A Live Worth Living

After watching two elderly family members suffer from a serious heart attack and a stroke, I realized the frailty of life and the realities of aging. Fortunately, they were both okay but it was a reminder to me about how aging is inevitable. Although they both are able to live in their own homes currently, it made it clear that eventually they will require some form of assisted living. After discussing different forms of long-term care in class, I see how varied in quality their experience could be. In our class on Health Policy, we are reading a book by Atul Gawande called Being Mortal. In this book, Gawande explores the past, present and future of long-term care in America. Many of the problems in long-term care facilities stem from viewing aging as solely a medical problem to fix with medical interventions. Gawande stresses how important it is to give those who are aging reason to live and help them retain their dignity. Although I am not sure if I will work in any sort of long-term care facility or not, reading this book has been an eye-opening experience. If I am a leader in a place like a nursing home or assisted living facility, I hope to bring the lessons I have learned about how to make the experience of aging better. Gawande mentions how successful organizations have used techniques like bringing in animals, plants, and children. Giving the residents as much freedom as possible is another way that quality of life can be improved. The opportunity to retain as much autonomy as possible is another vital component to helping people age with higher quality of life.

    Today in our Management class we discussed how the burden is on society to help take care of aging and other needy populations. Gawande’s book touches on this also and how the culture of that society is often reflected in their long-term care. Often times, Americans view the elderly population as a burden. They either have to be taken care of by younger family members or put into a long-term care facility. What happens after the drop off isn’t always considered. Once an elderly person moves into one of these facilities, their life does not have to be over. If we focus on giving our elderly population as much of their former life as possible, maybe aging won’t be viewed so negatively. As a society, and as healthcare professionals, we have a responsibility to continue to move our long-term care industry towards a culture that does not view aging as a problem to be treated solely with medical intervention. I hope that we continue moving towards a culture of compassion that focuses on letting our elderly population retain as much autonomy as possible!

Gawande's book: https://www.amazon.com/Being-Mortal-Illness-Medicine-Matters/dp/1250081246

Being A Team Player

One of the courses the UNH HMP Juniors are all taking is Healthcare Financial Management with Professor Bonica. After a recent exam, he told the class that there was the typical spread of good and not so great grades. It was what he said after that really stuck with me. He told the class that as a cohort, it was the responsibility of those who did well to help our classmates do better on the next exam. Emphasizing how healthcare is a team effort, that mindset should start now for us in the classroom. Today I had the pleasure of attending the Northern New England Association of Healthcare Executives conference, Shaping the Future: Leadership and Public Policy in Health Care. The theme of teamwork and building relationships that Professor Bonica mentioned was echoed by other executives throughout both panels. This was particularly eye-opening for me to see how important building relationships is in the healthcare field. Panelists from both the discussion on succession planning and the policy talk highlighted different ways that building relationships is critical. One of the big highlights was building mentor/mentee relationships which are beneficial to both parties. Another thing I found particularly interesting was how the executives all agreed that you should always be training your replacement, even if that means training them out of the organization. On the policy side, many of the panelists explained how building relationships is one of the most critical ways to solving problems. One panelist highlighted how important it is to build community relationships before times of crisis because it is imperative to handling emergencies well. Overall, this conference was a great opportunity to bring the classroom to life! Many of the points professors have made in the classroom, were reiterated with real-life examples from panelists. I am thankful for everyone who helped to organize the event and it was a great success!

