The Relational Link

While processes, protocols, procedures, and technology play an important role in the day-to-day of high-quality clinical care, the equally-important dynamics of “team-work” — how each of us “shows up”, engages in everyday interactions, collaborates, and pays attention to the characteristics of our relationships — don’t often receive the same level of attention as the technical aspects of our work. Increasingly, research suggests that what distinguishes some high-performing teams is their ability to focus on both functional change and cultural change at the same time.

Further, the data suggest, low-performing teams only focus on either functional or cultural change alone. Data, insights, and perspectives during COVID-19 are showing the value of these relationship strategies during the pandemic and the importance of implementing them in the long term.

COVID-19, Wellbeing, and Relational Strategies

Communication and Transparency as a Means to Strengthening Workplace Culture During COVID-19. This National Academy of Medicine article discusses the role of optimizing transparency and communication within the framework of medical teams as an essential component of a strategy to address clinician burnout, particularly during COVID-19. Leaders at Brigham and Women’s Hospital found that methods like community building activities can nurture relatedness, fulfill a need for camaraderie, and build a high-functioning team, and that a dynamic essential to establishing a culture of wellness is one in which trust is earned.

The Changing Face of Medical Professionalism and the Impact of COVID-19. Andrew F. Goddard, President, and Mumtaz Patel, the Global Vice President of the Royal College of Physicians in the United Kingdom, writes in The Lancet that COVID-19 has shown that we must move away from a model of medical professionalism that can lead to moral injury and towards one that provides proactive support for professionals in a systematic way and is focused on supporting moral repair. There have been here have been many wellbeing initiatives for clinicians that have been well received, but over time they need to be combined with organizational interventions and a wider systems approach that will lead to greater cohesiveness within healthcare and support individual professionals in a safer, more sustainable way.

Six Lessons on Fighting Burnout from Boston’s Biggest Hospital. Massachusetts General Hospital's Joshua J. Baugh, the assistant director of clinical operations, and Ali S. Raja, the executive vice chair of the Department of Emergency Medicine, share with the Harvard Business Review the strategies that have worked in their organization during the pandemic: rewarding work, fairness and transparency, autonomy, reasonable workload, a sense of community, and consistent values. Together, these actions underscore a universal and fundamental principle: the best way to prevent burnout and attrition is to empower people to perform their jobs effectively, in an environment that is safe and supportive.

Clinician Burnout During a Pandemic: Worsening Before It Gets Better (subscription required). A recently released survey of NEJM Catalyst Insights Council members found that 70% of respondents anticipate healthcare provider burnout at their organization will get worse in the next 2–3 years, up 10% points from their September 2017 study. For many, COVID-19 has exposed the degree to which providers are being overwhelmed with administrative requirements and their lack of capacity for additional tasks. When asked what healthcare leaders should do, Council Members said the top three actions are increased engagement with frontline leaders, empowering clinical leaders in problem-solving, and adoption of servant leader philosophy — essential dynamics of team-work.

Psychological Safety, Leadership Development, and The Post COVID-19 Era

Psychological Safety and the Critical role of Leadership Development. Survey findings released by McKinsey & Company released in February 2021 show that investing in leadership development across an organization — for all leadership positions — is an effective method for cultivating the combination of leadership behaviors that enhance psychological safety. The authors, including Amy Edmondson, an expert in the field of psychological safety, note that given the quickening pace of change and disruption and the need for creative, adaptive responses from teams at every level, psychological safety is more important than ever. The organizations that develop the leadership skills and positive work environment that help create psychological safety can reap many benefits, from improved innovation, experimentation, and agility to better overall organizational health and performance. It’s critical to develop a taxonomy of skills (having an open dialogue, for example) that not only supports the realization of the organization’s overall identity but also fosters learning and growth and applies directly to people’s day-to-day work.

Co-Creating a Thriving Human-Centered Health System in the Post-Covid-19 Era (subscription required). Emotional intelligence, humility, and a strengths-based approach to leadership are associated not only with workforce satisfaction, but with improved quality of care. Though there are no existing guidelines for health care leaders to foster well-being following a pandemic, organizational development research points to evidence-based leadership actions during the tail of the pandemic that could not only promote well-being in the short term but also imprint more permanently into the culture of the healthcare system. This 2020 NEJM Catalyst article argues that rebuilding thriving healthcare delivery organizations will require a newfound focus on relational and cultural leadership strategies, such as articulating a sense of purpose and cultivating psychological safety.

As calls for transformative change throughout healthcare continue to grow, finding common ground through shared values is an important first step. This must start with relationship-based strategies and exploring together the many ways our backgrounds, values, leadership strengths and growing edges, and approach to conflict impact not only our individual success and satisfaction, but also that of our team and institution. As we look ahead to the post COVID-19 era, we need to engage all team members in rebuilding new, higher-functioning communities systems that promote workforce well-being and the integration of both relational and technical best practices.

The Relational Link brings together frameworks, data, and on-the-ground stories of Relational Leadership in action. By incorporating perspectives from relational leaders in the field and lifting up fundamental lessons in PCP’s Relational Leadership framework, we’ll demonstrate “how” and “why” these moments of connection matter, and how transformative, safe, authentic, and trusting relationships can have a big impact.

 

PCP Founder and Chair Andrew Morris-Singer introduces Relational Link with three core concepts below.

Relational Dynamics: The Fundamentals of a Strong Team and Culture
Data suggests individual and team performance in healthcare is highly dependent on the characteristics of our relationships. Focusing on both the technical processes and the relational “team-work” can improve team performance and make employees happier.

 

Your Role in Creating Psychological Safety and the Signals We Send
Psychological safety was first defined by Amy Edmondson as a shared belief that a team is safe for interpersonal risk-taking. These are examples showing how psychological safety can be created and maintained, and why its presence — or absence — makes a difference on healthcare teams.

 

 

Finding Common Ground to Catalyze Change: Examples of Relational Leadership in Action
Conversation, negotiation, and compromise all require a relational approach. But how does this work when collaborating at the community, state, or institutional levels? Here’s how Dr. Michael Klinkman in Michigan and Dr. Howard Haft in Maryland used relational techniques to advance health and healthcare reform, and why these techniques are vital to our society right now.

 

Now more than ever, PCP is committed to helping clinicians and teams build connection, community, and agency. Because we believe that getting relationships right will be a catalyst for change in healthcare and health.

A New Take on Leadership