Team Training

July / August 2012

Shared Learning for True Teamwork

Shared Learning for True Teamwork

Commitment, not compliance, is the goal. Today’s healthcare organizations seem to be shifting from a command-and-control style to one of increased collaboration among all levels of the hospital. Interdepartmental collaboration, too, has taken center stage as the importance of service lines and managing populations becomes apparent. Today’s healthcare professionals desire and need to be involved in the continuum of the patient experience, which may extend beyond their traditional departmental duties. The training of individuals must reflect this shift and incorporate principles of creating shared meaning, which promotes commitment, versus compliance-driven top-down approaches.

Throughout my career, I have worked as an internal organizational learning and development (OLD) professional for various health systems. Positioning OLD internally is advantageous for the learning organization because it allows the organization to learn from “one of us.”  Internal OLD positioning can prevent learners from feeling “done to” by episodic encounters with consultants who may be unfamiliar with the organizational culture and who depart the organization upon completion of their work. Serving my internal clients has taught me numerous valuable lessons:

Train teams, not individuals.
Often, staff members are sent off to conferences on their own to gather new information. These individuals, excited to return and share new information and experiences with others, often are met with a deflating “huh” from colleagues. It is not surprising that individuals may find it challenging to communicate new information and enthusiasm to team members. The value of a shared team experience cannot be underestimated toward adoption of new information and team function. The often-heard expression “you had to be there” captures the importance of this concept. Content (what) without context (why) is seldom sufficient in the pursuit of change. Context is achieved through a shared learning experience in “striving together” towards a desired state.

Never work harder than the client.
When working with one of my internal clients a number of years ago, I learned an important lesson about team dynamics and professional boundaries.

I was working with a communications team within a healthcare setting that was experiencing team dysfunction around the matter of conflict. We were in the third evening of 2-hour development sessions. The group had stalled and seemed to be at an impasse. The director of the team filled in any awkward silence with non-pertinent information so as to avoid her personal discomfort with silence. I further noticed that the team was focused on my facilitation and questions. Once I realized the problem, I informed the group that the director and I were going to leave the meeting. The team was shocked and inquired why the director and I were leaving. How would the team resolve its problems without leadership?

It had become evident to me that the director and I were working harder at their problem than they were. My desire to resolve their problem was actually impeding their progress and limiting their ability to resolve their problem. I communicated that to the team, and the director and I left.
The following morning we learned that after we left, the team sat in awkward silence for five minutes. Predictably one brave soul finally spoke up and named the elephant in the room. The team took ownership and acted only after they realized that leadership was not going to resolve their problem for them.

As this example illustrates, teams often look to leadership to resolve difficult issues. The wise leader resists this temptation and creates a holding environment for difficult matters to be discussed. Giving the work back to the people is the responsible response from the leader. Whoever has the issue is the leader and is the owner of the problem. In his book Leadership on the Line (2002), Heifitz provides an excellent model and template for mobilizing people to do the difficult work of adaptive change.

Provide common focus.
Healthcare organizations are typically structured in a traditional corporate hierarchy. Existing within this hierarchy, however, is an organizational substructure defined more by professional roles than the relationships within the organization. Each profession values its autonomy and may place its own goals ahead of the goals of the organization. This can result in professions and the organization working at cross-purposes.

Recently, one of our hospital departments was engaged in colleague engagement improvement efforts. Findings from their colleague engagement survey identified opportunity within the question, “I receive the necessary support from employees on other units/departments to help me succeed in my work,” which received a low score. This division consisted of departments throughout the hospital all engaged in direct patient care and yet not routinely interacting with one another. The oft-noted “silos” had developed, resulting in decreased interdepartmental collaboration.

Lencioni’s book Silos, Politics and Turf Wars (2006) provides a solid reference to assist teams to achieve greater team collaboration. This book was distributed to all patient services team members as required reading prior to an all-day retreat to address the low-scoring question.

At the retreat, we asked all 15 team members to identify their “primary team.” Predictably, leaders named the individual departments in which they provided oversight as their primary team. Upon hearing this, the team immediately realized their problem as being a collective body of 15 silos. The phrase “working alone together” seemed to describe their current state. The team was then challenged with the question, “What would it take for you to name ‘this team’ as your primary team?”

It became evident to the team that Lencioni’s “thematic goal” (single, temporary, qualitative rallying cry) was the piece that was missing and necessary for enhancing team collaboration. This again describes the power of a team moving collectively towards a shared purpose. The team wrestled for an hour with the naming of a thematic goal and eventually settled on “Restore Respect” as its goal for the next period of time. This exercise and the resulting work, which included changing the structure and focus of future meetings, seems to have improved team engagement, energy, and sense of purpose.

Given the high value placed on professional autonomy in the past, rigid organizational hierarchy may fail to meet the needs of today’s healthcare culture. However, creation of shared learning experiences that cultivate trusting and interdependent relationships throughout all levels of the organization may provide the critical “glue” that connects a healthcare organization together.

Tom Hanson serves as director of organizational learning and development at Sacred Heart Hospital in Eau Claire, Wisconsin. He is a certified professional co-active coach, a Studer-certified Internal Organizational Excellence Coach, and is certified in the use of the Just Culture algorithm. Hanson is passionate about assisting individuals, teams, and organizations achieve their potential. He may be contacted at

Heifetz, R. (2002). Leadership on the line. Boston: Harvard Business School Press.

Lencioni, P. (2006). Silos, politics and turf wars. San Francisco: Jossey-Bass.