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polarity maps

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!

Caring for the Organization & Caring for the Workforce

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

Introduction: Case for Change

  • “Joy:  (as told by a hospital CEO)  “I am having a spiritual crisis.  I have dedicated my life to this work and I am exhausted.  I am getting emails from our system CEO at all hours of the night and weekends.  And when are our senior meetings?  Mondays.. so if we want to take a long weekend, we have to wrestle with missing those meetings or attending them on our time off.”
  • From a dear friend:  “My son (nurse in ICU) called me yesterday and told me he lost another patient.  He commented that this is a daily occurrence and he sent me this very poignant video illustrating the journey of his fellow nurses and care-providers.  He doesn’t feel that he can talk to anyone for fear they will think him “fragile” and unsafe.
  • From a senior leader whose position was eliminated:  “I was informed via a 10- minute zoom call that my position was eliminated and that I would be cut off from all communications as of that moment.  I could only go to my office to clean out my belongings with an escort.   I’ve worked for the organization for over twenty years and this is how I’m treated.  I understand the need to re-organize but why wouldn’t they allow me to transition my projects to others?”

The stories above are direct quotes from clients and/or friends.  As we reach the one- year mark for Covid-19 lockdowns and the now 500,000 deaths in the United States, more and more of these stories are surfacing.  SixSEED Partners is committed to providing integrated solutions to heal healthcare and there is no greater time of need than right now.

Crisis in the Making:  Grief, Trauma and Vicarious Trauma:

McKinsey & Company, in a December 2020 publication: “Grief, loss burnout: Talking about complex feelings at work” discuss the unparalleled levels of exhaustion and loss that have become “routine” for healthcare workers.  Provider burnout was a concern before the pandemic- it is only magnified now in the constantly “on stage” demands of taking care of patients and trying to recoup financial losses due to fewer elective surgeries.  The authors of “Healthcare Coaching Through Crisis and Trauma” (February 2021), published through Harvard’s Institute of Coaching, describe the experiences as passing even “severe burnout,” into the realm of trauma, vicarious trauma, and moral injury.”  How are we challenging ourselves to slow down enough to put resources to this significant need?  In many ways, we are reminded of our nation’s tension of leveraging individualism (each person responsible for their status/ wellbeing) with communal good (how are we caring for each other).

The Leadership Ecosystem Capacity Approach to Resilience and Restoration:

SixSEED Partners asserts that we each have a role in better leveraging caring for the workforce as we strive to keep our organizations afloat.  Without workers, we have no margin.  What’s in our control to do?

Please see the polarity map pasted below for some ideas of action steps and early warning signs to address this tension.  

SixSEED Partners recently partnered with an academic medical center to offer a polarity thinking workshop to sixteen internal medicine faculty.  These physicians were learning about leading change in patient quality and safety and we chose to help them expand their thinking to support their leading in complex and unpredictable environments.  They voiced appreciation for the safe space where they got to share with their colleagues and learn that the challenges they were dealing with were not unique to them. They were also able to acknowledge that they needed to assume individual responsibility for self -advocacy and health as they worked so hard at taking care of others- whether that was at work or at home.

Let’s hear from you;

We’d love to hear your perspective as you and your organizations better leverage caring for your workforce. Please post your responses on our LinkedIn page or send us an email here.

SEEDS for Success with New Year Resolutions

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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!

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.

Leveraging Specialized Knowledge and Shared Knowledge

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This is the sixth in a series on leveraging tensions during this time of the coronavirus.  For SixSEED Partners, Covid-19 is a powerful reminder of what already exists in our world which is complex and unpredictable circumstances that can cause much pain and expense unless we learn to take a more systemic view and get comfortable leveraging interdependent tensions.  Previously, we covered the paradoxes of:

  • Leveraging Facts AND Faith
  • Leveraging Staying Present AND Anticipating the Future
  • Leveraging Care for Self AND Care for Others
  • Leveraging Assuming Responsibility AND Delegating Responsibility
  • Leveraging Taking Ourselves Seriously AND Taking Ourselves Lightly

The tensions we are highlighting are coming from your real-world challenges.  We’re asking questions and staying present to your pain points, that, in already demanding circumstances, is taking additional energy that you don’t have to spare.  We want to help make this easier for you, while also increasing your capacity to lead others through this pandemic.

As I was listening and participating in a recent SixSEED Partners team meeting, I was hearing stories of inflicted trauma to businesses as a result of one or more of their partners contracting the coronavirus or some other illness and becoming either temporarily or permanently disabled.  The trauma inflicted, in addition to the loss of a loved one, was the impact on the business due to a lack of shared knowledge – knowledge transfer. 

Organizations who understand this tension have been rotating a greater pool of leaders through their Covid-19 Incident Command Centers so that the “show can go on” if one of the senior leaders becomes sick.  As hospitals have struggled with adequate personal protective equipment, and as we’ve learned more about the varying symptom manifestations of the virus, this reality of suddenly having someone out of commission is front and center.

On a personal level, as I’ve heard of couples contracting the virus resulting in one or both of their deaths, I’ve been moved to have discussions with my husband around “information sharing” that we’ve not previously placed as a priority.  Where are passwords; “important documents;” “house maintenance activities,” etc.?  For a system to be agile and resilient, these processes need to be in place so that immediate adaptation can occur.

Below is a polarity map, which outlines this tension of Leveraging Specialized Knowledge and Shared Knowledge.

At SixSEED Partners, we are committed to developing leaders who have the capacity to leverage these interdependent tensions that are here to stay.  We’ve taken the liberty of adding some action steps and warning signs to this map that you can use immediately with your teams.  

If you’d like your own editable polarity map to give yourself the systemic view of the tension you are navigating, or if you have questions about how you might use this information now, complete our contact form and we’ll respond within 1 business day.