Perspectives on the Acute Care Continuum

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A Culture of Trust

1/13/2015 6:35:44 AM | 1 comments

Welcome to Leading Mindfully Quarterly, a column by renowned leadership and mindfulness expert and author Dawa Tarchin Phillips. LMQ is intent on providing valuable insight and perspective on excellence in leadership, conscious high performance, meaningful professional impact and enhanced work-life balance for healthcare professionals.
Mindfulness-based leadership is an in-demand objective that thrives on high levels of emotional intelligence, focus and attention skills, professional engagement and effective decision-making, culminating in increased leadership effectiveness, joy and overall job and life satisfaction.

The past decade has been a period of great uncertainty for healthcare leaders, who've been charged with implementing a sweeping redesign of the entire industry. We frequently watch bills pass into law and wonder what regulations will follow. Population health, bundled payments and clinical integration are touted as the way forward, but essentially these key programs, like many others, are being designed on the fly.

On the other hand, openness to change is essential to move teams and organizations forward in creating better care for all patients. So how can we foster resiliency in uncertain times? One way is by cultivating the mindful habit of Trust.

Trust may seem foolish and naive in a world fraught with risk. On the other hand, an intelligent and realistic approach to Trust by leaders and their teams can unleash your organization’s potential and take service and performance to new levels.

Two Approaches to Trust

There are two very different approaches to Trust.

The one observed most frequently in people and organizations is that Trust is a reaction to the degree of safety and support you perceive in the world around you: “Make it safe for me, and I will trust you.”
We call this approach Trust as a reaction or a response. You feel it when, based on repeated observations, you decide that the people and conditions in your environment display a degree of predictability.

The problem with this approach is that it can stifle progress. The environment may never quite be safe and predictable enough to earn your Trust. And once Trust is lost, it can seem impossible to re-establish unless people or the environment undergo often unrealistic transformations.

When organizations rely on Trust as a response, Trust levels remain low. The organization and the individuals within it trade low reward for low risk. Their primary goal is self-preservation through ongoing self-protection. Access to full potential remains restricted, and opportunity for excellence is lost.

Let’s look at another, more desirable approach that is a lot more courageous — and more suitable for the reality we live in. We call it Trust as an investment.

This approach views Trust as an inner resource you are free to cultivate consciously and in unlimited quantities. By doing so, you begin to free Trust from its cognitive bias and emotional constraints.

Uncertainty and change are not going away anytime soon, if ever. You can resolve to invest Trust because you value what it brings to your life and organization.

Albert Einstein said, “The most important decision we make is whether we believe we live in a friendly or hostile universe.” When you resolve to invest Trust, you affirm the conviction that the universe is friendly. Not because it is safe, secure or predictable, but because it has endowed you with the inner resources to thrive in a risky and uncertain environment.

“If you can change something, there’s no need to worry; if you cannot change something, there’s no need to worry.”
—Himalayan proverb

Interesting Things Begin to Happen

When you choose to invest in Trust, you begin to worry less.

Worry, your general human response to uncertainty and change, comes at a cost. It consumes your inner resources and destabilizes your composure. What you may not realize is that your worry is based on your imagination. And usually, when you begin to worry, your initial internal monologue begins with, “What if...?”

At Empowerment Holdings, we call this the “What if...?” red flag. Everything that comes after the “What if...?” statement is by nature pure imagination, hypothesis. “What if I make a fool of myself?” “What if I lose my credibility?" “What if I lose my job?”

Although you are only imagining outcomes, the thoughts still affect you. If you dwell on the worst-case scenario, your body will exhibit the typical stress response. This means it will release adrenalin and cortisol in larger quantities, increase your blood pressure and heart rate and reallocate resources to fight or flee. Over prolonged periods of time, the collective costs of such worry on individuals and organizations are estimated to be in the billions. And having allowed your imagination to repeatedly dwell on the worst-case scenario — believing the universe might turn out to be hostile after all — has created a physical and psychological liability on your entire system.

There Are Options

But “What if…” we take a different approach?

If after the “What if...?” red flag you actually choose to imagine things going well and working out, your body will begin to relax and open up. You will begin to feel at ease in your skin, and your physiology will function normally, if not better.

It’s not that anything really changed. Uncertainty is still present. You do not yet know what will actually happen. But by choosing to invest Trust, you have reduced worry and its cost on your body and mind. You've also maintained access to your mental, physical, emotional and spiritual resources.

If you can promote Trust investments on an organizational scale, just imagine the impact on morale and productivity.

The Benefits are Multifold

If you choose to invest Trust in this way, something else begins to happen: You will begin to feel less resentful.

When you practice Trust as a reaction or response, you may resent others for not giving you the sense of certainty, predictability and control you crave. You may blame people and your organization for your contracted state and the taxing experience of your continual stress and worry.

If you choose to invest Trust, you will begin to fear less. While risk is real, fear is a choice.

Fearlessness is the natural outcome of not allowing your mind to dwell on negative “What if...?” scenarios. And a mind that is not dwelling will progressively give rise to confidence and resilience.

We are not suggesting here that it is not important to properly assess your strengths, weaknesses, opportunities and threats. But once you have done so, it is done. Take what steps you can, and Trust that this is enough.

Once you begin to experience firsthand the changes that occur from investing Trust, you will realize the power that is unleashed from making this small but vital change in your perspective and cognitive behavior. And like any good system, it begins to build on itself. As you invest more Trust, you begin to experience more Trust. As you experience more Trust, you have more Trust to invest.

To quote Einstein once more, “Compounding interest is the eighth wonder of the world. He who understands it earns it. He who doesn’t pays it.”

Just think what your investment of Trust can do for your organization, team and patients. As an approach to leadership, Trust is cutting edge. We trust you will not let this chance pass you by.  

[Image credit: "Cheerleader tossed aloft" by uwdigitalcollections licensed under CC BY 2.0]

Anne Bruce
This article on the "Culture of Trust" is one of the best I have read. Brilliant contribution Dawa!!!!!
1/14/2015 9:50:59 PM