Emergency Department Directors Academy Phase II Spring 2018
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1 Emergency Department Directors Academy Phase II Spring 2018 Course name: Crucial Conversations: A Leader's Duty 5/4/2018, 10:15:00 AM - 11:15:00 AM, FR-52 DESCRIPTION: Leaders have so many day-to-day responsibilities for which most must be carried out through others. Leaders have an obligation to provide feedback to the very people they lead. Confrontation is not easy. This is the single hardest and most uncomfortable action for leaders. This presentation will explore why confrontation is so uncomfortable for many leaders and review approaches and tactics that a leader can apply to carry out this important duty. OBJECTIVES: Review the key tenets of crucial / difficult conversations. Explore our personal communication style propensity under stress. Apply and practice conducting a difficult conversation FACULTY: Theresa Tavernero, RN, CEN, MBA BIO: Theresa Tavernero is the Corporate Vice President for Hospital Based Services and Performance and Innovation Consultants for TeamHealth. She has oversight of Emergency Medicine and Acute Care Services Contracts in over 700 hospitals across the US. She serves as executive coach for physician leaders and executive teams, specializing in domains of Emotional Intelligence and DISC personality profiling. She teaches as faculty in numerous leadership education development programs. She carries specialty certification in Lean and Six Sigma and TeamSTEPPS. Theresa atteded the University of Washington where she received her BSN and MBA/MHA. She is currently completing her Doctorates in Psychology for Human and Organizational Development. During a span of 40 years, as a nurse leader and executive, she has worked in many capacities, having served as a director and vice president over emergency services and trauma, educator, risk manager and Chief Nursing Officer. She is an active member of the Emergency Nurses Association, Organization of Nurse Executives, Sigma Theta Tau International Nurses Organization and Hospital Association. Theresa has been active in many international missions and endeavors, serving as one of U.S. lead faculty for Indo-US emergency Global Medicine conferences for 10 years. She has led and created the first Emergency Nurse Board Review and Emergency Nurse Fellowship in India. Thersea is an international and national speaker, having presented in many different venues for ACEP, Society of Hospital Medicine, ENA and Hospital Associations. She has been a faculty for ED Driectors Academy (EDDA) for many years. Theresa has authored many articles and was a contributor to the book 'Telephone Triage Protocol for Nurses. She has co-authored three chapters in the Strauss and Mayer s Emergency Department Management textbook. DISCLOSURE: (+)No significant financial relationships to disclose
2 DIFFICULT CONVERSATIONS A LEADER S DUTY ACEP- EDDA II MAY 2018 THERESA TAVERNERO, RN, MBA, MHA, CEN VICE PRESIDENT OF HOSPITAL BASED SVCS PERFORMANCE & INNOVATION CONSULTANTS
3 LEARNING OBJECTIVES Review the priority tenets of crucial/difficult conversations Explore our personal communication styles and propensity under stress. Apply and practice conducing a difficult conversation
4 PREVALENCE 42% OF MANAGERS TIME IS SPENT IN DEALING WITH WORK CONFLICT THAT REQUIRES DIFFICULT CONVERSATIONS.
5
6 IMPACT In the U.S., conflict costs employers $1 billion/annually. (Workplace Conflict: Facts and Figures, Mediate.com) Ernst & Young reports that the cost of losing and replacing an employee may be as high as 150% of the departing employee s annual salary. (Workforce.com) Organizations adopting communication training and conflict resolution processes report 50-80% reductions in litigation costs. (Thomas Stipanovvich, ADR and the Vanishing Trial : The Growth and Impact of Alternative Dispute Resolution 2004).
7 Companies who have mastered the art of difficult/ crucial conversations. Respond 5 times faster to financial downturns 2/3rds more likely to avoid injury or death due to unsafe conditions Save $1500 AND an 8 hour workday for every crucial conversation held rather than avoided Substantially increase trust and reduce costs in virtual work teams Influence changes in colleagues who are bulling, conniving, dishonest, or incompetent
8 WHAT S THE RISK OF NOT HAVING A NEEDED CONVERSATION?
9 STAFFING RETENTION & RECRUITMENT
10 IMPACT ON TEAM PERFORMANCE
11
12
13 DO THE RIGHT THING AND DO SOMETHING
14 CRUCIAL CONVERSATION DEFINED A conversation between 2 people when: The stakes are high Opinions vary Emotions run strong
15 CRUCIAL CONVERSATIONS
16 AVOIDANCE = FEAR
17
18 WHAT DIFFICULT CONVERSATIONS ARE YOU NEEDING TO HAVE AND HAVE BEEN AVOIDING?
19 COULD THESE BE THE BASIS OF SOME? Opposing positions Power struggles Ego / Pride Performance discrepancies Compensation issues Lack of resource And???
20 ROOT CAUSE(S) OF OUR DISCOMFORT
21 1. Will 2. Skill
22 WHY DO WE AVOID DIFFICULT/TOUGH CONVERSATIONS?
23 1. A DESIRE TO PLEASE I want people to like me. I don t want to look mean. We are nurturers; not gladiators.
