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.
Wednesday, August 21, 2013
Wednesday, August 7, 2013
Flexibility
How flexible is your thinking? How you address problems can either help or hinder your hospital's performance.
I hate the phrase "thinking outside the box,"but there is a reason that cliches exist. We all develop ruts in our thnking. It's easier. If we use the same processes we don't need to go back to the drawing board every time that we are faced with a challenge. Imagine if you worked up each skin case differently! Yikes! You'd spend half your life looking up Idexx tests and telling your staff what to do. You'd never get anything done. But, you know that there are times when your system failed. Maybe you don't automatically do a skin scraping and you should have, or maybe a biopsy was called for and you didn't do it. For whatever reason, your system that works 90% of the time failed.
Depending on how obscure the diagnosis was will determine whether or not you add the missing element the next time. But, because you learned something, you may still automatically do these same things, but you will now have a better handle on plan B.
The same thing follows for how we think, only, how we think isn't really evidence based. Cause and effect is harder to measure in interpersonal and business situations. Habits will help you avoid making mistakes that you know about, but they may actually create future issues that you are completely unaware of and have no clue about.
If every time something breaks you handle the situation by tracking down the person responsible for keeping that thing running and demanding that they get it fixed. It will get fixed. And if you make it clear how annoyed you are that it broke in the first place, maybe they'll do a btter job of keeping it working in the future. Maybe this solves the problem once, and maybe it works for certain staff members, but in the long run what you may achieve is a situation where everyone decided that no one owns that piece of equipment. Now, not only do you have no one to blame, but equipment is no longer being maintained because no one wants to get yelled at when it breaks (which it will).
More yelling will not solve the problem. Your habits got you here, and only by changing them will things improve.
Maybe your action is less overt, maybe you know that equipment breaks, and you have a team approach towards maintenance. The person at the bottom of the hierarchy is 'elected' to keep the equipment running. The person isn't very important to your hospital and she knows it. She cleans up kennels all day and scoops the dead fish out of the aquarium. She's counting her days until she can get her license or finish her degree and then she is out of here. She hates cleaning the autoclave, so she doesn't, and when it breaks, no one seems to care, so there is no incentive for her to do it.
You can continue to place equipment at the bottom of your list of items, and continue to delegate it to the people who get stuck with it, but ultimately you are going to break something that costs a whole lot to fix, and you are going to wonder why your best staff is delegating tens of thousands of dollars of equipment to the externs.
Both situations ended up with improperly maintained equipment. They were both costly, and both of their proximate causes can be seen as lack of maintenance, but the long term issues of management's behavior that led to these issues may remain hidden.
Flexibility requires investigation. It requires us to think about our actions and examine them in the face of new facts. Flexibility is hard, because it requires us to do things differently than we would habitually. It means taking steps to try to think outside of our boxes.
One way to try this is to invite discussions within the hospital that encourages people to examine their solutions to problems in an open manner. Ask them how best to keep the equipment running (from the examples above) and just like brainstorming in school, there's no such thing as a bad answer. You can start the discussion with the simple idea of adding the cost of broken machinery to client's bills. People will not like this and will hopefully step up with better ideas.
In order for people to remain flexible they have to feel that you (or anyone) really want their input. Again, this means that you need to step outside of your box, especially if you solve everything yourself. Start off by admitting that your idea hasn't worked. Add in the stupidest idea you can think of and invite conversation.
Hopefully, as your team gets better at communicating and feeling at ease they will step up with the solutions your hospital needs to move forward.
If you need help thinking outside of your box please contact 4 Dogs Veterinary so we can help you and your team become creative problem solvers. 520 940 4453
I hate the phrase "thinking outside the box,"but there is a reason that cliches exist. We all develop ruts in our thnking. It's easier. If we use the same processes we don't need to go back to the drawing board every time that we are faced with a challenge. Imagine if you worked up each skin case differently! Yikes! You'd spend half your life looking up Idexx tests and telling your staff what to do. You'd never get anything done. But, you know that there are times when your system failed. Maybe you don't automatically do a skin scraping and you should have, or maybe a biopsy was called for and you didn't do it. For whatever reason, your system that works 90% of the time failed.
Depending on how obscure the diagnosis was will determine whether or not you add the missing element the next time. But, because you learned something, you may still automatically do these same things, but you will now have a better handle on plan B.
The same thing follows for how we think, only, how we think isn't really evidence based. Cause and effect is harder to measure in interpersonal and business situations. Habits will help you avoid making mistakes that you know about, but they may actually create future issues that you are completely unaware of and have no clue about.
If every time something breaks you handle the situation by tracking down the person responsible for keeping that thing running and demanding that they get it fixed. It will get fixed. And if you make it clear how annoyed you are that it broke in the first place, maybe they'll do a btter job of keeping it working in the future. Maybe this solves the problem once, and maybe it works for certain staff members, but in the long run what you may achieve is a situation where everyone decided that no one owns that piece of equipment. Now, not only do you have no one to blame, but equipment is no longer being maintained because no one wants to get yelled at when it breaks (which it will).
More yelling will not solve the problem. Your habits got you here, and only by changing them will things improve.
Maybe your action is less overt, maybe you know that equipment breaks, and you have a team approach towards maintenance. The person at the bottom of the hierarchy is 'elected' to keep the equipment running. The person isn't very important to your hospital and she knows it. She cleans up kennels all day and scoops the dead fish out of the aquarium. She's counting her days until she can get her license or finish her degree and then she is out of here. She hates cleaning the autoclave, so she doesn't, and when it breaks, no one seems to care, so there is no incentive for her to do it.
You can continue to place equipment at the bottom of your list of items, and continue to delegate it to the people who get stuck with it, but ultimately you are going to break something that costs a whole lot to fix, and you are going to wonder why your best staff is delegating tens of thousands of dollars of equipment to the externs.
Both situations ended up with improperly maintained equipment. They were both costly, and both of their proximate causes can be seen as lack of maintenance, but the long term issues of management's behavior that led to these issues may remain hidden.
Flexibility requires investigation. It requires us to think about our actions and examine them in the face of new facts. Flexibility is hard, because it requires us to do things differently than we would habitually. It means taking steps to try to think outside of our boxes.
One way to try this is to invite discussions within the hospital that encourages people to examine their solutions to problems in an open manner. Ask them how best to keep the equipment running (from the examples above) and just like brainstorming in school, there's no such thing as a bad answer. You can start the discussion with the simple idea of adding the cost of broken machinery to client's bills. People will not like this and will hopefully step up with better ideas.
In order for people to remain flexible they have to feel that you (or anyone) really want their input. Again, this means that you need to step outside of your box, especially if you solve everything yourself. Start off by admitting that your idea hasn't worked. Add in the stupidest idea you can think of and invite conversation.
Hopefully, as your team gets better at communicating and feeling at ease they will step up with the solutions your hospital needs to move forward.
If you need help thinking outside of your box please contact 4 Dogs Veterinary so we can help you and your team become creative problem solvers. 520 940 4453
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