Reports from the EONS Leadership Summit 2017

Leading the team – Collaboration and communication in cancer

EONS President Lena Sharp addresses the all-important question of how to ensure effective team work through good leadership.

Lena Sharp

Lena Sharp

EONS President Lena Sharp addressed the all-important question of how to ensure effective team work through good leadership. She set out some key steps that would help achieve this. First, one had to identify the team and have a common view of the assignment; safety and quality must be a priority. Lena then advised promoting systematic routines for clinical work but also allowing for individual solutions when needed and encouraging team members to bring their own distinct approach.

Above all, a leader is a role model – but what makes a good role model? Lena set out some of the central qualities: a leader is someone who demonstrates confidence and leadership, who is not afraid to be unique and who will dare to leave their comfort zone. A leader needs to communicate and interact with everyone, showing respect and concern for others and encouraging them to develop. She should show commitment both at and outside work, and she must show humanity and a willingness to admit to mistakes.

Explaining this more fully, Lena said: “It is essential to pay close attention to the climate and culture you are creating in the team. Central to this is asking for feedback and encouraging other team members to offer opinions about how you are doing. This requires a willingness to acknowledge your own mistakes. However, in critical situations, you must have the confidence to show the way and make decisions, and then the other team members will follow.”

Feedback should be:

  • both positive and negative
  • constructive
  • specific
  • debriefings should be ongoing
  • members of the team should be each others’ critical friends.

As leaders, Lena explained, we should evaluate our own and our team’s work by measuring patient outcomes and experiences, discussing the results with the team and making plans together for improvements – and always recognising and rewarding success. She emphasised that your own health and that of your team, both physical and psychological, was another key responsibility of the leader: effective strategies such as mentorship, counselling and meeting outside of work all contribute to ensuring this.

When conflicts do occur it is vital to ask what happened, rather than who is wrong; to be collaborative rather than merely critical – after all, one should remember that the other person is just like you. Lena said: “Rather than apportioning blame, show curiosity – ask for solutions and ways that we can address this together.”

Collaboration and communication

 

Healthcare communication is complicated

Of course, all these approaches are dependent on one core thing: effective communication. This is a central part of healthcare but most of us have limited education in professional communication and are simply expected to somehow know how to do it well without guidance.

Lena explained that communication is a complex process and about more than just delivering a message – it means active listening, because everyone involved has their own valuable experiences, references and interpretations. However, during times of stress communications skills are notably reduced.

So, if we break it down, what does communication, or active listening, involve?

Active listening

  • Leave the phones during meetings
  • Encourage team members to share thoughts
  • Avoid interruptions
  • Show understanding by repeating
  • Ask questions
  • Don’t let any team member dominate
  • Be aware of non-verbal communication

Lena described how communication is collaborative: “As leaders we have a responsibility to speak and communicate our vision!” However, she was also clear that this required encouraging inter-professional learning and collaboration, through education, clinical practice and research and, avoiding ‘the doctor-nurse game’. Lena told the audience of the importance of improving collaboration with physicians: “Don’t apologise when you ask them to do their job! When you get invited to collaborate, accept! Demand the same policy regarding names and recognition and, avoid the doctor-nurse game and power battles!”

Finally, Lena returned to her theme of the centrality of psychological safety – a huge factor in successful teams which also plays an important role in workplace effectiveness. She said: “This takes trust! It means all team members feel safe to speak up without getting punished or fear of negative consequences. It is something that is both fragile and vital. We must encourage all team members to contribute with their ideas, and when they do, acknowledge and appreciate their input. This is a powerful tactic for inspiring others to follow.”

So, Lena asked, what do we gain from this approach? Higher levels of engagement, increased motivation to tackle difficult problems, learning and development, better performance and creativity, and, outside of the box and strategic thinking. “If our leadership can achieve these things,” she concluded, “We are well on the way to improving the workplace for ourselves, for our colleagues and for our patients.”

Lena Sharp is head of cancer care improvement, Regional Cancer Centre, Stockholm-Gotland, Sweden.