As I am on a missions trip in Kenya right now, I was directed to conduct my interview with someone on the missions team.  I was able to steal a little bit of time with the President and Founder of Sew Love Foundation Inc., Lori Peters late one evening when the tasks of the day had been completed.  Due to the fact that there are 5 ladies staying together in a room and Lori is a friend outside of our roles with Sew Love, the interview ended up being less formal than it would have been with a fellow student, or a colleague from work, but still a valuable learning experience.

Q:  What skill behaviours to see as contributing to your success?

A:  First and foremost is a passion for the “why” – why are we doing this.  Second would be a faith in God, that he will guide and provide, and trusting in what he shows me and leads me, and being led by the Holy Spirit.  Next would be dedication, which is different from passion.  When things get hard, you can’t not keep going, you “can’t not” get the job done and let things slide because the “why” holds us, and the “who’s” hold us.  Lastly would be learning to ask for help, and releasing people to help without getting in the way and not hyper-focus and not be controlling.

(At this point there was a break in the interview and there was a significant amount of coaching that took place but I was not the primary facilitator of that coaching.  One of the other members of the team staying in our room actually made the comment that Lori does not “do this well” – does not ask for help when needed.  Lori gave a number of reasons why it is difficult, but was also able, with prompting from both team members to give responses as to why these barriers cannot hold her back from continuing to ask for help.  She has been offered assistance in the past, and then had people not follow through, or assist in a way that was not helpful – she recognized that she needs to communicate and set expectations for follow through and what it is that she needs for assistance.  Another barrier she identified was that she has difficulty asking for assistance when she feels she isn’t organized and doesn’t have the entire plan set out, and she was able to self-identify that she doesn’t always need to have all the details in place and that she can release some of the planning and delegation to others.)

Q:  When are you at your best?  When do you perform well?

A:  Honestly, when there are crises.  In pressurized situations I can rise to the occasion when others would crumble.  I see this as a gift from God.

Q:  Where do you want to be 5 years from now?  Describe your idealized future as if it is happening.

A:  I want to be more present with my family – my family back in Canada and my Sew Love family here in Kenya.  Not so wrapped up in the tasks and the details, but present with the people and in relationship with them.  And I want to be in a place where I am taking better care of myself.

Q:  How do you get there?  What ideas do you have for realizing this?

A:  Ask for help.  Don’t get caught up in the details that don’t matter.  That is very difficult for me due to the way that my mind works, but it is absolutely necessary.

For the last 2 questions I recognize that as a leader there were opportunities to facilitate a more in-depth conversation and ask for greater specifics.  However, as I stated earlier the interview ended up being less formal than I had anticipated, and at one point Lori became quite emotional as she recalled that her first trip to Kenya was with a young woman from our church that we lost to cancer late last year.  My leadership decision at this point was to not pursue the line of questioning further and leave the coaching for another opportunity.

Employee development in health care appears to have its share of successes and failures. As I have disclosed in a previous post I am not very tech savvy, and certainly not very familiar with social media platforms and the ways to optimize their use, so I am looking forward to learning from my fellow students for this assignment. After completing the assigned readings, these are my thoughts on a potential employee development plan.

