Authors

  1. Porter, Janet PhD
  2. Baker, Edward L. MD, MPH

Abstract

"The Management Moment" is a regular column within the Journal of Public Health Management and Practice. Janet Porter, PhD, and Edward Baker, MD, MPH, MSc, are serving as The Management Moment Editors. Dr. Porter is Associate Dean for Executive Education, The North Carolina Institute for Public Health, School of Public Health, at the University of North Carolina at Chapel Hill, and Dr. Baker is Director of the North Carolina Institute for Public Health, School of Public Health, at the University of North Carolina at Chapel Hill. This column provides commentary and guidance on timely management issues commonly encountered in public health practice.

 

Article Content

Most public health staff can relate to the thought recently expressed by Nancy Cripps, a Program Assistant at the North Carolina Institute for Public Health. She exclaimed, when reflecting on the joy of working with her neighborhood association, "Just when I was about to give up, everything turned around. All of a sudden, we just have such a good team!! It's seems like there isn't anything we cannot do. And I'm not even sure why." A gratifying team is like what they say about pornography. You're not sure you can describe it, but you know it when you see it.

 

Do you remember when you were a part of a great team effort and how incredibly satisfying that was? It may have been years ago and it may have been a community-wide effort or just a small team in the public health agency that came together to tackle a specific task. Oftentimes, the best team efforts are borne from crisis-having to do the impossible with no resources by tomorrow. Tales are told of every start-up company founded by dream-weavers with unending stamina getting the product out the door and the adrenaline rush that came from that wave of success. What energy is generated from people feeding off of each other's sense of possibilities!! We all look back with great fondness at the sense of brotherhood that came from not having just survived-but thrived-by overcoming insurmountable obstacles and accomplishing the impossible. Legends are borne of those efforts that live on in every company, not-for-profit and government agency in America.

 

Despite Nancy's exclamation that she wasn't sure what the essential ingredients were of a great team with monumental results, if you listened to her description of the transformation in her neighborhood, all the elements are there.

 

We really draw upon the strength and talents that our diverse community has to offer. After one member started a garden club, a single mother started a knitting circle, and the next thing you know another family had started a bible study.

 

Powerful messages: diversity, respect for talents, empowerment. Of course, because public health is an amalgam of disparate disciplines-environmental health, nursing, nutrition, epidemiology-glued together by a common mission of improving community health, we think we know the value of diversity. But really embracing diversity means actively thinking about how each new hire will broaden the perspective of the team and challenge their thinking. It is a paradigm shift for a manager to transition from thinking about hiring for each position not in terms of who the best candidate is for that job but in terms of what type of person will most benefit the team.

 

To respect the talents of others, every member of the team has to appreciate that each person's role is equally important. Years ago, when running a workshop to challenge staff to think about creating a vision for their future, one receptionist stood up to present her pictures that illustrated the team. One of her three pictures was of machinery with interlocking cogs and wheels-all different sizes but obviously interdependent. She simply stated, "We need to operate like a well-oiled machine. Like all machines, some parts are bigger than others, but all are equally important for even if the smallest cog breaks, the machine stops. And, the oil that lubricates our working parts, is the love we have for each other and for the communities we serve." You could hear a pin drop in that room and some eyes welled up as they looked at the little hearts she had drawn between the cogs to represent love. With her hand-drawn picture, she had so eloquently described that everyone was equally important to the overall functioning of the team regardless of how seemingly insignificant their tasks. This team was so in love with that drawing that they had it blown up, mounted and framed, and hung at the entrance to remind everyone who walked into that unit that they all mattered to get the job done.

 

Empowerment is fundamentally about trust. Gene, the NASA commander portrayed by Ed Harris in Apollo 13, has the unenviable task throughout the film of solving one mounting crisis after another in an attempt to get the Apollo 13 astronauts home safely. At one point when the CO2 is fatally rising in the crippled space capsule, Gene directs a team of engineers to "Figure out how to fit a square air filter in a round hole." Now picture this: the engineers go and do it without any interference from Gene. Despite the fact that the eyes of hundreds of millions of people throughout the world were watching NASA's very move, Gene trusts those engineers to solve the problem. Empowerment requires trust. If you don't trust your team, you need to step back and ask whether it is an issue of skills or unclear roles or poor working relationships or lack of tolerance for failure.

 

The welcoming committee greets every new family and tells them they have moved into the best community in Durham. Then we talk about the community activities and the friendliness of the neighborhood.

 

Most organizations realize the powerful socialization process that happens during employee orientation. Psychologists have long known of the power of primacy and recency. We remember our first encounter-and our most recent encounter. People remember their first day at work, who asked them to lunch, having to ask to be taught basic tasks like using the copier or their first staff meeting. What happens in those first hours-or days-at work is a powerful socialization to the code of conduct in the workplace. Nancy's welcoming committee is actually creating expectations about the way neighbors will treat neighbors, about the way neighbors will take pride in their community. Do you have an organized employee orientation? Does your orientation reflect the core values of your public health agency or is it basically about policies and procedures? If it is the latter, then the message new staff get is that rules matter more than knowing the names of other staff or serving the community.

 

Of course, we also have an annual neighborhood association meeting where we talk about what we want to accomplish in the next year and how we might work together to accomplish those goals.

