I love to stir the
pot and I have been blogging a lot lately about why patient centered care
and person centered care have not taken firm root. Some of it you have
heard before.
·
Unless
there is a correlation between pay for performance and the experience of
employees, patients, residents, and families, few will act. Carrot and
stick.
·
People are
terrified to step out of their comfort zone. They have done it the same
way for decades; why change now?
·
The
hierarchy of hospitals and nursing facilities lends itself to a command
and control style that is totally opposite of what the gurus are saying
will be needed going forward.
Readers of the blogs
came back to one systemic issue - leadership. A couple of recent Harvard
articles might hold the answer to the leadership question. The article,
Are You Ready to Manage in an Irrational World?, is a kind of primer
for the second.
I particularly like
this quote: “Instead of a management philosophy centered around the
manager as the play-caller, assigning tasks and motivating people to carry
them out, we are told by the neuroscientists that the new management job
is one of facilitating more of a customized, do-it-yourself process
centered around each newly-energized employee, one centered on questions
(often leading) rather than direction.”
1.
From
Play Caller to Context Provider
The new leadership calls for people to help paint a picture and create a
context that allows the proverbial light bulb to go off in employees’
heads so that they instinctively know what to do.
Many of you
are or should be aware of Beth Israel Deaconess CEO Paul Levy’s blog,
Running a Hospital. The transparency and truthfulness of that blog
has pulled the medical center out of some precarious situations. That same
style has led to the turnaround of the hospital, one that was facing dire
straights when Levy took the helm. He laid it on the line to his
management that things were dire and layoffs were imminent unless they
could find creative ways to stem the tide. He offered some suggestions but
they were not mandates. He was creating context and his employees
ultimately transcended any solutions that he alone or his top
lieutenants would have devised.
2.
From
Check Lists to Collaboration
The second article,
Leadership in a (Permanent) Crisis, takes the stance that economy
recovers, things won't return to normal and a different mode of leadership
will be required. That leadership will embrace staff empowerment,
collaboration and shared problem solving.
Much of healthcare is based on rules and regulations that purport to
improve quality of care but may not necessarily improve quality of life.
When you have “your” job and “your” checklist to do there is often tunnel
vision of what it all means to the whole. So after creating context,
leaders must allow others to work together to problem solve.
Levy at first asked hospital management to take cuts in salary to save
lower salaried jobs. It was applauded but it was only the tip. Seeing
the context, people went back and working across disciplines figured out
other ways to create efficiencies and cut costs.
3.
From I Have
to Do It to I Want to Do It
Fundamental shifts come from self-driven authentic change by empowered
people. You can see this in your own life. When you are passionate about
something, where you have come to a belief for yourself, when you
understand the bigger picture – how much faster does change take place? A
whole lot. You change because you want to change.
Leaders need to create context that shows how change not only benefits the
community at large but also offers fulfillment for every individual. It
is not a “WIFM” mentality, maybe more of a win-win mentality. Ultimately
it is about understanding the higher calling, the basic purpose, of
healing and providing hope and comfort that first drew most to the field.
Are you one of the new
leaders? Whether you are running a hospital or a nursing home or a
marketing department, you can step forward. Create context. Paint the
picture. Remember the ultimate reason for why you do what you do. Then
step out of the way and empower people to figure things out
collaboratively.
It is not for the feint of heart. It may require checking egos at the
door. But hey folks we’re not in Kansas anymore.
