Team Dynamics: Navigating Change and Staff Communication Sam Calabrese, B.S.Pharm, MBA, FASHP

Associate Chief Pharmacy Officer

Cleveland Clinic

Cleveland, Ohio

Cleveland Clinic •1400 licensed beds

• 44 buildings on 167 acres

•10 community hospitals 3050 beds

•5.1 million visits

•13 Family Health Centers

Mission: “…care of the sick, investigation of their problems, and further education of those who serve.”

Objectives

•Describe the change management process

•Identify strategies to manage change and transitions

•Describe methods to maintain employee engagement during change

Are you playing chess or checkers?

•Bet on Leadership

•Act as One

•Win the Heart

•Excel at Execution

Bet on leadership

•Don’t wait until you need a team member (Leader)

•Develop the individual • Personal development plan • Stretch assignment • Identify a coach

•Develop the team • Clear goals and purpose • Focus on team basics • Build community among the members

Act as one

•Alignment multiplies impact

•Everyone pulling in the same direction

•Master cascading communications

•Shared vision and values

Win the heart

•Engagement

•Leverage the unique capabilities of individuals

•Foster freedom to reach goals

•How will you add value for them

Excel on execution

•Move with urgency

•Build a system rather than rely on a person

•Don’t forget short term goals

•Visual management

Trust – 6 elements

Emotional bank account

•Amount of trust that is built up in a relationship

•Emotional reserve

•Account is high, communication is easy, instant, and effective

•Frequent withdrawals without deposits leads to mistrust

Six major deposits

•Understanding the individual

•Attending to the little things

•Keeping commitments

•Clarifying expectations

•Showing personal integrity

•Apologizing sincerely when making withdrawal

Five dysfunctions of a team

Team development – Four stages

Personalities in your team

•Pioneers

•Drivers

•Integrators

•Guardians

Pioneers

•Value possibilities

•Risk takers

•Drawn to bold new ideas

•Stifled by: Rules or structure Focus on process Negativity

Guardians

•Value stability / order

•Pragmatic

•Data and facts are required

•Learn from the past

•Stifled by: Disorder Time pressure Risk / uncertainty

Drivers

•Value challenges

•Generate momentum

•Results and winning

•Stifled by: Indecision Inefficiency Lack of focus

Integrators

•Value connections

•Draw people together

•Diplomatic and strive for consensus

•Stifled by: Conflict Inflexibility Politics

Managing the styles

•Pull opposites closer

•Elevate those least represented Avoid cascades Provide opportunities to participate

•Pay attention to introverts

Change Process Change – situational Focus on the outcomes

Transition – psychological Process that people go through as they come to terms with a

change

Terms are not interchangeable

Mutual Dependence

Phases of Transition “Transitions start with an ending and ends with a beginning.”

Getting people through the three phases is essential to achieving change

Kotter’s Eight Steps for Leading Change

1.Establish a Sense of Urgency

2.Forming a Powerful Guiding Coalition

3.Creating a Vision

4.Communicating a Vision

5.Empowering Others to Act on the Vision

6.Planning for and Creating Short-Term Wins

7.Consolidating Improvements and Producing Still More Change

8.Institutionalizing New Approaches

Kotter JP. Harvard Business Review 1995;59-67.

Relation Between the Two Models

1. Establish a Sense of Urgency 2. Forming a Powerful Guiding Coalition 3. Creating a Vision 4. Communicating a Vision 5. Empowering Others to Act on the Vision 6. Planning for and Creating Short-Term Wins 7. Consolidating Improvements and Producing Still

More Change 8. Institutionalizing New Approaches

Kotter JP. Harvard Business Review 1995;59-67.

