Leadership in Healthcare

Atiq Rehman, MDDirector for Minimally Invasive Cardiac & Transcatheter Valve Surgery

Director for Performance Improvement & QualityLourdes Health System

Why do we need Change?

Why do we need to talk about Change?

Need for change

To continue your current

success

To develop the potential you

represent todayLife is dynamic

Change…..before you have to!

A grateful person a happy person

• Show me a grateful person and I will show a happy person

• Life-long pursuits which one ought to strive for

• Appreciation of common everyday things (flowers, nature, fresh air), conscious differentiation between musts & wants

• Freddie Mercury: “I want to be happy, because it shows in my work”!

Motivation defines success

• Internal motives would mean learning for a student, teaching for a teacher, treating patients with empathy for a physician, serving the people for a politician, serving the nation for a soldier etc.

• Instrumental motives would be studying for good grades for a student, teaching for promotion for a teacher, treating patients for generating more income for a physician, serving the people to be re-elected for a politician, serving the nation for medals/promotions for a soldier.

• Concentrate as a doctor treat patients with empathy and skills fame and income will come with time as a good byproduct. People who have internal motives in their spheres of life are successful in the long run and many a time in the short term as well!

Better Me

• The desire to achieve and to excel a self competition or with someone

else or a combination?

• Gore Vidal famously said “When a friend succeeds, a little part of me dies”

• “I am in competition with no one…I am simply trying to be better than the person I was yesterday”.

• Combination: we need to concentrate on our own inner personal competition and that may alone bring happiness, success and contentment!

Getting along with others

• The ability to get along with others will also determine the diversity of your stakeholder network.

• Your success is dependent on others

• Jehangir Ratanji Dadabhoy Tata once mentioned;

– “If I have any merit, it is getting along with individuals, according to their ways and characteristics… At times it involves suppressing yourself. It is painful but necessary”.

Riding the Tide

• Tides and waves are part of anyone’s life

• A. Lincoln lost the Senate race to Lyman Trumbull. At that time he told a friend, “I would never strive for office again”. 

• Comments about Judge Stephen Douglas: “Twenty two years ago, Judge Douglas and I first became acquainted; even though, we were both ambitious; I perhaps quite as much so as he, what about today? With me, the race of ambition has been a failure---a flat failure; with him it has been one of splendid success”.

• Although devastated after losing the senate race to Douglas, that night he said to himself, "It was a slip and not a fall"! 

Survivor

• Erwin Rommel famously said “To become a hero, one must above all SURVIVE”.

• One has to develop survival skills in private and professional life.

• A culmination of emotional & social intelligence, focus & energy, belief & inner strength, resolute & resilience

• Ability to bounce from downturns of life. Thus be a SURVIVOR!

Aim High

• If the goals and objectives are very simple, they may be achieved in a very short time and then one is wondering what to do next.   

• Although goals vary relative to the individual, aim so high that you may not be able to achieve them in one life time.  .

• You will retain your drive and gain more energy as you try to catch on to your High goals!

Avoid distractions

• Two Boeing 747s (carrying a total of 1000 passengers) were about to collide in mid air above Scotland. The collision was averted when the alarms went off and the pilots had a visual of the other plane, leading to immediate change of the  planes’ course of flight.

• The possibility of pilot’s distraction inside the cockpit.

• As they say, winning teams have the least distractions and their members are focused on the common goal.

The Grit to Strive

• The one common factor in all those who outshine (regardless of the IQ, EI, SI, background) was GRIT.

• Inner tenacity, drive, passion, the marathon spirit of life, staying focused on ones goals and it comes from within.

Minor Factors are major factors

• STS 107:• Smaller pieces of foam had come off one various shuttle flights, ignored

and with no consequence. Feb 1, 2003, STS 107 Space Shuttle Columbia is on its reentry path and the 3000oc heat burns through the protective shield since a bigger piece of foam (an amalgamation of multiple minors) had come off during take off…… leading to the only second crash in the shuttle history.

• Three Mile Island Meltdown:• Multiple valves built in nuclear reactors and supposedly if one of them

fails, it may not have an untoward outcome. Thus a single valve malfunction was ignored in the Dauphin County Nuclear Reactor……a bucket size leak led to the partial meltdown of the Three Mile Island Nuclear accident on March 28, 1979.

