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PMTimes_July18_2023

Manage Adversity with Resilience

Written by George Pitagorsky on . Posted in Articles.

The way we handle adversity, particularly our resilience, impacts performance. Adversity is anything that gets in the way of achieving goals and objectives. It takes many forms, including self-doubt, emotional reactivity, and disruptions like loss, error, stress, or unexpected change. Some adversity is to be expected.

 

Our self-awareness and mindset are the keys to successfully handling adversity. Train the mind so you DON’T FREAK OUT. React in panic, anger, or fear and you will not be able to respond effectively. Calm down, manage emotions and mental habits, in the face of adversity and you will be able to recover and respond.

There are many techniques for calming down, but that is a topic for another time. You can visit www.self-awareliving.com for some ideas.

 

Here, in this article, the focus is on how we perceive adverse events. We can view them as obstacles or opportunities. We can believe that we are helpless or that we can influence our situation.

 

Resilience

Resilience relies on accepting adversity, perceiving it as an opportunity to recover, and knowing you can act even though you may not be in complete control.

Resilience is the ability to roll with the punches and recover from adversity, to return to a stable state after a disruption. When your project hits a wall, resilience allows you to carry on as best you can.

 

For example, after a poor performance review, resilience enables an individual, team, or organization to grow from the feedback rather than becoming depressed by it or resistant to it. A resilient project manager will bounce back and learn from the experience of a failed project. An organization that promotes resilience does not blacklist a manager who has failed, but instead provides support.

 

A resilient person tends to take an active approach toward solving problems, perceives their experiences as constructive opportunities, engages others for assistance and support, and has a positive and practical vision of life.

A resilient team or organization is made up of resilient individuals who support one another. It recovers and moves on when faced with adversity

 

Adversity Quotient®

Adversity Quotient® (AQ) is a measure of resilience.

“Adversity Quotient® – is a measure of a person’s capacity to deal with the challenges that he or she experiences on a daily basis” (Paul Stoltz, Adversity Quotient®: Turning Obstacles into Opportunities, 1997).”

 

Paul Stoltz identified four C. O. R. E. dimensions for measuring AQ – Control, Ownership, Reach, and Endurance.

 

Control is the degree to which there is a sense of the ability to predict and influence adversity. The perception of control, the ability to influence outcomes, results in an incentive to act. The opposite leads to apathy. The person who feels that they have no control is likely to think “There is nothing I can do, so I won’t do anything.” Of course, the practical reality is that we do not have total control. But we can influence the future. Knowing that, if we work at it, we can at least control the way we think and act.

 

Ownership refers to the sense of accountability for outcomes. With ownership comes the drive to avoid or work through adversity.

 

Reach looks at the scope of adversity. If adversity is viewed as having a very broad impact on one’s life, the individual will likely feel helpless and pessimistic. They will feel as if they have little control, and according to Stoltz, will make poor decisions and isolate themselves. Containing adversity, seeing its impact as having a defined scope, benefits individuals and groups by increasing a sense of control and promoting ownership.

 

Endurance is linked to the perceived duration of an adverse event. If the adversity is seen as temporary one will be more likely to push on than if it is viewed as never ending. For example, a project manager who perceives that their innate ability (a permanent condition) is the cause of a failure is less likely to persevere than one who views the cause as a temporary condition, like an error or insufficient effort, which can be corrected.

 

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Developing a Resilience Mindset

Resilience can be cultivated. The C.O.R. E. dimensions point to a mindset change. Mindset drives feelings and feelings drive behavior, and performance.

When we have a mindset that believes that we can influence the conditions we face and that we are accountable for the outcome, we shift from helplessness to power. With a mindset that is intent on learning from the agitation that comes with adversity there is acceptance rather than pushing away or hiding from unpleasant feelings.

 

In one situation a project manager faced with the loss of a key, highly skilled project team member who held significant institutional knowledge was able to move on and recover. Recognizing but not being driven by her anxiety, she mentally stepped back and worked out a transition plan including a “download” of information and adjustments to the schedule. The project would not only succeed but would be in a better position because it no longer relied on a single key player.

We are most able to manage adversity when we step back, own the situation, assess it, define its reach and duration, and understand that the change or problem is not the end of the world as we know it.

 

How do You Change Your Mindset

It is easy to say, “Change your mindset and become resilient.” However, doing it requires intention, self-awareness, and intentional patient effort.

