All teams get tossed about at times and lose their momentum; it could be a staffing shortage, a manager change or a pandemic causing the problems. In this session, you will learn to recognize current levels of team engagement, steps to regain momentum and how to increase resilience for the next time your team’s boat is rocked.
Team engagement video featuring local work by:
• Steve Morris, MBA, BSN, RN on Barnes-Jewish Hospital Leader Rounding
• Karen Looper, BSN, RN, CPN on St. Louis Children’s Hospital Triad Leader Rounding Team
Speakers share how BJH and SLCH utilize leader rounding by touching base and engaging, themselves and their staff building stronger team tithes.
we're so glad to be here with you today. So we're talking to you from Oregon and I hope that you're having a great day. We really enjoy Doctor Sexton's first hour where he talked about individual engagement and resilience. We're going to talk Rhonda and I are going to talk today about team engagement and team resilience and then dr Williams will take it into the final general session talking about community and how important that is. So, Rhonda, what would you say about yourself? Your hobbies? What do you like to do? What do you like about Team? Well, this is what I like to do most is when we get to go and just share. You know, we really believe in the power of team. Um We think team engagement is a key factor in becoming a high reliability organization um, and just becoming highly reliable in life. You know, it takes a village. So we love Team Jan and I have been doing life together. We've been teaching this kind of stuff together for over 10 years, but gosh, we've been a life team like for 20 plus years. So it's just a great joy to take what we know to be true and get to share that with you today. So thanks for having us. And as you can tell, we do life together. So monitor our husbands and uh we live in the same community that we decided to be in the same covid bubble because we believe in team and um so that's why you see it. So we're not dangerous without our massive time. Just let me know. Well, let's talk today about how today will go. Um you'll notice that the session is a bit long and what I want to let you know is um what I want to let you know is this idea about the Q and a box. This is interactive. So to do it, virtually what we're going to have, you do is open your Q and a box, you can slide that to the side and Rhonda and I, you'll see us take notes. We're going to be watching as the other person speaks, watching your comments and watching what you're thinking about and how that's going. So please just go ahead and fill that up Q and a notch at Q and A. So the other thing that we're going to use is that feature about polling will help you when it's time. But we're going to post a poll that will ask you a few questions and when Diane helps us post that pole, we're going to ask you to choose one thing and then we'll close the pole and you'll be able to uh see the results about what your colleagues are thinking about, or basically, that you're not alone in this struggle about reengaging your team after what's happened. So anything I forgot. No, I think just you know with just coming off the heels of the pandemic here, we are all aware of our need to kind of reset and re adjust how we re engage that high quality of patient safety. Um And and just as brian talks just about our personal resilience um and how do we maintain both of those things? Our commitment to patient safety and what we need to be resilient ourselves as we all work towards this new normal. Yeah. New normal. That's really great. Well let's get to our presentation here. I'm going to share my screen and pop that up for you. Perfect. So our streets, our talk today is gonna be team overboard and we're gonna be talking about the idea that um when stuff happens. So it could be pandemic. Which uh it could be electronic medical records, which used to feel hard. But now it seems easy compared to the pandemic. We're gonna be talking about when your team gets thrown overboard. It could be a new manager, it could be a tragedy in your community, It could be here in the West wildfires where we go in a different kind of hierarchical model of survival and access services, that kind of thing. Today, we are hoping that you go away from this idea in that you will be empowered and have some really specific tools about how to get your momentum back, How to get your members back in the boat and get that going forward again. Because in patient safety, if there's fractures in the team or the team has is all disjointed, we're going to be making mistakes and the team engagement as well as uh, the retention, all that just drops completely. So timor broker board how to get your team back into the boat and I'm gonna advance this slide. There it is. So I'm just letting you know, we have no financial relationship with any commercial interest related to this presentation today. And I just want to give you are learning objectives. So today we are hoping that you're going to walk away. Being able to assess and interpret the current state of your team's engagement. We hope that you can identify at least two steps to help your team regain some momentum. And then hopefully you'll be able to explain how to employ tools of resilience in order to prepare for the next challenge, which we all know. We'll be right around then. Mm. So, okay, so Jan and I adult live far from the Oregon coast and every year there are at least a couple of significant incidents involving sneaker waves. Nobody expects them. People might just be enjoying their day at sea and then suddenly out of nowhere seems to come this big, huge riptide that threatens to pull you out to sea. And you know, this is how the pandemic has felt to me as I've watched it play out and my team at work, we were so completely sidelined by this sneaker wave called Covid 19. Now, just like with a real riptide, there were some big visible waves in front of us. Things like our teams and workflows were interrupted. Our PPE was in short supply and required a new approach and gosh, even things like taking bathroom breaks and figuring out how to eat something. Those all became big issues for us. So we had these large visible waves but similar to an ocean riptide. The greater force that was trying to pull us off course was happening underneath the surface where we couldn't see it. It wasn't as easily identified and so it was harder to counter its effects. So this was things like leaders that employed a crisis management style, having the frontline lose their voice, having staffs to come to change fatigue, right? Which revealed itself mainly as anger and push back right on everything from workflows to just general attitudes that got brought to work. Now, the hard thing about a sneaker wave, whether it's at the beach or in your workplace, is that in our concerns or our grief, we give way to blame. Why didn't that life start warn us. How come there weren't any signs posted? What were those people doing swimming out there anyway, The same thing happens when a sneaker wave happens at work. Everyone can find a they to blame for this riptides untoward effects. But what we want to tell you today is that pointing the finger and casting blame on people cannot change the past. It's not helpful for the present and it's actually gonna work to sabotage your future success. So we love to know has something like this ever happened to you or your team? Go ahead and get that question and answer box, letting us know some of the things that have bumped your team off course. Now the pandemics an easy grab right now, right, that's in the front of our minds, so probably but is Jansen earlier, it could be anything, it could be a change in leadership or a staffing shortage or any number of things. But go ahead and pop into that Q and a box. Um just let us know what have been some of your challenges over the last year. What bumped your team off course now, just letting you know Jan and I this doing this only virtually that's kind of a brand new fun thing. But we're super used to being interactive in our sessions and so we really do want to be interactive in our session. So several times throughout this presentation you're gonna curious asking, hey, just post your thoughts. Just let us know what's on your mind or we'll have some polling questions like john said where we really do want to want to kind of get a pulse on where we are around the nation and around the world. And then in this Q. And A. You can do the thumbs up and the more votes that gets, it'll pop to the top. Really interesting. So we'll have all the things, but if you like what somebody else put thumbs up it'll if it's your boot camp please. That's awesome. Good. Gosh I'm thinking that restructure limited resources short staffed. Well gosh um the some of the statistics about the staffing ratios that changed really stressful at work delayed learning and training in a new role. Yes. I mean the on boarding blown out of the water right? All their restructuring. We're seeing that pop up to, gosh again it's this this last year has kind of required us to just turn things a complete 180 in some ways with just how we have to structure our work clothes and and all of that. My my daughter guilty said that's really interesting thing. She works at a big hospital in Seattle she goes where the cardiac nurses where did they go? Because they took the cardiac unit turned it into a covid unit and she was looking to see where the talent was to handle the patient she needed to transfer. Amazing. Like I used to know that they worked on this floor but not anymore. That's the code for like this whole piece about like I don't even know right master trainer turnover and I would add to that. Yes Denise. I would add that every turnover like some people went out and never came back. This core between direct report in direct reports like this breakdown in communication flow from top to bottom left to right is amazing change in leadership. Lots of accessibility important process improved data reports. I love that. I'm not not sure how to pronounce your name or logo or llama. There we go. Um I have that whole