Get Your "Shift" Together

You know many healthcare executives and clinical leaders. In fact, if you’re reading this, chances are you are one. Most likely you’re already successful, have developed a set of strong competencies, and are even producing measurable and positive outcomes. Even so, do you ever feel like you’re not working to your fullest capacity? Do you wonder if you’re making the type and amount of impact you could? Do you wish you could be even more effective, particularly in the face of mounting challenges?

If you answered “yes” to any of these questions, you’re not alone. According to a recent survey* across multiple industries, 71% of organizations believe their leaders are not prepared to take them into the future. Questioning efficiency, effectiveness, and impact is common among accomplished healthcare leaders. They are challenged to better lead their organizations through the turbulent environment. They face the often-polarizing expectations of achieving excellent patient safety and quality outcomes, while simultaneously improving financial performance, increasing physician and employee engagement, and more.

Expecting different outcomes from the same set of behaviors is often described as “insanity.” However, the difficulty rests not so much in changing the behaviors, but with the unexamined thinking behind those behaviors. Engaging in this “thinking about your thinking” is incredibly challenging, but not impossible. It takes intentionality and commitment and often the support of a trusted partner and coach.

Health care organizations of all types and sizes are seeking leaders, especially clinical leaders such as physicians and nurses, who are better prepared for new and upcoming roles in the C-suite. Beyond building technical leadership competencies in a traditional training program, transformational leaders will need to dig deep, challenge their thinking habits and mental models, and be willing to be vulnerable and open to entirely new ways of facing problems and challenges.

Turn Off Autopilot

We all know that behavior change is difficult – think of any number of personal health behavior improvements you’ve tried to make in your personal life. Or think about the number of times you’ve returned from a conference with the best of intentions to implement all the new things you’ve heard. I’ll ask you, “How’s that working for you?” That is, basically, my point.

You have heard, and you are aware, but you haven’t put your learnings into practice or leveraged them consistently. Knowing what to do and doing are two very different things. Human beings are anchored in the “status quo.” In fact, at a biological level our bodies strive to stay the SAME (remember homeostasis from 9th grade biology?) by making only minute changes. Basically, as long as things are not going horribly (and we really like to work with successful people who want to be even more effective), you keep “doing what you’ve been doing,” and creating neural pathways and mental models that support that.

This “autopilot,” as we like to call it, is very strong at a neurobiological level as well. It allows our brains the capacity to be on alert for threat (formerly in the physical form of a sabretooth tiger and today in the social form of a loss of status or control – more on that in another blog post!). With this in mind, we can appreciate the “self-protection” often offered by our “auto pilot” thinking – but we can also see its potential limitations.

Dig Deeper

So, how do we move past self-protection into a place of broader opportunities and growth? Let’s explore a real-world example.

I have a client who isn’t getting enough sleep. She knows it, she feels it, she even has the data that proves it as her wearable device is showing 5-6 hours on most nights. The desired result or outcome is more sleep. When asked if she knows what she needs to do to get more sleep, she says “Sure – I need to go to bed earlier.” When asked what she is doing instead of going to bed, she sheepishly replies that she is scrolling through social media sites. She knows she should go to bed earlier without the additional screen time. Yet, many nights she makes the opposite choice. Why doesn’t she consistently do the things that she should to do?

Many of my clients have this exact issue. So, using my coaching frame of reference, I help her (and them) dig deeper. And I hear many “autopilots” or thinking habits preventing the behaviors they know they need to change (here, that is simply going to bed on time) including:

  • This is my only time in the day to relax and do something for myself (“I’m distracting and numbing from the stress of the day…”)

  • There is so email much that comes in each day, this is the only time I can go through all of it and catch up on issues and other items. (“If I just work harder…”)

  • I am the “boss,” and cc’d on everything… I need to make sure that I am not missing something urgent or needed to provide support to my team. (“I am so responsible for everyone else…”)

  • My “to do list” is never-ending. I don’t want to let one thing slide. (“I expect perfection…”)

The problem is that many of these underlying mental models (those things in the “quotes”) may have actually worked for you in the past – so well, in fact, that you don’t even know you’re using them and that they aren’t that effective anymore. So, on you continue, in autopilot mode, getting only incremental or unsustainable improvements in your desired results. This is what happens when we engage in transactional change – focused only on shifts in behaviors to get outcomes.

But you don’t want to be a transactional leader, do you? You’d prefer to be a transformational leader, right? Transformational leaders don’t continually work in autopilot mode. They become intentional in how they are leading.

Slow Down, Open Pandora’s Box

Leaders committed to transformation in the healthcare environment must first be committed to transformation within themselves. Probably the most challenging first step for many is to slow down and commit the time needed for examining their past experiences and the beliefs and mental models they’ve created from them. Working with a coach provides leaders with the structure, process, and most of all the “accountability” to help them commit the time to themselves for this important work.

This work also takes a level of openness and vulnerability. Sometimes this part of the process feels like opening Pandora’s box. We all appreciate feeling comfortable and confident in who we are and how we lead. Expert coaches “hold up the mirror” and create a safe space for leaders to look both critically and compassionately at their experiences and the types of thinking habits they’ve grooved from them.

Increasing self-awareness, being intentional about exploring mental models, and building new muscle in how to make different, less habitual choices is the core of creating transformational results in yourself, your leadership, and your organization. This is hard work. I often and vividly recall the exhausted look on the face of one young CEO at the end of our two-day coaching kickoff. When I asked what he was experiencing he said, “I’m exhausted! I’ve never spent this much time thinking about my thinking!”

Coach as Catalyst

Looking at the pyramid (Fig. 1), many leadership development and leadership education programs focus on changing results or outcomes, based on new behaviors and actions. We know that sustained change requires active interruption. A coach partners with you to challenge conditioned thinking, mental models, and paradigms.

The question I hear often from those who have not experienced work with a coach is, “Shouldn’t I be able to do this on my own?”

The simple, yet honest, answer is, “No.” For all of us, our “autopilot” and habitual thinking are so strong, it’s nearly impossible to create the breakthroughs that are necessary for transformational change on your own. In the truest sense of the definition of a catalyst, a person or thing that precipitates a change, you as a transformational healthcare leader need a coach to get this process started, to challenge you, and to help you be accountable to the changes you want to make. Over time, healthcare leaders become increasingly capable of holding this space, the more intentional leadership space, for themselves and for others. THIS creates the potential for bringing the kind of organization and industry transformation that is needed in healthcare today.

*Brandon Hall State of Leadership Development 2015: Time to Act is Now