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Leading People & Building High Performing Teams
MGMA IdahoAnnual Conference September 12, 2019
Tracy J Farnsworth, EdD, MHSA, MBA, FACHE
PresidentIdaho College of Osteopathic MedicineMeridian, Idaho
Associate Professor Health Care AdministrationCollege of Business / Idaho State University
When leading a team …
Question: What is the first Rule of Leadership?
When leading a team …
Answer: When placed in command, take charge!
Most want to be Lead! Leadership vs. Management
Management Leadership
Managers administer Leaders innovate
Managers maintain Leaders challenge
Managers supervise (accountability)
Leaders develop (empowerment)
Managers control Leaders inspire
Managers ask how and when Leaders ask what and why
Managers do things right Leaders do the right thing
Are you ready to lead?
System Mastery Leading and managing change
Team Mastery Developing synergy and high performance
Interpersonal Mastery Engaging difficult conversations
Personal Mastery Understanding and developing self
Pat Sanaghan & Clint Sidle
Leadership IQQuestion: What do folks want in their team leader?
Leadership IQAnswer:
1. Trust!2. Forward thinking3. Competence4. Inspiring
Kouzes & Posner (2007), The Leadership Challenge
Results: Consistent over industry, nation, and time!
Other Characteristics of Admired Leaders
1. Honest2. Forward Thinking3. Inspiring4. Competent 5. Intelligent 6. Fair minded 7. Straightforward 8. Broadminded 9. Supportive10. Dependable11. Cooperative 12. Courageous13. Determined14. Caring15. Imaginative 16. Mature17. Ambitious 18. Loyal19. Self Controlled 20. Independent
Leadership IQ• Question: What are the most common mistakes
leaders make?https://www.youtube.com/watch?v=iiorMUkqqDY
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Introduction
How would you rank the U.S. healthcare system vs other industrialized countries?
U.S. Healthcare: World Ranking (WHO)
37th!13
Institute of Medicine (est. 1970)
• 1999 IOM Report: “To Error is Human: Building a safer health system” • 44-98,000 die in hospitals each year from
preventable medical errors • Medical errors: 8th leading cause of death in
U.S. (more than breast cancer, auto accidents, aids)
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U.S. Healthcare System Results:
1. 13.5% of hospitalized Medicare patients experience an “adverse event” (CMS, 2010)
2. 44% adverse events were “preventable” (PAE) (errors) / (CMS, 2010)
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U.S. Healthcare System
1. 40-50% of all medical expense is wasted1
2. Half of all medical care is substandard2
3. 75% of medical costs treat preventable disease3
4. Transaction costs consume up to 31% of every healthcare dollar4
5. Healthcare providers facing reimbursement pressure from all payers5 (including patients)
References (Steve Hyde: Climbing the ACO Value Chain – IHA June 2015)1 – 2005 report from Institute of Medicine2 – New England Journal of Medicine3 – Centers for disease control (CDC) 4 – Wall Street Journal (2003)5 – Moody’s investors report
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Fragmented / Silos / Non-team-based
Why does teamwork matter?
Can better teamwork improve outcomes?
Exercise: What are you most afraid of?
What are you most afraid of?
Fear Individual Ranking Team Ranking Darkness
Death
Deep Water
Dogs
Elevators
Financial Problems
Flying
Heights
Insects & bugs
Loneliness
Sickness
Speaking before a group
Greatest Fears (Nationwide Survey: Findings)
1. Speaking before a group2. Heights3. Financial Problems4. Sickness5. Deep water 6. Loneliness7. Insects & bugs8. Darkness9. Death10. Dogs11. Elevators12. Flying
The wisdom of the crowd• Judge B. Lynn Winmill, U.S. District Judge, Idaho• Sir Francis Galton, English Victorian era statistician
Cohesive Teams • Single greatest competitive advantage • Not complicated• Requires hard work – sacrifice – courage • Intentional leadership decision
Patrick Lencioni
How to develop cohesive teams • What cohesive teams look like• Stages of team development• Recognizing & fixing dysfunctional teams • How to build trust• Giving and receiving feedback• Collaborative decision making• Energize & engage team members • Coaching and mentoring others
Dye and Garman, Exceptional Leadership, 2006
Developing Cohesive Teams• What does a cohesive team look like?
Cohesive Teams• Efficient! Make decisions quickly (& with buy in) • Meetings:
• Passionate• Intense• Exhausting• Never boring • Agenda items: compelling and vital (no email or busy work)
• Cohesive teams fight (issues, not personalities)
Cohesive Teams How well teams talk to each other absolutely determines how well the organization will function. Is the dialogue stilted, politicized, fragmented, and butt-covering? Or is it candid and reality based, raising the right questions, debating them, and finding realistic solutions? The leader sets the tone.
