| Making real change seems a formidable challenge, but | | | | awful?" "There's nothing we can do." "It's not our |
| the only limitation is in the way we think. That's | | | | fault." |
| right...the answers to positive change lie within each | | | | Although I enjoyed a close relationship with the |
| of us and center on the way we think about | | | | group, their response to my observations was one |
| behaviors, attitudes and the corporate roles we play. | | | | of deafening silence. I waited, with "tar and feather" |
| We can all point to poor communication (from | | | | fantasies of humiliation parading through my mind. |
| others), lack of candor (in others), dishonesty (in | | | | Finally, a doctor known both as a firebrand and as a |
| others), and turf battles (fought by others) as the | | | | respected Board member stood. "I'm choking on |
| root causes of most problems faced by hospitals | | | | these words, but I have to say I'm a gossip." He |
| today. But what if we turn the tables and start to | | | | then proceeded to confess to their faces what he |
| look within ourselves for the forces that will produce | | | | had said about these people behind their backs. As |
| positive change? | | | | he owned his behavior and committed to speaking up |
| Chances are you want to make a difference but | | | | more in meetings, he created the opening for many |
| don't believe you have the resources to create real | | | | other people to do likewise. It became a |
| results. As a hospital administrator, department | | | | radicallyresponsible meeting with unforgettable |
| chairman, clinical director, or physician leader, you may | | | | breakthroughs. |
| believe there is something "out there" that will help | | | | You can encourage personal accountability by asking |
| you make the right choices and have a significant | | | | yourself these questions: |
| impact. I'm here to tell you, you already have what it | | | | What is it about my attitude or behavior that keeps |
| takes--if you're willing to make some personal | | | | this going? |
| changes. | | | | Is there anything I'd like to communicate, but |
| These five actions, taken on a personal level, are | | | | haven't? |
| guaranteed to create radical positive change in your | | | | Have I broken or missed any agreements? |
| healthcare setting. But remember--to change your | | | | What can I learn from this situation? |
| healthcare center, you must first change yourself. | | | | Action 4: Tell the Truth |
| Action 1: Learn on the Run | | | | Just as in today's corporate world, hospital workers |
| Effective medical care comes from taking in signs, | | | | suffer from epidemic levels of lying. About 95% of |
| symptoms, lab results and diagnostic studies, then | | | | the time, we lie or manipulate the truth because we |
| combining them to arrive at an accurate diagnosis and | | | | want to control the uncontrollable: others' reactions or |
| treatment plan. Unfortunately, many of us do not | | | | emotions.We actually believe that the truth is not |
| apply these same skills to the rest of our jobs.We | | | | good for people and that we are protecting them by |
| stay attached to our patterns in spite of indisputable | | | | withholding or shading what's real. |
| evidence that what we're doing isn't working. We | | | | This is wrong and it slows your facility down! Truth |
| even defend what doesn't work, because it's | | | | instantly gets all the information on the table so |
| comfortable. | | | | everyone involved can quickly make informed |
| Learning on the Run is based on "taking in" all available | | | | decisions with the benefit of all details and opinions. |
| data, then "diagnosing" the problem before acting. | | | | True power and enormous speed are the results |
| Become willing to drop your defenses, take in all the | | | | when people deal directly with the truth, and with |
| feedback you can gather and then assess the | | | | one another. |
| situation. Don't allow yourself to become defensive, | | | | Much of the exhaustion and burnout of our medical |
| respond from habit or act based on stale relationship | | | | lives comes from the energy expenditure of not |
| patterns. Open yourself up to learning--looking at the | | | | telling the truth. The host of reasons generally falls |
| situation with fresh eyes, from new viewpoints. | | | | into one of three categories: not facing a feeling, not |
| Action 2: Drop the Roles That Bind You | | | | communicating an experience, or not keeping an |
| Most stress and upset in healthcare settings result | | | | agreement. As soon as you face these |
| from our tendency to get stuck in the drama of the | | | | energy-eaters, you'll fast-forward your healthcare |
| moment and inauthentic patterns of behavior. | | | | interactions into far greater ease and speed. |
| Authenticity--congruence between your inner state | | | | Perhaps you've done something you feel guilty about |
| of being and your outer behaviors and | | | | and you haven't come clean with the other person. |
| actions--makes you a high-integrity player, regardless | | | | You may feel angry with someone or hurt about |
| of title, position or identity. | | | | something someone has said, and you haven't told |
