mistake as a learning opportunity, lessons will be learned, and the organization will become stronger because each individual is allowed to take risk. The key to success is to keep the team focused on the common goal. One of the powerful actions described by Covey is “Begin with the end in mind” where the mission and vision of the organization are known and shared by all. High functioning workgroups are founded in trust, collaboration and holding one another accountable. By affirming the common goal and using mistakes as teaching moments, effective leadership can pave the way to success.

Work is accomplished through relationships and trust is the glue that holds relationships together. Trust begins with you. Begin your journey toward becoming an effective manager by looking within. What is your capacity to trust? What would happen if you approached every interaction from a baseline of trusting that you and the other person share common goals and seek common outcomes? Because you may disagree on a step in the process does not mean that your greater goals are different. In the book Trust and Betrayal in the workplace, the Reina and Reina suggest the following for developing trust in relationships:

Share information
Tell the truth
Admit mistakes
Keep confidentiality
Give and receive feedback
Speak with good purpose
Take issues/concerns directly to the person involved

Effective communication is essential in healthcare for patient safety, efficient workflow and employee morale. Empowering Leadership upends the traditional top down leadership pyramid and makes each team member an equal participant in patient outcome. The best decisions are made when opinions are solicited from a broad base of individuals who have a common interest in a positive outcome. As a trained professional and leader, your insight and opinions are needed when decisions are being made however not all opinions are openly welcomed and received. Grenny suggests the following when confronted with a difficult conversation:

Share your facts. Let the other person know what is behind your opinion.
Tell your story. Explain how you see things and why they are seen as they are.
Ask the other’s path. Openly solicit the other person explain why they see things as they do and listen to learn. Do not argue or confront as the other person explains their position.
Talk tentatively. Ask “what if” or “what would it look like” questions to suggest your remedy and then listen as the other person responds.
Encourage testing. Come to a mutual agreement on a next step with the agreement that it will be reviewed and can be tweaked.
Being an effective manager does not require an MBA or that you were born into a family of corporate executives. Put the micromanaging aside and trust in the abilities of your team. By developing relationships, building on strengths, and communicating effectively, you too can be “the highest type of ruler” where your team achieves amazing results without your heavy hand.

Build on individual strengths to raise the collective performance of the group. Each member of your team brings different strengths to the workplace. The person with the most creative ideas is not always skilled at putting the plan into action. Teaming with others who can organize and execute the plan enables the creative genius of each individual to come to life. No individual can effectively do it all.

Hess, Edward, April 28,2013. https://www.washingtonpost.com/business/capitalbusiness/servant-leadership-a-path-to-high-performance/2013/04/26/435e58b2-a7b8-11e2-8302-3c7e0ea97057_story.html
Dennis Reina and Michelle Reina, Trust and Betrayal in the Workplace.
https://hms.harvard.edu/news/safer-patient-handoffs
Grenny, Patterson and McMillan, Crucial conversations: tools for talking when stakes are high

Thomas Davis is an experienced leader, author, speaker and teambuilding coach.

Getting the Right Match

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By Thomas Davis, CRNA

“What counts in making a happy marriage is not so much how compatible you are but how you deal with incompatibility.” ― Leo Tolstoy

Neil Clark Warren is a name that you may not know, however, when you see his face and hear his voice you will say, “Oh yeah, that guy.” Mr. Warren is a clinical psychologist, Christian Theologian, seminary professor and CEO of eHarmony.com. Most likely you know him from over a decade of TV commercials. As a marriage counselor, Neil worked with couples who, despite their love for one another, had compatibility issues. The eHarmony.com web site was designed to assess the basic character and values of each person and then match them with a partner based on compatibility. The success of this online dating plan has been impressive. Compatibility is foundational to every good relationship, including work relationships.

Compatibility is just as important in the workplace as it is to your personal life. Being in the wrong job is like being married to the wrong person…lots of work and not much fun. All too often production pressure influences a manager to hire a person primarily to get them on the job and working quickly. After months or years of frustration, the manager realizes that the employee is not compatible with his leadership style or the institution’s values. Both are unhappy and neither is as productive as each could be.

