Latest / Integrity at Scale™ / When Urgency Feels Like Clarity
Transcript
- Hey, Dr. Tara Vossenkemper here. You're listening to the Culture Focused Practice podcast. Thank you for being here with me, of course. So you know if you're a leader at a practice, you know that there are moments, times, experiences where one freaking thing can happen and it makes you question everything, the entire system. The work that we have to do is not to, A, dismiss the alarm entirely because it might be legitimate, or, B, obey it without thought because it might not be anything. Our goal, our role as leaders is to figure out what's actually happening before our response becomes the second problem. That's also where leadership gets hard. I think that's where leadership gets hard. The way that you read an event shapes what you do next and what the system then learns from your response. So that's what we're talking about today, and to get there, we're gonna go through four agenda items. We have, number one, the loudest thing feels global. I love that, actually. Uh number two, action can soothe the leader. Guilty as charged. I think you probably are, too, to an extent. Number three, moving quickly for safety. That'll make more sense when we get there. And number four, your response teaches the system. So agenda item number one, the loudest thing feels global. So think about this. Whenever something happens, whether it's an angry client call or email, whether there's a massive billing disruption, whether there is a shitty review, whether there's a terrible week with scorecard metrics, whatever it is There's a very big difference between this is happening and this is happening everywhere. Those are two very different things. What I think can happen for some of us is that the intensity of how we're feeling shrinks the space between a thing happening, you know, a, a situation, a circumstance happening, and it feeling like it is happening all around us, like everything is just going to shit. One of my favorite questions to ask, and I mean, I'm saying this like I'm good at it all the fucking time or something. That's absolutely not the case, but I am consistent with it because it is something that we will frequently talk about in leadership, even whenever we're dealing with issues, you know, in our IDS time, issues list time, within our L 10 meetings. So one consistent thing that we have learned to ask ourselves is whether or not whatever is happening is global or specific. Because if this is a global experience, then you should have way more than one example of it to, you know, support that stance. And if something is global, obviously, you know, your approach to it is different than if it's something specific, for me, the question is about clarity. So I would say the purpose of the question is clarity, but then the indirect effect, I don't know if indirect effect is the right word, tertiary benefit, something like that, is that it also helps to decrease some of the intensity of how you might be feeling. Like, it creates a little bit of space between, thing and emotional response. Or again, just the intensity of the reaction, like it just, shoo, like powers it down some. I mean, I think about, a client, like somebody sending an angry email, let's say it's just kind of a fluke. And I'm, I'm trying to think of a recent example. I feel like we have had something recently where, yeah, I mean, we had, a situation where the client was very disgruntled with our intake process. And for the record, we messed up. We absolutely messed up. I love my client care coordinator. I think she is the fucking bee's knees, and she just missed something, and she's great 98, 99% of the time. She's also human, and like all of us, all the rest of us who are human, she makes mistakes in the same way that everyone else does. A lot of the time, mistakes are met with graciousness because we also, you know, core values for us are owning your shit, so if you make a mistake, you own up to it, and you say, "Oh my gosh, that was me. I'm so sorry. Here's what I can do to fix it." And you try to make it right, you know? And so there's ownership and accountability, and also, here's what I can do. Again, a lot of the times those are met with graciousness from people, 'cause I think most people can recognize that everybody makes mistakes, and sometimes that's not the case. And so there was a very disgruntled person, and The reality is that The intensity of the feeling was there, but we don't need to go in and adjust a bunch of things that client care is doing, create new rules, create new processes, create new automations, create a whole new intake workflow because of one mistake. Regardless of how unhappy this person was, the flip side is that if this happened multiple times, probably three, three for me is like, shit's gotta change. Like three times the same thing happens, that's not an exception and then a fluke. That's like the start of patterned behavior. We would be having a separate conversation about what is happening that things keep falling through the cracks. But a one-time deal makes it specific, which really sucks still, this person was not happy with what happened. We're feeling the intensity of that emotion, and then