Teamwork is crucial to an organization’s ongoing success. When management runs smoothly, employees tend to enjoy their jobs, exhibit greater passion for their work, and collaborate more intelligently to positively shape their industry year after year. But when an organization is run by inefficient management who regularly causes day-to-day, or even hour-by-hour, workplace challenges that drain employees and waste resources, lack of communication is often a key culprit.
However, pacifying the egos of incompetent management who are resistant to change, resolving deep-rooted personality conflicts, and streamlining inefficient workflow is easier said than done. David G. Javitch, PhD, Program Director of the Leadership Strategies for Evolving Health Care Executives program at the Harvard T.H. Chan School of Public Health, winner of Harvard University’s “Most Inspirational Instructor Award,” a psychologist, and contributing member of the American Psychological Association, is an expert in teamwork.
Javitch conducts global leadership and management training to help health care executives maximize organizational effectiveness, encourage team building, and practice conflict resolution. Additionally, he helps leaders maximize their decision-making power by educating them on how to best hire (and fire) employees, communicate to minimize conflict, and strengthen greater operational performance. He also teaches them how to be less resistant to change and incorporate teamwork into their company culture.
How a Health Care Organization Embraced Change
Last year, Javitch analyzed executives’ management choices and styles at one poorly run health care organization to determine why it was falling apart. This organization was a 600-bed facility with numerous nursing homes, outpatient sites, and hospital service lines. Ultimately, the health care corporation’s large size hindered communication among team members, explains Javitch.
The goal was simple. Says Javitch, “You want the bad people to leave, but you don’t want the good people to leave.” To make sure the best employees stayed put, he started asking a lot of questions about what people liked and did not like most about their colleagues, jobs, and workplace environment.
Javitch examined factors including how many people were quitting, how much work was getting done, and how many people were taking time off from work. “I interviewed a random sampling of employees from different sites and service lines. I wanted to get a description of the internal and external environment each was working in, the goals, roles, processes, trusts, and interpersonal relationships,” he says. Javitch also assessed four outcome variables: increased productivity, increased employee satisfaction, decreased negative turnover, and rate of absenteeism.
When an organization is run by inefficient management, lack of communication is often a key culprit.
Javitch discovered a lack of communication meant workers felt isolated. “The staff were not well coordinated between sites, and even within sites. There was no feeling of anyone working together,” Javitch states. “There was duplication of services, non-responsive transport, and ineffective material management. Different floors had different medical specialties. Morale was low and there was backstabbing,” he notes.
Javitch says he is able to successfully uncover workplace challenges such as these thanks to the work of James H. Shonk, author of the book, Working in Teams: A Practical Manual for Improving Work Groups.
“Shonk addresses 5 out of the 6 factors that I say lead to success: environment, goals, roles, processes, trust, and – I added an extra one in – relationships. I use this factor model when I’m called to diagnose a team where things aren’t working well, or to build a team from scratch,” he explains. “Even though this theory of change is 70 years old, it’s easy to learn, and easy to implement.”
Javitch assesses the outcome variables by determining to what extent each one increased and assesses growth by analyzing goals, not numbers. “You assess if your productivity has increased, not by looking for, say, 1 or 2 percent productivity growth, but by quarterly goals,” he explains. When goals are not met, Javitch recommends teaching your team how to achieve success and growth.
Tools That Address Conflict Resolution
Javitch spent several months interviewing employees at the 600-bed hospital via two questionnaires: the Strength Deployment Inventory – an organizational tool that teaches leaders how to influence people – and the Thomas-Kilmann Conflict Mode Instrument – a conflict resolution tool first introduced in 1974, administered millions of times annually, that addresses five conflict management styles: collaborating, competing, avoiding, accommodating, and compromising.
Know your people. Your people are more important than your budget, other resources, and structure. They are your key asset to success, so use your people appropriately.
Javitch says questionnaires like these often reveal hidden workplace challenges quickly and easily. For example, when Javitch shadowed hospital workers, he discovered an uneven workflow among teams. Some physicians had little work to do, while others in the intake department were swamped with a high number of patients.
