I think the best management advice I ever received was a reminder that I, as a leader, accomplish all of my work through the people on my team.
Therefore, my goals as a leader are:
- to make sure that the team members I am privileged to lead are happy, engaged, productive and
- those team members are working within a system of work that is continually optimized to accomplish clearly articulated goals quickly, cost-effectively and without defect.
That first leadership goal raises the question: What makes employees happy, engaged and productive? Over the years I have observed that most employees want the same things:
- Employees want to feel like they are part of a something important, a mission that transcends the daily activities of their workplace. Healthcare leaders are lucky because we have a great story to tell about caring for the people in our communities that is easily embraced. Lately I have expanded our mission to include transforming the healthcare system to provide better, safer and less expensive care.
- Employees want to feel that they bring meaningful contributions to the mission. Employees do not want to be over-managed. My greatest management mistakes were micro-managing employees. My greatest frustration as an employee was being micro-managed, especially when the supervisor was less capable. Leaders need to provide employees the big picture, direction, and periodic feedback – then get out of the way.
- Employees want to be recognized for their contributions. Studer Group provides great guidance to leaders on how to recognize employees.
- Employees want their leaders to have their backs, and in turn they will have yours. When the division as a whole lets down their customers the leader needs to accept responsibility, never singling out anybody in the organization. We are imperfect people. Mistakes are made. Leaders need to create a culture where we treat mistakes as learning opportunities and not times to dole out punishment. Leaders need to lead by example and admit when they make mistakes and to vow to learn from that mistake in order to do better in the future.
- Employees want leaders that ask them what they need to do their job better and what are management’s misconceptions that negatively impact productivity and quality. Employees can accept constraints if they understand them.
- Employees want to know managers are concerned about their satisfaction and continually gauging what can be done to improve the workplace, even if it is already a highly regarded workplace.
- Employees want to be surrounded by other high performers that have the same passion achievement and good work. That means leaders need to address performance issues in a timely and candid manner.
What would you add?
A couple of years ago we separated our “technology division” into two groups: IT Engineering and IT Operations. The dividing line between the two is the production environment. Any new technology is architected by our Engineering group before it goes into production. Once something is in production it belongs to IT Operations and it cannot be touched without going through the change management process.
Here is an example of the IT Engineering group doing a good job:
All IT organizations are seeing a mounting desire for employees to use their own devices (especially iPads) in the workplace. When I recognized that this demand would be huge, I began advocating to connect Android and iOS devices to our Exchange Server via AtciveSync I went to the Engineering team, who is charged with evaluating new technologies before they go into production.
To their credit they said that the vanilla approach to device connectivity would not meet our security expectations. They told me that the only way we could safely manage employee owned devices would be through a device management system that would sandbox the organization’s data, protecting it from security flaws, malware and poor user security practices. They also told me that this would only cover the Exchange connectivity use case and that any other use cases would require further analysis (and perhaps additional expense).
I was disheartened to learn about the added cost, but I would much rather surface that with our executives so we can make a fully informed decision rather than spring a surprise expense on them later.
My car was being repaired on Wednesday, so I took the bus home from work. Fortunately, the main bus terminal is one block from our IT offices in Appleton. Unfortunately, the closest the bus gets to my house is over a mile a way.
I jumped on the bus looking forward to getting a little exercise with a crisp fall walk. By the bus arrived at my stop it was snowing hard and snow was accumulating on the sidewalk. I was feeling so sorry for myself I almost didn’t notice the person that got off the bus at the same time. When I did, he was smiling and trying to catch my attention. I returned the smile he went on to tell me that he was so happy to see the snow. It turns out he is a college student, on an exchange program from Guatemala, learning Business and English. He had never seen snow before. We shared much of the same path and time and weather seemed to disappear from my list of concerns as we had a pleasant conversation as we walked. Seeing his joy in what I was dreading completely changed my attitude.
At work attitudes are so powerful. Not only does a manager set the tone with their attitude and non-verbal signals. But all employees’ attitudes have so much influence over how a meeting is perceived. I value every employee’s opinion and when they appear uninterested or disagreeable, I cannot help be affected by that. Luckily, the folks I work with are supportive people.
Being a good listener and bringing a sense of excitement to your work is powerful. When I was relatively new to the workforce I remember listening to a fellow employee present some information. Whenever she missed a fact I would shake my head no. After a while I realized this was having a negative on her presentation (duh). Since then I always try to be a good listener. If someone is presenting and I am not expected to engage them in dialogue, I look them in the eye, I shake my head affirmatively and I smile. I know this puts people at ease which allows them to be their best.
I had the pleasure of being in a small audience to hear Wisconsin’s own Quint Studer speak. Most healthcare folks will recognize Quint as the guru of approaches to achieve great results in hospitals (patient satisfaction, employee engagement, financial performance and quality).
Quint criticized healthcare organizations that have tried to address financial challenges by reducing training budgets. I have been guilty of this short-sightedness in the past. However it is now clear to me that the only way we can continue to address the continually increasing demand for IT is to better leverage our employees. As we ask more employees to lead more complex projects they need the support and education to be successful.
I am working on several fronts to address this. One small but meaningful effort is to encourage employees to read. Recently I sent every IT team member a Barnes and Noble gift card so they can get a book. The only thing I asked in return is that they post a short book review on our internal social networking site (we user Yammer). Some bought traditional books, some of our road warriors bought audio books and others bought ebooks for their nook.
I love the Dave Ramsey quote: “You are the same today as you’ll be in five years except for two things: the books you read and the people you meet.”
I told my team that the book did not have to be related to their work. I did not want people to buy SQL Server Administrator guides that would collect dust on a shelf next to the Lotus 1-2-3 floppies. As I have have blogged in the past, inspiration will come from unlikely sources as long as you are open to it.
