Kendall L. Stewart, M.D. July 23, 2004

1. Rules of EngagementMaking the Case for Clarifying Interpersonal Behavior Expectations for Organizational LeadersA Presentation for Holzer Medical Center Kendall L. Stewart, M.D. July 23, 2004

2. Most organizational leaders know how they should behave. But it’s easier to misbehave. And since everybody from executives on down are often behaving badly, misbehavior is frequently accepted as the norm—or inevitable. Many leaders don’t even realize what they are doing or how destructive their behaviors are. We can do better. And we should. And we must. After listening to this presentation, you will be able to Identify three characteristics of high-performing leadership teams Describe three common interpersonal behaviors that undermine organizational excellence Give three compelling reasons why clarifying your expectations makes sense List three practical strategies for successfully developing and deploying your own “Rules of Engagement” in your organization What is the point of this presentation?

3. What are some of the characteristicsof high-performing teams? • Every member of the team is relentlessly focused on performance. • Members are always slightly uncomfortable. • Members trust each other. • Members are honest with each other—without being hurtful. • Members hold themselves and each other accountable. • Roles are clearly assigned but interchangeable. • Members value and discuss different perceptions openly. • Each person’s distinct contributions are recognized. • Members love working in this energizing context. • The best idea is the boss. • Rank has little to do with it. • Members are fiercely loyal to each other, but neither awed nor intimidated by their colleagues. • Members talk to each other instead of about each other. • Risk taking and mistakes that produce learning are encouraged. • Such teams are usually characterized by organized chaos, not practiced choreography. • The team gels in response to some daunting task. • Team members challenge each other openly, and this encourages innovation instead of resentment or hurt feelings. • Members fully understand the enabling power of positive emotional arousal and the destructiveness of negative emotional arousal.

4. We talk about each other instead of talking to each other. We fail to confront each other when we should. We conduct our real meetings after the meetings. We fail to recognize that emotional arousal is a danger sign. We use our positions of power to intimidate instead of facilitate. We indulge in temper tantrums in the workplace. We support inept and negative leaders when we should extrude them. We fail to hold each other accountable. We avoid conflict instead of resolving it. We avoid asking the hard questions for fear that we will hurt each other’s feelings. We fail to make our expectations clear then react resentfully when others don’t read our minds. We tell people what they want to hear instead of taking a clear position and sticking to it. We avoid discomfort and drift when we should be paddling furiously. We settle for mediocrity when we should be demanding more of others and ourselves. We blame others for our feelings and behaviors. We make impulsive decisions before considering all of the options. We procrastinate instead of acting promptly. What are some of our most common inappropriate interpersonal behaviors?

5. Why might it make sense to clarify your “Rules of Engagement?” • It would acknowledge the problem. • It would demonstrate your resolve to face up to it. • It would hold you accountable for your own behavior. • It would help you clarify your expectations of your colleagues. • It would encourage appropriate confrontation throughout the organization. • Over time, your clarification will weaken this critical barrier to achieving exceptional organizational results.

6. Recognize this issue as an opportunity for improvement. Select an executive champion. Make the case that this issue should become a priority. Obtain executive staff commitment. Review the interpersonal behaviors of high performing leadership teams. Identify your interpersonal behavioral strengths. Identify your opportunities to improve (OFIs). Specify those common interpersonal behaviors that would need to change. Identify the key barriers to change. Encourage executives to agree on a draft document. Obtain broad-based support. Keep the guidelines simple and brief. Make them understandable and practical. Make a public commitment to conform. Begin by changing your own behavior. Confront each other when you slip. Recognize and celebrate incremental success while acknowledging that “change is hard.” Clarify your expectations for new leaders. Seek feedback about whether the organization’s leaders “walk the talk.” Extrude those leaders who refuse to embrace these guidelines. What are some strategies for successfully deploying your own “Rules of Engagement?”

7. Why should you? Executives are frequent barriers to organizational success. They set priorities and allocate resources. Like everyone else, executives long for comfort, and they are not likely to change unless someone makes them uncomfortable. A determined executive makes her peers very uncomfortable. You need the leverage with your peers. One of the executives needs to take the point if this effort is going to succeed. How can you? Identify an opinion leader. Choose and executive with some behavioral insight. Find someone who is committed to the pursuit of excellence. Avoid executives who regularly misbehave. Recruit champions by making a compelling case. Make it their idea. Guarantee them the support they will need. Convince them you are in this for the long haul. Build this joint effort on an existing relationship. Select an executive champion.

