Leadership tools for transformation: complaints, conflict, and core motivation
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Leaders often begrudge time spent on “negative” work, such as dealing with complaints. It steals resources from positive change efforts. This article explores how complaints, conflict, and core motivation offer powerful tools for positive transformation.
KEY WORDS: leadership tools, complaints, conflict, motivation, change, transformation
Transformative change requires enormous amounts of time and energy. At Southlake Regional, our team transformed the way we provide emergency services.1,2 We went from chronic staff shortages with below-average wait time performance, to province-leading wait times3 and an oversupply of people wanting to work at Southlake. The transformation stretched our leadership skills and forced us to take a different perspective on issues that used to frustrate us.
At times, our team forged ahead building positive change for patients. At other times, change stopped completely, mired in complaints, conflict, and a lack of motivation. Some of us grew frustrated at the waste of time and effort required to work through negative issues or to motivate the team to do something that seemed, to us, obviously better for patients. With time, we learned to see complaints, conflict, and core motivation as opportunities, not roadblocks to change.
A serious complaint can make a leadership team stop everything and focus on it. Complaints can come from patients, staff, regional health authorities, or other departments in an organization. Each complaint heightens sensitivity. Sequential complaints make the most responsible leaders more desperate to fix them as soon as possible. Leaders worry about what other departments, or senior administrative teams, will think of them, if complaints become repetitive.
Some people in leadership positions develop immunity to complaints. They are not leaders; they present a risk for an organization, as complaints often mark early signs of bigger problems.
At the other extreme, weak leaders become hyper-sensitized to complaints. Hypersensitive “leaders” freeze at the thought of another complaint. They panic and search for safety in accepted practices: protocols, standards, and whatever all the other hospitals are doing. Their anxiety about new complaints gives enormous power to those who might threaten to complain. Staff picks up on this. Staff members only need to hint at complaining to the board, and hypersensitive leaders will abandon change efforts.
True leaders function between immunity and hypersensitivity. They take a meta-level look at complaints, instead of treating all complaints with extremes of insouciance or dread.
Meta-view of complaints
In Management of the Absurd - Paradoxes in Leadership, Richard Farson4 writes that leaders expect their improvement efforts to make people happier. We expect staff to value our efforts and complain less about work. But staff members often complain even more. Farson says it’s the theory of rising expectations: “The better things are, the worse they feel” (p. 92).
Leaders need to frame complaints at a meta-level. They might ask, what kind of complaint is this? For example, complaints about safety should make leaders stop what they are doing and attend to the problem. Leaders can apply Maslow’s hierarchy5 as a heuristic to develop a meta-view of complaints (Figure 1).
Safety sits near the bottom of Maslow’s hierarchy, and leaders must address safety first. But other complaints, for example complaints about resources and supplies, do not warrant the same immediacy.
As organizations improve, staff members eventually start complaining about not being able to apply the full scope of their training or not being able to volunteer for extra-curricular change efforts. Once staff members start complaining about self-actualization and the inability to fully contribute all they have to offer, leaders can celebrate. You have arrived. The complaints have not disappeared, but they have moved to the top of Maslow’s hierarchy.
Some leaders use one idea to explain too much. This happens often with personality conflicts. Carl Jung’s paradigm of conflicting personality types,7 for example introversion versus extroversion, offers an irresistible explanation to describe, and dismiss, conflict. Personality conflict gets used to explain too much.
Leaders miss a great opportunity, if they explain away conflict too quickly. Most courses on conflict management train us to handle conflict and work toward healing and unity. These have value, but they often miss a transformational secret: conflict tends to flare over ideological differences. Paradoxically, high-functioning teams use conflict to build unity.
Mine for ideological conflict
In Death by Meeting, Peter Lencioni advises leaders to “mine for ideological conflict.”8 He suggests that conflict offers teams a great opportunity to dig to the bottom of an issue. Encourage passion; do not jump to extinguish all conflict. Of course, people need to fight fair. They need to protect others’ dignity. Leaders need to step in and referee as necessary.