Fortunately, problems like these are often easy to identify with observation, curiosity, and maybe even a workshop or two. In addition to administering questionnaires, Javitch also held a series of small group workshops with approximately 20 people each to discuss interview and questionnaire findings in greater depth. At the workshops, Javitch discussed Patrick Lencioni’s The Five Dysfunctions of a Team: A Leadership Fable. He had everyone tell their team which dysfunction – absence of trust, fear of conflict, lack of commitment, avoidance of accountability, and/or inattention to results – they were experiencing. “We discussed ways of turning dysfunctions into functions,” he adds. Then he helped the managers better understand their employees’ concerns to work towards positive change and improve functionality.
Put People First
When Javitch followed up with interviewees six months later to assess outcome variables, noticeable change was evident. “Morale, collaboration, and teamwork had increased. Fighting and competition had decreased,” he explains. “Overall, people said they were working better together and realized many of their behaviors had led to dysfunction, aggressiveness, and an unwillingness to compromise.”
Javitch says results like these are achieved when companies put people first. “Know your people. Your people are more important than your budget, other resources, and structure. They are your key asset to success, so use your people appropriately,” he suggests.
He also says identification of skill sets – and where people are deficient – is key. “Identify the knowledge, skills, abilities, and attitudes of your people. Train, mentor, and grow them so they all can achieve optimal performance. Identify which ones clearly need more attention than others, and make sure you’re working with them together to help improve their skills – and attitude,” Javitch advises.
What to Say to “Hardcore Resistors”
Nonetheless, when someone is fully against change, Javitch recommends you take a graceful, but firm approach. “Tell them something like, ‘Right now, your knowledge, skills, and abilities (KSAs), and attitudes don’t align with our future growth. I want to help you get in line – but only if you’re interested. If not, let’s find another position for you,’” he suggests.
And if that advice is ineffective, Javitch advises not to be afraid to kindly close the door to such a person, by genuinely saying, “I’m willing to help you grow, but if you’re unwilling, well, good luck at your next job.”
Those resistant to organizational change – even when it is beneficial to patients – primarily have underlying anxiety.
“If they’re unwilling to change, at least they’re being honest and will not further burden resources,” he explains. “You can always just part as friends.”
But parting as friends is not always easy. And, turning questionnaire feedback into actionable, positive organization-wide change is difficult when stubborn personalities are resistant to anything different.
“We talk about how to turn feedback from questionnaires around – if people want to. When some just want to be aggressive, we explain, ‘You don’t have to change, but there are downsides to this kind of aggressive behavior.’”
Javitch says those resistant to organizational change – even when it is beneficial to patients – primarily have underlying anxiety, a concern that renegotiation misaligns with union rules, uncertainty about the future, or fear of potentially losing the power or influence they have come to enjoy. One tool to help change resistors’ minds, he says, is having a face-to-face chat to explain your goal to help them develop and be more productive within the organization. In doing so, you also must ask “Are you interested in the process of doing this?” suggests Javitch.
“Some people are just stubborn and don’t want change. They say, ‘But we’ve always done it this way. Why are you suddenly asking me to cut down the number of employees who report to me?’” Javitch explains.
But others, says Javitch, are eager to embrace organizational change – even when a workplace environment has become too stressful to bear. “Some say, ‘I want to give team building a try and we’ll see what can come out of it,” he explains. “Many people who are chomping at the bit to leave are going to give team building a final chance.”
Raising Awareness Promotes Positive Organizational Change
This chance can only come about if health care executives and leaders address conflict head-on. Javitch says his psychological and leadership exercises encourage people to tell their executives and leaders about their honest concerns, because they are designed to give most people – except for perhaps the most assertive or aggressive personalities, that is – permission to stop being afraid of saying the wrong thing or initiating disagreement.
But the primary goal of any health care executive or leader should be to prevent rising conflict and abate future destructive impact – all the while embracing change.
Perhaps Patrick Lencioni, author of The Five Dysfunctions of a Team: A Leadership Fable, sums it up best: “Successful teamwork is not about mastering subtle, sophisticated theories, but rather about embracing common sense with uncommon levels of discipline and persistence. Ironically, teams succeed because they are exceedingly human.”
Harvard T.H. Chan School of Public Health offers the Leadership Strategies for Evolving Health Care Executives program, which focuses on skill building in the critical areas of leadership and management development, conflict resolution, operational analysis, employee management, and quality management. To learn more about this opportunity, click here.