A High-Performance Culture Based on Teams – NOT Programs! Eight Steps

Don’t Assume There are Effective Teams to Implement Your Program

Every brilliant organizational initiative assumes that you have leaders and managers with the team-building skills for successful implementation.  How many programs fail to live up to their potential because of team dysfunction? The good news is you CAN build effective teams.

Healthcare is prone to dysfunctional teams.  Why?

  • We are an industry built around silos.
  • There is a culture of expertise, and of being right – which can impede open, productive collaboration and a healthy approach to conflict.
  • Sometimes people value professional autonomy over achieving a team goal.
  • The decades-old dynamic of clinicians not trusting administrators (even when they come from their own ranks).
  • Clinical professions often promote a healthy skepticism that is beneficial for scientific inquiry, but can be counterproductive in other areas.
  • Individuals can sometimes rise to high levels within their own discipline without developing effective collaboration, emotional intelligence, communication, leadership, and team-building skills.

(We wrote recently about “Healthcare’s Dysfunctional Team Problem”)

Certainly, we’ve all worked with outstanding teams, but these don’t happen by accident. 

Certainly, we’ve all worked with outstanding teams, but these don’t happen by accident.  More often than not, they exist because a leader – a physician, nurse, or administrator, is particularly adept at team building.  But it’s not the norm and it’s not usually because an organization is deliberately and consistently focused on building teams as the most important way to ensure high performance. 

Think in Terms of Teams

Rather than thinking about initiatives as top-down, organization-wide solutions, we should be focused on building effective front-line teams that can successfully implement these solutions. 

Creating effective teams, though, requires motivated leaders and a highly interactive approach at the ground level.  When we work with teams of leaders, managers, and even physicians, we find some combination of the following issues getting in the way: 

  • The strategy has not been effectively communicated
  • There is underlying unaddressed team conflict
  • A lack of role clarity
  • The team isn’t effective at addressing operational barriers
  • The team never reached consensus on the goals or how to measure success
  • Leaders are inexperienced or lack specific skills (change management, communication skills, team-building, establishing a culture of psychological safety, flexible leadership styles, conflict resolution, etc.)
  • There’s been no attention to culture, norms, team behaviors, conflict or effective team communication.

If a team is willing to do the work, they can make substantial progress and learn these skills WHILE working on resolving real problems.  The work reveals the challenges, and provides a structure to improve how they function while working on achieving common goals.  They build trust and leadership/team skills through interactions – not through generic, didactic training.

They build trust and leadership/team skills through interactions – not through generic, didactic training.

Support Front Line Managers

Most organizations make the mistake of promoting outstanding individual contributors to manager roles with little support or training.  They struggle to survive, let alone thrive and build engaged, high-performing teams.  In our experience, though, they want to succeed!

These people are at the front lines of these initiatives, but building an effective team requires a unique mix of skills –  skills that few new managers bring to the role:

  1. Self-awareness
  2. Learning agility 
  3. Communication skills 
  4. Political savvy
  5. Motivating others 
  6. Influencing outcomes

Where is the training and support for front line managers?

Leveraging the Psychology of Teams

We’ve learned from other industries that performance is directly related to how well teams function, but healthcare organizations spend precious little time talking about, understanding, or improving team function. 

[H]ealthcare organizations spend precious little time talking about, understanding, or improving team function.

When it is addressed, it’s often done in a manner that doesn’t resonate with managers and staff.  Success requires a combination of

(1) Expertise in behavioral and organizational science;

(2) A practical understanding of the operational issues;  AND

(3) The ability to communicate that the initiative is in each team-member’s interests – it needs to be about their success!

What we know about teams:

  • Employees are engaged when they have a clear sense of purpose, shared notions of what’s important, confidence in the future, and feelings of psychological safety.
  • The best teams work to build trust, are structured to encourage frequent interaction with managers and leaders and “learn together” – (work together on shared learning initiatives that have direct and immediate impact on their success – rather than individual, generic, didactic training)
  • The inability to foster relationships and build an effective team is one of the challenges that most often derail a healthcare leader.

Teams function well when the members:

  1. Believe that it functions with a basic sense of fairness
  2. See each other as dependable
  3. Have role clarity
  4. Demonstrate effective communication skills
  5. Handle conflict in a healthy, productive manner
  6. Appreciate the meaning in their work
  7. Feel a sense of “cohesion” – a shared intentionality and mutual support
  8. Create a culture of psychological safety
  9. Trust each other.  Trust is built over time, by members learning that their fellow team members are competent, and act with benevolence and integrity.

The Leader’s Role

Team dysfunction, is NOT the fault of the team-members.  A group of people rarely gel as a team on their own.  Leaders choose the team, model behaviors and put structure, and processes, in place that help teams function – or foster dysfunction.

How We Go About It

Have a team struggling to meet its goals?  Are you willing to dig into understanding why, and doing the work to build a high-performing team? 

(One of the tools we’ve been using in our work with teams was created by the experts at Deeper Signals.)

Try this approach.

  1. Make the entire initiative about the team and the individuals, their success and what they care about.
  2. Start by having the group identify its goals.  This starts them down the path toward cohesion, but it requires an open, frank discussion.  It’s amazing how many times a group has never really discussed the their goals and what they care about.
  3. Next- An honest discussion about what barriers exist to achieving the stated goals.  It could be operational issues, organizational structure, poor communication, a lack of trust – anything.  Don’t judge the opinions you hear.  Allow the group to express their opinions, but, as much as possible, re-frame things in a positive, solvable, light.
  4. Prioritize the challenges – Often it helps to organize them into three categories:  Outside influences you can’t control; operational issues you can; and group/culture issues that need to be addressed. 
  5. What can we improve?  What training, or resources are required? 
  6. “Training” should teach the fundamentals but have the group apply them to solving  real problems -all the while modeling effective team dynamics and communication skills. (Again, “learning together.”)
  7. Where necessary, take advantage of skilled individual coaching resources.
  8. We believe in starting this process with an exploration of self-awareness.  Each member of the team must be willing to examine his or her own barriers and challenges.

To learn more about our innovative approach to working with healthcare teams, visit us at www.j3phealthcaresolutions.com