Content Submitted by Thrive Pet Healthcare, a Strategic Alliance Partner of dvm360®
Most of us have been there: the team needs to make a decision. The issue requiring the decision involves multiple key stakeholders, perhaps even more than 1 group in the hospital. No matter how much time and effort team members put in, they can’t come to a satisfactory decision.
Inevitably, everyone turns to the “boss” to make the final decision. However, once it has been made, few people like the decision. Guilt, whether stated or not, is very common.
So what is the problem?
Traditionally this situation has been analyzed as a problem of leadership, teamwork or both. The solution often employed is to reinforce the team building and communication skills of the leader to support the establishment of mutual trust in the team. This strategy misses the real problem, which lies in the decision-making process itself. Deadlock is inherent when a group attempts to arrive at a collective preference based on all individual preferences.
There are practical measures designed to break the impasse. These measures allow teams to break the cycle of the blame game and move to a blameless decision-making style.
Break the cycle and manage the impossible
Let’s see how to implement this using a real example of the trenches:
recognize the problem
Inpatient treatments are sometimes delayed, missed, or happen slightly differently than anticipated by the attending veterinarian. The team comments that this is a result of everyone being very busy and finding it difficult to understand things on the very old and somewhat outdated inpatient treatment sheets currently hanging on each cage. Everyone believes that a new system is needed.
Clearly articulate what result you are seeking and achieve alignment with the desired result
It is essential to keep the discussion about the desired result separate from the discussion about how to achieve it. In this example, the team is aligned that all treatments must be administered to each patient on time and accurately using a system that is efficient for the nursing staff.
Ask team members to provide the proposed solution(s) to achieve the results
Each key stakeholder on the team should be encouraged to come forward with their idea(s) to achieve the goal the team has aligned with. Some team members want a new treatment sheet to hang in the cage with a more ergonomic format. Some want to move to a paperless electronic treatment sheet. Some want to take advantage of a dry-erase board at the same time to note which patients have any treatments each hour to draw attention to those cages. The options are abundant and varied.
List the pros and cons of each option and come up with new options that retain the best features of the existing ones.
Explain preferences early and determine if there is flexibility in those preferences. These strategies will reduce the probability of a deadlock.
The team analyzes each option presented, recording the professionals identified, the calls and the resources needed to implement each option. Team members also provide their option rankings and mention the immovable barriers, called walls, to implementing any option. Walls can’t be moved, but fences can.
In this discussion, a wall was noted for the option that required a fully electronic iPad-based treatment system, as the hospital’s budget would not allow this this year. A fence was noted with some technicians for the option of moving to a new hanging treatment sheet with a concurrent whiteboard for central ICU use. These technicians indicated that they were not in favor of having to check 2 different places (the hanging treatment sheets and the whiteboard), but would be willing to consider the perceived redundancy if the team felt that an aligned result would be more likely to ensure the 100%. accurate and timely treatments for all patients all the time.
Be prepared to make the final decision as a 51% stakeholder
There is no such thing as a true committee decision. In most cases, someone should be the person who makes the final call. This person, usually the team leader, boss, or manager, should be identified early in the decision-making process. When the above steps are complete, 51% of stakeholders make the final call.
In our example, the team split fairly evenly between a newly designed cage-side treatment sheet and the simultaneous use of that sheet plus a whiteboard in the central ICU to note which patients receive treatments each hour. The team leader decided to go with the latter solution, sharing with the team the belief that this option would be more likely to achieve the team’s desired aligned outcome without too much inefficiency in the workflow.
Check back to see how things work for the team and iterate as needed
Make sure the team knows at the time the decision is made what the exact plan will be to accomplish this. In this example, our team leader informed the team that their individual feedback on the success of the new system would be solicited through several different mechanisms.
After a month of using the new system, a survey would be sent to all team members requesting feedback. At this time, the number and percentage of delayed, missed, and inaccurate treatments would also be calculated and compared to these numbers using the old system. Lastly, there would be an open door policy to receive feedback from each team member in person, by voice, or by email at any time.
The basic rules
Ground rules are essential to create security and a sense of “firm ground” for the team.
It is essential that there is no triangulation or side talk during the decision-making deliberation. Decision-making conversations must be transparent and direct. It is also important that the decision-making deliberations occur in an appropriate time frame; Decision-making should not be rushed, but an achievable time frame should be set to complete the deliberations and align with the decision.
Make sure the team knows that any decisions will be followed up with iterations as needed. Establish defined time points at which a newly implemented process will be evaluated as a result of a team decision to assess effectiveness, efficiency, and accuracy. Don’t be afraid to pivot and reevaluate the decision if it’s not executing as planned. Team decision making is not about who had the right idea; it’s about which decision most completely and easily achieves the desired outcome.
The bottom line
A team cannot make effective decisions if its members do not trust each other or if they do not listen to each other. Open and transparent communication and monitoring of established actions are also key. With these tips, you can guide your team to make effective, judgment-free decisions to raise team culture, morale, and engagement for the benefit of your patients and pet owners.
Frisch B. When teams can’t decide. Harvard Business Review. November 2008. Accessed September 7, 2022. https://hbr.org/2008/11/when-teams-cant-decide