As healthcare managers, Chief CRNAs have a vested interest in ensuring that employees are fully engaged in their work. Engaged employees provide consistent, high levels of productivity. They are your problem solvers and proactively identify ways to streamline workflow and improve patient satisfaction. They embrace the vision and values of the organization and are on board with your management style.

In contrast, disengaged employees are actively or passively against just about everything. They believe that they are right and everybody else is wrong and would rather hold on tightly to the problem than fix it. Most people reading this article can name both engaged and disengaged co-workers. As a manager, you seek to increase the number of workers carrying the load and to reduce the number of those who put a drag on the system. Your goal is to have a fully engaged workgroup, and employee engagement starts with the hiring process.

As my mother used to say, “It’s easier to avoid getting into a bad relationship than it is to get out of one.” As a manager building a team, the Chief CRNA must assess compatibility of every applicant and stay out of bad relationships. Always remember, there are highly qualified, fully capable applicants who have the work experience that you seek but still may be a terrible fit on your team. Compatibility is as important as capability when assembling your team. Building compatibility into your team begins with the application/interview process.

Competence and capability are foundational for any employee to become a valued member of your staff. Competence is evident by the applicant’s having the education and skills required in the job description, however, capability relates to the willingness to work and the quest for professional growth. When interviewed, an engaged applicant will ask about your expectations and will also ask about taking on more responsibility. The person will want to know how you define and reward excellence. When you follow up with calls to references, ask about work ethic and ask for examples of when the applicant went above and beyond the basic requirements of the job. If all the person does is show up, earn a pay check and go home, don’t expect to see an attitude change after becoming your employee.

An applicant’s Commitment to the mission, vision and values of the larger organization aligns them with others in the workgroup and provides a stable platform for future interaction. When you interview, ask the applicant why they want to work with your group. Are they committed to the group values and are they committed to a long term work relationship or are they passing through until a better option arises? Before the interview ends, get a verbal commitment that the applicant supports the values of the group. Regardless of their competence, if the applicant cannot commit to the values of the group, the person is not a good fit.

Compassion and caring about the welfare of patients and co-workers are signs of emotional health. Having a sense of happiness and a good sense of humor will elevate the mood of the entire group and make your hospital a preferred workplace. Build your team with people who appear happy, who support one another and have a desire to connect socially. The interview is your opportunity for a conversation with the applicant that is relaxed and easy. If the interview is stressful or there is not a free flow of thoughts, the applicant is not a good fit.

Compensation to include both pay and benefits is important to the institution and to the applicant. The offer should be competitive with the local market and the applicant should be satisfied with the offer. Employees who feel that your offer is too low will feel under-appreciated and may quickly become under productive. Not only do they become a drag on your system, they drag others down with them and create discord on your team. Don’t apologize for your offer. If the applicant does not gladly accept it, they will not fit in and will jump ship at the first opportunity.

Communicate with people who know the applicant and their work ethic. The applicant will provide a list of people who can be relied upon to give a glowing testimony. When you interview, ask the applicant for names and contact information for current employers/supervisors. Follow up with a phone call to validate the things told to you during the interview.

Just as Neil Clark Warren uses eHarmony to assess values and characteristics of people to increase the likelihood of compatibility, the Chief CRNA must have a working knowledge of the values of the institution, conduct a focused interview, and follow-up to assure that the applicant is a good match. A happy, healthy and engaged workgroup is founded on a compatible partnership.

Remember, it is easier to teach technical skills to the right person than it is to change the basic personality of a highly skilled but wrong person. For eHarmony in your workgroup, do your diligence and make a good match.

