The Stellar Healthcare Team: How to Take Your Good Employees to the Next Level

If you’ll not settle for anything less than your best, you will be amazed at what you can accomplish in your lives.

– Vince Lombardi

Creating a stellar team is one of the hardest things a healthcare executive can do, for three reasons. First, you may have employees who are satisfied with their adequate performance and who hold fast to the idea that good enough is good enough. Such employees may be unmotivated and unwilling to change. Second, you may have external pressures working against you such as limited resources, problem employees, understaffing, or an HR mess you’ve inherited from a predecessor. And third, you may have employees who want to improve but who have trouble doing so because change is often complex, hard, and unpleasant. Employees who seek to improve their performance must disrupt comfortable, familiar habits while simultaneously fostering new, possibly unfamiliar, ones. They may be filled with self-doubt, lack needed skills, falter, and backslide. Call(1) warns, “This process [changing behavior] takes time—usually longer than we prefer.” In some cases, the change employees aspire to is so painful and takes so much effort and time that they give up, reverting to their more comfortable good but not stellar performance.

Talent and motivation need to be nurtured.

Although creating a stellar healthcare team is one of the hardest things a healthcare executive can do, it is also one of the most important. Everything that happens in your healthcare organization relies on the people who work in it. In fact, your employees are your most valuable asset, more so than the building you sit in or the equipment you use. The quality of your professional services and the very reputation of your healthcare organization depend on your employees. As VP Legacies(2) says, “Employees champion your business and determine the success or failure of it.” Healthcare executives can certainly be grateful for their good employees. However, they cannot afford to allow good-level performance to slide by unnoticed and unchanged year after year because they are too busy putting out fires or racing to keep up with a punishing workload. A stellar healthcare team must be every leader’s goal.

It’s up to you to set the bar high. It’s also your job to identify what next-level performance looks like for your employees individually and as a team and, then, to help them to get there. Ideally, a stellar team begins at recruitment. Every healthcare executive wants to hire job candidates who have the potential to become stellar employees, and there is merit in seeking the best of the best. Yet while hiring the best talent helps stack the deck in your favor, that strategy alone will not ensure stellar performance from your healthcare team. Even the most promising job candidates can plateau or become jaded once on the job if we are not careful with them. Talent and motivation need to be nurtured. It’s hard for new hires to hang onto their rookie enthusiasm and work ethic when they are surrounded by coworkers who do a good job but who don’t seek to improve, or who have just-OK working relationships with one another. McKinnon(3) explains, “Employees can become uninspired, distracted or frustrated if we don’t develop a positive and collaborative work environment for them.” Certainly, they will be unlikely to reach their full potential and may learn to settle, as others have, for good-enough performance. Those new hires who hang onto their desire and passion to be stellar performers won’t remain for long in an organization that doesn’t foster that excellence within them. When they’re ready to seek greener pastures, another employer will be all too happy to encourage and help them to improve if you and your organization can’t or won’t.

Most healthcare organizations have good employees. They may even have some stellar ones. But imagine if you could help your good employees to ramp up their performance to the next level. Imagine a healthcare organization where every employee is continuously improving, striving ever upward to achieve higher and higher levels of performance. As Hppy(4) argues, “It is your responsibility to take them [your employees] from good to great.” Doing so will benefit your employees but also, your healthcare organization and every patient you serve.

The Benefits of a Continuously Improving Healthcare Team

Your employees will be most receptive to leveling up their performance if you take time to prepare them for the task. Without preparation, they may dig in their heels about what you ask of them or be afraid that their jobs may be in jeopardy. Some may placate you by telling you that they want to improve their performance but not do so in spirit or deed. Be transparent about your motives.

Describe what your employees stand to gain if they level up their performance.

