Anytime we do a workshop with a healthcare leadership team, we end up spending a lot of time talking about trust, collaboration and accountability. For decades, we’ve been trying to build highly collaborative teams. The vision is that interdisciplinary teams will build more effective care delivery models.
Often, though, it becomes clear that group dynamics are getting in the way of achieving this goal. We see a room full of bright, talented, accomplished leaders in their field and department, who struggle to work effectively, as a group. Sometimes it’s a lack of trust and openness. Sometimes there is a fear of vulnerability – the vulnerability required for real innovation and productive collaboration.
Collaboration, accountability and autonomy intersect in interesting ways in healthcare:
We value professional autonomy
Each profession prides itself on its role in the patient’s care. Medical and nursing culture and education both sometimes claim to be the most important part of the care team.
Traditional conflicts between nursing and the medical staff sometimes limit meaningful and open collaboration. It’s not limited to physicians and nurses. Other healthcare professions and departments value their profession and autonomy. The upside is professional pride as well as a sense that each is the most important champion of the patients’ best interests.
This degree of professional autonomy, however, sometimes fosters a strange sense of, and need for, control. Sometimes, experts from other industries are surprised to see the degree of resistance to change that is common in some healthcare organizations.
I recall a hospital patient satisfaction initiative. Six months into the project (which was mandated by senior leadership) a department director had made little progress. When asked about it, the Director said the team still wasn’t sure why the project was necessary. This would be almost unheard of in a retail or manufacturing company.
Collaboration is hard
The challenges facing healthcare today, are complex and pressing. There is a new expectation of accountability for organizational performance. Collaboration is an imperative. We are taking bright people who train in silos - accomplished in their respective fields - and asking them to work together to re-design the way we deliver care, and find ways to improve outcomes while reducing costs. Do they even have the skills to collaborate?
Leaders are learning what accountability really means
A chief medical officer recently told me that none of his medical chairs has ever actually seen themselves as accountable to him, or to the system, for the performance of his or her department – at least not on hard metrics like patient satisfaction, financial performance or outcomes.
An example: although every physician is, to some degree, in a position of leadership, you’d be shocked at how many times when presented with department patient satisfaction or cost information they say, “I don’t control everyone in the department and how they impact these metrics!”. Some people just aren’t wired for organizational collaboration.
Progressive organizations and leadership teams identify the metrics that matter and then collaborate to drive them, with everyone assuming accountability for success or failure.
Want another real-world example? Bundled payment – everyone that touches the patient is going to have to cede some autonomy, to collaborate, and be willing to be held accountable for the results.
Experience and research shows that teams are far more likely to succeed if each of them individually has the behavioral ability to collaborate, be accountable, and balance these with their sense of professional autonomy.
What Does this Mean?
Organizations are facing complex problems that require high levels of collaboration.
Traditional healthcare culture has always valued professional autonomy, which may conflict with this need for effective collaboration among leaders.
Accountability is still a relatively new concept in healthcare – accountability for system-wide metrics and accountability to fellow leadership team members.
In building a leadership team, past performance in a specific profession/department is not, necessarily, predictive of success – you need to understand a leader’s ability to overcome their sense of professional autonomy, to collaborate, to be vulnerable, to support colleagues and to leverage a high level of emotional intelligence.
Leadership learning and development efforts need to focus on these critical skills.
Progressive talent acquisition teams and healthcare hiring professionals are learning to adapt cutting edge solutions from other industries to increase their odds of success.
Download our whitepaper below: