Achsah's Springs

A Journey of Expectation and Legacy

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Introduction, and What is Evidence?

My name is Liz.  As a personal introduction I am currently on a trip for my 25th wedding anniversary, and I am the mother of 3 daughters, 2 currently in university, and one finishing high school.

As a professional introduction I am a Director in healthcare overseeing 3 programs: Home Care, Therapies, and EMS. I have been a physical therapist since 1995. I recently took training to become an Emergency Medical Responder so that I could gain a better understanding of EMS. I have volunteered in a number of professional capacities, and I am currently the Chair of the Legislation Committee of the Saskatchewan College of Physical Therapists, and was a former President of that organization. I also sit on the Legislation Committee of the Saskatchewan College of Paramedics. Personally I volunteer in many areas in my local church and in my community.

My experience with research is limited, and I must confess that I am terrified of this unit, and especially so now that I am behind in the coursework. I have always struggled to understand the research literature, and my interest in doing formal research has always been hampered by my fear of it.

I have struggled to access the library articles while in Europe, and due to the limitations with the internet the videos are almost impossible to view. What I have learned about scholarly inquiry is that it has rigorous criteria that, if not followed, will not pass the peer review process. It takes significant periods of time to complete, and to be published, so often is not “cutting edge”; current research is often a few years old. Informal research is a process that I attempt to be involved in every day. I feel privileged to be in healthcare in Saskatchewan right now. Although the previous Premier and his government have been criticized in the media for introducing Lean principles into healthcare the culture that has been created is one that is constantly looking for improvement, completing PDSA cycles on a weekly basis, and taking on larger improvement projects when indicated. This is the research that excites me – practical, based on data, quick actionable items, staff engagement, lots of failures, but lots of successes.

A recent decision that I made as a leader was to provide intravenous hydration for clients in their home through our Home Care program. This was very unpopular with the Home Care Registered Nurses as they still feel that this is very unsafe for clients and puts their licence at risk. This decision was made because we have clients right now who become very ill and dehydrated after their chemotherapy, and with the difficulties that they are facing, it is even more disruptive to have these clients have to stay in hospital to remain hydrated. And there is no evidence that indicates that home IV hydration is unsafe when certain criteria and parameters are met. In addition, the decision to purchase new technology to make it easier for patients was made by the frontline manager that reports to me, and I supported this decision to make the situation safe. The factors that influence my decision making are: is it patient and family centred care? Are patients safe? Are the staff safe? Is there evidence that supports or refutes the decision? What internal data supports the decision? If there is no data, can we run a trial or PDSA cycle to gather our own data?

I wasn’t able to access the article through the library.  Though I have completed two MA courses already there has been no teaching or coaching in accessing articles this way, and with being overseas and having internet issues, it was just an insurmountable task to attempt to navigate and self-teach.  If I am able to keep up with the upcoming coursework I will attempt to edit this blog post. The Pfeffer & Sutton article was very interesting to me due to the comparison between evidence based medicine and evidence based management. Evidence is conceptualized in this article as both formal and informal inquiry, using facts to make decisions, and changing the culture to one that always asks questions and challenges traditional ways of thinking (Pfeffer & Sutton, 2006).

Evidence based decision making is so important in leadership for the same reason it is important in medicine. In medicine patients are put at risk, treatments may be ineffective, and people may die if evidence based decision making is not used. In leadership followers are put at risk, actions may be ineffective, and organizations may no longer be relevant if evidence based decision making is not deemed to be important.

In healthcare leadership so many traditions and myths still exist, and old methods that were effective at one time but are no longer are still being used. Is this your experience?  If so, how can we, as one leader of many, turn this tide?

Reference

Pfeffer, J. & Sutton, R. I. (2006).  Evidence-based management.  Harvard Business Review.  Retrieved from https://hbr.org/2006/01/evidence-based-management

Assignment 1 – Research Concept Map

Research Concept Map

This was truly a challenging assignment in many ways. The first challenge was deciding which interests to include on the concept map. In the end I landed on two personal interests, and three professional interests.

As I am traveling through Europe right now, my interest in world history is in the forefront of my mind. I have been a worship leader in my local church for many years, and worship music is another personal interest. I have worked in health care for over 30 years, and continues to be a passion. Specific to health care I am very interested in the sustainability of public health care in Canada, and improving patient and family centred care. I am a physical therapist, and clinically my greatest skill and passion is teaching patients and families how to self-rehabilitate, or self-manage their condition. I have been a manager for over 11 years, so leadership is a recent but dominant passion. I have 5 managers reporting to me, so I am very interested in how I empower and equip them. I volunteer in my local church with teenagers, have teenage and young adult daughters, and have many new graduates in my employ, so I am also very passionate about teaching the next generation.

Unfortunately due to the technological issues currently being experienced in Europe my concept map is only a Word document at this time.

Based on the interests I selected, I was able to identify five potential research questions which are in the red text boxes on the concept map (please refer above). Four are related more to my current role as a director, and one is related to my clinical practice.

The one research question that I have selected as the strongest is: what teaching methods do managers perceive to be the most effective? The reason that I have selected this one is because I think it best meets the criteria that have been outlined. It is a topic that I will remain interested in and likely to pursue to completion. I currently have 5 managers reporting to me, one who has been managing for years, one who just began two months ago, and 3 who have various years of experience, so selecting participants is possible. This is also a question that can potentially be used as it is posed, or refined if too large in scope as currently stated, or if the question has already been answered as stated. I expect that since it crosses the lines of leadership and education in scope that a literature review will be possible.

I am interested in knowing how others selected their areas of interest. How would you decide?

Drawing to a Close – Unit 10, Learning Activity 1

It is hard to believe that 10 weeks has gone by so fast.   There are many learnings from this course that have impacted my practice, but there are two that stick out above the rest.

First, I have become more intentional about supporting the women in my workplace.  The section on women in leadership highlighted for me the need to offer encouragement and support to the other women in my workplace in leadership roles, whether recognized by title or not.  I have become intentional about listening, learning, and coaching women to be who they are called to be as leaders, no matter how different they are from me.  I had not recognized the unconscious biases that I had in this area; now I am able to make the unconscious conscious, and serve my gender in a purposeful way.

Second, I have incorporated much of what I learned from watching the movie Invictus into my practice by changing how I lead myself.  I need to forgive, and forgive quickly – I can only be a servant leader if I owe no man anything.  I need to be vocal when I truly believe that what others’ are doing or deciding is wrong.  I need to take my thoughts captive when they are destructive and self-defeating and think on what is true, just, pure.  And I need to keep practicing these skills until I can lead by example.

“Excellence is an art won by training and habituation: we not act rightly because we have virtue or excellence, but rather have these because we have acted rightly; “these virtues are formed in man by doing his actions” (Aristotle); we are we repeatedly do. Excellence, then, is not an act but a habit.”  (Durant, 1926, as cited in Unit 3 Notes)

References

 Eastwood, C.  (2009). Invictus [Motion picture].  USA:  Warner Bros.

Unit 3 Notes. (n.d.)  Retrieved from https://create.twu.ca/ldrs500/unit-3/unit-3-notes/

 

“Grow Old Along With Me” – Light From Many Lamps Assignment 5

I have enjoyed these biweekly readings and have learned so much from being pushed to thoughtfully apply the concepts to the practice of my own leadership.  I am so thankful that this fantastic idea was included in the course curriculum.  (Thank you “Leadership Prof”!)

This week I was drawn to the excerpt from Robert Browning.  There are so many aspects of this particular section that appealed to me at this stage in my life and highlights leadership lessons that I have learned over the years and need to continue to apply in my leadership contexts.

  1. I enjoyed reading poetry again. In my day to day activities I am not exposed to poetry.  Or rather, in my day to day activities, I don’t intentionally choose to read poetry.  It was a nice change and a bit of a challenge to my right brain.  As leaders, we need to be well-rounded, and I sometimes forget to look outside of my four walls for inspiration and enjoyment.
  2. The poem was written in honour of another leader. In particular, a historical person whose writings had profoundly impacted Browning’s own worldview.  More and more I find that I am drawn to both the teachings and the life stories of men and women who were not only leaders in their own time period, but continue to have positive influence centuries later.  Browning had never met Rabbi ben Ezra, but knew his teachings well enough that he could choose to use creative license and write the poem as though the Rabbi was penning the words of wisdom himself.  To honour this man and his wisdom in this way was creative and represents how impactful this historical figure was in Browning’s life.  I also want to honour those who have gone before and paved the way for me, and the poem inspired me to act on this desire.
  3. It encourages us to value the difficult times in life. There has not been one difficult season in my life that I enjoyed at the time, but each and every one has taught me something and shaped me into who I am today.  So much so that I am able to now “consider it all joy… when [I] encounter various trials…” (James 1:2, NASB).  I am encouraged by the reminder that there is both temporal and eternal value in the trials of life.  This is a leadership lesson that was hard to learn, but so valuable.
  4. It encourages us to look at the entire story that is our life. “Child,’ said the Voice, ‘I am telling you your story, not hers. I tell no one any story but his own.”  (Lewis, 1954, p. 139)  C. S. Lewis reminds us in his allegory that our life is a story that enfolds chapter by chapter, line by line.  John Eldredge, a more contemporary writer reminds us of the same:  “Life, you’ll notice, is a story…. When it comes to figuring out this life you’re living, you’d do well to know the rest of the story.”   (Eldredge, 2004, pp. 3, 4.)  When we view life as a complete story, we cannot afford to invest our time looking backwards, but look forward to the next chapter, and anticipate and plan for a happy ending.  As Browning so wisely advises us:  “Grow old along with me, The best is yet to be….” (as cited in Watson, 1951).

How about you?  Have you ever considered your life as a story, like a novel that is written in chapters?  I look forward to your thoughts.

References

Eldredge, J.  (2004).  Epic:  The story God is telling.  Nashville, TN:  Thomas Nelson, Inc.

Lewis, C. S.  (1954).  The horse and his boy.  New York, NY:  Penguin Books.

Watson, L.E. (1951)  Light from many lamps.  New York, NY:  Simon and Schuster.

Identify the Foresight – A Comparison (Learning Activity 2, Unit 9)

This has been one of the most intriguing learning assignments to date for me.

I do not consider myself to be adept in the skill of foresight.  When we have done development activities as a leadership team it has been clear that my personality is not one that naturally leads to being visionary.  In growing as a leader I have attempted to work on these traits and skills in myself, and have learned to turn to others with these skills for their assistance so that we can capitalize on each others’ strengths as a team.

I know little, if anything about the corporations and businesses listed as examples – the US Postal Service, Canada Post, and Walmart, so I had to go looking for information.  I was able to access a discussion paper regarding the future Canada Post published in Sept 2016.  I was also able to access a media release from October 2017 outlining Walmart’s strategic planHowever, I really only have a surface understanding now of the current and projected future state of both of these organizations on which to form some opinions.

Canada Post has maintained a respected reputation in Canada.  However, three major reviews of Canada Post have been completed by government since the 1980’s, and in 2016:  “Many of the key challenges that were identified in previous reviews are still relevant today, if not more acute as a result of the digital disruption of postal services in developed countries…” (Bertrand, Hoeg, Hopson & McLaughlin, 2016, p. 13).  One could argue that the need for three major reviews in that period of time with no appreciable change tells the story of an organization that has lacked foresight.  The most recent discussion paper provides suggestions but for incremental change, not transformational change.  However, though I don’t have the knowledge or time to expand on this further, two factors that cannot be ignored in this discussion that the limitations imposed by the collective bargaining agreements and the legislation requirements of a crown corporation.

Walmart does not have a reputation as an innovative company, but I believe that they have done a fantastic job of anticipating the needs of their customers.  Whereas they have been criticized for eliminating some products (fabric, fishing rods), they have replaced these with high frequency purchases and met customers’ desire for one stop shopping by expanding to include groceries and bakeries.  The partnership with McDonald’s has made it convenient for families to shop over a meal period.  I know from completing a recent survey that WalMart is moving to online ordering for customers to pick up their purchases when convenient, allowing customers to spend less time shopping and more time on what they value.

I don’t have a document or resource to reference, but I have been informed that WalMart has changed their initial approach on employee engagement.  Certainly tensions with employees in Canada Post have been publicized.  Employees who are loyal and committed to their organization are motivated to use foresight in their workplace (Malgeri, 2010). If we are to learn from companies like SouthWest airlines, foresight is not the only factor in success; companies do well when they adopt a servant leadership approach.

What personally challenged me was this statement in the Canadians value postal services but do not necessarily think about them often and in general assume they will always be provided.  One could easily replace the words “postal services” with “healthcare services” (Bertrand et al., 2016, p. 15).  Having visited health care organizations in the US there is a requirement to have foresight, and urgency to remaining current and to continually improving because there is a competitive market.  I sense complacency in Canada because there is a dangerous assumption that public health care “…will always be provided”.  In writing this blog I am convicted to realize that I have partially adopted this complacent attitude, however, I would suspect that this is a pitfall for any of us working in any public sector role.  What do you think?  Is there a difference in innovation, foresight, planning between the public and private sectors?  I welcome your thoughts.

References

Bertrand, F. , Hoeg, K.T., Hopson, J., McLaughlin, M.  (2016)  Canada Post in the Digital Age:  Discussion Paper 2016.  Retrieved from https://www.tpsgc-pwgsc.gc.ca/examendepostescanada-canadapostreview/documents/EPC-CPR_rpt-eng.pdf

Malgeri, J. (2010). Organizational foresight and stewardship.  Public Manager, 39(4), 39-42.

Invictus Assignment

After being truly challenged, moved, and inspired by the movie Invictus, the list below includes what I would consider to be the key lessons.

  1. Leaders must first learn to lead themselves. Leaders cannot avoid going through tough times, and often they will be required to go through these times alone.  Leaders must have strategies to lead themselves.  “Just words.  But they helped me to stand up when I wanted to lie down.”
  2. Leaders must learn to forgive. An attitude of unforgiveness and bitterness can only create a self-centered and self-absorbed focus.  It is only from a position of forgiveness that we can truly focus on others and be effective leaders.  “Forgiveness starts here too.  Forgiveness liberates the soul.  It removes fear.  That is why it is such a powerful weapon.”   “We have to surprise them with compassion, with restraint, with generosity.  I know.  All of the things they denied us.”
  3. Leaders must be prepared to learn from others. This includes opening our minds to the possibility of learning from anyone and everyone.  In a climate charged with racial and political tensions Francois could have chosen to decline the invitation to have tea with the President– he did not.  And he demonstrates a willingness to listen and learn in every interaction.
  4. Leaders must recognize when to follow.  When the team received the news that they would be required to complete coaching clinics while preparing for the World Cup, the majority of the team was resistant.  Francois recognized that this was not the time to lead, but to follow.  “Times change.  And we need to change as well.”
  5. Leaders must have courage in the face of opposition. This is particularly difficult amongst team members, but no less important.  President Mandela was prepared to oppose his own countrymen at the risk of losing his support and popularity.  Francois openly challenged his teammates to learn the South Africa national anthem, and to do the coaching clinics without question.  “The day I am afraid to do that is the day I am no longer fit to lead.”  (Mandela’s response to the accusation:  “You are risking your future as our leader.”)
  6. Leaders must accept that their influence is far-reaching. All leaders are role models, and have influence beyond their immediate positions that needs to be recognized and used for the common good.  “We’ve become more than just a rugby team.  And we might as well get used to it.”
  7. Leaders empower others to become better than they think they can be. Leaders can see the potential in individuals, teams, and organizations and then have the ability to create that vision and capacity.   “Because in order to build our nation, we must all exceed our expectations.”

Truly an inspiring movie based on a true story I would encourage every current and future leader to watch Invictus.

 

Reference

 Eastwood, C.  (2009). Invictus [Motion picture].  USA:  Warner Bros.

Recognition and Fostering Inclusion of Women in the Workplace – Learning Activity #2, Unit 8

This learning assignment has truly been eye-opening.

First, I was taken aback by my results on the Gender-Leader Implicit Association test. Even though the test itself explicitly states that many of us have have subconscious biased association favouring males and leadership that we are unaware of (Northouse, 2016), I was still unprepared when confronted with that reality. I was surprised by how often I associate leadership traits with the male gender.

Second, I was surprised by how little I am doing to foster recognition and belonging for other women in my workplace. Health care is typically a female dominated workplace, and the situations that stand out in my memory are the ones where men are prejudiced against. For example, in Home Care I have had the responsibility of communicating with more clients and families who have refused to have a man provide their personal care than the opposite.

As a woman leader in my workplace I haven’t really taken the time (well, sometimes I feel like I haven’t really HAD the time) to think about myself or other women in leadership roles. There are as many men as women at our Director table and I am not consciously aware of any overt prejudices against women in leadership, however, the learning materials from this week have caused me to reflect more on what I am unconsciously accepting or ignoring. Certainly I do think that there are always opportunities to promote recognition and foster a sense of belonging amongst my fellow women in senior leader and frontline management positions. The positions come with multiple responsibilities, and building support and capacity is important for their individual and team success.

After reading the Catalyst report (2016) I have identified many ways that I can personally foster recognition and a sense of belonging:

• Make personal connections with my staff – not just the managers that report directly to me, but the front line staff that report to them. This includes seeking to understand their successes and challenges at work, but also getting to know them personally.
• Recognize when other staff are engaged in inclusionary behaviours, and where possible (within a unionized environment) reward this behaviour. This recognition and reward can be personal (a quick thank you in person or by email) or public (a “bouquet” in the organization’s newsletter, or a mass email to all the staff in the department with a cc to the ED, or VP)
• As I am the Chair of a number of meetings I can seek out those who aren’t normally vocal and encourage them to participate, and capitalize on the information they have to offer if possible
• During staff meetings include an agenda item where staff can share experiences of inclusion and exclusion. There would need to be enough time to validate these experiences, and then time to ask for staff input into how we develop share language, understanding and vision so that the number of inclusion experiences go up, and the number of exclusion experiences go down
• Although our organization has policy that makes overt biases and stereotyping unacceptable, there is an opportunity to me to be more aware and conscious of language in the workplace and to role model behaviour that immediately addresses unacceptable language and actions
• There is an opportunity to recognize and coach the champions and ambassadors to continue to role model positive change
• I need to role model inclusionary behaviours.
• One value can be highlighted each week at our weekly huddles and then follow up with this education during personal interactions
• I can work with my managers and champions to celebrate success stories and share setbacks and barriers that the teams can work on correcting or eliminating
• I can work with the team to establish metrics, develop plans, and openly share the strategies created by the team to get to where we want to be

I am truly intrigued by this week’s learning materials that have challenged my assumptions and directed my thinking towards what I unconsciously accept as fact or truth. Have others’ discovered personal unconscious biases? Have others been challenged by their assumptions? Are others in work environments where women leaders are not recognized as equals with their male counterparts? Looking forward to the discussion.

References

Northouse, P. G.  (2016).  Leadership:  theory and Practice.  (7th ed.)  Thousand Oaks, CA:  Sage Publications Inc.

Nugent, J. S., Pollack, A., Travis, D. J.  (2016). The Day-to-Day Experiences of Workplace Inclusion and Exclusion.  Retrieved from http://www.catalyst.org/system/files/the_day_to_day_experiences_of_workplace_inclusion_and_exclusion.pdf

Case Study Evaluation – Unit 8 Learning Activity 1

Responses to Case Study #1 – “The Glass Ceiling”

Refer to P. G. Northouse, Leadership:  Theory and Practice (7th ed.), pp. 412, 413.

