SixSEED Partners

leadership

Healing Drama in the Workplace

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An Application of Three Models to Heal Healthcare

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

The Drama:

Let’s see if this situation sounds familiar to you:  You have a senior, C-Suite leader, or high-volume surgeon, or your flagship hospital CEO who is widely perceived as demonstrating obstructionist behavior.  In polarity language, they tend to over-leverage the “I” focus: they over-advocate for their organization/ service line/ system entity to get more resources to the detriment of the rest of the system.  They are perceived not as team players and are perceived as being an “urban legend” in the systemic fear of their power and intimidation.   You may hear the following spoken in hallways or in private zoom chat rooms: “Everyone knows that “he/she” wants total control and you best not mess with him/ her because there will be repercussions!”

The Impact:

When systems perpetuate these urban legends and make up stories around motivations for behavior, everyone suffers and healthy cultures are undermined.  There is toxic energy that is spent on workarounds, defensive positioning anticipating a negative outcome, disrespect to the senior leader with many talking behind their back, and a crystal-clear message to everyone witnessing this behavior of: “it’s not safe here.”

The Solution & Invitation:

There are three frameworks we use to help shift these cultures from unhealthy, unsafe and low trust cultures to engaged, supportive, healthy and safe cultures:  @theconsciousleadershipgroup ’s “Above and Below the Line;” The Collective Leadership Assessment from the Leadership Circle,  and Polarity Thinking—adding both/and thinking to traditional problem-solving thinking. When used recently with a group of nursing and patient care leaders, over a series of several sessions spanning six months, their comments included: “we now call each other for support;” “we are more solution-oriented,” and “we can be vulnerable with each other since we now share a common language.”

Let’s hear from you:  

We’d love to hear your perspective on what you and your organizations are doing to shift your cultures from blame and persecutor-victim relationships to healthy, trusting partnerships.  Please post your responses on our LinkedIn page or send us an email here.

Leveraging Accountability for Self and Others

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By: Lisa Hompe MSOD, BSN, ACC

Background:

In the current healthcare climate of uncertainty, complexity, and change, how do we manage accountability? That is a question I often asked myself as a former healthcare leader managing a very busy ambulatory surgery center, and a question that I frequently encounter as I coach other healthcare leaders. In my previous leadership role, I was often faced with the dilemma and tension of holding oneself and others accountable. Accountability can have various meanings to different individuals, teams, and organizations, and is often rooted in organizational culture, norms, and behaviors. 

Assessment:

Self:

As a leader, when the work was stressful or challenging, I noticed my own internal challenge of wanting to take the path of least resistance. I found it was easier to delegate to those people who were more willing to take on additional tasks while avoiding those that were less interested or approachable. According to Harvard Business Review, recent data shows it is a common dilemma leaders face in holding others accountable successfully. Difficult conversations and creating an environment of accountability require a thoughtful and intentional approach. Approaching things with diplomacy and candor can help to create awareness and develop teams.

Team: 

What was I showing and modeling to my team by not having these crucial conversations? I realized as a leader, I was doing a disservice to those that needed to grow and learn. How was I holding myself accountable? When difficult conversations needed to take place for undesirable behavior or actions, I may have been unintentionally communicating that only a select few of the team were capable. Self-awareness is a first step and a key leadership and emotional intelligence competency. 

Impact:  

I believe no one intends to go to work every day creating problems and issues. The stressors currently impacting many healthcare workers place undue burdens on an already constrained and overtaxed system. This context can lead to undesirable or suboptimal behavior. It may be possible that leaders are unknowingly playing a part in perpetuating a lack of accountability with individuals and teams. If we’re honest with ourselves and our teams, we all have blind spots. What we model matters. It is possible to consider the well-being of others, while holding them responsible for their actions. I learned that having crucial conversations and asking others to step up creates an environment of shared interests; it creates an environment where everyone feels heard and valued, willing to show up and do their best. I encourage all leaders to take notice of how working with team members to create shared accountability and responsibility helps foster a more positive work environment.

Takeaways:

For yourself, look at what you can control-

  • Assume positive intentions for all individuals  
  • Notice who and how often you may be tapping into? Are they often the same people?
  • Check yourself. Did you have all the correct data and facts before you acted? Ask yourself, what if the opposite were true?
  • What is the intention of your messages? And how does your communication impact others?

