1. Empowerment Some Practical Questions & Answers A Presentation for Hempstead Manor Kendall L. Stewart, MD, MBA, FAPA April 5, 2002 The Portable Mentor Presentation Series SOMCPress

2. What’s in this for me? Appropriate employee empowerment is essential to organizational success in the services industries. Everyone claims to empower employees, but this is easier said than done. This presentation will explore some of the myths of empowerment, and then offer some practical guidelines for success. You may want to pay close attention. A failed organizational empowerment initiative is at best a waste of time. At worst, such a failure will damage trust and goodwill forever.

3. What is empowerment? It is a management approach designed to give frontline employees the authority they need to do what needs to be done without having to check with management. In spite of all the favorable buzz, there is little hard evidence that it has really made much difference in routine organizational life. Some empowerment does exist and, when accompanied by accountability and appropriate guidance, it can lead to increased employee and customer satisfaction. Significant employee empowerment is rare, and it is not easy to initiate or maintain. I have been building leadership teams at SOMC for 15 years.

4. What are some of the common myths about empowerment? Everybody’s doing it. It’s easy. Every manager wants empowered employees. Every employee wants to be empowered. All the manager needs to do is leave the empowered employees alone. When I suggested patient care teams in 1982, the administrator discouraged me.

5. What are some guidelines for effective employee empowerment? Select the right managers. Choose the right employees. Provide training. Offer guidance. Hold everyone accountable. Build trust. Focus on relationships. Stress organizational values. Transform mistakes into opportunities. Reward and recognize. Share authority instead of giving it up. Encourage dissent. Give it time. Accept increased turnover. Share information. Realize that empowerment has its limitations. Watch for mixed messages. Face your own ambivalence Involve employees in decision-making. Be prepared for increased variation. Physicians are empowered. Are you ready for a bunch of employees like us?

6. Chose the right managers. Why? –Not every manager is capable of being a coach instead of a boss. –Facilitators are born, not made. –Controlling micromanagers will always slip back into their old ways. –Pick the wrong managers and everyone will see that you are only giving lip service to the idea. How? –Select leaders who are already empowering their colleagues routinely. –Confront dictatorial leaders. –Give them a fair chance to change, but make it clear that their odds of success are not good. –Call attention to leaders who are doing it right, and encourage young leaders to select them as mentors. An exasperated manager in a Leadership Team insisted on knowing who the boss was.

7. Select the right employees. Why? –Not every employee wants to be empowered. –Only a minority of employees want to work this hard. –Announce that everyone is empowered and watch the work come to a grinding halt. –Only volunteers are eligible. How? –Identify those people already taking the initiative. –Explain the risks and benefits of empowerment, and then wait for those who want to stretch to step forward. –Share information openly, and then identify those with good instincts, confidence and the willingness to take risks. Not every leader signed up to work on SOMC’s first book. That is okay.

8. Provide adequate training. Why? –The inclination to take the initiative is natural, but effective techniques are acquired through learning and polished through experience. –Those permitted to flail about aimlessly will quickly grow discouraged and withdraw. –Training increases confidence and encourages risk- taking. How? –Identify the most common challenges they will face. –Demonstrate attitudes and behaviors most likely to be successful. –Point out that nothing works every time. –Celebrate every incremental improvement; perfection is in short supply. –Enlist them as trainers ASAP. New physician leaders are a hoot. They think this is so simple.

9. Share information. Why? –Information really is power. –Everyone overestimates how much leaders know. –Sharing your information encourages others to share too; their information may be the key. –Data encourages analysis and discourages impulsive action. How? –Begin by asking what information is needed. –Encourage everyone to contribute to the information pool. –Except for personal stuff, avoid secrets. –Demonstrate openness. –Invite questions and challenges. –Change your position readily when new information demands reconsideration. I decided the mental stability of those with access the nuclear weapons in the Air Force.

10. Hold everyone accountable. Why? –Authority without accountability becomes self-centeredness. –Every little bit of power is seductive. –Unrestrained freedom is the seed from which tyrants grow. –Individual freedom introduces increased variation into key organizational processes. How? –Find out what happened. –Ask why it happened? –Inquire whether, on looking back, a better option might have been employed. –Let the emotion of the moment pass. –View mistakes as opportunities to grow –Let the empowered associate come to that conclusion on her own. I asked a nurse to come talk to me. Her nurse manager demanded to know why.

11. Where can I learn more? Argyris, Chris, “Empowerment: The Emperor’s New Clothes,” Harvard Business Review, May-June 1998. Nelson, Bob and Blanchard, Ken, Please Don’t Just Do What I Tell You: Do What Needs to be Done: Every Employee’s Guide to Making Work More Rewarding. Hyperion, 2001. Covey, Stephen R., “What is Empowerment?” Quality Digest, January 1996. Byham, William C. and Cox, Jeff, Zapp!: The Lightning of Empowerment: How to Improve Quality, Productivity and Employee Satisfaction. Facwett Books, 1998.

12. How can we contact you? Kendall L. Stewart, M.D. Medical Director Southern Ohio Medical Center 1805 27th Street Portsmouth, Ohio 45662 740.356.8153 stewartk@somc.org www.somc.org

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