 

Disparate people doing disparate tasks are unified by common goals. Teams become teams rather than individuals when they have to work together to accomplish something larger than any one could accomplish alone. In leadership development courses, one of the most powerful exercises is for a group to go through a ropes course. One of the exercises that is most challenging for the UNC leadership groups is called the spider web. In this exercise, the entire team is on one of side of a web of roping strung between two poles-similar to a very widely strung volleyball net. The team has to figure out how to get everyone to the other side of the "net" by having members step through the various holes without touching the net or using any of the holes more than once. The teams have to strategize and make decisions and work together to be successful. And some teams will spend hours trying to figure this out-despite the fact that there is no concrete reward. Just successfully accomplishing the task is reward in and of itself. Does your team have an over-arching goal that everyone can see is a part of what they do on a daily basis?

 

The problem so often with annual goals and objectives is that they are not simple or meaningful or visible to the majority of the staff. One group of staff held a "What We Would Be Proud of" workshop where the group identified what would make them very proud if it was accomplished in the next year. Then the list was made into a big poster, hung on the wall, and everyone walked by it every day. If an item was accomplished, one member of the team got to ceremoniously strike that item off the list. "Done!!" Goals accomplishment needs to be visible to bond a team.

 

True success in team goals is when no one remembers which parts of the project or the goal belong or are attributed to anyone, but they are owned by the whole. A few years ago, a team at NCIPH designed a team-building exercise for one of the leadership programs called the "museum walk." In this exercise, teams are asked to illustrate their team project without using words. While this tests artistic ability, it also challenges teams to try to portray the most essential parts of their project for others. When this exercise was first conducted with great success, NCIPH team members were elated with the outcome, and they all attributed authorship to each other. Giving credit to each other, they literally could not remember whose idea the original concept had been.

 

One reason everyone is our association knows what is going on is because we use every avenue for communication.

 

Teamwork requires communication. Coaches have long meetings with their basketball or football or soccer teams to communicate what each team member's assignment is with split-second precision. Ann Bancroft, the noted South Pole explorer, describes in the video made about her all-women, cross-country skiing expedition, "The Vision of Teams," that one of the most important aspects of their teamwork was working out a method of communication with glaring ice, -40 below temperatures, swaddled in winter wear. She states that ultimately they decided as a team that acknowledging each other-even with a grunt or a pat-was essential as they skied past each other to switch off on who would take the lead and face the howling winds. Whether it is through complicated hand signals that are indecipherable to anyone but the pitcher and catcher--or a company newsletter--deliberately designing a communications plan that says "we" to the team is essential to individuals bonding.

 

Employee satisfaction surveys invariably point out that communication could be better. As one human resources director stated, "Employee satisfaction surveys that say communication should be improved are the bane of my existence." One of the major mistakes managers make in trying to improve communication is telling more "what" and not enough "why." Staff-like vital team members-want to know not only what they have to do, but also why. How does their role fit into the big picture? It is easy to seem insignificant until someone communicates how vital your part is to the overall team. One example is to think about how an entire murder mystery can be ruined by the butler failing to point out the letter opener missing from the desk in the drawing room-a line which all other actors are using to cue them.

 

We also have learned from our mistakes. Not all of our clubs and events have been big successes but we have learned from them to do better the next time.

 

Learning organizations-and learning teams-improve because they learn from their mistakes. And mistakes are tolerated-even encouraged. As long as the team debriefs, reflects on lessons learned and does better the next time. "The Vision of Teams" portrays Ann Brancroft's South Pole team practicing and failing, learning from the mistakes, practicing and failing, learning from the mistakes. One key element of learning organizations is debriefing sessions that are held after every major event to review the logistics, the processes, the outcomes, and to provide constructive feedback between the teammates to improve performance the next time. In debriefings, the coach is merely the facilitator ensuring a systematic, nonthreatening review of the event supporting feedback between teammates, not necessarily even needing to provide feedback himself.

 

Memorable teams not only work well together and get things done, they want to work together again because overall it was a positive experience. Unfortunately, so often it happens that teams get their goals accomplished but never want to be in a room together ever again. Years ago, an Ohio team of physicians and administrators spent almost two years meeting on a weekly basis to structure a contractual relationship between the parties. They succeeded in striking a deal, but failed in that they were so sick of each other they didn't work together on anything for the next two years.

 

It was speed bumps and lighting, both of which had been tried before to no avail, which ultimately made all the difference in this neighborhood. And that would not have happened without leadership.

 

Virtual teams emerge in work settings to get goals accomplished, dissolve, and sometimes leave an indelible impression on the organization's future. Yet, even those virtual teams have someone in an informal leadership role who helped to connect the dots, to keep the group on schedule, to provide a sense of energy. Leadership does make the difference in teams.

 

We have discussed several key principles that build teams. Good communication will keep the team focused. Make sure team members understand the big picture and keep communicating along the way: celebrate successes, analyze failures, give your teammate a pat as you ski the trail. Appreciation for diversity will enhance your team and give it a much broader base of skills to draw upon. Empowering team members builds individual confidence and spills over to the rest of the team: give team members permission to take on new projects without micromanaging. Finally, recognizing your team members' talents help create a whole larger than the sum of the parts: some parts may be bigger than others, but all are equally important.

 

For more information about the North Carolina Institute for Public Health, go to http://www.sph.unc.edu/nciph.