Effective Actions: Less Confusion, in Higher Resolution
Patient and Process Outcomes and Effective Actions
With the universal priorities of the practice made clear and memorable, and each role given a memorable method to remember their part of the process, a further refinement of effort began, and along with it came another epiphany:
Just as there were Four Fears and four key responsibilities in each role, there were, in similar proportion, a relatively small number individual results and tasks that had an outsized impact on the overall results.
These results and tasks are Effective Actions.
We found, for example, many important downstream effects when people came in early enough to prepare for their day. Instead of having to micromanage every detail of that preparation, asking the team to focus on the single act of preparing for their day did the job just fine, and without the training overhead or negative impact of actually micromanaging. Team members would self-direct and share their tips on preparing for the day. It lead to exchange of knowledge. This was more like it.
As for the second epiphany, after applying this single-task principle, it was a simple leap to try to use the simplicity of single simple initiatives as the overall method of communicating our ongoing efforts to improve and adapt the needs of our patients and the measured results of our actions.
Because we were simply asking the Team to try to achieve a result and record and discuss what happened in the attempt, the Team felt comfortable asking for support from peers and managers. This is unlike the standard approach, where training initiatives are issued more like a challenge, or a retroactive redefinition of their duties, which they feel frustrated or embarrassed to have any trouble in meeting.
Modern Learning Science, Active Learning,
Repetition of Your Business Ecosystem, and Connecting to Purpose
Recognizing that it takes time to learn, and it takes time to change, and supporting the team through that interval of 21-66 days is not just humane and easier to comply with, it’s also consistent with the current understanding of habit formation.
Seen this way, we understood that past training failures had everything to do with presenting the learning payload in too large of an upfront chunk, exacerbated by then supplying insufficient support and too short of an expected timeframe for successful adoption.
We needed to make it an ongoing process, and set realistic goals about the time it takes for a human being to learn and change.
How and Why
Learning is also improved when there is an emphasis on teaching “The Why,” and allowing for personal cognitive engagement and individual problem-solving, rather than micromanaging “The How.”
If you say what needs to ultimately occur and supply your rationale, given time and support, your Team members will be able to connect those outcomes to their personal frame of reference and make adjustments to their approach.
Methods are important. But in cases where you can’t really teach or expect a single approach, accept reality and nurture psychological security (these two things always go together), and teach the why.
Supply demonstrations, checklists, algorithms, guidelines, and heuristics for your team to follow along with your rationale as to why this supports the desired learning outcomes and why these outcomes support the desired patient outcomes. Your clarity on this will be reassuring and motivational, and is required for helpful coaching, anyway. You can adapt based on feedback. EAs give as good as they take. As stated in the Cynefin Framework, in complicated environments, best practices can’t be fully ascertained; good practices must suffice.
Knowledge only really takes root as it is applied. To supply a scientifically sound structure for learning, we supplied training material upfront, which was amplified by demonstrations by role mentors who were available thereafter for review and individual support. Then we issued a series of strategically chosen EAs to guide and provide context for the application and repetition of the information.
The Ultimate "Why" is the Sustainable Success of the Practice as a Business
And another important thing gets repetition with the EA method: the business model and everyone’s role in it. Because it’s important to connect to existing motivation, all initiatives will be couched in terms of achieving business outcomes more easily or efficiently, which means making each person’s job easier.
Explaining each EA in terms of its impact on the overall business process will introduce repetition that will help everyone understand what they’re doing and why—both in terms of how benefits them and how it benefits others.
It’s perhaps hard to imagine the benefit of this, until you imagine having a Team where everyone wants the same thing, and knows what they need to do to make it happen.
So many conversations are made difficult by not letting the Team think about the business in terms of how their actions relate to the financial health of the practice and each person’s stake in that. It’s worth the effort.
Side Effects of the Effective Action Approach
Connect to existing individual motivation
Provide team/family purpose and belonging
Contextualize personal effort in the greater scheme of the business model
Show the greater purpose of daily tasks
Increase engagement
Create structures for proactive communication and conflict resolution
Improve morale
Inoculate against burnout