(And why don’t we always function like this?)

People WANT to be connected. They WANT to succeed.  They WANT to be part of teams and feel supported.  Learn to take advantage of these needs. Don’t wait for the next Pandemic!

ALAN FRIEDMAN

Healthcare’s Dysfunctional Teams

Healthcare, notoriously, has done a poor job with consistently building effective teams.  We tend to leave it to chance.  The industry is, for a number of reasons, prone to team dysfunction. 

While companies like Google and organizations like the Navy Seals spend a lot energy on how to deliberately and consistently build effective teams – healthcare neglects it, almost completely.

See our blog…Healthcare’s Dysfunctional Teams

The Psychology of Teams

We’ve all heard stories, though of healthcare teams coming together to achieve amazing things under the stress of the Coronavirus Pandemic.  Even groups that have, historically, struggled to collaborate, found themselves feeling like part of a team.

To understand this, we need to review the relevant psychology of teams. What are the attributes of effective teams?

  • Trust – High functioning teams trust each other. According to Dave Winsborough in his book, Fusion, The Psychology of Teams, they build trust by consistently displaying competence, benevolence,  and integrity.
  • A clear sense of purpose – They understand what they are trying to accomplish.
  • Shared notions of what’s important – Similarly, they agree on what is most important, in order to achieve that purpose.
  • Confidence in the future – Leaders and team members work to ensure that members maintain confidence in the future – their own future, and the organization’s.
  • Feelings of psychological safety – The best teams create an environment where people feel safe to challenge ideas, to ask questions, to propose new solutions, and to ask for feedback.
  • Structure and clarity – Teams tend to struggle when roles are unclear or overlap too much.
  • They find meaning in the work– Teams come together when they find meaning in the work –making a difference that matters to them.

COVID-19 Brings Intense Pressure

Let’s examine these attributes in the context of t the COVID-19 crisis:

  • As entire departments dropped everything other than responding to the crisis, people were able to focus intently on clear, simple, goals. 
  • There was cohesion.  People agreed on what was important. 
  • People dropped ego and actually realized, innately, that psychological safety was critical to success – and they behaved accordingly.  
  • People supported each other and knew they were working to save lives.
  • Confidence in the future was less of an issue as they were focused on today, and tomorrow.

I asked Winsborough about this..  His response is insightful:

First, humans are ancestrally hardwired to cooperate in the face of threats to the collective – or in the modern world,  teams only exist to get something done that we cannot achieve alone. So, a clear and present mission acts to enhance teamwork by temporarily causing us to subsume our ego needs to those of the group. 

[A] clear and present mission acts to enhance teamwork by temporarily causing us to subsume our ego needs to those of the group.” 

DAVE WINSBOROUGH
Dave Winsborough
Author Fusion, the Psychology of Teams

Second, leadership becomes more salient in crisis situations.  We push back less and cooperate more.  We drop more readily into the role of followers rather than individual contributors.

Third, we are more emotionally invested in the success and wellbeing of our colleagues – after all, we now need them as much as they need us.  Crisis enhances bonding, as anyone who has been through life or death situations with others will attest.

Fourth, and critically for the medical context, training matters.  Functional teams who have clear roles and where colleagues are competent and trusted perform better.  (https://journals.sagepub.com/doi/abs/10.1177/1046496416676892?journalCode=sgrd).

Practice and rehearsal reduce cognitive load when the pressure is on (which is why combat teams drill, drill, drill.)”

After the Crisis…

Winsborough also points out that “These conditions will hold only for so long before the stress and fatigue begin to pick off the emotionally less resilient and our extremes begin to reveal themselves.” 

Not only will fatigue set in, but after the heart of the crisis, as people move from the focus and adrenaline rush, reality sets in.  The emotional drain sets in.  Frustration, fear, and reality set in.  On top of this, there is the new pressure of how to get departments back up and operational.

The variables that drove the focus, cohesion and psychological safety, go away.   These teams, that have not been, particularly, cohesive before the crisis, are now facing new, unknown pressures. Whatever team dysfunction existed before returns, often exacerbated.

See our Blog:  Ten Early Physician Leadership Lessons from the Frontlines of COVID-19 

The Best Teams

The best leaders, and the best teams, will evaluate their performance and acknowledge that the crisis was the perfect example of the psychology of teams in action.

We are encouraging clients to dedicate time to examining these principles.  Point to the performance as proof that attention to specific team attributes, and the behaviors that are required, deserve attention.

We CAN build effective, high functioning teams, consistently, WITHOUT the pressure of a crisis. How?  Teach leaders and teams the specific skills that create and support the attributes, above.  It can be done.  Google does it.  The Navy Seals do it.  Healthcare teams are made up of incredibly dedicated, talented, intelligent, passionate people. 

Integrate People, Strategy and Performance

Our work continues to teach us that they CAN function as teams if we give them the structure and support that they need.  When they succeed, it drives outcomes, and physician, nursing and staff engagement, and joy.

The Key?  Not separate didactic “training” on leadership and teams.  You need to help people to enhance their own self-awareness, challenge teams to solve problems and teach them the skills they need WHILE they do the work.  People WANT to be connected. They WANT to succeed.  They WANT to be part of teams and feel supported.  Learn to take advantage of these needs. Don’t wait for the next Pandemic!

Alan Friedman, M.A., is the Founder and CEO of J3P Healthcare Solutions.  To learn more about our work, visit us at www.j3phealthcaresolutions.com