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September 29, 2022

5 Strategies That Cultivate Positive Change!    

I help dental teams nationwide successfully embrace change. This message is dedicated to learning how to cultivate a culture where change can be a more positive, successful, and sustainable experience!  Change requires us to have courage to face our fear of the unpredictable unknown! Regardless of how dysfunctional, unhappy, unproductive, or toxic the current culture maybe it often feels safer to keep the status quo. The known almost always feels safer than the unknown. That is why the value of the change must be clear to those expected to make the change. It is important for the value and benefits of change to rate an 8 or above on a scale of 1 to 10 with 10 being high. Otherwise, the chance for the change to be sustained is limited.

“Change starts in our mind!”

I facilitate Culture Camps nationwide.  I have found 5 consistent strategies that cultivate positive change!

  • Trust in leadership
  • Clear and consistent message
  • Structured plan
  • Adequate training and practice time
  • Realistic workload

Number 1!  Trust in the leadership. If the team members trust their leader(s) they will be more willing to step into the unpredictable unknown. Leaders can build trust by embodying the following traits:

  • Model the waddle is the number one leadership principle – in other words lead by example
  • Aligned leadership – Have a clear and consistent direction
  • Be transparent and keep the team in the loop as much as possible
  • Be open to suggestions and feedback
  • Address any obstacles, fears, or concerns the team may have in open communication

Number 2!  Communicate a clear and consistent message. Set your team up to succeed by communicating the change clearly and concisely. I suggest the following communication process:

  • Clarify expectations
  • Ask questions to make sure everyone understands
  • Write objective down in bullet points if more than a couple of things
  • Set realistic expectations for completion time and date
  • For more involved or longer tasks schedule a check in

Number 3!  Develop a well-structured plan. If you want the team to embrace a change, ask for their suggestions and feedback on how to implement the change. If you want the team to have ownership, give them authorship as well. A well-structured plan is well thought out and clearly defined. I teach teams the R.I.S.E. Implementation Process to help them work together to create a well-structured plan. R.I.S.E. is an acronym for Review, Implement, Sustain and Evaluate.  Email me at JudyKay@PracticeSolutionsInc.net and request R.I.S.E. Process White page.

Number 4!  Schedule appropriate and adequate training and practice time. I have found that the most positive and successful changes happen when the team has time to train and practice.  Team meetings are the perfect opportunity for training and practice time.

Number 5!  Be realistic with workload expectations. It will be very difficult to get the team excited about embracing something new if they already feel swamped and are consistently running behind. It is important to evaluate if there is enough time, money and people to implement the change successfully. Even the most committed employees will become resistant to change if they are consistently overwhelmed.

Implementing these 5 strategies will help you cultivate positive change!

September 1, 2022

A Code of Commitments!

Even the best of us can lose our way in all the noise and hubbub of the day-to-day stresses! Establishing a Code of Commitments for the practice will help the entire team keep on track…even in stressful situations when the wheels fall off!

A Code of Commitments is about having a preplanned game plan on how to react. Behaviorally, that means testing decisions and planned reactions for “integrity” that support the core values before implementing them.

Here are 4 questions to help you create your own code of conduct:

  • Is it legal?
  • Is it ethical?
  • Does it align with the practice core values?
  • Does it support each other and the patients?

I suggest a team meeting (4 hours minimal) to establish a Code of Commitments for the practice.  Start the meeting by reviewing the practice’s 4 core values.  Owner doctors you will need to have established 4 core values in order of priority.  All owner doctors must support the same 4 core values.  Ask the entire team to share how, when and where they feel the Core Values are not being supported.

Utilize a large easel pad and markers to write down all the concerns being shared.  Discuss the breakdowns that are happening.  What current attitudes and behaviors support the Core Values?  What current attitudes and behaviors need changing to support the Core Values?  The behaviors you list that support as well as the necessary changes become your new Code of Commitments!

