Imagine Two Healthcare Systems in California in 2014

Imagine two healthcare systems in California. Both face changes in health insurance and reimbursement. Both are concerned for market-share. Both consider building new units. In both, these changes adversely stress nurses and other employees. In each, the executive committee is divided over what to do. In each several key managerial teams become less productive.

Alpha Healthcare addresses the conflicts directly, promptly, and transparently. Anne the CEO hires a facilitator to explore the viewpoints of both sides of the executive committee. The facilitator is expert in the tools and skills of technology of consciousness and so feels the underlying agreement and brings it into the open. The two sides now understand each other’s viewpoint. They agree to disagree on some issues but to move forward for the good of the patients and the organization.

The facilitator sits in with the disordered managerial teams, one, by one, gets their respect and trust, explores the reasons each team’s goals are important to each member of the team, and motivates them to inspire themselves to high performance.

The nurses and other staff are invited to meetings with the facilitator.  By holding a neutral viewpoint, the facilitator gains their trust and employees openly vent fears, frustrations, and suggestions.  The facilitator inspires executives and managers to listen actively to the views of the employees. Some issues are resolved rapidly; the employees are willing to wait to have the remainder resolved.

Alpha Healthcare moves forward. The CEO and executives devote their time and attention to the critical issues of the future instead of the internal conflicts. Absenteeism from stress drops; people work productively; people who were disengaged become reengaged with Alpha’s goals.

At the other extreme, Epsilon Healthcare buries the conflicts. Edna, the CEO, puts motivational posters on the walls. She urges her managers to get the most they can from every team: to work them, manipulate them, pit one person against the others by subtly playing favorites now with Betty, now with Sam.

The executive committee argues instead of functioning. Managerial teams meet but don’t produce. Absenteeism at Epsilon rises. Were an outsider to observe the staff at work, he would see “presenteeism”: people repeating work, daydreaming, and gathering at water coolers and copying machines to vent complaints no manager hears (so Edna never addresses). Productivity falls.

Tom, Bill, Helen, and many good employees became disengaged. They no longer care for the institution in which they once invested hope and eager work. Angry chides from managers upset them, stop their creativity, and make them indifferent, even antagonistic, to Epsilon’s goals.

Sid, Elizabeth, and Henry luck out. Their LinkedIn profiles were up to date, attractive, and private from Epsilon’s management. As each gets an opportunity to go elsewhere, anywhere else, each jumps ship.

Epsilon continues to fail.

So where is your Healthcare System on this spectrum? Alpha and Epsilon are extremes. Where are you?  Lawrence Hebberd of http://www.gravitatedesign.com (LinkedIn) and Gallup Polls’ State Of The American Workplace report that absenteeism from stress cost the US $30 billion last year, “presenteeism” – being at work but unproductive ‒ $200 billion, active disengagement about $500 billion. What are these problems costing you?

Conflicts Inside Companies

There are conflicts in every company. Some are minor. Some are serious, toxic, interfering with the goals of the company. How does a company handle them?

Some executives  believe a turbulent situation is best cured by firing the people involved. Maybe. Firing is an expensive solution. It can cost as much to fire and replace someone as it does to pay one or two years’ salary. Firing also has human costs. Friends of the former employee lose morale. Others in the company who fear they might be fired lose morale.

Other executives try training sessions or courses. The effects are limited, limited both in the time the effects last and in how deeply the courses change attitudes and behavior. The exceptions are those few courses that give students tools to look into themselves and change beliefs they want to change. Those courses produce a lifetime change and their graduates can revitalize a company.

There is another solution. Look at the problem from the viewpoints of the people in conflict.

If the members of a key team are in conflict, there is an alignment hidden underneath. The conflict need not be solved: find the alignment, and the two sides can agree to disagree but move forward to the company’s goals because of the alignment.

If the people are in a team that is stuck, not moving forward, not being creative, the approach is different. Motivate the team to inspire themselves to high performance. Inspire themselves? Yes, so they take ownership of the problem and of its solution.

The problem can be a key employee, or someone who once was key, but now is dysfunctional. He or she no longer contributes to the goals of the company but has valuable knowledge and skills. Dysfunctional people often have a hidden agenda. Work with them, find the hidden agenda, and discuss it openly. It is no longer hidden. The company will improve because of the discussion. The individual will often realign with the company’s goals.  At the worst, it will become clear that the person cannot realign (and usually, why they can’t), and they may need to be fired. The open discussion will have made it clear to all why this is the case, and likely there won’t be problems with morale.

There is the problem of an executive, perhaps recently promoted, who has technical expertise but has not yet learned how to deal effectively with emotional situations among staff. This can lead to lots of conflicts. Coach the executive to be effective with emotions and those conflicts begin to disappear. New ones of the same type no longer appear.

One thing is critical to help a company do any of these, or to teach senior executives to do them themselves. That is rapport. The consultant must create rapport with the people he or she is working with, the quicker the better. Executives and staff need to feel that the consultant is on their side, is trying to understand them, is compassionate, is nonjudgmental, keeps confidential matters confidential, and takes responsibility for his – the consultant’s – actions and for guiding the people he works with to the best possible solution. The consultant and those he is helping need to be an aligned team.