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Welcome to the Therapist's Coach Forum - July 6, 2005 10:02:00 AM   
cnelligan

 

Posts: 54
Joined: February 15, 2005
From: Indianapolis, IN
Status: offline
Teams have always fascinated me. Perhaps ?growing up? in an acute rehab hospital with authentic leadership and a true transdisciplinary approach I was never meant to lower these great expectations. Ever since this experience I have continued to be intrigued by what truly unifies a group of people working together and why some teams are winners and some never quite get there. My experience on the Moss Drucker Brain Injury Center got me completely hooked on the concept of a winning team. The leader there, part researcher, part clinician, part father and physiatrist set the tone for over 30 individuals to form and perpetuate a confident team.

One of my favorite reads in 2004 was business guru, Rosabeth Moss Kanter?s book Confidence: How Winning Streaks and Losing Streaks Begin and End. From the simplest of ball games to the most complicated business situations, she explored the common element in winning - a basic truth about human nature: People rise to the occasion when their leaders help them gain confidence to do it. How does she define confidence?

Confidence truly is an expectation of success.

When a person or a team expects success, they are willing to put in the effort to achieve it. It is confidence that attracts investments from a team?not just financial investment, but their time, energy, loyalty and commitment.

Kanter writes about the three cornerstones of confident and winning teams. Through years of research with such organizations as Continental airlines, Verizon and the New York Yankees, she points to the cornerstones of accountability, collaboration and initiative.

Accountability means that people take personal responsibility; seeing where one?s responsibility lies. They face facts and feedback honestly, being able to admit mistakes quickly and do something about them. Accountability comes from honest, accurate facts and knowing what responsibility a person can take for acting in light of those facts. Accountability provides a firm foundation for confidence. You can be confident in leaders if you know leaders are telling you the truth. As a leader you build accountability around your people. You put the facts out on the table. You hold up the mirror of accountability. You show people where their performance fits in with the goals of the your clinic, your unit or your multidisciplinary team.

Collaboration is the second of Kanter?s cornerstones. It means teamwork. It means support. Confidence builds when you feel that you can count on the people around you and when they feel that they can count on you. But what is important is not doing everything together as a group, but whether you know what your team members are capable of. You respect other people for their strengths.. A great leader ensures that we understand each other?s discipline, clinical expertise,unique abilities and the like.

Finally there is Initiative. Unless there is permission and encouragement for people to take the initiative and feel that their actions can make a difference there is no confidence in the systems, in each other, and in the leader. It isn?t a secret that leaders don?t do it all by themselves. Initiative leads to innovation. It leads to new ideas and the right kind of risk taking. People need to be able to feel that they are supported in being active, in making contributions. Our basic need for meaningful work. In our field in the purest sense it would seem like a no-brainer but when we impose systems without some freedom it can slowly erode the meaningful work of getting patients well and back to their lives.

So it would seem confidence is truly confidence in others. Are you as a leader fostering these cornerstones in your present Team, Clinic or Organization? What steps could you take to create more confidence?

I welcome your comments and questions.

_____________________________

Carroll Nelligan, MHA, OTR
Professional Coach
Post #: 1
Re: Welcome to the Therapist's Coach Forum - July 11, 2005 7:57:00 AM   
cnelligan

 

Posts: 54
Joined: February 15, 2005
From: Indianapolis, IN
Status: offline
Hi Kaley:
Thanks for your question. I have found in my travels that the good always want to get better; so kudos to you this Monday morning! To hit on some of the points in your question. First, leadership and implementation of improvements can come at any level in an organization. Good communication with your supervisors and making them aware of the positive changes you are making is an important step. Ultimately, you do need to be supported at the next level.

