Solution Saturday: Hired to Get Them In Shape
I’ve followed your blog for along time and have used many of your thought-provoking ideas. But I have run into something I’ve never come across before and would appreciate your thoughts.
I am a department director in healthcare, who has been recruited to “get a clinical department into shape”. The personnel have been allowed to work whenever it is convenient for them, however they want.
From a scheduling standpoint that is disaster, and from a patient care standpoint it’s dangerous.
I’ve also added inherited young salaried supervisors who constantly bicker among themselves, who constantly complain about not being paid overtime, who constantly give the excuse that they don’t have enough time to meet regulatory standards & deadlines, and who rarely, if ever, have a positive attitude.
Their expectation is that I will “fix” all of their woes.
I’ve tried talking/guiding them individually and as a group. We’re now reading “Reality Based Leadership” with guided discussion from HR. I’ve explained to them my vision for the department and expectations of them. Nothing seems to help. In fact, I feel that their attitudes are even worse, with a comparable impact on their staff and patient care.
Short of firing all of them and starting over (hard to do since they’re also 50% working supervisors and we’re understaffed although making progress on recruitment), do you have any suggestions.
Thank you for taking the time to read this,
Hired to get them into shape
An optimist would say, “What a great opportunity to lead!”
A pessimist would say, “When you took this job, what were you thinking!”
In either case, my hat’s off to you. The road ahead will expand your leadership, if you continue with an open mind and clear direction.
The first person to change is you.
Stop doing what isn’t working. You’ve tried talking and it didn’t work. More talking isn’t going to change anything. The staff knows that hospital leadership is all bark and no bite.
Build partnerships. You wrote, “I’ve tried,” and “I’ve explained.” Both statements, taken with the rest of your email, have the feel of an outsider. I could be off base on this, but the first barrier to break is the one between you and your team. The first thing that comes to mind is sharing power.
You’re working too hard.
7 steps to establish a scheduling team:
You mentioned that scheduling is an issue. I wonder if there is a way to establish a scheduling team?
- Determine the purpose of a scheduling team. You might say, “Scheduling is painful for everyone (Problem). I want to make it better (Intention) so that patients are served well and staff feels in control.” You’ll need to come up with your own purpose statement.
- Discuss this with your supervisor so that he/she is in the loop.
- Recruit three or four respected staff members. Do this early. Don’t work out the plan and give it to them. Explain the purpose and intent in language that makes sense to them. Ask yourself how their lives will be better by being on the Scheduling Team.
- Establish the plan together. Don’t do it for them. Too often, leaders do the prep work and expect everyone to love the plan. People commit to the plan they design, not the one given to them.
- Create system that makes scheduling as easy as possible.
- Explain the purpose and plan to staff. Ask for feedback.
- Run a pilot program and evaluate results.
Tip: Transparency is your friend. When someone complains about the schedule, let it be known in the scheduling meeting. When someone is happy, celebrate.
My suggestion is based on three ideas.
- Talking isn’t working.
- Leadership is partnership.
- Culture change is about behaviors.
- Build relationships outside your organizations. Find a coach. Buy lunch for some mentors. Complain a little. Seek practical – behavioral – solutions.
- Put some bite in your bark. Remove the worst offenders, even if it seems painful. Put them on probation. When they don’t correct the situation, remove them.
- Write a brief weekly newsletter. Celebrate successes. List challenges. Seek feedback. Invite staff to write short articles. Perhaps a great patient experience they had, for example. The email must connect directly to the purpose, plan, and goals of the Scheduling Team.
- Give feedback, both positive and corrective. When you see useful behaviors, pat people on the back. Negative situations often cause leaders to ignore positives. There are some good things going on in your department!
- Smile, but don’t make light of challenges. When something doesn’t go well, pick the scab off. Don’t minimize issues. However, approach them with a forward-facing stance.
- Study culture change.
- Write a gratitude list every morning. Include three things that make you grateful.
- Record something praiseworthy about everyone on your staff. I’ve found this helps leaders accept people, even if those people aren’t a fit for the organization.
- Thinking, Fast and Slow, by Daniel Kahneman.
- Nudge, by Richard Thaler.
- The Power of Moments, by Dan Heath and Chip Heath.
- Don’t allow the dark to overshadow small flickers of light. Create and celebrate small wins.
When this is behind you, you will be a different leader. If you work on yourself, you will be a better leader. But if you blame others, anger and bitterness will eat at you.
You have my respect and best wishes for success,
What suggestions might you offer to “Hired to get them in shape”?
*I lift the 300 word limit on Solution Saturday.
Understanding scheduling fist for their clients is critical for staffing, remember ” we are here for them.” As Healthcare providers that is mission critical.
The individuals who had free range need to be controlled through policy for all or leave.
Ask yourself why you chose Healthcare? It’s not about you , it’s finding your purpose to help people get better as best you can!
It also sounds like there are to many Chiefs and not enough workforce delegation.
The over time issues can be fixed with scheduling, not to mention shift differentials to compensate. Healthcare is everyday like it or not! You choose the path that fits.
