Archives for category: Management

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I know this is difficult
Because it is difficult for me too.

I know you are scared
Because we are all scared.

I know you are tired
Because everything is harder.

I know you are frustrated
Because what should be simple is fiendishly complex.

I know you are wanting this to end
Because the end is not in sight.

I know you want to get back to normal
Because normal was awesome.

I know you are glad to be busy
Because the alternative sucks far worse.

I know you value your teams
Because we all feel the same way.

I know we can do this
Because we kick ass on a daily basis.

 

Written as the introduction to a staff meeting.  

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The Vice President, Mike Pence, toured the Mayo Clinic, without a mask, in the middle of a pandemic.

When questioned by reporters as to why he was not wearing a mask in line with hospital policy, a policy that the Mayo Clinic stated that Mr. Pence was aware of in advance in a now deleted tweet, the Vice President stated that he is tested regularly as are those around him and he wanted to be able to “look people in the eye.”

Footage of Mr. Pence’s visit can be seen below.

Later that same day, a question was posed on Quora (where I spend an inordinate amount of time) that got me thinking.

Why didn’t someone in authority at the Mayo Clinic stand up and tell Mike Pence, “If you don’t wear a mask, you are not entering this hospital.” Should that person who was in charge on that day be fired for failing to protect the patients?

A fair question, but one of the reasons the question gave me pause for thought, was that I had faced a similar dilemma a couple of days earlier.

Like most veterinarians, the animal hospital I am Hospital Administrator for is operating locked down – with clients being made to wait in their cars and only patients and staff allowed in the building. In addition, all staff have their temperature taken before entering the building and wear a mask for their whole shift. That policy worked just fine, until the day a client walked into the lobby and refused to leave when asked by staff members.

I was called into the lobby by one of my front desk supervisors. When I arrived, the unmasked client was defiant and refused to leave the lobby when asked multiple times. The client was upset that her dog was sick and currently hospitalized. She felt that it was too hot for her dog to be brought out to her in her car for her to visit with, and therefore was demanding entry to see her dog. I explained that I knew nothing of the situation, and that I would be more than happy to help in whatever way I could, but none of that was going to happen until she left our lobby and returned to her car.

I have had to ask clients to leave the premises in the past, and I have even had to call police to make it happen. As I was talking to this client it was running through my head that I might have to do this again, or at least threaten to, to protect the doctors and staff. However, it was also running through my head that we had a hospitalized patient who was in the middle of treatment. Could the forced removal of a client from the building be interpreted as denial of care? It is doubtful that the client is going to continue their pet’s treatment at our hospital if the relationship breaks down to this point. What happens to the pet? Is the pet well enough for an orderly discharge? What happens if the pet dies either directly, indirectly, or just shortly after being discharged?

All of this with raised voices in the lobby, out of the blue, with no time for refection or the advice of others.

Now, as it happens, the client did return to her car and a quiet chat with the doctor, car side, resolved the immediate issue. But what if we would have called the police and had the client removed from our property, her pet discharged before being even close to well, and things had continued to deteriorate? Review and social media warfare for sure. Local news and / or regulatory involvement? Quiet possibly.

Upon reflection, I would do the same thing again and I actually feel more than ever that even if I had ended up calling the police it would still have been the right call. But I’m sure others would have disagreed. And some of those may have been people that I report to – including the staff it was my aim to protect.

I don’t run an organization anything like the size, or complexity, of the Mayo Clinic and one can’t imagine what it must be like to hold that position, in human healthcare, in the middle of a pandemic. Having a dignitary like the Vice President means national news coverage. It is the kind of publicity that public relations departments were created for. It could mean government dollars, PPE, and access; all of which are sorely needed right now.

If, of course, it goes well.

If it goes wrong, all of that could be in jeopardy and a lot more; The reputation of the Mayo Clinic in the eyes of half of the electorate, for example. As Mike Pence has stated, the risk from him is probably minimal, given the protective bubble he currently finds himself in. The example that he sets, however, is awful. It is an example of “the rules don’t apply to me” because of XYZ – much like my lobby client.

I cannot condemn the administrators at the Mayo Clinic though. Standing up to people because it is the right thing to do, can have serious consequences. Embarrassing the Vice President of the United States would have had serious consequences for the hospital, the staff, and the administrators. Being right is not always a defense from consequence. To make that kind of decision in the heat moment, is an almost impossible. And it is certainly impossible to make it and to not double guess yourself.