1. Include a way for patients to provide their feedback to employees and programs directly using social media or a survey that is communicated back to either the employees or to the manager in real time. The front line managers for most of my programs already have weekly huddles with all the staff so small improvements can be discussed in a timely manner with all staff. We also have quality teams for most of my programs, so large scale improvement suggestions can be taken to those teams. If patients are able to share their experience in other provinces and other countries, there could be learning from what others are doing to make the patient experience positive.
2. When patients submit ideas they could be invited to be patient or family representatives on quality teams or large scale projects. This would provide opportunities for co-creation and innovation and facilitate customer (patient) empowerment. Although this would not use technology directly, there should be a way to recognize patients for their contributions on a social media platform, website, or other means. If patients or families submit a suggestion for improvement and that change is implemented there should be an electronic feedback loop to that person that indicates that changes were made based on their suggestions. This would communicate to patients/families that their input is valued and acted on. Although not an internal organizational citizen behaviour, this could potentially lead to customers/patients speaking highly of their health care once discharged.
3. Have a way for patients to rate their provider. This is already available in an electronic format for physicians at RateMD.  Because of the number of healthcare professionals in our organization with varying education levels I would suggest that this direct feedback has potential to be useful for other self-regulated professionals, but any paraprofessionals or unregulated professionals I would suggest that the feedback only come back to the manager. As the literature suggests that different employees require different levels of feedback it is anticipated that this type of feedback would not be very useful for any provider without a professional background. For professionals, develop a way for the rankings to be de-identified and then presented in a way so that each employee can see how they compare to others in their ranking. This has the potential to be an internal motivator for professionals to improve in patient service in comparison to their colleagues. Recognition of employees who are consistently getting high rankings could influence customer focused citizen behaviour.
4. Also develop a technological platform for customers/patients to rank the facility, program or service in real time. Develop an app that every patient or family member can access to rank or comment on their overall experience. Again, develop a way for the rankings to be de-identified and then made available so that the managers and employees can visualize how they compare with other facilities or programs of a similar size.
5. Develop a platform that enables employees to provide peer feedback on each other. This could be set up on an internal SharePoint site with a notification sent every time someone submits a comment or feedback. As a disclaimer, I think that this would be difficult to monitor as it would need to be set up in a way ensure that the peer feedback is constructive and useful. If employees are permitted to submit anonymous feedback, this could potentially be destructive or lead to negative organizational citizen behaviours. If employees are not permitted to remain anonymous, they may not wish to come forward with any feedback that would be useful for employee development.
6. Develop a platform for employees to provide improvement ideas to management or senior leaders in real time. Often staff have great ideas but they get forgotten, or if they do get shared with their manager, they get lost due to the operational concerns of the day to day business. Ensure that when ideas are put forward that multiple people and departments receive notification (ie. The quality department, any other department who may be affected) so that those who are able to act on innovative ideas are able to more forward quickly. This would create greater momentum and staff engagement. Staff who bring forward innovative ideas would also need to be recognized to encourage the culture of creativity and idea generation.   This would create a culture of employee support and a positive organizational citizen behaviour.  Where possible, employees would also need to be empowered to make changes with patients/families without having to go through a manager for authorization every time.
7. Develop a technological platform in which employees are able to complete self-assessments, upload formal and informal learnings, post a learning or development plan, and request performance evaluations outside of the regular schedule. This would be a personal platform that only the employee can access with some limited permissions given to the manager to permit feedback where requested.

Because of my limited knowledge of technologies these are a few suggestions that are likely in use right now in other sectors, but only recently incorporated, or not utilized in health organizations. I look forward to reading the innovative and creative ideas that are being suggested in other contexts and any suggestions for my health care environment.

I have had the opportunity to teach groups of adults many times, and I would argue that my role as a physical therapist is highly, if not solely dependent on my ability to educate adults one on one. But my most profound experience in understanding andragogy is my personal experience

As a first year physical therapy student we were required to spend 8 months learning anatomy. Three hours per week in lecture, 2 hours per week in the cadaver lab. We were required to purchase tools, do our own dissection to see how tissue relates to one another, and learn from the dissected models already in the lab. In that first year of my bachelor’s degree it was overwhelming the amount of information that we needed to synthesize, learn and memorize. The practical learning alone was overwhelming – essentially learning Latin (ie. All the anatomical terminology) added to the complexity.

I doubt that I am alone in this experience, but the honest truth is, the learning in the first year of my bachelor’s degree was based on getting the best possible grade that I could in that class. I had always been a good student, and I measured my learning by my performance. I really, really enjoyed anatomy, but my study was based on wanting that good grade and completing my program – more of an external motivation than internal. Also, the time perspective of andragogy was in play – there was no immediate application of this knowledge, only future application. I understood the reason for learning anatomy, but did not really understand how it would relate to how I would treat people in physical therapy practice.

Many years later I had the opportunity to go back into the cadaver lab for a post-graduate course that I attended at the university of Toronto. The course was all about the upper limb (how the arm works in interaction with the neck and torso) and the morning was spent reviewing anatomy. Dissected pieces of the arm, neck, upper body were set up in stations all over the anatomy lab, and we were to review how the muscles, nerves, tendons, ligaments, joints interacted. The specimens were also set up in different anatomical positions to simulate how all of these structures relate when in motion. I had been told that going back to the anatomy lab after years of practice would be impactful – I had no idea how impactful.

I had been treating patients for years by this time, and what I was learning was at an entirely different level. I now had a reservoir of experience, and there was an immediacy of application to this learning. I had matured, and there was no longer a dependency on the curriculum or the professor directing what I needed to learn to get that good grade; I was now able to self-direct my learning and apply it to the pathophysiologic response of patients I had treated in the past. There was a keen readiness to learn because my internal motivation was to develop as a professional for the benefit of my patients and to have the personal fulfillment of growing in my career. There was a deeper understanding of the reason why the knowledge of anatomy is so critical to treating patients, and my self-directed learning as I viewed all the specimens was definitely more problem centred.