24 2. PERSONAL SAFETY My colleague is aggressive and scary. I don t want the pain and agony. I don t like tears or anger making people feel unsafe.
25 3. PERSONAL COMFORT Confronting this will take too much work. I don t want to make waves.
26 4. FEAR OF THE UNKNOWN We value and seek harmony and stability.
27 5. LACK OF SENSE OF URGENCY I will wait until it happens again The third time s the charm I ll address it then.
28 6. OUR ORGANIZATION DOESN T SEEM TO. SO WHY SHOULD I?
29 7. WAITING FOR THE PERFECT MOMENT.
30 8. PERFECTIONISM
31 9. DISTRUST OF SELF JUDGMENT Maybe I m being too sensitive; I m not sure I trust my gut instinct. Is it my place to tell someone else how to do their job?
32 10. LACK OF AUTHORITY Who am I to bring it up. I m not in charge
33 11. FEAR OF KICKING SOMEONE ELSE WHEN THEY ARE DOWN He is such a nice person and has enough problems this will only overwhelm him.
34 12. NEW ROLE AND EXPECTATION I don t know how to confront peers or people in authority positions; I don t have the training nor experience. I don t agree with this policy decision anyway, why should I confront someone over it?
35 OTHER: TOO CLOSE TO HOME I ve known this person for a long time. We have been good friends. I need to preserve this relationship.
36 FINAL REASON: FATIGUE I really don t have the energy nor the time to take this on. I just can t.
37 OUR PROBLEM IN DEALING WITH CONFLICT & DIFFICULT CONVERSATIONS
38
39 WE FALL INTO A COMBAT MENTALITY
40 WE SOMETIMES MAKE IT MORE COMPLICATED
41 WE DON T BRING ENOUGH RESPECT TO THE CONVERSATION
42 WHEN CAUGHT OFF-GUARD, WE FALL BACK TO OUR OLD HABITS
43 SO WHAT? WHAT CAN WE DO ABOUT IT?
44 Anticipate and consider EI / Styles Study the Specifics of the Problem and Situation Create Safety-Confront and Apply the Crucial Conversations Dialogue
45
46 EI MATTERS & MUST BE APPLIED IN ALL INTERACTIONS, ESPECIALLY FOR DIFFICULT CONVERSATIONS EMOTIONAL INTELLIGENCE
47 START BY PREPARING YOU
48 What specifically makes you uncomfortable and anxious?
49 THINK AND EXPLORE ALL THE WAYS A CONVERSATION CAN GO
50 BOTTOM-LINE 1.Be aware of style, discomfort, hot buttons & preferences of yourself and other person 2.Prepare, Anticipate & Practice 3. Control your emotions and non-verbals 4. Adapt to the person 5. Be brave and do it!
51 COMMUNICATION
52
53
54 TALK T- Think about framing how you think about the situation. Don t regard situation as difficult but an opportunity. (Imagine success.) A- Always use clear, simple and neutral language. Refer to specific examples and facts. L- Listen to what the other person is saying and not saying and hear their point of view. Show respect and show you care about how they see things. K- Keep the focus on the issue and not the person
55 COMMUNICATION TECHNIQUES
56 DANGER WORDS TO AVOID
57
58
59 POWER WORDS:
60 MAGIC PHRASES
61 Tell me more. Help me understand..why you say that you would do that.you would ask that.. I care about what you think and feel.. What would you suggest instead.
62
63 NON-VERBAL COMMUNICATION
64
65
66
67 HEAD POSITIONS
68 BE MINDFUL OF YOUR FACIAL GESTURES
69
70 ANOTHER NON-VERBAL TECHNIQUE: THE 3 SECOND LOOK
71 DESC SCRIPT
72
73 NEW ED STAFF
74 DESC SCRIPT
75 HOW MIGHT YOU SAY IT DIFFERENT? What I feel like saying How I could say it differently Inappropriate hygiene or dress??????????????
76 HOW CAN WE MAKE THE MESSAGE MORE CLEAR? You need to improve your communication skills???????????????
77 STRESS AND THE AMGYDALA
78
79 PUTTING IT TOGETHER
80 DIRECTNESS & SENSITIVITY (DIPLOMACY)
81 AND
82
83
84
85
86 BOTTOM-LINE
87 REMEMBER THE CRUCIAL CONVERSATIONS YOU HAVE BEEN AVOIDING?
88 YOUR MISSION: 1. Discuss a crucial conversation you need to have or have been avoiding. 2. Prepare a written script and role play on how you would conduct this crucial conversation.
89 REVISITING TODAY S LEARNING
90 SUMMARY PEARLS Conflict is normal and ok. Start with knowing your own communication and conflict style. Stay mindful and control your emotions Ensure safety in interactions. ADAPT
91 Cell:
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