piece. I love it that you're following the data because we're going to be able to look and see what that is for us. I also picked up unit expansion schedule change and I would say poor communication seems to be pretty universal um in our list. Thank you for sharing that. That's really helpful. And I think that uh the bottom lines were not alone. You're not alone in this, this is actually universal piece of it I would say for nursing to the uh as a nurse watch doing leadership rounding the nurses that had uh learn how to create a workflow to nasal swab outside. Where this where do they chart? Just even like that? They got it all dialed in and then it turned cold and then they have to re dial it in to figure out how they were going to do that in Oregon weather. So yeah, I think one of the things that chan and I have talked about this incredibly dynamic landscape that we're living in. A dynamic landscape, it felt like all the time. Like, you know, you come to work, you start your morning and you think you've got to dial in and then you go to lunch and you come back and find out that just getting everything you thought you knew in the morning has already been redone and retooled before you even come back from lunch. So that constantly dynamic changing. It was among us, right? It had to be it we were it was required of us in this last year. And you did it, you guys you did it, but it did come at a cost. It came out of it. And that's kind of what we want to address today. Yeah, I I love this, having for little staff during covid talk about a morale breaker and then to get the fertile staff back into the mindset of coming back to work. And the interesting thing we're seeing a parallel in the education system here in Oregon is just beginning to wake up to get kids back to school. And we're seeing I'm watching what health care experienced a year ago. You know about like, what do we do? How do we do it? I'm seeing it in education as a people group. I kind of want to partner up with them. So let's go ahead and go on to this next uh uh thought here, team development is like the tide coming in. So as you look at your own process, I want you to be kind to yourself. I want you to be thinking to yourself. It's OK that it's not gonna happen all at once. When the tide comes in, it comes in and then it backs up and then it comes in farther and backs up and eventually the tide comes all the way in. However, this tsunami that just hit us took us all the way out to sea and so it's going to take a while to bring us back. I don't want you to be concerned that you're not there yet or you think I can't even see the shore against too far out there? I want you to be encouraged that team development. Sorry. That was mean team development is really takes gaining momentum and it takes practice and you will get there if you lean into it. So be thoughtful about where you are now. In fact, that's the next thing I want to ask you about is that where are you? It's really important when you are thinking about where to start? Where do I start to get my team back in the boat. Where do I begin to move closer to shore Because we're way out. You're still want you to be thinking about? Well brian had some great tools about where to think about yourself. But I wanted you to think about your team you work with. It could be the team you manage or it could be the team you work with, right. Or it could be this up and down team about how's the flow from top to bottom. If you're someplace in the middle, I want you to be thinking about a particular team as you answer this next poll. Diane's gonna post a poll up here and we'll talk through the three skills uh sorry the five sections. And as I talked through it, I want you to kind of go ahead and enter in what you're thinking about. So let's go through the five skills and when you're ready with your vote, you can just throw in your vote. Number one is shocked. This shock and we see it really in healthcare is people get frozen like uh absolute shock. They don't make good decisions. They don't see things in a way that you might see him every day. They stop whole teams do this like what just happened? I don't know. I'm just gonna do what I used to do. Um What is it that stopped us? I don't know. Maybe that's where your team is. Way out there. Number two denial. It's like, well, that happening. No, didn't happen. Doesn't hurt. Um You see a lot of patients actually when they experienced a an emergency, they actually are. Do not know. I'm okay. I'm okay. Well, your leg is not a pouch but you're actually not okay. This denial piece about Covid, it doesn't affect me. I don't want to wear that P. P. E. I would say mask compliance when people wear their masks below their nose. That's denial, right? Because where do we swamp right up your nose? So if you're not covering your nose, that's denial that this actually matters or it matters to me, um, denials are really strong um, emotion and can make your team freeze in place. Number three disengaged. This is where you're given during broken and you swipe your time clock and you go, not going to change today. I I'll just catch it later. I'll just do what I used to do. I'll catch it later. I'll just call in sick. A lot of people are, I don't necessarily want to come back. So I won't do they pull out of the team behaviors like this? You see like to work. It's real passive late to work. Uh don't do everything like they used to, their energy is gone. This disengagement, you need to go after these folks. They're so valuable. They know stuff we don't know. So go after those folks. So number four is protest and Rhonda already mentioned this. But these are the behaviors like anger and no and uh going, going in this, I'm not going to play, I'm not going to talk to you and you drive me crazy. And um uh this really interesting expression, uh uh this shock is really just grief, right? Anger protest is such a part of the grief cycle. And then finally you get teams back into the solution mindset about let's get all these things together and we'll get them driving forward. So last chance supporting your votes and Diana. If you could pull off of the results, that would be great. So everybody can see it will just take her a minute to do that. Thanks for voting. Um, yeah, you see that you guys disengaged number one solution mindset. Let's just say we're hoping you feel the chat box with some of your solutions so you can feed the rest of us. This is a sharing community, but what worked for you um disengaged and protests, but you can see that we are not in the shock and denial of the pandemic. Um, and really this is where you live in the country or the world about where you are in the cycle of how things are going, I would say so thank you so much for polling. We'll have another poll in their uh for you next time. All right, so where are we going to go from here? We're going to talk about three things. Three buckets about how do you get your team back in the vote? We're going to talk about compassion and um that that quality of leading your team, whether you're appear or leading up or leading to the side or leading down, we're going to talk about that being in the moment with the person. Is that the first step to recovering people back into your boat? We're going to talk about how to build your team's confidence and momentum. And then we're gonna finish up by talking about the benefit of challenges going forward. So, Rhonda, why don't you talk to us about compassion? I'd love to So getting your team back in the boat. It's got to start with compassion for both the people and the process. If your team's boat has been capsized, it's not gonna do you any good as a leader to point to the horizon and say, look there it is. There's land ahead. Quite frankly, your team isn't going to care about your long term goal if you don't show some compassion and solution for their short term problem A. K. A. They're drowning, compassion. My friends lowers the lifeboat. It says, I see you and I care about your world, you're worth saving. So what does compassion lowering the lifeboat of compassion? What does that look like in practicality? So first you've got to acknowledge their loss and give them permission to grieve it, what your team has been through is really hard. It's required a great deal from them. And the example of the pandemic, some of your staff are reading the actual loss of loved ones and certainly all of us are grieving the loss of life as we once knew it. And that includes in the workplace, maybe especially in the workplace. One nurse that I work with is probably in the last five years of her career and the other day she said to me, I don't think I can finish my 40 year career in a mask. Your team is saying this is hard, I don't like this and what's percolating under the surface, whether they're saying it out loud or not, what's percolating under the surface for many of them is this fear of, I'm not sure I'm going to make this curve. So if you want your team back in the boat, you've got to start by validating their experience and its impact on them, acknowledge their losses and find ways for them to grieve it in practical ways, like a group debris for maybe as a leader just being very intentional about your touch points, will you commit to just being with your staff and just listening as they process? You don't have to have all the answers. Just let them know you're with them in the boat. Secondly, some of your team may just need a time out. You likely have some folks that have been pushed to the brink physically emotionally, maybe relational E or financially, they need safe, Haven, a place to rest and regroup. So how do we do that for them in practicality? How do we take this idea of safe haven from a concept into the daily boots on the ground interactions with our team. So, first have an extra measure of grace for their humanity. They've been in crisis mode. It may take a while to get them firing on all four cylinders. Again, they may not be the solution oriented, effective team member that they've been in the past, that's okay. They'll get there again, have a little patience and continue to speak out your confidence in them folks. Words create worlds if