This post summarizes principles that became themes in our ED transformation (No More Lethal Waits: 10 Steps to Transform Canada’s Emergency Departments). Leadership books bulge with other great ideas, too.
[I worry that this post feels a bit breathless, like drinking from a large hose. I promised it for those who do not have time to read the book. Cheers!]
Find out what motivates people.
People are moved by different things. For example:
- Promise of reward.
- Fear of punishment.
- Resonance with concepts.
- Appeal to morality.
- Social pressure.
If you only speak to one aspect of motivation, you leave out 80% of your audience.
Learn the language of influence.
Doctors, new to leadership, often act like doctors. They investigate, diagnose, and treat.
This does not work well in administration. Influence starts with relationships, shared project objectives, respect, and commitment to work together. Read more here: influence.
Don’t hide the pain of bad news.
Let people work through it with you in the room.
It takes 5 communications to get one message across.
By now, you have probably heard about complexity theory. Check out How to Lead Using Complexity Theory.
- Baking a cake is simple.
- Sending a rocket to the moon is complicated.
- Raising a child is complex. Success with one child is no guarantee of success with the next.
Too often, military and machine metaphors dominate healthcare thinking. Metaphors shape our solutions. Mis-applied metaphors feel awkward and hold teams back.
Learn to Love Conflict
Do not blame conflicts on personality. Look for the ideological debate that underlies the conflict. Very few conflicts are only about Jungian clashes: Personality Conflict – An Excuse Great Leaders Never Use.
Focus on outcome, describe success. People engage when things matter to them, make a difference to them, and are enjoyable for them.
Form follows function, and function follows purpose. We need to understand our purpose in medicine.
Stakeholder needs, wants, and preferences shape what we decide to accomplish but should not block positive change.
Spend time learning about governance. Here’s two earlier posts:
These days, no one gets fired for saying, We’re going to lose!
Clinical competence is necessary but not sufficient for outstanding performance.
Attitude must be a key measure of Performance Management.
Process vs Leadership
People change the names but never tire of chicken versus egg debates:
- Which comes first?
- Can leaders lead transformation without a process destination?
- Can departments change, without leadership, if the destination is clear?
I think leadership comes first. Process based on rigid designs that offer grand solutions never work as promised, outside of car factories.
Even assembly line technicians use skill and judgement.
Complex, messy systems, like healthcare, require leadership before process. Terrible processes can perform reasonably well with outstanding leadership. But we need both for excellence.
That gives you a taste of Step 9 in No More Lethal Waits: 10 Steps to Transform Canada’s Emergency Departments. One more to go!
Photo credit of my dream guitar Gibson ES 175