Less Listening, More Deciding

Want people to lose faith in your leadership? Listen for too long.

A hospital CEO is paid to make the hard calls and own the decisions. At some point, that means shutting down the listening tour and getting to work.

Different people need – or think they need – different amounts of input to reach a conclusion.

Some, like me, prefer to move quickly. Give me an overview of the “why” around an issue, a snapshot of data, then let’s quickly finalize a plan. Others want data. Lots and lots of data. That’s my sister, a CPA. Still others want a deeply emotional experience, the chance to hear many perspectives and take the temperature of a room.

When my sister and I plan joint vacations, our different decision-making styles can cause frustration. (Does she really need a month to decide which hotel to book in New York?) In healthcare, the stakes are much higher.

I’ve worked with CEOs who managed by committee. Is there anything more frustrating? Even if a decision isn’t exactly the right one, too much is happening in our industry to stand still. Hospitals, health systems, the executives leading them and the service providers supporting them need to move.

I’m not advocating for moving in ignorance. We often talk about “instinct” or “going with your gut” as if those things are based purely on feeling unmoored from any other context. It’s not true. A gut decision is possible because we have a baseline level of knowledge and expertise in an area. Our brains are “constantly comparing incoming sensory information and current experiences against stored knowledge and memories of previous experiences, and predicting what will come next,” according to psychologist Valerie van Mulukom. In other words, our subconscious is pretty good at making decisions, or at least getting us most of the way there. An experienced healthcare executive should have enough background to make an informed decision, even with limited additional input – or less input than they think they want.

On the other hand, too much information can be crippling. I think about how I make buying decisions. I don’t take a lot of time, and I get overwhelmed by too many choices. Give me too many options and I shut down. (There’s research backing this up, too.) So, maybe I’m the norm and my analytical sister is the outlier?

But back to those healthcare executives who live and die by committee. They want everyone to agree, so nothing ever gets done. I’ve seen it first-hand. It’s chaos. Decisions are delayed until it isn’t worth making the decision. You really think that a hospital can afford to wait so long to decide on a course of action that it’s not longer worth doing anything? No. First, a competitor may come in and take the business. Or a disruptor. After all, CVS is adding 1500 HealthHubs in the next two years. There’s a decent chance one of them will open down the street from your hospital.

The other concern is the interpersonal cost. Imagine a leader who can’t make a decision or who even looks indecisive. Eventually, people will lose faith in his or her ability to lead. Hard to come back from that.

Why are you listening?

How do you know when you’ve listened long enough? First, try asking yourself “Why am I listening?”

Your goal should be to gather the input you need from your key stakeholders to solidify the idea that the journey you’re on is the right – or wrong – one. Listening is useful up to the point when you’ve gathered all the data that you need.

But, if your goal is to satisfy people, if you’re listening in the hopes that everyone will eventually say the same thing, you’re always going to be disappointed. Even in healthcare, where the goal is to “please” the customer – the patient – by delivering high quality, personal and compassionate care. If your goal is to provide the most excellent care, you might be recruiting a few physicians who don’t have the best bedside manner, regardless of what patients say they want when it comes to their surgeon’s personality.

How to switch from listening to doing

Of course, I can’t tell you when enough information is enough. Only you know that. Maybe a quick poll of your executive team plus your gut will get you there. Maybe you really do need a 70 percent response rate to your system-wide survey. Your mileage may vary.

Briefly, though, here are a few general steps to take:

  1. Identify your key stakeholders
  2. Ask them for feedback
  3. Ask them again (no one answers on the first ring, right?)
  4. Collect their feedback, make it clear that they’ve been heard and thank them for their input
  5. Review the information
  6. Move

Now, a brief detour into step 4…

Since people think and process information differently, a leader must be sensitive to those unique personalities. That goes for collecting information as well as communicating it. Set up a few methods for people to give their feedback. For example, you could host a couple of townhall meetings, create an online survey and be available during lunch every Tuesday and Thursday for three weeks. Just like limiting the amount of listening you do before moving, it’s worth limiting the mechanisms by which you listen, too. At the same time, not everyone will want to communicate through your preferred channels, so there must be some give and take. Some listening but not too much. A few channels but not too many.

Once you’ve listened

And so, we come to storytelling.

After you’ve listened and gathered information and made a decision, share back what you heard: “Here’s what everyone said, here’s what we learned, here are the data points we considered and here’s what I’m seeing in the industry.”

That said, follow up with “Here’s what I want for this organization, here’s what our strategy is telling us and here’s where we’re going. Now let’s go. Follow me.”

No matter how analytical or emotive the people in your audience are, your report to them will be strong and more compelling with some storytelling. Provide the context and the data, and people can figure it out. Like listening, provide a few different formats for reporting back. Some people will want a quantitative report, others will want to be in the room cheering when a new initiative is rolled out. Give them options, but not too many. As long as you offer enough (there’s that word again!) information for people to draw their conclusions, the vast majority of people will figure it out and support you.

To that end it’s also okay to say, “We tried that, and it didn’t go well. So we’re going to take what we learned and try this. We’re going to course correct.” Give people credit. They understand that things change and, generally, they’ll be on board if you give them the why.

After that, if they don’t want to follow? You keep going anyway. Don’t be paralyzed because someone, somewhere wasn’t happy.

About the Author /

kfox@jarrardinc.com

As a partner and leader of Jarrard Inc.’s Regional Health System Practice, Kim Fox brings to our clients an in-depth understanding of multihospital systems and the evolving healthcare marketplace. Fox has spent her entire career – which includes more than two decades of in-hospital experience – helping healthcare providers use the power of communications and engagement to accomplish their most important strategic goals.