You can’t serve from an empty vessel.

Donna Sollenberger, EVP & CEO, UTMB Health SystemLast week, we explored the importance of working together effectively on our teams and addressing challenges in a positive way, particularly as we embark on our journey towards achieving Best Care at UTMB. In my post, I mentioned the importance of stress management, because when we operate under stress, we may not always be able to contribute to our teams in a positive way, or we may create a situation where our environment could potentially become unsafe. Over time, stress can even begin to affect our health.

This reminded me of a talk I have given in the past to different groups of caregivers and leaders about the importance of self-care. I was often asked during these discussions about how I managed to effectively juggle family and career—how did I manage to “have it all”?

That question always made me laugh, because I am not sure anyone ever “has it all”.  What we do have is the outcome of the choices we have made in life that best suited us, our family, and our career. The outcome largely depends on how we set our priorities, and there really is no single answer for how we should go about doing this. We make the best decisions we can based on the knowledge we have at the time. In fact, I believe we have to approach most problems and solutions on a case-by-case basis, because our priorities can shift with time and depend on where we are in our current stage of life.

From a personal perspective, I realize managing stress isn’t always easy to do, especially when one has a great deal of dedication to those for whom they care and for the work they do. Over the years, however, I’ve learned that I must carve out time in my schedule for myself to ensure I can continue putting my best foot forward.

When I have led my talk on self-care, a visual aid I often used was a Mrs. Butterworth’s syrup bottle, which I washed out and filled with rice. I would begin by talking about the many important priorities and obligations we have in our lives, and how in the process of putting so much of oneself into fulfilling these tasks and into caring for others, little things begin to drop off our radar when it comes to our own well-being. These little things can add up to have a significant impact.

As I continued the talk, I would shake a little rice out of Mrs. Butterworth as I went through the tasks of a “typical” day in the life of a career person with a family. Each time the responsibilities of the job or family required “action” on the part of Mrs. Butterworth, I would shake out a little rice.  I did this over and over in the talk until we got to the end of the “typical” day.  At this point, I shook and shook the bottle, but nothing came out—Mrs. Butterworth had expended all that she had by the end of the day with nothing left for herself to replenish or recharge.

I think that this is probably true of many of us. We love and are committed to what we do at work and the role we have within our family. However, after a busy day, we often forget to make time for ourselves and we have depleted our “reserves” over time. As a result, we can overlook important details, become forgetful or less productive, or feel irritable and incredibly stressed.

As we work together in a positive manner and navigate the challenges we encounter along the road to achieving Best Care, it is important to remember that in addition to being positive with others and maintaining a focused and optimistic outlook, we also need to take care of ourselves. No one can go on endlessly doing for others without also recharging their own batteries. There are some simple things we can do each day to help re-energize ourselves:

  • Outside of work, take time to look at your daily activities and determine which ones help you feel your best. Add these activities to your calendar. If you plan them, you are more likely to actually have time for them.
  • Check-in with yourself regularly to see if your routine needs to be changed. Sometimes we forget to ask ourselves the most obvious questions, like “Am I tired?” or “Am I happy?”
  • Go for quality not quantity. Even though you may like watching TV, and can spend several hours doing that, aren’t there other things that would be better for you?
  • It can be okay to say “no”. If you’re taking on so many commitments that you’re left feeling exhausted, it’s time to start prioritizing. Whether you decline an invitation permanently or simply take a rain check, saying “no” is sometimes exactly what your body needs.
  • Take a break. If you’re passionate about your job, you might feel reluctant to take a vacation. However, if you don’t take breaks, not only are you not taking care of yourself properly, but you may eventually end up undermining your performance. Working more does not mean you will maximize productivity. In fact, just the opposite is true.
  • In addition to feeling like you don’t have time for a vacation, having a hectic life can also give you a sense that you need to let your hobbies slide. Consider setting aside an hour a week that is only ever to be used for those activites.
  • People with busy lives can often forget just how valuable self-reflection can be. If you don’t spend time thinking about how you’re feeling about what you’re doing each day, you risk losing touch with what you really want from life (and reduce the chances you’ll feel grateful for all the good things in life). If you have 15 minutes of free time a day, then you have time to keep a journal. Reflecting on what happened in your day and how you’re feeling can help you understand you get a better sense of your needs.
  • Stay focused on the present moment. Practice mindfulness and use basic breathing exercises to get your mind into the right zone for creative visualization. Spend time listening to your favorite music, keep up with hobbies that help you feel fully in tune with your body (such as yoga, walking, swimming or cycling).
  • Finally, never underestimate the benefits of laughter! It releases a flood of feel-good endorphins that boost your mood and help you to relax. So, surround yourself with family and friends that make you laugh!

