Am I serving the group?

At work, I have been sharing with many teams lately about the concept of reflection as a reflex. The concept is about using what Viktor Frankl described in his book Man’s Search for Meaning as the space between stimulus and response. Stephen Covey also included this concept in The 7 Habits of Highly Effective People.

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At times in my career, I have found myself hesitating in meetings. Reflecting on it, I think I hesitate because of things like Automatic Negative Thoughts (ANTS), fear that what I say will sound obvious to the rest of the group, or that others in the room are smarter or more experienced than I am and I probably do not have anything of value to contribute. Is this something you struggle with too?

Over time, I have learned a quick “test” that has helped me and I hope will help you too.

Any time I hesitate to speak, I ask myself, “Will what I am about to say serve the group?”

This yes or no question gives me enough time to reflect without missing the germane part of the conversation and to make a decision on whether my comment will add value to the discussion. This question is also consistent with my personal definition of leadership and my desire to practice servant leadership. It gives me the confidence that even if my comment is controversial, it will be received in the right way because my motivation is service to the group.

I use this test in almost every meeting that I attend. It helps me to reflect in the moment and make sure that I am contributing at a high level. The test also keeps me centered. For example, the “test” prevents me from being too quiet or too dominant because my comments are always in pursuit of service to the group.

I hope you find value in this test as well and it helps you create better and more productive meetings.

KEY TAKEAWAY: Leaders can practice reflexion in most contexts, including meetings. Before you speak, simply asking yourself, “Will what I am about to say serve the group?” will give you the confidence to speak up and reflect the authenticity of your point of view.

 

Miracles

A few weeks ago, my wife and I were in Atlanta on vacation. I had been excited for years to go to Atlanta. Not only is the city wonderful (my wife raves about it after having lived there for two years as a graduate student at Georgia Tech), but it’s one of two cities with the “Trifecta”: A ballpark, a Presidential Library, and a State Capitol building.

I enjoyed going to all three, with the icing on top being an Atlanta United vs. DC United game at Mercedes Benz Stadium, which is one of, if not the best place I have ever seen a sporting event. But it was an exhibit at the Jimmy Carter Presidential Library and Museum that made me think and want to learn more.

The Carter library has an entire exhibit on the Israeli-Egyptian peace process, facilitated by Carter, which took place at Camp David. The exhibit describes the 13-day marathon negotiation that yielded peace between Israel and Egypt. The exhibit displays copies of President Carter’s notes about the personalities of the other two country’s leaders; Prime Minister Menachem Begin from Israel and President Anwar Sadat from Egypt and many pictures and artifacts from the summit.

Carter Library

Photo taken at the Jimmy Carter Presidential Library and Museum on July 19, 2019

Ultimately, the long negotiation concluded with peace between two neighboring countries, who were previously in an almost constant state of war. The exhibit alone was not enough to satisfy my curiosity, so I read the book Thirteen Days in September: Carter, Begin, and Sadat at Camp David by Lawrence Wright.

My main takeaway from the book is that the outcome of a peace treaty from the summit was nothing short of a miracle. The three principle leaders had to set aside both ancient and modern history and religious beliefs just to begin negotiations. The outcome of the talks were constantly in doubt, and the three delegations had personalities that the others could not stand to be around. Even within the delegations there were stark differences of opinion, style, and personalities.

There have been a couple of events recently that have made me reflect on a concept that gets thrown around a lot: diversity. The benefits of creating diverse teams is well documented, yet we still struggle with an enduring distrust in the “other.” This made me wonder if diversity is a relatively new construct for humans. Since international travel is a relatively new concept, did our ancient ancestors only associate with people who were like them? Do we lack the muscle to embrace the other in a way where we can solve problems together like the leaders did at Camp David?

I find that coming to comfortable agreement even among people who share similar backgrounds can be challenging because everyone has a unique perspective. When we layer on history, personality, faith, etc, the odds of reaching agreement or collaborating on the most critical issues of our time get more and more challenging.

It has made me realize that the miracles I believe in are not acts of nature or coincidence, but those instances where diverse people can come together to solve problems. In my experience, diversity of thought and experience tend to make solutions better for all involved. Yet the pull of how we are different from one another can be stronger than the push of our commonalities.