feel bad and can't fix it. And also I'm having a reaction as the owner because I don't want people's experience with the practice to be unpleasant. Therapy's hard enough. It doesn't need to be hard to get in the door. And it's not global. It doesn't happen all the time. So regardless of how I feel, it doesn't matter if it's one specific situation. We can just treat it as such and, obviously learn from our mistakes, but we don't need to change a bunch of shit around, again, the intake process in this case in order to fix, in quotes, something that isn't actually a global problem, a consistent problem. So- Even if the loudest thing does feel global, that doesn't mean that it is. And that's where, again, that global specific, Identification, like questioning yourself, can be really, really helpful. Okay, let's do agenda item number two. Action can soothe the leader. Have you ever done this? I was gonna say show of hands, but I can't see any of you. So bro, I have done this way too many fucking times. I am a lean into pressure animal. If you intensify the air and the atmosphere around me, I'm gonna start vibrating. I'm gonna move, like I'm gonna start to push back against the shit that is closing in around me. I do not shut down easily, and if there is any sort of like pressure, intensity, you know, I'm... I just lean into it. It's like, "Well, I'm gonna lean into it, 'cause I gotta go through it." And so it just, like, whoop, you know, I start to move. So that's me. Like, that's a me thing, meaning, like, taking action controlling what I can, changing what I can, tracking what I can. All of that can help to soothe me. It soothes the leader. All of the reports we make, the rules, the process changes, again, whenever we have something shitty happen, so a disgruntled client, a billing issue, what the hell ever, you know? All of those things where we start to take back work from another seat, please don't fucking do that. Just don't ever do it. If you... Don't. Just stop. Stop it. Get some help. That just creates relief for us. It gives us immediate visceral relief, and that feels like, oh, thank God, we've done something. We haven't. We've probably just made more work for ourselves. Movement helps us to feel responsible, and so it doesn't actually make us more responsible, you know? But again, it, like, helps us to soothe things. I'm pointing this out because Doing that doesn't necessarily fix the problem. And so this whole concept of, like, urgency feeling like clarity It's important to recognize that something really loud immediately feels global, and so we have to discern is it actually global or is it, like, specific? And then relatedly, taking action helps us feel better. But does it really fix the problem? I know that taking action helps me feel better. I like information, data, feedback, looking at the system. That all helps me to feel better, but in the case of what happened, there's not much to do. Like, in the case of a person being unhappy about a mistake well, there's not really any action to take. I might talk to my client care and say, like, "Hey, talk me through what happened." That's kind of it, you know? And then it's up to me at that point to further say, like, "Yeah, I mean, it sounds like you're human and you made this mistake and you tried a few different ways to try to make it right, and it's, it didn't work." And so, um, okay, maybe my action is literally just talking to her in that case, you know, and that helps soothe me, even if, again, the outcome still kind of fucking sucks. I think another example of this is Just let's say somebody misses a handoff or there's I've been thinking a lot about actually our onboarding process lately. I don't know if I've talked about this to y'all or not, but I love hiring. I just like processes. I like clean systems with clear handoffs. That's really what it is. Like, I like to look at a system and see how it fits, you know? Anyway, so I like hiring processes, and I also really like onboarding processes, and I don't mean somebody's first week. I mean the full-on, like, from offer letter, accepting, you know, signing, all the way through to the end of the first 90 days. That is what I call, we call onboarding at my practice. So what I have noticed lately, and again, I haven't really been talking about this, not for any reason other than it just hasn't come up It's kind of fucking messy. And it's not messy for the person going through it, which is great 'cause I don't want it messy for, the people who are being onboarded. But on the back end, to me it's a little bit messy. And there's something about, just nuance within the steps and/or a lack of clarity around responsibility for key passes and key handoffs. And so I'm using this example because in this sort of mindset of action can soothe the leader. Okay, so with this onboarding process, let's say we are going through the, process with somebody, they're being onboarded. There's a missed handoff somewhere. As the leader, sort of like the one responsible for the entire group, I could take big action and basically say that every handoff for onboarding has to go through me I could say that, and that would be taking action to soothe myself because I notice that shit is