human-centered leadership: a foundation for creating joy and … · 2019-04-08 · human-centered...

Human-Centered Leadership:

A Foundation for Creating Joy and

Resilience in the Practice of Medicine

Passion & Purpose

Reigniting the Commitment to Quality and Safety

Maryland Patient Safety Center

April 5, 2019

William J. Maples, M.D.

President and Chief Executive Officer

Four Principles of Relationship-Centered Process

• Being personally present; using reflective listening and inviting others to do likewise

• Speaking your truth; listening and inquiring in order to understand

• Valuing difference and diversity as a resource

• Letting go of control; attending to and trusting the process

© 2011 Anthony L. Suchman, M.D., David J. Sluyter, M. A., and Penelope R. Williamson, ScD

Fee for

Service

Payment

System

Value-

Based

Population

Payment

System

Physician-

Centered

Patient-

Centered &

Team-

Based

Care

The Secret To Sustained Improvement

IMPROVEMENT

Technical

Capabilities

Cultural

Capabilities

I = TC x CCGeorge Eckes

Quadruple Aim

Person-

Centered

Quality Cost

Joy

Culture + Experience of Work

Bryan Sexton,

National Taskforce for

Humanity in Healthcare

• Emotional Thriving

• Emotional Recovery

Burnout, at its core, is the impaired

ability to experience positive emotion.

I’m Burned Out

I’m Thriving

Christina Maslach

• Emotional Exhaustion

• Depersonalization

• Personal Accomplishment

Bohman, Dyrbye, Sinsky, et. al.

• Culture Of Wellness

• Personal Resilience

• Efficiency of Practice

Outstanding culture, at its core, is the

cultivation of positive emotion.

What Emotions Are We Talking About

Joy

Hope

Gratitude

Inspiration

Awe

Interest

Amusement

Pride

Serenity

Love

Tiny Engines Undoing Effect

Resilience – and Outstanding Performance – is a Team Sport

“Culture of Wellness”

We’re Burned Out

We’re Thriving

26% of your individual burnout score is predicted by the burnout of the

people around you.

How Are We Going to Do That!?

(What’s the Path Forward?)

What Skills Support That Kind of

Cultural Transformation?Systems and organizational habits that

enhance access to positive emotion

Human-centered leadership

Positive connection & relationships

Individual wellbeing

The Feedback Fallacy


“I am able to control only that of which I amaware. That of which I am unaware controls me.

Awareness empowers me.”

John Whitmore, Coaching for Performance

“When others try to keep us comfortable bysanitizing feedback, or “being nice,” they do us adisservice: We’re deprived of crucial information

we need to improve.”

Goleman, Boyatzis & Mc Kee, Primal Leadership


Think of a time when someone gave you

feedback or you gave feedback to

someone else that was difficult.


How can we help each person

thrive and excel?

• Telling people what we think of

their performance does not help

them thrive or excel

• Telling people how we think they

should improve hinders learning

Buckingham, Marcus, and Ashley Goodall. “Managing People - The Feedback Fallacy.” Harvard

Business Review, 21 Feb. 2019, hbr.org/2019/03/the-feedback-fallacy.


Marcus Buckingham’s Three Theories

Theory of the Source of Truth

"...other people are more aware than you are of your weaknesses and that the best way to help you is for them to show you what you cannot see for yourself..."

Theory of Learning

"...you lack certain abilities you need to acquire, so your colleagues should teach them to you..."

Theory of Excellence

"...great performance is universal, analyzable, and describable, and that once defined, it can be transferred from one person to another, regardless of who each individual is...



The Feedback FallacyThe Source of the Truth

• Humans are unreliable raters of other humans

• Our evaluations are deeply colored by our own understanding of what we're rating others on , our own sense of what good looks like...

• More than half of your rating someone else reflects your characteristics

• Feedback is more distortion than truth

• We can state where he/she stands with us



The Feedback FallacyHow We Learn

• Learning is less a function of adding something that isn't there than it is of recognizing, reinforcing, and refining what already is

• Neurologically we grow more in our areas of greater ability

• Learning has to start by finding and understanding patterns where you are strongest, not someone else's patterns

• Getting attention to our strengths from others catalyzes learning, whereas attention to our weaknesses smother it

• Learning happens when we se how we might do something better by adding some nuance or expansion to our own understanding



The Feedback FallacyExcellence

• Excellence in any endeavor is almost impossible to define, and yet getting there, foreach of us, is relatively easy

• Excellence is easy, in that it is a natural, fluid, and intelligent expression of our best extremes

• If you study failure, you'll learn a lot about failure but nothing about how to achieve excellence



The Feedback FallacyHow To Help People Excel

• Look for outcomes - "That! Yes that”

• Never lose sight of your highest priority interrupt

• Explore present, past, and future - "What has gone well?"



