1. MARCH 25, 2012 Amy C. Edmondson | Novartis Professor of Leadership & Management | Harvard Business School

2. Teaming is a Verb Teaming is teamwork on the fly–coordinating and collaborating, across boundaries, without the luxury of stable team structures team ing (v.) Teaming is especially needed when work is COMPLEX and UNPREDICTABLE

3. Execution facing Uncertainty Leaders have the ANSWERS STABLE work processes are put in place IMPLEMENTING CHANGE is a huge undertaking Feedback is ONE-WAY Employee judgment is DISCOURAGED Fear (of the boss) is NORMAL Leaders set DIRECTION (strategy) EXECUTION-AS-LEARNING EXECUTION-AS-EFFICIENCY TENTATIVE work processes provide a starting point CONSTANT SMALL CHANGES are a way of life Feedback is TWO-WAY Employee judgment is ESSENTIAL Fear inhibits EXPERIMENTATION, ANALYSIS, and PROBLEM SOLVING GOAL Be profitable today GOAL Create value over the long term

4. Interpersonal Risk NONE OF US WANT TO LOOK: IGNORANT INCOMPETENT INTRUSIVE NEGATIVE IT’S EASY TO MANAGE! DON’T ASK QUESTIONS DON’T ADMIT WEAKNESS OR MISTAKE DON’T OFFER IDEAS DON’T CRITIQUE THE STATUS QUO

5. You Learn What They Let You Learn WORK UNIT MEMORIAL 1 UNIVERSITY 1 UNIVERSITY 3 MEMORIAL 2 MEMORIAL 4 MEMORIAL 5 UNIVERSITY 2 MEMORIAL 3 ERROR RATE 23.68* 17.23 13.19 11.02 8.6 10.31 9.37 2.34 * preventable and potential adverse drug events (ADEs) per 1000 patient-days Sorted by Survey Ratings of Unit Psychological Safety

6. Psychological Safety Psychological safety is a belief that one will not be punished or humiliated for speaking up with ideas, questions, concerns, or mistakes. IT’S ESSENTIAL TO TEAMING. What gets in the way?

7. Hierarchy and Psychological Safety Nembhard, I. and Edmondson A.C. (2006). Making it safe: The effects of leader inclusiveness and professional status on psychological safety and improvement efforts in healthcare teams, Journal of Organizational Behavior. N=1100 clinicians

8. Sacrificing Accountability Is it a matter of finding the right point on a balance beam? PSYCHOLOGICAL SAFETY ACCOUNTABILITY

9. Psychological Safety & Accountability high low high ACCOUNTABILITY PSYCHOLOGICAL SAFETY Apathy Zone Comfort Zone Anxiety Zone Learning Zone

10. The Blame Game POTENTIAL CAUSES OF FAILURE Experimentation Uncertainty Complexity Lack of Competence Inattention Procedural Violation QUESTION Which of these antecedents involve blameworthy acts? QUESTION What percent of failures in your organization are caused by blameworthy acts? QUESTION What percent of failures does your organization treat as caused by blameworthy acts?

11. Leading the Learning Organization VISION Set a clear direction that engages hearts and minds CULTURE Model and reward beliefs that make it safe for learning TEAMING Institute and support team-based processes