Have you experienced any of these characteristics with a coworker or a boss?

• The need to be “right” all the time
• Quick to take credit for everything but be the first to assign blame on others
• Minimize people and their emotions
• Pit employees against each other
• Desire to be appreciated and attended to all the time
• Show no consideration for others or display empathy or compassion
• Inconsistent behavior – you may be their best colleague/employee one minute and they may be threatening to fire you the next
• Insistence on compliance with their demands regardless of how unreasonable they might be
• Complete disregard of ethics, standards and morals, like they are above the law

If any or all these behaviors seem familiar to you, then run as far as you can from this individual, especially if they are your boss! Since that may not always be an option, below are some strategies that will help you deal with narcissists.

1. Make them look good. Praise and acknowledgement make them tick
2. Give them the attention they need, within reason. They feel threatened when you do not comply with their own self worth and aggrandization
3. Do not try to reason or argue with them, it will just aggravate them. Let them talk while you listen
4. Learn their pet peeves and avoid those. Similarly, learn what is important to them and cater to that
5. Build a wall – you cannot take anything these individuals say personally. They can be manipulative and abusive, damaging your self-esteem. Disengage with them
6. Find your drivers – do not expect them to motivate you and do not let them take you down. Keep the fire burning by focusing on what’s important for you
7. Be proactive. While this is a good management mantra all the time, learn the triggers to narcissistic behaviors and control their occurrence as much as you can
8. Enhance your emotional intelligence and learn tactics to cope with the behaviors professionally
9. Let them micromanage or make decisions. They want their way and will get it. If you don’t agree with it voice your concerns but don’t expect to have the final say

Narcissists may be very successful entrepreneurs or professionals owing to their ability to turn on the charm and risk-taking skills, but they make ineffective leaders. Learning how to cope with narcissists in the workplace can be a great lesson in managing up or around!

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Leadership Transformation Series

The Operating Model: Closing the Strategy-Execution Gap

This is Part 3 of a Four-Part Leadership Transformation Series (LTS).

Read Part 1 and Part 2.

Transformation in healthcare is personal: it requires the transformation of health system leaders. This LTS begins to speak to key differences in some of the fundamentals of transformational vs traditional leadership in healthcare.

This article focuses on how leaders operate.

You have a strategy. How do you rate your organization’s execution of that strategy on a 1-10 scale? For most, it is not high – or as high as they would like. Closing the strategy-implementation (aka, the knowing-doing or what-how) gap is the leadership Achilles heel of any business, but especially for hospitals, a business recognized by Drucker as the most complex organization to lead. Given that his observation pre-dated some of today’s larger and more evolved and blended academic-community healthcare systems, the complexity he referred to then has only increased. Across industries, the results of studies consistently identify unsuccessful execution for the vast majority of strategies; and the results of CEO surveys cite execution as the biggest current challenge, but reasons for such failure and concern vary widely. A sampling of HBR articles on the topic cite too much of an internal focus, poor CEO preparation in both strategy AND execution, “a people problem.” (Read Full Article)

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My father taught us, “If you want to be happy, simplify, simplify, simplify.” He loved the quote from the movie, Amadeus, in which the Austrian emperor told Mozart that his music had “too many notes.” My father did not agree with the criticism of Mozart’s music, but felt the quote was great for describing anything from cluttered architecture and art to overly complex solutions to problems. His house that he built from steel is pictured with this article. It is an expression of his design and artistic philosophy: clean, smooth, uncluttered, simple lines.

Albert Einstein said, “The definition of genius is taking the complex and making it simple.” Steve Jobs surely met this definition as he brought us the power and complexity of computing through as simple a user interface as possible. He took the complex and made it simple.

We often find that we cannot complete all of the tasks that are already on our “to do” lists let alone other tasks and goals we should be adding. We can choose what is most important to us and drop some good things from our list that are standing in the way of our accomplishing better. Advice I received from the book, Scrum: The Art of Doing Twice the Work in Half the Time by Jeff Sutherland and JJ Sutherland, helped a lot. Give yourself a short deadline. I needed to write an application to the Texas Medical Board to start a hospitalist fellowship. It seemed to me like this should take several weeks to complete which I did not have so I kept pushing it down on my to do list. I gave one of my hospitalists and me two hours to complete the application. We were done, and the application was accepted. My inner OCD wanted to overly complicate the task. I needed to simplify. Read Full Article.

