As I talked with leaders about their results from the pulse survey conducted at UC Davis Health last fall, I noticed a pattern. When I spoke with leaders from the Patient Care Services (PCS) units, I consistently heard some form of “We’re encouraged to take care of ourselves first, our team second, so the patient gets the best care.” I was intrigued and had to know more! I had an inspiring hour-long conversation with Toby Marsh, R.N., M.S.A., M.S.N., F.A.C.H.E., N.E.A.-BC, Chief Patient Care Services Officer.
The Professional Practice Model
Toby directed me to the Professional Practice Model, the roadmap for how Patient Care Services (PCS) approaches their work. I want to highlight the “Professional Relationships and Teamwork” portion, which is applicable to and can be impactful in all work units.
No matter what knowledge base, skill set, or expertise we use in our jobs, we don’t work alone. All our work affects other employees at some level. PCS defines clinical competence as: “…the combination of both technical and relational competences.” Consider the impact if everyone acted from a belief that everything will work better when relationships are healthy. In a 2019 New England Journal of Medicine article, Dr. Lisa Rosenbaum stated, “Although much of the system is shaped by factors beyond our control, when it comes to how we work with one another, we are the system.” We have the option and the opportunity to make our teams, our departments, our committees, and our university better. How do we do that?
Google's research study: The Aristotle Project
Almost a decade ago, Google launched a large study to uncover the keys to successful teams, called the Aristotle Project. Over the next few years, they read the leading literature and observed hundreds of teams within the company. What they discovered as the main source of team success is an element of team culture called psychological safety. Amy Edmonson, Harvard Business School professor defined it as a culture within a group that is a ‘‘shared belief held by members of a team that the team is safe for interpersonal risk-taking.’’ In other words, ‘‘a sense of confidence that the team will not embarrass, reject or punish someone for speaking up.’’ ‘‘It describes a team climate characterized by interpersonal trust and mutual respect in which people are comfortable being themselves.’’
Patient Care Services (PCS) puts that into practice through creating a relationship-based culture. They have four practices that everyone can adopt and apply:
Attuning – The practice of being present in the moment and tuning in to an individual or situation.
Wondering – The practice of being genuinely interested in a person. It requires an open-hearted curiosity about what can be learned about this unique individual, while intentionally suspending assumptions and judgement.
Following – The practice of listening to and focusing on what an individual is teaching us about what matters most to them and allowing that information to guide our interactions. It requires consciously suspending our own agenda.
Holding – The practice of intentionally creating a safe haven to protect the safety and dignity of an individual.
Being present, being genuinely interested in each other to learn about and from each other, suspending our assumptions, judgement, and agendas to open ourselves to really hear others are what creates that psychological safety that we all need.
Toby puts this into practice every morning as he visits different unit huddles within the hospital. He always begins by asking an individual how they are, and how their family is doing right now. Only after he’s connected with a person as an individual will he ask about their patients.
What’s one practice you can start doing today to enhance your positive contribution to the relationships in your team?
New England Journal of Medicine 380;7 nejm.org February 14, 2019
Google study: NY Times article by Charles Duhig Feb. 28, 2016, Page 20 of the Sunday Magazine.