8. Why should you? You have no chance of sustaining a cultural change without making this case. There is no more time in the day. Everyone is already busy doing stuff they think is important. Executives are exceptionally set in their ways. Executives think they already know what the organizations priorities should be. Few of us change without some sense of urgency. How can you? Acknowledge the competing priorities. Highlight the problems caused by the status quo. Recall recent examples of flawed leadership behavior. Emphasize the emotional cost of continued avoidance. Illustrate organizational benefits of less dysfunctional interactions. Find an emotional hook to promote engagement. Ask for their help. Agree on next steps. Establish a timeline. Make the case that this issue should become a priority.

9. Why should you? Acknowledges the resistance triggered by change Confronts the challenge of sustained behavioral change Identifies negative, incorrigible leaders who must be confronted—and possibly extruded. Enhances leaders’ credibility Spotlights behavior that has become acceptable Gives hope to frustrated and discouraged leaders Signals the malcontents that their days may be numbered How can you? Convene a group of positive, engaged leaders. Describe the objective clearly. Admit your own resistance up front. Face reality. Learn to tolerate the discomfort that facing reality occasions. Focus on behavior, not suspected motivation. Write the barriers down—and discuss strategies for overcoming them. Remain positive. Identify the key barriers to change.

10. What can you conclude? • Your interpersonal behaviors are huge factors—for good or ill—in the pursuit of organizational excellence. • Inappropriate and destructive leadership behaviors are distressingly common, and these behaviors are often go unchallenged in the workplace. • The chance to identify, formalize and begin to comply with our own culturally-specific “Rules of Engagement” is a substantial challenge and opportunity. • This is not easy. If it were, it wouldn’t be such a problem in most of our organizations. • All leaders must face this issue. • And they will either make up their minds to behave more appropriately, or they will stymie their organization’s success by their avoidance and cowardice. • Every leader has the obligation to reflect on the consequences of his or her behavior and to confront his or her colleagues about theirs.

11. Where can you learn more? • De Vries, Manfred Kets , “Leaders Who Make a Difference,” European Management Journal, Vol 14, No 5, October 1996 • Katzenbach, Jon R. and Smith, Douglas K,. The Wisdom of Teams, HarperBusiness, February 2003 • Kur, Ed, “The Faces Model of High Performing Team Development,” Management Development Review, Volume 9 Number 6, 1996, pp. 25-35 • Londino, Fiore, “Developing High Performance Teams,” Lightwave, June 2002 • London, Manuel and London, Marilyn M., “Tight Coupling in High Performing Teams,” Human Resource Management Review, Volume 6, Number 1 1966, pages 1-24 • Stewart, Kendall L., et. al. A Portable Mentor for Organizational Leaders, SOMCPress, 2003 • Stewart, Kendall L., “Physician Traps: Some Practical Ways to Avoid Becoming a Miserable Doctor” A SOMCPress White Paper, SOMCPress, July 24, 2002 • Stewart, Kendall L. et. al, “On Being Successful at SOMC: Some Practical Guidelines for New Physicians” A SOMCPress White Paper, SOMCPress, January 2001 • Stewart, Kendall L., “Bigwigs Behaving Badly: Understanding and Coping with Notable Misbehavior” A SOMCPress White Paper, SOMCPress, March 11, 2002 • Stewart, Kendall L., “Relationships: Building and Sustaining the Interpersonal Foundations of Organizational Success” A SOMCPress White Paper, SOMCPress, March 11, 2002

12. How can we contact you? Kendall L. Stewart, M.D. Medical Director Southern Ohio Medical Center President & CEO The SOMC Medical Care Foundation, Inc. 1805 27th Street Portsmouth, Ohio 45662 740.356.8153 stewartk@somc.org Webmaster@KendallLStewartMD.com www.somc.org www.KendallLStewartMD.com

13. What questions remain? www.somc.org Southern Ohio Medical Center SafetyQualityServiceRelationshipsPerformance 