If you see something, say something….. PLEASE!


As I have traveled by rail and air this summer I have noticed more signs, reminding me “If you see something, say something”.   What would I do if I saw an unattended package?  Who do I report my concern to?   How much time will it take?  What if I speak up and the package is nothing?   Will I be made to feel like a fool for speaking up?

There are so many barriers to speaking up when you suspect something may not be right, so maybe you just don’t bother. Is that our problem in Healthcare?

Creating a culture in which individuals are free to report concerns before they turn into big problems is an integral component of a “Culture of Safety”.  Finding the recipe for the secret “culture of safety” sauce is the goal of transformational leaders because they know “culture eats strategy for breakfast” (Peter Drucker).  If you get the culture right, the rest falls into place.  Performance improves as individuals feel secure enough to put their neck on the line to contribute more than the status quo.

But, the status quo can be scary and hard to change.  The status quo may keep a nurse silent instead of questioning an unclear patient care order! It may stop a co-worker from calling out a break in sterile technique that could lead to a surgical infection!   The status quo may keep a technician from reporting an equipment malfunction that could lead to patient harm if it occurs again.

In healthcare, we are 30 years behind the aviation industry in creating a culture of safety that encourages all levels of employees to speak up about a concern  then accepts the concern and proactively responds to the concern.  By focusing on healthy team communication for the past 30 years, aviation has produced an extraordinary safety records.

In healthcare, our multi-disciplinary, hierarchical teams make establishing a culture of speaking up a challenge.  But, we know creating an environment of Psychological Safety where people can speak the truth without fear of retribution is what we want.

Are you ready to take your organization, department or team to the next level of safety culture and team communication to accelerate your safety performance?  Here are a few questions to get you started in identifying your gaps in order to create your high performing safety culture:

  • Does your staff speak up honestly about vulnerabilities, stress and obstacles or are you blindsided with the information when it is too late to make course corrections?
  • Do you have structured communication processes for staff to utilize to voice concerns and escalate it if needed?
  • Do you have a process to proactively gather concerns from staff?

Do you see an opportunity to promote a culture that embraces speaking up? Now is the time to take advantage of all the tools and resources available to get your team or your organization moving in the right direction.

If we all work together, we can make healthcare better.

Thanks for reading!

Best Thinking: Uncovering the Invisible

When trying to solve a problem or make an important decision, how do you approach thinking about the solution?  Do you go with your first thought and go deeper with your focus on a solution?  Or, do you think wider, considering all the possibilities before you focus?

As an Intrinsic Coach, I have learned the value to the later.  When I am coaching front line hospital leaders who are facing problems, or difficult decisions, their first reaction to a problem is to start talking about strategies to solve the problem.  That seems like the obvious first step, right?  We only have so much time in the day, and we need a solution, now.  Our systemic thinking takes over.

Systemic thinking serves us well and tends to dominate our thinking.  Systemic thinking allows us to react quickly to a situation based upon our experience and knowledge.  This is perfect for solving a problem in an urgent, crisis situation like an internal disaster, or managing an unstable patient.  The solution is black and white and the variables around the situation are visible for all to see.  We base our decision on experience which is based upon old thinking and old knowledge.  Using old information can block our ability to see new information that may not be readily apparent.  That is the flaw in starting with systemic thinking when making decisions about non urgent situations.

In thinking about non-urgent situations, taking an intrinsic approach will serve you better.  When thinking about an important decision or solving a problem, disable the dominance of systemic thinking and consider the intrinsic.   The intrinsic means focusing on the goal and what is most important to you before you start to lay out the strategies to solve the problem.

The intrinsic leans on widening our thinking about the goal before we focus on a solution.  Intrinsic thinking means spending the most amount of time thinking to determine what is most important for this unique person or team, in this unique situation, in this moment in time.  It is based upon new thinking and searching for what is most important by uncovering thoughts that are initially invisible.


While having a conversation with a colleague who is in job transition, her first thought about her goal is “to find a job”.  “Find a job” is actually a strategy, and if we went forward from there we would have skipped the intrinsic.  As we talked about  what was really important to her about this decision, and about all the opportunities and thoughts about what she is looking for,  new thoughts began to emerge about what is important.  She began to uncover information and new thoughts that were previously not apparent to her.  Her intrinsic formulated a goal:  “To find a job in which I can truly be myself.”  What she is wanting is a job in which she can let her guard down and use her creative skills that she loves.  This opened up a new ideas and more options and possibilities.   Suddenly, there wasn’t panic about how I will find a job.  There was hope and energy about the array possibilities that can unfold in the future.  Her options quadrupled.

The goal in leaning on the intrinsic to promote best thinking is to uncover new learning, new information about what is important.  If we allow our minds the time to think about what is truly important, our strategies and actions will snap into place and we will know what to do, and it will be the right thing for us.

So the next time you are faced with an important decision or problem to solve, don’t go with the first thought that your systemic thinking offers as a solution.  Spend some time thinking broadly about what is truly most important to you as a unique person, in a unique situation in this moment in time.  If you use your intrinsic wanting to decide what to do, you will make better decisions about your future.

Tapping into the intrinsic takes discipline and self management.   Here are a few tips.

1.  Ask the “What” – “What do I want?”  “What is important to me in this situation?  Listen to your internal dialog for clues about what is most important.

2.  Don’t focus on the “How” till you determine the “What”.

3.  Don’t ask “Why?”.  Why takes us into the past and won’t be productive, unless you ask why to create new learnings.

4.  Don’t rehash information you already know.  And, If you are in a conversation with someone trying to make a decision, don’t ask questions about information they already know, for your own curiosity.  That is letting your systemic thinking dominate and it will interfere with their fragile, intrinsic thoughts.

5.  Start with broad thinking before you go narrow.  The broad thinking will make your practical thinking smarter and uncover more options.

Give this some thought.  Best thinking starts with clarity around goals which leads to best planning to achieve the outcomes that matter most.

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!