New England Medical Group Manager Association 2016 Conference: Healthcare Paths and Perils 21st Century Leadership in the Healthcare Environment Lizza Robb, MSW

POP Model for Purposeful Action Purpose: Why is this important? Why is it a valuable use of my time and energy? Outcomes: What do I hope to accomplish? Process: How am I going to do it? The POP Model for purposeful action comes from Robert Gass’s work through the Social Transformation Project

Purpose: Why is Leadership Development important? Constant pressure within a rapidly changing healthcare environment and culture Demands continuously outpace our capacity to deliver Highly engaged leadership is directly tied to the happiest, healthiest, most effective organizations Happy, healthy organizations are resilient in response to pressure and change I don’t need to tell you that contemporary medical groups face constant pressure within a rapidly changing healthcare environment. Demands constantly outpace the capacity to deliver, and rarely do leaders in healthcare have an opportunity to reflect on their personal development and impact as leaders. Meanwhile, research suggests that positive, engaged leadership is key to the happiest, healthiest and most effective organizations—the organizations that will be best positioned to be resilient in the face of change. It is so easy… become passive as leaders. To be reactive.

What I most want for myself at work in the next year is… What I most want for my medical group in the next year is… What I most want for myself and my family in the next year is…   [Click to remove first and third statements.] At your tables, take a couple minutes each to share this second statement. What I most want for myself and my team at work in the next year is… [Give enough time for each person to share at their tables.]

Outcomes: What we hope to accomplish Make a case for the importance of prioritizing leadership development in healthcare Participants will have an opportunity to reflect on their own leadership Discuss simple tips for self-directed leadership development Discuss three powerful concepts for leaders: resilience, change and resistance, and the “intentional narrative” (the concepts will be further explored in breakout sessions)

Process: How we’ll get there Topics: Leadership in healthcare Simple leadership development tips Three concepts: Resilience, Change & Resistance, Intentional Narrative Format: Teaching Discussion Reflection

STATE OF OUR ORGANIZATIONS A Harris poll of 23,000 workers showed that: Only 20% had any enthusiasm about their organization’s goals Only 20% understood the relationship of their tasks to the organization's goals Only 17% felt there was open communication A Towers Perrin study of 90,000 employees across all industries in 33 countries showed that: Only 21% of employees feel engaged at work Harris; Towers Perrin

STATE OF OUR ORGANIZATIONS Imagine a soccer team with 11 players: Only 4 of the 11 know which goal is theirs Only 2 know what their position is and what they’re supposed to do Only 2 care about the game Stephen Covey

STATE OF OUR ORGANIZATIONS In the United States alone, lack of engagement is tied to a $300B annual loss. Engagement is borne from non-financial incentives: #1 is attention from boss. Poorly managed work groups are 50% less productive and 44% less profitable than well-managed groups. Talk through slide. What does this have to do with leadership development? THIS IS leadership development. Many leaders choose to be passive. With constant demands and an unmanageable pace, it’s so easy, right? To let life and work live us instead of us living it. I work with a lot of leaders. And at some point it comes down to the question of agency. What is within my span of control as a leader. It’s not what happens to me. Or around me. Or certainly not on the federal healthcare policy front. But the best leaders recognize that they have a choice about how they respond to all of that. About how they stand up and lead. Towers Perrin; Gallup Organization

Attention from boss Know your people As employees What are their aspirations? What conditions support their best, most energized work? How do they like to receive feedback? As human beings Where do they come from? What obstacles have they overcome to get where they are? Who do they care about? What are their hobbies? Attention from boss This is not feedback. It’s not mentoring. It’s about basic connection and empathy. Being seen. Like how’s it going? Anything you need? I know you’re wife’s been sick, how’s she doing? How are your kids? Talk through slide We often know these things about our “favorites” Nick example It can be hard to make that personal connection. Law enforcement Kevin example Healthcare setting and emotion (carry the weight)

WHO HELPED ME? I want you to think about someone in your life who helped you. Someone without whom you would not be who you are today.   What did they do? How did they help you? How did it feel to be around them? How does it feel to think of them right now? Now turn to your neighbor and tell each other about your person. Here’s who they are. Here’s what they did for me. Here’s the difference it made to my life. Take a couple minutes each. [Give 4-5 minutes.] Let’s hear from several people. Who helped you? [Hear from several.] Not everyone has someone really powerful in their past, but many of us do. More than one if we’re lucky. Often what you hear is, They saw potential in me. They gave me a sense that I could do more than I thought I could. They gave me confidence to trust myself. They accepted me unconditionally. So my question to you right now is: If I come back here in five years, who might name you? That’s an invitation for everyone in this room. An opportunity. And it doesn’t take that much time or energy to convey to someone, Hey, there’s more to you than you even know, and I believe in you. They people you named didn’t actually do it for you. They gave you a more expansive sense of yourself and of your possibilities. That’s part of leading.

