Friday, December 18, 2009

Even more faith in our front liners

I've been looking through my training sessions work diary for the last 12 months.

Turns out I’ve met around 1000 front line healthcare employees during 2009 in training sessions that I’ve run. Never mind what they may have learned - hopefully they will have learned the odd thing or two in our session together – they will definitely have learned from each other through the networks they create for themselves.

More importantly though - what have I learned?

Here are a few thoughts on reflection about an extremely busy year alongside these front line folks:

  • I’ve often said front liners know all the answers all the time. I’ve not changed my view – 2009 has strengthened my view if anything.
  • Front liners are capable of taking on far more responsibility than the boxes the system puts them in.
  • Front liners are very modest about their own abilities and skills.
  • Front liners want to do a great job for patients.
  • Managers must learn to let go of more of the power they have thus allowing front liners to get on with the job.
  • Managers must be there for support when front liners need it – they are well capable of judging when they need help.
It is always an absolute pleasure for me to work with these folks. I thank them for allowing me to spend time with them in 2009 and I look forward to meeting at least another 1000 front liners in 2010.

The great news is front liners do a terrific job and they are keen to learn more.


Dave Wheeler said...


I absolutely agree with your point of view. The more you get them involved and engaged, the better the planning, the better the execution and the more satisfied the customer! Simple for why do so many of todays managers not recognize and exploit that fact?

Dan Gunter said...

Dave, I think that somewhere in the process of becoming managers, far too many FORGET how to be team members. The "Peter Principle" is alive and well, to boot.

Marilyn Jess said...

Dan, you hit the nail on the head. The incompetent often keep getting promoted. Those with real integrity stay on the front lines.

To illustrate...a department head was recently let go from his contract at a hospital. His reputation included verbal insults toward his staff and withholding raises from deserving people. No one actively complained due to fear, but all knew about what he did.

The good news is he can no longer do this to front liners there. Not so good, he got another job.

Dan Gunter said...

It's sad how often we see this happen, Marilyn.

Trevor Gay said...

Thank you Dave, Dan and Marilyn – it is really amazing how simple this stuff is and all the more remarkable that some managers just don’t get it.

The sadness is, as Marilyn says some of these folks get another job once they’ve been found out and moved on. Maybe we need to ask questions about the people who hire them! The best leaders in my experience are those who spend time with the front line employees. They work alongside them rather than spend time locked away in the comfort of the office.

Mark JF said...

" Managers must be there for support when front liners need it – they are well capable of judging when they need help. "

I'm not sure whether you mean the managers are capable of judging when to step in or that frontliners know when to ask for help.

Whichever, I disagree. I think the 2 key problems are i) people simply don't know when to ask for help, or how; ii) they're frightened to ask for help (fear of ridicule or appearing daft etc); iii) people don't always know when or how to offer help if they see someone seeming to struggle.

I ought to be able to ask for some help with my arithmetic but seem to keep getting it wrong...

Trevor Gay said...

Hi Mark - I meant the front liner knows when to ask for help. That has always been my belief and remains so. Perhaps not on every occasion but most of the time the person doing the work is the expert. Too many managers interfere too soon which restricts the freedom of the person doing the job - they then feel like they have to ask more than they actually need to. Management is as much common sense as front line service is and many problems occur because managers 'dabble' in the role of the front liner when it is not necessary to get involved. I feel the best managers know when to get involved and when to back off. The one's who get it wrong most are those who interfere too much too soon and too often. We can have great faith in our front line folks and we can have equal faith in those managers who know their place and keep out of the way of front line folks doing effective work.

The best managers will also provide the leadership, culture and environment to alleviate the problems you rightly highlight Mark such as "i)people simply don't know when to ask for help, or how; ii) they're frightened to ask for help (fear of ridicule or appearing daft etc)"

hucknjim said...

Hi Trevor.

I'm proud to say that my hospital conforms to all but two of your comments, but they're biggies and related.

First is "frontline employees know all the answers all the time." Second is that management should get out of the way and let the front liners do their jobs.

I get very tired of accountants, aka bean counters, having the final say on staffing levels. We are deep in a recession, and budget cuts are a necessity but patient safety should be the priority.

Tied into that is the fact that we have been protesting these changes to management for a long time, and most of us feel that they're being made with little or no input from us.

To its credit, based on the last employee satisfaction survey, my hospital is trying to address these issues. I just pray that this recession will be over soon and that health care reform will pass. Then we can all stop worrying about this stuff.


Trevor Gay said...

Hi John and seasons greetings to you and your family. Always good to hear from you as an employee at the real front line!

The best managers and leaders ALWAYS involve front line workers in making the tricky decisions about money saving.

Paul Levy on your side of the pond is an excellent example of an ‘involvement leader.’ He is President and CEO of Beth Israel Deaconess Medical Center in Boston and he involves ALL employees in difficult decision on budget cutbacks Take a look here at the evidence – its not just talk – its REAL involvement – click here to read the story

I’m sorry to hear about the cutbacks affecting your hospital John and like you I pray the recession ends soon. I heard today on BBC Radio today that the recession is apparently officially coming to an end in the UK at the end of this month. It is a very worrying time for everyone.