The Feedback FallacyThe Right Way To Help Colleagues Excel

Buckingham, Marcus, and Ashley Goodall. “Managing People - The Feedback Fallacy.”

Harvard Business Review, 21 Feb. 2019, hbr.org/2019/03/the-feedback-fallacy.

INSTEAD OF TRY

Can I give you some feedback? Here’s my reaction.

Good job! Here are three things that really worked for me. What was

going through you mind when you did them?

Here’s what you should do. Here’s what I would do.

Here’s where you need to improve. Here’s what worked best for me, and here’s why.

That didn’t really work. When you did x, I felt y or I didn’t get that.

You need to improve your communication skills. Here’s exactly where you started to lose me.

You need to be more responsive. When I don’t hear from you, I worry we are not on the same

page.

You lack strategic thinking. I’m struggling to understand your plan.

You should do x [in response to a request for advice]. What do you feel you’re struggling with, and what have you

done in the past that’s worked in a similar situation?

If you want to get into the excellence business, here are some examples of language to try:

Achieving Peak Performance

Peak Experience

Think about a peak experience you’ve had

recently in your job/career.

What made it a peak experience?

What motivated you to excel in that

experience?

What were you doing?

What were you working on?

Who were you working with?

How did the people around you impact the

experience?

What were the results?

Summarize the key components.

Excellence in Modern Healthcare Environment =

Maximizing the Opportunity for Peak Experiences

Excellence in Modern Healthcare Environment =

Maximizing the Opportunity for Peak Experiences

Requires Tapping Into Intrinsic Motivation

Motivation Types

1.0 – Survival

2.0 – Extrinsic

3.0 - Intrinsic

1.0

Primary Motivator = Survival or Loss Aversion

Leaders access by: Threatening survival (or a proxy)

2.0

Primary Motivator = Receive Rewards, Avoid Punishment

Leaders access by: Sticks (- incentives) and Carrots (+ incentives)

3.0

Primary Motivator = Attraction, Excitement

Leaders access by: tapping into—

• Autonomy

• Mastery

• Purpose

• Connection

• Play

Emotional Experience &

Motivation Types

1.0 – Survival → strong negative emotion

2.0 – Extrinsic → minimal positive, moderate negative emotion

3.0 – Intrinsic → strong positive emotion

Human-Centered LeadershipGoals

1. Sharpen the leadership skills of leaders, particularly with regard to interpersonal skills and emotional intelligence/self-awareness required for high performance

2. Develop and nurture advanced communication skills, which will allow for development of a common language and enhance accountability

3. Explore the attributes of complex systems in which we work, and practice skills to enhance curiosity, inquiry (rather than debate), and compassion when redesigning complex systems in teams

4. Learn how to develop a vision that authentically accesses intrinsic motivation in the workforce to create alignment and accelerate compelling change

5. Learn how to effectively conduct positive leadership rounding and develop an approach to evaluating effectiveness

Human-Centered LeadershipGoals

6. Learn how to conduct a relationship-centered meeting as a vehicle for creating a culture of excellence and positive emotions

7. Develop skills to welcome and appreciate different perspectives to enhance innovation and the quality journey

8. Enhance the culture of safety and the culture of excellence through reinforcement of positive emotion

9. Create a network of personal relationships within the leadership group which will be an important conduit for getting the organization’s work done

10. Provide participants with a perspective on caregiver burnout, including contributing factors, consequences and evidence-based solutions focused on positive emotions

LEADERSHIP

Leaders are called to stand

In that lonely place

Between the no longer and the not yet

And intentionally make decisions

That will bind, forge, move

And create history.

We are not called to be popular,

We are not called to be safe,

We are not called to follow,

We are the ones called to change attitudes;

To risk displeasures,

We are the ones called to gamble our lives,

For a better world.

-Mary Lou Anderson, April 1970

Address to House of Delegates

human-centered leadership: a foundation for creating joy and … · 2019-04-08 · human-centered...

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