Doing More with Less or More with Many?

How many times have your heard “we need to do more with less”? This language of scarcity is coming from a leader’s surrender to the changes that are unfolding in healthcare.  Doing more with less is a recipe for disaster.   To me, doing more with less when it comes quality and safety in healthcare means doing more harm with less thought.

As leaders, we owe those we lead an inspiring, optimistic approach to doing things a new way when we are asked to do more.  Can we, for a moment, shift our thinking from scarcity to abundance?  Instead of fretting over another problem  that needs to be fixed by Monday, take on the “more with many” approach and engage your staff in solving the problem.

Abundant mindset

The people closest to the work need to be the ones to fix the problems.

So why don’t you let them fix it?  Feeling guilty to ask a front line clinician or leader to take on an improvement project?  Think back to how you felt when a supervisor asked you to take on additional responsibilities.  What did that mean to you?  Did you feel awesome and honored?

What’s holding you back from engaging your front lines in quality improvement? Too busy?  Afraid to give up control?  Unable to trust others to step up and meet your expectations?  Clueless on how to start unloading these rocks from your back pack?

Your staff want to be pushed to pursue excellence.  Start small.  Turn to your key, positive influencers to be your foot soldiers in solving problems and improving quality.  Your font line staff want to be part of something bigger.  They want to make a difference. You can give them this opportunity as a gift.

The next time you have a quality improvement project or problem to solve consider these tips to engage your staff and lighten your load.

1.  Ask staff for their opinions on the problem being solved.  Use email, posters in break rooms, huddles to gather ideas.  Round on key stakeholders and physicians to gather information.  Share what ideas are being carried forward.  By gaining input front line staff, you will prevent rework from poorly conceived solutions.

2.  Involve staff in small tests of change.  Ask highly engaged staff and physicians to pilot-test work flow processes.  Start small – one nurse or one doctor or one patient at a time to experiment with new process.  Gather feedback, revise and retest on a small scale.  Staff involved in small tests of change will gain so much insight into quality improvement and you will benefit from this in the future.

3.  Recognize a Champion.  Meet them where they are in terms of what they can or are willing to do.  Start small and let them bloom or give them the project to lead.  If there will be administrative time needed, sit down with the Champion and determine how much time and how they will schedule to get the work done. Depending upon the skill of the Champion, they can take care of steps 1 and 2 for you.  This is a great way to begin grooming your future leaders and create a culture of continuous learning and improvement.

It’s up to you on how many rocks you want to carry in your back pack.  Sharing the load with key front line staff has so many benefits.  You get to give front line staff the gift of being part of something bigger, build the department’s leadership and quality improvement capacity, and create your leadership legacy.

Thanks for reading my blog!

Happy thinking, creating and being!







Biggest Mistakes of the Chronically Overwhelmed

We have all had times in our lives when we have bitten off more than we can chew.  It’s human nature for many of us in the helping field of healthcare.  We are overly optimistic about how much we can accomplish.  It is our optimism and desire to serve others that gets us into trouble.

In coaching front line leaders in health care, I see many making the same mistakes over and over again, and wondering why they can’t achieve their goals.

Is this you?

1.  You are an early adopter.  You love new ideas and want to be the first to pilot, so you volunteer.

2.  You love to help other people.   If a coworker from another department has a crisis, and they need your help, you drop everything on your to do list to help.

3.  You are easily distracted and welcome interruptions. Sitting down and planning for a better future is boring compared to fixing or problem solving an urgent issue.

4.  You like being the “go to” person who helps when others might take a pass.  It’s all about the team, right?

5.  You believe that “one more thing” won’t significantly impact your workload, so you say yes.

The problem lies in your optimism and spirit of teamwork.  It is both a blessing and a curse.  

1.  The “one more thing”  is probably the tenth extra thing you took on.

2.  As the “go to” person, you are so busy helping others that you are not helping your own department, or staff.

3.  The distractions prevent you from spending time doing your best thinking, to build a better future.

4.  The spirit of teamwork may not be reciprocated.  You help others to “pay it forward”.  Do you ask for help in return?  Do you get help or support when you need it?

5.  Always being the early adopter can put a strain on your staff,  and distract you from your core work.  It can also rob other peers of the opportunity to be a pilot site.

angel_marquee-newFor all this teamwork and action packed activity you will be rewarded, right?  People around you will recognize and appreciate all you do, right?  Your staff will see how hard you are working, right??????

Wrong……….. here’s what your peers and staff see:

1.  You are so busy.

2.  You stay late and bring your work home.

3.  You can be counted on to volunteer for extra work.

4.  Your staff are dealing with work processes that are inefficient because you are too busy to attend to your own house.

5.  You fall behind in meeting deadlines because you added one more thing for someone else.

6.  You are becoming increasingly anxious as you become overwhelmed.

Is this what a leader looks like?

Prioritization Matrix 2A leader spends time working in the upper right hand quadrant of the priority matrix.   A leader has focus and spends their time doing the right things at the right time.   If you are overwhelmed, chances are that you are not saving enough time for the sacred work that gets done in the upper 
right, or quadrant II.

Think about the leaders you admire.  Do they have an aura of peacefulness and balance or frenetic activity?

Which leader are you?  Which leader do you want to be?

What can you do?

1.  Analyze your time for one week.  How much of your time at work or play is spent in each quadrant?

2.  Learn to say no.  Explain to a requester what priorities you currently have an why you cannot take on an additional project at this time.

3.  When you must say yes, be realistic.  What priorities do you currently have and when can you fit in a new project or activity?  How long will it take you to complete the work when you fit it around your work?  Is there an opportunity to share the project or activity with a subordinate as a growth opportunity?  Don’t just plop it on top of your important work and hope for the best.

4.  Don’t invite interruptions, especially when you are doing upper right quadrant work.  Shut your door.  Let calls go to voice mail.

5.  Respect your work and your time as much as the work and time of others.

It’s time to reclaim your priorities and focus on what is most important to you and those you lead.

Thanks for reading my blog and engaging in the process of thinking about your leadership potential.

Happy thinking, planning, being!




Rescue a drowning leader

What does it look like when a leader is drowning and needs to be rescued?  Have you ever been overwhelmed and didn’t want to share this fact with your supervisor? Sometimes it’s hard to spot.  If you are the one drowning, you know it.  How can you keep your head above water, or help those you lead stay stay afloat when the tide of work rises?

red_life_buoy_on_wooden_wall_background_padfolioMy favorite tool for leaders who are feeling overwhelmed and paralyzed with the amount of work on their plate is the “Sticky Note” exercise or “Brain Dump”.  This is the best 45-60 minutes you can spend to get a handle on the work and clear your mind of all the worries.

This link to my website coaching page has the instructions for the “sticky note” exercise that will enlighten you and end with a realistic plan to get the most important things done.   I have helped numerous leaders dig out from leadership quicksand in one telephonic coaching call using this tool.   Arm yourself with a pack of good sticky notes to write everything down that you do or need to do and have a large surface to arrange,  categorize, prioritize and schedule what is most important to you and your success.  You can do it on your own or with a trusted coworker or supervisor.  The important thing is to DO IT.  Time spent thinking and planning will put you on the right track in doing the right things at the right time and give you peace of mind that you haven’t forgotten something.

Thanks for reading my blog!  Happy thinking, planning, doing!