It is very important for the We Team (leadership team) to lead by example on whatever is established as the Code of Commitments.

Here is an example of a Code of Commitments.

  • Model the waddle you want to see
  • Set and maintain high standards – no double standards
  • Support a no gossip culture
  • Communicate openly, honestly, and respectfully
  • Treat each other as well as you treat your patients
  • Resolve conflict by going to the source the same day if possible
  • Take ownership, follow through, and be accountable for your mistakes
  • Support each other and help each other succeed
  • Hold each other accountable to the practice’s standards for behavior, communication, attitude, and service!

Having a Code of Commitments will empower the entire team to interact with patients and each other with integrity!

December 1, 2021

Keeping Your Team Engaged!

Keeping your team engaged starts with understanding and identifying the different levels of engagement.  There are three levels of engagement: Rowers, Riders, and Resisters!

Rowers – Engaged Employees – are passionate about their work and feel very connected and loyal to the practice.  They are always looking for ways to improve performance and patient care.  They are focused on the big picture of helping the practice succeed.  They base their success on the practice’s success!

Riders – Not Engaged Employees – are essentially checked out.  They can be difficult to spot.  They are just coasting through their day by putting in time without energy or passion.  They are thinking about lunch, who just called on their cell phone, or what they are going to do when they get off work.

Resisters – Actively Disengaged Employees – are unhappy at work and demonstrate it in their words and actions.  They monopolize the doctor/manager’s time (always having to issues that need addressing), have more on-the-job accidents, create more quality concerns, are sicker and miss more days.  They undermine what their engaged coworkers accomplish and sabotage the practice.

 

 

Clear and Consistent Expectations

We start with an open and candid conversation clarifying expectations and the results desired.  Go deep enough to explain what, who, when, where, why and how.  So often time’s when delegating things are left unsaid.  Assumptions are made resulting in frustration for the doctor, the manager, and the employee!  If the employee is not clear on expectations, they cannot possibly deliver.   If you are thinking, they should just know that, or I already told them once…I don’t need to tell them again…your results will be limited!

“If you don’t ask for what you want don’t be angry when you don’t get it.” ~ Judy Kay Mausolf

 

Appropriate Equipment and Supplies

Next is making sure the team has the appropriate equipment and supplies to maximize efficiency and get better results.  It demonstrates to the employee that their work is valued because you were willing to give them the support needed to do their job.  For example, a specific instrument to aid your hygienist in safely cleaning around dental implants.  It is important to ask employees if they have what they need to be able to do their job efficiently and effectively.  The initial cost is outweighed by the ROI of increased performance, service, and productivity.

I have found men are usually much better at getting the right equipment and supplies whereas women will try to make do.  This summer my husband Steve and I went a little crazy with filling our deck with pots of flowers, succulents, and evergreens!  It became huge watering chore for me because we did not have a hose up on the deck.  I have been traveling a lot more for business…which means Steve has become the water boy!  Surprise!  I came home to find a faucet and short hose up on the deck.  Watering is now so easy it is fun!  What used to take me 1/2 hour or more now takes under 10 minutes!  We have just tripled my productivity and increased job satisfaction by having the appropriate equipment and supplies!  

  

Focusing on Strengths 

We focus on identifying and building on each team member’s strengths. This one step alone can change productivity by as much as 12.5%.  The best opportunity for people to grow and develop is to help them discover their innate talents.  It just naturally creates a feeling of wellbeing when we can do something well.  We enjoy our work more.  Focusing on a team member’s strengths is a far more effective and positive approach than constantly focusing on their weaknesses.    When employees know and use their strengths, they are more engaged, have higher performance, and are less likely to leave the practice.

Research shows that the management style of focusing on the positive strengths reduces active disengagement to 1%.  Whereas a negative focus management style produces 22% disengagement.  Surprisingly, being ignored causes the most damage at 40% disengagement!  The old saying, “If you can’t say anything nice, don’t say anything at all!” is not a successful management style.  It delivers to the most negative outcome of all.

