By Valerie J. Dimond, Contributing Reporter

Problems crop up every day in healthcare. Although some are tougher to solve than others, one of the biggest and most common obstacles to finding good solutions is disagreement among team members. People will always have dissimilar ideas and perspectives on how to reach a shared goal. However, successful outcomes can occur more easily and frequently when stakeholders become very aware of the different “influencing styles” people use and incorporate those elements into their case to cement buy-in and sustainable change. Sounds reasonable but the practice is harder than it sounds — as dozens of healthcare leaders discovered during the Institute for Healthcare Improvement’s 2019 National Forum, December 8-11 in Orlando, Florida.

Janet Porter, Ph.D., a professor and board member at Ohio State University, commenced the first half of a three-hour session “Leading, Managing, and Coaching to Excellence” with an interactive, eye-opening presentation on how to build consensus and solve problems more effectively. She said the trick is to understand and leverage the various approaches people take when working together. Porter explained how individuals tend to communicate using one or more of the following five styles:

• Asserting: “Assertive people tend to feel comfortable insisting that their ideas are heard and consider challenging the ideas of others,” said Porter. “They say things like let’s talk about the elephant in the room. You guys tend to push your perspective and assert your ideas. You like to challenge the organization and say we should do this because it’s in the strategic plan. You should do this because it’s a policy. You believe in structure and rules.”

• Rationalizing: “Rationalizing people like data and expert opinion and facts; you’re logical thinkers. You like things to make sense,” said Porter. “If you’re doing something on quality improvement it has to be logical to you. You like to use expert opinion or historical data or benchmarking data.”

• Negotiating: “Negotiating people tend to look for compromises,” continued Porter. “I do a lot of work with AARP and they are experts at how to persuade every senator before they go in the office. They know what their constituents’ latest poll shows and how they’re going to persuade that base on what’s in it for them. They’re good at bargaining. You might say I know this is not a long-term solution but perhaps we can make some progress.”

• Inspiring: “Inspiring people tend to advocate and encourage a position by giving a shared sense of purpose and possibilities. You’re likely to say 'imagine if we could be a zero-harm organization — imagine what that would be like.' You like to pull people together by encouraging them with a sense of shared purpose. 'Can you imagine if we lived in a country where we really had opioid abuse under control?'”

• Bridging: “Bridging people tend to build relationships with others,” concluded Porter. “You are good listeners and you do that by being empathetic and connecting with people. You also like to use stories. [Others are] going to give data about how long the throughput time is in the emergency department and you’re over here going 'who cares?', because you want to talk about Aunt Mable who was in the ED last night and wasn’t seen and how traumatic it was. Also, you guys are good at showing appreciation. You use words like 'I think I understand your dilemma; it sounds like the three of us have a common agenda.'”

Did you identify your style? Equally important, did you recognize that of whom you collaborate with on a regular basis? The main point is that your view shouldn’t be the end-all. “That go-to perspective you use can blind you to the fact that not everybody is influenced like you are,” said Porter, who helps healthcare leaders across the country improve communication and problem-solving skills. She said every style is valuable and can be used to solve problems but requires problem-solvers to step out of their comfort zone and appeal to different theories when making decisions. This might sound simple and cliché, but how often do we really put it into play?

After Porter did this work with healthcare professionals at Kaiser Permanente recently, she said, “I got a long note that said: ‘I thought about it and I realized my boss is a rationalizer. I haven’t been using data and I know the data from what I care about. I went in today [with the data] and had the best meeting with him I’ve had in three years. I’ve been pitching stories and inspiring but here we made more progress than we’ve made in three years on something I’m really passionate about.”

So, the next time you build a case, strengthen your leadership and sway by considering a style different from your own. “That’s how you influence people,” said Porter. “You give them something to think about afterward. Go into every session you have like this. You can really make a difference.”

The next step is to combine this insight with effective coaching strategies. Dr. David Munch, senior principal, Vizient Advisory Solutions, explains how in part two.