Tom is an experienced leader, educator, author and speaker with a passion for team building. Contact tom@procrna.com

Chief CRNAs are Team Builders

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Chief CRNAs are Team Builders

By Thomas Davis, CRNA

“Never doubt that a small group of thoughtful, committed, citizens can change the world. Indeed, it is the only thing that ever has.” ― Margaret Mead

As CRNAs we live and work in a rapidly changing healthcare environment. The mandate to provide more care for more people at a lower cost combined with increased Federal regulations has introduced both stress and uncertainty into the healthcare industry. New challenges have emerged in the healthcare workplace. Value based reimbursement, systems integration, and regulatory changes are but a few of the issues that are stressing the status quo. Now more than ever, having a staff of fully engaged, cost effective workers is essential to the survival of the organization.

CRNA leadership on the local level is more important now than at any time in history as hospitals adjust to the new reality of regulation and reimbursement. With safety and outcome metrics being publicly reported and reimbursement being tied to patient safety and satisfaction, it is essential to have the right people providing patient care. As highly skilled, cost effective front line providers of anesthesia, CRNAs are regarded as leaders in the operating room. We are in a unique position to make a difference on a daily basis not only with patient outcomes but also with the overall success of the institution.

Chief CRNAs across the country play an important role at the intersection of the operating room and the larger institution. CRNA leaders are challenged with putting together a team that will provide a positive experience for the patient within the financial limitations of the Hospital. Selecting the right people and having them fully engaged is an ongoing challenge for managers. As Chief CRNAs, we must look beyond the fact that a person has a license and wants to work. We must carefully select the right people who will be fully engaged in their work and raise the bar on patient safety and satisfaction. The following are tips for selecting the right people to join your team:

Set a greater goal for your group. Have a meeting with your current CRNA group and discuss the mission, vision, and core values of the larger organization. Share your personal vision and values with your group and then listen carefully as you discuss your vision with them. Take the initiative to develop a written vision statement for your CRNA group with a list of core values. The vision and values that you share must become the foundation when interviewing applicants for a new position. Develop interview questions to determine the applicant’s alignment with your vision and values. The person may be an accomplished anesthetist however if they do not align with your vision and values they are not a good match for your group.

Describe your leadership style and how it aligns with organizational leadership. Literature from business management states that the traditional top down “captain of the ship” leadership style blocks creativity and engagement. In healthcare as in the private sector, shared governance “serving leader” style of management promotes creativity and engagement. Take the initiative to learn about serving leadership and develop a one on one relationship with each member of your group. A sincere desire to promote the career of each person will lead to CRNA engagement which translates into improved patient safety and satisfaction. An applicant who views you as a serving leader and a person who will promote his/her individual career will be eager to share your vision and will give 100% on the job.

Discuss all of the positives and negatives related to the job. It is unfair to both you and the new employee for surprises to emerge after they start working. The applicant should walk away from the interview with a clear knowledge of your expectations. If there are less desirable assignments or shifts, the applicant should know before they agree to join your group.

Communication is essential. In this era of instant messaging and 24/7 access to texting, email and internet, it is possible to avoid basic one on one communication. As a manager, you need open and honest, face to face, two way dialogue with each employee. If you have problems communicating with the applicant at interview, you will also have problems later. Patient satisfaction is founded on connecting with healthcare providers. Your new employee must have the communication skills needed to connect with each and every patient. In addition, conflict is inherent within any healthcare team. It is equally important that your new hire have the skills to have constructive conversations with difficult physicians. At interview, ask the applicant about times when they have connected with patients as well as times that they have disagreed with physicians. If they can not have positive interactions in difficult situations, they may not be a match for your group.

Not every skilled CRNA is a good match for your team. When you have a clear vision of your goals, have an empowering leadership style, and clearly communicate your expectations, you will be able to determine the right candidate for your position. At the end of the interview, the applicant will know your expectations and will be able to commit to your vision before accepting the position. When both the manager and the new hire agree on the greater goal up front, the road to success has been paved.

Let me help you excel as a Chief CRNA. Consultation service available related to team building and serving leadership. Contact tom@procrna.com