 

Which response would your employees say best reflects the management style in your practice?

  • My manager/doctor focuses on my strengths or positive characteristics.
  • My manager/doctor focuses on my weaknesses or negative characteristics.
  • My manager/doctor does not say anything at all, and I feel ignored and invisible.

Leadership teams can help engage the team by creating clear and consistent expectations, providing appropriate supplies/equipment, and focusing on strengths!

Contact Judy Kay today if you would like to learn more about how she can help you get your team ENGAGED and WORKING together to build a happier, healthier, and higher performing culture! 

November 1, 2021

How to Encourage Accountability! Part 2

Training is often a culprit of lack of accountability.  It is difficult to complete a task if we are uncertain how it is to be done.  Uncertainty lessens accountability!  Set standards for the practice by defining one way instead of multiple ways.  Standards create consistency and consistency escalates excellence.  The more consistent we are the more accountable we become resulting in a higher performing team and practice.  Provide personal training and cross training as well as entire team training to get everyone aligned on the same page.

 

 

Asking for help is being accountable.  Give your team permission to ask for help when needed.  Asking for help can often feel like a weakness when in essence it is being accountable to make sure the job gets done.  There are some team members who have OCD – Over Committers Dysfunction.  You will often here them say; “I got this!”  when they have so many plates already spinning, they can’t possibly get them all done.  Saying yes can sometimes be less accountable then delegating or asking another person for help.

Prioritize tasks as there will be days even the entire team can’t get everything done!  If we communicate and get the rocks done, we will be okay.  I utilize the rocks, pebbles, and sand analogy to help teams prioritize their responsibilities.  A rock is anything that is important and urgent (needs to be done that day) or there will be negative consequences for the practice.  The biggest rock is always the patient right in front of us.  Everyone helps everyone with their rocks (as long as it is legal, ethical and within their licensure) before going on to their own pebbles and sand.  Once all rocks are completed, the team member may move on to their pebbles.

Pebbles are also very important but not urgent.  Pebbles are never delegated because they can be done another day without affecting the practice negatively.  Everyone is responsible for their own pebbles.  A pebble can eventually become a rock if left undone based on change in urgency.  For example, ordering supplies might become a rock if you must order that day, or you will run out of necessary supplies before they arrive.  Even washing uniforms may become a rock if there are none available for the next day and it is close to closing.

Sand is the filler to fill in open time with cleaning and organizing.  Sand is also never delegated.  Everyone is responsible for their own sand.  This helps to prevent delegating the things that are less desirable.

Confirming by checking in when a task is completed is part of accountability.  It keeps everyone in the loop and ends the night wondering/worry of whether a certain task was completed.

Clearly defined consequences are necessary.  An accountable high performing team is dependent on supporting the patients, the team, and the practice standards.  Our job is whatever is legal, ethical, and within our licensure to help the team and practice thrive!   We must choose to support our patients, team, and practice if we want to be a part of the team!

October 1, 2021

How to Encourage Accountability! Part 1

Just hearing the word accountability often results in a big sigh, rolling the eyes and that ugh feeling.  Let’s face it cultivating accountability can seem like a daunting task.  What usually pops into mind are the words babysitter or micro-manager from past failed attempts at trying to get others to be accountable. We often give up after two or three attempts to hold the person accountable.  We feel that the effort isn’t worth the frustration.

 

 

However, without accountability, execution suffers.  Performance deteriorates when we don’t hold ourselves or others accountable to getting work done well and on time. The more we let things slip the more acceptable it becomes to let them slip again.  A day becomes a week, a week a month and finally not at all.

I am often asked by my clients and audience members; “how many times do I have to ask or remind someone?”  My response is always until they do it or you let them go.  Otherwise, your culture reaps the result of lower performance.  Culture always starts with the leadership team.  It is either what leadership does or allows which becomes viewed as accepted by the team.