For your team, start with open dialogue and conversations-

  • Intentionally create coaching conversations. Learn to ask open-ended questions in a psychologically safe environment
  • Listen and be open and curious for the answers your team is providing
  • Be clear on roles and responsibilities and get feedback if people need more clarity, communication, or training
  • Embrace the challenge and use the support of a coach or colleague 

This is simple but not always easy. Learning to manage these leadership challenges can make a world of difference. How you define accountability reflects the agreements and commitments you are willing to make. What are you committed to? How do you support and grow others to be aware of their behavior and actions? What is the culture you intentionally want to create for your team and the broader organization? Part 2 of the series will address creating a positive culture in the current healthcare environment. If you’d like to learn how to increase the accountability of your team while holding yourself accountable in a courageous and compassionate way, contact sixseedpartners for more information.

Developing Integrated Accountability in Healthcare

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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!

How to Hire a CEO: Neglected Attributes

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

Introduction: Case for Change

Turnover at the CEO position remains high: According to the American College of Healthcare Executives, CEO turnover was 17 percent in 2019.* (ACHE: “Hospital CEO Turnover Rate Shows Small Decrease.” – press release. In Development Dimension International’s 2021 Global Leadership Forecast, that polled close to 16,000 leaders across the globe, 55% of CEO’s indicated developing the next generation of leaders as their top challenge. These statistics and personal experience working with clients who have been traumatized by making a wrong choice, motivated Dr. Larry McEvoy, Dr. Kevin Mosser and I to offer healthcare boards a webinar through The Governance Institute  called “How to Hire a CEO: A Guide for Ensuring Effective Selection at the Most Important Position.”  

For SixSEED Partners, we see the hiring of a CEO as only one part of our sixth seed: Leadership Ecosystem Capacitation.

 

Current Process:  Strengths and Gaps:

Whether in our country or within healthcare, we continue to look to the CEO as a heroic leader and in doing so, often place great emphasis on the CEO’s accomplishments and experience.  It was fascinating to us that the participants on the webinar placed low importance to the role of experience in their candidate selection yet, in practice, it was one of the top three attributes that they assessed. (see graphs below).  Bob Anderson and Bill Adams, in their book: Scaling Leadership: Building organizational capability and capacity to create outcomes that matter most” dispel the myth that leaders that prioritize results and technical expertise have the greatest impact on business results.  To the contrary, after culling through hundreds of thousands of 360- degree -feedback assessments and comments from around the globe, these skills were shown to be non-differentiators for high performing leaders.  Their research identified ten attributes, six of which were people-related.  Some of these include developing others; empowering people; team-builder; leads by example; and good listener.  

We were also surprised with the time paid to assessment results and interviewer ratings, given neither interventions were rated as having great importance to the participants.  In our experience, we agree, in part with this assessment, given our observation that this process is often incomplete, where the personality profile results remain with the search firm and are not used by the hiring company to integrate into designing behavioral interview questions targeted at possible gaps, nor using as development once the candidate is hired.

The Neglected Attributes:

If you’ve read this far, you are probably guessing where we believe you need to focus to have the greatest chances of success for the candidate; your executive team; and your organization.  The two attributes least assessed yet deemed most important to the CEO’s success is their ability to scale leadership, and to leverage and manage paradox (seeming opposite tensions).

Experience matters less in rapidly changing and volatile situations.  What matters more is the degree to which you’ve built leadership and thinking capacity in your organization.  As an example, SixSEED Partners was asked to offer change leadership training to a cohort of internal medicine physicians.  In partnership with the Chief Quality Officer, we designed a workshop where we introduced both/and thinking as an adjunct to traditional problem-solving thinking.  If these physicians have the thinking capacity to leverage individual AND team; mission AND margin; decentralized AND centralized needs; candor AND diplomacy; advocacy AND inquiry among others, then collaboration is strengthened and we increase their ability to lead sustainable change.

The Leadership Ecosystem Capacity Approach to Hire and Develop

What does this mean for you?  Here are several steps you can take make a better CEO hire:

1. Elevate talent development as THE FIRST Strategic priority- for the board; for the executive team and for each leader.

2. Ask your CEO candidates a question similar to the following:  “If your current organization were to give you a grade of A to F in relation to how well you’ve prepared them for your departure, what would they say?  On what would they be basing their rating?”  You want to listen for details around the use of development strategies like rotational assignments; creating a learning environment; internal promotions; and prepared successors.  You want to listen for a blend of “I” and “We” statements.

3. Assess for their thinking capacity to manage paradox:  “Give me an example of a decision you had to make where you felt torn between two or more competing perspectives.  Who was involved?  What was at stake?  What did you consider in your decision-making process?  What did you do?  What was the outcome?  What did you learn through the process?

Let’s hear from you

We’d love to hear your perspective as you and your board plan for your next CEO hire.  Please post your responses on our LinkedIn page or send us an email here.