you want your team to rise up and be confident again, start speaking that over them, tell them that you believe in them in spite of the bumps that they've encountered or even the bumps that they've produced. Okay, so let them know that you believe in them and then being grateful is so important. Be grateful for your team and I want to say it out loud. Don't just expect that they know or that they should just assume that you're grateful for who they are and what they've done in the process of this crisis that you've all been through. Everyone needs to be recognized and appreciated for a job well done. They have all uniquely contributed to the team and its success. And just speaking that out goes a long way and replenishing their trust bank. When you give that genuine recognition and appreciation and then be intentional about celebrating what they've done and what they are doing well in the midst of this upheaval that were in there have been successes. If you can't see him a challenge, you go back and look for them. They really are there. There have been successes that have been burned through this, just this need for creativity and ingenuity. Team synergy has surfaced at critical moments. Come on celebrate those things. It's so important. And one of the best pieces of leadership advice that I have ever received was to say yes whenever you can, there will be enough situations where you won't have a choice. You will have to say no. So purpose to say yes just as often as you can. I think that's particularly important when you've got a burned out team or maybe just a team that feels like they've been burned. Right? So have you got any give when it comes to going ahead and granting that PTO, can you let them be creative with their scheduling? Do you have any flexibility to give them a little more control over their processes? Think outside the box and ask yourself, is there any way that I can say yes to what they would perceive as providing them safe haven? And then lastly, compassion means being brave enough to go first when there's mop up to be done. If you and your team have just been through a situation that's capsized your boat, chances are that there are some things that you could have done better or would do differently if you had the chance to go back and do it all over again? Own it, own it, be the first to show up with a mop and just say, I'm sorry that didn't go well, would you forgive me for being reactionary? I apologize for not recognizing your need. Whatever it may be owning your home, humanity lets them know that you are with them in the boat. So let's hear from you again. We have another poll for you. We can go ahead and throw that up now. We love to know. What do you think your team is most in need of right now? Is it some safe haven? Do they need an extra measure of grace? Do they need some gratitude just to be told? Hey, I'm so grateful for who you are and what you've done? Do they need some celebration? Do you need to show up at work with some balloons and some cupcakes one day or something individually wrapped Of course. And then what about saying yes to some of your team? Do you feel like your team just need you to say yes? They've had so many no's over the last year. Do they just need to hear you say yes to them? So go ahead and throw that into the poll there and let us know how things are going for you there. So I just want to add on to your poll. Is that acknowledgement of the loss like that that piece where you just sit and you just listen, you know you, it's really that listening skill is also in a poll. I'm looking at the chat box and I wanna you guys, this is just powerful what you're posting. So can teams be mix of one versus the other? And I would say that individually everybody's experiencing out of the boat in their own unique way and then as a leader, be looking for overall how do so for the practical piece of this talk practice piece about if you were to kind of, you know, sway your team, what's the bulk of my team and night shift might be in a different place than Daesh, no kidding or you know, some role versus another bowl. And then Maria is asking about how do you regain your confidence when you have trust with your leader breakdown And so this is really, trust is really a foundation. I would say trust is really the bottom building block. So when you have a breakdown and trust over this, covid results or personal exposure or anything else Going back and opening those communication lines and operating in these five things that Wanda's brought forward is a great way to begin begin to rebuild your team trust. So, um, I love Julie says we need gratitude out loud, especially from leadership. I would, I would say two things about that. Yes, 200%. Yes. And then the other thing is that a leader, my definition of a leader is anyone someone follows. So all of you on this call, our leaders, there's someone watching you that doesn't have enough of the same experience or education or if you're in a different role, someone's watching you. So the other thing that I would kind of say to that too is remember that this gratitude and compassion thing has to go both ways up and down the chain. Okay, so you know, yes, your boots on the ground, your front lights gap, please absolutely show up with compassion for them and be grateful. But also think about what your senior leadership has been through. Did they respond perfectly in this whole thing? Of course not, But neither did you write like, thanks for pointing that out. I mean it's been a learning curve right from the boots on the ground, all the way to the top tier of leadership in that C suite. This has, gosh, this new normal has put us on every level. So make sure that that idea of acknowledgement of loss and gratitude, but that goes up and down the chain. Both ways, there's not not one person on your team, no matter which role they sit in, that isn't in need of this right now. Really good dan. Could you put up our results please? Yes. Oh yeah, wow. Okay. Yeah. What does your team need gratitude? Going back to dr Sexton's talk. I love the poster that they put in the hallway with the pedals and the short in two weeks will change your culture, this gratitude. You can do it. You can take it on as a whatever role you're in. Hey, yeah, I love the idea of putting white board on your door. He brought up. This gratitude piece will get your team going forward and you can start with yourself. You can be an atmosphere changer. Um, it's all about your own choices about what you're grateful for you guys start with you and then I show you something good to find in that. So thank you so much for letting us know and looking at you. You're not alone in what you need. Um, so thank you so much. Yeah. The other thing that I would just add to that is I love the gratitude is the first thing that pops up. Why? Because it's the easiest one to do. I mean really, it doesn't take a whole lot to just think, okay as I walk out on the unit or into this meeting, I'm going to thank three people for something or tell them something that I appreciate for them. That's an easy grab. And again, as Dr Sexton said, so easy to do and has the biggest impact of anything else. So easy grab make it happen. So why don't we forget? Why do we forget? Gosh, I think it's just exactly like Dr Sexton talked about earlier because our eyes automatically gravitate to what's going wrong, Right? So what you've been, what we've all kind of been trained to see over the course of this last year is where things going to fall through the cracks. What's gonna go wrong? How do we have a backup plan for a backup plan? Because we just expect that things are going to go wrong, so we're looking for that. So it does take what I like to call a manual override, go back to just kind of flipped that and go, okay, I'm going to assume that there's something going right around here and let me be intentional about finding that. That's great. Okay, great questions. You guys keep filling that checkbox because honestly it's so helpful to hear about where you're at. So let's go on to this next tool. So we started with compassion and that's just like stop and be, be in the moment, be with your staff, really get a sense of where everybody is. I've been doing a lot of leadership rounding because it just takes a few minutes to sit with the night shift, just blast through their sit down a little bit to get the vibe of um what they're doing. So we're going to move on to this idea about building confidence, building confidence in your team. So this picture is white water rafting. I don't know how many of you um how many of you like to walk? Right rather raft, You can put it in the chat box like support for that. But you can see in the boat how many different emotions there are about when the waters get turned up, you know, you might have somebody on your team that's in the front with your ice close or someone who's concentrating really hard or of course the team leader in the back. But we're gonna talk about this whole impact of challenge and whether it's covid or leadership or schedules or being laid off those kinds of things. We're going to talk about. How do you regain the confidence that you've lost? So when a raft guide, when a raft guide sees that there's rapids coming up, when your leader sees or you yourself as a leader see that rapids are coming up. What other leader often does is that he prepares the team and says, Powell's up paddles in. So confidence is built when you get at least everyone's paddle in the water. Now, I've been on lots of rap trips and there are great paddlers who listen to the leader and get the paddling. And there are some people like the scowl on the front here is that they're like, I can't even paddle. All I can do is hang on, but putting in the paddle in a raft stabilizes the raft to get every person just engaged in a little bit. Of course, the deeper the dig interact, the more buy in, the more, more engagement, the more you'll get momentum. We'll talk about that amendment. But your step one is to get your team to buy in onto one project. It provides stability and confidence and basically it's getting your team back intentional about one thing