There are always consequences when there is lack of accountability to the patients, practice, and team.  Therefore, there must also be consequences to the person who is not being accountable.

Without it, it is difficult to get people to assume ownership of their own actions because they believe they will not face any consequences.

Here are ways leaders can demonstrate and encourage accountability.

Establish clear job expectations.  What are the daily, weekly, monthly, and yearly expectations?  I like to use S.M.A.R.T. Goals

  1. Specific
  2. Measurable
  3. Attainable
  4. Relevant
  5. Timely

 

Communicate daily and address any concerns immediately.  We often let things go a few times before addressing.  The concern is once something is allowed (not addressed) it is considered acceptable.  Nip things in the bud as soon as they happen.

Have constructive conversations.  Notice I did not say constructive criticism.  I have yet to find anything constructive about criticism.  A constructive conversation starts out with what you appreciate.  For example, “I really appreciate, or I really like that you did ____…And I would add ______ to make it even better.”  Notice I used the word and not the word but.  The word but negates what was previously said.  The word and builds on what was good.  Three positive comments to one growth opportunity make a good conversation.  Five positive comments to one growth opportunity make a great conversation!  We want to build our team up and make them feel more confident.  Confidence helps nurture accountability.

Read November’s Show Your Shine for Part 2 of How to Encourage Accountability!

October 1, 2019

Your Team Is Your Greatest Asset… When You Invest in Them! Part 2

In Part 1 we covered how YOU can get your team aligned and engaged to become your greatest asset.  In Part 2 we will cover how to empower them so THEY can become your greatest asset!

Have team meetings and discuss with your team the core values of the practice.  Together define what it means in words in actions.  Make agreements as a team that support the core values on how you will communicate, work together to serve each other and the patients.  Establish as your number one standard that the team treat each other as well or better than how they treat their patients.  It is vital that you do not set double standards for how the team treats each other versus how they treat the patients.  Print the standards and store them in a binder accessible to the team.  Keep them alive by reviewing them at huddles, team meetings or when hire someone new or when someone’s behavior deems it necessary.  Everyone helps everyone support the standards by holding each other accountable once the agreements are in place.

Some examples of standards:

  • Greet and smile at each other in the morning
  • Ask for help
  • Ask don’t assume
  • Offer help
  • Say please and thank you
  • Don’t gossip
  • Be kind

 

Empower

Empowerment happens with clear training and implementation processes.  We need to let go of perfection and instead strive for excellence.  Proficiency comes after mistakes and leads to excellence.    “Unless we try to do something beyond what we have already mastered, we will never become what we might have become!”

  • Set high standards not impossible standards
  • Learn from mistakes and move on
  • Share what will be done differently

Have a clear and consistent training process.  Which means the team does tasks the same way.  So often times I see team members choosing how they will complete a task based on what they think is right.  Or because it’s how it has always been done.  Or it’s just someone’s opinion…usually the most vocal team member.  Often times there hasn’t been a formal team meeting discussion defining and agreeing on how the system or process will be done.  Utilize the R.I.S.E. Process to successfully implement new ideas and create clear and consistent systems and processes.

Set realistic weekly training goals for you and your new employees to measure their progress.  Base training expectations on the average time it took for an employee to learn instead of the quickest time.  It will help lessen new employees feeling overwhelmed and allow them and the team to measure their progress.  Have a constructive conversation weekly with the new team member discussing goals, expectations and accomplishments instead of criticizing what they are doing wrong.  Catch them doing things right and highlight them at a minimum of 3 positives to every 1 growth opportunity.  Exceptional relationships are built on a 5 to 1 ratio.

Our life, the people in our life and our circumstances continue to change.  Therefore, it is necessary to continue to invest in learning and training to continue to grow.  Where are you in your growth process?  What is working what has changed?  What investment would make the biggest impact in your team being your greatest asset?  Your team will be your greatest asset when you invest in them.

