How to move your staff forward

There are two things that can cause us to move forward when inertia and fear try to hold us back - it's the whole carrot and the stick scenario. Either you are driven by the fear of what will happen if you do not do it, or you are encouraged by the excitement of what can be realized if you succeed.

If your hospital is moving towards a vision, and you are trying to move everyone in the same direction do you favor the carrot or the stick? Or do you use one and fall back on the other if it fails?

Of course, we all know that the carrot is a better option. But what is the carrot? You're probably not giving bonuses for your hospital reaching its goals, and the goals are always moving - 'getting better' isn't a destination; it's a journey.

It can be difficult at times to motivate staff to keep moving towards a goal post that is itself traveling. Because of this, not only do you have to make a compelling case for your vision and reinforce it time and time again, but you need to provide mile markers along the way.

I run ultramarathons, and take my word for it, no sane person lines up at 4am and looks down the trail and thinks, "I'm going to run half the distance between Tucson and Phoenix (or from Albuquerque to Santa Fe (exactly 100k) or San Juan Capistrano to LA)." I don't care who you are, 32, 50 or 100 miles just isn't something any sane person believes that they can run (we'll table the sanity question for now).

But I know I can run 20. That's easy, and what is easier still is the five to the first aid station, and then the five after that. I always know I have more to run. I know that the finish line is a staggeringly long way from where I started, but I also know that every step takes me closer.

That's what you have to do with your moving goal posts. Let's say that as part of your stated desire for excellence you have embraced the idea of 100% compliance. Well, where you are now is the start line. You start small. You start with the goal of asking every well visit to become compliant. Asking is doable. Put up a board and track how many clients are asked every day. Every team that achieves 100% gets a Starbucks card (or chocolate chip cookie - whatever has the most currency in your hospital). Next month the team that asks 100% of their clients to be compliant goes to the movies on the hospital.

You are not even looking at the big scary goal of 100% owner compliance; instead you are looking at small doable goals that everyone can do. As your team becomes more proficient you can keep moving the goal posts a little each month (a 10k turns into a half marathon, turns into a marathon...).

In six months, when you look at your compliance numbers again and they're up from where you started, you throw a huge party - you take everyone to lunch, you do something and remind your staff that their actions have meaning, they do matter. You remind them that the journey may seem impossibly long, but every step, no matter how small takes them closer to that impossible seeming goal.