Sunday, January 10, 2016

Week Seven - Collaborative Decision Making


-       Ludwig Erhard

Week seven has literally flown by; with the recent loss of one of our executives, this was the first month end closings where so much more fell on my plate than in times past. I never mind learning on the fly, and I was pleasantly surprised that others were able to step up their game and help carry the weight.

This week reinforced that we have to remember that making decisions in a vacuum or silo doesn’t work in the real world; as we learn to listen to the stories of others, we find that even under the most stressful of circumstances, that as we listen, everyone can begin to identify the best solution for all stakeholders (Levine, 2009, p. 156).

Six months ago, we identified needs in our Physical Therapy service line; the person performing the functions of registration is not an expert, has never been trained, and really is more of a receptionist role that previous supervisors attempted to expand. We began researching how we can justify hiring yet another person to help support us, now that our vendor was closing its doors on the area. Because I had worked closely with other projects in the area, it was not coincidental that I was able to identify that the impact to this service line would be huge to us, and I needed support. However, many other departments deemed this as witch hunt and blame game.

The reality was that the receptionist was not the right person for the job; because she was not trained in the practice of admitting patients, she was not consistently calling for authorizations, sending over medical records in a timely fashion, and was never brought into compliance changes that affect this area. This resulted in tens of thousands of dollars a year in net revenue being written off, all unknown to anyone. As we sat in meeting, everyone pointed fingers, tensions were high, nobody wanted to accept responsibility, and trying to justify the hiring of another person when we just went through layoffs would be next to impossible. As everyone continued fighting, blaming, and supporting a unified impasse with all other departments holding the Physical Therapy to blame, we were getting nowhere fast. The meeting ended with lots of laundry aired out, but no solutions and healing took place. Furthermore, we were exactly where we started.

When I reflect on the decision to have the meeting, in my mind I had it all planned out. I thought the other department heads would be able to professionally articulate what their needs and frustrations were, not the anger fest we had. We should have made ground rules and set time limits. People should have been given an agenda and been prepared to speak about specifics surrounding the challenges…not have made it personal and attacking other team members. I should have taken into account all the stakeholders; we needed administrative support, we needed the patient perspective, the financial impact perspective, as well as the human element. Without these considerations in mind, there was no way to bridge the gap between how we needed to collaborate and move forward, in comparison to how angry and resentful everyone felt about the therapy department.

This week has shown that long-term collaborations are far more important than the money lost; I needed to re-frame my focus on the proof that things needed to change. I got caught up in the money and the proof to try to gain support, subsequently ignoring the emotional side of the entire picture from everyone’s involved perspective. I certainly learned the hard way that “First, you listen and learn what others need. Then you learn what you need” (Levine, 2009, p. 205). I also learned that prior to forming a team meeting that is supposed to be handled in the spirit of resolution and collaboration, I need to share what my intent and vision of gathering everyone together to get on the same page in order for us to all realize what each other’s desired outcomes center around what we need to do in order for us to be able to collaborate and work effectively in the future (Levine, 2009, p. 189). 

Until we blog again!

Reference

Levine, S. (2009). Getting to Resolution: Turning conflict into collaboration. San Francisco: Berrett-Koehler Publishers, Inc.





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