SixSEED Partners

Well-being

Moral Injury: HealthCare’s Public Health Crisis

by Leave a Comment

A Systemic Lens Perspective

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

Background:  

On March 10th of this year, I published a blog focused on “Caring for the Organization AND Caring for the Workforce.”  The higher purpose of that tension was to support a healthy ecosystem within healthcare.  Writing this close to six months later, not only is that tension still relevant, it has reached a crisis point in healthcare as droves of physicians and nurses leave their organizations and/or professions.  How do we take care of healthcare as a system, as we take care of the public’s healthcare needs?  In this writer’s opinion, right now we are failing.  The purpose of this blog is to invite creative, systemic solutions to this thorny challenge.

Impact and Case for Change:

Panagioti, Geraghty, and Johnson published an article in JAMA Intern Med 2018 (10) entitled: “The Association Between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction.  Their review of the literature revealed that there is a 2-fold increase in odds for unsafe care, unprofessional behaviors, and low patient satisfaction amongst physicians experiencing burnout.   Reith published another article in Cureus titled: Burnout in United States Healthcare Professionals: A Narrative Review.   He expands the impacts from both physician and nursing burnout to include higher rates of patient mortality; transmission of hospital-acquired infections; increase in medical errors and an increase in medical student alcohol abuse and suicide.  Of note is that both of these articles were published in 2018:  prior to Covid 19.

One less quoted yet just as serious sequelae for nursing and physician burnout is your ability to get timely and effective care for you and your loved ones.

Complex and Interdependent Challenges:  Variations of Individual AND Team Tensions:

Many of us are familiar with the process of looking at root causes for problems to permanently eradicate the disease.  The challenge with Covid and burnout in healthcare is that they are not problems to solve.  They are systemic and interdependent challenges to leverage that can be boiled down to a tension between meeting individual needs AND meeting collective needs.

Look at the below examples:

Impact (So What?):

  As Einstein said: “The significant problems we face today cannot be solved at the same level of thinking we were at when we created them.”  We must facilitate dialogues that address these thorny challenges, and which include healthcare worker well-being. If we don’t, physicians and nurses will do more of what they are starting to do which is saying “no more.”  They are saying this as they submit their resignations; leave for higher-paying jobs; or leave the profession altogether.  This leaves hospitals struggling to manage the finances of healthcare with their mission to serve and meet the needs of their communities.  What solutions are people creating to respond to the fear of closing beds and not being able to meet expense needs?  We hear from our clients their staffing challenges as Traveling Nursing companies are perceived as stealing staff from hospitals less equipped to pay higher salaries and offering to those who can.  I liken this strategy to one that hopes to improve nutritional health by offering organic produce to affluent communities while depriving or limiting healthy food choices to lower socioeconomic communities.  When will we learn that localized or individual approaches will not eradicate systemic challenges?

SixSEED Partners Interdependent Solutions:

We believe that these times of epidemic crisis require a different way of thinking and acting to sustainably impact and transform these issues.  Examples include:

  • Leverage Competition & Collaboration:  bring local hospital systems together to look at community health needs and discuss how blending resources and talent might be able to better meet community needs and organizational needs.  Instead of three hospital systems vying for digestive disorder patients, consolidate and refer specialties across hospital systems, in service to patient care AND provider well-being.
  • Medical and Nursing Professional Associations uniting in lobbying their governments to establish temporary laws that promote access to resources and prohibit possible poaching of scarce resources by any one organization at the expense of others.
  • Leverage social media to impress the public of OUR responsibility.  Just as we’ve seen the near -death lung cancer patient with poor color, on oxygen, doing commercials on TV, healthcare workers should be posting photos on social media of their tears; their marked faces; bodies lining hallways due to lack of beds and/or staff.    The story of healthcare’s reality must be presented unfiltered, visible and in a media venue that the public see’s frequently and consistently.  The public has a role and responsibility for decreasing the demands on our healthcare systems and this is one way to keep the public informed of what is happening behind the scenes in the delivery of healthcare.
  • Gather regulatory, professional and education/ training organizations in dialogue around training that could take place to upskill volunteers or provide jobs for those needing work in supplementing nursing and physician staff.  As with scribes, how can we lessen the burden on our clinicians so that they are doing only the highest acuity patient care needs.  The  other tasks which require less clinical expertise can be done by other members of the care team.   

These examples require both/and thinking and require us to get out of our silos, holding our greater purpose and not just our lone survival as paramount.

SixSEED Partners is looking for leaders and systems who are ready to do this work.  We have no time to waste.  The time is NOW.  Will you join us?  If you are curious, please email me directly:  joy@sixseedpartners.com.  

