Over 350 healthcare professionals and educators from around the country were attracted to downtown St. Paul for “High Performance Teams: An Interprofessional Approach”, the 2017 IPE Summit hosted by St. Catherine University’s Henrietta Schmoll School of Health.
The event featured guest speakers Brian Welle, director of people analytics at Google; Cory Sevin, director of the Institute for Healthcare Improvement; and Eduardo Salas, professor and Allyn R. & Gladys M. Cline Chair in Psychology at Rice University. The day also included breakout sessions and a research poster display.
Welle, who delivered the morning keynote, has conducted research on employee motivations, productivity and well being, and translated insights into action. He said his team was motivated to study teams because very little research had been done.
“Teams are fundamentally different from individuals,” said Welle. “Yet everything we know about organizational assessments is based on the individual.”
Google, he told the audience, is organized into many teams that are solving complex problems that no one individual could do alone. His goal when deciding to research effective teams was to create what he called, the “Pokemon Hypothesis" — every individual has his or her own superpower and if each person knew what that was, an algorithm could be created to help put effective teams together.
Welle admitted his idea didn’t quite work out that way. The first question, “what is an effective team?,” depended on who you asked. Company executives were interested in results, team leads were focused on ownership of the work as well as vision and goals, while team members were concerned with team culture, preferring to be asked: Do they like to come to work? Were they fulfilled by it?
“It took many inputs to attack the question,” said Welle. “Our search for the perfect algorithm included 35-plus statistical models and more than 3,000 lines of code.”
What they learned in the end was that team dynamics were the biggest indicator of effective teams.
“How a team works matters more than who was on the team,” he said. Most important to this dynamic was "psychological safety" — a shared belief and sense of confidence that the team will not embarrass, reject or punish an individual member for speaking up.
Welle outlined psychological safety as:
- Voice – individuals can speak up
- Trust – members won’t get trashed in performance reviews for speaking up, “it’s ok to be wrong”
- Inclusion – everyone feels like they are included
Other attributes of an effective team:
- Dependability — team members get things done on time and meet Google’s high bar for excellence
- Structure & Clarity — team members have clear roles, plans and goals
- Meaning — work is personally important to team members
- Impact — team members think their work matters and creates change
The research, set against Google’s sales teams and their financial goals, proved their findings. Sales teams that felt safe outperformed their goals by over 17 percentage points, while teams that reported they didn’t feel safe missed their goals by 19 percent.
Welle was quick to point out that psychological safety doesn’t mean being comfortable. Effective teams can be challenging environments if members feel they can express themselves freely and take risks. He drew from a healthcare organizational study conducted by Harvard Business School Professor Amy Edmondson that illustrated how important speaking up and psychological safety are to a healthcare team.
The study identified two types of team members — the adaptive conformer and the observant questioner — and how they reacted to obstacles, errors (both their own and others) and subtle opportunities for change.
The adaptive conformer adjusts and improvises without communicating to managers or teammates, seamlessly corrects the errors of others without confrontation, creates the perception that they never make a mistake and are committed to the organization and its processes.
“I know I’ve acted in this way many times,” said Welle. “I think we all have.”
Unfortunately, he added, it doesn’t lead to teams learning and improving. The observant questioner is the “noisy complainer” who corrects errors but also points them out so the team can learn from the mistake, and is a “disruptive questioner who won’t let well enough alone” when it comes to challenging the process and looking for ways to improve service delivery. So, it’s important for teams to have an attitude of learning from mistakes rather than assigning blame.
Welle's findings also showed the importance of post-mortems in the team process — so much so that he started conducting “pre-mortems,” asking his team at Google to brainstorm what could go wrong with a project before launching it. It’s one way they’ve turned the research into action.
Research into action
He admitted it can be daunting to take research and make it real and alive. At Google, Welle’s department is relatively small so they created “self-service” tools that teams can use to conduct a survey, create a report, discuss it and create an action plan.
He also urged the audience to be enterprising and read research. “There’s so much information the academic community has created that people don’t avail themselves of,” Welle said.
When asked how HR can foster trust, Welle said it’s important to publicly acknowledge failures. He pointed to Astro Teller, leader of Alphabet X (formerly known as Google X), whose philosophy of rapid iteration celebrates failures with as much respect and fanfare as successes. He added that Teller considers his role “devil’s advocate” to ensure that employees don’t kill a project before it’s been fully explored and that they debrief each failed project to foster learning across the enterprise. He suggested Teller’s TED Talk as a valuable resource.
In addition, Welle said that Google leaders demonstrate openness to feedback with a weekly meeting, "TGIF", hosted by CEO Sundar Pichai and Google's founders. They field questions from any employee, no matter how controversial, or if the question runs counter to an executive's point of view. “Employees need to be able to ask questions of their leaders and receive honest answers,” he said.
More on teams from the IPE Summit
Felix Ankel, MD, vice president and executive director of health professional education at HealthPartners Institute for Education and Research, led the breakout session “Learning organizations 2.0: 10 tips for success” and offered this advice:
- People are the books they read and who they hang out with. Hang out with different people than yourselves.
- No one is unapproachable. Ask... this is the most underutilized aspect of building a learning network.
- Are you trying to make a point or make a difference?
- Have the ability to cognitively bend.
- How many of your jobs look exactly like they did the day you started?
Eduardo Salas closed the 2017 IPE Summit with the afternoon keynote that discussed analytics and team assessment. The Rice University Professor and Allyn R. & Gladys M. Cline Chair, outlined his seven Cs of teamwork to answer the question, "How do you turn a team of experts into an expert team?"
- Capability... right people with the right mix of KSAs
- Cooperation... right attitudes about and willingness to learn
- Coordination... demonstrate necessary teamwork behaviors
- Communication... communicate effectively with each other and outside
- Cognition... possess a shared understanding of priorities, roles and vision
- Coaching... leader and team members model leadership behaviors
- Conditions... have favorable conditions (resources, culture, etc)
Salas closed with axiom, the "One Pizza Rule for Teams: If you have to buy more than one pizza, your team is too big."
By Julie Michener