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Your greatest value is your ability to solve problems

As a healthcare professional you may face problems that require problem solving at the least and the generation of creative solutions ideally. How do you hone your creativity?

The results revealed that leadership clarity is associated with clear team objectives, high levels of participation, commitment to excellence, and support for innovation. Team processes consistently predicted team innovation across all three samples. Team leadership predicted innovation in the latter two samples, and there was some evidence that team processes partly mediated this relationship. The results imply the need for theory that incorporates clarity and not just style of leadership. For health care teams in particular, and teams in general, the results suggest a need to ensure leadership is clear in teams when innovation is a desirable team performance outcome. West et al

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Is normal too thin?

Try this experiment. If you are tending to overweight ( Body Mass Index (BMI) 25 or over) then try to get to BMI 18.5 -24.9.  If you succeed people will decide you have lost ‘too much weight’  even when your BMI is in the middle of the normal range. If normal was defined as ‘what is most common’ then to have a ‘normal’ BMI is unusual and we may have become blind to normal so that what we perceive as ‘normal’ is not ideal. Rates of overweight and obesity are now at 60-70%.

In an Australian study on the public perception of body size the authors report that:

Overweight participants were also most likely to incorrectly identify themselves as a healthy weight (67 per cent, p<0.001), compared to 12 per cent of obese participants . The majority (89 per cent) of normal weight participants accurately identified themselves as being a healthy weight. Flanagan et al

Therefore it is not surprising that when people are challenged about their weight in healthcare they are reluctant to identify the issue as a problem.

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Does parking stop doctoring

Imagine you have back pain. Your doctor suggests you need special scan. You have to travel an hour across town to get to the hospital where you have an appointment at 9 am. You take the morning off but hope you might get to work in the afternoon. It’s peak hour traffic as you arrive at the hospital. The queue to get into the car park stretches down the street. You join the line of cars and realise it’s now 8.45am. The X-ray department is a long walk from the car park. Just as you get to the entrance to the parking lot the attendant indicates that it is full and you have to try and get a spot on a side street. The chap in the car behind you is getting frustrated- are you waiting in the queue or trying to back out? It’s a one way street you can’t turn the car here. It’s now 9 am you are going to be late- not sure how late. You toy with the idea of just going home.

In November 2011, an editorial in the Canadian Medical Association Journal called hospital parking fees a barrier to health care, saying the charges amount to “parking-centred health care,” and recommended hospitals stop charging patients for parking. The editorial stirred up a debate in the media. The Ontario Nurses’ Association, for one, agreed with the recommendation and noted that many of its members could tell stories about patients who had avoided seeking care or had cut appointments because of high parking costs. Canadian Nurse

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Not all solutions are linear

We mistakenly believe that the path to solving some of our customer, client or patient’s problems is linear. Want to improve your liver function? Stop drinking alcohol. Want to lose weight? Go on a diet. Want to have more energy? Stop smoking. The ‘solution’ is simple. But it doesn’t usually work that way.

Sophie sat looking glazed as her doctor suggested a strict diet that might help her shed the kilos. It didn’t end well. She never lost any weight and eventually stopped attending that clinic. Her life was complicated. She had always been overweight and after the babies were born she got steadily heavier until she was obese. She lives in a modest two bedroom rented home with three children and partner. He works as a bus driver. Sophie does shifts at a laundry when her friend needs help covering the roster. The family buy their clothes second hand and just about pay their bills. At the weekend they go to the mall and have a takeaway meal from the food court. Sophie enjoys the day at the mall where she meets her friends and spend the afternoon gossiping while the children are in the play area. She didn’t learn to cook and her small kitchen is barely equipped to turn out the simplest meal. She never enjoyed school and can’t read. In quiet moments Sophie admits she doesn’t like the way life turned out but she has dreams that she might win the lottery and then life will be so much better.

With this as her back story the diet and exercise program wasn’t appealing. She may decide she wants to reduce the risk of developing diabetes, a condition that impacted her father. It may be a meandering journey but the best coach will stick with her.

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How do you prepare for work?

I don’t know him personally but I don’t imagine that Michael Phelps dives into a pool when he isn’t ready to race. Similarly Usain Bolt might look like he jumped off the viewing stands and popped himself on the starting blocks but in truth his mind and his body are ready to make him the fastest man on dry land. However when we arrive at work we might still be thinking about the argument at home, the traffic jam or the news. We might arrive a bit disheveled, a bit breathless or a tad tired. We might not hear the first few things we are told or notice more than we can take in at a glance of our first customer client or patient. However to perform at our peak we might consider what might get us in the zone so that our performance is not in question.

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Are you worried they’ll never stop talking?

It’s a busy day at work and the next customer, client or patient settles in to tell you something. Are you secretly asking yourself:

 How long will this take?

Will it pay off allowing them to take a couple of minutes to speak about whatever’s on their mind? Have you tried it and timed how long before they stop?

Studies have even shown that participants are willing to give up between 17% and 25% of the monetary reward offered for talking about others in order to feel the intrinsic rewards of talking about themselves. And outside of the lab, 40% of our everyday speech is devoted to telling other people how we feel or what we think. That’s almost half! Belle Beth Cooper

So if you want to do something special for your client, customer or patient give them a chance to say what they want- you might be surprised that it doesn’t take that long and pays enormous dividends.

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Could you do better?

Do you think your work could be better? How? If you think it could be improved what are you waiting for?

The intense debate about how to move forward is a sign that overtreatment matters,” Brownlee says. “We want everyone involved and sharing their expertise on potential solutions. There is room for many political ideologies and beliefs about how to pay for healthcare. The crucial step right now is to get the medical community mobilized around the idea that overtreatment harms patients

BMJ Jeanne Lenzer

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Are you sure they can help?

One of the key roles in healthcare is to refer people to other sources of help. The list of therapists, specialists and clinics is as long as any phone directory. However off loading someone elsewhere is hardly worthwhile if it’s a waste of time and money.

The goal should always be the initiation of a discussion about a patient’s needs and the beginning of a triaging process to address these, rather than problem identification being an end‐goal itself. Gemma Skaczkowski

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Are you persuasive?

If your job involves advising- are you a credible source of advice? How do you know?  What can you do to make yourself a more influential? Apart from giving credible advice is there something you can do to make your advice more likely to persuade?

There’s a critical insight in all this for those of us who want to learn to be more influential. The best persuaders become the best through pre-suasion – the process of arranging for recipients to be receptive to a message before they encounter it. To persuade optimally, then, it’s necessary to pre-suade optimally. But how?

In part, the answer involves an essential but poorly appreciated tenet of all communication: what we present first changes the way people experience what we present to them next.
Robert B. Cialdini, Pre-Suasion: A Revolutionary Way to Influence and Persuade

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How do you frame your solutions?

How do you frame a suggested solution to someone’s problem? Do you mention the possibility that your suggestion won’t help? If you are a doctor do you speak of the number need to treat? We know that not everyone is helped by a medicine or intervention — some benefit, some are harmed, and some are unaffected. One of the commonest reasons that patients consult doctors are for sore throat. How many people with a sore throat should be treated for one person to be free of the sore throat at day 3 of their illness? At day 7 of the illness?

Protecting individuals with sore throat against suppurative and non-suppurative complications in modern Western society can only be achieved by treating many with antibiotics, most of whom will derive no benefit. Cochrane Primary care

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