Email Judy Kay at JudyKay@PracticeSolutionsInc.net to learn more!

February 1, 2018

Say Bye Bye to Fly-Bys!

 

Say Bye Bye to Fly-Bys!

This message is focused on developing a We Team decision strategy to avoid fly-bys! Let’s by start by illustrating a fly-by.

Foundation of a Fly-by!

It’s another busy day! Doctor you just stepped out of treatment op 1 and are hurrying to hygiene ops 3 and 4 to do checks that have been waiting for at least 10 minutes. The hygienists have buzzed, messaged and are now tapping their feet with impatience. You avoid eye contact with the three team members (office administrator, assistant and hygienist) lining the hallway as you know they are all waiting for you. A blur of questions assault you as you pass by them. “Doctor can I…, Doctor what do…, Doctor how would…!” All you want to do is get to the hygiene rooms before the hygienists get more upset. So without lifting your head you mutter responses on the fly…yes…no…do this starting now. You’re not even sure what you said or to who. All you know is that you cleared a path to get to the next room. You have just successfully completed another fly-by.

Fly-bys may seem like an effective and efficient resolution but can be very toxic to the team and practice culture.   There is no time to process benefits and consequences, get team feedback and input or discuss with the entire We Team (leadership team).   A new standard or process is put into place with a few sound bites of discussion with the one lucky or unlucky team member who happened to ask the question. Everyone else on the team including the other members of the We Team are unaware of the decision and new process. In a short time, the We Team will no longer be cohesive and the team will start to doubt what the standard is for the day. The team will no longer fill confident or empowered to take even the smallest action without asking questions. This will result in consistently fueling an even longer line in the hallway. If you hear your team say ask each other; “do you know if we are doing it this way today,” you know fly-bys are happening. Fly-bys fuel incompetence, uncertainty and divide the team. Doctors, fly-bys are neither effective nor efficient.

I would like to introduce my W.O.W. Decision Making Strategy.

W.O.W. is an acronym for weed out weeds. A weed is anything that does not benefit the patients, practice or the team. W.O.W. Decision Making gives the We Team a positive, practical and proven decision making strategy. The results are decisions that are consistent, fair and support the team, the patients and the practice.

The W.O.W. Decision Making Strategy is based on the following concept questions:

  • Patients, Practice & Team
    • What’s in the best interests of Patients, Practice and Team – not any individual (including doctor)
  • Practical
    • Does it make common sense
    • Is it realistic with resources available regarding Time, Money, People, Or are you willing to invest
  • Precedent
    • What precedent is being set? If it is done once for one team member, it becomes the expectation for entire team. If it is not across the board, it will feel like favoritism or inconsistency and, therefore, it will be unfair. Only say “yes” to what you want to set as a precedent.
  • Passionate
    • Is the We Team passionate enough about the decision to defend it – even to the point of possibly losing a patient or a team member? I suggest not implementing anything that the We Team thinks it is just a “nice to do”! “Nice to do” won’t be worth defending if the practice could lose a patient or team member. On a scale of 1 to 10 with 10 being high does it rate 8 or above. Don’t implement anything that does not rate at least an 8 or you will not be willing to sustain the change.

Team Behavior Decisions

When we don’t see the results we desire from a team member we get frustrated and tend believe it is a behavior issue that warrants consequences. However, before we take any action we need to identify whether their lack of performance was truly a behavior issue. Maybe it was an issue with training, expectations, or communication that caused the problem. It is critical to not just react to what you think it is because you really don’t know. This is why it is so essential to meet with the team member and ask questions. The reality is that we could clear the majority of our team problems if we just asked questions. Schedule a time to meet with the team member and ask them questions to verify if:

  • They have been trained to do the task
  • They were clear on what was expected
  • They were clear on what was communicated

In many cases you will find it is either a lack of training, expectations or communication and not behavior that causes the performance problem. If that is the case the ownership lies on the person delegating and not the receiver of the task.

