Great Teams

Leaders who build great teams not only push for perfection in the products; they only tolerate “A” team players. Jobs was famously impatient, petulant, and tough with the people around him (Pentland, 2012). Everyone finds his or her leadership style; Jobs clearly had his own, and his style is not necessarily advocated explicitly by me. The principle is simple: to aspire to be the best, you must get together the most effective team. The best leadership teams in history not only have a great leader but have committed players who are usually highly talented leaders in their own right. Great teams and their constituents all contribute high energy; they communicate effectively because they are engaged. This ability to be engaged, use effective communication, and channel intrinsic energy allows robust and fast exploration of opportunities and threats and conversion to action with rapid improvement and sustained improvement.

At this point, I would like to ask the reader to rise to my first challenge. Rather than give an obvious example of an international leader or champion of palliative EOL care, I would ask the reader to think of a person or professional who does this day in day out in his or her own community. Think why they do this and how they succeed. In my experience, these leaders have drive, motivated by ethical and altruistic reason to deliver care to people, because they know it will make that positive difference, often without accolade. This
primary drive to help is often aligned with their spiritual energy and connection to people, the patient, their family, and the team(s) around them. Whether born into a vocation or grown into, the difference these dedicated people make is huge, by reducing fear, ameliorating pain and distress, and giving realistic hope when hope and spirit had been taken.

Leadership is not about making clever decisions and doing bigger deals. It is about helping release the positive energy that exists naturally within people.

Henry Mintzberg

When Great Teams Are Not Enough

In today's fast-moving ultracompetitive global business environment, you can't rely on stable teams to get the work done (to deliver exceptional results). Instead you need “teaming,” which is flexible teamwork where you gather experts from different divisions and disciplines into temporary groups to tackle unexpected problems or emerging opportunities. To “team” well, employees and organizations must embrace principles of project management and team leadership. Those who master teaming will reap benefits. Teaming allows individuals to acquire knowledge, skills, and networks, and accelerates the delivery of current offerings while responding to new challenges (Edmondson, 2012). This is in clinical terms the basis of multidisciplinary and interagency working. The team knows that in some cases they must think and act differently, often with a pressing time scale for completion. Dying often finds its own schedule, waiting for neither man nor priest. Therefore, it is essential to start earlier, getting the right team together and approach for the job, actively seeking and listening to preferences and making decisions. Starting with the end in sight helps to give that focus and produce the right outcome. In health care “business” terms I have often seen teams become ineffectual and unable to respond to new or different challenges or increase productivity at scale because they become static or concrete in their thinking. All “A” teams, including clinical “A” teams, need new player acquisitions and sometimes a bench of talented specialists or special teams to bring onto the field—a new team for a new play. In simple clinical terms, for example, bringing in a professional with specialist palliative care skills to a team focused on renal replacement to support the transition from dialysis to EOL care, when the dialysis ceases to be an effective or tolerated treatment.

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