 

To break the habits that get in the way of resilience:

  • Understand that your mindset is the result of years of conditioning and mental habits.
  • Know that you can change the way you think by patiently
    • paying attention to your thoughts and feelings,
    • questioning your beliefs and biases, and
    • persistently applying the effort needed to change.

 

References

The relationship between adversity quotient® and job – PEAK Learning
The power of Adversity Quotient to one’s productivity
Organizational Resilience and Adversity Quotient
PMTimes_July4_2023

Make Accountability a Cultural Norm: Stop Blaming

Written by George Pitagorsky on . Posted in Articles.

Just about everyone says they believe in accountability; many try to avoid it.

 

In previous articles[1] I highlighted the nature of accountability and its benefits. I’m returning to the theme because it remains a controversial topic that is linked to performance improvement and the cultural and psychological biases that get in the way.

 

Accountability is “The obligation for an individual or organization to account for its activities, accept responsibility for them, and to disclose the results in a transparent manner.”[2] It is the obligation to report and explain about what one does and does not do and to take responsibility for the consequences – “being called to account for one’s actions.”2[3]

 

Accountability is simply about acknowledging both your own behavior, and the behavior of others.

 

Though it is not so simple. It is linked to perfectionism and the avoidance of criticism. It is complicated by the reality that there are often several decision makers responsible for an outcome and that results are caused by changing and uncertain conditions, outside of anyone’s control. Accountability is too often linked to blame.

A goal is to make accountability a norm embedded in a culture committed to optimal performance. When we do that, we must avoid finger pointing and replace it with cause analysis and action to remediate current issues and avoid future instances of unskillful behavior.

 

A Scenario

Let’s look at a scenario from a construction project that as an example of accountability in action:

A contractor responsible for laying down a concrete sidewalk pours concrete on one segment that is widely off from the color expected by the sponsor. The contractor had provided a selection of samples and a light gray one was chosen. The concrete poured was yellow! When the project manager saw it he was not happy. He was even less happy when the sponsor saw it and irately demanded an explanation. The PM was accountable to the sponsor but was not responsible for the error. The contractor, accountable to the PM, took responsibility even though the underlying cause of the problem was with the vendor who supplied the cement. That vendor was accountable to the contractor.

 

The contractor didn’t try to wriggle out of the need to replace the concrete (an expensive undertaking). He took responsibility.

There was no anger, no finger pointing. Just recognition of the problem, who was responsible for remediating it, a course of remedial action, and agreement about the outcome.

 

Had the contractor behaved differently, the issues would probably end up in a legal battle and over time a poor image for the contractor. By looking at the causes of the error, the contractor and the sponsoring organization could find ways of avoiding similar problems in the future.

 

Blame is Why We Are Not Candid and Honest

Accountability is simple, but there is a big if. Candid and honest reporting is not always evident. And the reason for that is rooted in the need to blame someone and the tendency of people to avoid blame.

To blame is to “assign responsibility for a fault or wrong.” Synonyms for blame are to criticize, condemn, find fault with fault, denounce, attack, guilt, etc.

 

A recent Harvard Business Review article stated that blame is the most destructive behavior in relationships. It encompasses criticism, contempt, defensiveness, and stonewalling.

The author goes on to explain that “humans are all naturally wired to blame other people or circumstances when things go wrong.” … “Our brains interpret blame the same way they interpret a physical attack.” And “Blame also kills healthy, accountable behaviors. Nobody wants to be accountable for problems if they think they’ll be punished for doing so. Furthermore, learning and problem solving go out the window in workplaces that tolerate blame. Instead of learning from mistakes, blamed employees tend to hide their mistakes.” [3]

 

To make accountability part of the culture it is necessary to change the mindset from blaming to learning from mistakes.

To do that it is necessary to combine training, planning, and practical lessons learned sessions following projects and when errors occur during projects.

 

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Training

There is a need for training that directly addresses accountability and awareness of the tendency to blame and avoid being blamed and how that tendency gets in the way of sustainable optimal performance.

That kind of training is uncommon, particularly in the places that need it most. It is often left out of project management and other business courses. There is a tendency to avoid psychological and mindset issues.

 

Effective psychological and mindset training requires skillful facilitation and is often best done by embedding it into “practical” management education and reinforcing it regularly in lessons learned activities. Many very good technical management skills trainers are not qualified to teach the emotional and social awareness skills that are needed to address the issue of blaming and accountability. These skills require experiential learning that goes beyond intellectual/conceptual thinking, and sensitivity to those who may be averse to looking at their own thinking and emotional awareness.

