Solution Saturday: Hired to Get Them In Shape

Dear Dan,

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

Dear Hired,

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?

  1. 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.
  2. Discuss this with your supervisor so that he/she is in the loop.
  3. 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.
  4. 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.
  5. Create system that makes scheduling as easy as possible.
  6. Explain the purpose and plan to staff. Ask for feedback.
  7. 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.

  1. Talking isn’t working.
  2. Leadership is partnership.
  3. Culture change is about behaviors.

10 suggestions:

  1. Build relationships outside your organizations. Find a coach. Buy lunch for some mentors. Complain a little. Seek practical – behavioral – solutions.
  2. 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.
  3. 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.
  4. 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!
  5. 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.
  6. Study culture change.
  7. Write a gratitude list every morning. Include three things that make you grateful.
  8. 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.
  9. Read:
    1. Thinking, Fast and Slow, by Daniel Kahneman.
    2. Nudge, by Richard Thaler.
    3. The Power of Moments, by Dan Heath and Chip Heath.
  10. 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.