Feature Article:

Team EQ: Getting Your Staff Involved

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

I recall once going to a doctor?s office for an appointment and spending the few minutes I had to wait observing the staff. The four or five staff members I watched appeared to be efficient, but I noticed they rarely spoke to one another. They did their jobs, but seemed to lack any real sense of flow or enjoyment. It was as though each person was in her own little world, doing her assigned tasks — but with little regard or appreciation for her co-workers. They shared a common work area, but they were essentially disconnected from one another. They were inattentive to the feelings of each another, to me, and to the other patients who waited. The subtle tension within the group seemed to radiate into the waiting area. After my visit with the doctor, I left the office feeling tense and uneasy. It wasn?t because of anything the doctor did or didn?t do. My dissatisfaction was very much related to the negative energy in the office and the tone set by the staff. Looking back, I realize what was missing within this group was resonance and synergy.

High patient satisfaction can often be traced to a positive feeling that is palpable in the practice. It?s hard to measure, but you know when it?s present. Practices that consistently deliver quality service also tend to take care of the staff who work in the office. The staff, in turn, enjoys working as a team and patients pick up on their positive energy and commitment to the practice. One of your jobs as leader is to encourage in each staff member a sense of responsibility and accountability for the well-being of the team as a whole. Good leaders know how to balance the focus on productivity and task-oriented behavior with attention to developing people and their relationships with one another.

In this, the fourth and final article in our series on Emotional Intelligence (EQ), we take a look at teams and how their collective EQ impacts — positively or negatively — your office environment, staff morale, productivity levels, and the delivery of patient care. Just as individuals can raise their EQ by developing awareness and practicing certain skills, teams can also learn to function at higher levels by taking specific steps to develop competencies that increase team EQ.

In case you missed the earlier articles in this series, the core elements of personal emotional intelligence are: the capacity to recognize and understand one?s own feelings and the feelings of others, the ability to be self-motivated, and the competency to manage one?s emotions. In other words, self-awareness and self-management. The two over-riding categories of EQ, according to author Daniel Goleman, are personal competence (self-awareness, self-management, how you understand and manage yourself) and social competence (social awareness, relationship management, how you behave with and influence others).

When well developed, these personal and social competencies can make practicing less stressful and more manageable which can lead to better outcomes, more satisfied patients, and enhanced career satisfaction. Because working in healthcare requires the ability to handle stress, complexity, and conflict — while at the same time maintaining positive relationships — EQ competencies are critical for individuals and teams alike.

The cultural norms within a practice (that is, the usually unstated rules about how a group works together and how they feel about what they do) are what often determine whether staff functions at a high level — as a team — or simply as a loose collection of people who have to work together. Goleman says that collective emotional intelligence is what sets top-performing teams apart from average ones. Research conducted by Vanessa Druskat and Steven Wolff (reported in the Harvard Business Review) suggests that groups that demonstrate high collective EQ outperform teams that do not by a margin of two to one.

Teams create their own emotional reality and collective identity. How a group sees itself, and how its members interact and function together, and how roles are defined largely shape the team?s collective EQ. While similar to and based on a foundation of individual emotional intelligence, team EQ is distinct and has unique core elements. These include:

• Emotional awareness — the ability to identify and understand tendencies and emotions as they surface in one?s self and in other members of the team.
• Emotional management — the ability to respond to and manage emotions and moods appropriately and constructively in a given situation and to achieve team objectives.
• Internal relationship management — the ability to get along and work effectively with team members and be flexible, even in difficult or challenging situations.
• External relationship management — the ability to connect and communicate effectively with patients, vendors, referring practitioners, etc.

How can you determine whether or not your team?s EQ is as developed as it could be? Or should be? Consider these five questions. If you answer yes to more than two of them, it?s likely that your team could use an EQ tune up.

1. Do you spend more time than you?d like settling disputes, interpersonal rivalries, and power plays among staff members?
2. Does your team frequently fall short of achieving goals that are important to the success of your practice?
3. Do you sense tension within your team?
4. Do patients ever comment negatively on or complain about the behavior of members of your team?
5. Do team members appear to be bored, pessimistic, negative, or defensive?

Here are four brief scenarios to illustrate teams with low EQ. The rationale for offering these is based on my experience that practitioners and staff all too often cannot accurately see some of the habitual behaviors and attitudes that hinder their effectiveness at the group level. Perhaps these scenarios will bring to mind other situations or patterns that may impact the success of your practice and satisfaction of your team.