 

Planning

On a more concrete level, accountability and responsibility begin with planning. Communications planning sets the stage for accountability by establishing a reporting process.

Human resource planning establishes responsibility for reporting and performance. Task planning, scope definition, scheduling, risk management and cost estimating set expectations and define roles and responsibilities.

With a comprehensive plan a baseline and with the expectation of candid and honest reporting, accountability becomes a reality, unless it is blocked by cultural and emotional resistance.

 

Lessons Learned: What, Not Who, is the Cause

Lessons from past performance are learned during debriefs held whenever a project ends and at key points during project life. Looking back at performance is a means for individuals and organizations to learn from experience. The focus is to find causes, not point fingers.

Quality management gurus agree that the causes of errors and quality shortfalls are caused by flaws in the system rather than by individual performance alone. Even though an individuals’ behavior is the direct cause of a problem, systemic issues like poor training, inadequate support, unreasonable expectations, and flawed processes are often the underlying cause

 

[3] https://hbr.org/2022/02/blame-culture-is-toxic-heres-how-to-stop-it#:~:text=Humans%20are%20wired%20to%20blame.&text=These%20propensities%20are%20partially%20psychological,or%20environmental)%20influencing%20their%20behavior.

 

Assess Your Process

The way forward to a culture that values and uses accountability to promote improvement begins with assessment, so that individuals, teams, and the organization as a whole can acknowledge the degree to which they avoid or promote accountability and eliminate blaming.

 

[1] https://www.projecttimes.com/articles/accountability-and-performance/ and https://www.projecttimes.com/articles/accountability-a-contributor-to-optimal-performance/
[2] www.businessdictionary.com/definition/accountability.htm
[3] Sinclair, Amanda (1995). “The Chameleon of Accountability: Forms and Discourses”. Accounting, Organizations and Society20 (2/3): 219–237. doi:10.1016/0361-3682(93)E0003-Y

 

PMTimes_Jun28_2023

BREATHE Your Way Through Conflict

Written by Anthony Gray on . Posted in Articles.

Conflict in and of itself is not bad. It can drive innovative solutions as organizations tackle tough, challenging, and complex problems. While some conflict is healthy, too much is not. Conflict, if not managed correctly, can quickly spiral from something healthy, to something toxic resulting in destroyed relationships. How we manage conflict matters, in leadership, business, or at home.[1]

Conflict management is a skill everyone needs in their kit bag. When dealing with emotionally charged topics, one should have the courage to communicate their way through conflict. Confrontational situations may require one to take a moment to breathe.[2]  While physical breathing techniques to remain calm during conflict are helpful, BREATHE is a conflict management framework one can use to navigate their way to achieve productive results. BREATHE stands for:

  • Be aware of the situation; and with whom one is in conflict.
  • Reflect, then respond. Do not react.
  • Exercise emotional intelligence and empathy.
  • Actively listen, ask clarifying questions, and acknowledge.
  • T Think of others first.
  • Humble yourself.
  • Execute and evaluate the results.

This BREATHE framework can serve as a cyclical, sequential and nonlinear tool, with interconnecting components. One can initiate the framework at any point and execute multiple elements simultaneously. For example, empathy may open the door to active listening and acknowledgement, which may activate one’s humility, allowing one to think about others first and engage in teamwork. Moreover, while each component can serve as its own independent conflict management device, the comprehensive employment of all elements working together may prove most effective in producing optimal outcomes.

Be Aware.

Be situationally aware. Understand the factors contributing to the conflict. A tool to help one become situationally aware is to conduct an environmental assessment. When conducting an environmental assessment, consider the following external and internal factors. Externally, analyze the political and economic situation. Determine whether one is dealing with social or cultural issues, or labor market challenges. Evaluate technological capabilities.[3]  Internally, various friction points could contribute to conflict, such as production problems; lack of assets and resources; and ineffective policies.[4]  At the individual relational level, environmental contributors could include work life stressors, health concerns, personal finances, and or relationship issues. Finally, something to keep in mind. One or all contributing factors could exist simultaneously, affecting one or all parties.

