Team Empowerment – The Solution in Hospital Revenue Cycle

Teams are everywhere from sports, to business, to entertainment. There are many different types of teams based on function, location, dependency, professions, etc. The list goes on and on. The variability is well detailed in Wikipedia. [1] A team is defined as a “group of people who perform interdependent tasks to work toward accomplishing a common mission or specific objective…”

In the business word there are essentially three types of teams:

Process Improvement Teams
Work Groups or Natural Teams
Self-Managed Teams [2]

All three of these categorical teams also exist in the healthcare industry and it is also very important to think of teams from a holistic point of view. Essentially, holism states that no one part is more important than the whole, or said differently, the whole is greater than the sum of its parts. Yet, there must be something that is the matrix, the cement that holds all of the parts together, something in common to all of the parts. When it comes to teams, there is no one member that is more important than any other or the team as a whole.

The human body is the perfect example of holism to exemplify this concept. There are many different components to the human body, and some may say that the heart or the brain is the most important, yet neither of them can function independently. Yes they are important, but not more important than the whole. In addition, there is a matrix, a cement if you will, that holds all of the human body together and that is the skeletal system and connective tissue. So too, in a team there has to be a matrix, something common to all parts or components, that holds it all together.

It is important to understand that there is an overall structure that exists which includes teams. We commonly see that structure in sports teams. One must also realize that both leaders and manager are responsible for the empowerment of their teams:

Leaders
Managers
Teams

Leaders control process flow and are like a coach in a sports game; they are not in the trenches, nor do they play the game. They have a plan and give their teams direction and motivation to help them to reach their goals as they empower that team. They must ensure effective communication. remove the roadblocks, the workarounds, including the bottlenecks. Leaders do everything necessary to facilitate their teams to be successful. John Maxwell has said in his book Developing the Leader Within You “leaders become great, not because of their power, but because of their ability to empower others.” An unselfish team starts with a leader who gives away the credit when things go well and accept the blame when they don’t.

Managers oversee and direct by planning, organizing, staffing, directing, and manage through utilizing human, financial, and material resources. They direct but don’t coach. How would you define “manager?” Google will tell you a manager is “a person responsible for controlling or administering all or part of a company or similar organization.” That sounds easy enough ― like anyone can be a manager.

But what makes a good manager? The kind that inspires a team, fosters growth and productivity, and frequently asks for feedback on their management style? Simply managing a team doesn’t make a good manager. It’s the amount of effort and leadership they put into making their team successful. [3]

Teams A team is a group of individuals working together to achieve their goal and, when empowered, will do the work, towards achieving the desired results. The level of accountability then belongs with them and not the upper level. Captain Sully Sullenberger, the captain from the US Airways flight that landed on the Hudson River after a double engine bird strike said in a LinkedIn Post:

“When it comes to teamwork, there are lessons to be learned from the cockpit.  In air travel, when the captain first meets the crew, after making introductions, they align team goals and open channels of communication with everyone; they make it psychologically safe for even the most junior flight attendant to approach a senior captain about a potential safety issue and know that they will be heard. We create among the team members a shared responsibility for the outcome of the flight, that it’s not only their right to speak up if they need to, it’s their responsibility to.
It’s not about who’s right, but what’s right.”

This is team empowerment in a nutshell, the essential ingredient to the success of any initiative.

What is Team Empowerment and Where Does It Come From?

Empowerment is really quite a simple action. It is giving someone the authority or power to do something. Yet, managers and leaders must empower teams, not individuals. Remember the concept of holism, no one person is any better than anyone else on the team. In order to empower your teams, one needs to give them what they need to accomplish their goals, but, in order to effectuate it correctly and properly, there are four essential principles involved. Without these you will likely fail

1 – Give your team the latitude and authority to take initiatives

Define the boundaries within which a team can make their own decisions but don’t make them so constricting. In doing so, you give them freedom to act. Toyota took this principle and perfected it with Principle #5 – “Build a culture of stopping to fix problems, to get quality right the first time.” Anyone on the assembly line can halt the process when a problem is identified without repercussions. Teams can recognize the difference between a correct scenario and a problematic one. They are in the trenches.

As you give your teams authority to take initiatives, there are two thoughts that need to be kept in mind. They may not do it the way you would have but you should get the intended result:

Play to their strengths
Show them that you trust them

Teams know what their responsibilities and duties are, yet managers must know and understand the jobs and understand what the team does. It’s not the manager that makes the line work, it’s the team that makes it work. Empower your teams to have creative thinking and investigate their suggestions as possible solutions as it will likely end up with a better result. One cannot have an attitude of “this is the way we’ve always done it.”