A challenge only becomes an obstacle when you bow to it.

Donna Sollenberger, EVP & CEO, UTMB Health SystemThis week, I was reminded of a time in the past when I worked on a leadership team that did not function as well as it could have. We were a diverse group of people from many different backgrounds with a wide array of professional expertise. Individually, we were all really good at what we did, and we all accomplished a lot within the departments we directed. As a leadership team, we even had a pretty clear idea of what our individual responsibilities were; however, we did not work well together to accomplish our shared goal.

We all knew what we were working toward, but we became frustrated when we did not progress quickly enough to the end result. So, we each started doing our own thing, according to our own leadership styles. Pretty soon, everyone was confused because there was so much duplicative work. No one seemed to know what the other was doing, and as a consequence, teams across the organization didn’t know what they needed to do to contribute to the goal or who was supposed to be doing what. I knew in my heart that the employees’ frustration was justified. So, I made a decision—I could allow this lack of coordination to continue, or I could try reshaping the team so that we worked together more effectively. I decided to do the latter.

As the team worked hard to come to an agreement, we conducted an exercise that involved completing a questionnaire to help identify our preferred working styles. It also honed in on how we each responded to stress in the workplace. Many of you have probably taken similar questionnaires, and you were categorized as a combination of letters or a certain color, like yellow, blue, green or red, which defined how you normally acted, as well as how you acted under stress. For example, if you were categorized as yellow, it meant you were generally process driven—a sequential thinker. If you were categorized as blue, it meant you were a “people person” who generally tried to understand everyone’s point of view and tried to get people to work together. Green meant you were a planner and strategist who was easily bored with details. If you were red, you were a detail-oriented person.

When our team shared their predominant color for our normal work mode, we had a great blend of the colors—something all teams should have. We had a people person, a planner, the process-oriented person, and detail-oriented team members. But what happened when we were under stress was really interesting. We were all in the red category. This meant that under stress, we all approached our work from the same point of view, and we didn’t have the important input from the sequential thinkers, the planners or the outgoing people with strong communication skills.

To really emphasize to our group how the organization was affected when this happened, I put tape on the floor so that we had four clear quadrants. I then asked everyone to stand in their respective color quadrant, exactly as the survey tool had placed us in “normal mode”. The closer someone was to the center, the more they reflected traits from multiple quadrants; the further away one was, the more strongly they reflected a single working style.

Under normal circumstances, we were all pretty well distribute across the colors. But when I asked everyone to occupy their stress quadrant in the exact placement the survey depicted, the result explained everything—we were all deep into the red, trying to occupy each other’s space. No wonder the employees said they were confused! In stress mode, our leadership team each tried to take charge, and to the organization, this seemed as if no one was in charge.

Why do I tell you think story? If we are going to achieve Best Care, we need everyone in the organization to contribute their unique talents and working styles to the team. Whether you are mostly a planner, a people person, a strategist or an operational process person, we need all of you contributing to reaching Best Care by August 31, 2017.

So what can you do?

  • Make sure that you understand your primary role on the team – whether you are on a patient care team or an operational team. Your position description provides guidance on your job, but what is your role on the care team? If you are not sure, your manager or leader should help you better understand your role and the contribution you can make to Best Care.
  • If you are a manager or leader, your job is to have clarity about how your area can most effectively contribute to Best Care, and then make sure that everyone knows they are on the team and what their role should be.

It is so important that we try to stay in our “normal” mode at work, because if we are operating under stress, we may not be able to contribute to our teams in a positive way, or we may create a situation where our environment could potentially become unsafe. Dr. Gary Grody defined stress this way: “Stress is defined as an inability, or the perception that you are unable, to take control of your life. If you feel in control, even if you’re not but you perceive you are, you won’t feel the stress.”

We all have high hopes for what UTMB Health can achieve over the next year as we work toward our goal of Best Care. We are already beginning to emerge as a leading academic medical center in many ways—we have experienced unprecedented growth and are performing better than most in many areas. Now, to deliver the Best Care to every patients, every time, we must remain focused on what we want to happen as an organization.

We will be rapidly moving toward our goal, so let’s remember to continue working together steadily as a team toward the goal, even in the face of challenges or frustration. Zig Ziglar says, “When obstacles arise, you change your direction to reach your goal; you do not change your decision to get there.” We must identify the areas in which we can make a change and come up with creative solutions to move the needle. We have an opportunity to become a model healthcare organization, and teamwork, focus and effective communication will be critical to improving the health and well being of all we serve!