• B-52 H-bomb:• In 1960s a B-52 bomber carrying a 24 megaton H-Bomb  dropped in North

Carolina but did not explode because of a single safety mechanism that held on (there were six interlocking safety mechanisms in place, but five were set off by the fall except that one which held on).

Opportunity in Failure

• Sallie Krawcheck (ex Head of Smith Barney and CFO Citibank) recently wrote (on being fired) ten points to learn from the experience;and  there is one which stands out: It is this time that one needs to look into personal and self development.

• Nilofer Merchant was an assistant to Apple executives. In the same week she lost her job and got divorced. She came back with voracity and now runs a successful consultancy and a speaker at TED.

• Neil Pasricha was happily married for a few years. And one  day his wife told him that she no more loves him and they broke apart. Within a month his friend from childhood (unfortunately struggling with a mental illness) committed suicide. He was devastated; but he made it an opportunity to write a tremendous blog which became a bestseller book..."The book of Awesome".!

Responding to Errors

• 'To Err is human"...

• Nikki Giovanni said, "Mistakes are a fact of life, it is the response to errors that counts".

• Thus our past experiences, behavior, attitude, culture, circumstances all play a role in our responses to errors.

• Errors could take two routes: – the negative outcome situation will be where the error is

missed and is exacerbated– the positive outcome will be when the error is mitigated and

controlledstill happen!

Gap Analysis

• A dream leads to a vision in our mind

• Need "Analysis of the Gap” to go from point  'A' in life to point 'B‘

• • Preparation for curve balls

• Identification of growth opportunities

Perseverance

• Challenges become major problems and we tend to stay in our comfort zones. Our reactions remain reactive instead of being proactive! Failure becomes an acceptable option.

• Edison said "Many of life's failure are people who did not realize how close they were to success".

• Marie Curie said, "Life is not easy for any of us. But what of that? We must have perseverance and above all confidence in ourselves. We must believe that we are gifted for something and that this must be attained"

Avoid Multitasking

• What is the truth about Multitasking.

• Loukopoulos at NASA's Human Cognition Lab very elegantly demonstrated that Multitasking is a myth and in a 13 year review of the aviation accidents (where crew were thought to have made an error), multitasking was one of the key avoidable factor which could have prevented the accidents.

• Multitasking increases ones vulnerability to error.

• Thus when doing something of importance, reduce the number of tasks performed simultaneously, recognize whenever interrupted and develop salient cues in your system to avoid distractions

Don’t be about ypou

• The "Self" phenomenon is innate to all of us.

• However as Alfred Adler said, "It is the individual who is not interested in his fellow men who has the greatest difficulties in life."

Poise under pressure

• On Apil 29, 2011, I was with my family on the grounds of Cape Ke...nnedy, part of a 700,000 crowd awaiting the 2nd to last launch in shuttle historyi.e. STS 134- Endeavour.

• President Obama was visiting as well and millions watching on TV. The payload was around $4.5 billion and 6 crew on board.

• Just in the last moments, launch director Mike Leinbach called it a 'NO GO" and scrubbed the launch. Later talking to a veteran astronaut, I was told Leinbach followed standard protocols

Ship the product

•We work on a project, build a product, do a household chore, it is the last few moments that drag us the most.

• To paraphrase Steve Jobs, a job is not done & product not complete until it is shipped

Resilience of bouncing

• Ups & downs, troughs & valleys, that is what they call LIFE.

• Essentially it is quality of being hit and bouncing back which helps you tread through the downturns of life.

• As Scarlett O'Hara (Gone with the Wind) said, "...After all, tomorrow is another day!"

Man in the Arena

• So it is the one who takes the initiative who may achieve the unthinkable.

• Ted Roosevelt put it at Sarbanne College, Paris, "The credit belongs to the man who is actually in the arena, .....

• Eisonhower put it, "Must take the jump....whether the bottom contains a nice feather bed or a pile of brickbats".

• Thus analyze the task well and then just do it!

Empathy & Compassion

• Life long training

• Essential in our field

• Don’t be like CEO BP

Family

• It is essential to have:– a friend– family – power group