Removing the Barriers to Collaboration

Have you ever been working on an improvement idea and when the time comes to share it with others you think to yourself, “Ugh, I don’t want to.”

If you’re like me, maybe you even groan and make a face.

Well, it turns out that those little pangs of *UGH* are moments of insight. They are a signal that it’s time to dig deeper and ask ourselves, “What am I really avoiding?”

It’s easy to tell ourselves stories about why we put off involving others in our improvement project. Perhaps these explanations look familiar:

• I’m up against a tight timeline, I just need to get it done.
• They don’t have the necessary context to properly weigh in.
• I always get frustrated trying to explain things to them. They don’t get it.
• They are going to have a million opinions and try to change everything.

And these explanations, these barriers, are true. Partially.

The reality is - collaboration is hard sometimes!

Collaboration typically involves all kinds of challenging situations, from scheduling conflicts and miscommunication to unhelpful suggestions and arguments.

In addition to being frustrating and exhausting, these situations illuminate something we may not want to admit: a gap in our own skillset.

• Maybe we only know one way of pulling a group together.
• Or we’re not very practiced at group decision-making.
• Perhaps we never learned how to receive constructive feedback.
• Or we’re not sure what questions to ask in the first place.

So, we avoid the conversation until the conditions are perfect or it becomes absolutely necessary.

But the impacts of avoiding collaboration are worse than any feelings of discomfort or frustration. Failing to pull in the right perspectives at the right time can lead to   

an incomplete understanding of the problem, disengaged team members, last minute redirection, and rework. Not to mention missing out on perspectives and possibilities that you could never come up with on your own.

Fortunately, many of these negative impacts can be prevented, or at least minimized. And you already know a helpful framework.

Plan – Do – Study – Adjust.

That’s right, our good friend PDSA. It turns out that we can use the phase of our improvement project to guide how we engage our stakeholders.

So, let’s tackle one of our common collaboration barriers through the lens of the PDSA cycle.

Barrier: I don’t have time to pull in others.

If you’re feeling the pressure of time, it is probably because you are in the Do phase of PDSA.

You are ready to launch your improvement and the thought of slowing down to involve others feels frustrating, or even risky.

Maybe the deadline moved up and you’re expected to deliver results ASAP. Or perhaps you just didn’t think about involving others until it was too late. Or if you’re being completely honest, you are excited about your idea and don’t want anyone to stop you.

Regardless of the reason, you still have collaboration options.

Focus on asking go-forward questions.

Spend a few minutes getting clear on the input you need at this phase in the process. Your stakeholders may not be able to inform the Plan at this point, but their insights are still valuable.

Questions that can help guide feedback at this point include:

• What should I consider as I move forward?
• What roadblocks do you anticipate?
• What have you seen work before?
• Who else do you think I should speak with?
• What are some potential gaps in my thinking that I might want to explore as the work evolves?

Involve your stakeholders in the Study-Adjust portion of the process.

Take time to outline the scope of your experiment (perhaps using an A3 or SBAR) so that you are able to communicate the what, why, and how with your stakeholders. Then, establish the meetings needed to support their timely input.

For example, you might invite your stakeholders to:

• An Implementation Kick Off meeting where you share your Plan and next steps.
• A huddle series to consistently check in and evaluate the impacts of the change.
• 30, 60 and 90-day follow up meetings to reflect on what you learn and set the next experiment iteration up for success.

Listen respectfully.

From tight timelines to misunderstandings about roles and responsibilities, there are many reasons why a stakeholder may not have been involved in your Planning phase. And whatever the reason, some stakeholders may feel frustrated that they were not included sooner.

If you find yourself in this position, the best thing you can do is listen to what they have to say.

Respectful listening can look like:

• Letting the other person share their frustrations without getting defensive or providing justifications.
• Saying, “Thank you for sharing your feedback with me.”
• Asking, “How would you like to be involved going forward?”

While not guaranteed to fix every miscommunication, respectful listening is helpful in demonstrating a commitment to a collaborative approach going forward.

"No one can whistle a symphony. It takes a whole orchestra to play it." – H.E. Luccock

I love this quote because it reminds me of what is possible when we commit to bringing together different backgrounds and experience to solve problems. Collaboration isn’t always easy, but the outcomes are worth the effort.

Effectively leading transformational improvement work requires collaboration skills.

And the great thing about skills is that they can be learned!

For more practical tips and hands-on practice at building collaboration into all the phases of your improvement process, please join my 2023 Lean Healthcare Transformation Pre-Summit workshop, “Engaging Your Teams in Collaborative Process Design.”

We are going to build on tools you already know, while introducing new approaches to enhance both your problem-solving and change management skills. It will be equal parts fun and immediately applicable.

I do hope you’ll join me. I look forward to seeing you in Chicago this June.