Perfect just the way you are. And...

That’s the thing about Zen masters. You never really know when they’re joking.

Shunryu Suzuki is best known for founding the first Buddhist monastery outside Asia and one of the most influential Zen organizations in the US. In the late 1960s, he was giving a lecture on “non-gaining mind” in which he was emphasizing practice for its own sake, as opposed to some benefit in the future. The striving and clinging to expectations not only distorted your practice but could also leave you miserable. 

“You become very idealistic with some notion or ideal set up by yourself and you strive for attaining or fulfilling that notion or goal. But as I always say this is very absurd because when you become idealistic in your practice you have gaining idea within yourself, so by the time you attain some stage your gaining idea will create another ideal…Because your attainment is always ahead of you, you are always sacrificing yourself for some ideal. So this is very absurd. “

A student asked Suzuki to clarify what he meant, so he simplified it.

“You are perfect just the way you are. And there’s room for improvement!”

Although I’m not sure if Suzuki was kidding, something clicked for me when I read that. I had always thought that being content with the way things are would be a sign of laziness, something not to be tolerated. My way to motivate myself has been to keep focusing on the improvement, the thing to be fixed or made better.

But as I get older, I see it only leads to a life of never-good-enough. You race towards a finish line that doesn’t exist, unable to complete the simple declaration: “I will be happy when…”

What if you could tap into all the benefits of getting better without the stress and drama? What if you accepted yourself exactly as you are - and others exactly as they are - and still remained open and curious about further development?

An example of kintsugi, or making art from damaged pottery - Photo credit: June’s Child

What could WOL for Healthcare look like?

Her note started off nicely enough. Then I read her feedback, including a challenge I didn’t know what to do with.

Bettina had heard about WOL Circles at a conference and liked the idea. “I started my first Circle directly. With great success!” She said she is working as a Change Manager in a large non-profit healthcare organization in Germany, and that she wanted to spread Circles. But she made it clear that WOL, in its current form, would never work. 

“The nurses, doctors, and other professionals do not have 60 minutes a week for WOL, there is too much text, the examples have to refer to the health sector…” 

Ouch. She even said the German translation wasn’t acceptable, as the informal pronoun (“du”) simply isn’t used in her organization’s “official papers.”

I knew she was right. I asked if we could speak on the phone. 

The challenges in Healthcare

Healthcare organizations suffer from the same cultural issues that plague many large companies. The hierarchical structures limit information flows in ways that are bad for individuals, the organization, and the patient. Too often, nurses don’t question doctors and medical technicians don’t question the ambulance manager. (Atul Gawande, surgeon, author, and CEO of the recently-formed healthcare venture formed by Amazon, Berkshire Hathaway, and JP Morgan Chase, captured these challenges in dramatic fashion in The Checklist Manifesto.) 

The same is true across the hierarchy as well. People in a given role are not in the habit of of sharing problems and solutions to improve quality, and in many cases there may be no mechanism to do so. So the same mistakes get repeated, and innovations don’t spread. 

On top of such challenges, all of this takes place in an environment that is extraordinarily demanding. It’s busy, stressful, and unpredictable - and the stakes are extremely high.

One possibility

Of course, not all healthcare organizations have the same cultural issues. Buurtzorg, for example, has over 10,000 professionals in “a nurse-led model of holistic care” that emphasizes “humanity over bureaucracy.” They are portrayed in Reinventing Organizations as a model of self-organization and self-management. But for every Buurtzorg, there are thousands of traditional companies. 

How could WOL help?

I told Bettina how we had already adapted WOL for leaders by making it shorter and simpler, and by integrating it into a reverse mentoring program. Perhaps we could do something similar. 

Together, we decided that Bettina’s colleagues could also meet in pairs (perhaps one with more experience and one new to the organization), and we could limit meeting to no more than 30 minutes. Then we identified eight different exercises over eight weeks - eight contributions they could make that would help them find their voice, improve their craft of patient care, and enable them to re-connect with the sense of purpose that inspired them to join the profession in the first place.

What would you do?

The challenges faced by people in healthcare environment are similar to those in other operational environments, be it manufacturing, retail, transportation.