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It was my first time back to a rural hospital. Though I had practically grown-up in rural health – both with frequent visits as a volunteer and as a support services employee – I had not been within the walls of a rural hospital in many years. And never had I been in one as a healthcare executive.

I arrived early, intending to look around and meet a few staff to better prepare me for a meeting with the Critical Access Hospital’s Board of Directors.

One of my first interactions was with a nurse coming out of a patient room. She was clearly emotional. Practically crying. I had seen the impact of caring for patients over the years. But this was not that. No, it was not simply a nurse and patient, but something much more. Even with my many years of experience, I didn’t yet know what I didn’t know – or regrettably, perhaps had forgotten. (Read Full Article)

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""When everything seems to be going against you, remember the airplane takes off against the wind, not with it", Henry Ford.

Ask any pilot if they remember the first time they flew the airplane alone. And you’ll get a resounding yes! The solo flight is a milestone in each pilot’s life, it’s the time when preparation and opportunity all come together. You are alone in the airplane, no instructor by your side correcting mistakes, keeping you safe, it’s all up to you.

Although my solo was over 20 years ago, I remember it as though it were yesterday. The weather, the sounds of the engine and the wheels rolling down the runway. But what I remember the most about that day is looking over to my right and seeing that empty seat next to me, knowing I was completely responsible for returning this aircraft safely to the ground, intact.

Whether your piloting an aircraft, an organization or a team, how you face and ultimately handle adversity will largely determine your success or failure. What my instructor taught me long ago was a simple lesson, the goal for each flight is for takeoffs to equal landings, what happens in between is up to you and will determines your success in achieving this goal. Read Full Article

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I am sure you have heard the old adage “the definition of insanity is to keep doing the same thing over and over again expecting a different result.” I would like to expand to that definition “and doing something without appropriate planning and expecting a better outcome.” Have you ever witnessed an unexpected result or outcome followed by a flurry of activity which is expected to positively impact the outcome? The danger of this reactionary activity is the false sense that the problem is being solved. Reactionary activity may address the fringe of the problem, but the root cause remains festering and aggravating the organization. To help with the risk of confusing activity with root cause problem solving, I suggest the Four Steps to Achievement, or what I like to call P8. Read the Full Article

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This is Part 2 of a Four-part Leadership Transformation Series (LTS). (Read Part 1 Here)

Transformation in healthcare is personal: it requires the transformation of health system leaders. This LTS begins to speak to key differences in some of the fundamentals of transformational vs traditional leadership in healthcare.

This article focuses on the changing role delineation of leaders.

The leadership need for ‘the Integrator’ is re-shaping traditional CEO and COO roles.

A few decades ago, the role of ‘the Integrator’ in healthcare leadership did not exist – at least not in the form needed today. Unlike roles with new names – CTO, CMIO, CPHMO, etc. - the same titles of CEO or COO may be used for a healthcare system, yet the shapes of these roles bear little resemblance to those with the same titles used in a hospital or other ‘vertical.’

While a hospital administrator/CEO is expected to stay close to the pulse of acute care operations, the system CEO is expected to transcend operations to assure an aerial view/perspective, i.e., to become more visionary and system-focused. The transition from hospital to system requires a view that is less entrenched with how we have run hospitals and more focused on the population served. Despite use of the same title for both roles, it is the difference between being ‘tied down’ and ‘freed up.’ (REAd Full Article)

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We’ve closed the books on another year, and it’s time to review your performance. Maybe you’ve completed all your goals -- congratulations you’ve failed. Failed? How could that be, I’ve completed all my goals? And therein lies the problem, you didn’t set your goals (or the bar) high enough for your own performance. Goals by definition are aspirations and should be set high enough to stretch the organization and yourself in new directions. If you are constantly beating your goals, you’re not stretching enough.

But why don’t we set our goals high enough? Well, it’s complicated. It has a lot to do with you, and with equal parts of your companies’ culture and goal setting process.

Take this simple test: Read Full Article

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INTEGRATING SUPPORT SERVICES AND FAMILIES FOR PSYCHOSOCIAL CARE.

He is that family member we all know, regrettably often looked upon as bothersome, annoying or cantankerous. Throughout my career in home health, skilled nursing and acute care, these family members are at every level – anywhere that involves caring for vulnerable patients.

One doesn’t even have to be in patient care – simply working in healthcare means each of us will likely deal with these troublesome family members at one time or another.