The issue reminds me of the incident at University Hospital in Salt Lake City where nurse Alex Wubbels was arrested for not going against a policy agreed upon between the police and the hospital. She would not provide a blood sample without the consent of the patient. The clip below shows Nurse Wubbels on the phone with the hospital administrator, and the police officer concerned, right before her arrest. The arrest of Nurse Wubbels was national news.

All decisions have consequences. In the Alex Wubbels case, the arresting officer was fired, and his supervisor was demoted two ranks. The City of Salt Lake also settled a lawsuit for half a million dollars. But this took serious guts on the part of the hospital, and of course Nurse Wubbels. It would have been so easy to bend the rules for people who you work with routinely, want and need to have a good working relationship with, and even been seen as doing the right thing in many corners.

Being right can often be a balancing act. Second guessing decisions made in the heat of the moment, particularly when confronted by authority, or just someone who is confrontational, is often unhelpful. As managers, we have to fall back on integrity and the momentary weighing of risks.

But the balancing act is rarely black and white.

advice trap

When the nice people at MBS Works sent me a copy of The Advice Trap to review, I was intrigued by its premise: That we all have an inner advice monster that gets in the way of us getting better results from the people we manage, coach, or mentor, because we talk too much.

This is me in a nutshell. And while I freely admit it, I find it difficult to do anything about it.

Mr. Bungay Stanier is also the author of The Coaching Habit which I have not read. This is unfortunate, because a failing of the Advice trap is to act as too much of a sequel / advertisement for Mr. Bungay’s other book. But if you can look past this, and its other main issue (see below) there is actually valuable and worthwhile advice for all those who are routinely asked their opinion. This is, of course, the central paradox behind the Advice Trap, it is a book about how giving advice is a trap and a monster, which can only relay this idea by… giving advice. To Mr. Bungay Stanier’s credit he does freely admit and deal with this irony.

A central theme of The Advice Trap is that giving advice is generally more about the person giving the advice and does not actually solve the issue at hand, never mind actually benefit the person who is doing the asking. What the Advice trap does is give the reader tools to help them stop immediately leaping to give their own take on what they have been asked, but to dig deeper, be more curious about the issue, and see if by working with the questioner that a better solution cannot be arrived at. It also makes the point that the best solution may very well not be arrived at by the yourself and how to be prepared for that.

These are powerful and useful tools and ideas. Framing them as “The Advice Monster” is actually close to genius. It also goes deep into why as leaders and managers we often fall back on giving advice when it does not work as well as we think it does, and rarely does anything for our team’s growth.

That managers need to be more empathetic and have humility is not new to anyone who has read a business book in the past twenty years. Where the Advice Trap succeeds is in actually giving practical advice (there’s that paradox again) on how to do that while in the middle of leading a team or coaching an employee.

This brings me to The Advice Trap’s main failing: it is so jargon heavy that it becomes overwhelming at a couple of points, and gets in the way of what the author is trying to achieve. That Mr. Bungay Stanier has created a useful toolbox is not in doubt, but that tool box can be very difficult to open and to remember which tool to use when is a problem.

This is a book to take ideas from and to adapt and use them for your work environment. Which indeed seems to be how the book was written in the first place given the references to other works. The Advice Trap is a good book for both new and experienced managers, because we are human and we all fall into the same trap – The Advice Trap. It makes for uncomfortable reading in places; its never nice to see one’s unconscious motivations laid bare, but The Advice Trap is important because business books so rarely challenge our own assumptions about ourselves.

This is a challenging book on multiple levels, but that should not let that stop you using it to tame your advice monster. Those monsters need taming and the Advice Trap has the tools to help.

 

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Routine.

We have routine.

“Good morning “while waiting for the thermometer all clear.

The snatched moments of laughter – less than before, but not gone altogether.

Some days are busy, some days less so.

But the days have less form than before, less shape. Less to keep them in memory. Less to measure them by.

We can measure time in policies and protocols that have come and gone. Some that we never used at all. And some that may still need to be dusted off.

Lets hope not.

Businesses that have a healthy culture see this culture bear fruit, and weather the storms, disagreement, and fear.

Businesses that have culture problems are finding that now it is too late to try and fix it.

Crises act like a magnifier. Just what you had before only more so.

Like all situations there are rarely heroes and villains, the world is more complicated than that. There are heroic acts and acts worthy of villains.

The fractures in teams, departments, and relationships are tested. How resilient we are, depends on the history we have; good or bad.

Managers and leaders, have a new appreciation of the J.K. Rowling’s Snape; doing wrong things for the right reasons; being perceived as the bad guy, and shouldering that burden silently, when so much is about survival and the greater good.