#systemintegration #leadershipecosystemcapacitation #wellbeing #burnout #ecosystem 

A Grounded Approach to Healthy Leadership

by Leave a Comment

Celebrating the work of Bob Rosen and The Healthy Leader®

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

Background:  

One of our Six SEEDS includes a focus on Well-Being and our passion has only increased given the numerous traumas healthcare leaders and their teams have been exposed to during the pandemic.  It is our firm belief that healthcare delivery can’t be at its best if those working within it are unhealthy.  Therefore, it seemed perfect that we would affiliate with The Healthy Leader® in facilitating their Grounded and Conscious Healthy Leader Content.  Since we’ve been focusing on building resilience, we wanted to showcase the great work that Bob Rosen, Rick Auman, and the team have been doing and the impact it makes in creating healthy leaders.

 The Grounded Leader Model:  Recently, we commented on a posting on Linked In that referenced a Center for Creative Leadership Article on Eight Steps to Become More Resilient.(provide link).  In our work with The Healthy Leader,® we focus on evidence-based research that links the six dimensions of the Grounded Leader to business performance results.  You’ll note in the above graphic that the six dimensions of the Grounded Leader model include: 

  • Physical Health:  How you live
  • Emotional Health: How you feel
  • Intellectual Health: How you think
  • Social Health: How you interact
  • Vocational Health: How you perform
  • Spiritual Health: How you view the world

As we reflect on resilience, we can easily discern that it is the interplay of all six of these dimensions that prepares us for resilience, adaptation and thriving.  Resilience is a root within the emotional dimension yet it is our assertion that one cannot be resilient without growing the other five dimensions as well.

The model also links the six dimensions to the major disruptors of our current world.  For example, the more we attend to the dimension of physical health and energy management, the better able we are to effectively deal with the unrelenting speed of life.  Technology was a gift during Covid 19 isolation yet we would argue that it was an inadequate substitute without the addition of social health and nourishing communities.

All of these resonated with the participants from a Fortune 500 Technology firm for whom we are delivering this content.  Through small group interactions and accountability partners; the support of an online portal with videos and reflection/ journaling exercises, and integration of their organization’s leadership imperatives, the participants are living and learning new habits to support their resilience and that of their teams.

Application: 

To those who might think this content is “soft,” The Healthy Leader® has partnered in conducting research on the impact of healthy leaders to business results.  Ross and Squires published a 2015 article entitled “Tone at the Top: Leadership as the Foundation of Organizational Health and Wellness” in which they describe the impact of leaders who score high in these six dimensions to job performance.  Below you can see two of the charts included in the article.  Of note is the significance of spiritual health to performance.  When’s the last time you discussed spiritual health with your employees?

Let’s hear from you

If you’d like to chat more about The Grounded and Conscious Leader Program, and about a methodical and systemic approach that supports the individual and systemic change and resilience, we’d love to hear from you. Please message us on our LinkedIn page or send us an email here.

#culture, #systemintegration, #wellbeing

Acknowledgment: The Healthy Leader

8 Steps to Become More Resilient

by Leave a Comment

Appreciating The Center for Creative Leadership and DavidMcLean for sharing these insights

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

Background:  

As the world experiences a massive “re-entry” after being in fear and reactivity mode for the past eighteen months, becoming more resilient is on many people’s minds. David McLean, Director of People and Organizational Development at Lambton College recently highlighted on LinkedIn, a Center for Creative Leadership (CCL) article on eight steps you can take to become more resilient.  We share David’s interest in resilience as we promote Well-Being for those who work in healthcare.

Appreciations:

David’s brief and succinct expansion on the wonderful graphic shared by the CCL in 2016 remains relevant for today.  We notice elements of Daniel Pink’s Drive Model®: Purpose; Autonomy and Mastery; Carol Dweck’s: growth mindset® (learner mindset); Simon Sinek’s: “Why®,” and David Emerald’s work around The Empowerment Dynamic®, amongst others.  These eight steps, as identified by the Leading Effectively staff in November of last year summarize very well actions in our control to become more resilient with whatever comes our way.

The embedded article expands on these eight steps to include taking care of one’s physical health including getting enough sleep and prioritizing exercise.  They expand on reflection to include a journaling practice.  All great suggestions with proven impact.

Yes, AND…..

I can imagine the sarcastic responses I might hear from those who’ve been working tirelessly to take care of others, allowing little time to spend on themselves.  Is it lack of knowledge that prevents leaders from cultivating these habits or something else?  It reminds me of the way we’ve approached “solving” the burnout issue within healthcare.  Within our work at SixSEED Partners, as we take an ecosystem and system-integration approach to dealing with complexity, we advocate individual AND system responsibilities to create a generative culture and resilient leadership.  Well-Being/ Resilience is not only an individual challenge; it is a cultural one as well.

