Healthcare Leadership Series - Lesson #1
Active Listening
As leaders, it is important to truly listen to the opportunities, challenges and ideas of those we lead and those we report to. As I thought and reflected on active listening as a skill for leaders, I decided to look up the definition. According to Wikipedia: “Active listening is the practice of preparing to listen, observing what verbal and non-verbal messages are being sent, and then providing appropriate feedback for the sake of showing attentiveness to the message being presented. Active listening is listening to understand. This form of listening conveys a mutual understanding between speaker and listener. Speakers receive confirmation their point is coming across and listeners absorb more content and understanding by being consciously engaged. The overall goal of active listening is to eliminate any misunderstandings and establish clear communication of thoughts and ideas between the speaker and listener. By actively listening to another person, a sense of belonging and mutual understanding between the two individuals is created.” (Active listening - Wikipedia)
Active listening is a skill that must be learned over time. Often as leaders, we seek to find solutions and solve problems. When someone speaks with us, our minds instantly go into problem solving mode, or into our rebuttal to whatever is being discussed. When you are instantly inwardly focused into what you will say next, your mind is not able to fully absorb what the other person is saying, so you may miss key points of the conversation. Early in my career one of my mentors noticed that in the midst of a discussion, I often interjected my thoughts quickly, without allowing the other party to fully introduce the topic of discussion in the room. He pulled me aside after a meeting and gave me simple coaching: “God gave you 2 ears and 1 mouth for a reason. You should listen twice as much and speak half as much.” It really made me think about how I had handled the previous meeting. I seemingly had interrupted my colleague, and not allowed him to fully explain the situation at hand prior to me offering a solution. I started bringing a notebook to meetings and making notes of what my colleagues were describing, and pausing to ensure they were finished sharing their thoughts before I spoke. I would then reflect on my notes and repeat back what I had interpreted from their discussion. After there was agreement that I understood what the topic in question was, then I would ask probing questions prior to offering any advice or thoughts I may have on the subject.
The skill of active listening is challenging when your personality naturally leads you to intervene quickly and make decisive decisions. However, understanding all aspects of a situation prior to making a decision is vitally important. Also, if you are able to ask for solutions from others while assessing a situation, you may not have to intervene at all. Often the best solution doesn’t come from the leader of the organization, but from the people experiencing the issue.
I love using stories to share leadership concepts. Often times a story of a real-life situation can help an adult learner truly understand the concept being taught. So here are true stories from my days as a hospital CEO.
When I first became CEO of a hospital in Louisiana, I was shocked by how many different people across the organization gave me books on leadership. Within the first 3 months I had accumulated a pile of books with great intentions on reading them all. As many of you can guess, there is little down time for a new CEO, so the books sat on a shelf for quite some time. There was one department director that had given me his favorite book called “It’s Your Ship” by Captain D. Michael Abrashoff. Every time I met with this leader, he would say things like “Do you remember when Capt. Abrashoff did this? Don’t you think this is similar to that situation in the book by Capt. Abrashoff?” I always nodded my head, but had no idea what he was talking about. One day I was about to head to a conference out of town, so I decided to bring the book with me to read on the plane. It was a fairly easy read, and by the end of the 4-hour flight, I had pulled out my highlighter, made notes in margins, and dog-eared important passages that I wanted to go back to later. Over the course of the following few weeks, I read the book 4 times to ensure I truly reflected on the concepts that Capt. Abrashoff was trying impart to the readers. When I made it back to the office the following week, I called this department leader into my office and apologized to him for not being straightforward and telling him I had not read the book up until that point. In my efforts to learn the hospital I was leading, and being “too busy” to take the time to read, I forgot one of my key elements of success. Listening to those I lead. What is funny is that this leader looked at me and told me that he knew I had yet to read the book, but he figured if he kept bringing it up, I would eventually read it!
Listening to someone who had lived and worked in a community, where I was new and considered an outsider, should have been a key element of my initial days at the organization. This leader had found a book that told the story and the techniques of turning a low performing organization and culture into a high performing organization. That was exactly what I had been preaching to the leadership of the hospital and what I had been focused on since my first day on the job. Listening and learning from this leader, who I now consider a dear friend, changed me and made me better. Being able to have open, honest discussions, and using proven techniques from others, helped to change me and the organization that I was leading. Had I not eventually taken the time to truly listen to this leader, how long would it have taken me to learn these lessons, and would the organization have had the results it did over the next few years. Thankfully, I will never have to know.
Now, whenever I bring a new leader on board, or when I am asked to be someone’s mentor, the first thing I do is buy them a copy of the book and ask them to read it prior to our next meeting. The key concepts of the book are simple yet profound:
· “See the ship through the eyes of the crew”
· “Communicate, Communicate, Communicate”
· “Create discipline by focusing on purpose”
· “Listen aggressively”
Truly listening to the team you lead can have a huge impact on the morale and effective operations of your organization. Another real-life example from another hospital that I had the privilege of leading involved elevators. From the first day that I started at the organization, roughly half of the elevators were not functioning. I was receiving complaints from doctors, patients, staff, and I often found myself walking up 7 flights of stairs not wanting to wait on elevators. After much discussions with the current vendor about root causes of the elevators being down, and being told that “parts were on order” for months on end, I was at my wits end. At one point, with a bank of 4 elevators in the main lobby, only 1 elevator worked. This was the entrance that mothers to be came in to ride up to the OB unit to give birth, and was the main access point for our OR’s and Cath Labs. I had a medical staff meeting one night, and the Medical Executive Committee brought up the issue of the elevators to me in the meeting. I shared with them what the current vendor had told me, and the physicians continued to raise concerns. At the end of the meeting, one physician pulled me aside and said that he knew the technicians that maintained the elevators at a competing hospital and would be happy to get me in contact with that company to help us with the situation. I thanked him for the offer and took the contact information. The next day, I asked my facility leader and COO to reach back out to our current vendor with a definitive timeline for resolution of our elevator issues. Again we were put off with “parts are backordered and we do not have a timeline.” The next week I saw the surgeon that gave me the contact for an alternate source in the dining room. He asked if I had reached out to them for resolution, and I told him I was still working on trying to resolve the issue with our current vendor. The physician became very upset with me and shared that he would be moving his patients to another hospital, since we could not even ensure that our elevators would bring his patients where they needed to go. That weekend I came in to the organization to round on staff and patients. I stood in the lobby with patients and visitors, and it took over 15 minutes for a pregnant woman to get on the elevator to go upstairs. Then and there I decided to make the phone call to the contact I had been given. The next week the new company came in and within hours had many of the elevators were operational again, and within weeks all elevators had been fixed and were functioning appropriately. It turns out that our old contracted vendor lived out of state and did not have resources near our facility, so we were put off until they could get someone to come to town. I called the surgeon to thank him for the contact and told him of the resolution to the elevators. He told me that he had asked the previous 2 CEO’s to reach out to his contact to resolve the issue, but no one had ever listened to him. The surgeon brought his patients back to the hospital, and he later became the Chief of Staff of the organization and an active member of the board.
Listening matters… I hope that the lessons learned from my journeys in leadership can help you on your journey.
Kristin Wolkart, RN, MHA, NEA-BC, FACHE
President and CEO
H.O.P.E. Healthcare Consulting, LLC
