Spotlight on Pediatric Emergency Care Volume 2, Issue 2, March 2004 The Undiscovered Bounty in Your ED or Office Practice Are you ready for that great annual transition from "respiratory season" to "trauma season?" As kids get that first taste of warmer weather, their joyous carelessness can, and will, get some of them into trouble. We'll start seeing more and more cuts and twisted ankles, as well as more serious injuries from bike and car accidents. Care for children presenting with both minor and major trauma is at its best when teams work well together. Does staff at your institution work well together? Are you tapping into the full potential of individuals and teams in your ED or practice? Throughout many years in leadership positions at different organizations, I was always struck by seeing a consistent, disconcerting thread. Generally, organizations like hospitals and group practices have at least some, if not many, truly dedicated individuals with all sorts of experiences and talents that can be put to work to benefit the organization. Most of us went into the healthcare field because on some deep level, we felt passionate about working to improve people's lives in this critically important area. Yet, somehow leadership frequently glosses over that very talent right in front of them. Turbulence begets Turbulence There is no doubt that like many industries, healthcare has become increasingly turbulent over the past several years. Of course, it is precisely during these times that strong leadership is required--leadership that brings out the best in people. And by working through the leadership process, individuals in the organization are able to grow personally and professionally, giving back even more. But exactly when turbulence hits--when more collaboration and creativity are demanded--what I observe instead is increasingly conservative thinking. As real problems are uncovered, those that affect how an organization treats disease and enhances health for the population it serves (sound like your mission statement?), leadership retreats to its own to solve them. We know from other industries that problems are often identified, and solutions created, in the "front lines" where those with direct public contact struggle with the day-to-day issues and challenges facing the organization. Yet it is also in the front lines, a group often alienated from participation in problem identification and solution processes, where a tremendous pool of talent lays dormant, awaiting leadership's invitation to join in collaborative problem solving. And the result, all too frequently, is not only lack of input from talented front line employees, but ironically, increasing job dissatisfaction which then leads to destructive attitudes and behaviors that result in yet further turbulence and difficulty for the organization. Quelling the Turbulence; Enjoying the Bounty This is not rocket science. The reality is that we live in challenging times, and bottom-line financial decisions seem to drive organizational thinking, even if those decisions mean cutting into core values of the organization. Whether we function in staff, leadership or even perhaps both positions in an ED or office practice, we may be limited in our capacity to influence leadership styles on the "macro" level. However, no matter in which positions we serve, we can certainly influence how our immediate environments function. Here are some strategies to consider: If in a leadership position: Hold regular meetings with staff and ask for specific input on what they see as current problems facing the department or practice. Identify individuals who would be willing to take a leadership role, with support, to help clearly articulate and then develop solutions for the top two problems. These individuals also should enlist the help of others who are interested. It is important to choose problems to tackle over which the department has reasonable control. Work with staff to determine if proposed solutions can be implemented realistically. And then make them happen. If staff identifies these issues as problems, there should be enough creative energy in the group to develop and implement strategies to solve them. Develop an evaluation tool and ask staff for feedback as to whether the problems have been solved. If not, help staff figure out why not and try again. If so, celebrate! If in a staff position: You know the challenges facing your department or practice. Identify the top one or two problems you believe you and your colleagues have sufficient control over to solve. Situations vary, but if you have a reasonably good working relationship with leadership, let them know you've identified specific problems and will be working on potential solutions that you believe can be implemented at the "local" level. As you develop solutions, be aware of the financial and organizational constraints leadership is working under. Think creatively about how your problems can be solved and solutions implemented within those constraints. Lastly, work with leadership to implement solutions. As part of your plan, create an evaluation tool to assess whether your solutions actually solved the problems. If your combined effort as staff and colleagues truly has resulted in improved care or satisfaction for the patients you serve, leadership will notice. That can only be good news--for you, the organization and the community you serve. Conclusion Obviously, this is a huge topic, with issues much more complex than can be conveyed in a brief newsletter. But I will tell you this--we work in difficult, challenging environments, filled with patients and families who are in distress, and with organizations at the helm that are losing sight of core values as they relate to healthcare for our communities. It is very easy to become "disconnected" in this large picture. If we are to maintain (or regain) passion about our work, we need to reconnect with those core values, and engage those with whom we work in the service of our patients. By doing so, we not only ensure improved care for our young patients, but we help ourselves by enhancing our day-to-day work lives. About Our Organization Created in 2003, Petrack Consulting is dedicated to helping physician and hospital leadership bring excellence to emergency services for children. We work collaboratively to fully understand our client’s needs, and then address programmatic initiatives with measurable outcomes. Our unique background in pediatric emergency medicine, administrative medicine, and organization development allows us to create uniquely effective solutions for enhancing emergency services for children.