Thanks Tim. “It’s not about you,” says it all!
Wow, excellent feedback for an extremely difficult situation! I learned a lot from reading both the problem and solutions! Thank you for sharing! One thought in healthcare. The whole system is under the stress of crisis. It is felt from the halls of congress to the hospital room and home health bed. All workers are straining under a culture of insecurity and fear of change.
A major shift in healthcare mindset is from serving the regulatory and administrative bodies to becoming consumer centric. The patient becomes the target of the services provided. If you can help the team make a mindset shift to what is best for the patient, the regulatory standards will be met by default as they actually exist to assure patient care over profit.
Thanks Paul. Your observation about turbulence in healthcare is powerful. It’s all the more reason for teams to pull together.
The shift toward consumers is more painful with all the uncertainty in healthcare. I don’t want to be overly optimistic, but this is an environment where leaders can make a difference.
WOW! This is a keeper forever! So many good ideas and advice here, Dan. Thank you so much!
I am most appreciative of your start, which to demonstrated the need to the end-customers…the patients. Reminding colleagues that this is the source of the need is very powerful in helping them hunker down and accept change.
There is so much more I could praise and comment on, but I’ll stop there.
Thanks Stephanie. It’s too easy to forget why we do what we do. We start to think it’s about us. Thanks for dropping in and your kind words.
Sent from my iPad
Thanks Dan this is great! I am going to get those books asap. I am in a similar position although right now things seen to be going better than hired (although this could change at any moment).
I am also in health care, I asked the staff within the first couple of weeks (within context), what would we want our clients (patients, Drs, nurses etc) to say about us as a team? This seemed to be a bit shocking for some of them, once we got through the surprise at the question we worked through what we wanted e.g. kind, caring, empathetic, efficient and accurate service and then worked out what we needed to do to make the clients think these things. When someone seems to get off track I gently remind them and it seems to help. Having said that I’m only in stage one so this method will need to adjust but having a team vision created by the team seems to be helpful.
Thanks Bethany. Your question really sings. “What would we want our clients to say about us as a team?” That sure gives us something to mull over and take action on.
A follow up, what will we do today that might cause our clients to say what we want them to say about us?
Here’s another question, “How do we want our clients to feel about themselves/us?” “What will we do to produce that feeling?”
Oh I love this follow up question about feelings! I’m going to find a way to integrate that into team conversations at some point. Talking with this style of language in health is sadly quite new but I plan to continue to refocus staff in this direction.
Powerful post. The question in my mind would be, Has “Hired” determined that the supervisors he has to work with are indeed qualified for their positions, or for what the positions need to be?
Good question, Alan. Perhaps, Where are then now? Where do they need to go?
Dan – your advice is loaded with great ideas and crisp. It is for “keep”!
Point 6 – Study Culture Change is too wide in scope! What would be you best advice for starter! Are their any books or your past blogs which could be used for culture studies – diagnosis of cultural ills and course correction strategies naturopathy, pills or surgery?
Thanks once again for your daily dose on leadership.
Hi Vinod. Thanks for your question. Here is a short list of books that focus on organizational culture.
Organizational Culture and Leadership, Edgar Schein. (A standard in the field. It’s not an easy read.)
The Advantage, Patrick Lencioni.
The Culture Engine, S. Chris Edmonds
Another suggestion would be to study Zappos and Google. They have had an interesting journey. Zappos in particular has had it’s ups and downs.
An elephant in the room is that the originator has been “hired to get them into shape”, that is to say he has been (in the view of the original team) imposed from above to change them because they are perceived as not being up to scratch.
Based on my own experience of having to go in and do something similar, he is less likely to be perceived as a saviour and servant, and more as a management-appointed kicker of butts and knocker of heads. Until he isn’t seen as “the enemy”, the originator is not going to get much traction.
Hopefully, there is some common cause he can play to (patient safety?), to get himself seen as part of the team rather than “the boss”.
Thanks Mitch. You picked up on something important. That’s why I wrote about partnership.
I didn’t explore the issue of upper management, but it’s an important factor for success.
> “supervisors who constantly bicker among themselves, who constantly complain about not being paid overtime, who constantly give the excuse that they don’t have enough time to meet regulatory standards & deadlines”
> “we’re understaffed”
I guess Hired would agree they have a point about not having enough time.
Maybe the new hires will help there.
The bickering and the complaints about overtime, I suspect, are connected.
If there’s no reward for doing overtime, and no formal means for sharing it around, then it’s probably allocated by the ‘who complains the least’ principle. If that’s typical of the culture, then that would explain why bickering is a large part of the culture.
If so, then a move to a fairer distribution of load is going to create winners (those who currently don’t complain much) and losers (those who currently complain the most).
If so, then Hired might have more potential supporters, but only if s/he can give them ‘protection’ to speak out safely.
Thanks Ben. Love the underlying idea of creating a safe environment. Psychological safety is important.
Even as I respond, I wonder if there are people on the team who don’t speak their mind because of fear. They might fear the complainers. Definitely something to explore.