I believe in diverse teams and I thoroughly enjoy living and working in diverse environments. The benefits of living in a diverse society, however, can only be reached if we listen intently to one another and turn off the filters of distrust.

What happened at Camp David was a miracle that produced incredible benefits to the Middle East and the world, ending wars and establishing peace. As leaders, we must help the world embrace diversity and candor to create more of these miracles that produce diverse and inclusive societies.

KEY TAKEAWAY: Diverse groups of people living and working together can produce tremendous benefits. Leaders should embrace diversity, while creating an environment where people from diverse backgrounds can explore their differences, while embracing similarities to create thriving organizations.

Book Review: Prescription for Excellence

You may have noticed that health care has been in the news a lot recently. Whether it is the Democratic Party presidential candidates talking about their plans, price transparency, or access to prescription drugs, it is fairly safe to say that the current system is not working for a group of people in our country.

There is so much to fix, including the experience of receiving care. Many patients experience customer service outside of health care and they expect that same level of care, treatment, ease, and convenience.

RxforExcellenceSeveral years ago, the University of California, Los Angeles (UCLA) health system decided to work on fixing the experience of care. Their results were astounding, going from the 30th percentile of U.S. hospitals to the 99th percentile. Dr. David Feinberg, the then CEO of the UCLA hospital system (he has since run the Geisinger Health System and now is the VP of Google Health), was committed to doing better as the UCLA system grew in Southern California.

Using the lessons from other retail leaders who are known for their customer experience, UCLA did some progressive things to enhance and enrich the hospital’s patient experience. The progress is summarized in Joseph Michelli’s book Prescription for Excellence: Leadership Lessons for Creating a World-Class Customer Experience From UCLA Health System.

I appreciate that Dr. Michelli, who has written on companies like Starbucks and the Ritz Carlton, used part of his introduction to the book to acknowledge why it was important for him to write about a health care organization. The demands are high, regulations abound, safety is paramount, and politics are rampant. Delivering excellence in that environment is a unique feat and one that keeps those of us who are part of the business aspect of health care both fired up and very busy.

What I enjoyed about Prescription for Excellence was learning about the leaders from the organization who invested in the patient experience system, called “CICARE” (pronounced See-I-Care). Leaders modeled the behaviors that they asked the staff to model as well, and they were constantly present, speaking to patients to learn more about their care.

What UCLA figured out is that, just like in another industry, the three main elements of hard-wiring a consistently excellent and customized patient experience are: alignment, empowerment, and engagement. CICARE was their system of alignment, they empowered the team to act on it by training them, and engaged them in the work, partly by emphasizing the importance of it.

The following quote in the book sums this idea up nicely, “Relationships-based caste is often about empowerment. Empowerment starts with leaders giving staff members the tools and the trust they need to provide extraordinary service. Those tools include structure service behaviors…When well-selected employees are given resources, trained, and empowered effectively, extraordinary service relationships developing, and customers are empowered to build skills that meet their needs.” (Michelli 64).

Developing systems and allowing people to innovate within those systems are keys to delivering service excellence whether in health care or any other industry.

KEY TAKEAWAY: Excellent service systems are created from aligned, empowered, and engaged team members.


Prescription for Excellence is available for purchase on Amazon for $30 (does not include Prime discount)

Who’s “in the box”?

My wife and I have been traveling more than usual over the last couple of weeks. Like clock work, when we are in the airport (usually in line to board the plane), I look at my wife and say, “Uh oh. I am so in the box right now.”

What I am referring to is an anecdote from the book, Leadership and Self-Deception published by the Arbinger Institute. The book discusses how many of us remain “in the box” in our work lives, where we tend to see people more as objects or obstacles rather than as people who have the same hopes, desires, needs, and wants that we do.

By way of example, picture boarding a Southwest Airlines flight. They are known for their unique boarding process where passengers are not assigned seats, but are instead assigned boarding numbers that create a queue for entering the plane and choosing any open seat. When traveling with a companion, most people with early boarding numbers sit one on the aisle and one on the window, hoping the plane is not full, and no one will choose to occupy the middle seat.