um, together. Okay, so let's talk about some tools for resilience, when you want to go back and build some confidence into your team. Sometimes it helps to just go back to basics. The obvious is actually more essential than you think so first. And arguably, I think most importantly, when you're trying to get your team back in the boat, the debrief can highlight what truly did go or is going well. Again, as we've already mentioned when the sea is rocking the boat, it's easy to get tunnel vision on what's going wrong. And the thing that I love about a beauty brief is it helps us to gain that wonderful thing called perspective. A debrief gives us the opportunity for people to gain awareness and perspective on the many things that are going right, Being able to identify the winds that are most certainly present, It's a great way to build some critical momentum for what's next on the horizon. And then secondly, giving people an opportunity to express what isn't going so well is a great way to help them process the grief that we talked about earlier folks, Pain needs a voice, you cannot embrace change without releasing the loss you feel of the safe and familiar. So a debrief can be a great platform to process those emotions in constructive ways, with the support of others, who know exactly what it feels like to be in this boat. And then lastly, debriefs can be a safe place for us to move the team from emotional reactions into proactive responses. Let's drill the thing down and see what we can actually do differently. Groupthink is powerful when it comes to moving the team forward and my personal goal in debriefs, I think that a debrief should leave your team with a profound sense of hope that not only can they weather the storm, they can actually be a driving force in steering a new course. Yeah, that's good, Rhonda, that is good. This whole piece of building confidence, rebuilding confidence, once it's like giving back on the horse kind of idea, kind of um this is you actually as a leader, have to go back and actively go get people and encouraged and confident about to take that small little step. One of the way you can get that paddle in to get that first stroke in is to ask for solutions. So the brief or debrief again back to the H. R. O. Safety tools is really this fantastic way to get a paddle in what happened, at least in our facility. And I am just looking around nationally about our connections. Is this idea about when we go into crisis management, we for good reason going to top down hierarchical communication and those at the very top are so overwhelmed with making it up on the fly. I love what grenade Brown said about we're doing this new thing together, We've never done this, we're doing it together. So at the top they're making up on the fly there, gathering research. They're saying, what should we wear this week? What is our PPE adequate supply? You know, those are the conversations up here, how it hits the front line is that they get a new directive everyday at their brief, they get a new poster on PPE or donning doffing or you know, pick your, pick your process, change, it's been overwhelming. The change fatigue, it's really been significant. So in the course of that no one's fault. The front line lost their voice. So you as a leader go back and get that paddle in and ask for their solutions. So bring the problem to them. I love the front line. The front line is the most valuable source of solutions that is often untapped the intelligence and experience. It makes me kind of joke up little. The people working on the front line know the solution that would work for them. You as a leader, you need to go after that. You need to garden that to see what's out there as solutions are best solutions for all these new processes. Was when we went to the front line and say how do we rebuild this? How do we make this work for you? How would you chart on it? You know, like we asked them, we didn't take all their solutions for sure, but we went back and garden and asked for their feedback. It's a way to get engaged actually, we need this information. So questions like, so what would you suggest? I see that you've been working in this a while, um can you break that up for me? How about putting that in an S fire and sending it to me? So what would you think? And then maybe, you know, parameters, finances or other things that they don't know about because they're not in those meetings, you can say, well, okay, so if I added this other factor now, how would you solve it? People on the front lines, love to do the studio and problem solving that affect them in their day, get that paddle and get them to lean in on what they know to be doing. One of the things that I learned, super interesting story is our clinics um uh with Covid, we have morning at the clinics to call morning huddle, which is the same as the brief they went to meet outside. And I said, well I heard from one of the front line, I said are you having briefs? And they said no, I thought well that's interesting. So I asked the clinic supervisor and I said uh so I heard, can you tell me more? And I asked this question, you tell me more about your morning grief. She goes well, we meet outside and I take my clipboard out there because it's windy and I go through the list and then we go back to work and I said, oh so you're not really having the brief that gathers all the information. So the frontlines perspective is they didn't have one. The supervisor said, oh yeah, we have briefs, but nobody talked, nobody shared solutions or information. It was back down the top. And so I mentioned that to her and she goes, oh my gosh! She changed it tomorrow, they regained that that source. So super interesting. Yeah. What john was talking about there is just how the front line has lost their voice in a lot of ways, you know. Exactly. So moving on, mutual support, developing mutual support, great tool for resilience in this time. And it's one of my favorite concepts and team training because I'm a firm believer that I only get to the goal when we get to the goal. Now Jan showed that picture of the white water rafting and every once in a while so chance of water person me not so much, but every once in a while, you know, she was born, swaddle me into going with her. And invariably, you know, I'm the one was absolutely no clue what to do with her paddle. That's true. She's telling you the truth. And sometimes I think jan you know, every once a while has to question her wisdom and bring me me along at all life jackets, but she brings me along because she knows it's actually gonna take both of us. Yes, I'm gonna, my partnership is gonna take a little work, I'm gonna need a little more mutual support, but she's smart enough to know we are not gonna make it to the goal unless Ron has got her paddle in. And that's really what mutual support is all about. Now. Here's what happens in times of crisis. We unknowingly shipped towards this inward mindset. Our eyes come off the horizon and drop onto our naval. And suddenly it's all about me. How is all of this affecting me, me, me and we begin to blame others for our frustrations? Or maybe we feel victimized by circumstances. And honestly, what happens is that the survival mode, we fall into this survival mode and that blinds our eyes not only to the collective need, but the collective strength that we have available within the team to meet that need. So the solution to this is not going to be a big news flash to you, right? It's just gonna be a great reminder because sometimes in crisis we forget the basic things. So the solution, of course, is to develop that outward mindset that embraces team synergy and the truth that we really are stronger together. So whether you are a designated leader or a situational leader, you've got a model and encourage your team to engage both the attitudes and the actions that reflect that they are for one another. Your team needs to know that you're for them. Every team member needs to know that the other people on their team have got their six right, have got their back. And that's going to be especially important for those who are slow to jump back in fear. Just makes people self protective. So moving them from that inward fearful mindset to an outward mindset, that other centered and focused on collective results. I. E. Your win is my win. That's going to rebuild trust in both the people and the process. But mutual support also means mutual accountability. I believe that accountability that's encouraged and enforced by an army of piers is going to be far more effective than just a drop the hammer from up above type of support. So you've got it again, give ample opportunity for your team to grieve their loss is that's why we started with compassion, right? Your team has to feel like they've been heard. But once they've had that opportunity, folks, there comes a point where they must embrace being a part of the now that's going forward. We can show up on the other side of this better and stronger than ever before. But it's a chance that earlier, it's going to be everybody whores in in order to make that happen. And that particular message of, hey, everybody whores in your win is my win. That message is gonna shine clearest and the brightest when it comes from within the team itself. So simple mutual support tools. I asked her help offer helper that great H. R. O. Toole of 5 to 1 feedback that's going to reinforce the truth that I only get to the goal when we get to the goal and the slide needs some mutual support. There we go. I want you guys do look in the chat box. Cynthia has this great tip tip for mutual support for a group. Is that helping to increase the confidence of the staff? Really changing what you speak, how you talk about it? Like thanks so much. Couldn't do without you. I'm appreciative you. I actually actively do this with our housekeepers on a regular basis because they're the silent uh silent heroes in my opinion on this uh project that we've recently been doing. But again, it's not just about the pandemic. It could be all sorts of things that throw you out of the boat and you need to gain confidence and then James uh has the story in the chat