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