The external and internal environment is complex and complicated enough without introducing the volatility of the human dynamic. However, one must understand with whom one is in conflict. Maintaining positive relationships is critical to achieving desired outcomes because it involves trust. Positive relationships build trust, contribute to esprit de corps within an organization, and enable one to achieve their objectives with the help of willing participants. The goal of the BREATHE framework is to help the implementor move the needle from a negative relationship to a positive one, from conflict to collaboration.[5]

To help one maintain positive relationships, a stakeholder analysis may be helpful.[6]  The intent of conducting a stakeholder analysis is to decide with whom you should engage, how you need to engage them, and when. You are trying to determine: 1) Is the conflict worth your time and effort? 2) Is the stakeholder of such influence you should care? Given the gravity of the situational context, and the relational importance of the stakeholders with whom one is in conflict, how we respond is an essential element of ensuring a positive outcome. This leads to the next stage of the BREATHE framework, reflect, then respond.

 

Reflect, then respond. Do not react.

Instead of impulsive reactions typical of conflict, take time to reflect, then respond. The difference between reacting versus responding, is analogous to instinct and thought. Instincts are primal behaviors below the conscious level responding to environmental stimuli without reason. Thought on the other hand, is a developed plan based on the intellectual product, views, and principles of a group or individual.[7]

Another difference between reaction and response is the potential impact. Depending on the severity, reacting without thinking can lead to potentially negative unintended consequences. Conversely, reflecting, and then responding can lead to planned outcomes. The BREATHE framework is a methodology requiring reflection through each phase, resulting in a deliberate and intentional response. Reflecting, then responding, is the gateway to the next phase of the BREATHE framework, exercising emotional intelligence and empathy.

 

 

Exercise emotional intelligence and empathy.

            Responding instead of reacting is an exercise of controlling one’s emotions. Therefore, while in the moment, we should understand what we are feeling, why we are feeling that way, and what can we do about it. Meaning, we should exercise emotional intelligence (EI). EI “is the ability to identify, assess, and manage the personal emotions of oneself and other people….”.[8]  The exercise of identifying, assessing, and managing one’s feelings can serve as a calming technique in and of itself. Additionally, deliberately mapping out the BREATHE framework may help influence one’s emotions to a less aggressive state. The last step of EI is to repeat the process but from the perspective of the person or group with whom you are in conflict. This leads to exercising empathy.

Empathy is “the ability to understand and share other people’s feelings”, [9] enabling one to “see others as they see themselves”.[10] As you think through your assumptions regarding the other party, try to think through how the other party may feel if your assumptions about them were true. Try to place yourself in the other party’s shoes. Ask and answer, “How would I feel if I were (insert other party)?” After completing this exercise, the next step is to turn your assumptions into facts through fact-finding techniques. The most effective fact-finding technique is face-to-face communication.[11]  This leads to the next phase of the BREATHE framework, actively listen, ask clarifying questions, and acknowledge the other party or parties.

 

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Actively listen, ask clarifying questions, and acknowledge.

            Communication is a widespread problem in every organization, as well as in relationships. Therefore, effective communication skills are essential.  An essential element of effective communication is active listening. Active listening is the ability to apply one’s undivided attention to the speaker, taking in not only the words spoken, but the tone and mannerisms as well. It is the ability to hear and see past emotions to understand what the speaker is trying to communicate. One who is actively listening, hears the message, understands it, signals their understanding with appropriate body language and gestures, reflects on it, then communicates their understanding by repeating the message to the sender, followed by an appropriate interpretation.[12]

When engaging in conflict management, ask clarifying questions. Asking clarifying questions deepens one’s connection with the other party. It helps each party further understand and empathize with each other’s perspective. Asking why questions, such as, “Why did you”, may spark defensiveness. Instead, use the “What? So what? Which means? Therefore?” Technique, which is useful in turning data into actionable information.

The “what” statement acknowledges the transmission of data between sender and receiver. For example, “What I hear you saying is….” The “so what” communicates the importance of the data. It may sound like, “So this is important to me because….” The “which means” statement translates data (what and so what) into useful information, which may potentially affect the individual receiving it. Finally, the “therefore” statement translates the information into potential decisions one may take in response to the information received.

The “What? So What? Which Means? Therefore?” technique increases communication between the sender and receiver by confirming the receiver received and understood the sender’s message and knows what to do with the information. When communicating through conflict, each party wants the opportunity to voice their opinion and be heard. This technique ensures that opportunity by acknowledging the communique.

