Leadership: The essential ingredient!

Below is the most recent table showing unit-based team performance across Kaiser Permanente. Our National Agreement goal was to have 658 high-achieving teams by the end of 2011. With 1,097 teams rated at level 4 or 5 in early January, we have almost doubled our goal for the year – and more than tripled the number of high performing teams in place in January 2011.

For reference, please go to the National Agreement and take a look at the Path to Performance guidelines. The activity attributes and achievements that define team level performance are set forth in that chart.

This is all great news.

 As we spend time in the regions and medical centers, we learn things that further inform the data shown here.

• We know that some of the reporting through UBT Tracker that determines team development is not always completely accurate or reflective of all team members’ or sponsors’ views. We don’t believe this is an insurmountable concern; we do encourage team leads to reach true consensus before reporting results. We certainly do not want to inflate our progress artificially.
• We know that there is wide variation of team development across the program
• We know that this process of team development should take time to be done right. We expect progress and we are making a great deal relatively quickly. But the work we are doing to develop true collaborative learning environments is a transformational process, and we should be rigorous about how we measure progress and evaluate outcomes. If we were moving too fast, that could be a problem, too!

I believe that the transformation of the workplace to flatten out hierarchies and develop a true learning environment is fundamentally based on leadership at the medical center level, with support from all levels above. That leadership must be committed to:

• Giving teams the opportunity to select problems to solve that are directly related to the strategic plan of the medical center and the organization
• Providing data for teams to understand baselines and how tests of change will impact the data and advance the team’s project. There must be time allotted for analysis, recording, reflection, learning and moving ahead.
• Encouraging teams to learn from what they have accomplished. Ultimately, higher performance comes from the relational environment that is created. That environment can be developed best when team members learn by doing!

It takes leadership to have the vision to break from the past and forge into the unknown territory of innovation and experimentation. But this is what we have all agreed to, and this direction is well supported in organizational effectiveness literature and practice. We know that all of the experience and knowledge needed to solve problems and innovate are embedded in the day-to-day experiences of the frontline.

So, as we follow the mandates of the Path to Performance, we should keep in mind that leadership will always remain the essential ingredient to make it all work. It is very difficult to break from the comfort of doing things the same way as we always have. But we know that the problem-solving dynamic among teams is what unleashes the change needed.

It is simple and elegant to think about change this way: knowledge exists in all of us, and it must be unleashed to grow!