Utilizing W.O.W. Decision Making Strategy will help you say good bye to fly-bys and cultivate a happier, healthier and more cohesive We Team, Team and Practice Culture!

March 1, 2016

How to Prevent 3 Communication Pitfalls!

Our level of success in life is in direct relationship to how successfully we communicate. Communication can often be difficult and sometimes very frustrating. When we don’t say anything, an assumption is made – and in most cases, it’s negative. If we do say something, it may be perceived incorrectly. If that is not enough, there are all the “shoulds” from others – their comparison expectations on how we should do something, or be something or live our life a certain way. In other words, their way!

Because of assumptions, perceptions and comparison expectations we often make commitments to either do things we don’t want to do or don’t have time to do. Just writing this makes me feel exhausted! Wouldn’t it be nice if we didn’t have to worry about communicating? But that is not reality.

Our success in life depends on our ability to communicate. Therefore, it is necessary to learn how to communicate and overcome these pitfalls regardless of how frustrating or difficult they may be. I have found from years of coaching dental teams nationwide that the best way to get good at something is to remove or overcome the obstacles.

Let’s start with assumptions. This one is a biggy! We make assumptions every minute of every day. Something happens and we instantly assign meaning to it. It may be correct or it may be incorrect. We won’t know unless we take the next step. That step is asking. Sounds easy but it’s not. We often fear that if we ask, we may open ourselves up to an emotional reaction. We can’t let fear stop us from asking. We don’t know what someone meant by their actions or words or the way they said something. Sometimes even what they say or the words they use can mean something different than what we believe them to mean. Ask with care, concern and respect. Continue to respectfully ask questions until you understand the other person’s true intent. If you are still thinking “I think they meant…”, you are assuming and it is important ask more questions to achieve a clear understanding.

Perceptions are just as dangerous as assumptions. Both the person speaking and the person listening play a role in perceptions. I often hear team members say, “I didn’t mean it that way! They just took it wrong! So it’s not my fault!” If you are always being misunderstood, it is important to reflect on how you are communicating. It is not just what you say that counts in communication. It is also how the message is being perceived. The listener often bases their perception on their past experiences they had with you as well as your words, body language and tone of voice. They often assign meaning based on what it would mean if they said or did that same thing, which in many cases does not accurately reflect the other person’s intent. Inaccurate perceptions also happen when we don’t hear the entire story or all the reasons or steps. It is important to take the time to clearly explain your intent to avoid false perceptions.

Comparison Expectations create negative expectations! They are the “shoulds” that guilt us into doing things we aren’t comfortable doing or feeling terrible about ourselves when we don’t. We have all heard and even said, “You should….!” Comparison Expectations happen when we compare ourselves to others…or when others compare us to them. The comparison is what creates the expectations for who, what, when where, why and how we should do something based on what others do. Comparing is toxic; someone always loses. We may even believe that others are wrong when they don’t do something our way. Comparison expectations can make us feel or do something out of guilt. Guilt creates shame and shame inhibits communication because if we feel shameful about something, we are less likely to communicate openly and honestly. Stop the comparison noise! Quit allowing the “shoulds” from yourself and others to dictate your actions AND quit expecting others to do things your way. Instead together as a team create clear standards and support them!

(If you would like to receive the white pages for Team Communication Guidelines please email me at JudyKay@PracticeSolutionsInc.net and write Team Communication Guidelines in the subject line.)

Our success in life will depend greatly on how well we communicate in our personal and professional lives. Communicate clearly, ask questions to avoid false assumptions and perceptions and for goodness sake…stop “shouldng” on each other!

December 1, 2015

5 Core Culture Characteristics that Nurture Change!

December 2015

5 Core Culture Characteristics that Nurture Change!

You may have heard the quote; “The only thing that is constant is change!” It is true, change is inevitable but not always positive or successful! The reality is that some work cultures support positive and successful change, while other cultures sabotage change. There are many factors involved, such as team workload, other current changes in progress, team beliefs about change, clear communication about the change, benefits of the change, appropriate training, coaching and support provided during the change, etc.

