Comments

"!!!"

Posted by Dan Gunter at May 6, 2009 10:05 AM

I guess the devil in this detail is that "getting done what is necessary to get done" might be subject to different objectives.

The Hospital Board thinks financial performance is what needs to get done and the staff thinks patient care is what needs to get done.

This dangerous mis-alignment has existed in every company I have worked for; it all starts with the mindset at the top.

Posted by Roberto at May 6, 2009 1:10 PM

Roberto,

I know this situation all too well. As a hospital CQI Director & Risk Manager, I was compelled to answer to ALL the stakeholders:

• The patients who needed and wanted excellent care,
• The Board/Administration who wanted to stay in business, and
• The caregivers who wanted to provide quality care AND keep their paychecks.

The hardest thing to do is to get people from all three of the above groups to sit down and agree to what we will refer to here as "What HAS to be done." In other words, agreeing that staying and business AND doing the best possible job (allowing for circumstances while trying your best to work around those or change them) is absolutely necessary.

It is a very difficult process because -- as you pointed out -- the primary objectives can be different between groups. If you have a hospital board comprised primarily of people who care AS much about quality of care as they do financial results (not more, but in balanced proportions) then count yourself very fortunate.

In the end, the key to survival is for everyone to accept ALL the constraints AND needs involved. This is not a time for warfare. Instead, it is a time to pull together and find solutions that truly address the needs of all stakeholders. Unlike other businesses, failure to address ANY of the critical needs mentioned above means more than just lousy products or services that lose business -- someone is likely to lose their life.

Posted by Dan Gunter at May 6, 2009 3:48 PM

Which all goes to underline the importance of managers making clear to their teams what the job IS. To many people are condemned to "do their best" in the absence of a clear definition from their manager of the overriding goal or the task.

Posted by RobCH at May 8, 2009 5:22 AM

RobCH,

I hear you, my friend. Ambiguity about what "The Work" consists of only begets ambiguous results. Management can not throw blame at anyone else but themselves for failures that result from not doing the up-front work of sitting down with the team and reaching agreement on ALL of the goals and objectives. To put it another way: "Don't you dare to try and hold me accountable for results you didn't even tell me we were going for, and don't withhold the information I need to figure out if I'm accomplishing them."

Ironically, I have seen companies that preach "customer service" all day to their front-line and middle managers, then do a 180 on them when the bottom line takes a nose dive. They then switch to crisis mode and everything is about cutting corners. This sends very confusing messages to the team, making them feel tossed around and as though they were being lied to about the importance of customer service.

For many years, Tom Peters, et al have tried to drive home ideas like "open book management." As said many times by many people, if a person can learn to balance their own checkbook and manage their personal finances, they can learn to read the bottom line on a financial statement -- and everything above that bottom line.

Don't even try to hold people accountable for results that they don't feel a direct connection to.

(1) Get everyone involved in defining "The Work."

(2) Get everyone involved in defining the general values that are behind the methods, and devising the methods and tools that will be used.

(3) Get everyone involved in identifying known "failure points" (don't repeat known mistakes -- learn from them.)

(4) Get everyone involved in determining the measurements that will be used to figure out "how we're doing."

(5) Get everyone involved in determining where we stand regularly, based on the data and feedback -- and make sure everybody can interpret it on at least a basic level. NOTE: that's not to say that everyone has to draw the exact same conclusions. It's important that people be allowed some room to "read into" the data and spot correlations, trends, and possible cause/effect relationships that might otherwise be overlooked. Sort of a "loose/tight" interpretation philosophy, if you will.

(6) Get everyone involved in coming up with ideas for course corrections and improvements regularly.

(7) Get everyone involved in the rewards for team success. Important note: avoid creating competition BETWEEN team members. If you want people to pull together and BE a team, then make the rewards TEAM rewards. Grab and hang onto the Marine's motto of "No man left behind." Encourage the TEAM to pull the weaker members in and support them. It's tough, but if done right, ineffective and permanently dysfunctional team members will eventually weed themselves out typically. Not always, but I dare say more often than not. Nobody likes being where they don't feel they fit in.

Note the common denominator of all of the above items: GET EVERYONE INVOLVED. The fine line between embracing and utilizing diversity and total, dysfunctional chaos is communication. And that starts with management laying everything out on the table for everyone to scrutinize and prioritize. Nobody will every "buy in" otherwise, much less really get behind the wagon and push.

I humbly admit that this is not THE DEFINITIVE "HOW-TO" list for team/organization success. But I do maintain that it is A list that can be used as a jumping-off point for building a "learning team" that is all pulling in the same direction and addressing ALL the objectives, instead of constantly changing priorities in mid-stream.