Naturally, your employees will suspect that you want them to improve their performance for the sake of your organization. Admit to them that this is true. Your organization will enjoy many benefits from their improved performance, such as increased productivity and profitability, lower costs, more efficient operations, fewer errors, lower turnover, and higher quality. These are the outcomes every healthcare executive seeks, so be unapologetic about it. However, help your employees also to see that your goal as a leader is to develop them professionally and to help them to succeed. Share with them the benefits that they will enjoy both personally and professionally by bringing their performance to the next level. As Skhmot(5) argues, “Knowing the benefits of the process can provoke action, allow for proper allocation of resources, and inspire everyone to put in the hard work necessary to pull off a successful program.” Before proceeding, be sure that your employees see that, as Nye(6) suggests, becoming next-level employees “benefits everyone, not just the business.”

Specifically, describe what your employees stand to gain if they level up their performance. Here are five of those benefits described in detail, with several more listed later. Explore these with your employees, but also ask them what they think they will enjoy when they bring their performance to the next level:

• Better work environment: Problems can be solved and the work environment can get better. But do your employees believe this? Have they experienced it? Nothing demonstrates that the work environment can improve more clearly to employees than leaders who take action, have high expectations, and continuously work to make things better for the people they lead. Be a continuously improving leader and show your employee how bringing their performance to the next level will make the work environment better for everyone.

• Greater happiness: Employees will enjoy working in a better work environment, and logically, Nye says, “Better working environments result in happier employees.” Continuous improvement, when undertaken without inordinate pressure, ultimately makes employees’ jobs easier, not harder. It can promote higher morale, a sense of wellbeing, and greater happiness about work.

• Less fault-finding and conflict: Employees who are happy are far less likely to find fault with others than employees who are unhappy or neutral in their feelings. Happy employees are less likely to nitpick, spread gossip, or complain about coworkers. They usually don’t dwell on negative thoughts for long and are less likely to act on them. As well, happy employees are less likely to take the bait and engage in a fight when a coworker provokes them. In short, Nye says, “Happier employees are less likely to create conflict with others.”

• Better relationships with coworkers: Happy employees are more likely to form strong teams. They generally believe that obstacles will be easier to overcome if they work together. They will believe, too, that creativity will flourish through collaboration and that achieving goals as a team will be extremely gratifying. They will find that victories will be sweeter when they are won together. Happy employees will also find that it is easier for them to stay motivated and true to their individual next-level paths when the whole team is doing the same. As Milsom(7) suggests, “Continuous improvement acts as the glue” that helps employees to develop stronger bonds and to work collaboratively.

• Opportunities for advancement: Of course, you cannot promise your employees that improving their performance will guarantee them promotions and raises. However, you can tell them that setting and achieving higher performance goals will be reflected positively in their performance reviews. And, as Indeed(8) suggests, employees who produce quality work and continue to improve “are more likely to have greater job security.”

There are many more benefits that employees will enjoy by leveling up their performance. For example, they may feel that they take more pride in their work, that work is more interesting, and that they are developing new skills and gaining new knowledge. They may find that their confidence is increasing, too, as they master new skills and that it is exciting to work toward becoming the best version of themselves. There is something naturally appealing about self-improvement. Greco(9) explains, “I am an absolute sucker for a before and after. I love watching home improvement shows. It’s amazing to see the big reveal at the end and see how all of that hard work paid off to create something absolutely beautiful.” So, too, will your employees enjoy seeing their progress and results. If you doubt the allure of self-improvement, take a look at the number of self-help resources that you can find in a bookstore or online. In fact, think for a moment about why you are reading this article right now. Aren’t you reading it because you want to improve or expand your approach to managing your good employees and to add new tools for your leadership toolkit? Your good employees are no different. They, too, will be attracted to self-improvement activities, provided that they see them as such. Therefore, be sure to help your employees to appreciate that taking their performance to the next level, from good to stellar, will indeed be a gratifying self-improvement effort.

