Feature Article:

Nine Strategies for Turning Your Staff into a Team

By Shelley Simon, RN, DC, MPH, EdD
Founder, Beyond Practice Management

In his book Good to Great, author Jim Collins uses a bus analogy to make a point about building a great team. Collins says you have to get the wrong people off the bus, the right people on the bus, and then get those right people in the right seats. That’s excellent advice, but it’s only part of the story. Once you have everyone on board and your bus motoring down the road, how do you keep from having to pull over every few miles to reassign seats, study the map, settle squabbles, and make repairs?

While team building does require time and effort, the benefits of having a high-functioning team cannot be overstated. Some of these include increased trust, enhanced performance and productivity, job satisfaction and staff retention, shared purpose, and a sense of community. All of this adds up to good traveling companions on a happy bus. The absence of teamwork, in contrast, will show up as unwillingness to engage in honest communication, avoidance of accountability, frustration, resentment, suspicion, and lack of commitment. Who would want to travel on that bus?

In this issue of Practice Your Way we address the fundamentals of building and maintaining a healthy, cohesive team. Something that all healthy teams have in common is an ability to communicate effectively — among themselves, with patients, and with the practitioners in the office. I’ve coached healthcare professionals from all around the country over the past several years and have come to realize that almost all staffing problems are related to poor communication. Misunderstandings, assumptions, things left unsaid, and unhealthy or ineffective leadership styles can create chaos within a team. Once practitioners (and their managers) recognize the value of developing a progressive leadership style, enhance their own emotional intelligence, and model positive communication skills, their staff begins to come together and function at higher levels.

Just because you have a staff does not necessarily mean you have a team. Here are nine strategies to help you develop an up-to-date style of leadership, improve communication in your practice and, as a result, enjoy a more motivated, engaged, and committed team.

(1) Be clear about purpose, expectations, and common goals. This is best achieved through a series of strategic office meetings or during a practice retreat. Once agreed upon, the purpose, expectations, and goals of the practice should be documented, updated at least annually, and referenced frequently — especially when there is evidence that the practice bus is weaving dangerously into the wrong lane or is at risk of running off into a ditch.

(2) Develop and use coaching skills. A “top down” management style (“Do what I say because I’m the boss”) is outmoded and largely ineffective with today’s workforce. Communication and collaboration is the name of the game now and forward-thinking practitioners and their managers are learning and using coaching skills to successfully manage their teams. If you are interested in improving your ability to coach others (staff and patients alike) see the last issue of Practice Your Way for a list of recommended books on developing coaching competencies. Or, consider being coached yourself as a way to get a sense of the process and benefits of coaching.

(3) Have explicit ground rules about how the team will work together. Again, a group meeting or practice retreat is an ideal setting in which to create and agree upon such a list of rules. Ground rules should be customized to the practice. A four-person office will likely have a list that is quite different from an office with twenty staff members. Ground rules fall into two major categories — task-oriented (how the work gets done) and relational (how we work together). On the task side, consider ground rules about how the workload is shared and how goals are set and measured. On the relational side personal behavior, fairness, communication, and how to compromise might come into play.

(4) Delegate with clarity. You can help team members avoid boredom and burnout by providing them with new responsibilities and opportunities to grow their skills. When delegating a task or project to an employee, be certain that they understand not only what they are expected to accomplish, but also why. How does this project fit into bigger picture? What practice goal does this task contribute to? How will the progress of this effort be monitored? What precisely is the desired outcome? Answering these questions will help ensure that the job is done properly and with a high level commitment. From the day of delegation until the task or project is complete, check in and coach the responsible individual based on their level of need for support.

(5) Commit resources to staff development. As a practice leader, you no doubt regularly attend continuing education courses as well as professional development and practice management workshops. Savvy practitioners budget for their employees to participate in continuing education directly related to skills they want or need to develop and that will enhance their value to the practice. Seminars on communication, emotional intelligence, team building, and patient relations are all worthwhile considerations. But don’t make the all-too-common mistake of shuttling an employee off to a seminar with the idea that your job is done. Follow-up with ongoing support and coaching to ensure that the learning sticks as demonstrated by the employee utilizing new skills, being more proactive, and implementing effective new procedures.

(6) Offer feedback on a regular basis. Both casually and through a formal evaluation process, staff members should always know where they stand. Studies show that feeling valued and being acknowledged at work ranks higher than the paycheck when it comes to job satisfaction. Praise staff members promptly and specifically on a job well done. For example, if a patient comments on how friendly or efficient your assistant is, relay that information to her before the end of the day. If someone goes out of their way to help you or another team member get through a crazy day in at the office, let that individual know that their efforts were noticed and appreciated. Prompt feedback is also in order when it’s less than positive. For example, if you observe an employee being abrupt with a patient, bring it to their attention privately as soon as it’s feasible to do so.

(7) Lead with consistency. Whether you have two employees or twenty-two, make every effort to be consistent in your decision-making. Being a consistent leader means applying office policies equally and not “playing favorites.” This is easier said than done. When there is inconsistency, it’s often unconscious on the part of the practice leader. Let’s face it — some employees are just more likable and easier to deal with than others. When making a decision or an assessment about an employee, if you have any doubt about the fairness of your action, pause to ask yourself what you would do in the same situation with a more favored employee. Communicate decisions clearly and to everyone affected either at the same time or within a short period of time. No one likes to be the last to know about a change in plans or policy.