But all of this is fine. We are okay.

In that awful phrase, over used and misunderstood; this is the new normal.

This is us digging in for the long term.

Reassuring clients over misleading headlines.

Addressing customer service issues like the old days.

Accepting praise where we can get it.

Ignoring Yelp reviews – because.. really?

Creating a social life by computer.

Valuing connections like never before.

These are people I choose to go through a pandemic with.

These are the people I will get through a pandemic with.

 

*Apologies to Dr. Michael “The Harry Potter Vet” Miller for appropriating his Snape analogy. You can check out Michael’s work on Instagram: @harrypottervet

 

letters

Ten Days.

It’s been ten days since we stopped allowing clients into our building.

I could not believe it today when I made an updated client blog post, you can read it here if want, that it had been ten days since the last one.

It feels like three days ago.

The days have melded together.

We are getting into our stride, and everyone is adapting.

Some genius (not me) suggested numbering our parking spots and marking them out in chalk. Someone else suggested papering basic instructions and our phone number on our windows.

But at home it all melts into one.

Again, I’m still very lucky. I’m employed and well. I have a vaguely normal schedule. I’m not on the front lines, even in the veterinary world. Its more, so much more, than many.

But I can only decompress and try to relax, or go back to work.

I’m either on or off. There is no middle ground.

It’s grief.

That’s the only word I can find for it.

Grief for the dog park.

Grief for dinner with colleagues or friends.

Grief for home projects, for which I always have had boundless energy.

Grief for Hockey, I miss my Golden Knights.

Grief for meeting with my team, usually the highlight of my working week.

Grief for my town, everyone else’s playground that I call home.

Grief for how things used to be.

I am so spoiled.

My loss is measured in an unwillingness to do vaguely productive things with my free time.

Until my friends start to get sick, as one did today.

Until my friends tell me of clinic owners wanting to cut their losses and sell.

Until my 90-year-old Mom starts off our weekly transatlantic phone call with “I’m not sick.”

Until the worry, fear, anger, frustration, boil over into words.

It’s been ten days since we stopped allowing clients into our building.

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The worst week of my working life.

I’m sure it is the same for a lot of you.

I’m lucky.

We were prepared.

We had a plan.

We are open.

I have a job.

I am well (so far).

But I am pretty beaten.

The constant planning, changing of the plan, and then changing again.

Messaging to staff and clients, much of it contradictory, from day to day.

The difficult conversations; “it’s not enough” through to “it’s too much.”

The constant conversations, decisions, and monitoring of decisions.

Getting into work first, and leaving late.

Snapping at people who are just trying to keep things light and being their normal upbeat selves. Or whom are not as quick at checking their email as you would like.

Trying to enforce social distancing.

Seeing the town I love, and I’m proud to call my home, look like it is dying.

The constant, ever present, worry about colleagues, friends, and family.

I am not ashamed to say I cried at my desk yesterday.

But I did not cry because of all of the above. I cried because I as posted that we would be cutting our hours, not letting clients into our building, and fearing, as I have for weeks, for what is to come, a client responded:

“So typical of Craig Road, they care about their patients, and pet parents. ❤️”

And what I thought about is my colleagues.

The team I work with.

The ones who have done everything they can to help prepare, implement new policies, and new cleaning regiments. Who have been dedicated to ensuring we had the basic supplies we need to be there for our patients. Who accepted daily temperature checks like is was the most normal thing in the world. Those who have had really bad days and still are at work, and want to work, to look after our clients, and our patients.

My Team.

The internal culture of workplaces can be a fragile thing. But it can also be resilient. They can even thrive in adversity. People check in on other people. Making sure that their colleagues are OK.

Making sure that I’m OK.

The stuff of nightmares, does not have to be a nightmare.

Undoubtedly, the worst is yet to come.

We will get through it.

Things will be different.

We will have changed.

But we will also have grown, and we will have our teams with us.

Stay safe.

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Photo by Andreas Fickl on Unsplash

What is common sense?

Is common sense to a manager the same as common sense to a veterinarian? Or to a veterinary technician? Or to a customer service specialist? Or perhaps, most importantly of all, to a client?

Common sense should be knowledge that we all share; however, it is rarely used that way. It is often used as a bludgeon on people for not reading our minds. Common sense is short hand for “you don’t know what I know, and I think you should.” The problem is that we rarely recognize that our own common sense is more often than not a point of view with some additional specialized knowledge.

