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Case Study

Developing Integrated Accountability in Healthcare

July 7, 2022 by Joy Goldman Leave a Comment

By: Joy W. Goldman RN, MS, PCC, CEO, SixSEED Partners

Background:

SixSEED Partners (SSP) was engaged by a senior health system leader to complete a 360-degree feedback process in support of the client’s ongoing systemic leadership and development.  This leader was brought into the health system to integrate service line leadership from a decentralized and competitive model to a more centralized and collaborative model.  The Leadership Circle 360 Profile (LCP) was administered after the client had been in the system for a year.

The Strategy:

The client had previously completed the LCP at another system so we were curious to see if the themes would be any different from his prior results.  In reviewing the results from 32 respondents, the client’s attention went to two variables:  there continued to be a theme of his strength in relationships and in his overdoing that strength with complying behaviors (for detail, see The Leadership Circle Website).  This leader’s development opportunity was courageous authenticity and achieving results and decisiveness—dimensions well known to him. 

However, his greatest concern was that the ratings from his direct reports was drastically different (lower) than other stakeholder groups. 

The Solution:  

As we explored internal and external dynamics, we found support in the theoretical frameworks of the Empowerment Dynamic, and Polarity Thinking which correlate perfectly with the LCP framework of reactive and creative modes of energy management.  Through coaching and much reflection, the client was able to see how his direct reports were placing him in a rescuer (hero) role and were presenting themselves as victims to system leaders, mainly hospital Presidents who were perceived as villains (see graphic).  This dynamic was evident through numerous cultural stories in the organization—not only did this dynamic occur within his organization:  it was prevalent throughout the system, with a displacement of accountability to “higher ups,” which was also convenient when something didn’t work.  Blame was a well -known song sung throughout the system.

The Impact:

From the client’s perspective, he was able to see that he was re-enacting that dynamic with his boss and part of his development was to be conscious of the roles he was playing and putting on others.  He started individual meetings with his direct reports and shared the distinctions between victim and creator, encouraging them to take ownership and identify actions they can take to influence what they wanted to create in the system.

The client was also challenged to lead a system-level leadership development effort where both/and thinking (polarity thinking) would be introduced and measured for the prevalent tensions of Centralization and Decentralization (system service lines AND local hospital entities) and Individual AND Team accountabilities.  In this way, he would broaden the leadership capacity of system leaders which would minimize the victim/persecutor conversations and support mutual accountability throughout the system.

Are victim/ persecutor conversations rampant in your organization?  Are you fatigued in having to spend time on these draining discussions that result in stagnation and energy drain?  We feel your pain!  Contact us to learn how you can lead sustainable, empowering change in your system!

Filed Under: Case Study, Uncategorized Tagged With: #thefullcirclegroup #accountability #theempowermentdynamic #thedreadeddramatriangle #leadershipdevelopment #teamdevelopment #leadershipecosystemcapacitation #systemintegration, #theleadershipcircleprofile360, diversity, healthcare, leadership, polarity maps, polarity thinking, retreat, scaling leadership, sixseedpartners, transformative leadership, well-being

Supporting Clinician Well Being with Both/And Thinking

March 31, 2022 by Joy Goldman Leave a Comment

By: Joy W. Goldman RN, MS, PCC, CEO, SixSEED Partners

Background:

The Institute for Healthcare Improvement (IHI) has, as one of their initiatives, “Improving Joy at Work.”  In their 2017 whitepaper on their “Framework for Improving Joy at Work,” Balik, Swensen et al quote Maureen Bisognano as saying: “You can’t give what you don’t have.” On the heels of the beginning emergence from the pandemic, Dr. Larry McEvoy, CEO of Epidemic Leadership and I partnered with Physician and Nurse Executives at WellSpan Health to design and teach polarity thinking to forty clinical leaders in their nursing and physician leadership academies.  We used the context of measuring two tensions: care for self and care for others, and continuity and transformation to illustrate the power of both/and thinking as a supplement to traditional problem-oriented thinking.  Our goal in working with the leaders was to help cultivate a more sustainable and impactful way to address complex, individual, team, and systemic challenges, with less wear and tear on individuals, thus contributing to improving “joy at work” (no pun intended).

The Strategy:

We were hoping that the pandemic recovery would allow us to gather the forty leaders in person yet, two weeks before our delivery date, there remained concern about social distancing and covid transmission so we adapted to a virtual gathering.  We met with the nurse and physician executive sponsors several times to discuss real tensions within the group and the system and decided to focus on the above polarities of Continuity & Transformation and Care for Self & Care for Others.  We wanted to provide validation through data for what these clinician leaders were experiencing while also providing a structure that supported their expanding perspectives and learning from each other.

