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Common Ground

03/10/2009

Chairman's Message 

Given that my investment portfolio has achieved the velocity and trajectory of a tossed jackhammer, I find it increasingly compelling to devote more time and attention to events that I can control, such as improving one's management abilities.

Here are some particularly insightful thoughts on consensus building by a gifted healthcare leader at a leading New England hospital.

Common Ground

Nothing fosters trust and respect within a team environment like giving each team member the opportunity to voice his or her opinion constructively.

This model of decision making isn't ideal for every situation, of course, but building consensus can be a powerful catalyst that turns a poorly functioning department into a well-oiled machine.

The trick is to determine when a consensus is appropriate. We spoke with Jill Berry Bowen, Vice President of Patient Care Services at Mercy Hospital in Portland, Maine, about her experience with getting her staff on common ground.

Jill, do you feel that, in general, getting a consensus is better than the majority rule system?

Jill: Yes, I believe it is. There's a place for both, of course, but when you take the time to build consensus around a particular issue, you're building a tremendous foundation of trust. I like to use the metaphor of building a house - once you build a solid foundation, the sides and roof go on more easily. When you get a consensus of agreement on long-term strategic goals, the environment is much more collaborative and focused, allowing decisions to be reached more quickly and thoughtfully.

When is it not appropriate to try for consensus?

In critical situations, such as an emergency or disaster, a leader must move quickly and make the best decision using set policies or protocol. Afterward, however, it can be extremely helpful to review and discuss, as a group, whether the decision was in keeping with standard practice and long-term goals. At that time the group can agree to what should happen going forward, and even improve or add to the system already in place.

Please describe how you begin the process of getting all concerned to reach agreement.

It's best to put an idea out there to the group and let it settle in. I like to give people as much information on a given matter as possible, and give them time to consider it from all angles. Breaking a large issue into smaller parts is also an effective way to gain insight into ways to reach a larger goal.

When you put an idea up for discussion, it's important to really listen to those who are impacted most. Getting their insights, concerns and feedback, and reporting these back to the project team lends credibility to the process. I also like to ask the group if there is anything I may have missed. This question may seem terribly obvious, but you'd be surprised how often this simple step is overlooked.

What's the downside to including many people into the decision making process?

Gaining consensus is an investment in time that takes effort, patience and the ability to listen well. People new to the process can be more concerned with hearing their own opinion than collaboratively reaching agreement and shared commitment. Trust and respect come into play as group members give each other feedback on how constructive their contributions are to the larger goal.

Once a team has gone through the process of making decisions as a group, subsequent consensus building takes less time. It's great to be in a meeting where after a particular problem and possible solutions are out on the table, we simply go around the room indicating thumbs up for yes, thumbs down for no, or thumbs to the side indicating uncertainty. Depending on the level of uncertainty we take time to discuss the topic further. Otherwise we move forward. If trust is there among members of the group, it doesn't matter how many folks are involved in the decision making process.

What three things should a leader keep in mind when trying to get a position across to a group?

Be open and honest. Realize that the goal is always open communication and leaders must be willing to listen to all sides of the issue at hand in order to understand what impact a particular change might have on others, including patients and their families. Set clear expectations. Be very clear what the group's role is in the decision. Set a plan with a timeline to work within.

Test out possible solutions. Gather feedback on ideas upfront. Test out possible options with individuals ahead of time to best prepare for dialogue. Acknowledge the shared problem, first, then pitch the position on what it will take to overcome it. As a leader, the team will look to you first for answers, but when they know you are sincerely looking for their input to arrive at balanced and well thought-out resolutions, your team will add valuable insight to the process every time.

Invite discussion. Validate legitimate concerns and invite solutions from the team. Thank people for sharing their views and make it clear that each voice counts. Encourage team members to brainstorm possible solutions to challenges as they arise. Be prepared for give and take. Anticipate barriers and be prepared to work through them. Giving people the opportunity to be creative in a "no-criticism zone" can be quite productive.

And a fourth...

Always give credit to the group. Validate their role. Recognize contributions and celebrate.

Jill Berry Bowen, RN, MBA, MSN, FACHE, is the Vice President of Patient Care Services at Mercy Hospital in Portland, Maine. A native of Farmington, Maine, Jill oversees a division of 758 employees within the nursing programs for inpatient and outpatient acute care, behavioral health programs, surgical services, pharmacy, transport, respiratory care, clinical education and organizational patient satisfaction. Her areas of interest focus on developing strategies to advance clinical outcomes, securing talented and passionate staff, developing creative leaders, and enhancing the patient experience. 
 

Management Quote

"A winner is someone who recognizes his God-given talents, works his tail off to develop them into skills, and uses these skills to accomplish his goals."

~ Larry Bird

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