Chip and Dan Heath in their book Made to Stick, talk about the “curse of knowledge.” They outline a simple experiment conducted at Stanford, where by a number of “tappers” were given 120 well know songs to recite using just knocks on a table. “Listeners” would then have to guess which each song was. The Listeners were right only about three times out of 120. What was extraordinary; however, was that when the Tappers were asked whether the Listeners should be able to pick out the song, they replied that they should be able to 50% of the time! The Tappers felt they were being understood more than 47% more than they actually were. The Tappers were hearing the song play along in their heads while tapping it out on the table. The Tappers had knowledge that the listeners did not, and so dramatically over estimated the Listeners ability to recognize the song.

Common sense is a side effect of the curse of knowledge. A team member who may excel in looking after an unhappy customer, or preventing a customer from becoming upset in the first place, may not automatically understand the seriousness of a cat that is straining to pee. Likewise, a veterinarian may not understand the reason why their client is not being immediately shown to an exam room is because of the 12 other people that just walked through the door that the customer service representative is trying to deal with.

Now in both of the above examples, training, proper protocols and procedures, and a commitment to teamwork should solve all of these issues. But when we fall back on common sense, or a lack of it, we are doing a disservice to our team members and even to ourselves. If we replace “common sense” with the words “knowledge and experience” in the phrase “you have no common sense when it comes to dealing with clients” the person at fault switches from being who the phrase is directed to, to the person saying the phrase.

Give it a try – I’ll wait.

Common sense is an excuse for leaving training and continuing education to osmosis. It has no place in management, and really has no place at work at all. Employees are not going to place themselves in shoes of clients without being trained to do so, and they rarely have the knowledge to place themselves in the shoes of managers or veterinarians. Common sense is lazy, overly broad, and does a disservice to the person using it and the person whom it is directed against.

It is time to recognize it for the dysfunctional symptom that it is.

Did you dress up for Halloween while at work this year?

Did your team?

It is no secret. I love Halloween.

I’ve been managing veterinary hospitals since 2006, and every year except one (more on that later) I’ve dressed up and encouraged my colleagues to do the same. Particularly at my current practice our embracing of All Hallows’ Eve has become part of our identity.

Part of our culture.

My first Halloween at my current practice was only a couple of months after I had started. The staff and I were still getting to know each other. We did not know each other’s boundaries. I’m sure none of them expected for me to turn up as Scooby-Doo with an oversized head.

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Note the name badge still identifying me as the Hospital Administrator

While I was not the only person to be in costume that morning. There was a clear division between those who trusted that I was serious about dressing up and those that did not.

I really was serious that it was ok to go “all out” as long as they obeyed a couple of simple rules: Still be able to do your job, and don’t be inappropriate.

Something interesting happened that day as the first shift gave way to the mid-shift, and then to the second shift, and pictures were posted to our company Facebook page. The ratio of those dressing up to those who were not exponentially increased. Some of the costumes had obviously been hastily thrown together, but they were all fun and it culminated in a great group photograph.

2012 group croppedThe next year more people dressed up, this time evenly across all shifts and departments. The morning shift trusted that other were going to dressed up and they would not be alone.

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I’m in second row, on the left, in the wolf mask and dinner jacket.

The following year there were far more people dressed up than not. If you were not dressed up, you were the odd one. The year after that, forever known as the year of the squirrel (see below), even the practice owner, and the majority of the doctors, got in on the act. Halloween was entrenched in our culture. It was a day when we could all be a little silly, and still be the professionals that we were for the other 364 days of the year.

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Yes, the tail did make the day… “challenging.”

A couple of years later I screwed up, however. I booked myself on a business trip over Halloween. Halloween, went on without me, of course, but participation was down significantly, and traditions, such as our group photo, never happened.

The following year a majority were in costume again; but we were still down from the heady days of the “Year of the Squirrel.” By not being around the year before, to be the guarantee that there was going to be someone who was going to go all out.

To be silly.

To lead.

As a leader, one has to be prepared to stand up and take the initiative; to literally lead the way. Show others what and how to do things. To be prepared to look ridiculous, even to look ridiculous alone.

My colleagues do not dress up for Halloween for me – I’m not quite that that deluded. Dressing up for Halloween is fun, it’s a change in routine. But creating a safe space for your team is the job of a leader. To allow your team to make mistakes, look silly, and take risks takes the same set of skills as creating an awesome Halloween.

And if you are not dressing up, maybe its time that you start.