(8) Plan ahead for how to resolve conflict. Even with clearly defined shared goals and carefully crafted ground rules, your practice bus will occasionally veer off course — which isn’t necessarily a bad thing as long as the bus isn’t totaled. When handled in a safe, respectful manner conflict can be a vehicle to refine views, expand perspectives, and build empathy and respect for diversity of opinions. Out of conflict it is possible to enhance self-awareness and creativity, and find new ways to solve problems. Practice leaders should have some knowledge about how to mediate conflict along with at least basic coaching skills to use when issues arise. Deal with issues that crop up in the office quickly and fairly to demonstrate your commitment to having a harmonious workplace. Ignore conflict and risk rising levels of resentment and tension.

(9) Increase emotional intelligence at all level in your practice. The eight strategies above will be effective and more likely to “stick” when both practitioners and practice managers understand the value of leading with a high level of emotional intelligence. In addition, it’s possible to raise the level of emotional intelligence among entire teams. You’ll know if you have an emotionally intelligent team when most of the following elements are in place:

• Strong group identity
• Effective and efficient individuals functioning as a team
• Good performance under pressure
• High level of trust within the team
• Good motivation and initiative
• Team members who proactively and creatively solve problems
• Accountability for achieving goals and positive outcomes

You can find out much more about how to develop high levels of EQ in your practice by reading my July, 2007 article in Dynamic Chiropractic, Team EQ: Your Edge in Practice Development.

It is one thing for a practice leader to have good working relationships with each individual in the office; it requires different skills altogether to assemble, lead, and be a member of a cohesive team. Teams do not spring up magically. Improving communication and building a team involves a dedicated process, but, don’t be surprised if you notice a positive change within just weeks or months as a result of implementing even a few of the nine strategies in this article. Try not to get discouraged if some team members are resistant to change or hold back in their efforts. View this as hidden opportunity to confirm your strong intention to move forward and create a team that is willing to engage honestly, commit to shared goals, and achieve results. Even reluctant travelers will come around once they realize they are on a safe and interesting journey with a competent practice leader in the driver’s seat.

Book Recommendations:

On Communication

Practitioners interested in developing their coaching skills might benefit from these books, some of which are used as texts in formal coach training programs

• Fierce Conversations: Achieving Success at Work and in Life One Conversation at a Time, by Susan Scott
• Non-Violent Communication: A Language of Compassion, by Marshall Rosenberg
• How the Way We Talk Can Change the Way We Work: Seven Languages for Transformation, by Robert Kegan and Lisa Lahey
• What Did You Say? The Art of Giving and Receiving Feedback, by Charles Seashore, Edith Seashore, and Gerald Weinberg
• Social Intelligence: The New Science of Human Relationships, by Daniel Goleman

Online Now:

Read Dr. Simon’s Latest Columns in Dynamic Chiropractic

Is it possible to turn a casual encounter into a spontaneous marketing opportunity? Yes! Read The Language of Marketing: Turning Acquaintances Into New Patients in the May 6, 2008 issue of Dynamic Chiropractic to find out how.

Professional burnout is becoming an epidemic among health practitioners. Learn how to identify, avoid or reverse this common problem in Primary Prevention for Career Burnout: Building Resilience in the June 17, 2008 issue of Dynamic Chiropractic.

An Opportunity:

Need Support to Develop Your Team?

Is high turnover a problem in your office? Do you ever wonder why it’s so challenging to find and keep employees who are authentically motivated? Have you grown weary of refereeing petty squabbles among staff? Could your staff be better at patient relations and practice marketing? If so, a Planning for Change workshop or group retreat may be the solution you are looking for.

Planning for Change: How do you maintain a sense of control in your life and career amidst constant change? This interactive half-day workshop provides conceptual understanding of the Cycle of Renewal and practical tools to help individuals navigate the cycles of change they experience in their lives. Many of us feel we are constantly reacting to change, rather than proactively managing opportunities to move forward with our goals and plans. In a world of constant change, lives and careers must be redesigned over and over again, chapter-by-chapter, as we live them. Each participant will identify where they are in this cycle of change, create personal and professional life plans and goals, commit to next steps, and develop skills to move forward. This energizing workshop provides an empowering individual experience and powerful group learning opportunity for understanding how colleagues experience and manage change.

Planning for Change — Renewing Team Focus and Energy: Using the same change model described above, this full-day workshop focuses on building team trust and effectiveness. What is our shared history and where do we go from here? How do we successfully adapt to the many changes we experience? How do we navigate and negotiate during times of change and make the best decisions for the practice or organization? How do we achieve our goals and not burn out in the process? Is it possible to have a successful career and a life outside of work at the same time? With a variety of concepts, tools and exercises, the workshop addresses these questions and leaves the group feeling inspired and hopeful. It is forward-looking and emphasizes how teams can arrive at practical solutions to challenging problems, set goals that are in alignment with group values and vision, and understand the dynamics within the team.

Retreat Facilitation: If you know your staff could function better as a team, or that your practice could use some attention and a nudge in a positive direction, then a strategic planning retreat may be the answer you are looking for. A retreat is the ideal forum to bring your team together, clarify your vision, develop or revisit your statement of purpose, generate fresh ideas, and set goals. Using a combination of coaching and consulting techniques, I facilitate one-day and multi-day retreats. Following the retreat, you’ll receive a customized report and, if indicated, follow-up coaching to support the successful implementation of ideas and plans.

For more information about scheduling a workshop or retreat for your team, please contact me today.