missing in the process or there's handoffs that aren't working. I'm not going to do that, for the record, but I am saying this example because I think it highlights how quickly a lot of owners, and probably even leadership really, but people who are responsible for like, the full experience of the practice, they fall really quickly and really easily into the trap of just taking shit over and doing it themselves or sort of saying like, I need to confirm this. It's not happening consistently," or, "We really messed this up. I'm gonna have to just review it every time. That's gonna be the new process is I'm the one doing the final review." Yeah, I mean, sure, You could do that. You could be the one doing the final review. I would argue that you're just setting yourself up to be a bottleneck, and then also that you are just soothing yourself by taking action rather than solving the crux of the problem, which is not that you're not the confirmation for handoffs, you know? So I think that's it for agenda item number two. Let's do agenda item number three. All right, we're gonna change tracks here a little bit. Agenda item number three is moving quickly for safety. So if my argument up to this point has been that we, in essence, need to slow down, like we need to not take action and take ownership of shit that's not ours in order to soothe our anxiety, and we need to not assume globality... Is that a word? 'Cause it should be if it's not, for specific things that happen that just kinda suck. There are also moments where you have to move fast before you have all the information, before you can actually make a clear assessment of what happened and what went wrong, and do we need to fix the system? You just have to fucking move. For me, in the field that I'm in, which is, behavioral health, mental health, those moments are In the case of a HIPAA breach or like, we deal with PHI, personal health information, we have to keep it safe and secure, encrypted and all that. So in the case of a breach of PHI going somewhere that it shouldn't go, I don't get to ask questions about a process. I have to move immediately. We need to shut this down, notify these people, notify this office. We are moving to not just fix the problem, but, like, stop the leak right away and then from there we're assessing the process and figuring out what the fuck happened. Another example of where you would move quickly, and again, this is kind of specific to my field, so sorry if you're not in, behavioral mental health. But another example would be in the case of a clinician acting unethically or engaging in egregious behavior, a provider, you know, acting unethically, engaging in some sort of real shitty behavior. They are up for immediate termination. Like, it's like grounds for immediate dismissal. Right then you have to cut off access. And there might be a moment afterwards where you question, "How did we miss this?" At that point, you would review the process. Of course, you'd review, like, what did we miss? What red flags were we not paying attention to? How did they get through the hiring process? What did we miss in onboarding? Who was their supervisor? There's so many questions you can ask. But before you ask those questions, 'cause those are important questions to ask, you have to disconnect them. They can't keep having access if they're not engaging ethically. If they've been terminated, they're done right then. That just sucks. I want it to be a seamless process for people departing, so it sucks when that happens. I've heard some horror stories. And also yeah, it still does happen. So something that's an example of when you would move quickly in order to ensure safety pretty much, for the group, for the clients, et cetera. Okay, last agenda item, agenda item number four. This is about really feedback. Your response, whatever it may be, teaches the system. You are a part of this living system. This, you know, again, I always think of the Integrity at Scale model, which is a living, breathing entity that our businesses are all alive, they're malleable, they're influenced by every different component that make it up. So think about it like this. If every time somebody makes a mistake, there's a new rule created, people are going to learn that if they come to you with a mistake, they're just creating way more of a headache for themselves in the future. They're basically feeding into bureaucracy. I don't know about you, but I fuck shit up on the regular. If I had to make a rule for every time I mess something up, oh, my gosh, I would just have a ginormous rule book that I would have to walk around with and constantly thumb through to make sure I'm not making some mistake, and in the case of, you know, the client care example that I gave a little bit earlier with this person who was very upset with us, sure, we could have made a rule. It could have been like every mistake that client care makes over the course of multiple years that she's been with us, we're gonna fix it with a rule. We're gonna fix it with, you know, "You need to do this next time." All that does is create more tension. I mean, that is more bureaucracy. We don't need to document every single possibility for every single thing that might