In the case study Lisa encountered a number of advancement barriers:

a. She was devalued in a typically male leadership role and although informally sought out for her knowledge, she wasn’t formally or publicly recognized for her knowledge by her peers
b. There was an implied prejudice that her promotion would negatively affect the public perception of the company (“there has never been a female partner in 103 years”)
c. There were only male raters assessing the performance, potentially negatively affecting the evaluation
d. There is an assumption by the CEO that she doesn’t know what is happening globally within the firm and has to be brought up to speed
e. She would not promote herself initially using the justification that she just wanted to be a team player, and “one of the boys”. There is a possibility that she was making this decision due to gender bias or the perceived threat of social disincentives
f. There is a prejudice that she won’t be able to handle it as a woman leader if she makes a mistake, and that she is not agentic enough
g. Though not explicit it appears that the CEO is engaging in homosocial reproduction specifically continuing to recruit and retain all male partners.
h. Although not explicit there is the potential that Lisa is experiencing pressure to represent her gender in a male dominated work environment

There are a number of steps that the CEO and executive leadership could have taken to retain Lisa:

a. Acknowledged and recognized her knowledge and expertise
b. Done an individualized evaluation with peer input when assessing her performance
c. Developed a promotion policy based on set standards including the success of accounts, the number of new accounts, customer satisfaction
d. The CEO could learn to refrain from making derogatory and sexist comments (Eg. “two women in one room, that’s scary”)
e. She should have been made a partner prior to her colleague if her performance indicated that she deserved to be a partner
f. If her performance didn’t warrant a promotion to partner this should have been constructively communicated to her, and she the CEO could have offered to provide training and coaching so she could be successful in this pursuit eventually

A number of organizational policies and opportunities could be developed to help women in this work setting:

a. Policy for promotion to partner based on objectives and standard criteria
b. Policy of non-acceptance of gender biased comments
c. Policy that supported mentorship and training available to all employees independent of gender
d. Education of clients if reluctance to have a female partner truly exists
e. Education of the staff that there does not need to be gender bias

Some ways the organization could raise gender consciousness are as follows:

a. Mandatory education sessions that include case studies
b. Have CEO spend time in a gender inclusionary work setting so that he is able to learn to role model
c. A review of policies to determine if there are gender biases inherent in the organizational documentation
d. Public recognition of all employees that are meeting or exceeding performance expectations so that it is evident that performance of genders are equitable
e. Adopt or develop a monitoring tool so that progress or setbacks are identified and acted on

Reform Begins at Home – Light From Many Lamps Assignment 4

“Then it came to me that reform should begin at home; and since that day I have not had time to remake the world.” (Durant, as cited in Watson, 1951, p. 245)

Durant discovered this truth when searching for the answer to the question: what is happiness? In observing another family he was able to come to the realization that his greatest blessing was the family unit that had been given to him, and then made the intentional change to invest in his daughter rather than allow the other affairs of this world take precedent over time spent with his loved ones. Too often I find that I fall into the trap of not making time with my family a priority, and as Durant discovered, my happiness is adversely affected when I lose sight of this.  I have been created for relationship, and when there is depth and intimacy in my family relationships, I am truly happy.

Yet the reason I was drawn to the quote above is because I am not certain that I entirely agree with it. I do agree that reform should begin at home – I owe that to my family and to myself. I have been granted the privilege of being the steward of my children, and I have an obligation and responsibility to steward them to the best of my ability. But I would argue that when reform begins in my home, that is when I truly have the time to remake the world.

I really have a very limited impact to remake the world on my own, but by investing in the people around me, and in particular my daughters, my reach extends far beyond my own ability. My daughters all have characteristics and traits that have identified them as leaders. They have been recognized and selected for leadership roles by teachers, peers, coaches and others. As their mother I have one of the largest roles to play in their lives when it comes to teaching them and modelling what effective leadership should look like. And as I make the time to grow them into effective leaders, that is when I choose to make the time to remake the world. I will do my own part, and they will do their part; if I have mentored them correctly their achievements will be greater than my own. As I teach them to invest in others, to serve others, to put others above themselves and purpose themselves for causes greater than themselves the possibility of remaking the world within our sphere of influence grows exponentially. And picturing that legacy adds one more drop of happiness into the joy that I already experience by being in  close relationship with them.

As I finish with my personal thoughts, my heart is saddened because I know that there are many who are not as sheltered or privileged as I am, and many will not find their happiness where I have found mine. And yet in spite of broken family relationships I know many who found happiness elsewhere. I look forward to learning from the varying perspectives and experiences of others, and expect I will be challenged to broaden my thinking as a result of your responses.

Reference

Watson, L.E. (1951). Light from many lamps. New York, NY: Simon and Schuster, Inc.

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