SixSEED Partners

polarity thinking

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.

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.

Leveraging Taking Ourselves Seriously AND Taking Ourselves Lightly

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This is the fifth 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

After hours of speaking with our clients who are on the front lines in hospitals or leading medical practices, the tensions we’re highlighting are coming from them—you.  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.

Below is a polarity map, which outlines this tension of Taking Ourselves Seriously AND Taking Ourselves Lightly in service to creating a healthy workplace for all.  What you’ll notice in the below polarity map that is different from prior maps in the series is an action step that is highlighted in yellow.  This is called a “high leverage action step” since it applies to both poles.  Intentional design of meeting agenda and space is necessary to leverage a business focus and a lighthearted/ energy-giving focus. 

As we’ve spoken to our clients, we see and hear the exhaustion people are feeling as a result of this prolonged pandemic along with the stressors of re-opening elective surgeries while also staying prepared for what could still be a surge in Covid-19 cases.  After weeks of being immersed in fourteen- hour days and incident command centers, your “higher-order thinking” can get worn down by the constant energy out.  Designing in activities that allow you to laugh and keep a “beyond-Covid” perspective helps to build your resilience for the ongoing demands.

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.

Leveraging the Tension of Assuming Responsibility and Delegating Responsibility

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This is the fourth 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

After hours of speaking with our clients who are on the front lines in hospitals or leading medical practices, the tensions we’re highlighting are coming from them—you.  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 we coach leaders, we often refer them to the powerful work of David Emerald who wrote: “3 Vital Questions: Transforming Workplace Drama.”  This book, along with his other book: “The Power of TED (The Empowerment Dynamic)” describe our tendencies to fall in roles of victim, persecutor, and rescuer.  Covid -19 calls on medical professionals and others to play the role of “Hero/ Rescuer” to patients who are sick and/or dying due to the coronavirus.  These patients are helpless to fight this battle without medical support.

The tension for leaders occurs when we extend that pattern of playing hero with others in our lives who are quite capable of taking care of themselves and possibly, even acting in a way that may exceed our capacity.  How do you determine the essential work that only you can do, as compared with those responsibilities another resource is, or could be, well-prepared to do?  If I were to use some of the examples I’m hearing from my clients, I’m impressed with the speed with which others have been trained to staff command centers, or resources have been summoned to expedite operationalizing telemedicine.  

It takes a conscious leader to pause during the crisis of reacting to Covid-19, and ask themselves and their teams the following questions: 

  • “What beliefs did we suspend during this crisis that helped us to be successful?” 
  • “How might we continue to challenge our former belief structure to allow us to expand our talent pool and create a stronger degree of shared ownership?”  
  • “What benefits might emerge for our ability to better care for ourselves while we create more powerful engagement for our teams that can help us meet future challenges?”

In the book above mentioned, the second question is: “How are you relating?”  During this time of complexity and uncertainty, pausing to notice with curiosity “how you’re relating,” (from what role) in addition to taking action will yield dividends in your future preparedness and increase in systemic well-being.

Below is a polarity map, which outlines this tension of Assuming Responsibility and Delegating Responsibility in service to creating shared ownership for all.  

At SixSEED Partners, we are committed to developing leaders who have the capacity to see these interdependent tensions to better lead in this time of uncertainty.  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.