To that end I just finished Operation Mincemeat. This is a wonderful non-fiction account of a British WWII deception plot. Toward the end of the book I was struck by this quote:
“Wars are won by men…storming up the beach with all guns blazing…They are won by planners correctly calculating how many rations and contraceptives an invading force will need. By tacticians laying out grand strategy. By generals inspiring the men they command. By politicians galvinizing the will to fight. And, by writers putting war into words.”
At the risk of being overly dramatic, it strikes me that large IT projects (like an EHR) are similar. They need champions willing to take on risks; great planners; people that envision how the system will serve a larger strategy; people at the top that can motivate the team and the users; and people communicating the right message to the right target audience. Contraceptives are probably not so important.
I am also developing a multi-day curriculum for IT Analysts that will make them more effective project leaders and team members. It is essentially a brain dump of everything our IT veterans have learned (often the hard way) implementing healthcare IT systems. I am thinking about opening it up to people outside of our organization. Let me know if you think there would be an interest.
I am in the process of a significant IT Reorganization. The goals of the reorganization are:
- make IT Operations more reliable and
- improve the overall efficiency of the IT team so we can complete more projects (the demand keeps increasing).
One of the new IT leadership positions is a supervisor to manage the work of support techs in each of our 5 IT regions. As you would expect, the candidates are primarily the existing support techs. I have had the greatest time talking to these men and women about their interest in the position and their ideas to provide end users with a better service. They are talented, bright, optimistic people. It has been a real energy boost for me.
For all of their raw talent, most are new to management. Providing them good mentorship will be key to their success.
Now there are libraries filled with books on management philosophies. But, that would require me to travel to a library, or to read a book. Instead, I chose to watch some reality TV on Bravo. Tabatha’s Salon Takeover follows “celebrity hair stylist”, Tabitha, as she travels across the country helping struggling salons. It is my guilty pleasure.
The owners of these salons are usually in deep debt and losing money. Much of what Tabatha does is address poor management, including bad employee supervision. The salon employees always have the same concerns, and as such, these have become the basis for my primer for supervising people for first-time managers:
- Employees want their manager to be present. There are various approaches to being present, some more effective than others. As Studer disciples will attest, effective rounding is a great tool.
- Employees want regular staff meeting where managers can communicate the big picture and where things are going.
- Employees want clearly defined, preferably written and measurable, performance expectations.
- Employees want opportunities for growth, including a plan for their continued education.
- Employees want feedback regarding their performance. They want to know when they are not meeting expectations and they REALLY want recognition for good work. Sending employees hand-written thank you notes is a Studer “must-have”.
- Employees want to be treated fairly. While low performers are often the biggest complainers about fairness, it is the high performers that are demotivated when they are treated the same as low performers. The Studer Group has great strategies for determining High, Middle and Low Performers and how to manage each group.
Should I tell our new managers to watch Tabitha’s Salon Takeover? Maybe that is not the best conclusion. I think the real lesson is that inspiration to be a better manager is everywhere. If you are passionate about being better at something, think about it throughout the course of your day and it will find you.
Every good geek (and Google) knows that the answer to life and everything is 42. This is a famous line from The Hitchhiker’s Guide to the Galaxy.
But it seems like there is a more sensible magic answer: In order for things to go well, there needs to be a high level of specification.
Yes, ambiguity kills. In fact, it literally kills according to a study by Spear and Schmidhofer that was recently published in the Annals of Internal Medicine. The authors found that high performing organizations achieve results “by specifying how work is expected to proceed—who will do what for whom, with what purpose, when, where, and how—before work is actually done. Then, when anything contrary to expectations occurs, it is immediately identified as a problem.”
Medication errors may be one of the most critical examples where a high level of specification is needed. But, I run into this everywhere.
This year I brought in consultant Kevin Behr to analyze our IT Operations. The single most significant finding is the IT Operations in my organization suffers because of a lack of definition. When everyone is left to define how work gets done there is bound to be mistakes and mis-connects. Our organization needs to dedicate time to evaluating what we are doing and how it needs to be done. All work must be EXPLICITLY defined, otherwise talented people (like I am blessed with) can’t achieve their full potential.
I believe my organizations do a superb job of running large and complex projects. That is because we spend so much time defining the right process, then learning from our mistakes and re-defining our methodologies.
Job descriptions are the same way. If you are not explicit about a person’s role and what they are expected to produce you should expect to get something unsatisfactory.
How many times have your interfaces gone through multiple re-writes because you did not have a high degree of specification when you started working on them?
Is this so basic that it is not worth a blog post? If so, why do I see so little definition of work or processes to a high level of specification?
Annually I work with Ministry’s IT Customer Advisory Board (our IT Steering committee) to identify the IT projects for the coming year. Like all capital budgeting processes, we have a IT capital target that is based upon a number of factors like recent financial performance and competing capital projects (usually new imaging equipment and construction projects).
At Ministry we really have two targets, money and time. As I have posted previously, we estimate how much time each IT employee has to work on projects (as opposed to support). We add all of that time to determine the total project time for the year. I am simplifying things, but you get the idea.
If we don’t spend as much capital as we had planned then we can save that money to spend in the future. However, time is different. Every hour that we had reserved for projects is lost forever if we are not using it that way.
We have such a great demand for IT projects, it is important to make sure we do not let that time go unused. In past years we approved projects, then waited for those championing the project to bring them forward. The problem with that approach is that our managers are so busy they tend to wait until the latter half of the year to get things going. In the mean time that time set aside for projects is going unused.
This year we are encouraging our business leaders to getting things moving sooner and telling them the resources are available now. This should better use scarce IT time and reduce the number of projects that carry-over into the next year (which ultimately reduces our capacity for a given year).
I will let you know how that works.