box is so great that they're facility created a spreadsheet where you could go volunteer and just answer call lights, whatever the staff needed. That extra thing. And then for our facility, one of the things that kind of reflects what jane's talking about is this really cool thing that happened is of course we went to vaccinate our staff and there is no vaccine clinic that handles the amount of vaccines that we had to get. Education department hosted. So we set up all the rooms that that kind of thing. And then at the last minute all of our vaccinators that we had planned on. They had booked our system had set that up for us all of a sudden. The night before they said just kidding. And so our chief nursing officer uh that night uh reached out to all the leaders including the C. E. O. And all the leaders hosted the vaccine clinic for the staff. game changer game changer in our whole facility. I can go back to those those vaccine clinics and say that changed it because of this helpful way our ceo is doing the logging. She's really good at data are C. N. O. Was the creator and then all of our managers took ships in observing and giving shots. Game changer when you get that first paddle in. And I must say if your leaders start with you. Yeah, yeah. Start with you. It changes everything. If you put your paddle in it changes everything for look for opportunities. So let's go into this next idea about getting the team voice. Obviously we feel strongly about this because now we have a slide we've talked about already a lot but when the event dominates, um let's let's step away from the um, uh pandemic a little bit because when you have uh say beloved uh uh we we consider family on your unit, a beloved coworker that passed away or um say you moved hospitals. I saw that earlier on in the chat. Um Anything that's really big and it could be relation really big or it could be pandemic big or it could be actual physical where you used to work on this unit or in this building and now you work at home and where are my people? The voices do get lost. And what happens in rebuilding is you have to go recapture and rebuilding their confidence in that. This isn't the first time that we have faced something big. I have been in healthcare long time, I think that's my 38 years of being a nurse. I'm 22 just in case you were wondering. But I was working in San Francisco as a bedside staff and labor and delivery, which of course what we say in perinatal is it's a very juicy process, a lot of body fluids. And I was working in san Francisco at the time when they came up uh they were just barely finding the name for HIV AIDS and how it was transmitted and I horrified to look back at what we weren't wearing gloves for like the change in process about what I was doing specifically. And then even putting in Ivs without gloves. Standard practice when I started. But when uh when HIV AIDS came up and we were trying to name it, figured out how it's transmitted, who's at risk for getting it uh changed everything. This is not our first big event. So get your team to take a breath. You as a leader, take a breath, it's gonna be okay, go back and find out the, support the voices. And I really appreciate this chance to gather together as a community and uh share our voices. What has worked for you, what's hard for you? Um, that's what we're gonna do next is give their voices back, we've touched on this before. So, um, whatever your vehicle is briefs, huddles, debriefs, shared governance, um, committees, um, support anything. Any really anything, create an event, uh, celebrates whatever you want to do, create a project that's pretty low level. Um, you can't lose to get everybody in there and then be brave, take notes and look for themes. So one of the things that I worked with, senior leadership on the group above me is that I was out rounding and the team was suffering and the senior leadership was really in the survival mindset and so I got to go to them and say, hey look, you need to get out there and they're so I love to their like, I'm afraid of what I'll hear. That was their human factors, they really in their humanness leaders, leaders like to be perceived as bulletproof, but actually they're human and this is hard for everybody above you. It's really hard. So when you go out and round sometimes you're going to get the uh disengaged and you're going to get the angry and that's not fun. But honestly by going out being brave and taking notes, I find bringing a pen and paper with me as a really good tool to say, I hear you, I'm looking for themes, I really want to know what the staff feels like. I want to hear from you. We were able to get some teams back in the boat by just saying, I hear you, it took a couple of meetings with who they felt like the bad guy was, it was just actually the thing right? But we brought in and so we hear you, we can't fix it, but we hear you, it really changed everything. It was really remarkable. Then they started to lean in a play again, I can't tell you enough about being present, taking notes that I hear you and then back to celebration factor appreciation, back to pride. And I saw that as one of the pieces and dr saxons talk about really living in that price. What are you proud of in crisis? In crisis? We'll talk about this in a couple slides, but in crisis you see people rise up, you didn't even know where stars. It's pretty fantastic to hear what they're proud of. It could be home schooling, I'm rocking home schooling. Never done it before and that they could be proud of something in their private life. Go around and hear what they're proud of. That. Building. That confidence to say we can do that. So what I'd like to do? Typical. No, not yet. Okay. Um usual support. That's what we do. Alright, Kathy says our Ceo and Cno started a town hall. Okay, fantastic. Right go electronic town hall presentation every week at noon. You can jump in. You can skip it. How great when Covid started to keep everybody in our five hospital health system informed, Well kept it on for a year and we will keep doing it. This whole piece of the creativity that's happened when hard things happened. I don't know, don't lose it, grabbed what really works for you. Okay. So our last tool of resilience here is what Jan and I like to term as engaged with a quick win once your team has regained their voice, you want to reinforce that they've been heard and that their ideas make a difference. And the best way that I know how to do that is to get a win in their pocket just as quickly as possible. What's something that you can implement right away that will get great results and make your team feel empowered again. Perhaps it's something that you started prior to the pandemic that had to kind of be put on a back burner. You know, some of the discouragement that Jan and I have heard from leaders is that they had all of this pre pandemic, they had all of this momentum going and excitement going to have these projects that they were ready to launch and then the pandemic hit And everything that they've been working so diligently on came grinding to a halt, right as everything that wasn't related to, oh my gosh! How are we going to do? Like everything differently now with COVID-19, right, that was our biggest fish to fry this last year. And rightfully so. But some of you were really excited about projects and things momentum you have going on your team and that'll just kind of got sidelined and pushed to the back burner. And some of the discouragement we've heard from leaders is that you're afraid that that those things you have to push back burner are never actually ever going to make it out to the front burner again. Now, I want to encourage you that you don't necessarily have to abandon everything you were doing pre covid. In fact, when you look at finding a quick win for your team, it's quite possible that one of those things that you started on prior to the pandemic, that might be your easiest grab and your quickest wind going forward. So, for example, quick story here in the emergency department where I still pick up shifts. There came a point a few months ago where it just seemed like morale was at an all time low. I mean these er nurses man, they are the front line that's a vulnerable place to be when you're in the middle of a pandemic. Plus, again, it's hard to work in such a constantly changing dynamic environment. Where as we said earlier, what you thought you knew in the morning is already been retold by lunch. So prior to the covid explosion. This spring, I have been preparing my team to transition from the old archaic trauma written flow sheet. Yes, there are people still out there using pens and papers. Um but we decided as a team of course, because now I like to call myself an older and wiser. I don't know what they call me season but season I'm well seasoned. Um, but we have a department that's now full of millennials. Right? And so this whole idea of moving from paper to an electronic um trauma narrator for a trauma documentation. This is something that they were super anxious to do. The physicians were excited about it. The staff was excited about it. It was just gonna be a win on so many fronts. But then the pandemic it and all of our trainings and our preparations came grinding to a halt and the go live dates got shut down, right? Just asked. And so as things began to stabilize for us a little bit, a little bit like were a far cry from normal yet just like the rest of you. Right. But I talked to my nursing manager just kind of telling her that I was concerned about the low morale on our team. And then I felt the staff needed a win to kind of get our overboard team back in the boat. And I personally thought of course I am the the trauma coordinator, so 12 in your front and I told my project that gets us moving again. Um so I got to restarting this trauma EMR would be a quick grab, an easy success for our team. And so again, even though we were a little nervous to start launch anything new, I said this is going to work and we did it and it did work. We went live on the new system, the nurses were happy, the docks were ecstatic and the whole tenor of the department just kicked up a