Angie’s post as part of “Project Outward” about our conversation about Leadership and Self Deception

However, the people with later boarding numbers are still people. They want to enjoy a flight that they purchased and reach their destination safely and comfortably just like anyone else would. But when we are sitting in our self-selected seat, avoiding eye-contact in hopes that the next passenger walks past us, those other passengers lose their humanity in our eyes and become an obstacle to our wants. When we do that, we are “in the box”

The book goes deeper to unpack this idea in a user friendly, narrative form. It explains how we get into the box and what we can do to get out of it.

Reading this book has made me think deeper about being “in the box.” I am more aware of times when I view people critically rather than trying to see the whole picture. It is a vital concept in patient or customer experience, because sometimes we create systems that put bedside caregivers,”in the box.” In those cases, not only are other people in the organization seen as obstacles, but our patients can be seen as obstacles too. In that environment it is almost impossible for one to display the empathy needed towards a patient in the hospital.

One of the biggest benefits of the book is the use of common language, including the “in the box” phrase. One of this blog’s loyal readers, Angie Bryl, Clinical Director for Dankmeyer Prosthetics and Orthotics, has used Leadership and Self Deception to advance the culture of her organization. Team members at Dankmeyer frequently use the term “in the box” to point out barriers in collaboration between team members. She has found the framework helpful not only at work, but personally too.

I have enjoyed Angie’s Facebook posts called, “Project Outward”, which she writes about people in her life who inspire her or make her think more deeply about a topic. She told me that being focused on being “outside of the box” has helped her be more true to herself, be more generous, and be less inhibited when her initial instinct is to do something nice for another person.

It is for all of those reasons that I recommend we follow Angie’s example and really internalize all of the lessons in Leadership and Self Deception. Angie gifted me a copy of the book and shared her experiences with me. I think it is making me a better person, both at work and in my personal life, and I so appreciate the thoughtful recommendation and gift. I only wish I had read it sooner!

KEY TAKEAWAY: Being “in the box” means seeing people as obstacles rather than as human beings with needs and wants just like us. As leaders, we must take steps to encourage team members to live “out of the box”, especially when interfacing with our patients or customers.


Leadership and Self Deception is available for purchase on Amazon for $16.95 (does not include Prime discount).

Empathy in action

Several months ago, I ran across this emotional video about the power of empathy and leadership in health care:

I often share this video and Jap’s story for several reasons. His positive attitude, coupled with his thoughts of wanting to do more with his life are inspiring. While his injury took away the use of his legs, it gave him a fresh perspective and new motivation in his life.

From a health care delivery standpoint, Jap’s story teaches us that we must do more for our caregivers and that anyone in the hospital can lead to make a patient’s experience better.

As you watched the video, did you notice what happened when Jap woke up from his accident? The first thing he did was scream out. But, nobody came to his aid. He was on the “diving accident floor” in the hospital, and according to the nurses, everyone on that floor screams after they regain consciousness. To the nurses, every scream was, “just another day at the office.” To Jap though, it was one of the scariest and worst moments of his life, and he was alone.

In my current role, one of my main responsibilities is to work on this very issue. Clinicians can become used to or numb to other people’s suffering. It is not because our bedside caregivers are bad people or doing something wrong, it is simply because of the nature of the work. Part of the role of patient experience is to create systems to remind caregivers that, for the patient, this is not just, “another day at the office.” Part of this work is done by creating mechanisms to constantly remind caregivers that our patients do not come to work in a hospital and the days they are here are unique to them. We must help caregivers connect to the fundamental emotions of most patients: That they are scared, stressed and confused.

The other lesson Jap teaches us is that anyone can lead. Carlos, Jap’s nurse in the ICU, not only goes to him when he screams, but instructs the other nurses how to comfort Jap. Carlos was behaving in a way that creates positive, peer-to-peer accountability. Carlos authorized himself to help the entire team care for Jap in his hour of need. Carlos took it upon himself to provide the reminder that this was a unique day in Jap’s life and he will need help to get through it. Carlos embodied how, in hospitals especially, patients expect more than just us treating a disease or an injury; they expect to be treated like people.

This powerful video shares these lessons elegantly and they apply to any work that we do interfacing with other people.

Thank you for sharing your story, Jap.

KEY TAKEAWAY: Patient experience is about reminding people to see care through the eyes of the patient and to treat their emotions, not just their physical condition. Anyone can lead in patient experience, it is up to leaders to create mechanisms for peer-to-peer coaching and accountability.