2 – Provide the resources your team needs:

Clear communication, as in all aspects of life, is the key resource a team needs to be successful. Roles and duties must be clearly defined for accomplishment of goals. On the other hand, team members must be allowed to offer suggestions and feedback as they are the ones in the trenches. Again, think of Toyota principle #5. Their concerns must be listened to, but they won’t say anything unless there is a feeling of trust. One way to establish that trust is believe in the members of your team and show it. Support them in hard times as well the good times and you will foster remarkable loyalty and tenacity in your teams.

Provide encouragement, it is amazing what team members will do for a compliment, a pat on the back. Let your team know when they are doing a good job ensuring continued high-quality work in the future, and they will feel more job satisfaction. When something good happens or is achieved, appropriately give them the credit; don’t take it for yourself. If something negative happens, don’t blame the team. The purpose of employee empowerment is allowing them to feel confident and courageous enough to take risks and make their own decisions. It is amazing how much can be accomplished when no one is concerned about who gets the credit.

Mistakes may get made in the process but be careful, because if you punish mistakes too severely, you will encourage overly-conservative behavior. Establish clear differences between acceptable mistakes versus mission-critical offenses. Lastly, reward outcomes, not task completion. Clicking off KPI’s (Key Performance Indicators) is not necessarily a sign of completion and attainment of goals.

3 – Standardize Processes

A process is a series of events leading to a desire result, a goal. Let’s go back to the Toyota Way, Principle #6:

“Standardized tasks and processes are the foundation for continuous improvement and employee empowerment.” [4]

There can be multiple paths to achieve a result, to get from Point A to Point B. Randomly chosen, some are shorter, some are longer, but there is always a best practice, a best route. With an inconsistent process completion become unpredictable to achieve sustainable results. Look at the Toyota assembly line; without a standardized, best practice, consistent process, the quality of the car coming off the line would be unpredictable and could have defects, missing parts.

With a standardized process, things move faster and better with higher rates of quality. Once that standardization is established then ways of improvement can be sought. Another way that standardization helps maintain consistent processes is that is prevents people from changing the process creating bottlenecks resulting in workarounds. ”In …project management, a bottleneck is one process in a chain of processes, such that its limited capacity reduces the capacity of the whole chain…There are both short and long-term bottlenecks. Short-term bottlenecks are temporary and are not normally a significant problem…Long-term bottlenecks occur all the time and can cumulatively significantly slow down production.” [5] If one looks at an hourglass, the best example of a bottleneck, there is all that sand at the top that needs to get to the bottom, yet it’s held up by the bottleneck, slowing up the process. Same occurs in a production line. In order to assist in the empowerment of teams, it is the responsibility of leaders and managers to eliminate these resultant bottlenecks and work-arounds. Your process is only as good as the throughput through your bottleneck.

4 – Establish Accountability

Listen to the team because they live with the game, management only lives with the results
Push the accountability to the level it belongs – make the team accountable for the results
Put them in the areas of their strengths, not their weaknesses

Create a culture of accountability. Every organization has its own culture, its own beliefs and behaviors that help influence interactions and daily functions. Team members should be held to these same standards. Sometimes accountability can be over simple measures such as being delayed in the completion of their duties to more major responsibilities. This simple type of delay will snowball all the way down the line until it becomes a bottleneck. Tolerating missed deadlines, lack of punctuality, and unfinished work have the tendency to make this behavior acceptable with no consequences to those responsible. Without accountability, everyone suffers.

When assigning a project to a team there are certain steps that must be taken whether this is a short-term or long term event. Those steps are contingent on what is trying to be accomplished but there is one item on that agenda that MUST always be present and that is setting goals. In this manner, you can’t close that agenda item until all the next steps are complete, so the team has a clear picture of what’s being done – and who needs to be held accountable for tasks that have been missed.

One reasonable way of establishing accountability is to set SMART goals :

S – Strategic and Specific
M – Measurable
A – Attainable
R – Results-Oriented
T – Timebound

In summary, fostering a culture of accountability on your team will not only improve employee morale and productivity, but it will also give your team the autonomy and sense of ownership they need to truly thrive. If you feel accountability is lacking on your team, it’s time to make some changes!

Summary

Team empowerment is the essential ingredient to the success of any initiative, but it cannot be engaged without thoughtful processes. Teams are composed of individuals with unique skills, personalities, backgrounds, and drive. Utilizing the ingredients provide here will help provide the cement, the glue, the structure to maintain an holistic approach where the whole is greater than the sum of its parts.

[1] https://en.wikipedia.org/wiki/Team

[2] https://asq.org/quality-resources/teams

[3] https://www.wrike.com/blog/what-makes-a-good-manager/

[4] http://leanblitzconsulting.com/2012/06/toyota-way-principle-6-standardized-tasks-processes/

[5] https://en.wikipedia.org/wiki/Bottleneck_(production)