notch. Why? Because it was their felt need, they're devised solution and they're winning, it was their win and that's the beautiful thing about a quick win, right? I like to think that a quick wind empowers the early adopters. It encourages the mostly convinced and it enlightens those later doctors and kind of says come on, slide on in, slide on in, there's just something so irresistible about the taste of victory and that's gonna be a critical tool and getting your whole team back in the boat or is in. Mhm. Okay, so it's time to hear from you and let's go into that Q. And a box. Always keep saying chat box, sorry, it's really the Q. And a box. Um Go back into your Q. And a box. Um thinking about these confidence builders, I really want to hear in a practical sense, what's your go to, what are you going to do about it? So I want you to give yourself assignment. If you're brave enough, you can go anonymous if you don't want to own it publicly. But because your colleagues are on the call to hold you to it. But what's your action plan? We talked about a lot of tools here, about getting paddles in. We talked about the quick win. We talked about getting voice back. People in the chat box have been about in encouraging a supportive environment, getting leadership buy in. So put in the chat box right now about what is your action plan? What are you hearing today that your team needs? That you can kind of self assign yourself. So I'd love for you to throw that in there. We'll give you a minute to do that. Um there's lots of things you can do that, I must say, listening to Dr Sexton. And then of course, Dr Williams who follows us. They have all this beautiful data. Is so terrific and ours is based on this experience and then we pull the data for sure. But um I don't want you to go away without an action plan for yourself. So um right in there, you guys are pretty quiet right now. Maybe I put you to sleep okay. Lorrison People or Sin. All right, we'll just keep going to this next section. And um after this third section will have a Q. And a time. So we be thinking about where you want to have a question in there. But uh write down your own action plan. So when you finish this uh conference today is that you are going to put something in place shortly? Oh I love that Dina, thank you Dina did our Corporate Culture committee back up and running. This is something that takes intentionality because to be honest, I was kind of glad that some of my committee stopped. Is that fair to say? I know my bosses are listening, it was great to have a little break, but you also need to uh go back and restart those and we did pathway to excellence for nursing in the process and it was actually part of getting us back in. Um so also debriefing and daily debrief roots brings up is a good place to start. Yes. And the frontline needs attention. Absolutely. And Laurie says we need to find the small winds that is this multiple small winds that are going to gain your momentum back. Absolutely, Laura, you're right on right and this um this part about being willing to voice appreciation for my colleagues, our system has something electronic. It's my uh leadership goal to do one or two a week. I just go in and say thank you or a shout out. It goes to their boss. So it could be something as a sticky note on their locker or it could be the electronic high five, whatever you guys have in your system, be looking for that pretty easy. Okay, I got to see this. I love this one. There was a ensured gratitude by doing party favors. That's that's that's her. She does so great at that. I'm terrible. I've got wrap up, wrap up those cookies and get them out there with little gratitude moments, but maybe if you're really good you can bake a little thing in that like the fortune cookies uh right about now. Okay, so Irene says, increasing my signs of gratitude. Simple, I appreciate you to my colleagues, lisa is saying compliment. Do you see the theme? We're really seeing a theme here of really being intentional about voicing out what we appreciate. Um it's really great if you have a low performer, be researching some of the people that you need to get in the boat, you're going to have to say, gosh, I'm so glad you're on time today. It really makes the difference or you know, like you're gonna have to find something, but it's really a helpful thing. So um jen says, oh yeah, yeah, wow, jen says our communities first. Covid patient was identified one year ago today, wow your front lines in the whole solution to your state. I just want to thank you to, I want to thank you for leading the team. I want to thank Seattle for leading our west coast for California for hitting it hard recently. You guys are my heroes. I so appreciate you. I so appreciate. I'm so proud of how health care has stepped up in this unknown thing and not only influenced your healthcare system but in your grocery store and in your all the phone calls we receive as health care providers at home. Like what should I be doing, that kind of thing. So anyway I appreciate you to the point of tears. I just think there we go. All right, where else do we have? Yeah, there we go. Rhonda's gonna read while I move on. Thank you. Terry moment. Okay. The next part is interestingly enough that you might think your team isn't ready for a big challenge, but once you get people's paddle in you need to reconnect them to the bigger idea of why do we do this? So I have the benefit. In fact I just did it yesterday. I get to train our new employees in our reliability tools and I spent quite a bit of time reengaging the why are we here anyway? So when, when stuff happens, we get lost in the details, we get lost in the PPE, we get lost in this new change environment or my schedules, changing my building's changed or the stressful thing, my leader doesn't communicate, I've lost trust with the senior leadership. Whatever challenges this piece about pulling the team thing is to, um, you might want to start with challenging people to re engage with why they got into health care. It's a great team builder and to get people back into the idea about we care because we care about we're in health care, because we care, we care about patient care, about people in the hallway, we care about their health, we care. So as a leader, as a colleague to say, we care about you as a peer is really, really important. So getting people reconnected is really about this bigger idea of resiliency. It's about creating resiliency on the team. Is connecting them back to the bigger idea. It's connecting them to the mission and vision of your system, your clinic, your organization, it's connecting it back to the patient. It's connecting back to White Excellence Matters or why safety matters. Setting bigger challenges is to pull the team forward when they're ready, when all the battles are in. You need them to do this idea of digging deeper a rafting. The bigger the wave, the deeper you ask your team to dig. It's really interesting. So you can accomplish so much together if people are leaning in and digging hard. So if you're back on the easy stuff, some people don't paddle at all. and that's why setting challenges really matters. Heart is just hard. Heart is just hard. We want as leaders as colleagues to dig in. I want you to figure out what is the big idea? What is the big challenge that you can put in front of your team to drive that forward? Number one, here's tips and tricks is not exhaustive by any means, but these are just things I've been thinking about which gets into the bigger win, recast your vision. Vision gets lost just like voice gets lost when the event is very confidence. Trust are critical to forward progress, recast that vision say, where are we going to be in a month? Where are we going to be in three months? Where are we going to be in the six months or a year? Like getting your committee's back together, getting your shirt governance or whatever uh team speak that you're working on. It could be a project, it needs to be bigger than just them. If it's just then they will stay just them. We need to get them glean entity in behavior because we know we can accomplish great things together. So set a clear vision, recast the vision. Sometimes it's because you forgot, or sometimes it's because they got overwhelmed and forgot. So rebuild that idea that we can be doing this together, then reattach your project to around the patient. Right now in fractured teams, there's a lot of opinions nationally, there's a lot of opinions about a lot of things, pick a topic we have, Oh, I feel strongly about this. Everybody in this times, emotions are way up here. So whatever they hell disengaged or angry, they feel that strongly. So finding a topic, finding a better vision for the next month or three months or six months is challenging. But everybody in health care will zing when you rebuild your vision around the patient. Now, the next key pieces about rebuilding your vision around the patient is that you need to go back and have the staff drive it of course, stand close, stand near, help them be successful. But what we want to say is, hey, you know, um fred, hey Susie, we would love for you to team lead with me on this project. What do you think we should do first? How should we approach the staff in this and you as leaders, pick something you need done anyway. Right. So, but if you partner in with staff then it will be staffed driven. It will be uh in the pace and timing that the staff intuitively knows that they can hear. It's really amazing. If you let them drive it, they will help you in ways you cannot even imagine number one staff driven projects. Number two staff solutions. This again, is that regaining the voice garden everybody make sure you have a representative of every type of I call it badge, but every role on your team, right, needs to have a voice, the hawk, the admin, the, you know, whoever's on your team, surgical team, whatever we need to have stacked solutions from every vantage point because that will color your success. We need buy in from all players. Right. And then it's this third kind of thought about leading towards larger goals. Want to encourage you to be looking at when you're