For clarity, acknowledgement is different from agreement. One does not have to agree with the other party to acknowledge what they are saying. Acknowledgement is a way to extend dignity and respect to the other party. It signals one values and understands what the other is saying. With understanding, the conflicting parties can work through the issues together to achieve amicable resolution. With shared understanding, conflicting parties can attack the problems instead of each other. This leads to the next phase of the BREATHE framework, teamwork and think of others first.

 

Teamwork. Think others first.

Conflicting parties should work through issues together as a team. Their goal should be to reach amicable solutions based on mutual interests. Suggestions for setting a positive atmosphere of trust and collaboration may start with eliminating counterproductive behaviors such as stigma and biases. These behaviors tend to isolate and divide rather than unify. To mitigate these behaviors, one should embrace the differences between parties, be culturally competent, and establish an atmosphere of psychological safety to build trust and teamwork.[13]

While cultural diversity typically applies to different ethnic groups, one can apply cultural diversity in other contexts as well.[14]  For example, within professions, there are distinct institutional cultures. Within these cultures, there are dimensions distinguishing one culture from another, driven by the output each profession produces. These differences drive how each profession deals with such topics such as power, risk, autonomy, teamwork, and operational versus strategic orientation.[15]  Further, each profession has its own distinctive language, to include, subtext associated with subspecialties or special skill identifiers. They each have a preferred way of communicating, whether a common core language or terminology, direct or indirect communication methods, or adjusting tone and volume.[16]

To effectively communicate with diverse groups, one should display a measure of cultural competence. One demonstrates cultural competence by communicating and behaving in ways that demonstrates knowledge and understanding of diverse groups. By going out of one’s way to demonstrate cultural competence, one begins to set the atmosphere for psychological safety, which enhances teamwork while reducing conflict.[17]

Psychological safety is a teamwork enabler. It sets conditions for collaboration. Psychological safety is when one feels comfortable in their environment because they believe the group in which they belong will not discard or embarrass them, regardless of circumstance. In this environment, people are free to share their relevant opinions. Once there is an atmosphere of safety, collaborative learning begins to take place.[18]

As part of establishing and maintaining teamwork, teammates should think of others first.[19] To help one think of others first, consider three key factors. First, the importance of being a steward by placing the needs of stakeholders first to build and maintain trust.[20] Second, exercise an emotive approach by focusing on the individual, trying to satisfy their individual needs while accomplishing one’s goals and objectives.[21] Third, as able, meeting reasonable accommodations.[22] While reasonable accommodation is traditionally a term used to accommodate those with physical or mental limitations, one can use it to negotiate one’s way through conflict. The objective of any negotiation is to achieve mutually beneficial outcomes. Thinking of others first while navigating and negotiating one’s way through conflict can assist in achieving this goal. Effectively managing conflict through teamwork, requires a measure of humility, which is the next phase of the BREATHE framework.

Humble yourself.

Thinking through problems as a team, and thinking of others first, requires humility. It takes humility to admit, “Hey, we are struggling in this area, and we need help solving this problem.” It takes humility to remain silent and listen while fellow teammates share their opinions and ideas during open dialogue. It takes humility to keep an open mind while listening to creative solutions aimed at solving complex problems. One must remain humble enough to admit when someone else has a better idea and be willing to support the idea with proper effort.

Leaders must remain humble enough to allow their fellow teammates to speak truth to power when trying to attack and solve organizational wide issues. These leaders display humility by underwriting risks associated with recommended actions, while leveraging adequate staffing, equipment, and resources necessary to ensure the plan’s success. This leads us to the final step of the BREATHE framework, execute and evaluate.

 

Execute and evaluate.

            After working through the problem as a team, it is time to execute the plan and evaluate the results.[23]  Here we are talking about measures of performance and measures of effectiveness, with measure of effectiveness being the most important, as it deals with results and desired outcomes. Measures of effectiveness answers the question of did we achieve the desired effect? Conversely, measure of performance has to do with efficiency. It answers the question of did we do what we said we would, and can we do it better? Bottom line, we are talking about quality, the “perceived degree of excellence”.[24]

We measure quality in terms of outcomes and improvement using evidence-based methodologies. Quality and its associated outcomes start with evidence-based management, which is a method of incorporating performance measurements, best practices, as well as systems and processes to achieve desirable outcomes.[25] Outcomes are the results of something.[26] Meaning, in any endeavor, results matter. However, how we achieve those results matter as well. The right way to achieve desired outcomes is through quality planning and use of evidence-based approaches and continuous quality improvement.[27]

Conclusion.