Separate from all of the principles and assumptions of andragogy, that learning opportunity not only impacted me intellectually, it was perhaps one of the most spiritual encounters I have ever experienced. With a strong belief in creation and intelligent design, I was not only able to recognize the practicality of the learning, but also able to step back from the intellectual exercise and experience the wonder and the beauty of the human body. I actually became emotional as I stood in awe of the creation and the Creator. Maturity and experience allowed me to step back from the science and appreciate the art. And the education that day was far from merely cerebral.

I look forward to hearing from others on their adult learning experiences and their impact.

References

Unit 6 Notes, Leadership 500

Any serious study of servant leadership will lead the student to the work of Larry C. Spears.  Spears’ work, based on the seminal work of Robert K. Greenleaf, has been focused on understanding the nature and character of servant leaders, and his publications include the following ten characteristics that he posited were “…of critical importance – central to the development of servant leaders.” (Spears, 2010, p. 27)

1. Listening – listening receptively with the purpose of identifying what others want, but also listening and reflecting on one’s inner voice
2. Empathy – learning to understand, accept and recognize the uniqueness of others
3. Healing – the intentional healing of oneself, relationships with others and making them whole
4. Awareness – includes general awareness and self-awareness with the purpose of understanding situations and context
5. Persuasion – seeking to convince others rather than coercing, building consensus
6. Conceptualization – requires the discipline and practice to have vision for the future and articulate it
7. Foresight – utilizing experience from the past within the situations of the present to predict the outcome of the future
8. Stewardship – viewing the organization in trust for the greater good of society
9. Commitment to the Growth of other people – every person has value and deserves to be invested in personally and professionally
10. Building community – lead the way to building a community in the organization

There are many different actions that leaders can take to effectively coordinate a group project to a successful outcome.  I have selected two actions that I think are critically important and that I believe highlight how the ten servant leadership characteristics proposed by Spears can be incorporated into and enacted in servant leadership.

1. Listen to the people who do the work, and act on their recommendations where possible. Dreams and a vision for the future are imperative for an organization to grow, and leaders must practice but leaders must marry conceptualization with listening to those who are fighting the good fight on the front lines.  The employees understand the work.  The front line staff will know what steps in the project can be implemented right away, and what steps will need to wait.  The employees will have done some problem solving that leadership is not even aware of and will have solutions and ideas based on objective experience rather than just conceptualization.  When employees are listened to, and heard, leaders are able to use persuasion rather than coercion because the team members become invested in implementing their own ideas and solutions.  When leaders listen there is an awareness of the skill sets and knowledge that others bring to the project and leaders can encourage and optimize the use of these skills and knowledge, thereby committing to the growth of members of the team.  An equal exchange of information and ideas between leaders and employees builds community within the team and once achieved the majority of the team members become invested in the success of the project.
2. Seek to know and understand what has been tried in the past and how. This action may be specific to environments like health care where there is often a mix of long term staff and new staff, and a lot of turnover in leadership.  Leaders need to listen and understand what has been expected of the staff in the past.  Leaders need to be awareness of the environment – if there have been a lot of projects in the past the employees may be experiencing change fatigue.  If staff were expected to participate in projects in the past with no ability to provide input into the work, a new project may present the opportunity for a leader to show empathy and facilitate healing in others and the team.  It also may be an opportunity for a leader to further develop self-awareness, being intentional about how they are coordinating the project and reflecting on why they are coordinating the project and if this meets the criteria of stewardship.  Seeking to understand what has, and has not, worked in the past, and the reasons why will assist a leader in developing foresight to know what the outcomes of this project and future projects will be.

There are many actions that could, and should be taken by leaders when coordinating a project in their context.  What actions do you think are most important?

Reference

Spears, L.C.  (2010).  Character and Servant Leadership:  Ten Characteristics of Effective, Caring Leaders.  The Journal of Virtues and Leadership 1(1)     25-30.

The study of teams is of particular interest to me working in a health care role.  The majority of patient care is delivered by teams – whether it be an emergency team, a surgical team, or any number of other interdisciplinary teams.  Effective teams provide exceptional care, and this is what leaders in health organizations aim for.

The two critical functions of team effectiveness are performance and development (Northouse, 2016).  Performance is demonstrated by the achievement of goals and objectives that are recognized for quality.  Development is demonstrated by team cohesiveness and by individual members meeting their own needs while still meeting the objectives of the team (Northouse, 2016).

