Though I have heard of the Mayo Clinic I would not have taken the time to learn management lessons from it’s success without this piece.
There are a number of elements that, on their face, might not work to attract world class talent – the clinic is not located in a major centre and doctors are salaried. That said, the level of the talent attracted to the clinic creates its own momentum and contributes to a successful culture.
Give a group of high performers an amazing atmosphere in which to do their work, and eventually they will simply be attracted by each other. This can go on a long time.
The article is also worth a read to better understand the client-driven benefits of the “one stop shopping” model for health care concerns – the clinic is basically a medical city.
The pop-up dental clinic is being set up in a high school in Memphis. Tarp laid and chairs set up.
One of my foodie friends enjoys reading the comment threads on recipes to read the responses from the recipe haters who swap out this for that and sub out a few more things they didn’t have on hand and angrily give a one star review to a recipe that bears no resemblance to the the one posted. A wiser person than me finally handed me the clear rule that I have now adopted, the first time you make something, just follow the instructions to have some idea of how it is supposed to go down. Even respecting the instructions so much can change your outcome. Using baking as an example, how hot is your oven really? How much moisture is in that flour that has been sitting in your dry as bone mid-winter house? You get the picture.
This was one of many lessons I had re-enforced when I went down to Memphis recently to fulfil a long held curiosity to help at a pop-up medical clinic put on by Remote Area Medical. I was in turn, fascinated and pushed to exhaustion by my minimal contribution to this clinic.
One of my firmly reenforced mantras was to first, seek to trust the instructions. What abetted this trust was understanding the reason behind the instructions and hearing it from such credible sources.
I was trained on-the-spot for a number of tasks in a clear, step-by-step fashion. These instructions might include things like the number of parts I was looking for and what order I would have to do them in. Perhaps most importantly, they would usually include the why behind the instructions. The job accurately billed as the worst of the day was to set-up 60 folding dental chairs. They were heavy and not entirely cooperative but could be made to stand just fine if you followed all the instructions. In one case we had to move the position of a central rod using a crank before we started other parts of the set up. If you did this in the wrong order, you’d have to redo the set up to correct. Horrors. In other cases we would sanitize an item and then leave some object in a particular place as a symbol that we had done all the required steps.
I generally follow rules and instructions so it wasn’t a hard sell to follow along and given that you have the background motivation that you want vulnerable people well served. That said, there were motivations to cut corners. This work was exhausting with a small crew that had mostly been recruited to do actual medical work and it wasn’t the patient-facing work which many volunteers were likely hoping to do when they signed up.
What also helped was that I could fully and completely trust the source of the instructions. My admiration for the RAM folks was very deep because it was evident that they had hammered out the design of the clinic thoughtfully and deliberately over time (they have done over 800 clinics). Things are put away in a specific way so that they can be carried or hauled and so that it is clear what is in each bin. They tie off plastic bins to show that they are full with three complete settings for dental stations. No need to count, we can trust this. Carrying cases are colour coded so they are directed to the right vehicles.
As a last observation, I can see now that I was also motivated to follow the instructions because I was continually surrounded by people who would help keep me on track if I was unsure as to how to go ahead- not choking micro-management but supportive access to supervision. There was no need to wildly freelance to fill in the gaps.
Tony Schwartz describes CEOs as Chief Energy Officers and writes here about his experience of re-orienting a meeting where he was feeding the group many new ideas with enthusiasm, and not receiving the warm welcome he had hoped for. Instead he was hearing about people’s stress and lack of recognition for the work done so far.
My two favourite points in his response:
“Because human beings have a strong “negativity bias,” we pay more attention to our bad feelings than to our good ones. It once clearly served our survival to be vigilant about what might go wrong and that instinct persists. Today, it may serve to buffer us from disappointment, but it also promotes disproportionate and destructive discontent. The simple question “What’s going right?” provides ballast in tough times.”
