I have been supported by several people to try and put down on Radio some of my thoughts about how things are going with the Pursuing Perfection Project from a team development standpoint. I seem to be one of the more sensitive and outspoken team members about general structure, culture and team development aspects of our project, and have been bringing out thoughts and concerns surrounding those issues at group meetings, but this will be my first attempt to put it to “paper”… so bare with me.
What is happening with our team? What am I (and apparently others as well) experiencing that feels as if it’s holding us back from achieving our full potential as individuals contributing to the team as well as a team as a whole? Why are we finding it difficult meshing seamlessly with each other as team mates? Why does it seem so difficult to move forward?
As a precursor, I’d like to emphasize the fact that I truly believe each and every person I’ve encountered who’s involved with the pursuing perfection project knows, understands and believes strongly in the system changes we will be attempting to implement as part of the project. The people involved are also extremely capable, typically at many levels and with many aspects of the project. The people are motivated and hard-working. The people are completely committed to both their contribution and the overall project goals. Every person involved is wanting and attempting to do his or her best as part of the grant effort. Many of us have given up security and a known future for a chance at being merely part of this movement toward a perfect healthcare delivery system. So, let it not for an instant cross your mind as you read my thoughts that I believe that any person, in any way, is to blame for any of the “problems”.
I will attempt to use the “Awareness Star” to express my thoughts on this topic. This is difficult for me since I seem to be perceiving issues on two separate levels… there is the general project perception: what is going on with the team as a whole; and there’s the individual level: what is happening to me, likely as a result of the bigger picture issues. I don’t think I can successfully separate these, so I apologize for any confusion this may cause. For clarification, when I say “the team”, I am referring to the collective whole of all the individuals who are contributing to the Pursuing Perfection Project, not the “project team” per se, although I think the “project team” interactions exemplify the team as a whole.
I’m feeling…..
I’m feeling disconnected from the project itself. I’m feeling a lack of definition both in my purpose and place in the team and in a general sense. I’m feeling a severe lack of utilization of my gifts that I have to give the team. I’m feeling misused and used as a “worker bee” in a capacity that is not even my specialty, rather than as a contributing member to the project as a whole. I’m feeling duped… like I took this job thinking that I would be used for my mind, my analytical ability, my creativity, my experiences both as a patient and with patients but instead am being used strictly as someone who can put predefined “stuff” up on the web. I’m feeling like I’m alone… like the team is elsewhere… like no one knows how or why to utilize me and my gifts, nor I them.
I’m sensing….
I’m sensing discontent and frustration from nearly all people present at meetings. I’m sensing frustration at not being able to make authoritative decisions. I’m sensing discontent about process and decision-making capacity. I’m sensing general confusion about who’s leading who, how to involve patients, what we mean by patient-centered. I’m sensing a need for very general discussions about these topics. I’m sensing a need for social change that isn’t being talked about. I’m sensing hesitation about bringing forward confusing issues. I’m sensing a need to move quickly and a resulting loss of control.
I’m thinking….
I’m thinking Mary is the only person who has the “big picture” view and that this is not healthy. Mary used the analogy of an orchestra where she is the conductor and we all need to be playing our own instruments, not other people’s, in order to make the music work. My contention is that if we don’t all learn how the entire piece sounds, when the violins play and what their part sounds like, if we don’t understand how our own part fits in, then the music will fail to come together. I’m thinking there is a lack of learning about each other’s parts, not due to lack of desire, but due to lack of opportunity. To use the same analogy… my perception of the way things currently are is that each section of the orchestra is practicing their own part separately, at different times. Mary, as the conductor, is privy to the entire piece and what all of the different sections sound like and has a vision of how they will all come together beautifully at the concert. My concern is, if we don’t practice together as a whole, how will we be able to perform together seamlessly?
I’m also thinking there’s a lack of role definition and clarity along with a lack of authority granted to those who are supposed to be leading projects. I understand that collaboration is key, but there has to be a process for coming to decisions and I’m thinking that process, if it exists, is not commonly known or bought in to.
I’m thinking that we talk an awful lot about making this new system “patient-centered” and about involving patients in the creation of this new system, but don’t see the process through which this is or even should be happening or even if we’re all on the same page as to what it means to be “patient-centered”.
I’m wanting….
I’m wanting the people involved with the project to be more involved in defining the roles they play within the team. I’m wanting there to be more information sharing to be happening between various groups, teams and projects so that we can all better see and understand how our pieces fit in. I’m wanting general discussions about the project, what the current projects, goals, opportunities, etc. are. I’m wanting ongoing discussions about the project, on a general level, that allows new participants to give some input into the overall plan and goals. I’m wanting a process for continually evaluating where we are, where we want to be going, what our goals are, how successful we are at being patient-centered and at allowing it to be “their treehouse”, if we’re taking a proper path… and I’m wanting all people interested to be able to be involved in these discussions…. Perhaps this is a good use of Radio Userland? I’m wanting a methodology established for obtaining and utilizing patients, family and care givers in the project development process.
For me, personally, I’m wanting to have more say in what I am assigned to do and to not do (in a general way). I’m wanting more access to people and more information so that I can understand my role. I’m wanting to not only understand my role better, but to have some say in what my role is. I’m wanting well established boundaries so that I can both fulfill expectations of me and take control of my turf so that evaluation of me and my performance will be accurate. I’m wanting to be more involved in the development of the shared care plan (not on a technical level as much as a conceptual level) and the involvement of patients. I’m wanting to have discussions on the technological aspects of the project in general – given the “fact” that only 25% of our patient population will be comfortable utilizing technology, I’m wanting discussions surrounding how this fact will be dealt with. I’m wanting to be able to visualize the project as a whole… not just my piece. I’m wanting to be able to discuss reasons surrounding decisions that result in work that is designated to me, or preferably, to be involved in the discussions that end up in decisions that affect my areas of expertise.
Action I will take….
Should I act? Can I act? How will my actions be interpreted? I guess one action is my writing this down; to attempt to begin discussions about what is happening with me and possibly with the team. Another action I will take, and have already begun, is to collect names of patients, family members and care givers who have volunteered to be available to members of the Pursuing Perfection Project in various ways to contribute their voice. I am also establishing a process through which project members can access these folks for various needs. A further action is to meet with Mary in an attempt to establish better role definition and clarity for myself. I would like to initiate an educational movement whose goal would be a social change throughout Whatcom County, changing the beliefs surrounding medical care toward the new model, both to providers and to all potential patients; the primary message being “for chronic illnesses, primary responsibility for treatment lies with the patient and their family.” (this message is my interpretation only and I recognize it as extreme.)
Well, there it is… my brain, heart, soul…. downloaded on the Internet and open for discussion.