Larson and LaFasto (1989) listed eight characteristics of effective teams (as cited in Northouse, 2016).  Effective teams must have the following:

1. A clear, elevating goal that is worthwhile, important, and can be realized.
2. A results driven structure that defines the task design, team composition and norms of conduct.
3. Competent team members that exhibit technical and interpersonal competencies.
4. A unified commitment so that individuals develop a sense of unity and identification.
5. A collaborative climate that enables team members to focus, take risks, trust and compensate for each other.
6. Standards of excellence that create positive pressure for all to perform at the highest standard.
7. External support and recognition that include the provision of resources, rewards, education and information.
8. Principled leadership that allows team autonomy but is observant enough and discerning to act when necessary to restore team performance or development.

Hackman (2012) proposed that there are six enabling conditions for team effectiveness, and these are  posed as yes/no questions (as cited in Northouse, 2016). Many of these conditions overlap with Larson and LaFasto’s eight characteristics.  The questions that need to be answered by the team, or by team leadership are as follows:

1. Is it a real team?
2. Does it have a compelling purpose?
3. Does it have the right people?
4. Are the norms of conduct clear?
5. Is there support from the organizational context?
6. Is there team focused coaching?

I had the opportunity in 2013 to receive training and visit the Virginia Mason Medical Center in Seattle, WA.  I was able to observe effective and exceptional team functioning, and this opportunity was truly a turning point in my career.  In 2002 Dr. Gary Kaplan, the CEO had applied lean principles learned from Toyota, and together with his senior leaders developed the Virginia Mason Production System^TM – a system that demands excellence in patient care.  The center was able to define their compelling purpose and the clear, elevating goal via their strategic plan which had been visualized as a pyramid with the patient at the top (Kenney, 2011, p. 4).  The right people, competent team members and a unified commitment were identified through the Virginia Mason Medical Center Physician Compact (Kenney, 2011, p. 9) in which five organizational and five physician responsibilities are outlined.  Organizational support and principled leadership were demonstrated when the CEO and the senior leader team committed to learning lean principles, becoming certified, and then committed to training for every existing and new employee.  Norms of conduct and standards of excellence were made clear when leaders were required to be present and available to front line staff and provide team focused coaching and employee recognition in real time.  For more information, visit here.

Principled leadership is committed to the team and intervenes only when the team requires the input of the leader.   Zacarro, Rittman, & Marks (2001) identified four processes by which principled leaders influence their teams (as cited in Northouse, 2016).  The cognitive process assists the team members to understand the problems, the motivational process sets the standards and helps the team achieve them by building confidence and capacity, the affective process sets clear goals, achievable assignments and strategies to eliminate stress, and the process of coordination allows the integration of activities by matching skills to roles, strategic prioritization, monitoring feedback, adapting to environmental changes.

I was able to experience the positive influence of the motivational process when in the role as the music leader in my former church.  The music team consisted of volunteer instrumentalists and vocalists, and the performance and engagement of the team had stagnated.  The senior pastor set new standards for the music, inspired us to rise to those standards, equipped us by sending us to conferences and workshops, worked alongside us as an instrumentalist, and encouraged and recognized us when each new level in technical performance was reached.  The team was able to play and sing technically difficult pieces with excellence as a result, and there was a renewed sense of ownership and passion that developed in the entire team.

Teams that function well can accomplish much; teams that are dysfunctional can be destructive.  Having studied the work cited in this chapter, I can now identify what characteristics or conditions were missing in the teams that were not effective.  Have others also experienced dysfunctional teams?  Can you identify why?  Have you experienced exceptional teams, and can you identify why?  I look forward to the discussion.

References

Kenney, C.  (2011).  Transforming health care:  Virginia Mason Medical Center’s pursuit of the perfect patient experience.  New York, NY:  Productivity Press.

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

Servant leadership was first coined by Robert K.  Greenleaf in 1970, however, as a newer field of study empirical evidence has only been available for the last decade (Northouse, 2016).  Although it is similar to other theories in that it observes leader behaviours, the behaviours of interest focus on the needs of, and development of others first (Northouse, 2016).

No consensus has been reached on a clear definition or framework (Van Dierendonck, 2011).  The definition most often cited is the one from Greenleaf himself, however, authors appear to agree on the following foundational principles:

1. Leaders have a need to serve, and to serve first (Greenleaf, as cited in Northouse, 2016). The model is unique in that it begins with the leader’s motivation (Smith, Montagno, Kuzmenko, 2004).
2. Others’ needs are the priority of the leader, and the central focus is altruism (Northouse, 2016; Van Dierendonck, 2011). Although different models have cited over 44 leader characteristics, (Van Dierendonck, 2011) these characteristics are the central focus of all models and all point to a focus on others (Liden, Wayne, Zhao, and Henderson; Liden, Panaccio, Hu, and Meuser as cited in Northouse, 2016; Van Van Dierendonck, 2011).
3. There is a reciprocal relationship between the leader and the follower in that the leader also learns and benefits (Smith et al., 2004).
4. Outcomes are met when self-actualization of the followers has been achieved, leaders create more leaders, and there is positive societal impact (Northouse, 2016; Smith et al., 2004; Maxwell, 2013).