            Conflict in relationships is unavoidable. It is not a matter of if, but when. Therefore, how you deal with conflict matters, as it will impact the results achieved. You can avoid it, or deal with it counterproductively, inevitably degrading trust and perpetuating conflict. Or you can manage it using more productive methods. The BREATHE framework offers “a way” of navigating the potential messiness associated with complicated and complex relationships.  The framework encourages awareness of one’s environment, and each other. It intentionally attempts to get its users to slow down and think through their next steps. It encourages self-awareness and shared understanding. It advocates for teamwork through humility.  Finally, it is result oriented. While the BREATHE framework does not guarantee a relationship free of friction, it can provide a life raft when sailing its turbulent waters.

 

[1] A. Ripley, “How to Work with Someone Who Creates Unnecessary Conflict,” HBR, 26 March 2023, https://hbr.org/2021/08/how-to-work-with-someone-who-creates-unnecessary-conflict
[2] A. McDonald, “A Powerful Tool to Stay Grounded in Conflict,” The Ripple Effect, 26 March 2023, https://therippleeffecteducation.ca/mindful-breathing-tool/
[3] R. Dunn, “Haimann’s Healthcare Management”, 8th ed. (Health Administration Press, 2007), 123.
[4] S. Walston, “Strategic Healthcare Management: Planning and Execution, 2nd ed,”(Health Administration Press, 2013), 181-212.
[5] S. Covey, “The Speed of Trust”, (Free Press, 2018), 13-26
[6] P. Spath, “Introduction to Healthcare Quality Management,” 3rd ed. (Health Administration Press, 2009), 143-144
[7] Webster online dictionary instinct vs. thought https://www.merriam-webster.com/
[8] “A Guide to the Project Management Body of Knowledge PMBOK,” 6th ed. (Project Management Institute, 2017), 705
[9] M. Moudatsou, A. Stavropoulou, A. Philalithis, S. Koukouli, “The Role of Empathy in Health and Social Care Professionals,” 3.1, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151200/
[10] A. Kovner and D. Neuhauser, “Health Services Management,” 8th ed., 2004, 7;
[11] Dunn, “Haimann’s”, 8th ed., 72; “PMBOK”, 360-393
[12] R. Abrahams and B. Groysberg, “How to Become a Better Listener,” HBR, December 21, 2021, https://hbr.org/2021/12/how-to-become-a-better-listener
[13] E. Forrestal and L. Cellucci, “Ethics and Professionalism for Healthcare Managers,” 1st ed., Health Administration Press, 2016, 191-192, 267-268; K. White and J. Griffith, “The Well-Managed Healthcare Organization,” 9th ed. (Health Administration Press, 2019), 502
[14] Dunn, “Haimann’s” 10th ed.
[15] White and Griffith, “The Well-Managed Healthcare Organization,”, 337-365
[16] C. Sampson and B. Fried, “Human Resources in Healthcare,” 5th ed. (Health Administration Press, 2021), 125-150
[17] White and Griffith, “The Well-Managed Healthcare Organization,” 348
[18] C. Sampson and B. Fried, “Human Resources in Healthcare,” 5th ed. (Health Administration Press, 2021), 513
[19] M. Miller, “The Heart of Leadership,” 1st ed., Berrett-Koehler Publishers, 2013;
[20] Forrestal and Cellucci, “Ethics,” 311
[21] Dunn, “Haimann’s”, 8th ed., 438
[22] Sampson and Fried, “Human Resources,” 5th ed., 38
[23] D. Sinha, “ADDIE Model: A Comprehensive Guide to the 5- step Instructional Design Model,” CHRMP, March 26, 2023, https://www.chrmp.com/addie-model-guide/
[24] Spath, “Quality,” 3
[25] White and Griffith, “The Well-Managed Healthcare Organization,” 9th ed., 509
[26] E. Briggs, “Healthcare Governance: A Guide for Effective Boards,” 2nd ed. (Health Administration Press, 2011); M.A. Krousel-Wood, “Practical Considerations in the Measurement of Outcomes in Healthcare,” NCBI, October 1999, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3145439/
[27] Spath, “Quality”, 12-14, 54, 1-7
PMTimes_Jun27_2023

Evidence Based Decision Making: A Pillar of Optimal Performance

Written by George Pitagorsky on . Posted in Articles.

Decision making is at the heart of leadership, management, and performance. I write about mindful conflict and expectations management, and the decision making that underlies both. Last month the article on the use of the Evaporating Cloud technique addressed the power of collaborating to face conflict to identify goals, wants, and needs.