Apply the “i+1” Principle to Employee Performance Improvement

The i+1 Principle is a learning theory developed by the linguist Stephen Krashen(10) in the 1970s. It suggests that learning is most effective when we meet a learner’s current level and add just one level of difficulty, like the next rung on a ladder. Western(11) suggests that although Krashen developed his i+1 Principle for those striving to learn a new language, “We’re talking about more than just language here, this applies to anything you decide to do.”

I’d like to share with you now an example of how Krashen’s i+1 Principle worked in my own life to illustrate how you can use it with your employees to help them improve their performance. I play jazz standards on the piano. Several years ago, I wanted to improve my playing, so I decided to listen again and again to recordings of the greats, like Art Tatum, Oscar Peterson, Marian McPartland, Errol Garner, and Mary Lou Williams. However, my playing got no better, no matter how many times I listened to a song or how hard I tried to figure out what these incredible pianists were doing. Then one day I stumbled upon recordings of jazz standards by a pianist I’d never heard of (and probably most people haven’t). He was a cocktail pianist at a hotel lounge. His playing was very enjoyable but just a little bit better than mine. I listened to his recordings repeatedly and found that I could figure out what he was doing that made his playing better. Pretty soon, with more listening and practice, I pulled myself up to his level for one song, then another, and another, until my overall playing improved. There is no way that at my level of playing at that time or even now that I could begin to understand how to play like Oscar Peterson. His intricate runs and improvisations were and are unfathomable to me and certainly beyond my technical ability. But playing like that relatively unknown cocktail pianist was something I could achieve because he was only a little better than me. In Krashen’s terms, his playing was +1, or one level above mine. Peterson’s playing, on the other hand, was probably +1000.

Your job will be to inspire your employees to set their sights high and to work toward them step by step.

If we ask employees to ramp up to Oscar Peterson-level employee performance, it will take a miracle for that to happen. Too ambitious a goal can overwhelm them, and they may react to it by deciding that it is impossible. However, if we ask them to level up just one level, as Krashen suggests, such a goal will seem reasonable and within their reach. When they make it to that next level, they can set their sights on the level one step higher and achieve it, too. Then they can move on to the next level and the next and the next. Employees who are continuously applying Krashen’s i+1 Principle to their self-improvement will enjoy many successes along the way that will reinforce their efforts. They will also learn a strategy that they can use to improve their performance continuously throughout their careers.

Your job is to help your employees to identify their +1s, give them the support and time they need to work toward them, troubleshoot and guide when needed, and reinforce and reward their efforts and accomplishments. Your job also will be to inspire your employees to set their sights high and to work toward them step by step. As Muhammad Ali(12) wrote toward the end of his life, “I have learned to live my life one step, one breath, and one moment at a time…I am still learning.”

How to Create a Next-Level Culture in Your Organization: 10 Strategies

Employees can be motivated to improve their performance by different things. As Hppy suggests, “Anything from positive reinforcement to providing methods of professional development and upward mobility can have a desirable impact on employee development.” However, what works to motivate improvement in one employee may not work for another. The common denominator in every stellar healthcare team, though, is a leader who creates a next-level culture, one who envisions, describes, motivates, supports, and reinforces next-level performance for everyone. Here are 10 strategies that you can use to create that culture within your organization:

1. Start with yourself. Oliver Goldsmith(13) famously wrote in 1832, “People seldom improve when they have no other model but themselves to copy.” His words ring true today. What are you doing to level up your own performance? For instance, what books are you reading, courses are you taking, conferences are you attending, or new skills are you learning? Are you working with a leadership coach or a mentor? Do you meet regularly with other leaders to share best practices? Have you been the subject of a 360-feedback review? Webster(14) suggests, “You must become the change you want to see in your team or organization.” Commit to leveling up your own performance and share your next-level goals, strategies, and progress with your employees.