A good self assessment of where your clinic is at is a good place to begin. For example with respect to accountability, I have seen numerous situations where the players did not know for sure their full range of responsibility and what they were "accountable for". A clinic I worked with had a very loose accountability for marketing to physicians thus there was not a systematic or strategic way in which they went about it and it was hurting their volume. Another broad question in this area is "Do your people really have the skills, knowledge, ability to do their jobs?" For example, if your support staff is assisting with the coding process, do they fully understand the ICD-9 sytem with respect to your fiscal intermediary/carrier and the implications of getting it "right"? I truly believe that most people want to do a good job; it is the lack of systems, knowledge, skills that are barriers for them. Sometimes they are staring us right in the face!

With even small teams I believe it is critical to set ground rules for team behavior. As a group drafting up a Team Charter or Team Norms and giving each member of a team the ability to hold each other accountable to these values and communicate respect. This is a very important step in collaboration especially with teams that may be on shaky ground. Even with teams that have good rapport, a Team Charter will get you through times when stress levels are high and unexpected conflict.

Do your team members feel that they can take the initiative? Do they have the opportunity to make improvements or suggest them in the way you operate your clinic? How do you get their input? Answers to these questions may give you a better sense of your team initiative.

In respect to the three cornerstones, a practice that I have found to be of help again and again involves the leader asking the right questions. Even with a small team checking in frequently and really listening to their responses: What's going right? What systems or tools could be improved and Do you have what you need to do your job? Responses and conversation that ensue from these questions will provide good gage on accountability, collaboration and initiative.

I would love to hear from others out there what small steps or leaps! you have taken to lay the foundation for confidence. What has worked for you and your teams? Thanks for sharing.

_____________________________

Carroll Nelligan, MHA, OTR
Professional Coach

(in reply to cnelligan)
Post #: 2
Re: Welcome to the Therapist's Coach Forum - July 14, 2005 3:20:00 PM   
lmcarpenter

 

Posts: 1
Joined: June 20, 2005
Status: offline
Carroll,
I am interested in your opinion regarding a situation. I am a manager of an outpatient therapy department which includes PT, OT, and ST. While I am relatively new to this facility, <6 mo, I am not new to management having spent nearly 13 years in a supervisory capacity. In this new situation I find a HUGE lack of teamwork in this department which I feel could be related to the leadership. The director I report to seems to like to be "the keeper of all information", very controlling, and at times I wonder if she feels threatened by my presence.
My question is, do you feel this is a situation where one can be successful? At times, I consider cutting my losses and moving on to a more supportive environment and at other times I feel I should focus on the task at hand which is building a strong team.
Any thoughts? :confused:

(in reply to cnelligan)
Post #: 3
Re: Welcome to the Therapist's Coach Forum - July 14, 2005 8:42:00 PM   
cnelligan

 

Posts: 54
Joined: February 15, 2005
From: Indianapolis, IN
Status: offline
Greetings "carp4" and thanks for taking the time and effort to get your agenda out in this Forum. Even without knowing the specifics of your situation, I want you to think about a few observations/questions and see how they "sit" with you.

A couple things I noticed in your posting. First of all you state that you are still relatively new to this experience and I feel it points to the fact that you are not quite ready to throw in the towel. I also sense that with a good deal of supervisory experience you have what it takes to build this "strong team" that you desire and I am sure the folks around you would appreciate and thrive in. The Director you describe as someone you ...report to... not someone you collaborate with or even are supervised by. The fact that you even question that she might be threatened by you probably means that energy is there.

Let's shift the framework from this situation to a "HOW CAN I build a strong team" for a minute. If you took the Director out the picture what does your team look like? What are you and your team doing differently? What is the morale like?

Now,even with the Director present what is preventing you right now from making these positive changes? Is she/he truly the barrier? Is there a way to approach this Director to collaborate on your plans? Even if you are the one who initiates, you can make the exchange non-threatening to your Director.

Some food for thought. (As a Coach I don't really give my opinions...yours is the one that matters.) ;)

_____________________________

Carroll Nelligan, MHA, OTR
Professional Coach

(in reply to cnelligan)
Post #: 4
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