I most agree with these writers that the mirror has to be turned inward.  We need to abolish blame-filled cultures and ask our individual and collective selves, with courage and compassion:  “how am I / are we contributing to the challenge I /we see before me/ us?”  And we must ask this question when we are rested and healthy.  We cannot see the horizon if we’re still buried beneath the earth.

Let’s hear from you

If you’d like to chat about a methodical and systemic approach that supports the individual and systemic change and resilience, we’d love to hear from you. Please message us on our LinkedIn page or send us an email here.

#culture, #systemintegration, #wellbeing



Acknowledgment: Centre for Creative Leadership


#learningagility #leadership #resiliency

SEEDS for Success with New Year Resolutions

by 1 Comment

Introduction: Case for Change

Have you given up on New Year’s resolutions because of repeated failures to achieve your goals?  Are you searching for the right way to get sustainable results?  Has the scale betrayed you again in this new year as you struggled to manage your weight amidst a work from home or constant adrenaline rush lifestyle?  You are not alone.  As so many of us do, we look back to our learnings from the past to inform our changes for the future.  We are taking a different spin to a prior post in the context of supporting your wellbeing in this new year.

The Challenges:

As we enter a new year and vow to make changes in our personal and professional lives, we struggle with how best to do that, particularly amidst what we may hear about the failure rate of New Year Resolutions.  In our efforts to find an example that might be universal, 2020 found many of us struggling with weight maintenance given our moving less and staring into a computer screen for 8-10 hours/day.  While there is great literature on successful habit cultivation, they often fail to take a systems’ and mindset perspective necessary in dealing with complex situations.  

2020 has required us to create structures AND be flexible and adaptive; leverage what we know as we advance into what is not known; honor existing familiar traditions as we create new ways of being with each other.  In revisiting our post from May of 2020 on taking ourselves seriously and taking ourselves lightly, we present this spin as it relates to improving personal health goals around weight management.

Leveraging taking ourselves seriously and taking ourselves lightly:  

At SixSEED Partners, we help our clients integrate both/and thinking in addition to traditional problem-solving- either/or approaches.  The elimination of perceptions of “good or bad,” “right or wrong,” helps our clients to take a more systems-oriented approach to complex challenges.  In the polarity map pasted below, you will notice a common tension of a serious/structured weight management approach and a more playful and spontaneous approach to weight management and health. Effective and sustainable weight management requires leveraging both upper poles, and mitigating the risk of overdoing either, to the neglect of the other.  

When we take ourselves too seriously to the neglect of a lighter approach, our inner judgers become active when we find that we’re not meeting our health goals and we’re not enjoying life.  If we overfocus on a more spontaneous approach to weight management (as just one common health attribute), we’re having fun but not meeting our physical health goals.  Using a polarity thinking frame helps us to see ourselves as a system that requires leveraging both poles.

What can you do? (action items and warning signs):

Even as I write this blog, I notice physical signs where my breathing becomes more shallow; there is a sense of tightness and heaviness and I notice my active judger interfering with my free flow of writing.  As I notice my own warning signs of taking myself too seriously, I open my chest more to allow easier breathing; I laugh and put this blog in the context of other problems in our world today; and I take a time out to exercise and move my body which amazingly impacts my movement in thinking.  I also access others more expert than I to help modify and edit, knowing I’m not alone in this work.  See our sample map below for actions you might take for success in weight management and other similar thorny challenges.

Polarity Map of Taking Self Seriously vs Lightly

Let’s hear from you:

What have you found helpful in leveraging taking yourself seriously and taking yourself lightly? In our next blog, we’ll be focusing on our leadership development seed as we discuss a common challenge of holding others accountable AND giving them freedom in doing their job. If you’re interested in learning more about how our team can help yours, contact us today!

Maximizing Team Development: Leveraging Theory & Application

by Leave a Comment

The Forming & Norming Team:

SixSEED Partners was invited to facilitate an executive council retreat for the Heart and Vascular Institute (HVI) of a community-based medical center. The HVI recently re-structured their roles and leadership within the institute to better meet their mission. The Chief Physician Executive of the Institute, in partnership with the Business Strategist, wanted to provide a day of learning and development where the members could build trust, align around shared objectives and engage in establishing accountability. Amidst Covid-19, the leaders felt these objectives were so important to warrant an in-person gathering.  It was clearly as important to the executive team members, who showed up engaged and fully present during the full day team development process. As several of the members are also clinical physicians, it highlighted to us that proper planning can facilitate the space for them to join in this work, which is also important to them. 

Can we learn multiple tools and apply them in 1 day?  YES!

