Surgeons as Educators A Guide for Academic Development and Teaching Excellence

(Ben Green) #1

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want to ask stakeholders, e.g., What are your ideas? What is your depart-
ment’s contribution?


  • During this 4–6 week period, leaders are assessing the organizational culture
    while building relationships with subordinates and key stakeholders, and assess-
    ing talent and the overall ability and willingness to collaborate.

    • They are beginning to identify the cultural problems, such as “shame and
      blame,” finger-pointing, inability to speak up to authority, weak commitment,
      low morale, and feelings of underappreciation.

    • They are assessing strategic design and misalignments, such as poor coordi-
      nation, vague goals and standards, lack of knowledge about costs, inefficien-
      cies, and the need for process improvements.

    • They are discovering customer experiences and the true value proposition, the
      people proposition, and the value to the organization.



  • After 4–6 weeks in the GEMBA, talking with dozens, or for a CEO, hundreds of
    people, critical issues and hypotheses emerge.

  • The next 4–6 weeks are marked by reviewing the diagnoses, separating the facts
    from assumptions.

    • Groups are formed and are engaged in challenging discussions. They are test-
      ing hypotheses, reframing the problems and opportunities, and assessing the
      full set of consequences, the risks, uncertainties, and tradeoffs.



  • The leader’s job is to stay out of the content and instead to manage the process—
    keeping people as rational as possible while ensuring good relationships.

    • The leader also ensures that people use a process of inquiry, not advocacy,
      allowing challenging discussions, debates, and friendly arguments.

    • The leader asks everyone to explore the uncertainties by exploring the “what
      ifs” and the contingencies for 2–3 likely scenarios, asking for example, What
      would happen if we pursued this solution? Or that goal?

    • The discussion allows for more reframing and more argument, building on the
      ideas of others. Everyone is exploring the alternatives and options.



  • The last month of this 3–4 month period is spent communicating the implications
    of the targets, the rationale, and the plan to get there. Finally, the 3–4 months end
    with an announcement:
    Ladies and gentlemen, thank you for the challenging discussions and all your ideas during
    the last 3–4 months. We have decided that the objective of this group (department, organiza-
    tion, etc.) is X, Y, Z, and this is our strategic action plan to get there. Here are your roles and
    responsibilities, and now we have to execute the plan.
    Some leaders will make a final commitment:
    If this plan we developed does not work over the next 12–18 months, and we do not make
    significant progress towards our goals, I will take responsibility and resign—no excuses.
    We will do this right or not at all.^28


(^28) Carlos Ghosn, CEO of Nissan and Renault, used reciprocal commitment. Here are our goals and
your role and responsibilities. In addition, he publicly promised his resignation if they did not get
the expected results in 1 year.
J.A. Chilingerian

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