rebuilding. Looking at where do I want to go in a year and splitting that up and bite size pieces so you get momentum. So at the beginning you're doing these quick wins, quick wins, quick winds, we've got a little more thing momentum and you can pull that out and drive the thing on a bigger success. You have a bigger thing to celebrate. And it's remarkable once they gain some confidence uh, in that, uh, things move forward. So, um, want me do that perfect. Um, now some of you are going to want to know, what about the people that are still struggling? I want to let you know that you're not alone. I don't think we're gonna make it out of this crisis. Whatever your crisis is, I saw somebody up there that didn't have lights and power. Maybe you're from texas. Um, not everybody is going to make it back and it's heartbreaking. And I want to encourage you to throw one more life jacket to the person who is unable, they might appear to be unwilling, and it might be true, but sometimes it's on evil. Our staff are experiencing home challenges like home schooling or maybe their partner has lost the half their homes income in this. Certainly if they're married to somebody in the entertainment industry or if they look in their restaurant industry, it could be this personal stress that has put them in a place that they're unable to get in the boat. Want to challenge you to throw one more life check one more encouragement. One more personal meeting. Uh maybe an intentional three weeks of stickers on their locker or in their email about what you value of them are. Team members are worth saving and they're worth standing there like a lifeguard looking for who's drowning and throw them one more. But at the same time I'm going to tell you that there is a time that you draw lying in the sand and you release them to succeed someplace else because attitude is contagious. We learned that this morning attitude is contagious. And if you have this persistent consistent, even though you've thrown lifejackets and help and coach, if you have this persistent sinker, you might help them find success elsewhere and then you can watch your team float up higher. I just want to take a moment and talk about those because honestly, I think there's one on every team that I know of. You think at least one. Yeah. I think there's one on every team that isn't going to make it for a host of reasons. Have compassion for that. There are lost to our healthcare community, but sometimes they need to be released and let go. That's a brave thing. But as your team recovers, uh, is that you've got to protect your team basically in the end. So let's go on to this um last set of ideas I have for you and then I'm going to ask you to self assign something to yourself. So um let's look talk about this other leadership strategies. These are my favorites. These are this is not an exhaustive, it's not exhaustive list. These are just my favorite tools that I use when I'm going back to recover leaders. Is that I do a lot of observing. So hi I go and I show and I do a lot of watching. I watched for leaders that have popped up. I just invited a new uh situational leader, She's attack. I invited her to learn how to teach our new employees with me. She just started yesterday. I look for leaders to develop. I look for natural leaders because to fit and fly, we've got to engage these people and mentor them, mentoring. What is caught is better than what's taught. So look for leaders that have shown up under crisis, that's actually the future of health care. So nurture them, invite them in, invite them into your bigger strategies. They're bigger solutions. Look for projects that the team is interested in. So if you're looking for the quick win, like the trauma narrator be looking for what is the felt need here so you can activate that project Good. It's another just leadership thing I love and then some things will never be the same. So go ahead and mourn that, take a moment, take a breath, put your mask back on. Uh some things need to be reimagined and I hope we keep some of these things like um they, they talked about the new thing from their ceo look to reimagine and reengage. So I want you to throw in the chat box before we go to our summary slides about what are you going to look for as a leader? What are you going to look for? What what things are you going to think about re visioning um uh that kind of thing type that in um to the chat box and I keep saying that I'm sorry it's you and a and a reimagine jail and you know jim we actually have a full here for them. We do. Hey Diane, can you put that up for us? Teamwork humor? Uh huh. Oh there we go. Okay so what are you going to start with first here? Could you please assign yourself um one of these four buckets and we'll just give you we about nine minutes left of our session today cast a new vision rebuild around the patient's address. The later doctor. Oh. Oh, you have a joy twice on that way. Okay. Human factors, I forgot to watch her. Who is watching me? All right. Okay. Tracy says thank you. Tracy. Tracy says she's going to look to reimagine again, identifying it's painful. Some of the changes. I'm just not liking it when we have to teach online or you know, some of these things are hard. I can't wait till we get people back in real meetings instead of virtual meetings. That's my own thing. Is that uh, this whole piece of new vision rebuilding around the patient or addressing uh, the later dr um, is great. Dina mentions that you just got a grant. How cool is that to see if we can spend some money on rebuilding your culture. Oh, that is so cool. Nice job. All right. Diane, could you please give a results for a poll? Uh Post does. Thank you. Oh, cast a new vision. This is just I just love all this. Your feedback casting a new vision. So important. Um Sometimes new vision about yourself. Like I'm going to do three good things inspirational or cast new vision. But it has to be a vision that can capture and get a hold of. So rebuilding around the patient. Yeah that's a strong y address the lady doctor. I'm sorry that you have one. It's just super hurt. Okay let's wrap up here and I want you to be thinking about your questions. Oh well what's gonna look at that here? It is. Alright. Um Here's the summary slide. What do you think of your questions And I'll give you a chance in the two and a box to put those up. But here's the summary, build a new normal. We're not going back, build a new normal. Get your team back in the boat. Remember the tide does come back? You do get on shore. I promise people grow in their pressure, creativity blooms when it's necessary. Uh, sorry, new leaders emerge. That's my favorite. Some staff won't make it. It's really up to you to set the stage and cast the vision, which why don't you committed to today? So there's an old proverb that says for as a man thinks within himself, so he is. And you know, that's always just been a great reminder to me that how I choose to think about something is what gives it its creative power. I can dwell on my losses, hunker down in self protection and effectively sink the ship. Or I can reinvent reimagine, regain some team synergy and road towards a brighter horizon. So will you allow, here's the question for you. Will you allow whatever's bumped your team off course to sideline you as a threat or will you embrace it as an opportunity to rise? Strong. Don't get stuck in playing those old tapes about what didn't go well, grieve the loss and then give that negativity a proper burial, right? It's time to reframe is Jansen earlier. Heart is just hard. It's not a deal breaker. So the challenges that are before your team right now might just be the very platform that they need to showcase their creativity, their ingenuity and their ability to shine brighter than ever before. It's time my friends to get back in the boat and embrace the possibilities. Hell event, don't you let being around somebody positive? It's just so much fun. Okay, so there we go. Key takeaways. Here's your top three things to remember. Getting your team back in the boat is about compassion slowdown, recover their people. Maybe that's where you are as an organization number to build confidence, get that first or in small strokes quick wins. Little projects that they really are, uh, potential to be grateful. Right? All the way through this process. Be grateful up, be grateful. Don't be grateful lateral be a person of gratefulness. Right? And be verbal about that. Um, challenge. Cast that vision for a strong and resilient team. So those are three kind of takeaways for you and now we want to hear from you. So, uh, put in the Q and A box, some questions you might have for us and we will Make sure we honor your time. We have about four minutes uh, to be thoughtful about that and we'll take notes on that. So what do you, what do you guys want to say? Uh, well while you're putting that in the chat box, sorry, I want to get an answer, raise the new, um, while you're putting in the Q and a box, um, I just want to thank you for all your doing and what a difference that you're making so important. So thank you so much. So, um, here we go. How do you respond when your team members don't opt into team building ideas such as asking for a positive feedback. Okay. So I think that again, one of the things that you've probably heard multiple times this morning already from brian and from us is actually, um, we like to say, look for the harvest. Where, where where are your folks that are buying in? Where are your early doctors? Right. If you can build enough momentum with the people who are yours in those people that are those, those later doctors, you build enough momentum. It's the board's gonna tip like this and they're going to have to slide in. So just allowing that positive movement, that forward motion of the rest of the team rather than just kind of again focusing on what's going wrong, focus on the ones that are doing it right and those others will slide in or they'll opt to like Get out of the boat. Yeah, I see a couple of you want to see that last fight again? No problem. Thank you for highlighting that I lasted through that. I'll share it on while you read the next