I was still a teenager when I first encountered “the husband” as we came to know him. Little did I know that those few days with him would have an impact upon my entire future, and that of my very role as a healthcare leader.

Interacting with patients’ families while working both in dietary as a dishwasher/server and facilities as housekeeping/maintenance taught me the importance of both support services and family members within the patient care experience – beyond the medicine. Read Full Article

Reactive vs Proactive Leadership

I do a lot of reading on leadership. About 2 years ago, I read a book in which the author briefly contrasted reactive and proactive leaders. The author said that reactive leader does not seem to anticipate problems and does not see them coming until they are blowing up in his face. The reactive leader is constantly putting out fires. The proactive leader on the other hand sees problems just as they are starting to grow, or even before they begin, and calmly takes quiet and gentle steps to correct and avert so that the conflicts and disruptions are minimized or even completely prevented.

A reactive leader may be confronted with ugly contentions for any combination of the following reasons:

1. Does not see the problem or consider that it might develop.
2. Sees the potential problem, but does not want to be bothered over something that “might” happen.
3. Sees the problem, but is afraid to act.
4. Created the problem by misguided attempts to solve other problems.
5. Enjoys contention and creates problems in part to create sparring opportunities or opportunities to assert dominance that are ego driven rather than leadership required.

The proactive leader does as Walter Gretzsky did and skates “to where the puck is going, not where it has been.” He has an eye to future disruptions. He sees the problems and is ready, willing and unafraid to act. He does not shy away from healthy conflict resolution, but prevents or minimizes unhealthy contention within his organization. He may disrupt his organization to move it where it needs to be to survive and thrive, but he will not allow his organization to be disrupted to no purpose.

I recently read an online article that presented reactive and proactive leaders as two equally valid leadership styles.ⁱ The reactive leader is presented in this article as strong in the surprise conflict, but weak in anticipatory leadership and the proactive leader as strong in long-range planning, but weak when called upon to “shoot from the hip.” I could not disagree more. A reactive leader is responding to whatever hits him and cannot have a firm hand on the tiller of the organization. For the proactive leader, the ability to extrapolate likely future scenarios and to predict human nature and act with vision and foresight does not make one unable to act upon the present urgencies and emergencies. Indeed, a proactive leader who has an eye to the future will be able to craft acute conflict resolution that is long lasting and strengthening to the organization.

Now, here is the part that stuns me, yet I have seen time and time to be true. This unknown author says that the reactive leader is often seen as the stronger leader, because he is often seen with guns blazing at a terrible dragon he is slaying for the organization, even if he is the one who fed and nurtured that dragon. The proactive leader is too often seen as weak or irrelevant. Why is he even needed? The organization seems to run itself. He often addresses problems discretely allowing key stakeholders to save face in front of the rest of the organization while bringing them effectively back on track. So much of what he does is unseen so it is assumed that it is not happening.

ⁱPROACTIVE OR REACTIVE LEADERSHIP, WHICH IS MOST EFFECTIVE IN THE WORKPLACE? VICKY BAILEY, 2016-12-02

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Leadership Transformation Series

This is Part 1 of a Four-Part Leadership Transformation Series (LTS).

2012 Womens Olympic Triathlon finish in London - After two hours of racing with the best in the world, what would one or two seconds in transition time have meant for the top three athletes?

Transformation in healthcare is personal: it requires the transformation of health system leaders. This LTS begins to speak to key differences in some of the fundamentals of transformational vs traditional leadership in healthcare.

This article focuses on how the nature of our work is changing.

Many compare the healthcare transformation journey to one of our oldest Olympic sports: “It’s a marathon!” Although this might reflect the persistence, resilience and endurance sentiment, I offer an analogy upgrade from one of our newest Olympic sports: “It’s a triathlon!”

Why?

First, transformation requires mastery of multiple disciplines. We – and our organizations - may have competency in one or two disciplines, but adaptive learning is required to develop and integrate the different and stronger skills needed for next level or breakthrough performance. We cannot count on simply doing more of the same ‘one foot in front of the other’ plodding and grinding to advance our mission – our people are burning out. Unlike in the run or bike, the first triathlon discipline – the swim - does not ask as much of the legs. While the upper body provides most of the forward propulsion, for swim speed it is more important to reduce drag. Drag is not a material factor in running, but it is in running our organizations – and barnacles, barriers and anchors come in many, mostly self-inflicted, forms.( Read Full Article)

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Over the years, I’ve heard many stories, inspirational stories on leadership, one of my favorites involves President John F. Kennedy and his first visit to NASA in 1962. As the story goes, the President was touring the facility when he came across a janitor carrying a broom down the same hallway as the touring President. Kennedy, a great lover of people stopped him and asked him what he did for NASA, not missing a beat he replied, “I’m helping to put a man on the moon”.