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new econmics
The New Economics was first published in 1993; the year of its author, W. Edwards Deming’s, passing. Now on its third edition; however, it is arguably more relevant now than it has ever been. Deming has never received the acclaim in the United States that he undoubtedly deserves. He seems to be one of those authors that people cite, but rarely read.

The New Economics does not feel like an almost 30-year-old business book. Its ideas seem fresh and its voice is refreshingly new. If it was written today, and there are several books that focus on several of his core ideas such as the excellent Measures of Success, it would be hailed as a master piece of business literature.

Deming is an advocate for the process. This is often interpreted reducing the people is those processes as mere cogs in the machine. This, however, is unfair to Deming who is a believer if people driving the process. He is also a believer in management managing by taking responsibly for its failures. “The operator is not responsible for quality.” Says Deming. “That is the responsibility of management in conjunction with the customer.” He then proceeds to prove it with his famous red bead experiment (see below.)

Deming was an advocate for a sensible use of numbers, but Deming also believed that “We manage by theory prediction, not by numbers.” The use of numbers can help inform the theory, but really it is the manager’s responsibility to make that intuitive leap. “He who innovates, and is lucky, will take the market” says Deming. As an example of this Deming uses training. We never use numbers to justify training, but everyone does it – why?

I find Deming, and The New Economics, particularly interesting when it comes to goal setting and the importance of having a system which is often overlooked, even with our obsession with S.M.A.R.T. goals. “Companies have aims. With goals you must have by what method. Numerical goals need processes. A numerical goal without a process is meaningless.”

This is a heavy and involved book that is probably not for everybody. But it focuses on the way that management is performed. Not in how we motivate out employees to do their tasks better, but in how we design those tasks so they are naturally performed better. A the red bead experiment points out we often grade and evaluate employees based on the results of a system that they have little to no control over. We so rarely focus on process in business, we leave bad processes in place and then pour money and energy into managing employees who by their very actions are telling us that the problem is the process.

It is not too late to learn the lessons that Deming was trying to teach us 30 years ago.

It is about time.

measures of success

When reading business books, the reader, hopefully, takes away some great new ideas. Or has a realization that they should double down on something they are already doing. Occasionally, one comes across a book that actually reframes what you do and how you do it.

Mark Graban’s last book, Lean Hospitals which I reviewed here, had that effect on me; it made me realize that as a manager, my strength is to focus on processes and work with my team to make processes work better. Now with his latest book, Measures of Success, Mark has done the same again; this time with how we look at data and measure results.

The main argument in Measures of Success is that as managers we often are given, and collect, huge amounts of data that but that we either overact to “noise” or miss the signals that the data is giving to us because we are looking at that data in the wrong way. What Measures of Success gives us is a tool, in the form of an X-Chart and an MR chart, which allows us to view the data in a process and see the signals that the data is giving to us. Armed with these “signals” managers can then try to find out what has happened to the process to cause the signal in the first place. Because we are not chasing our tails looking for signals that’s are just noise and therefore not indicative of anything we should have the time to react appropriately when we see a valid signal.

Mr. Graban not only explains how X-Charts and MR Charts work, and how they work together, he also gives the reader exact instructions on how to create them and also why they are superior to other charts and methods of looking at data. He is particularly dismissive of targets and trend lines and provides damming evidence for both. The whole section, in fact reminds me of the Economist Roland Coase’s famous quote; “If you torture data long enough it will confess to anything.”

His case is compelling.

There is a point early on in Measures of Success where I was having issues understanding exactly how MR Charts (which measure rate of change) related to X-Charts (which measure actual data). Thankfully, a very helpful appendix takes the reader step by step through creating both, including excel formulas and providing links to where templates can be downloaded. The take away here is: if you get stuck read the appendix.

“Measuring is Easy, Managing is Hard.”

Measures of success, at its heart, is a plea to manage from what the data actually says, not what a manager or senior executive thinks it says. It makes the case that; “We don’t manage the metric, we manage the system that leads to the results, and we lead the people who help us improve the system.” If we set a target, what does that mean, other than just being a vanity metric pulled out of thin air? If we are wanting different results that what we already have the focus should not be on the target but on changing the system that gives us those results.

Mr. Graban’s Measures of Success is actually quite a short book, but is filled with color illustrations, and examples with which to make his case. There is even a section on how to implement X-Charts and MR-Charts at your business.

For anyone who considers process important to their work, and those who look at data, Measures of Success is a must. This is a book that promotes a structural change in how managers react and adapt processes. Most business books talk about how we manage change, few focus on why we are changing in the first place or whether there is an actual need to change.

Simply put, this book will change how and why you manage.

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