“The highest skill — whatever your role — is the willingness to embrace opposite feelings without choosing up sides. Acknowledging bad feelings is key to being able to address what’s causing them. Recognizing they’re only one part of the story frees us to notice what we feel good about and grateful for, which helps us to feel positive even in the face of ongoing challenges.”
I’d add a third observation from the first rate materials and training that I have received from the National Managers’ Community in the Government of Canada: Behind every complaint is a commitment. Whereas in my early days as a manager my instincts might lead me to wonder why people were “just being oppositional” when work needed to get done, when now I take the space for explorations of the values that people are indirectly expressing when they are complaining, I have found important information that may provide a jumping off point to a better working relationship. The number one reason that people are complaining: they want sufficient time and space to submit a good product.
This is a great article on why taking some time to ascend in your career has benefits.
The article lists many good reasons to take a measured approach to promotions including avoiding burnout and gaining the skills you’ll need to succeed. And my favourite of all:
“Following a “deliberate” path may prevent the problem experienced by any number of hard-charging executives: getting to the top of the career ladder only to realize it’s leaning against the wrong wall.”
I’ve read two pieces recently on the need the need to manage discomfort with uncertainty. Though there is a a good evolutionary reason for discomfort with things that don’t fit regular patterns, many types of work require a certain comfort with uncertainty. They’ve suggested that the MCAT add questions on dealing with ambiguity.
Seth Godin argues that you have to keep “levelling up” and not assume you are ever fully baked and that your knowledge stash would be complete.
Using some extreme examples such as the Waco hostage taking and the rise of the Nazis. author Jamie Holmes talks about the benefits of holding space for grey areas to advance thinking. What I appreciated most was the need to keep alternative perspectives on the table as long as possible because they might present solutions. I also appreciated the reminder that divergent approaches may be seeking the same end game – I tend to crave closure on big ideas and fact checking whereas others crave more perfectly presented documents – same craving with different stripes – closure and certainty.
This article focuses on the ability to empower employees by shaking off the inclination to be a constant contributor to the ideas they bring and resisting the temptation to give step-by-step instructions for every task.
I especially liked the quote that when you give advice, the brain is essentially asleep versus when you ask questions it engages the listener.
This is a valuable piece which does a good general job of laying out explicit strategies for something I didn’t think could be explained well – what to do when you have to get command of a new and complex subject really quickly.
This has been a struggle for me as a manager because I haven’t been able to reverse engineer my own ability to (usually) hack together a decent understanding of most subjects through self-learning fairly quickly. I can read fairly quickly and if I jump in at the deep end and it eventually starts to make sense.
The advice below is therefore especially helpful because it forms a strategy to respond to the questions and resulting resistance that I hear a lot: I can’t do this because I don’t know the file like the expert and I would have to know the file inside out to be able to give advice. In fact, most people are capable of getting a working understanding of a file in a limited period. Yes there will be gaps and you can admit those but this piece should shine the light on the ability to get a credible start.
The whole article is worth a read but the gist:
Do an initial google search and then stop researching before you fall down a rabbit hole. Now is the time to map out the extent of your understanding of the topic through borrowing visuals from others or making your own;
Then talk to people close to the topic who may be outside your sphere and (may not your first stop as subject matter experts); and then
Write out an description of your topic that would allow you to teach about it to a truly outside audience.
I liked this piece on the importance of humility in leadership. I have posted here and here on this issue, but this one brought more practically to the subject which I appreciated.
The need for humility in leadership may not be obvious when you think of the stereotype of leaders who should be confident taking decisions and giving direction. To me the why of humility in leadership is a fusion of understanding that: you need a lot more information than you have to do your job, you may be your best version of a leader when you are in service to everyone, and that humility will help you build endurance for the journey.
From this piece, I particularly liked the test to ask yourself the question “How do you act when you are interrupted?” (and ask yourself how you’d react when you are busy and when it is someone below you on the org chart).