Posted by Dan Gunter at May 8, 2009 8:57 AM

I’m with you Dan - When you get ‘everyone involved’ in my experience it may sometimes feel like a tortuous and difficult route but it is …. by far … the most rewarding route. The ‘everyone involved’ philosophy will ALWAYS beat camps of people talking in their own silos.

I hope you are sitting down Dan and you are ready for this earth-shattering piece of profound wisdom from li’l ol’ England on a Friday afternoon:

“A team is either a team or it is not a team” – Trevor Gay

Have you recovered?

You simply cannot call a bunch of people a ‘team’ if there are things going on that some are involved in and some are not. The best team captains know that in their ‘team’ everyone has a role; everyone has a place; everyone is valued; everyone can learn from everyone else; everyone relies on everyone; there are no secrets; there are no surprises. The list goes on …. Make up your own.

Can anything be simpler than this?

Posted by Trevor Gay at May 8, 2009 9:56 AM

Trevor,

One of the best summations I've ever seen on the steps need for a team to achieve improvements:

• Forming
• Storming
• Norming
• Performing

Have you seen this before?

Posted by Dan Gunter at May 8, 2009 12:32 PM

Yep Dan - I've referred to the model often in my work in team development. Personally I love the forming and storming stage ... that’s when the creative juices flow - norming and performing are about finding our place in the team and then delivering. I like the model and with positive recruitment of new team members to challenge the norm, the cycle can keep on starting over. This prevents stagnation in teams. Nice and simple once more! Re-invent your team regularly. My hero Sir Alex Ferguson – Manager of Manchester United is the master at re-inventing a world class team.

Posted by Trevor Gay at May 8, 2009 12:56 PM

If you can effectively navigate THIS cycle, then the Shewhart/Deming "PDCA" cycle can be put to good use. But screw up on the Forming/Storming/Norming/Performing cycle (especially the first three parts) and you're dead in the water.

Posted by Dan Gunter at May 8, 2009 2:45 PM

That's where many teams fall down. That and the inability to change by welcoming new people into the team. I love the PDSA cycle - more simplicity in action of course. One of the most effective tools in any managers toolkit. Mr Shewhart was way ahead of his time.

Posted by Trevor Gay at May 8, 2009 3:43 PM

Dan I would say that many managers also suffer from not knowing what the goal is. All the Excellence in the world won't help if the organisation is heading in all directions at the same time. Setting the goal clearly is what the leader has to do. Then they can, as you say, stand well back and see great things happen.

Posted by RobCH at May 9, 2009 1:49 AM

Hi Rob – hope you are well. Effective leadership is indeed an integral part of excellence. If we want to see an example of where we end up when excellence in leadership is blatantly and staggeringly absent we only have to look at the scandal of MP’s expenses claims that has 'hit the fan' here in the UK in the last couple of days. I Blogged about it this morning. http://www.simplicityitk.blogspot.com/

‘Do as I say not as I Do’ indeed. Where is the leadership? Where is the role model behavior from people we look to for such? No wonder so many people in the UK, including me, are completely disillusioned with politicians of all parties. As a fellow Brit I’d love to hear your take on this Rob.

Posted by Trevor Gay at May 9, 2009 3:20 AM

Trevor a large part of the problem is the excuse that it's "all within the rules" which to me falls into the same category as "I was only obeying orders". We need to believe that our politicians can both discern and live to a higher scale of values, not to do anything they want as long as there is no rule against it. Sadly, very few of they rate as leaders or representatives in my book.

Posted by RobCH at May 9, 2009 4:45 AM

Rob - I have this naive hope that one day I will wake up and find it was all a bad dream and our politicians can be trusted after all not to put their snouts in the trough. Eleven pages all about it in The Telegraph today after nine pages yesterday and apparently still much more to come in the next few days. I think the press should keep digging to expose the lot of them. I hope there will be some learning. I am pleased we now have the Freedom of Information Act. I wonder if we – the public – would ever have known about this scandalous behaviour by our supposed leaders had it not been for that legislation. What irritates me most is the sanctimonious way in which many MP's in the past have criticised the poorest and most vulnerable in our society for allegedly abusing the benefits systems. Pots and kettles come to mind.

Happy Saturday!

Posted by Trevor Gay at May 9, 2009 5:29 AM

Talking of which, our illustrious media hardly have a great track record when it comes to practising what they preach, do they? Pots and kettles indeed.

Posted by RobCH at May 9, 2009 7:26 AM

I guess not but on this one I hope you agree we should support their digging. Some things need to be in the public domain.