Bossidy and Charan, Execution, 2002
Stages of Team Development
FormingStormingNormingPerforming
Forming (Pick-up Sticks)
• High, unrealistic expectations • Some anxiety: How fit in? Trust? • Unclear about norms, roles, expectations, goals,
timelines, etc• High dependence on leadership for direction & guidance • Behavior: tentative & polite • Major issues: personal well-being, acceptance, trust
Storming (“At Odds”)
• Teams gets experience . . . Recognize discrepancy between expectations & reality -- Morale dips
• Difficulties in accomplishing task lead to confusion, contention, frustration & growing dissatisfaction with dependence upon leader
• Subgroups form; team is polarized • Primary issues: power, control, conflict
Norming (“Coming Around”)
• Issues are addressed and resolved• Morale begins to rise• Task accomplishment & technical skills increase—
contributes to positive (euphoric feelings)• Increased clarity and commitment to purpose, values,
goals, norms, etc • Willingness to share responsibility. Speak as “we”
versus “I”• Major issues: Sharing control & avoiding conflict
Performing (“As One”)
• Productivity & morale are high! (reinforce one another)• Sense of pride & accomplishment in being part of “high
performing team”• Primary focus: Performance• Purpose, roles, and goals are clear!• Standards are high; mutual trust• Major issues: Continued refinements & growth
Two Important Variables are woven through the four stages:
Enthusiasm & Skill Level
Remember the Titans (2000)?
Points to Remember
• The stages enable us to anticipate (& prepare for) what a team will likely go through
• Use appropriate strategies (& leadership styles) to smooth the progress of a team as it evolves
• Different teams evolve at different speeds; Many regress to an earlier stage
• May be in different stages (different projects) at same time
(See handout)
Why Create a Climate of Trust? • Without trust you cannot lead• Trust – most fundamental element of a winning team • Trust is at the heart of collaboration• The more trusted people feel, the better they perform
How to increase Trust?• Be the first to trust (Demonstrate, before asking)• Be vulnerable and open to influence • Share information and resources • Trust is contagious (so is mistrust) • Trust cannot be forced; it must be earned
Giving & Receiving Feedback• Do you like to give & receive feedback?
• What does giving good feedback look like?
Giving Feedback Requires emotional fortitude / intelligence (EI)
• Set clear expectations• Address the important issues • Deal with people/problems clearly, directly and
frankly• Provide timely feedback (criticism and praise)
Collaborative Decision Making
The Art of Decision Making
Facts
PeopleTiming
Collaborative Decision Making
People will support what they help create
Marv Weisbord
Collaborative Decision Making
Engaging the Team
Engagement vs Satisfaction
• There is nothing wrong with being satisfied, but the world is full of satisfied employees who come to work, play solitaire, surf the net, (paint over dead animals) . . . do the bare minimum and collect a paycheck while waiting for retirement.
Engagement
• Engaged employees are different • They have an emotional attachment to their
company or business unit• They give you their very best even when no
one is watching.
Engagement
• Worldwide, only 13% of workers are engaged.• In China . . . Only 6%• In Canada . . . It’s 16%
Source: Gallup’s State of the Global Workplace report, 2013
So, how are we doing?
• 30% of American workers are engaged in their job.Source: Gallup’s State of the Global Workplace report, 2013
What engaged employees do
Top quartile of engaged employees• 42% fewer errors• 51% fewer safety accidents• 40% less absenteeism• 28% less turnover
Source: Gallup’s State of the Global Workplace report, 2013
Employee Engagement• https://www.youtube.com/watch?v=y4nwoZ02AJM
How to Engage & Energize the Team • Trust and empower teammates• Model the way (example)• Be enthusiastic & optimistic • Rise to new challenges• Approach work with energy, passion, drive • Recognize & reward • Celebrate success• Use good humor & have fun
Mentoring Others• All activities that support the long term growth
of employees / direct reports
Leading and mentoring others“In my 35 years as a healthcare executive, the best career advice I received was from someone early on who told me that goal of the usual leader is to make him/herself into more of a leader . . . and the goal of an exceptional leader is to get others to believe in themselves.”
Jack O. Bovender, Jr., FACHEFormer Chairman and CEO
Hospital Corporation of America
Summary & Conclusion• Cohesive teams improve outcomes• Behaviors of a cohesive team:
https://www.youtube.com/watch?v=pHxuAg9TZTE
Leading People & Building High Performing Teams
MGMA IdahoAnnual Conference September 12, 2019