Many healthcare leaders say they don’t feel “safe” in the current healthcare environment. One hospital CEO I spoke with recently said “It is not like it was ten years ago when we all tried to stand out by being innovative and creative. Today, you don’t see many innovative CEOs doing interesting things. This is a risk averse environment. Senior managers have learned to keep their heads down, be compliant, and, in a few years, collect a really good pension.”

This is the logical outcome from a system dominated by fear and anxiety — and it will get much worse if we don’t push back to find a less threatening management style and if we don’t become more emotionally intelligent.

In my organizational transformation practice over the past 20 years, I’ve learned more and more about how and why emotional intelligence is perhaps the most important success driver. The latest research on brain functioning and human behavior proves Deming’s coaching advise was spot on. Neuroscientist Evian Gordon says that the fundamental organizing principle of the brain – at a very primal level – is to “minimize danger” and “maximize reward”.

CEO’s and transformational change journey designers need to be aware that when the journey (or the leadership) create threatening environments, they will create an “amygdale hijack” (limbic part of brain which triggers fight or flight responses).

In “Managing with the Brain in Mind”, David Rock in Strategy & Business Magazine summarizes what happens to people who are placed in an emotionally threatening environment at work. He says “the threat response is both mentally taxing and deadly to the productivity of the person – or a whole organization. Because this response uses oxygen and glucose from the blood, they are diverted from other parts of the brain, including the working memory function, which processes new information and ideas.” The research demonstrates that “this impairs analytic thinking, creative insight and problem-solving: in other words, just when people most need their sophisticated mental capabilities, the brain’s internal resources are taken away from them.”

The conclusion: when leaders trigger a threat response, people’s brains become much less efficient. So when Queen’s Park slaps down a Performance Agreement with the LHIN in which they are to be “held accountable for things over which they have no control”, the fear-driven dynamic begins. Same thing if a LHIN wants to hold a HSP accountable for things over which they have no control. Or when a CEO holds a manager unfairly accountable.  This is unproductive bullying, and it is a failing strategy that is modeled by the very top leaders in our health care delivery system today.

David Rock’s research demonstrates that “when leaders make people feel good about themselves, clearly communicate their expectations, give employees latitude to make decisions, support people’s efforts to build good relationships, and treat the whole organization fairly, it prompts a reward response. Others in the organization become more effective, more open to ideas and more creative. They notice the kind of information that passes them by when fear or resentment makes it difficult to focus their attention. “

It is this feedback — from the heart, not the head — that ignites creative genius and intuition, keeps us honest with ourselves, shapes trusting relationships, clarifies important decisions, provides an inner compass for life and career, and guides us to unexpected possibilities and breakthrough solutions”. Emotional Intelligence is what enables us to move from the Knowingand Doing phase — into the Being phase of life.

The very sad part about the current environment in the health sector is that top-down fear mongering seems to be the only approach that our leadership wants to practice.

Fear of punishment, and fear of never getting into the inner circle have become the leadership style modeled from the top. It is very discouraging for people who actually want to “fix things”, or make things better.

Nevertheless, around us are vivid examples of emerging excellence in care delivery. Hands-on experience, and transformation case studies, have convinced me that the estimates of 20% to 30% (of LHINs, CCACs, hospitals, Community Health Centres, home support agencies) that are fully engaged on a positive change journey towards improvement, are valid estimates.

I keep uncovering wonderful case examples of innovation that have broken out in our Ontario healthcare delivery system. When I find these examples I do my best to shine a little light on these projects and on the outstanding leaders who made them happen in my blogs.

When front-line staff, middle managers and senior mangers get positive feedback on their improved performance and their innovative breakthroughs — which they know is deserved — such acknowledgements of “good work”, spurs everyone to  even greater heights. It’s our human chemistry.

“Fear” and “anxiety” will never lead to an improved and transformed health system. That takes “creativity” and “innovation”. That takes emotional intelligence.

I’ve written about various emotional intelligence tools. I like the Personalysis framework best because it has the very same framework as the Balanced Scorecard and the most advanced tool of its kind available (see Personalysis).