Do you believe it is possible to deliver four different tools in three hours and have participants feel they learned them and could immediately apply them for their benefit? Thanks to Petra Platzer, our COO, we know we can! In less than three hours, the administrative and physician leaders were introduced to Thinking Environments, DiSC®, the Team-Work Cycle®  and the Three Vital Questions®. Petra also facilitated experiential activities that had  participants immediately applying what their learnings to their own work and team dynamics. Joy Goldman further facilitated application of these tools through the team beginning to draft their team charter. Elements of focus were their interaction rules around meeting practices, communication, decision-making, communication, feedback and evaluation.

But was it effective? Yes

We modeled creating an environment for feedback & evaluation by dialoguing on feedback for us within the session. Each participant said the day was effective for them, some surprisingly so, in fact, as they often are skeptical about “these things”. Each also named how one or more tools were new and powerful for them, and immediately applicable in some way. Some spoke about their insights into their own behaviors and styles as compared with others on the team. Others especially enjoyed the powerful visuals by physically going through the team work cycle. They quickly identified gaps, and possible solutions, to some of their self-identified needs for moving more efficiently from ideas to execution. The visual exercise provided the gift of addressing these topics without  blame or personalization, which fostered trust and new understandings together. The best gauge for how effective they rated this was their assertion:  “we need more of this from you.”

How is your team developing together?

Whether your team has been working together for a while, is newly forming due to a re-structure, or is somewhere in between – how are they working together? Is there a benefit to focusing on their ways of interacting and learning additional ways for navigating what seems to be never-ending change together? Making the effort on this work is what makes teams perform higher and more productively, with much less wasted energy and re-work along the way.  Like this HVI executive team experienced, it is often a pleasant surprise and energizing to spend time developing together.  And, without doing this kind of work, teams can often experience side conversations, wasted energy and good, but not great performance. 

What are your experiences in teams for creating clear agreements on how you’re interacting so there’s greater productivity with less wear and tear on the system?  We’d love to hear from you about your experiences and challenges.  

To learn more about applying these frameworks with your teams, contact us at: www.sixseedpartners.com or by tagging us on LinkedIn or Facebook.

Shifting from Reactive to Proactive Work

by Leave a Comment

“How does our executive team become more proactive and less reactive? We are so busy putting out fires, but we’re not really moving forward on what the organization needs from us.”

If you have been asking yourself the same question, you are in good company. This year is a prime example that the one constant in life is change – which brings with it unknowns and an increasing pace of so many variables in the day-to-day and the big picture.

The Challenge

For the client who asked the question above, her clinical organization had acquired several other practices as a strategic move to keep each practice viable in this current economic climate. As a result, there were some key leadership changes, along with a need to establish a new organizational culture and vision. Instead of proactively working on those elements, the executive team was instead spending many hours reacting to perpetual fire drills, like EMR integration and compliance issues.

The Diagnosis

In an earlier blog, we introduced the concept of an Outcome Orientation. Just like a compass, this mindset puts our focus towards the results we want to achieve, instead of the alternate mindset of getting rid of the problem(s). One way to “diagnose” which orientation we are operating from, is by asking the 3rd Vital Question from David Emerald’s 3 Vital Questions™ (3VQ) framework: “What Actions are You Taking?” 

If the answer involves merely reacting to the problems of the moment, without any intentional actions focused on continuous improvement or forward progress toward the prioritized outcome, your diagnosis is clear: you are operating from the Problem Orientation. And just like the example, when we are operating from this orientation, we can feel stuck, frustrated, and burnt-out. We are also more likely to be experiencing and contributing to workplace drama from this orientation.

The Tension 

Once you have your diagnosis, you can proactively choose to take a different set of actions. 

How? By harnessing the inherent energy that is in the gap between the Outcome you want to achieve and the Current Reality that exists. This inherent energy, called Dynamic Tension follows the fundamentals of physics: to create movement between two points, tension is required. The pivotal key is developing the skill to “hold the tension” in a way that the rubber band doesn’t snap (too big a gap/tension) or fall off (too small a gap/tension) when the default reactive patterns show up again. In our experience, when clients become aware of the need and positive attributes for this kind of tension, this understanding can liberate them to work on becoming proactive.

The Shift to Proactive Actions

Once you’ve defined the Outcome you want and assessed your Current Reality, you have started working on the 5-step Action Planning Process to create proactive actions! Similar to climbing a ladder – one does not reach the top by starting at the first rung and jumping to the top rung. By using this foundational structure, however, you are able to identify baby steps – one rung at a time – resulting in incremental, deliberate, and long-term actions.

As we have been applying the planning process with the executive team from our client example, we can already see a lift in their individual energy, more cohesion as a team, and a change in their approaches for their expanded organizational culture. This is another great example of why we integrate the 3 Vital Questions™ framework within our SixSEED Partners solutions for all of our 6 service “seeds”!