As different as those jobs may be, the people doing them all share the same human needs for control, competence, and connection. And all of the organizations they work in need to improve quality for their customers and for their own sustainability. The future of work isn’t limited to people working in offices.

Bettina and I will meet in Frankfurt this week to work on details of a pilot. Whatever the outcome, we’ll surely learn something that can help us take a next step and try again.

If you were Bettina, what would you do? What could WOL for Healthcare look like?

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“What’s one thing I could do better?"

Imagine you’re about to deliver a presentation. You’re nervous, and uncomfortable talking in front of groups. But you prepare as best you can, muster up your courage, and deliver the talk. 

Afterwards, you breathe a sigh of relief and ask someone the worst possible question you could ask:

“How did it go?”

At Zukunft Personal in Köln, September 2018

Just because everyone does it doesn’t make it good

The other person knows your anxious, and she wants to be supportive and encouraging. So she responds, “It went well!” 

And in that moment, you missed a chance to get constructive feedback and learn, and the other person is robbed of the chance to help someone. 

I realize this exchange is so common that it may seem strange to deviate from it. But ten years ago, I learned a better way from Keith Ferrazzi.

From criticism to contribution

It was 2008, and I was sitting in the Relationship Master’s Academy, a 30-person course from the bestselling author of Never Eat Alone and Who’s Got Your Back. It was that course that made me think differently about how to ask for feedback (and about relationships in general). Keith Ferrazzi taught me how to turn a potentially uncomfortable conversation into one that can benefit both individuals and even deepen the relationship. 

The problem, Keith pointed out, is the way we frame the question. “How did it go?” ( or“How did I do?”) puts the other person on the spot, uncertain of what they should say and worried about offending you. The only safe thing for them is to give you a generic, positive response. 

Instead, Keith suggested, you should explain that you’re trying to improve, and then ask, “What’s one thing I could do better?” That turns an imposition into an invitation. Now you’ve given them explicit permission to give you specific critical feedback. It’s no longer personal but about the learning, and they get to feel that they’re being genuinely helpful.

The cumulative power of “one thing”

I’ve been asking Keith’s question ever since, and it’s led to many interesting conversations. People seem grateful to be asked their opinion in this way, and they almost always come up with something I can do better.

“You should move side to side a bit less”

“That slide was hard to read”

“You should use some different examples”

“You talked really fast”

“You should hold the microphone closer to your mouth”

I listen intently to each bit of feedback. Sometimes I don’t agree or may get conflicting opinions. But I almost always learn about new ways I can improve and about things I need to keep working on. Each exchange is also a chance to practice, both offering vulnerability and receiving constructive criticism.

Try it for yourself. Asking “What’s one thing I could do better?” can help you with any skill you’re trying to develop or improve.

The missing piece in most quality programs

I fell in love with W. Edwards Deming over twenty-five years ago. He was already in his 90s by then, but his philosophy of work and management was only gradually spreading. I felt like I had discovered A Fundamental Truth. But like other Truths, it was inconvenient to people in power, and was ignored or purposefully misinterpreted.

So when I saw a recent article titled “Deming, Finally!” I was curious. When I noticed it was co-authored by Celine Schillinger, I made a point to read it carefully, since I greatly respect her work driving change at the pharmaceutical company, Sanofi.

“Today, everyone in the manufacturing quality world has read, heard, spoken about Deming. His vision for quality and “14 points of management” as well as the “System of Profound Knowledge” in particular are inescapable reference points.
However, Pharma may have got this all wrong for the last 30 years. By focusing on processes, control and exhortations, manufacturers have missed the essence of Deming’s message.
Deming advised us to actually put the Human at the center of quality and to focus on how the system works.”

The missing piece in most quality programs is the human being. Deming understood that and most of the elements of “the Future of Work” decades ago, but he wasn’t really heard.

Deming would have benefited from better communications & behavior change methods, and I think Working Out Loud Circles can help with both - whether it’s work in an office or in manufacturing plants, in hospitals or schools. I’ll offer some specific suggestions in an upcoming post. In the meantime, read Celine’s article if you can, and let me know what you think about the topic. 

How would you make quality and continuous improvement more human?