one, I'm sure. So let's see here, 75 turnover in the department in the past eight months. Lord have mercy reset division mentored this new team, build relationships with each other across the hospital. Set examples for the culture shift that is needed. Yes. Yes and yes. So I think that that staff turnover, that's a huge issue. Um that's going to be facing us as a nation. And so really those things that dan talked about, yeah, we're going to have to recast that vision all over again About what it means to rebuild around the patient, about what it means to create atmospheres of resilience within our teams. And as a leader, if you've lost, you know, 75 of your team, It may feel redundant to go back and do those things. It's going to be essential. Go back to basics, those high reliable organization tools like the brief and the debrief that 5-1 feedback, all of those things are going to be essential as you build your new team and start into your new normal good, great questions, anybody else. What are your thoughts here? Hi ladies, it's Jody Jody. Great job. We're right at 11 o'clock. I want to thank you both for your energy for everything that you shared with us. Um, I took some notes as well. Um, I wasn't able to capture everything in the Q and A, but Jan had a great suggestion on there about how their coworkers could reference a spreadsheet when they came on board that day. Who needs the most help passing water, etcetera? The responsible charlotte mentioned thank you Thursdays where you can the leaders right to thank you notes. So there's some really wonderful things in there. I've been texting with Darcy to ask how could we maybe post these later and share them with all the attendees because I think there We learn from each other and these are some simple take away, so we'll figure out how to do that so that people can reference that. Um so with that I'm going to have uh Diane in a minute, share a video. This is a seven minute video that features some of our local leaders on how to engage 13s. This features Karen Looper from ST louis Children's hospital on triad leader rounds and how they're attacking collapse C. And then steve Morris from Barnes, shoes hospital. We'll also talk about lead around. So with that Diana, if you could. Q. R. Video mm the triad team developed out of a call for action to really reduce preventable harm in our patients specific to central line associated bloodstream infections, also known as club sees. Um This try it approach was really put in place in some of our most at risk areas that include the heart center, the niCU, our pediatric ICU in the hematology oncology division, which is division that I support. Um It really is a multifaceted approach to make sure that all members of our care team have our patient safety and preventable harm at the front of our minds. Our try a team consists of three important professions. We have nursing and nursing leadership as one, and they really are there to be able to be that constant day to day update of what's going on with the patient. Um Our front line nurses are an intricate piece of our team. Um they are they're in communication with the family 24 hours a day and really can relate to us on a day to day basis. What is going on? What is the feeling in the room? How are patients and families are reacting to their care? Another member of our team is myself. I serve as a patient safety specialists for the human ecology oncology division and I am really there to kind of help make sure that we are focusing on what our evidence based practices should be when it comes to collapse prevention, I'm able to kind of remind the team what are bundle elements are why they are so important and all the different strategies that we are doing to reduce harm in our patients. Um And another piece of our team is our physician leader. DR Willis is our quality and safety physician leader for the human ecology oncology team and he is really there to give that multifaceted approach. He looks at the patient's medical care as a whole um and helps with answering any specific questions about the patient's treatment plan, upcoming appointments as well as just specific medical related questions that may come up on our rounding. We have phenomenal engagement from all team members, nurses are excited. They're willing to participate. Um they're willing to be a part of the solution and in trouble shoot through some of these issues that we've had identified. Um we've partnered with our vascular access teammates significantly and included them to become a part of our team. They've integrated into our team to really make sure that we are doing the right thing for our patients every day. Our primary focus right now is collapsing prevention. And so we are able to run reports and epic to identify what patients have a central line on our unit. Um, and then we really try to work off of our nurses schedule as well. So we want to make sure that we are incorporating every nurse and every leader round that we do um to really give them that exposure to what triad leadership feels like and what it looks like every day on the floor and so from that we pick our patients that were going around on and while we are rounding we're able to offer education not just to the patients and families but to our bedside nurses as well on different structures and implementations that we're doing around collapse prevention. We are able to have upfront discussions on a daily basis and then round on a weekly basis with our patients and families, just having that awareness on the unit and having it at the forefront of everybody's mind everyday truly makes a difference. I think our patients and families would tell you that they see more streamlined communication, they feel cohesiveness amongst our teams and they really do feel like we are taking an extra step an opportunity to provide education and keep their patient and child safe. Leader around is really uh the process of um you know going to to the areas as leadership um that we oversee and um visiting them, seeing what is happening, they're touching base with people, things like that um doing those things too, first of all show visibility um and second of all being um kind of being aware uh you know gumbo awareness, so you know that visibility piece um in the Gambia, it gives the um the leaders a chance to go there to see their their front line, team members, see the work that they're doing um hear from them, connect with them all those all those wonderful things that that leaders need to do um And secondly the awareness, you know, going to the Gambia and seeing, you know, if I'm a nursing manager on a nursing floor, looking and seeing and hearing and understanding what's happening on that floor, do I have nurses that are running around looking for equipment, looking for supplies, things like that when I'm visiting patients? What are they telling me? What am I seeing in the rooms? You know those types of things? So you know going in that Gamba, you know, leader rounding in the area where the work is being done is invaluable and can give you so much information. But the executive leader rounding is is really that that upper senior leadership visiting those areas. Like I talked about going to the Gambia where the work is being done right? So when they're doing that they're they're focus is really on um connecting again with that front line staff, you know um letting them know that hate up to the hospital president and beyond. You know the work that you're doing is important to us. So we want to come and visit and see what's happening I want to hear from you. So making those connections uh those those type of things showing gratitude, you know uh and then also learning and hearing and understanding what you know, what are the decisions that I'm making as an executive leader? How is that impacting our front line team members And what does that translate? What's that look like? Right. Also an opportunity to share the vision right? Um you know, let the front line team members here, directly from the executive leadership. What the vision is the hospital where we're where we want to go, what we want to do. We should as leaders um ask our staff to have an open door policy so we can come to them and not tell them our problems but come to them and and listen to them ask them about their work, you know that the staff member wants to know, what do you want me to do? What can I do better? How can I do it better? You know, what's your your vision for the what are we, what are we striving for here? So you know when your leader rounding ask those things or let the employees know what you're looking for and and how they're doing and those type of things that will it will translate into better work for them. It will make them more aligned with really what what the vision is and what the goals are leader rounding and improves teamwork on the units by um really when I talked about earlier removing those obstacles, removing those barriers right? When you're in the Gambia and noticing those and working hard to remove those, it gives your nurses more time to focus on on their work or your staff members patient care tax, it gives them more time to focus on their work. Right? And to support each other. As leaders are rounding they are also looking for uh different um different things around are preventable arm initiatives right? So um they are looking to see if if our fall prevention initiatives are are in place, right? Does this patient have have what they need with regards to falls is the alarm in place plugged in, you know bed rails of those kind of things? Right? So or if it's a patient with the central line they're they're assessing that that dressing um making sure that the I. V. Tubing is is appropriate, making sure that the supplies are in there they needed to care for that. Um that patient central line. So leaders are looking to make sure that that the initiatives and the care that the patients getting um is what's appropriate and what what's needed for for each and every patient that they around on. Thank you. So we will now take a break and return at 11:20 for our next general session on community engagement. Thank you everyone.