As I reflect on this, I’m struck by the absolute simplicity of this statement, but also the way it speaks volumes. This individual clearly understood that he was an integral part of the team, no matter what the role. If he did his job well, he contributed to the overall success of the team, engineer, scientist, astronauts etc. His job, although different in almost every way imaginable from his colleagues, still contributed to achieving the overall goal, that of putting a man on the moon. Read Full Article

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As healthcare (including acute care, nursing homes, home health and all downstream providers) moves towards a greater focus on patient/family satisfaction, the model of healthcare must also evolve, for both the government and patients/families will be closely reviewing these in determining healthcare provider(s) of choice. A satisfied patient is a more compliant patient, making for a more engaged patient. Providers at every level must now move beyond the patient centered approach, into an understanding of the patient/family perspective and be willing and able to convert input to action and measurable goals, benefiting staff, patients and families. Read Full Article

Why is it that some people thrive and others survive in business? Much of it comes back to their network. A network is like a garden. You have to water it on a consistent basis for it to grow. However, most of us put our heads down and focus on daily tasks. We say that we are too busy to network. We end up neglecting our networking garden and focus mainly on what others can do for us. Unfortunately, this self-referenced behavior is the equivalent of spraying Roundup® on your lush networking garden that you worked so hard to create. So what’s the cure?

Reciprocation is the Miracle-Gro® of networking. Without it, your network will shrivel up and look like you won a pallet of Roundup®. Here are three ways to rethink how you network, which can start to produce some Miracle-Gro®:

1. When you talk to an executive recruiter next time, see what you can do to help them find a new client (not only a referral to a candidate). Go out of your way to introduce them to someone you know that might take their call. This can do wonders for your relationship with the recruiter.
2. Instead of thinking of suppliers or vendors as another salesperson, invest time in getting to know them personally and see if you can introduce them to someone that might make a difference in their business. Remember that vendors may visit hundreds of organizations each year and their network could be very large.
3. Focus on informational networking rather than looking at how you can find a new position. Invest in the relationship, find out about their journey and see what you can do to add value to the conversation. You might decide to follow up with writing an article that is relevant to the other person.

By investing in relationships over the long-term, thinking of others first and finding ways to reciprocate, you will develop a beautiful networking garden for many years to come.

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Many high performing companies have discovered the value of servant leadership, which simply defined is serving others first. When leaders make this simple, but fundamental mind shift, the culture and the organization will follow as will bottom line results. Employees working under leaders who put their needs first, build self-confidence, make decisions more autonomously, have greater job satisfaction and engagement, and are more likely to practice this same style with their direct reports.

How does servant leadership build organizational and team performance? Read Full Article

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Healthcare has been in a tremendous period of change, mergers, acquisitions, leadership restructures, and new and improved strategic plans and priorities fill the time of most leaders. During this time of change, many leaders may wonder privately, does the mission of this organization still matter? Or is it only about the bottom line?.

When looking at high performing companies outside of healthcare, they all share some things in common, first, they have a clear and well spelled out purpose/mission. This is important so everyone, front line staff to executives can understand the why we are here, and how we will define success. This is not just a feel-good statement, and properly developed and executed this has the potential to pull people forward, especially during uncertain or difficult times. Read Full Article

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In healthcare, how often have you heard this, he/she is a great clinician, but has no personality. Or, take me to hospital A, but if I’m really sick take me to hospital B, this assumes hospital A is the “Nice” hospital but Hospital B is where all the best clinicians work. So, the obvious question is, can’t you have both? Yes, if you select the right people.

In Jim Collins book, “From Good to Great”, he writes, “People are your most important asset,” or rather the right people are. In today’s healthcare market many organizations are making the move from Volume to Value, with Quality being a primary focus, but how do our patients define quality? Sure, having the best possible outcome is right up there, with no medical mistakes or errors please. However, most patients come to our organizations assuming great quality, and value the interaction with their caregivers as high if not higher than any other part of the patient/caregiver interaction. Read Full Article

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Task oriented leaders, those using just workplans, measurements, goals, dashboards, etc.… sometimes may be left scratching their heads when their teams do not accomplish their goals, or performance begins to decline without any clear reason as to why.

