Reality chef Gordon Ramsey
rarely plays it cool with his underlings |
Imagine you're a contestant on
Hell's Kitchen and you're in charge. You're down
14 appetizers. Your line chef is losing his cool and
your risotto is getting cold. You're sure at least one
person has dropped the ball and it wouldn't be the first
time. You have to do some damage control — fast.
OK, back to reality. Replace Hell's
Kitchen with the OR and nasty Chef Ramsey with the
surgery chief. Your cold risotto is actually a crashing
patient. A colleague screwed up big time — again.
Things are boiling over and, in the heat of the moment,
you engage in some ferocious finger-pointing. Fortunately,
cooler heads prevail and the patient makes it.
No one wants that to happen again.
But what can you do to prevent a repeat?
TEAM
LIABILITY
About 80% of physicians worry about the competence of
at least one colleague, according to "Silence Kills,"
a study of medical conflicts and errors by corporate
training consultants VitalSmarts. But barely one in
10 approached the person to talk about it.
Avoidance means the same errors
are likely to repeat and unresolved conflict will create
a tense work atmosphere. Even if the immediate problem
is addressed but the broader concern isn't, the result
can be damaging, says VitalSmarts' David Maxfield.
"When the physician fails to confront
these problems, when instead he or she just focuses
on the work, rather than approaching the conflict and
trying to get it resolved," says Mr Maxfield, "then
they're more prone to burnout."
Mr Maxfield interviewed a heart
surgeon who has serious doubts about a cardiologist
he worked with. The cardiologist over-prescribed some
procedures when they weren't warranted or could be even
dangerous, and he was intransigent in meetings. Mr Maxfield
asked the surgeon to describe how he'd approached the
cardiologist.
"Their conversations always dealt
with a specific patient and a specific need to change
a procedure," recalls Mr Maxfield, who has worked with
hundreds of hospitals since he started consulting in
1981. "But it never dealt with a pattern."
The surgeon assumed if he brought
up each incident as it occurred, the cardiologist would
eventually get the hint. That wasn't the case.
ACT
NOW, STAY COOL
Few people enjoy confrontation, either with a colleague
or an underling. Trouble is, if you wait to have the
conversation about the larger pattern, invariably things
have already got to the point of no return. Your frustration
pours out and the person on the receiving end often
feels blindsided. This approach is usually utterly counterproductive.
So before the situation gets toxic,
you need to arrange a formal conversation with the staff
member in question. But before you even get to the meeting,
Mr Maxfield urges you to be prepared. Ask yourself what
you want to get out of the conversation, and write it
down if you need to. "One of the dangers is you get
into the conversation, it gets emotional, it gets political
and your motives can go downhill," he says.
THE
MEETING
Arrange a meeting behind closed doors for discretion
and make it one-on-one to eliminate the power differential.
Once you're together, says Mr Maxfield, reassure the
person. Make it clear your intention isn't to gang up
on them.
Start by discussing a mutual purpose.
Mr Maxfield recommends laying out the facts, starting
with the last incident and comparing it to a similar
one in the same context.
Watch for signs the person is getting
defensive. A tense posture and change in tone of voice
are some body-language indicators. But even if you see
signs of agitation, stay resolute in your message.
"The right thing to do is to step
out of the content [of the conflict] for a minute and
try to restore safety," Mr Maxfield says. Reinforce
that you're on the same team and you're trying to reach
a solution. Allow time to hear what your colleague has
to say. Don't rush to a conclusion, and make a plan
to follow up with another meeting.
Unlike Chef Ramsey, you're not
forced to fire anybody — unless you're sure their
performance isn't going to improve. But if the person
shows a willingness to cooperate, and actually follows
through, then it was all worth it.
Visit www.silencekills.com
to download the full "Silence Kills" report.
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