If you have come across human behavioral literature across different industries, there are many recurring themes in places where teams are highly engaged. These teams are doing something right regarding talent retention, innovation, and a sense of ownership regarding organizational goals.
What’s intriguing, though, is that the very leadership quality proven to spark innovation and engagement tends to strike fear in most leaders. They’re afraid that if they were to implement this particular approach, their workforce would become chaotic, disorganized, and misaligned from the system goals. These fears have become so common that many leaders resort to what they consider the most effective way of managing their teams: telling them exactly what to do to achieve a goal.
Some call this approach “top-down” or “command and control.” Unfortunately, it often extinguishes the things that make people feel engaged and valued – things like having a voice, feeling like they matter, knowing they contribute, and seeing the impact of their work.
Unfortunately, command and control leadership is still a predominant form of leadership in healthcare. Few openly admit this and often cloak their leadership approaches with phrases like, ‘We’re here to support you’ or ‘We value your ideas.’ Despite attempts to move away from the command and control model, it remains our default setting. The result? Employee and physician engagement continues to trend downward.
The disengagement challenge has become so prevalent in our conversations with leaders we created an entire workshop to help counter our command and control tendencies. Leaders representing ten health systems attended, and all were interested in leader enablement as an approach to better engage care teams. We outlined the engagement impact of top-down approaches and learned how to become multiplier leaders who amplify the contributions and ownership of our people.
So, what is leader enablement? First, enablement represents a unique set of leader actions known to triple leader and team contributions, significantly improve engagement, boost innovation, enhance the capacity for change, and foster an ownership mentality. Leader enablement is the process and commitment of equipping frontline leaders with the skills, knowledge, voice, and authority to guide their teams through change effectively.
I can imagine what you might be thinking: ‘If we grant power to frontline leaders and give them the authority to create approaches and local solutions, our teams might go in all directions! We MUST ensure they align with our goals!’ But, here’s the thing—simply telling people what to do has never been effective. Mandating to teams rarely works. For instance, telling patients to quit smoking or lose weight rarely creates results. On the other hand, I have never witnessed a team undermining a plan they actively created. During the workshop, we discussed the conditions that foster enablement–ultimately promoting greater ownership, innovation, and active participation.
For leadership enablement to work, a few conditions must be met:
- Clear organizational intent. What do you want your teams to become? There should be a clear and specific guiding principle that teams can pursue and innovate around. Intent provides the context for local solutions and ideas to achieve a goal.
- Competency of local leaders. Leaders must be developed to engage their teams effectively. Leader skills of fostering idea generation, harvesting solutions, creating an environment where people feel safe to share, developing a growth mindset, and influencing those we lead require the broad development of local leaders to do those things.
- Harvesting, recognizing, and spreading local innovations. Senior leaders must have an eye for recognizing and celebrating the local achievements and progress towards organizational intent. Honor local solutions, give out awards, pass the recognition to the front line, and spread the solutions your teams will invariably create.
We also had the chance to share the story of David Marquette, a naval commander called to lead the USS Santa Fe Nuclear Attack Submarine. The previous captain unexpectedly quit while the USS Santa Fe was ranked dead last in safety. The culture at the Sante Fe resulted in three out of thirty-five sailors re-enlisting the year prior to Commander Marquette taking over.
Commander Marquette knew little about the USS Santa Fe as he was preparing to command an entirely different submarine, the USS Olympia. His leadership approach in taking command of the USS Sante Fe? He turned the traditional command and control leadership approach on its head and passed agency and power to the frontline teams–harvesting solutions to improve the vessel’s performance and, most importantly, team culture.
In a year’s time, the USS Santa Fe received the highest survey results in the history of the United States Navy, while all 35 sailors re-enlisted. Commander Marquette proved that enablement of others radically improves engagement, encourages ownership, and enhances performance.
In healthcare, we remain a paradox. Our pursuit of excellence often prompts us to lead in a way that stifles the discretionary effort needed to achieve excellence. Our default command and control approach disengages, micromanages, and makes clinical talent check out and leave. By fostering a culture of empowerment, where leadership enables, values, and trusts teams providing care to craft innovations and local solutions, we can unlock the full potential and engagement of healthcare teams.
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Stephen Beeson, MD is the CEO and founder of Practicing Excellence. An author of two national best-selling books, Dr. Beeson has become a national thought leader in building organizational approaches and cultures that support patient connection, team collaboration, and transformative leadership.