2. Involve your employees in defining stellar performance. When it comes to your team’s performance, you will ultimately be the person to set the bar where it needs to be. However, your employees will take to the idea of leveling up more willingly if they have been part of the bar-setting process. As Horlick(15) explains, “By getting employees actively involved in a change that impacts them directly, you will provide them with an increased sense of control, build their commitment to the change and reduce the amount of resistance that is likely to occur.” Hold one or more staff meetings to engage your staff in a discussion about what stellar performance looks like. Where have they seen it both inside and outside your healthcare organization? Then ask them to identify ways that their good performance falls short of that definition of stellar. Ask them, too, to identify obstacles that they believe stand in the way of their achieving higher levels of performance. Asking and answering these questions together will encourage your employees to feel ownership of the process. That can feel very empowering as they embark on their leveling-up journey.

3. Emphasize the importance of soft skills. For decades, there’s been a strong emphasis on technical or hard skills in the workplace. Job candidates often are hired because of their training, credentials, certifications, technical knowledge, and experience. However, Keogh(16) says, “Hard skills get you hired, soft skills could get you fired.” That’s because soft skills, though usually harder to define and measure than hard skills, are just as critical. Explore with your employees the ways that leveling up their performance may require them to improve their hard skills, soft skills, or, very possibly, both.

4. Focus on what they are already doing well. It’s all too easy to dwell on our shortcomings. Help your employees begin their leveling-up efforts by taking stock of their strengths. Hppy suggests, “Your goal here is to build your employees up.” A strengths-based approach to self-improvement allows employees to capitalize on what they already do well. Be generous with your well-deserved compliments. Hppy says, “Complimenting employees is a simple way to make employees feel empowered and invested.”

5. Establish the first achievable i+1 goal. You may work with employees one-on-one to establish the first goal that they will tackle individually. You may also establish the first goal that your team will tackle together. In either case, agree to goals that are i+1, or only one level up from where employees are now. Stick to a behavioral goal that is easy to describe, observe, and measure. Make it specific. For instance, being friendlier to patients is too large and too unclear a goal. Making eye contact and smiling at the beginning of every patient interaction is a more manageable and measurable goal.

6. Go for a quick win. Ideally, employees should achieve their first goal in no more than one month. Reynolds(17) explains, “Quick wins seem like the antithesis of long-term performance improvement. Yet strategic leaders realize that quick wins are in their arsenal of tactics because it helps them achieve the Holy Grail of business leadership—sustainable long-term performance.” Keep in mind that the setting of the first goal presents a tender moment in the self-improvement process. Leveling up with this kind of focus and intention may be a new experience for your employees, and they may not feel sure about it. Don’t allow them to be too ambitious. Quick wins, especially at the beginning, are what Reynolds calls the “#1 way to keep the momentum going in the right direction.”

7. Establish a precise strategy for achieving the first goal. Work with your employees to figure out how they will work toward achieving their first goal. There may be more than one way to go about it, or it may be that a combination of strategies will work best. The key here is to explore the options and involve your employees not only in the “what to do” but also in the “how to do.” Are they going to take an online course, read a book, shadow a more-experienced employee, or practice a new skill at least 30 minutes a day? Are they going to document a behavioral change? For example, if they are trying to make it a habit to smile and make eye contact with every patient, how are they going to track their progress patient by patient, day by day?

8. Establish a deadline. When will your employees reach their first goals? One week? Two? One month? Choose a “Goldilocks” deadline for the goal—not too soon, not too late, but just right. As Young(18) suggests, “Parkinson’s Law states that tasks expand to fill the time given to them. By setting a strict deadline in advance you can cut off this expansion and focus on what is most important.” Don’t give your employees so much time that they lollygag, but also don’t give them so little time that they become stressed or give up. Young explains, “Robots can work without sleep, relaxation, or distractions. Your employees aren’t robots.” Therefore, don’t schedule your deadline with the expectation that your employees can work 16-hour days to meet it. As Young says, “Death marches aren’t healthy.”

