It’s just plain redundant to say it at this point, but it’s true – healthcare continues to change at an unprecedented rate. Running a hospital or health system was never easy. Management guru, Peter Drucker, said, “A hospital is likely the most complex organization we deal with and managing one is as challenging as it gets.” That was BEFORE we decided to change everything about the task!
In past decades, a hospital could succeed by putting together a team of highly talented individuals who were experts in their own domains, each of whom could run their little part of the organization with the sum of the efforts resulting in success.
That’s no longer the case; the senior leadership team must work collaboratively. The challenges are too complex. They cut across departments, functions, and specialties. The problem is that healthcare has not historically been a “collaborative” endeavor. In fact, it’s been a clinical, autonomous endeavor. In some regards it’s been beneficial. Physicians value autonomy and their role as the champion of the patient. Nursing and other professions, similarly, have grown to value their professional autonomy. In some regards administrators were seen as another category of professionals altogether. Individual departments fight for their goals and budgets, and even hospitals within a system sometimes focus more on their own success to the detriment of the system’s goals.
Everyone seems to recognize now that this approach won’t work. But how do you get people trained in one way of thinking, working, and managing to suddenly become one big collaborative family?
In preparing for an upcoming meeting with a system’s senior team about this exact issue, I revisited a Harvard Business Review article from November, 2007, Eight Ways to Build Collaborative Teams, by Lynda Gratton and Tamara J. Erickson.
The authors looked at 55 organizations and examined over 100 factors that influence collaboration of large groups dealing with complex issues. They identified several factors that correlate with success. A few of the more interesting findings include:
Today’s challenges require complex teams – often large, diverse, highly educated, and specialized.
These exact characteristics, though, create a challenge to effective collaboration.
These groups are less likely to share knowledge freely, learn from one another, help one another complete tasks, or share resources.
Creating conditions for collaboration in this situation requires a thoughtful, significant investment in the capacity for collaboration.
Successful organizations demonstrated specific practices in four areas: Executive Support, HR Practices, Strength of Leaders, and Structure of the Team itself. I found three specific purposeful strategies to be most relevant to the work we do:
1. Place Leaders who can be both task and relationship oriented
Leading a complex group requires a leader that can move back and forth from a focus on tasks and a focus on relationships. This demands not only a high level of emotional intelligence, but the ability to know when to use each skill and the flexibility to do it.
2. Model collaborative behaviors
The team won't learn to collaborate if the leaders of the group/organization don't demonstrate what collaboration looks like. One example was that members of a senior team often stand in for each other at official functions, meetings, etc. This way, the organization sees that everyone on the senior team is on the same page.
3. Train specific collaborative behaviors
Collaboration is a skill that can be developed, but it takes effort. The authors particularly noticed that the ability to appreciate others, to engage in purposeful conversations, and productively and creatively resolve conflict is critical. These are behaviors that can be developed, but only if they've been identified and people make the effort to apply them and evaluate results.
When I was teaching graduate students years ago, we used problem-based learning. The students worked on problems in small teams with a trained facilitator. The goal was not just to learn the material and solve the problem, but also to learn to collaborate. Every session ended with a 20-minute discussion about specific group and individual dynamics and behaviors that either contributed to, or detracted from, the group’s ability to function. At first it seemed like additional work in an already busy schedule, but the entire group quickly learned to value collaboration and made great strides in the ability to collaborate. I continue to hear from them today that those skills are invaluable.
One thing the Harvard Business Review article authors did not address is the value of assessment. We continue to find that this ability to collaborate requires an understanding of the person’s natural behavioral tendencies. When you are building your team through talent acquisition, it’s much easier to focus on finding people with the propensity or demonstrated ability to collaborate. Similarly, using assessments as a developmental tool helps to understand one’s own behavioral tendencies, which is a critical first step to developing these skills.
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