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Accountability is the glue that ties commitment to the result.

Donna Sollenberger, EVP & CEO, UTMB Health SystemOn Wednesday, I had the pleasure of speaking at a Lunch & Learn for Health System leadership about the importance of accountability for both individuals and members of leadership. I am sharing it today via the Health System Intranet for you to review. Whether you are a manager, director or individual staff member, there are worthwhile reminders in the presentation for all of us.

After the presentation, I began thinking about how important the principle of accountability will be to achieving our goal of Best Care this year. You will recall that Best Care is an initiative we are implementing in response to University of Texas System Chancellor William McRaven’s challenge that UTMB rank in the top 20 of academic medical centers by August 31, 2017 (as measured by the Vizient* Quality & Accountability Study).

In Stephen Covey’s book “The 4 Disciplines of Execution,” he contrasts an organization that thinks conventionally with one that thinks in terms of both individual and collective accountability. In the organization with conventional thinking, team accountability is always top down: “We meet with the boss periodically and s/he lets us know how we’re doing and what we should focus on next.” In the organization used for contrast, the individuals on the team collectively share accountability for achieving goals and results: “We make commitments and then we’re accountable to the boss; but more importantly, we are accountable to each other for following through.”

A culture of accountability is crucial to achieving goals, particularly when the storms of change and multiple priorities are whirling around us. Often in these types of environments, teams end up breaking apart because individuals decide to go off on their own to “just get it done”. The goal becomes increasingly difficult to achieve if, within the whirlwind, we are also trying to change the behaviors of a lot of people.

With this in mind, I started thinking about how much we have going on right now. We are really going to need to buckle down, prioritize our work, and maintain a steadfast focus on achieving Best Care, especially because reaching this goal will require changing the behaviors of many people and teams. Failure to achieve Best Care is not an option, because it is the right thing to do for our patients!

everstThe work that we must do to deliver on our promise of Best Care reminds me of the book, “Into Thin Air,” which tells the story of two teams of climbers who attempted to get to the summit of Mount Everest. The first team included the author of the book, Jon Krakauer. He wrote about the numerous adversities his team encountered as they tried to reach the summit. As blizzards, high winds and altitude sickness began to affect the team, certain members decided to split off on their own in an attempt to get to the top. Although each climber had the same goal, by setting out on their own, they abandoned the team and discarded discipline and accountability to each other. The results were disastrous as the weather conditions proved too much for eight of the climbers who ultimately lost their lives.

The second team of climbers included a blind climber, Erik Weihenmayer. If the group succeeded, Erik would become the first blind person to reach the top of Mt. Everest. The biggest difference between this group and first is that at the end of each day, they huddled together in what they called a “tent meeting” to talk about what they had accomplished and what they had learned. The team used the meetings to review their strategy, make needed adjustments in their approach to the climb, and define each member’s role. They also decided who on the team would go ahead to clear the path and secure the ropes so that Erik could climb.

Erik characterized the teamwork this way: “Our team stuck together and took care of each other, which gave me the courage to finish.” The result? On May 25, 2001, the team reached their goal, and Erik Weihenmayer became the first blind person to stand on the summit of Mt. Everest.

There are so many lessons to be learned from this story, but here are some of the critical ones that we will need to implement to ensure we achieve Best Care:

  • Form teams that have specific goals for achieving Best Care.
  • Make certain that the team has their specific goal, target and deadline assigned and understood.
  • Encourage the team to engage in developing the plan to achieve the goal.
  • Make sure that everyone on the team understands their role, including the role of the leader.
  • Hold each other accountable for making contributions to the team. Speak up in a kind and understanding way to help a team member who is not fulfilling their role on the team—encourage them, but also be firm about the fact that everyone on the team has to do their part in order to deliver Best Care to every patient, every time.
  • Meet regularly and make adjustments along the way.
  • Celebrate milestones and congratulate individuals who demonstrate exceptional effort along the way.
  • Most importantly, ensure that the patient and their loved ones are at the center of all decisions. This is not about “us” or “me”. It is about doing what is best and right for the patient.

Accountability is critical to any organization’s success. Even if we have all the goals, priorities and metrics set, without accountable leaders, teams and individuals, we cannot achieve our goal. If we commit to these actions, on August 31, 2017, we will have achieved our goal of Best Care.

*Vizient was formerly known as UHC.

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