Conflict foments over deep differences in opinion. For example, many providers believe that patients often attend the emergency department for selfish reasons; they could seek care elsewhere. That belief makes it very hard to build a welcoming attitude for all patients, all the time.
Leaders should open themselves up to conflict, not just challenge. Nothing humbles us like defending our position with a team, only to have it exposed as a cover-up for some deeper idea. Nothing builds a team more than when leaders show their group that they can change their mind on a deeply held belief. Mine for ideological conflict; it offers a powerful tool to influence change.
Physicians learn to diagnose and treat. Treatment delayed is unethical, even heartless. Leaders enjoy finding solutions, building visions, and planning major changes. But teams need motivation to change. Clinical rationality applied to organizational transformation does not work. Teams need more than evidence and logic. Leaders must speak to all aspects of motivation.
Spheres of motivation
A mentor once shared a tip that his mentor had taught him: different things move different people.9 Some people will change their mind if you show them a logical reason for doing so. Others will only change their mind if you convince them it’s the right thing to do. He suggested that there are at least five spheres of motivation: reward, rules/punishment, concepts, social pressure, and morality.
Leaders think and speak to the sphere of motivation that means the most to them. We might develop iron-clad conceptual arguments, with supporting data, to show why our team should support change. But the argument will only move 20% of the audience. Most of the audience will remain unmoved, unmotivated.
This frustrates leaders. Faced with the same situation, many of us try harder. We build more elaborate arguments and collect better data. But 80% of our audience sits uninspired. We start to question whether our team conspires to block change for selfish reasons.
People support change when it means something to them. Leaders motivate change when they speak to all spheres of motivation, or levers of influence,10 as much as possible. It might feel contrived to talk about aspects of social pressure, if you believe we should just follow the evidence wherever it leads. You might find it beneath you to appeal to your team’s rational self-interest, to motivate change. But, as leaders, we will continue to struggle with “unmotivated” teams until we get used to speaking in terms that appeal to all spheres of motivation, not just our own.
Complaints, conflict, and core motivation offer non-intuitive tools for transformative change. They represent just three of the tools used to transform our emergency department at Southlake Regional Health Centre into a provincial leader (see No More Lethal Waits: 10 Steps to Transform Canada’s Emergency Departments1 for more). When handled well, these tools can turn a failed change effort into a successful transformation.
1. Whatley S. No more lethal waits: 10 steps to transform Canada’s emergency departments. Toronto: BPS Books; 2016.
2. Whatley SD, Leung AK, Duic M. Process improvements to reform patient flow in the emergency department. Healthc Q 2016;19(1):29-35.
3. Murdoch J. Ontario Minister of Health Deb Matthews visits Newmarket to experience patient flow innovations at Southlake. Media release. Newmarket: Southlake Regional Health Centre; 2013. http://tinyurl.com/j6o9cuv (accessed 15 May 2016).
4. Farson R. Management of the absurd. New York: Free Press; 1997.
5. Zalenski RJ, Raspa R. Maslow’s hierarchy of needs: a framework for achieving human potential in hospice. J Palliat Med 2006;9(5):1120-7.
6. Kremer W, Hammond C. Abraham Maslow and the pyramid that beguiled business. BBC News; Sept. 2013. Available: http://tinyurl.com/qcqzpgb (accessed 21 May 2016).
7. Chanin MN. A study of the relationship between Jungian personality dimensions and conflict-handling behavior. Hum Relat 1984;37(10):863-79.
8. Lencioni P. Death by meeting: a leadership fable... about solving the most painful problem in business. San Francisco: Jossey-Bass; 2004.
9. Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci 2011;6:42.
10. Martin W. The levers of influence. Physician Exec 25(6):8-14.
Shawn Whatley, MD, is an author, physician leader, and member of the boards of the Ontario and Canadian Medical Associations.
Correspondence to: firstname.lastname@example.org
This article has been reviewed by a panel of physician leaders.