• This is a meeting? A team gathers for their weekly meeting. From the very first agenda item, people interrupt one another, shoot down ideas before they can be considered, ignore the team leader?s attempts to keep the meeting on track, and accomplish little if anything over the course of an hour. Lack of self-awareness and empathy for others makes it almost impossible for this team to accomplish their goals — inside or outside of the meeting.
• Why can?t we achieve our goals? This team thinks they have goals, but in truth their so-called goals are vague and their action steps toward achieving them are poorly executed. Team members won?t hold one another accountable (or even be accountable themselves) to follow through on their assigned tasks. When month after month nothing gets done, no one knows whom to hold responsible. This team lacks a sense of purpose and direction.
• What . . . us argue? This amiable team avoids conflict at any cost. They are so concerned with being nice and so worried about hurting anyone?s feelings that they avoid addressing interpersonal issues even when those issues are glaring and ongoing. Team members will talk behind the back of someone who is causing them angst, but would sooner have a root canal than confront that individual directly. Problems simmer, resentments build, productivity suffers . . . but nothing is ever resolved.
• What?s in it for me? Members of this team think of themselves first and foremost. They are competitive instead of collaborative, suspicious rather than trusting. They will go out of their way to help a fellow staff member or patient only if there is reward or recognition in it for them personally. Efforts at team building are viewed as ?just more work for me? rather than something that would benefit them and their co-workers.

The common thread in all of the above scenarios is that the individuals function almost completely independently, rather than collaboratively and interdependently. They demonstrate little awareness or empathy for those around them and they lack resonant, congruent behavior. As mentioned above, patients are quick to pick up on this at a subtle, energetic level and — sometimes without even being conscious of it — can lose trust in a both the practice and the practitioner.

Now that you know more about what low EQ at the team level looks like, can you turn these illustrations around in your mind and imagine what it would be like to have a high EQ team in your corner? A team that would achieve goals, stay focused on tasks, see the big picture, maintain a positive outlook even in the face of challenges, and be confident about their ability to succeed and, in turn, help your practice succeed? If you can visualize it and are willing to put in some effort, you can have this kind of team.

Here is a short list of qualities that high-functioning teams exhibit, characteristics and norms that demonstrate good EQ. Does this list describe your team and the ways you work together? You can use the list to assess, to guide, and to benchmark necessary activities or processes for building a more effective team.

• Team members are clear about purpose, expectations, and common goals.
• Roles are clearly defined and the group shares a common language.
• The team follows clear ground rules about how they work together to accomplish goals (including delegation, fairness, behavioral rules).
• Feedback is encouraged and conflicts are addressed as they arise.
• Decision-making, authority, responsibility, and accountability are shared within the group.
• Team members rely upon and respect one another; they rarely blame or point fingers.
• There is confidence at the group level that difficult or challenging problems can be solved.
• Members practice flexibility in dealing with one another, patients, and others both inside and outside the practice.

Developing and maintaining good team EQ is a process that requires ongoing attention and commitment. It?s not a ?one time and we?re done? proposition. As staff members retire or move on and you hire new ones, the dynamics of the team can — and frequently does — shift. If you have a core set of cultural norms and explicit guidelines in place that are positive and which reflect and promote good team EQ, new staff members should be able to adapt to them quickly.

As the leader of the practice, you have the influence and the responsibility to set an example for harmony, collaboration, and optimism. Demonstrating congruent behavior based on your most important values, reinforcing positive actions on the part of the team and making them feel valued, and allowing staff to have regular input in decision making all help foster an atmosphere that grows team EQ. Lead using the visionary, democratic, affiliative, and coaching styles whenever possible and avoid the less effective commanding and pacesetting styles. (See November newsletter for more on leadership styles.)

Remember that your team is made up of individuals. Try to create and sustain an environment where staff members feel safe in openly discussing the ?emotional temperature? of the team. This may be done informally on an as-needed basis, or at the beginning of staff meetings as part of a check-in process. To the degree possible, encourage personal EQ development within each of your staff members. Individual responsibility, accountability, and the ability to recognize and manage one?s own emotions go a long way toward turning a group of staff members into a high-functioning team.

Team members must do their part and be willing to regularly evaluate their tendencies, reexamine their shared habits, and review the big picture in order to stay focused on the ideal vision of good team EQ. They should be encouraged to address and resolve discontent within the team as it arises. Problems and challenges can only be addressed when they are out in the open and up for discussion.