| Ask yourself: Do our roles guide our behavior, or do | | | | the person directly. If you don't communicate the |
| issues drive our behavior? These role-driven | | | | truth directly, your inner self will keep reminding you |
| behaviors may sound familiar: | | | | with random flashes and thoughts, eating valuable |
| The Chief of Medicine has a predictable | | | | time and energy from your day. |
| "intellectualizing" and "astute diagnostician" style of | | | | Perhaps you didn't follow through on a commitment. |
| communicating, and is very defensive. The Chairman | | | | Such "integrity slips" tend to drag our energy down. |
| of Family Practice has a long-suffering and martyr-like | | | | All we have to do to get back to a highly productive |
| identity. And Surgeons--well, they act like surgeons! | | | | state is to handle the broken agreement through |
| One of my favorite moments of authenticity | | | | some kind of direct communication. Tell the truth. |
| occurred a few years ago during a highly charged | | | | Is there someone with whom you need to |
| Medical Executive Committee meeting at a major | | | | communicate? Is there something you've left |
| medical center. A very dominating, charismatic and | | | | undone? What will actually heal and resolve this |
| extremely influential Chief of Cardiac Surgery known | | | | particular issue? Each time we're willing to tell a hard |
| to be "surgical" even when outside the operating | | | | truth, we become lighter, faster, a positive force for |
| room, jumped to his feet still dressed in surgical garb. | | | | change. |
| He bellowed, "Dr. High and Mighty Heart Surgeon is | | | | Action 5: Awaken Your Sleeping Giant |
| about to show up and I can't stop him!" | | | | Does your organization focus time and energy on |
| The entire group took a collective breath and broke | | | | improving staff weaknesses, or capitalizing on staff |
| out in relieved laughter. Needless to say, the drama | | | | members' talents and strengths? |
| that had previously played many times was averted | | | | Truly successful people get "good enough" at basic |
| and energy was freed to deal with other issues and | | | | skills, but optimize their natural gifts, their areas of |
| problems. | | | | genius. They also recognize where they don't need |
| Now, how is your authenticity? Does your role bind | | | | to be a genius and delegate those areas to others. |
| you? If so, let it go. | | | | When your staff members are allowed to align their |
| Action 3: Take Responsibility (Be Accountable) | | | | purpose and genius with their jobs, your health |
| Too many people seem to feel more responsible for | | | | center's efficiency, productivity, satisfaction and joy |
| explaining their results, or lack of results, than for | | | | will skyrocket. |
| achieving them. | | | | In healthcare, we constantly ask ourselves to set |
| Accountable individuals, on the other hand, make solid | | | | aside gifts and passions to do "what needs to be |
| agreements and take 100% responsibility for their | | | | done." Instead, let's bring our gifts to the challenges |
| experiences and commitments. They look inside | | | | at hand and thrive and expand as a result. |
| themselves, wondering about their contribution to | | | | Our combined "healthcare voices" scream that the |
| problems, rather than lashing out and making them | | | | problems we face today are bigger and more |
| somebody else's fault. They communicate frequently | | | | complex than these five actions suggest. Because |
| with updates, they're reliable on tight deadlines, and | | | | we doubt the effectiveness of simple solutions and |
| they rarely drop the ball or manipulate reality to stand | | | | strategies, we continue old, unproductive patterns of |
| solo in the spotlight. If they must change an | | | | indirectness, defensiveness, blame and inadequate |
| agreement, they promptly alert those who will be | | | | communication. But these don't work. |
| affected and renegotiate the agreement. | | | | Today in medical therapeutics we are able to |
| You must be willing to ask yourself what part your | | | | abandon old therapies and technologies in favor of |
| attitude, words or behaviors play in interactions. | | | | those that work. To gain true power for positive |
| When I was asked to help the Board of a major | | | | change in our organizations, we must be willing to |
| healthcare organization improve the quality and | | | | abandon personal behaviors and attitudes in favor of |
| effectiveness of their meetings and planning sessions, | | | | new ones that work. |
| I observed Board members' discussions, breakout | | | | Adopting these five actions has completely |
| groups and activities during recesses and social | | | | transformed my life and the lives of thousands of |
| activities. I later reported on my observations, calling | | | | clients. They're yours, now. Your choice is a personal |
| these physicians on their hallway conversations, | | | | one. Take action and realize your dreams. Your next |
| gossiping, politicizing, and criticizing of people who | | | | decision determines your healthcare facility's future. |
| weren'taround. You know the general themes: "Ain't it | | | | |