The Solution:  

Dr. McEvoy and Ms. Goldman designed and administered a polarity assessment measuring the degree to which the participants felt they were leveraging the above -named tensions.  We presented a half-day workshop that integrated content that differentiated problem-solving with either/ or solutions from polarities which required both/and thinking.  We intentionally mixed nurse and physician leaders during breakout sessions; and we used whole-brain and somatic learning with liberating structures that demonstrated the power of using their peers as internal consultants while also hardwiring the learning.

The Impact:

Some tensions identified by these forty clinical leaders included:

  • System decisions being made without the input of the stakeholders whom they effect
  • Being burdened by administrative tasks that take us away from patient care
  • Conflicting messages; do more with less while also making self-care a priority. Decisions being made without stakeholder involvement.

We presented their data to them and demonstrated the ability to filter the data by relevant demographics:  in the case below, we were curious to see if there were differences between care for self and care for others between nurse and physician leaders.  As the below illustrates, all leaders were experiencing the downside of overdoing care for others, however nurse leaders were in the danger zone for all three markers.  This data served as powerful fodder as Dr. McEvoy facilitated the group through three rounds of Troika Consulting (Liberating Structure).  The group unanimously felt that the eight-minute exercise and process provided valuable feedback from their peers for ways they might individually better leverage “care for self” in themselves and in those they lead.

If you’d like to offer something like this with your physician and nurse leaders,  please reach out and let us know at info@sixseedpartners.com or by commenting.  

Filed Under: Case Study, Uncategorized

Case Study: Developing Dyad Trust and Partnership

February 4, 2022 by Joy Goldman Leave a Comment

Joy W. Goldman RN, MS, PCC:  CEO and Founding Partner, SixSEED Partners

Background

OneSixSEED Partners (SSP) was contacted by a Chief Clinical Officer for a large faith-based health system concerning our providing coaching services to two cardiac surgeons who needed to partner for overall program success and were currently in conflict.  The behaviors demonstrated were interfering with the engagement of other team members and posed a risk of departure for one of the surgeons who happened to be a high-volume, high revenue producer.

The Strategy:

SSP met with the local hospital Chief Clinical Officer (CCO) to determine measures of success and also to assess dynamics within the larger health system.  As may be common with less urban areas, the CCO’s marital partner was a peer to one of the referred physicians which impacted the CCO’s proclivity in setting firm boundaries. SSP modeled being compassionate AND direct in establishing performance expectations and outcomes.  While there was some interest in bringing the two physicians together immediately, we agreed that our approach would combine the organization establishing firm expectations and providing coaching support in developing these physician leaders.

The Solution: 

Choosing the right coach for the clients was essential in establishing trust in order to provide both challenge and support.  We decided to use the @CoreStrengths Strength Deployment Inventory to help each physician deepen their emotional intelligence as they understood their motivators and values within the context of six other motivational value styles and conflict styles.  In debriefing the physicians individually, each client was true to their style, often demonstrating their strengths and overdone strengths within the debrief conversation.

As you will note from the attached SDI triangle, the two surgeons had very different styles which contributed greatly to their sense of conflict.  One physician valued inclusion and the other physician valued autonomy and competition. As with all interdependent tensions/ polarities, what was essential was helping each physician understand their unique gifts/ strengths and how to leverage those, while also understanding their overdone strengths and the impact on their teams.  Each physician’s development plan included strengthening the opposite pole/ style:  to better leverage competition and collaboration.

The Impact: 

One of the strengths of the Core Strengths platform is that it has an app that allows a user to review their results and also compare their style to that of others and learn “do’s and don’ts” for emailing, messaging, communicating, and meeting with those who are different than them.  They learn how to flex their style to their audience so they can partner better and perceive behaviors less personally.  In being able to do so, not only is the partnership strengthened but there is less wear and tear on the physicians so their energy can go where it is most needed which is program development and patient care.  I’m noticing the desire to want to tie a pretty bow and say this story had a happy ending, and I’m sure it will.  The work continues yet it might be easy to guess that the surgeon with a high-performance motivation (red) is considering moving on to what’s next.  As leaders, our roles include establishing cultures where all can thrive.  There are times when that might mean people leave our organizations.  If we’ve done our job in creating strong development cultures, we increase overall leadership capacity so that regardless of departures, the organization continues to thrive and patient care is sustained.