Team Spotlight: Meet Joy

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Joy Goldman, began her career in healthcare at the Massachusetts General Nursing School over 35 years ago. Out of Nursing School, she began a career as a psychiatric nurse and from there pursued Masters’ degrees in Community Health Education, Strategic Human Resources, Organizational Development, and a certificate in Leadership Coaching. Since 2008, she has been practicing as a Leadership Coach and OD facilitator. 

As a natural big picture thinker, Joy gravitates towards systemic interventions that can multiply impact on a variety of levels such as individuals, teams and systems. Joy finds the most rewarding part of her job partnering with individuals that provides the space to do profound work impacting their thinking and behavior in ways that align with their highest values and purpose. Also rewarding to her is working with her partners and combining their unique talents to create something powerful that exceeds what they could accomplish individually. 

When asked how she imagines the future of healthcare, she hopes to see an integrated system that promotes health for all. In Joy’s words, “I envision individuals taking responsibility for their own health by making better choices and having access to healthy food. I see payors, providers, investors, technology experts, and administrators creating collaborative systems where health is a foundational element of all workplaces. Healthcare is more than fixing what’s broken. Creating health is multidimensional and includes economic, social, and environmental influences.”

Beyond being the CEO of SixSEED, Joy loves to travel, dance, take photos and spend time with her husband.

An Essential Leadership Competency: Leveraging the Polarity of Power And Love

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As we at SixSEED Partners live our declaration of being part of creating a just and equitable culture where health is a right for all, we notice our own internal “no more” struggles that put us squarely in the tension between peaceful protest/establishing clear boundaries AND Showing Understanding/Compassion/Forgiveness.  We’ve been listening to our clients as they encounter their own “no more” struggles and navigate difficult and emotional conversations about racism, antiracism and white privilege. It is our belief that especially now — an essential leadership competency is the ability to leverage the polarity of Power And Love.

“Power without love is reckless and abusive, and love without power is sentimental and anemic. Power at its best is love implementing the demands of justice, and justice at its best is power correcting everything that stands against love.” ― Dr. Martin Luther King Jr.

Power and Love Defined:

We view the tension of Power and Love as part of our SEEDS of “Leadership,” “Culture,” and “Well-Being”. We’re not alone. Several popular leadership and social change books have been written based on that quote. (See: Adam Kahane: “Power and Love: A Theory and Practice of Social Change,” 2009; and,  Barry Oshry “Power and Love: A systems perspective: http://newstories.org/wp-content/uploads/2015/01/Power-and-Love.pdf) 

We articulate below what we define as Power and Love:

Power – Spaces and Processes for Differencing

A Leader generates trust by making it safe for individuals to stand in their strength and voice their unique differences – and serves to create a strong Culture / Well-Being.

Love – Spaces and Processes for Integrating

A Leader generates trust by promoting shared values for equity and fairness to connect and unify to accomplish common goals and shared objectives – and serves to create a strong Culture / Well-Being.

Racial and Health Inequity: Power AND Love Tension in Operation

Recently, SixSEED provided support to a senior leader who described himself as, the “new kid on the block.” A person of color who had joined a predominantly white tenured senior leadership team. He was struggling. In his new role, it seemed that compared to his colleagues, it was seldom if ever being asked about his perspectives. When he volunteered his perspectives, it seemed they were pretty quickly dismissed. Add what he described as a “hierarchy-of-influence” — his support function was less “professional” than those of his mostly white colleagues who were “at top of the pyramid.” Add to this — his staff were also mostly people of color and frustrated by the perspectives he was attempting to share – and he was caught in the middle. Political tensions rooted in racial and health inequity dynamics were adding fuel to the fire and all this “adding-up” was taking a toll. One question was, “where do you even start?”

Mapping the Tension

We know from Oshry’s work that Top, Middle, and Bottom stories in organizations involve not just the hierarchical relationship – there are also conditions. At different times, we can be a Top, Middle or Bottom — at different times and for different work processes. One place to start is by heightening awareness of the polarity of Power And Love as we move through these conditions as leaders. The attached Polarity Map for Power And Love includes Action Steps that offer possibilities to intervene in the processes of “holding space” to honor differences and Commonalities. These processes are less about “who’s right” or “who’s wrong” and more about the spaces themselves – the seeing  differences and commonalities. 

The Polarity Map on the following page summarizes elements from Oshry’s work. If you’d like your own editable polarity map to give yourself the systemic view of the tensions you are navigating, complete this contact form and indicate “requesting Power And Love polarity map.”

We’d like to hear how you’re navigating this tension. Additionally, if you have questions about how you, your team, or your organization might apply this method now, send us a message and we’ll contact you within 1 business day to help guide. and support you.