Welcome to Mindfulness in Medicine, a monthly column by best-selling author Anne Bruce designed to cultivate leadership and collaborative relationships among hospital leaders, nurses, providers and ancillary staff. Mindfulness is a powerful leadership tool that enhances emotional intelligence in medicine. It is a tool that, when practiced, can help us develop and implement relational coaching skills and illuminate various ways to improve hospital operations and cross-departmental performance. Mindfulness also improves our capacity for decision-making and participatory medicine, all while enhancing our own health and well-being. Your comments and insights on these postings are greatly valued.
Unlike the prescriptions a physician or nurse practitioner writes, there is no magic pill that will guarantee the success of an emergency department's (ED's) team performance. Team performance has to be cultivated, nurtured, measured incrementally, supported by team surveys and data, encouraged and recognized with praise-in-progress — not six months or a year after the fact.
Today's Mindfulness in Medicine column, as well as >next month's part 2 of this article, can both be applied to emergency departments and their cross-departmental teams, including administrative departments, providers, ancillary staff, nurses, physicians and other hospital leaders. However, to keep things simple, I've used the emergency department here as a case study.
An ED's team performance can usually be monitored in two ways:
1. Immediate improvement. For example, perhaps a team training session has taken place, with an outside consultant facilitating the process. After such an event, people feel renewed and energized. You may see immediate improvement, but this is often temporary. Old habits and behaviors die hard.
Perhaps you see immediate results when team meetings are held regularly and employee morale is infused with positive support by team leaders. If so, do more of this! Repeat what works. Many times EDs will roll back when they assume all is well. Don't assume anything.
2. Continuous improvement. This measurement and monitoring takes place over a lengthier period of time.
Continuous improvement requires that teams are tasked with objectively looking at benchmarks and goals and helping create strong improvement plans for more productive and effective team performance. This happens when prideful behavior and daily improvements (large and small) have been instilled and recognized in everyone on the team and now play out as part of daily practices within the ED. These positive ongoing behaviors then become second nature and also an important part of the ED's culture. What is the culture of your ED as it stands today? This is an important question to answer. Continuous improvement should result in teammates who are comfortable exploring feasible improvement solutions and want to be part of developing and implementing ongoing improvement planning strategies. A "we" not "me" mentality is prevalent when this happens.
One powerful aspect of avoiding ongoing systemic problems within the ED is in building stronger, smarter hiring practices. Details on this will be covered in part 2 of this article next month.
Here are some of the criteria and questions you may want to consider when identifying team leaders for your ED:
The obvious complexities of the ED environment often warrant team representation from several hospital departments. So the following list may seem larger than expected. However, interdepartmental representation automatically integrates team performance improvement into departments traditionally outside of an ED.
In most cases, teams should be made up of internal ED staff and staff from ancillary departments. This includes nursing departments that receive admitted patients from the ED. The goal is to ensure a solid cross section of ideas and build a solid understanding of the basic causes of current process failures or problem areas.
If there are problems within the department, or challenging issues arise, it is critical that team members see the ED as a facility-wide challenge, not just an ED problem area. Here are some suggested individuals to include on your ED performance improvement team:
As things proceed, team leaders should evaluate whether or not to change the group members according to the ongoing needs of each team and the specific goals of the ED.
Next month, check back for part 2 of Anne's article on a Mindful ED's Team Performance, where details on creating a results-oriented ED team plan and philosophy for greater performance results will be outlined.
Anne Bruce has provided training and performance coaching for Vituity. She also serves as MBSI's Employee Development Coach and Leadership Facilitator. Anne is a bestselling author with more than 20 books published by McGraw-Hill Publishing, New York. She considers her award-winning life-coaching book, Discover True North: A 4-Week Approach to Ignite Passion and Activate Potential (McGraw-Hill Publishing) to be one of her most "mindful" books to date. She also leads a popular Discover True North Expedition group on LinkedIn. Anne can be reached at 214-507-8242 or by writing to her at Anne@AnneBruce.com.