go wrong or that has gone wrong. That's not the way to do things. For me, I'm like, fuck that, that's not the way to do things. That's just bureaucracy. It's just soothing your anxiety. It's creating more bureaucracy. That sucks. Okay, but on the flip side, of course, I almost said because every rose has its thorn. Don't know why. I was thinking because every coin has a flip side. There's something about, like, the opposite side of the thing we're talking about. On that flip side, let me get to my point, if there are serious concerns that have been brought up to you more than once and nothing happens, well, I mean, then what do you think people learn? I feel like it's obvious, but they learn that they don't really matter. Not just that they don't matter, maybe that's a little far, but that what they say doesn't have an impact on the system. Their feedback is not actually received and reasonably considered and then integrated when appropriate. Speaking up is a waste of time, so then why should they? That's what ends up happening. So you get either direction, people who aren't speaking up for different reasons. One is because they want less bureaucracy. They're afraid of more rules. The other is because what's the point? Like, why am I gonna speak up anyway if nothing happens? So they're not going to. I was gonna give an example for that, but I actually don't think that I'm going to because I think that it is simple. I don't know. I don't think that needs a specific example. Let's talk about why this topic. So I don't want to say that I would argue or strongly assert, but I would comfortably say that leaders will make big system changes when they aren't actually certain about the root cause of an issue because of the intensity of how they're feeling, that their sense of urgency and that tension and that discomfort they're feeling, it actually feels like clarity in the moment. "Fuck, we gotta fix this." That's why this topic, because as we've discussed, urgency, discomfort, tension, big emotional moments they're not necessarily global and they're Not necessarily correlated with clarity. And so therefore, there might not need to be anything to do But we feel strongly like we need to do something, and so therefore we move, and now we've created more headaches for ourself down the road. I like to think about this whole, like, conversation as really being connected to feedback systems. Which is almost like a vein based system in the integrity at scale model. And also really, really connected to leadership Because ultimately leadership is the one that sort of decides what messages are received inside the organism and also what is sent out. And so if there is feedback in that feedback system that's going around, leadership says like, "Okay, cool, we need to move on this," or we don't actually need to do anything with this," and it might dissipate, or they move on it and they establish a new process or even just a, a simple new, step within a process, you know? It could be something that small of course, I think that the entire, you know, model is interconnected, but ultimately, this topic is really, really strongly kind of entrenched in feedback and leadership components, like big time. And if there's one, let's just say, key takeaway or if you want a task of some sort, I would say before you go to change any system, like let's just say, hopefully not, but let's say you have a shitty experience that happens or something that really leaves you feeling strongly. For the record, it can also be internal feedback. There's been some moments where we've gotten feedback from people and it's been like a, you know, sort of this internal explosion of like, "Oh my God, wait, what? Hang on." You know, and it's like, "Oh, geez," like it leaves you a little bit flabbergasted or kind of floored. Even those moments count as like highly emotional, like, uh, strong, you know, loud moments in ownership life. So let's say this thing happened. So before you change anything within the system, I would say that you should ask, "Okay, what is it that I know?" Like, what do I know about what's happening? Again, that can be kind of global or specific. You could say, what am I assuming? For me, I think this ties in a little bit with even like an assumption that I need to be part of something in order to fix it. You know? Like, I have to move on this. I need to start doing this. So what do I know about whatever is happening? What am I assuming? And then I would also ask myself, what actually gets worse if I wait? Is there any risk in just waiting even a week to then see how I feel, or then assess what might need to change, or where I might still seek to insert myself into a process? Those are your prompts should you choose to accept to ask yourself those questions. So if this has been, I don't know, helpful, enjoyable, share it with a friend, subscribe to the podcast, of course. Also note that there are related episodes down below, so if you like this type of topic in particular, then check out three related episodes below in the description of whatever platform you are watching or listening to this episode. All righty, my friend, have a fantastic rest of your day, and I will see you next time. Thanks. Bye.