Passion: Developing the Drive to Create Positive Outcomes
With this chapter we begin an in-depth examination of the first of the six principles of PROPEL—“passion.” Here, you’ll find a story illustrating how destructive passion hampered people’s ability to solve complex problems and the research on how to increase productive passion in order to be more effective. The chapter concludes with the action steps that a group of professionals took to generate the harmonious passion they needed to work together to overcome obstacles and accomplish an outstanding outcome.
Curtis's Story: The Problem
Curtis, nurse manager of radiology at an academic medical center, has many responsibilities, none more important than getting children magnetic resonance imaging (MRI) services when their physicians suspect a problem. Doctors use MRI in pediatric patients to diagnose cancer and diseases of the spine, bones, and brain. Kids who need an MRI for any of these reasons are ill—usually seriously ill. And their parents are scared.
At Curtis’s hospital, conflicts between the MRI schedulers and the clinical staff members resulted in long waiting periods for appointments. Really long. Before Curtis learned to use the PROPEL Principles, these young patients were waiting 14—16 weeks to be seen. The doctors ordering the tests were frustrated about the delay, the parents were furious, and the children were being kept waiting. No one was happy, and no one was being well served.
This was Curtis’s first job as a nurse manager. When he first joined the leadership team, he was filled with enthusiasm. He was sure that he would be able to fix some of the long-standing problems he had observed as a staff member in the radiology department. The combination of poor patient satisfaction, safety and service issues, high cancellation rates, interdisciplinary squabbling, low-volume, and highly paid staff members meant that expensive equipment was underutilized.
As changes in healthcare reimbursement took hold, the hospital administrators exerted enormous pressure on the radiology department to stop the hemorrhaging of money. Curtis dutifully explained the problem to his nursing staff, who told him the fault lay with the schedulers, who explained to him that the physicians were the ones to blame. The doctors indignantly asserted that the problems were due to the impossibly slow pace of the technicians operating the equipment. When approached, the clinical technicians (techs) pointed their fingers at the nurses, claiming they were slow prepping the patients.
Curtis was initially undaunted. He proposed some feasible ideas about what could be done. To address the low-volume and high cancellation problems, he wanted to extend the hours of operation so that patients could come after work or bring their children in after school. He sent e-mails to the scheduling committee as well as the rest of the staff members asking them to start working together to figure out how to move beyond the outdated nine-to-five model.
Curtis believed that his radiology nurses would willingly support an initiative to improve patient wait times and satisfaction ratings. He met with the scheduling committee. He sent e-mails to the staff members explaining the problem and asking for cooperation. It did not take long to discover that the vast majority of the deeply entrenched staff members (who had been working the same schedule for years) were highly resistant to changes.
Curtis’s boss had served in the military for many years. He advised Curtis to take more of a command-and-control approach—tell the staff members what they were going to have to do to fix the problem and when they would have to do it. So, Curtis tried telling staff members what to do. But he discovered that setting expectations was insufficient, as staff members had no motivation to make his plan work and a strong incentive to sabotage it. After several months, Curtis was extremely discouraged. He had heard every excuse in the book:
- ? “The techs refuse to take on more work.”
- ? “The schedule doesn’t work because the staff members are calling out.”
- ? “There’s nothing more we can do because the doctors won’t cooperate.”
- ? “We can’t make patient flow work now; we’ll never be able to speed it up.”
- ? “The schedulers don’t have the right software to make the changes.”
- ? “Why should we do more for the hospital after they put a freeze on our pay last year?”
Curtis’s memo mandates didn’t work, his boss expressing frustration with staff members didn’t help, and the daily onslaught of problems eventually wore Curtis down. “This department is hopelessly dysfunctional,” he began to mutter every time his pager went off.
Curtis’s story serves as a good example of the importance of igniting people’s passion for achieving a positive outcome before trying to implement changes. Without creating unifying passion, most people remain stuck in their old patterns. They lack the motivation to make changes. Trying to overpower people works only briefly; the staff members will figure out how to sabotage the change initiative.
If you want to improve people’s performance—your own or your team’s—the first step is to generate sufficient passion to overcome the built-in resistance all human beings have to change. After learning about the research on generating positive passion, Curtis was able to turn his team around. You’ll discover how when you read the rest of his story at the end of this chapter.