A way to begin the discussion about team EQ in your office would be to print and distribute this article to everyone in the practice. Then, at your next staff meeting, use it as a jumping off point for a conversation about how your team is functioning. Setting aside time for this kind of communication is vital to the strength of your team. In too many practices staff members hold back in speaking their truth because they don?t want to ?rock the boat? or because they fear the reaction of co-workers, the office manager, or the practitioners. Do everything you can to create a safe environment in which honest discussions can be held.

My clients sometimes accuse me of ?asking hard questions.? That?s okay with me. I believe that excellence is derived, in part, from asking and being willing to address complex questions and coming up with answers that are meaningful, powerful, and true for you. On that note, I?ll leave you with these questions to reflect upon and share with your team:

• What is currently happening in my team that lowers our potential for great performance?
• What is currently happening in my team that raises our level for great performance?
• What does my team need to do less of?
• What does my team need to do more of?
• Am I, as the leader of my team, devoting adequate time and resources to developing my staff?

If your team could use attention in the area of EQ, consider the EQ In-Action Profile tool and/or a team building retreat or workshop. You?ll find a special offer for the profile tool at the end of this newsletter.

Note: Daniel Goleman?s newest book, Social Intelligence, is the next evolution of his groundbreaking work in EQ. Look for review in an early 2007 issue of Practice Your Way.

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Client's Corner:

Why Can’t My Staff Just Get Along?

Q: My partner and I have six full-time employees and on any given day, at least one of them is on the outs with the rest of the group. They all bicker and gossip and run behind the back of our office manager to one of us with grievances and complaints. My partner and I are both tired of playing peacemaker and just want them all to get along and do their jobs. Where do we go from here?

A: I strongly suspect that your team isn?t being challenged enough. Lacking worthy group goals and the support to achieve those goals, teams often become bored and spend their time engaged in less than satisfying activities — in this case bickering and gossiping. In his book Finding Flow, author Mihaly Csikszentmihalyi describes individuals being ?in flow? when they are challenged in a way that is commensurate with their ability. Too high a challenge, given current ability, leads to anxiety. Too low a challenge, given current ability, leads to boredom.

When a team is in flow, their collective challenges and abilities are aligned. They are focused on meaningful goals that require them to work together for the greater good (that good being your patients and your practice). If you can appropriately challenge your team with worthwhile group goals, you may very well see them rise to the occasion and begin to align their energy and use their time more efficiently. They?ll begin doing, if you will, a neural ballet . . . connecting, resonating, and caring about one another. Additionally, as they see that they can achieve results as a team, mutual trust and respect will increase and gossip and bickering will diminish.

Your team needs to be re-energized and it?s up to you and your partner in your leadership roles to take the needed steps to make that happen. I would suggest that you consider scheduling a series of facilitated meetings or an offsite retreat to include everyone in the practice — practitioners plus all full-time and even your part-time employees. This is valuable time you set aside for the group to assess where the practice is at this point, discuss where everyone involved would like to see the practice go over the next year or two, and map out specific, realistic, and achievable goals to work toward. Build in dates by which certain milestones will be achieved, designate sub-groups or individuals within your team to take on certain tasks, and lay out a tracking and reward system so that you?ll have a way to celebrate your successes as they occur. It is important to track not only measurable outcomes, but also the actions that lead up to those outcomes. To improve group dynamics, it?s critical that members of your staff become involved with and enjoy the process as well as the results of their efforts.

To read stories about real teams that have learned to function well together, read the Case Studies section on my website (www.beyondpracticemanagement.com), specifically case studies 3, 5, and 6.

Special Offer:

Make 2007 the Year Your Staff Becomes a Team

Schedule EQ In-Action Profiles for you and your entire team before December 31, 2006 and receive two follow-up conference calls (group coaching sessions), in addition to the individual debriefs. To qualify for this special offer, all profiles, debrief sessions, and the two follow-up conference calls must be completed by March 31, 2007.

Based on the well-established theory and respected model of Emotional Intelligence, EQ In-Action profiles provide a snapshot view of an individual's internal experience and habitual strategies when they are in difficult or stressful situations.

The value of this tool is that it places individuals in real situations, watching and responding to video segments of difficult conversations in challenging work situations. A report is then generated that identifies strengths and weaknesses in different dimensions of emotional intelligence and the person's capacity to respond in stressful situations. Suggestions for daily practices are then offered to build increased fitness in chosen dimensions. The result is improved interpersonal communication skills and more effective professional relationships. This profile is an invaluable tool for coaching individuals and teams interested in lasting change.

To schedule EQ In-Action Profiles for yourself and your staff, please e-mail or call today: info@beyondpracticemangement.com, (503) 504-5585.