9. Establish metrics or other assessment methods. How will you determine that your employees have achieved their goals? Will they have to demonstrate a new skill they learned or show you precisely how their behavior has indeed changed? Keep in mind that it is not adequate that they completed the strategy that they set forth, such as reading a book or attending a program. Those are learning goals, not performance goals. If they have done what they said they would do but they have not achieved their performance goals, you will need to work with them to figure out why, and next steps. It may be that the goal was too ambitious or that the learning strategies were not adequate. Or it may be that there was an obstacle standing in their way. A smaller goal, additional learning strategies, and more practice time may be needed. If so, reset the goal and strategy, and come up with a new deadline. Keep up with the employee’s progress the next time around and troubleshoot as needed.

10. Celebrate successes. It can be tempting when employees succeed in achieving their goals to jump immediately into the next ones. Take a beat before they do. Celebrate and reinforce your employees’ accomplishments, even if they were small. Amabile and Kramer suggest, “When we think about progress, we often imagine how good it feels to achieve a long-term goal or experience a major breakthrough. These big wins are great—but they are relatively rare. The good news is that even small wins can boost inner work life tremendously.” Reinforce the good work your team has done and make an effort to follow up with each of your employees individually. Amabile and Kramer warn, “The power of progress is fundamental to human nature, but few managers understand it or know how to leverage progress to boost motivation.” Talk with your staff about the sheer joy there is in progress. Congratulate them on their good work. Give them credit for achieving their goals or for trying if they did not.

Some goals will be achieved and require no follow-up. For instance, earning a certification is a one-and-done goal. Once the employee earns it, it’s done. However, behavioral changes require further assessments to ensure that the employee keeps up the new behavior and doesn’t backslide. Establish a follow-up assessment schedule and continue it until you and the employee are certain that the new behavior has become a habit.

What More Can You Do to Create a Stellar Healthcare Team?

The focus of this article has been on helping your employees to level up from good to stellar through goal setting and accountability. However, there is much more that a healthcare executive can do to create a stellar team. Additional leveling-up strategies, in fact, are the topics of my staff development articles in this journal. For example, I have written articles on coaching better performance, teaching your staff the basics of customer service, fostering a culture of gratitude, leveraging the informal leaders on your team, and creating an outstanding onboarding experience for new employees. I’ve written, too, about increasing team commitment, improving the workplace experience, using rituals to strengthen the team, teaching customer service basics to your employees, and fostering an above-and-beyond attitude in your employees. For more than two decades, I have written on these and other staff development topics in The Journal of Medical Practice Management, all aimed at helping healthcare executives to improve their employees’ performance. These strategies and many more are excellent ways to improve the performance of a good healthcare team.

That said, professional development is not a spectator sport. Your employees must be accountable for their own professional development and play an active role in it. They must work collaboratively with their teammates and with you to level-up their performance, and they must be willing to do the work. Simply put, you can’t do all the work for them, nor should you try to. At the end of the day, it is what they learn, what they practice again and again, what they strive for, and what they achieve that will determine whether they will improve or stagnate. The powerful combination of the individual work employees do plus the additional creative and strategic efforts of a good leader is what is necessary to transform a good employee into a stellar one.

When you ask your good employees to improve their performance, remember that it’s a big ask. Many employers would be thrilled to have good employees and would be happy to settle for good performance. Asking good employees to become better may not be met with triple cartwheels. Have patience, keep at it, and don’t let your employees lull you into that “good-enough” trap. Stay firm in your commitment. See the potential in your employees. It’s there if you look hard enough. Then, stay with it. The only way you will ever create a stellar team is if you believe that it is possible and if you are willing to be the catalyst for change.

References

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Ten Barriers to Creating a Stellar Healthcare Team

Even highly motivated employees who want to improve their performance may hit some roadblocks along the way. Hearn(20) identifies 10 barriers that employees often face when attempting to level up their performance and suggests how you can overcome them.