Coaching in the Upside Down World of Health Care

Their photos became a visual representation of their role. For example, they described executive leaders as “being those who shine a light onto and into the organization,” “see the possibilities,” “give people the ability to climb higher,” “provide a keystone of stability and a platform for growth,” “see the sky as the limit,” and “model hard work and being nice.”

The team summarized the most important descriptors of leadership as Inspiring, Enabling, Responsibility, Service to Others, and Bearing the Burden and Privilege of Stewardship. They acknowledged, however, that it was easier to live these aspects of leadership overseeing their own individual departments than working together on institutionally wide change.

In the ensuing discussion about being an “enterprise” leader, they pulled together the following thoughts:

• Put the institution first
• Articulate the scope, roles, and expectations of the work we are asking others to do early and often
• Help the leadership team see when it is stuck
• Hold and contain the organizational anxiety as changes take place
• Find the path to problem-solving
• Have each other’s back

These sound like the elements of any strong team and we continued to push them to talk specifically about the balance between the hats they wear. They discussed the challenge of aligning their people with the priorities of the organization. They realized the need to be much better at relentless communication, engagement, and listening. They determined they needed to actually remind each other if someone forgot to put on their enterprise hat.

The team also decided that the organization at large did not see them as aligned. They initiated monthly “listening tours” in which pairs of the executive team went out to different departments, satellite hospitals, and the research community to hear what was on people’s minds and answer questions. They developed consistent messaging around specific initiatives and worked hard to clarify the high-level, decision-making processes that impacted many of the providers and faculty.

Most importantly, they learned more about each other. They began to build greater psychological safety and trust so they could discuss, argue, and hammer out issues more fully and honestly. They slowly moved away from blame to see difficult situations as an opportunity to problem-solve and find resolutions together.