Seeing the Challenge

Get Started

Rollout

Results

TIME TO MOVE ON

Get out of the Dark Addressing Level 1 Create a sense of urgency

•Make the status quo seem more dangerous than launching into the unknown

•Tell them the why

•Identify and discuss major crises or opportunities

Get Started Addressing Level 2

Form guiding coalition

•Engage your informal leaders

•Small/medium group that believes in the change

•Work as a team with formal leaders to move change forward

Get Started Addressing Level 2 Create a vison • A picture of the future • Help direct the change effort • Easy to communicate • Appeals to the end users • Should be able to communicate in 5 minutes

Rollout Addressing Level 2/Level 3 Communicate the vision •Over communicate information

Define what is over and what isn’t Define the end

•Use all vehicles possible Meetings Emails Newsletters

•Treat past with respect

Rollout Addressing Level 2/Level 3 Empower others to act on the vision

•Remove obstacles • Change systems/people that undermine the vision

“Free their future”

• Organizational structure • Negative employees • Negative leaders

Rollout Addressing Level 2/Level 3

Create short term wins

•Keeps the urgency level up for long term projects

•Plan for visible performance improvements

•Recognizing and rewarding employees

•Begins the “hard wiring” of new processes

Results Addressing Level 2/Level 3 Consolidating Improvements and Producing Still More Change

Institutionalizing New Approaches • Provide consistency

Policies and procedures Own actions Rewards

• Hire, promote, and develop employees who can implement the vision

Engagement drivers during change

•Build trust through communication Crucial Conversations

•Seek team participation to manage change

•Display serving leadership qualities

Ensure team participation

•Structural Tension

•Thinking environment

•Communicate how decisions are made

Structural Tension Conversation

Thinking environment

•Explore an idea with a group

•Slow down a conversation

•Hear from everyone

Thinking environment structure

OPENING ROUND Up to 2 minutes each Ask the group: “What is your current thinking about ____?”

OPEN DISCUSSION 5 minutes total Ask the group: “What do you notice now that you’ve heard everyone’s thinking? Is

anything present that wasn’t before?”

CLOSING ROUND Up to 2 minutes each b. Ask the group: “What is your freshest thinking about _____? ”

•Describes the challenges to clear thinking

Complexity of situation Ego

•Individuals process information differently

•Hats allow individuals to shift easily from one mode or thought to another

Six thinking hats

Displaying leadership qualities

“The ripple effect of a leader’s enthusiasm and optimism is awesome. So is the impact of cynicism and pessimism. Leaders who whine and blame engender those same behaviors among their colleagues. Spare me the grim litany of the ‘realist.’ Give me the unrealistic aspirations of the optimist any day.”

Serving leader qualities •“Own” the organizational decisions

•Use your emotional intelligence

•Be visible with the team

•Balance empathy with channeling team energy

Key take-aways

•Having an engaged team prior to a change is a key to success

•Team members have different strengths and talents – be sure to leverage them

•Paying attention to transitions will allow change to be successful

•Engagement of the team by communicating and displaying serving leadership qualities is vital during change

References 1. Miller, M. (2015). Chess not Checkers. Elevate Your Leadership Game. Oakland, CA: Berrett-Koehler Publishers, Inc.

2. Covey, S. (1989). The 7 Habits of Highly Effective People. New York, NY: Free Press.

3. Lencioni, P. (2002). The Five Dysfunctions of a Team. San Francisco, CA: Jossey-Bass.

4. Johnson-Vickberg, S.M., Christfort, K, & (2017). Pioneers, Drivers, Integrators, and Guardians. Harvard Business Review, 95(2), 50-57.

5. Bridges, W. Managing Transitions, Making the Most of Change. 2nd ed. New York, NY: Da Capo Press, 1991.

6. Kotter, John P. "Leading Change. Why transformation efforts fail", Harvard Business Review, January 2007, pp 92-107.

7. Maurer, R. Introduction to Change Without Migraines. Accessed 11/8/2015, http://www.changewithoutmigraines.com/OpenSourceProject.htm.

8. De Bono, E. (1999). Six Thinking Hats. New York, NY: Back Bay Books.

9. Patterson, Grenny, McMillian, Switzler. (2012). Crucial Conversations. New York: McGraw Hill.