Kendall L. Stewart, M.D.

Wouldn’t it be nice if we all just did what we are supposed to do? Some of us are more self-disciplined than others, but all of us tend to slack off if we can get away with it. All of us know that we should wash our hands between patients, but an astounding number of us will not do it unless someone is watching. It’s discouraging, but it’s just the way it is.

1. Specify the behavior you expect. Be very clear and specific. Describe precise behaviors. Resist the temptation to focus on attitudes. Assume nothing. When you have clarified exactly what you expect to happen, make it clear that you expect it to happen every time.

2. Inform people that you will be watching. Then watch. When people figure out that no one is watching, they will fall right back in to their natural patterns of non compliance. Do you really believe that anyone would follow the speed limit if the cops were never around?

3. Hold people accountable. The consequences for noncompliance must sting. If you issue parking tickets to those employees who park in the spaces reserved for patients but do nothing more, the transgressors will just tear up the tickets and keep parking improperly. And they will complain bitterly about receiving these annoying tickets. If, on the other hand, a ticket results in an automatic corrective action and a letter to their files, they will find another place to park.

How do you inspect what you expect in your company?

Kendall L. Stewart, M.D.

We all face a blizzard of complex and confusing processes every day at work. It is easy to get lost. Confused, discouraged and distracted, we fall into doing what is right in front of us, what we feel like doing—or doing nothing at all. We completely lose sight of the goal. Average or below-average results predictably follow. Deliberate, focused activity does not occur naturally. Leaders make it happen.

1. Focus on the results you want to achieve. You cannot focus on everything at once. Begin every leadership meeting with your performance dashboard. If don’t have a dashboard, create one. Focus intensely on those indicators that are currently not meeting your targets.

2. Figure out exactly what you will have to do to improve your performance. This is not as easy as it sounds, but you must do it. Since you have selected indicators that allow for comparative performance, someone somewhere is getting the job done. That means it can be done if you will figure it out and do it.

3. Review your task list at every meeting. Everyone loves to talk about what others should do, but personal accountability and follow through are not nearly as much fun. Make sure every task has a timeline and that someone is responsible to see that it gets done.

How do you use task lists to produce and sustain exceptional results?

Kendall L. Stewart, M.D.

You know exactly who these people are. They are miserable and they make everyone around them miserable. They complain and whine. They stir the pot and deflate morale. Their colleagues hate to see their names on the schedule. They are poisonous. You only keep these people around because you need warm bodies and because you are hesitant to deal them. You just keep hoping they will straighten up or leave on their own. They never do.

1. Describe your net-negative colleagues in specific behavioral terms. This is not an issue of whether you like someone or whether they are popular. It’s about how they behave. It’s about repeated patterns of disruptive behavior or poor performance that have rendered the work environment toxic and limited the results you might have achieved without them.

2. Give them fair warning. These malcontents deserve a fair chance to turn themselves around. Meet with them. Tell them exactly what they are doing wrong and what they must change. Follow this up with a letter documenting your conversation and laying out the consequences of their failure to comply.

3. Do not set a deadline. Almost everyone can act better for 90 days or so. Make it clear that their negative behavior must change immediately. Emphasize that their behavior changes must be permanent. Any future regression into negativity may result in summary discharge without further notice. This is not a progressive corrective action. This is a line. They must tow it or leave.

How do you remove net-negative colleagues from your organization?

Kendall L. Stewart, M.D.

It would be great if all of us were equally effective leaders. That is just not the case. Some leaders are truly exceptional. Some are awful. Most of us are more-or-less average. Given this reality, every leader is obligated to field the best leadership team possible throughout the organization. This imperative is the most important test of leadership. It is not easy. Every leader is a legend in the leader’s own mind. Every person who has a leadership job believes that he or she deserves to keep it. We all have reasonable excuses for not producing results. It’s never our fault.

1. Take a hard look at your current leadership teams. Ask yourself if you could do better. If you could, then you must. It’s that simple. Do not permit your discomfort to dissuade you from doing your duty.

2. Ask your colleagues whether you are obligated to field the best possible team. This question will get everyone thinking more clearly. It will force everyone to face the competitive reality that leaders are not all the same. It will remind everyone that leaders exist to produce results, and it will trigger the sobering realization that fielding the best-possible team is their duty too.

3. Trade up. You can give lip service to fielding the best possible teams, but no one will believe you unless you actually do it. If you tolerate mediocre leaders when better people are idling in the wings, everyone will realize you are all talk. And your boss will be thinking about replacing you with a more effective leader.

How have you fielded the best possible leadership teams? What barriers did you overcome to accomplish this?

Kendall L. Stewart, M.D.

You have learned by now that people want to do what they want to do. They resist processes. They deride them as “cookbook” or “kindergarten.”  Most people would much prefer to fly by the seat of their pants. But the only way to consistently produce the results you want is by following a process that will produce those results.

1. Identify the process owners who care. Don’t waste your time with the slackers and whiners. Talk to the people who want to make a difference. You know who they are. They have good ideas about how to make things better, but their negative colleagues have hooted them into submission. They have just about given up. Your invitation to suggest how their daily processes might be improved will be a breath of fresh air.

2. Invite them to suggest how the process might be improved. Begin your discussions with the results you want to achieve. Document your current level of performance. Emphasize the gap. Ask your quiet champions to tell you what goes wrong and ask them how the process would flow better. They have ideas. No one has been interested before.

3. Find evidence-based processes. Somebody else in the world is probably successfully accomplishing what you are trying to do. They almost certainly have a process in place that they have been perfecting for a number of years. Ask them if they will share what they have learned. You will be amazed how often even your competitors will share their insights.

4. Document these processes. When you think you have found an evidence-based process that will work for you, write it down. Make it available. Be sure it is simple to understand and to use. Keep it short. Then keep improving it. Keep it up to date.

How do you identify and deploy evidence based processes in your company? What are some examples?