I help dental teams nationwide successfully embrace change. This month is dedicated to learning how to create a culture where change can be a more positive, successful and sustainable experience!

 

 

Change requires us to have courage to face our fear of the unpredictable unknown! Regardless of how dysfunctional, unhappy, unproductive or toxic the current culture may be it often feels safer to keep the status quo. The known almost always feels safer than the unknown. That is why the value of the change must be clear to those expected to make the change. It is important for the value and benefits of change to rate an 8 or above on a scale of 1 to 10 with 10 being high. Otherwise, the chance for the change to be sustained is limited.

After working with dental teams for many years I have found 5 consistent characteristics in the cultures that support positive and successful change.

  • Trust in leadership
  • Clear and consistent direction
  • Structured plan
  • Adequate training and practice time
  • Realistic workload

The number one core characteristic that supports change is trust in the leadership. If the team members trust their leader(s) they will be more willing to step into the unpredictable unknown. Leaders can build trust by embodying the following traits:

  • Model the waddle is the number one leadership principle – in other words lead by example
  • Have a clear and consistent direction
  • Be transparent and keep the team in the loop as much as possible
  • Be open to suggestions and feedback
  • Address any obstacles, fears or concerns the team may have

The second core characteristic is to communicate a clear and consistent direction. It is important to use a decision strategy to avoid emotion driven decisions in the heat of the moment. I teach the following four strategic steps:

  • What’s in the best interests of the patients, practice and the team – not any individual and long term
    • Think about 10 months and 10 years instead of next 10 minutes or 10 days
  • What is practical and realistic based on time, people and money currently available
  • What is the precedence being set – if we can’t do it across the board for everyone on the team it will feel like favoritism and divide the team
  • What is the level of passion which we are willing to support the decision – will we support it when push comes to shove even if it may result in losing an employee or a patient

Set your team up to succeed by delegating the change clearly and concisely. I suggest the following delegation process:

  • Clarify expectations
  • Ask questions to make sure everyone understands
  • Write objective down in bullet points if more than a couple of things
  • Set expectation of completion time and date
  • Under promise and over deliver
  • For more involved longer tasks schedule a check in

The third core characteristic is for leadership to work with the team to develop a well-structured plan. If you want the team to embrace a change ask for their suggestions and feedback on how to implement the change. If you want the team to have ownership give them authorship as well. A well-structured plan is well thought out and clearly defined. I teach teams the R.I.S.E. Implementation Process to help them work together to create a well-structured plan. R.I.S.E. is an acronym for Review, Implement, Sustain and Evaluate.

  • Review
    • What is it we are currently doing
    • WIIFTT – What’s in it for the team if we make the change
      • It is important for the value/benefits to rate an 8 or above on scale of 1 to 10 or it is difficult to sustain
  • Implement
    • What are we going to change
    • Who is going to do it
    • Who are we going to do it for
    • When are we going to do it – including time, sequence and flow
    • Where are we going do it – very specific location
    • Why are we going to do it – WIIFTT if we make the change – there must always be something in it for the team for the team to sustain the change
    • How are we going do it
      • Practice verbal skills
      • Practice role playing – yes I know it’s weird but it’s effective
      • Practice the entire physical walk through – never test it out for the first time on a patient
    • Create standard operating procedures
    • Schedule the roll out date
  • Sustain
    • In order to sustain it is important for the new change to become a habit
    • It takes a range of anywhere between 17 to 257 days to form a habit depending on the difficulty with the average being 66 days
      • Give any new change at least 60 days to get comfortable before considering any changes
    • Be precise and consistent to make the change become a habit much sooner
      • Same sequence and steps for every team member every time
    • Support the change positively in words, actions and attitude
  • Evaluate
    • Is the process still working effectively
    • If not what is the value and benefits in a change
    • Any change takes ongoing tweaking

The fourth core characteristic is to schedule appropriate and adequate training and practice time. I have found that the most positive and successful changes happen when the team has time to train and practice.