Posted by Trevor Gay at May 9, 2009 7:33 AM

What we thought of as journalism is quickly evolving, as the centralized power of traditional media is quickly eroding with the Internet and blogging. Arianna Huffington calls our present era a "link economy," although we are still grappling with the process of how such can be best monetized. There will undoubtedly be another such power base, as there is usually some kind of centralized power or leaders of the pack. But it will not look like what we currently have. This open source is by far too open. Information comes from everywhere. Bloggers have broken stories before the traditional media outlets.

There will probably evolve ethical rules to blogging and reporting on the Internet for serious journalism. Some bloggers and Internet news sources will rise to prominence, while others will not. This is just how these things seem to work. I know that the Huffington Post has been looking at the issue of investigative journalism for some time and have launched an effort to address this, the Huffington Post Investigative Fund, an initiative to launch investigative journalism.

An interesting issue that arises is that of specialized study and experts. Many will perhaps become journalists in various investigative initiatives without having earned a degree in such, without having been taught some of the basics, the rules to the game—if you will. In one sense this is exciting, but in another sense we have to wonder about the rule of ethics and training.

I suppose ethics and training can be built in any area, as they are in any business venture. Ethics are accepted rules among any group and many entreprenuers have had no specific training or education. In fact, it sometimes appears that education in this regard can be inhibitive. I have known a great many very successful entrpreneurs who have had no college degree.

We are definitely in a link era and there is no returning to traditional news sources for information alone, as the appetite for how we get news globally has changed. Links rule. The question is whose links will have value and whose will not and upon what basis will we choose? Who decides?

Posted by Judith Ellis at May 9, 2009 8:51 AM

generic viagra uk paypal Rob and Judith - I worked as a part-time journalist for 8 years early in my career to make extra cash whilst saving for my first house. This was of course a few centuries ago. (This was in addition to my job as a healthcare manager) I was very impressed with the emphasis on ethical standards that the editor of our small provincial newspaper imposed on all of us. Even though I was only part time I was expected to adhere to the same ethical standards as the full time professional journalists. I find myself defending journalists sometimes when they are given ‘bad press.’ Equally I criticise them for poor standards of ethics. I guess - like all professions - there are the good, bad and the ugly :-)

Posted by Trevor Gay at May 9, 2009 11:20 AM

Rob CH,

For some reason my RSS updates for comments aren't coming in right the last couple of days. I missed your excellent post. Sorry.

You are very right. Management, of all people, must have a very clear picture of the goals. Like piloting a ship, it is necessary for them to have their eyes on the destination and a clear enough image of it to recognize whether or not they are getting closer.

They also need the simultaneous ability to keep track of what is happening around the ships -- pirates and sea creatures abound -- as well as what's happening ON the ship. A good captain trusts his crew to make the ship sail properly and in the right direction, but he has to maintain constant two-way communications with all of them.

That's the difference between a simply determined captain and a truly effective one: Leading AND involving the crew. He knows he can't sail the ship alone and they know they need his leadership. And there has to be mutual trust, but that's the topic for another discussion entirely.

Posted by Dan Gunter at May 10, 2009 10:36 AM

Dan,

"Leading AND involving the crew." I would tweak that terrific observation by substituting the word is for and. Many managers rely solely on positional authority...leaders have the skills and credibility to get everyone involved, engaged, and on the same page. Sounds simple. But if were that simple how come more can't do it or worse, don't even recognize the need to do so?

Posted by dave wheeler at May 10, 2009 8:59 PM

Dave,

I wrote an article a few years back (don't remember who it was even for now) titled "So managing isn't working? Try leading." Exactly the point of late in this comment thread. And I agree with your worthy substitution above, with an additional "vice versa" on the end, perhaps. And let's do remember that this is only part of the equation. Combine it with the notion of knowing what "the job" consists of and knowing what the right thing to do is, and you've got some real potential.

I point out the latter about knowing "the right thing to do" because there are some really great leaders out there in terms of rallying troops but they are very misguided. Let's face it: in the most rudimentary sense, Hitler was a gifted leader. He got the bulk of a country behind his cause to a degree that is largely unrivaled in human history. He was wrong as hell in what he thought "the job" consisted of, but he definitely had a following.

Sometimes I think that in the search for advanced "management methods" we totally overcomplicate things to the point that "leadership" and the relative simplicity of leadership gets lost in all the fancy-shmancy technical B.S.

Big, high-fallutin' M.B.A. vs. some good old fashioned common sense and know-how in getting people to rally behind a worthwhile purpose and work together? My money's on the latter.

How many books have we seen on "Management" (and none of them seem to have turned the business world on its ear), vs. books that tell you how to simply be a good leader? Maybe a ratio of like 10,000 to 1? Higher?

Maybe we should quit buying all the management books and go sit down and talk with a good Cub Scout leader or little league coach. They could probably teach us a lot.

Posted by Dan Gunter at May 10, 2009 11:06 PM