 

This article focuses on making decisions based on evidence and rational thinking as opposed to unfounded opinions and emotions. While feelings are important, they are often without a sound basis in reality. Acting upon them without investigating evidence and alternatives is foolish. Not considering the feelings is equally unwise.

 

“When somebody on staff asks what we should do to

address a problem, the first questions I now ask are

‘What does the research say? What is the evidence base?

What information can we gather to determine if it will

fit in different contexts?’ It’s become a way of life.”

– Jim Hmurovich, BA, MS Ed, President & CEO, Prevent Child Abuse America

 

Decisions

Here is a simple example to bring out the practical nature evidence based decision making:

In an apartment building an occupant, Ms. H, objected to the practice of leaving a building provided package cart in the elevator for the next elevator rider to return to the lobby. 

She felt that the “rude behavior of some made it impossible for others to use our very limited elevators.”

Taking a rational look at the issue, it seems that if the person who borrowed the cart took it down in the elevator there would be one less spot on the elevator for other riders.  Further investigation may uncover that Ms. H. doesn’t like to or isn’t able to get on an elevator with a cart. If that is the case, adding the cart’s borrower to the trip will do her no good.

 

Ms. H failed to consider the facts. Her emotions and biases drove her demand. She was reactive. Imagine if she was good at convincing others without providing any foundation in fact and logic, and the decision makers just threw up their hands and created a rule that “borrowers or designated alternatives must return the carts themselves.”

This is a simple example. But how often are projects hampered by reactive behavior? Instead step back to consider evidence and apply analytical thinking along with emotional and social intelligence.

 

The decision gets more serious if it was about whether to purchase a product or create one. Ms. H, now in her capacity as senior executive and project sponsor, insists that buying a product is the way to go. She was convinced that development was too risky and expensive. She had been burned when in an earlier project a decision to build vs. buy led to a project with costly overruns. She was sold by product vendors and external consultants on the idea that the products were easily customized to the unique needs of Ms. H’s organization. And that the organization would be better off changing procedures to accommodate the products.

 

An analytical review of research, the experiences of others, and a clear sense of the nature of the customization required would uncover the risks and expense of adapting to or customizing a product rather than creating one’s own to fit special needs.

The decision could go either way. The point is to combine analysis and intuition to best decisions. “Good” decisions are informed decisions that combine information (facts, feelings, interpretations and opinions, etc.) from multiple perspectives. Good decisions are more likely to successfully solve the problem at hand than decisions made based on limited information.

 

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Evidence Based Decision Making

Evidence Based Decision-Making (EBDM) leads to informed decisions. “Evidence Based Decision-Making is a process for making decisions about a program, practice, or policy that is grounded in the best available research evidence and informed by experiential evidence from the field and relevant contextual evidence.”[1] Not only does it result in optimal decisions, but EBDM also cultivates collaborative action and cuts through unnecessary conflict.

 

Evidence Based Decision Making (EBDM) is described as a 4-part process with 10 steps and 47 sub-steps. The model is shown in Figure 1:[2]

Figure 1: The EDBM

 

Don’t worry, we won’t go into the 10 steps and 47 sub-steps. Though, having a detailed model is useful for training and to promote collective understanding of required tasks, roles, and skills. See the referenced source for the full model.

But let’s be realistic, getting decision makers and stakeholders like Ms. H to buy into a super-analytical process with 47 steps is virtually impossible. Well maybe not impossible, but requiring a mindset transformation, and that takes time.

 

The successful decision maker understands the process and adapts it to the current situation. She avoids analysis paralysis and understands that collaboration among the decision makers is as important as the weighting and scoring of facts and feelings. Based on inquiry the rest of the process is customized to fit the personalities, cultural influences, need for speed, availability of evidence and the capacity of the decision makers.

 

Evidence

EBDM means making decisions using four sources[3]

  • the best available scientific evidence – research studies, experiments, journal articles, etc.
  • organizational evidence – business data, including financial reports and performance, studies, project journals and history, organizational culture, etc.
  • experiential evidence – the collective experience of the decision-makers and outside experts
  • stakeholder evidence – stakeholder expectations, feelings, beliefs, biases, wants, needs, and values.