Team meetings are the perfect opportunity for training and practice time. Utilize your team meetings to:

  • Update systems/protocols
  • Implement new ideas
  • Monitor yearly goals
  • Practice, practice, practice
    • Verbal skills, role playing and physical walk through

Team meetings are more effective when you:

  • Schedule often enough
  • Schedule time enough
  • Schedule when most can attend
  • Get feedback from the entire team
    • Encourage solution focused suggestions on how to overcome potential obstacles

The fifth core characteristic is to be realistic with the workload. It will be very difficult to get the team excited about embracing something new if they are already swamped and consistently running behind. It is important to evaluate whether there is enough time, money and people to implement the change successfully. Even the most committed employees will become resistant to change if they are consistently overwhelmed.

Embodying these 5 core characteristics will nurture a culture where change becomes a more positive, successful and sustainable experience.

October 1, 2013

The Cost of Trust

One of the biggest signs of low trust is when the leadership team has difficulty getting the team on board and excited to follow their lead.

Imagine a culture of trust where:

•             Leadership was by example

•             Everyone could rely on each other to work together for the greater good

•             Co-worker’s didn’t question each other’s intent

•             Open communication was the standard

•             Gossip ceased to exist

•             Accountability was self-maintained

•             Honesty was the only policy

Trust is the foundation of a happy, healthy, and high producing culture.   There is a cost to low trust! 

How much more productive would your practice be if your team truly trusted each other?

The dictionary defines trust as instinctive unquestioning belief in and reliance upon something.  The culture of trust I am suggesting is not one of blind faith but instead one of confidence!  Confident trust is based on good reasons, definite evidence or past experience.

 Think about the people in your life that you trust the most.  Why do you trust them?  Confident trust does not just happen overnight.  It takes time to nurture and grow.  However, breaking one’s trust can happen in a heartbeat.  The great news is that building trust is a skill set that can be learned.  Once we can learn how to build trust we can prevent trust breakdowns!

I would start by having a team meeting to talk about the level of trust in your practice.  Discuss the benefits of having a culture of trust.  It is also important for the entire team to understand how much a low level of trust affects the practice and the bottom line.  Such as having to add steps to compensate, extra staff to cover for lack of accountability, and redundant systems and processes.

 Let me give you an example of low trust with patients.  You may have some patients that no show or cancel last minute.  Therefore, you decide to implement the following protocol:  All patients must sign a form that states they will owe $ if they don’t show or cancel last minute unless it is an illness (with a doctor note) or death in the family.   The cost is that now all patients are subjected to a protocol that shows you no longer trust them and makes them feel unwelcome…which could ultimately destroy the relationship resulting in them leaving the practice.  It is an insult to your patients who are responsible and accountable and the ones who are not will just ignore it!  The same holds true with your team.  When you add extra steps for everyone to compensate for the inadequacies of the team members you can’t trust…you may end up losing your good team members.

The next step is to ask the team to share what they feel they need from each other to build trust.  Use a large easel pad and write down all the answers being shared by the team.  Cross out any duplicates.  

Some examples might be:

•             If you have an issue with me talk to me first

•             Help me when you see I need help

•             Finish what you say you are going to do

•             Focus on the greater good instead of WIIFY

•             Tell me the truth but be compassionate

•             Don’t be late or absent for trivial reasons

 Put your list together and label it Trust Culture Guidelines.  Next print it, frame it and put on display for future reference.  It will be important to review whenever you hire someone new or…because old habit die hard; whenever someone’s behavior deems it necessary!

Ta-dah…your team has just established their guidelines on how to build the level of trust in the practice!  The awesome part is that when people create it they own it!

The bottom line is that trust is not just a social virtue it greatly affects your bottom line!