It’s a brilliantly simple question and it hits at an area of deliberate growth for me in the past few years. I work in an open concept office so there is no easy way to signal when I am trying to get through something and would prefer not be interrupted. Though I am sure that I have spent too long acting perturbed that I have been interrupted, I have now taken the decision to treat my entire work day (with rare, clearly announced exceptions) as if I am hosting office hours. This isn’t to say that I can give each conversation its due at the moment it is proposed – sometimes a sit down meeting is more appropriate and at times I am on my way somewhere. That said, as a default, I want to be as present as I can for what people are coming to say.
I have learned good habits on this from observing others. I used to marvel at senior leaders who acted as if they had all the time in the world to listen to you brief when I would be distracted at thinking about how busy they were and how I didn’t want to waste their time with a long briefing. I then resolved to also be calm and clearly in receiving mode when employees would come and talk to me since expressing irritation, anger or panic do not support receiving the information needed.
Humility may save you from a mindset that won’t serve you well when you hit unfamiliar terrain. The more you think you should (already) know how to be a good leader including from being told that you have inherent talent for the job, the less prepared you are to succeed when you reach an unfamiliar situation. Carol Dweck makes a great point in this piece on mindset and leadership – it is much easier to have humility at the beginning of your management career and this wanes over time. So the ultimate question is how to continue to show humility the longer you stay in a management role and no matter the stress you are feeling.
I’ve enjoyed reading through a book of commencement speeches this week called “Way More Than Luck”. Most moving to me was the one given by Madeleine L’Engle to Wellesley College in 1991.
She recounted how she was placed in a school which valued sport participation and she wasn’t able to contribute due to having been born with legs of two different lengths. For some reason, her home room teacher equated this with a lack of intellect and completely gave up on her. Madeleine withdrew from her schoolwork and began to dedicate herself to her own writing in Grade three. She eventually switched schools and ended up with a first-year teacher who considered it part of her role find and affirm in each person, that which is intrinsically valuable. The teacher tasked her with writing a sequel to the Odyssey.
I liked this reminder that people can rise to challenges but that your attitude about whether you think they can is crucial.
A recent article from the Harvard Business Review, People won’t grow if you think they can’t change, elaborates the point drawing on the fixed mindset versus growth mindset work of Carol Dweck. Not only is a growth mindset important to see the potential for people to grow, a fixed mindset may prevent you from seeing the progress an employee has made (and may also well prevent an employee from seeing the progress you are making) thus calcifying a difficult relationship.
What was also poignant about reading L’Engle’s commencement speech was that L’Engle’s teacher acted as a force multiplier for her by taking a task that she was willing to do on her own and asking her to stretch and build on it. I dipped into a book called Multipliers earlier this year on this theme. While “diminishers” are apt to believe that work can’t get done without the help of a manager are more likely to shut people down with sharp remarks, “multiplier” managers can get two times more work from their people if they can build on their employee’s existing talents – things they can do with minimal effort, things they do without being asked and things that they’d do readily without being paid. What is perhaps most liberating about multipliers is that they generate pressure to create the best work (and create the space that this could occur) without creating stress. They rather generate the belief that the impossible is possible.
L’Engle admits that her sequel to the Odyssey likely wasn’t that great but the suggestion to attempt it seemed to help plant the seed for her momentous career in writing.
We get better decisions (if we overfit for the past, this is a poor predictor of the future)
People can actually follow a small number of rules even under great stress.
The gist of the research:
Researchers examined product development teams to see who got the most done and overly rule driven and complicated processes resulted in the wrong products being produced very efficiently while teams with no rules had a great time getting nothing done.
Teams benefited from having a few rules that would guide work but leave flexibility for innovation.
The steps recommended to develop your rules:
Set your objective
Find the bottleneck (it may not be where you think it is – in the example given it was during the hiring process.)
Develop your rules by looking at your own data of when you have been successful and by talking to outside experts.
The hardest rules to follow are the ones telling you when to stop doing something – we are all great at starting something and very poor at stopping.