On the surface all four types of evidence seem objective, where “Objective evidence is evidence that is not subject to bias and is quantifiable and able to be independently confirmed and verified by using analytical or other tools. Simply put, objective evidence is based on facts and is the kind of evidence that can be independently examined, evaluated, and verified.”[4]

 

But go a little deeper and you find that there can be subjectivity in each. For example, there are often many ways to interpret scientific data. The same data can be used to justify any number of opinions, which when written up in a journal article can give the impression of being objective.

Subjective evidence is based on individual interpretations and opinions. It cannot be independently verified. When subjective evidence is valued and evaluated in concert with objective evidence and the multiple subjective experiences, it is often what leads to the most effective solutions. Evidence based decision making makes subjective evidence a valued part of the process.

 

Applying EBDM

EBDM is a process to uncover convincing evidence using objective analysis. Like all approaches to decision making, it is a quest for greater certainty about the outcome of a decision. Use it to go beyond both decision-by-the-numbers and decision-by-feelings. Objectivity and subjectivity are facts of life in any complex decision making, do not ignore either. To be objective a decision maker must acknowledge the presence of subjectivity and incorporate it into the decision making.

If you are fortunate enough to be making decisions optimally, resolving conflicts, setting expectations, experiencing great outcomes, just keep doing what you are doing. If there is room for improvement, bring EBDM into your work, whether it is you alone or the team. Raise it as a topic as you work to continuously improve performance guided by informed decisions.

 

[1] https://vetoviolence.cdc.gov/apps/evidence/docs/ebdm_82412.pdf
[2] https://archpublichealth.biomedcentral.com/articles/10.1186/s13690-022-00843-0
[3]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6308777/#:~:text=The%20four%20sources%20of%20evidence,expectations%20(1%E2%80%933)
[4] https://www.ocdisabilityattorneys.com/disability-benefits-for-objective-versus-subjective-evidence#:~:text=%E2%80%9CSubjective%E2%80%9D%20evidence%2C%20on%20the,accepted%20on%20faith%2C%20or%20rejected
PMTimes_Jun21_2023

Shake up Your Stand-up

Written by Carmen Kesho on . Posted in Articles.

Standups are a cornerstone of Agile project management. As a Project Manager, conducting stand-ups provides a daily communication touch point with your team that allows you to build rapport while gaining a deeper understanding of each individual team member. However, after you have worked with your team for a while and established a good sprint cadence and team dynamic, the standup may lose its flare and, in some cases, its necessity.

 

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If your stand-ups are getting stale, try a few of these tricks to freshen your stand-ups:

  1. Have a Standup or Two Via Slack. Post-Covid, we are inundated with virtual meetings. While the daily stand-up is meant to align all team members and get the day started with a common goal in mind, that 15 minutes may slow your team down if they are in the zone and want to complete a task. Try having the team write their updates at the start of their day and share them in a slack group chat. Chime in to help remove blockers as needed. Pro tip: Send out a template with the questions and ask for the responses by a certain time daily.
  2. Reduce Frequency. If team members are working on higher pointed tasks with multiple components, there may not be a daily update. Depending on the end of your sprint, try incorporating a no standup Friday.
  3. Celebrate Wins. While the “What did I do yesterday? What will I do today? What blockers are impacting me?” format is riveting, it may get a bit monotonous. Incorporate some time to celebrate wins during the standup. Pro tip: Name someone King/Queen of developers for a day when they complete a complex feature.
  4. Incorporate Team Feedback. A team member may want to pass along some nuggets of wisdom they acquired from working on a feature, another team member might want to share a helpful article or tutorial. Again, to keep to the true nature of the standup, it needs to be concise and contribute to the completion of tasks and the betterment of the team’s performance. Sharing knowledge helps attain both of those goals.
  5. Stand-up and Move. If you are working on-site and can meet with your team in person, have a walking stand-up. Walk with the team to get coffee or around the courtyard at your office space. If walking won’t work, get a stress ball, and pass it around as the team is talking through updates. Movement will help get everyone’s energy flowing and help the momentum for the day.
  6. Finish with a Bang. You could equate the standup for a project team to a huddle before a basketball or football game. It sets the tone for what you are about to accomplish for the day. End the standup with a team chant, special handshake, or a theme song. “Eye of the Tiger” comes to mind. Try whatever gets the people going and sets the day on a positive and motivational tone.

Every person is different, and teams are made of people, so tailor these tips to your team. If you don’t see something that will work for your team, consider this a challenge to motivate you to develop more ideas of how you can shake up your stand-up.