To motivate your teams, and accomplish your goals, perhaps you would be better served to examine your leadership relationship competencies.

WHAT IS RELATIONSHIP LEADING?

WHAT IS TASK-ORIENTED LEADING?

When determining what leadership style works best for your team, consider the make-up of the team, today’s workforce is motivated much more by team achievement but still values individual recognition. Workers today want to achieve the goal, but want much more flexibility than past generations when it comes to how to achieve that goal. Read Full Article

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In all the hustle and bustle of the holiday season, it’s easy to forget that in just a few weeks most of us will be looking at the New Year and a list of resolutions or promises that we have made to ourselves that we hope to accomplish. Some of our old favorites are bound to make the list, lose some weight, exercise, give more to charity, get back in touch with family or old friends.

But what about including in this year’s list the commitment to be a better leader next year?

Research tells us that when we write our goals down, we are far more likely to achieve them, so begin the year by taking a good hard look at what is means to be a leader, remember, you may have the title but being the leader of people requires these fundamental building blocks, can you complete these? Read Full Article

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Early in my career my father shared with me the following advice: “Leave your emotions at home. Do not take your emotions to work.” He was not talking about positive emotions. He was talking about the negative emotions that get so many of us in trouble at work. Chiefly he was talking about anger.

Many people believe that anger is like a boiling, caustic liquid inside of them that can be purged by expressing the anger. They think that they can blow up and “get it out of their system.” But that is not how anger works at all. Anger is like a muscle. The more we express our anger, the stronger it becomes.

Solomon is revered as an extremely wise king. Here is what he had to say about anger. “The discretion of a man defereth his anger; and it is his glory to pass over a transgression.” * “A soft answer turns away wrath: but grievous words stir up anger.” ** “He that is slow to anger is better than the mighty; and he that ruleth his spirit than he that taketh a city.” ***

Ambrose Bierce said, “Speak when you are angry and you will make the best speech you will ever regret.” The regret can be for the harm we have done to others and the harm we have done to ourselves. Anger can do great harm to very important relationships. Sometimes we are able to completely restore the relationship. Sometimes we can only patch it. Sometimes we are left with an irreparable breach. Regardless, our efforts at mitigation may require the expenditure of great effort and political capital.

Our anger can decrease our allies and increase our workplace foes. Whether at work or not, we can never have too many friends and even one enemy is a luxury that we can ill afford. In a large and complex work environment, we may find that we cannot always give everyone everything they want. People may choose to be our enemy in spite of our best efforts. It would be foolish indeed to recruit additional enemies with unbridled, unregulated anger.

On the subject of enemies, I will say that over the years I have had a few people who have chosen to be my enemy. I have never accepted their invitation to join the conflict. When I speak of enemies, I speak of those who bear me ill will, but I am determined to be a friend to all, even those who are my most implacable enemies. I may distance myself from them and take steps to prevent them from injuring me further, but I will not move to injure them out of spite or revenge. It has been said that the best way to destroy an enemy is to turn him into a friend.

Often our anger prompts us to tell people what we think. We would be most foolish to reveal our innermost thoughts to people who are truly our enemies. They have no right to know what we think. Stephen Covey said, “Seek first to understand and then to be understood.” Often our anger is prompted by a distortion in our perception rather than an unacceptable reality. Once we began working off the script of our perception, the victim of our anger will often perceive the barrage as a personal attack, whether it is one or is an attempt to resolve a problem. It is a natural, although often not helpful, response to respond in kind in defense.

Conflict is good. Contention is bad. We do need to resolve conflicts. We do not need to do so in a contentious way that disrupts our organization. I highly recommend the book, Crucial Conversations, for learning how to resolve conflict without contention. This book is so jampacked with valuable knowledge that it should be read, reread and studied to fully master its principles. It has the potential to transform our careers and our personal lives.

Conflict is good. Contention is bad. We do need to resolve conflicts. We do not need to do so in a contentious way that disrupts our organization. I highly recommend the book, Crucial Conversations, for learning how to resolve conflict without contention. This book is so jampacked with valuable knowledge that it should be read, reread and studied to fully master its principles. It has the potential to transform our careers and our personal lives.

* Proverbs 19:11
** Proverbs 15:1
*** Proverbs 16:32

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