Drawing Conclusions

Back in high school, I was able to take a course in film production. This class took us through the basics of making a film from start to beginning. It was very hands on. Throughout the semester, we worked in groups to produce short films of our own creation. One of the most tedious parts of making a film was storyboarding. This was the process of physically drawing out every shot and transition from start to end. It was tedious, but I quickly realized the value when it came time to actually shoot our film because we knew exactly what to do and when. If our storyboard was lacking in detail, we quickly realized how much more time it would take to make decisions when the camera was rolling. The better our storyboard plan was, the easier it was to efficiently shoot a film. I recently watched a TED talk that made me think of this notion. Tom Wujec talks about the value of visual planning as a group in his talk, “Got a wicked problem? First, tell me how you make toast?” Wujec outlines how planning things out visually as a group allows you to synthesize several points of view, much like making a storyboard helps plan out camera shots. This technique can be applied to numerous levels of business from decision making to aspirations for the company’s future vision. He uses the example of making toast as a starting point but explains how his technique can work for much larger business issues. Drawing out possible paths of action, made of nodes and links, can align executive teams. Nodes are the tangible steps and links connect them together. I have never heard of this as a business strategy prior to watching the TED talk, but I would be curious to see how this would work in the healthcare field.  I could imagine the resistance that would come from a board of administrators if asked to draw out their plan, but I think it could provide really valuable when trying to figure out a solution that everyone can agree on. Because everyone starts by separately drawing their path and then working to bring the ideas into one best practice, the process naturally breeds compromise and discussion. Although it may not be a realistic practice for every medical facility, those in need of an extreme overhaul or faced with a particularly tricky problem may find this useful. Although this may not be realistic for many organizations, I could see potential value for different healthcare groups at certain points in their time!

Link to Wujec’s TED talk: https://www.ted.com/talks/tom_wujec_got_a_wicked_problem_first_tell_me_how_you_make_toast

Let's Talk About Talking II

After writing my last blog post on the importance of how you speak to people and how to make them feel heard, I feel like there is more to be said about this topic. This was partially spurred by listening to an interview with Joni Spring on the Health Leader Forge Podcast. In this podcast, Joni says that one of the hardest things for her as a nurse in different leadership roles is having difficult conversations on performance. The close relationships she had with her employees made it hard to critique them. As I mentioned last week, I am an RA here at UNH. I have found that one of the hardest parts of the job is getting people in trouble. I think highly of my residents but even ones I am close to, still make mistakes. The hardest thing is having to call out someone I consider a friend. After thinking about this, I realized this will be a reality in the healthcare management field. There will be people who work for me that I will have to address issues with, no matter how much I like them as a person. I found this really interesting article in the Harvard Business Review that provided some good insight on how to have difficult conversations with your employees. Some of the big takeaways are to go in prepared and realistic. Expect that people probably won’t take the news well and plan out possible ways to respond. Another good tip is to put the conversation in perspective by talking about the future. Often times, our day to day lives can trap us into forgetting how much else is out there. If the conversation is framed in the context of how much this will matter in 5 months or 4 years, people may be more receptive to what you have to say. One thing I know I have a particularly hard time with is giving the bad news upfront. I often like to small talk and find an easy path in, instead of just jumping right into the tough topics. In a professional setting, it makes sense to cut to the chase. Time is money and as long as it is done with tact, there is no point drawing out a tough conversation. I’d like to pose the questions to those of you reading this, what are your tips for having hard conversations with your employees?

Links to the materials mentioned above:

Harvard Business Review Article: https://hbr.org/2009/03/7-tips-for-difficult-conversat

Joni Spring Interview: https://soundcloud.com/healthleaderforge/joni-spring-director-of-outpatient-nursing-and-clinic-operations-for-dhmc-edited (Links to an external site.)Links to an external site.

Let's Talk About Talking

Working as a Resident Assistant at UNH, I have had to have some uncomfortable conversations. There have been times that I have had to address conduct issues or resident conflicts. Frequently, I feel like the bearer of bad news. Although these conversations are one of my least favorite parts of the job, they are an important part nonetheless. Residents have problems and I am their go-to person to address it. This can be tough, but has also taught me a lot of valuable skills in conflict management and intervention. Today in class, we were discussing the tension between nurses, physicians and administration that run pretty typical across different organizations. During this talk as a class, we were talking about what we could say to an agitated physician to help them feel heard and validated. After class I began to mull over this issue. Although what you say is important, I feel like how you say it is just as essential. I have learned this during my RA training that simple things like body language and tone of voice can completely change the course of a conversation.  This makes me think of one of my favorite quotes by Maya Angelou, “At the end of the day people won’t remember what you said or did, they will remember how you made them feel.” Although Angelou wasn’t directly speaking to the healthcare administrator and physician dynamic, her words still hold a lot of value when we reflect on them. I hope that in my future career I am able to hold meetings where disgruntled staff members feel like their voice is heard. Although I may not always be able to give them the answer they want, I hope that I can make them feel like an important part of the organization and that I won’t just file their complaint away after the meeting is done and never think of it again. A big part of this is listening and trying my best to find solutions, whether that be through compromise or seeking out change. My goal in doing this is to create stronger relationships with employees in all areas of the future organization that I work for.