Filed Under: Case Study

Case Study: Developing Capacity for Leading Autonomously AND Collaboratively

January 27, 2022 by Joy Goldman Leave a Comment

Joy W. Goldman RN, MS, PCC:  CEO and Founding Partner, SixSEED Partners

Background

One of our clients was recently promoted from a clinical specialty department leadership role into a hospital-wide chief clinical officer position at an academic, inner city medical center that is part of a multi-hospital system.  SixSEED Partner’s coach offered to complete an onboarding 360 feedback process to assist this leader in integrating into his new role.  While we would do this for any C-suite new leader, transitioning to a larger scope role within a health system has the added complexity of reshaping existing perceptions and renegotiating existing relationships.

The Strategy:

SixSEED Partner’s coach engaged the client in providing names of key stakeholders, peers, and direct reports who have had an opportunity to observe him over the past four-five months in his new Chief Clinical Officer (CCO) role.  Interview questions were provided to the ten leaders and to the client’s boss: the Chief Executive Officer of the medical center.  The results of the interviews were summarized and presented to the client, linking the results to past assessments that included interview-based and online assessments.

The Solution: 

While many senior level roles require the capacity to manage complexity, the critical thinking capacity of being able to leverage paradox becomes magnified when one transitions internally and within the context of two National crises: the pandemic of Covid 19 and a national workforce shortage.  Amongst many noted strengths, numerous respondents acknowledged the need for this leader’s capacity to challenge the status quo and push the organization toward new ways of doing things and new levels of accountability.  With that strength, however, also came tension and resistance.

The coach integrated past learning from The Leadership Circle Profile 360® in shifting from reactive to creative behaviors and also continued application of noticing paradox (polarity) and seeming contradictory demands.  Prevalent for this leader was the ability to leverage his strength of internal (operations) focus with external (strategic) focus.  Another key tension, given the shift in his relationships with other existing leaders, was his ability to manage asserting the power (Individual) within his role of CCO, as he partnered with other system chief clinical officers (team). 

The Impact: 

As someone with a harsh internal judger/ critic—(perhaps this resonates for you, the reader?), being able to identify these tensions in a both/and approach allowed the leader to receive the feedback in a way that felt supportive and challenging.  Using both The LCP 360 frame and polarity thinking frames supported the leader in expressing their strongly held values and fears (often held in our reactive thoughts) and allowed the leader to lead into their creative talents of visionary leadership as they strengthened developing their bench strength and collaborative partnerships.  This process provided the leader an early compass amidst numerous strategic demands.

Filed Under: Case Study

Case Study: Applying Polarity Thinking to Family Strife

January 19, 2022 by Joy Goldman Leave a Comment

Joy W. Goldman RN, MS, PCC:  CEO and Founding Partner, SixSEED Partners

Background

According to Greater Good Magazine:  Science-based insights for a meaningful life, “Polarization occurs when we refuse to live next to a neighbor who doesn’t share our politics, or when we won’t send our children to a racially integrated school. The force that empowers polarization is tribalism: clustering ourselves into groups that compete against each other in a zero-sum game where negotiation and compromise are perceived as betrayal, whether those groups are political, racial, economic, religious, gender, or generational.”  And I would add: “familial.”

A respected colleague of mine encouraged me to write this personal case study of resolving familial political polarization through the application of polarity thinking to heal and deepen love in families.  I write this from two different perspectives:  the first and primary one as an evolving human being with a commitment to grow compassion, peace, and unity in our world.  The second is as the CEO of SixSEED Partners where we’ve been applying polarity thinking- both/and thinking to help leaders sustainably lead through complexity while promoting well-being and diversity, equity and inclusion in the process.

The “case” to which I’m applying this frame is that of my marriage where my partner and I share opposite political affiliations.

The Strategy:

I will write this as if I were coaching someone through a polarity map.  No conflict can be resolved without a shared purpose that holds great value for both parties.  As a family or couple, we have to ask “what is most important in our marriage/family?  For my husband and I, mutual respect and love rise to the top.  We needed to find a way to reach this outcome otherwise, our fear is that we feel disrespected and grow in anger/ hatred which would result in the demise of our marriage.  I must mention that navigating these tensions in the home are occurring during a pandemic which means we’re around each other A LOT!

