Shift from Talking High Performance to Delivering Optimal Outcomes wrap up

Wow!  What an evening!  First, we have to thank our terrific new sponsor, the University of Melbourne.  Next, we must thank Norman Swan, from The Health Report and, then, of course, highlight our immense appreciation to Michael West for his incredible insight.

So, from a “wrap up” perspective, better outcomes are derived in organisations that:

  • Have a clear vision (and a vision in which the leader actually pays attention to and “walks-the-walk”);
  • Have clear objectives with only 5-6 priorities that are championed and communicated often;
  • Possess great people management in an environment where there is low stress and high engagement (read:  enlightened leadership, high emotional quotient and really practice compassion and compassion-based hiring);
  • Always listen with fascination as a key to compassionate leadership;
  • Are good at innovation as they can identify areas for innovation and are able to resolve problems innovatively; and finally
  • Develop great team and inter-team workings.

If you’d like to revisit the exchange between Norman and Michael, please follow this link to their recorded conversation (27 minutes):  webcast of Norman Swan and Michael West – Feb 27th 2018.  If you think it’s good, please go ahead and share it with others!

The conversation was so rich with insights; so, please read on:

1.     About Patient Experience;

2.     About Teams; and

3.     About Compassionate Leadership.


Here are links to some of Michael’s most recent publications:

  1. Michael West: staff-engagement-comes-first
  2. Michael West: employee-engagement-sickness-absence-and-agency-spend-in-nhs


1.  About Patient Experience

From his extensive research and many years of experience, Michael concludes that, to really focus on optimal patient outcomes, we must incorporate “patient experience” surveys together with actual patient interviews (i.e.  the core details).  These, together, tell us about the culture of the organisation.  Where Michael is seeing, making and experiencing a quantifiable difference (i.e.  evidenced-based results) is the more patients’ views are incorporated into the co-design of the services, the more innovative the organisation is:  this then creates the difference and lasting impact.


2.  About Teams

Michael spent a considerable amount of time discussing the concept of teams:  what is a team; why we have teams; non-technical team skills (separate to the typical technical skills needed to perform the tasks) – the sense of cohesion, warmth of support, conflict management, and face-to-face time; team-work and collaboration; virtual vs. non-virtual teams; interpersonal conflict vs. robust debate; and the need for a team to take time out to review and reflect upon itself.  One of the most critical points Michael emphasised was for a team to assess its own team performance (not the individuals’) and use a metric on improving the team’s effectiveness in working with other teams (“co-operative effectiveness”).

Teams are critical to effective execution and ultimately the results achieved.  For teams to be able to perform at optimal levels, people must be able to speak freely about the core issues and be able to promote robust debate.  Interpersonal conflict is very damaging and we must be intolerant of this type of behaviour.  We need to create “psychological safety” so people can be and will be open and honest.  Good team work leads to better quality risk taking and taking time out as a team leads to a 25% uplift in performance.  By recognising and taking the proper steps to address this, only then, can we tackle those issues proving to be hurdles to achieving greatness.

So, that aspect deals with the staff issue but where’s the patient in all of this?  The patient must be at the centre of the team!  Michael was emphatic we need to create teams around the patient and the pathway of care.  We all recognise patients want high quality, compassionate care but how do we create a model for leadership with compassionate care?  At a starting point, we should be able to select and train for compassion.


3.  About Compassionate Leadership

The problem, Michael felt, is that it’s exhausting trying to be compassionate when there’s such a focus on volume and throughput.  Pretending to be compassionate is really exhausting:  if you actually have compassion, it’s very rewarding!  More importantly, Michael stated that we’re damaging the people who are providing the care.  We simply cannot keep piling on the workload – it’s damaging on the caregivers’ health and this has a lasting impact.

Consequently, taking the temperature of staff is critical.  Michael underscored the strong correlation between performance and levels of staff engagement.  From his work, he sees a direct correlation between performance and meaningful staff engagement, not excessive stress and workloads and relative autonomy.  All this falls under the umbrella of “great leadership” and excellent role models.  Quite often, the key issue cited by employees is about the lack of core leadership and “empty leadership”.

Michael voiced his concern we are not adequately preparing our leaders for their roles and “leadership in healthcare” in general.  Therefore, we need to teach and help train our leaders.  We need a pipeline of good leaders (including inter-generational) and then promote to have the right leaders in place.  Execution and performance issues are often related to an organisation’s culture and, as such, it’s about leadership as the leaders are responsible accordingly.  If it’s then about leadership, it’s related to “collective leadership” as everyone must and should take on a leadership role of sorts at different times.

To do this, leaders themselves must be confident or else they typically revert to the “command and control” hierarchy often seen in health organisations.  Michael raised the inherent dichotomy that healthcare, as an industry, employs some of the smartest people but, so often, these people aren’t allowed to make use of their intelligence freely in their decisions.  Health industry is such a hierarchical industry, it often creates its own hardships.  He noted John Lewis, the esteemed UK retailer, only has three (3) levels of hierarchy.

We need to create and support autonomy in the front-line roles.  To accomplish this, we need to reduce the levels of hierarchy and listen to the people in-the-know (i.e.  the front-line staff).  There’s a general lack of training, development and support of the people in the health industry.

In all this, organisations and the teams need data and empirical feedback with key metrics on how they are actually performing and engaging.  We need to “listen with fascination”.  Data and the results need to inform staff, not punish or manage staff.  We need to focus on values, not just the technical skills.  Healthcare organisations need to have values that match those of the staff.  We need compassionate leadership.  We need to try to reduce / collapse the levels of hierarchy (remember John Lewis’ 3 layers).  We need the boards to buy-in at the top and use the evidence to persuade them.  Taken together, all of these have a direct impact on the organisation’s overall financial performance.


We invite you to comment and share this on Twitter:  @healthnetwrk.