Can I Please Speak to Your Manager?

Working at a grocery store, I occasionally have customers who demand to speak to the manager. Often times it has nothing to do with what an employee has said or done, it is more about the fact that they know the easiest way to get an answer is to go straight up the chain of command. Those with more power have the ability to enact change, and any customer knows if they want their favorite brand of frozen pizza back their best chance is to let the manager know just how much they want it.  The manager then has to address any customer concerns and figure out a viable solution. 

So how does this relate to healthcare management?  Well, any business faces pressure to please their consumers. Any sort of medical facility still has "customers" to satisfy, and although they are not searching for their favorite frozen pizza, they still have needs they want met. Not only that, but the stakes are usually much higher. Medical professionals often see people in the more stressful situations of life. After listening to Anne Jamieson speak to our class about the role of being a Board member on a hospital, I was reminded how much personal investment leaders have in an organization. Jamieson spoke about how own personal experience as a board member at both for-profit and not-for-profit organizations. She mentioned that as a board member at non-for-profit organizations especially, you put yourself in a tough position. Personal information, such as your name and address, is readily available. This means you can easily be tracked down if someone does not like the decision you make. What stood out to me was Jamieson's commitment to still being a part of so many different boards, even if it means sticking her own neck out. As a board member, she is personally invested in the direction the organization is going. One of the qualities a strong healthcare leader has is being willing to fight for what you believe will bring the most good to an organization, even if that may be unpopular. I admire people like Anne Jamieson who volunteer to be a Board of Trustee member and work to improve hospitals that serve the community. 

Time to Change!

  Welcome to my blog, Management on the Mind! Here you will find all my musings on what it takes to be a great leader in the Healthcare field. Although I do not have much authority on the subject yet, I hope this blog will lead me to not only explore, but prepare myself for my future management endeavors. One of the readings assigned for class this week talked about transformative leaders and what that looks like for an organization. The article, “The Leadership Challenge” discussed how when there needs to be change in an organization, it is the role of the leaders to make this go smoothly (Tichy, 1984). In a TED talk, “5 Ways to Lead in an Era of Constant Change” Jim Hemerling also explores the topic of transformation. His viewpoint is a little different, as he claims that we are in an era of “Always-On transformation.” In his updated view, Hemerling argues that we should always be changing and adapting. As a self-declared creature of habit, I am someone who is often quick to resist change. At the same time, I have come to learn that change is the only constant in life. What I do have control over is how to approach whatever change may happen. This is especially critical to understand as a leader. Hemerling outlined how a good leader will put people first during times of transformation, which is almost always happening nowadays. I loved how Hemerling explained that a strong leader will empower their employees to handle whatever may come their way. A boss does not have to handle everything on their own, but instead empower the entire company to continuously learn and grow.

    The idea of transformation and how to address as a leader is especially relevant in the world of healthcare. There is always new technology and new methods that professionals have to learn about and adopt into their everyday operations. By empowering employees, a good leader can inspire their staff to be excited and ready for any changes. I hope to do this as a manager one day. I do not want my employees to see change as a hassle, but instead as another chance to develop. I hope to follow Hemerling’s advice and put my employees first to help with both their personal growth but also the growth of the organization.

A link to Hemerling’s TED talk: https://www.ted.com/talks/jim_hemerling_5_ways_to_lead_in_an_era_of_constant_change

Tichy, N. M., & Ulrich, D. O. (1984). The Leadership Challenge- A Call for the Transformational Leader. Sloan Management Review.