The Solution: 

If you wait for the other person to act first, you are part of the problem.  I challenged myself to apply what I know of polarity thinking to discern what matters to my husband.  You can find my insights represented in the attached polarity map.  My husband has a deep loyalty and appreciation for our country.  He demonstrates this by supporting wounded veteran organizations and by staying informed with what’s happening in our country.  I may disagree with how he does this but I can respect the underlying intent and wish.  I value “inter-nationalism:” a value for communal good.  It’s not that he doesn’t but his value of loyalty trumps (sorry, pun intended) his valuing of immigration and global prioritization.  He values autonomy and individual choice while I lean toward communal benefit.  If we approach our different perspectives from an either/or—right/wrong way of thinking, our marriage will be fractured.  Beyond that, we will be negatively impacting our world since our tension exists in 50% of the United States population.  The only hope we have for constructive dialogue leading to mutual respect and love is through appreciating what matters to the other.

The Impact: 

In brief, I am happier, laugh more, and am more kind and loving to my husband, which seems to evoke the same response back to me (imagine that!).   I am lighter because I am not holding on to resentment.  I have a greater appreciation for our individual and collective human stories that allow me to love more and hate less.  I may disagree with behaviors and actively support causes that matter to me, while loving the human beings that travel with me on this life path.  You will note that on the map, action steps and warning signs are the same for both poles.  These are called high leverage action steps since they are equally relevant and important.

If this touches you in any way, please reach out and let us know at info@sixseedpartners.com or by commenting.  As quoted in the African proverb:  “It takes a village….”

Filed Under: Case Study

Case Study: Faculty Development Leadership Academy

January 4, 2022 by Joy Goldman Leave a Comment

Joy W. Goldman RN, MS, PCC:  CEO and Founding Partner, SixSEED Partners

Background

University of Maryland Medical Center and the associated School of Medicine is a 789-bed, academic medical center located in Baltimore, Maryland.  The Medical Center is the flagship hospital within the University of Maryland Medical System- a thirteen hospital health system.  The Chief Quality Officer and Associate Chief Medical Officer invited SixSEED Partners to facilitate a presentation in their first Faculty Development Leadership Academy.  The purpose of the Leadership Academy was to prepare internal medicine physicians to lead Safety and Quality Improvement Projects within the organization. This was a pilot program that, if went well, would be expanded to other physicians within the medical system.

The Strategy:

Joy Goldman RN, MS, PCC: CEO for SixSEED Partners (SSP) worked with The Chief Quality Officer (CQO) to design a two-part series focused on leading change within organizations.  Since internal system resources were focusing on traditional quality improvement and project management principles, SSP decided to focus on providing a framework to help the participants expand their thinking capacity to better lead through volatile, complex, uncertain, and ambiguous situations.  If the clinicians could add the capacity to consider both/and perspectives in addition to traditional problem-solving, then that thinking capacity would enable them to better collaborate with those of differing viewpoints (engage stakeholders) and create sustainable change that was less focused on memorizing algorithms for change.  We also wanted to create a sense of community through integrating new knowledge with relevant peer conversations that solicited and validated their experiences and emotions

The Solution: 

After speaking with the CQO, SSP designed a polarity assessment that focused on Individual, Team and System tensions.  The polarities measured included:

  • Candor and Diplomacy (Individual)
  • Individual and Team (Team)
  • Mission and Margin (System)

Due to Covid-19 and pandemic restrictions, the workshop was delivered virtually.  SSP conducted an initial four-hour workshop where the participants were introduced to the polarity framework and were given their results for the polarity assessment.  The eighteen physicians, while coming from the same department, had not had much prior interaction.  They were invited to participate in break-out groups where they were able to share insights and personal experiences related to the identified tensions.

Toward the end of the six-month curriculum, SSP conducted a one-hour follow-up session to reinforce polarity concepts and to introduce The Empowerment Dynamic™ by David Emerald to help the participants discern when they were coming from a victim-persecutor-rescuer (DDT- Dreaded Drama Triangle) perspective as compared with the creator-challenger- coach roles within the Empowerment Dynamic.

The Impact:

Initial outcomes included:

  • Application of both/and- polarity thinking to strategic and systemic change projects
  • In this very diverse faculty group, verbalized awareness of cultural impact on use of voice in an effort to “fit in.”  Many in the group stated their realization of their habit of deference (diplomacy) to the neglect of exercising the healthy expression of candor
  • “This was a really well conducted session and was high-yield. Thought ** was really wonderful as a moderator and drew out the audience. Enjoyed the small groups.”
  • “Enjoyed the opportunity to interact more closely with other participants in the Academy.”
  • “We never have this time to share our experiences with each other and realize we are not alone in our struggles.  Appreciated the opportunity to use each other as consultants and advisors.”

A post-polarity assessment will be administered after their change projects are complete which is expected to be fall, 2021.

Filed Under: Case Study

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