Strengths of the servant leadership model are a focus on altruism, sharing control with followers, the identification that this form of leadership will be not effective in all situations, and the availability of measurement tools (Northouse, 2016).  Another strength is that leader behaviours are easily understood and applied, and these ideas are already used by many successful companies (Northouse, 2016; KnowledgeAtWharton, 2008).  One study suggests that servant leadership in the workforce can be integrated with positive psychology to enable employees to function at optimal levels generate positive individual, team and organizational behaviour, which can enable employees to function at optimal levels (Searle and Barbuto, 2011).  Empirical and anecdotal evidence suggests that employees who are served by their leaders will model this behavior and serve customers (KnowledgeAtWharton, 2008; Hwang, Kang, Youn, 2014).

Limitations of the servant leadership model are the paradoxical nature of terms, no consensus on a definition or framework, the inherent “value-push” and moralistic quality which can discourage study, and the inclusion of conceptualization when that behaviour not specific to servant leadership (Northouse, 2016).  Another weakness is that contextual factors that influence the success of servant leadership are underestimated (Smith et al., 2004).

As with all other aspects of servant leadership the purpose of awareness is to make things better for others, not for oneself.  This differs from awareness in emotional intelligence where the purpose is to recognize how emotions affects one’s own performance (Goleman, 2017).  The purpose of self-awareness in the psychodynamic approach is to assist the leader in improving personal behaviour and interpersonal relations for the purpose of improving as a leader and influencing others; again, the motivation is not serving others as it is in the servant leadership model (Northouse, 2016).

Historical accounts of Mother Teresa suggest that she was a true servant leader, and numerous web authors have supported this claim.  Her motivation was to serve others, her central focus altruism as she served “… the unwanted, the unloved, the uncared for…”  (Mother Teresa of Calcutta, 2018). She demonstrated a willingness to learn from those she served by living among them.  She established the Missionaries of Charity, investing in others so they would develop to their full potential and, in turn, then continue the work and develop other leaders.  As orphanages, hospices, and charity centers continue to function worldwide there can be no doubt that she had a positive impact on society  (Mother Teresa of Calcutta, 2018).

Servant leadership is a relatively new concept that has received attention by researchers and employers.  The primary motivation of the leader in this model is to serve others.  Outcomes are measured by the development and growth of the followers, reciprocal growth in the leader, a cycle of future leader development and positive change.  The model is can be practically utilized in work and other environments.  One example of a servant leader is Mother Teresa, whose motivation began with serving others and spent much of her life serving the least privileged in society.  The servant leadership model has much to offer for the equipping of the leaders of today and the future.

References     

Goleman. (2017, Jan 12). Self-Awareness:  The Foundation of Emotional Intelligence.  [weblog comment].  Retrieved from https://www.linkedin.com/pulse/self-awareness-foundation-emotional-intelligence-daniel-goleman

Hwang, H., Kang, M., & Youn, M. (2014). The influence of a leader’s servant leadership on employees’ perception of customers’ satisfaction with the service and employees’ perception of customers’ trust in the service firm: the moderating role of employees’ trust in the leader. Journal of Global Scholars of Marketing Science,24(1), 65-76.

JohnMaxwellCo.  (2013, Sep 10).  John Maxwell The 5 Levels of Leadership.  [Video file].  Retrieved from https://www.youtube.com/watch?v=aPwXeg8ThWI

KnowledgeAtWharton.  (2008, Jul 9).  Southwest Airlines’ Colleen Barrett on ‘Servant Leadership’. [Video file].  Retrieved from https://www.youtube.com/watch?v=6TgR95vnM0c

Mother Teresa of Calcutta. (n.d.).  Biography.  Retrieved from http://www.motherteresa.org/

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

Smith, B. N., Montagno, R. V., & Kuzmenko, T. N.  (2004).  Transformational and Servant Leadership:  Content and Contextual Comparisons.  Journal of Leadership and Organizational Studies, 10(4), 80-91.

Van Dierendonck, D.  (2011).  Servant Leadership:  A Review and Synthesis.  Journal of Management, 37(4), 1228-1261.  doi:  10.1177/0149206310380462