What we know is that if leaders are to successfully lead and manage their organization through a fundamental transformation, they need to have empathy. Paradoxically, the route to empathy is through self-awareness.

Engaging leadership teams with these sorts of tools provides them with frameworks that will enable people to more comfortably raise itchy issues and resolve relationship problems because people will become more self-aware, more emotionally intelligent.

Being self-aware involves paying introspective attention to our own experiences — including our feelings, as they happen. The more self-aware we are, the more skilled we will be at reading others’ feelings, and the more empathetic we can be. When we are empathetic, we have the capacity to perceive the subjective experience of another person. We demonstrate empathy when we imagine another person’s feelings, emotions, and sensitivities, think about how we might “feel” in their situation, and then behave in an appropriate way. 

But to be empathetic, it is necessary to be self-aware. When we are self-aware, we are in touch with our own emotions, and therefore are more able to read others’ feelings. Empathy leads to quality relationships, integrity, trust, and good communication. Many people fear being empathetic and showing compassion at work, because there is a mindset that emotions do not belong there, and therefore must be avoided at all costs. However, when people are emotionally upset, they are likely unable to remember, learn, or make decisions clearly.

However, self-awareness extends beyond emotions to knowing, at any given time, things like what our energy level is like, our receptiveness to new ideas — or our ability to focus on a task. It is about knowing yourself. And, when we are in touch with our own feelings, we can “read” someone else’s feelings — without them even having to tell us how they feel.

Rockbottom: empathy involves being sensitive to others’ feelings and concerns, taking their perspective, and respecting differences that people may feel about things. Since people’s feelings are not always put into words, we must also be able to read “non-verbal” cues, such as facial expressions. 

Again leaders can learn a lot from brain research and human behavior. In “Managing with the Brain in Mind”, David Rock points out that “when a leaders is self-aware, it gives others a feeling of safety even in uncertain moments. A self-aware leader modulates his or her behavior to alleviate organizational stress and creates an environment in which motivation and creativity flourish.” Rock points out that “one great advantage of neuroscience is that it provides hard data to vouch for the efficiency and value of so-called “soft skills”. It also shows the danger of being a hard-charging leader whose best efforts to move people along also set up a threat response that puts others on guard.”

In the end, it is about striking the right balance: while being empathetic and developing the skills and capacity of people to manage change with emotional intelligence is a best practice step, the bottom-line is: change must happen!

While 90 percent of humans would rather die than change, it is the leader’s task to convince everyone that “true safety” lies in change, not the status quo.

As change happens, it should also lead to real measurable improvements.

Bottom-line: you are accountable for bottom-line outcomes listed in your personal Accountability Agreement — which needs to be designed with the best practice approach of balancing the “supports required to be successful”, with the “outcomes for which you are accountable.”

In times of chaos and bifurcation, we need balanced practices like these, rather than public relations, spin-doctoring communications and cover-ups of the truth — common practices in highly political environments to maintain some “control”.

But real change is coming immediately after the election expected at the end of May.

The status quo for Ontario’s healthcare delivery system cannot, and will not survive. If people are experiencing their current environment as “threatening”, they will be guarded and risk adverse. Fear and anxiety will be very present – and bottom-line results will not flow in such a stressful environment. As successful change practitioners say: “it’s about relationships, relationships, relationships.” People must be made to feel “safe”.

As the father of total quality management, Edward Deming said: “First, drive out fear!” Change management practitioners also provide wisdom for transformation journey designers like: “Slowing down, in order to speed up”; and, “Slow is better”, etc.

However, best practices also suggests that at a critical stage of the strategy development process, a much more rapid pace of change will be required to mobilize and align the organization and system. The bottom-line for CEO’s and change journey designers is that you have to learn how to go slow and  fast – at the same time. That can be very difficult for people.

That is why we need empathic and emotionally intelligent leadership in these chaotic and uncertain times. If this blog has made you curious about this approach by all means, try Personalysis on yourself, it will be the best $200 investment you ever made. If you want to test this remarkable tool, give me a call @ 416-581-8814.

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