Simple Tips for self-directed Leadership Development Primal Leadership by Daniel Goleman Becoming a Resonant Leader by Annie McKee, Richard Boyatzis and Fran Johnston The Advantage by Patrick Lencioni Switch by Chip Heath and Dan Heath Good to Great by Jim Collins Hbr.com (Harvard Business Review) Forbes.com Subscribe to free e-newsletters like: Health Leaders Media FierceHealthCare READ Use Google, YouTube, TED Journal Connect with other leaders Peer coaching Practice There are many formal leadership development opportunities out there. Trainings, webinars, continuing education, conferences, executive coaching And those are great. It’s how I make my living.

intentionS FOR YOURSELF What is one thing you will commit to doing to give time and attention to your development as a leader? FOR YOUR STAFF Think of one direct report who needs your attention. What is one thing you will commit to doing next week to support that person’s engagement?

Three Powerful concepts for leaders Resilience Change & Resistance Intentional Narrative

Positivity by Barbara Fredrickson What are we talking about when we talk about resilience?   [Hear from several. They will likely say things like “our ability to bounce back.”] Right. Resilience is connected with our ability to recover. To bounce back after difficulties. There has been a massive amount of research over the last several decades on happiness and positivity and hundreds of books written on the subject. I highly recommend Positivity by Barbara Fredrickson at University of North Carolina. She and Martin Seligman at the University of Pennsylvania have done incredible work to further the field of Positive Psychology and bring it into our everyday conversation. What we now know is that we tend to overestimate the long-term positive effect of good things that happen to us. If I just get married, if I just get this job, if I just get this promotion, if I just get this new house, if I just whatever… I’ll be happy. We also overestimate the long-term negative effect of bad things that happen to us (divorce, losing your job, loss, accidents). Now, there are certain things that many people never recover from; we know that to be true. But most things we do. How do we know this? What usually happens a year later to someone who wins the lottery? [Hear from a few.] Right, they have a big spike in happiness and after about six to twelve months they’re back where they started. Research has also shown the same to be true for people who experience the loss of physical ability in an accident. Within 12 to 18 months, they often return to their level of happiness before the accident or even experience what’s called post traumatic growth and their long-term happiness level actually increases. So if we know that winning the lottery isn’t likely to make us happier. And we know that even experiencing an accident that robs us of our physical abilities isn’t necessarily going to devastate us. What accounts for our happiness if it isn’t these big good or hard things? If it isn’t the things that happen to us? Like our weight most of us have a lifetime happiness range. We tend to fluctuate within this range but rarely get too far above or below it. Positivity and optimism are NOT products of good fortune or results of success, they are predictors of success. Now, the question is what can we do to stay at the higher end of our range? Or to return to equilibrium after a difficult experience? That’s where resilience comes in. Positivity by Barbara Fredrickson

Relationships with family and friends Top ten factors related to resilience - American Psychological Association From: Top Five Regrets of the Dying by Bonnie Ware Relationships with family and friends  Avoid seeing crises as insurmountable problems Accept that change is part of living Move toward your goals Take decisive actions Look for opportunities for self- discovery Nurture a positive view of yourself Keep things in perspective Maintain a hopeful outlook  Take care of yourself I wish I'd had the courage to live a life true to myself, not the life others expected of me. I wish I hadn't worked so hard. I wish I'd had the courage to express my feelings. I wish I had stayed in touch with my friends. I wish that I had let myself be happier. Remember these lists from this morning?   [Pause.] What are you aware of? [Hear from several.]

Cycle of Change EXPLORE EXCITE EXAMINE EXECUTE EVALUATE EXIT

Resistance

Intentional Narrative We don’t live in a real world Blind Men and Elephant ("Wall!" "Snake!" "Spear!" "Cow!" "Carpet!" "Rope!“) Individual Collective Ex. Value-based payment (negative frame v positive frame)

Leadership Development Breakouts Breakout Session 101: Enhancing Resilience Breakout Session 201: Change & Resistance Breakout Session 301: The Intentional Narrative