Collaboration Trumps Control
Top-down, authoritarian leadership in health care’s new era of collaboration is likely to find its currency on the decline. Particularly in a wired specialty such as radiology, leaders will be challenged to engage an increasingly distributed workforce in the broader team approach called for by new delivery models in health care. Writing in a recent issue of Harvard Business Review, Ibarra and Hansen¹ offer the example of Marc Benioff, CEO of (San Francisco, California), whose company had invested resources in a social-media–inspired application called Chatter to share information internally. In watching the exchange, Benioff realized that many of the people with critical customer knowledge (and, therefore, high value) were unknown to management. Conversely, the rank and file had limited insight into the activities of top management. What was the solution? Benioff blew the doors off of the next executive retreat by inviting all 5,000 employees to join the retreat—virtually. With massive video monitors set up around the room to display the Chatter forum, tables equipped with mobile devices, and a video broadcast of the event, employees (and management) could instantly express their views on Chatter. The dialogue continued for weeks after the meeting ended. “More important,” the authors write, “by fostering a discussion across the entire organization, Benioff has been able to better align [sic] the whole workforce around its mission. The event served as a catalyst for the creation of a more open and empowered culture.” The authors note that businesspeople today are working more collaboratively than ever before—and not just with each other, but with suppliers, customers, governments, universities, and (within health care) payors. Leaders who rose using what the authors call command-and-control style can have a difficult time adapting to collaborative leadership, while managers intent on leading by consensus risk watching decision making grind to a halt. The authors, who have researched top-performing leaders worldwide, report that being a collaborative leader requires skills in four key areas. They also maintain that these skills can be learned. Four Key Skill Sets First, leaders need to be global connectors, a term that the authors borrow from Malcolm Gladwell’s The Tipping Point (Little, Brown and Company, 2000). Connectors are people who have ties to a variety of social and work worlds. Connector tactics used by David Kenny, president of Akamai Technologies (Cambridge, Massachusetts), include checking in on, a social-networking site where members can inform others of their locations; having lunch or coffee with 20 to 40 people wherever he goes; and making a point of seeing two to three people he knows in every location that he visits, usually with another Akamai Technologies employee in tow. Connecting with people from adjacent industries, hot spots of innovation, and other cultures and ethnic groups is another key tactic to further the connector activities of collaborative leaders. Second, the authors emphasize, if well led, diverse teams produce superior results. It is therefore advisable to build teams from people of different backgrounds, disciplines, cultures, and generations, and to leverage those differences (rather than doing what many companies do, which is to spend a lot of energy trying to make everyone the same). Nonnative English speakers, in fact, are passed over for promotions at many multinational companies. The French food company Danone (Paris) takes the opposite approach: It encourages employees to make presentations in their native tongues and spends heavily on translators to support them. Danone, therefore, excels at attracting top talent from competitors that are not as appreciative of diversity. In addition to cultural diversity, teams benefit from having people who are both experienced and new to their jobs, as well as members of different generations. The authors caution readers that the former executive team of one-time mobile leader Nokia (Espoo, Finland) was 100% Finnish. Monkey See Third, collaborative leaders must lead by example and model collaboration themselves. This is not as easy as it sounds, since most companies—and health-care systems—are operated by a leadership team that includes the CEO and a small team of directly reporting executives with their own fiefdoms, with neither the responsibility nor the incentive to collaborate, as a whole, on organizational goals. That is not the case at Brazil’s Natura Cosméticos (Cajamar), where competing executive agendas threatened to derail the company after a successful IPO in 2004. CEO Alessandro Carlucci asked members of the top team to embark on self-development journeys as part of their stewardship of the company. Aided by an outside coach who met with each person individually, as well as within the team, these executives explored their relationships with the company, their families, and themselves, resulting in a management that became better at team activity. The collaborative mindset filtered down into the organization, which repeated the exercise at the managers’ level, and the company grew 21% in 2010. While one executive believed that revealing their vulnerabilities to themselves and to one another was the key to the experience, psychologist Carol Dweck attributes improvements in the ability to collaborate to a shift from using short-term performance indicators to setting longer-term learning goals. Vineet Nayar, CEO of HCL (Noida, India), demonstrated his commitment to collaboration by inviting a broad range of people (not just those who reported to them) to participate in 360° multisource evaluations for his managers, and he got the ball rolling by posting his own 360° evaluation on the Web. Fourth, collaborative leaders need to resist overdoing collaboration. You can’t collaborate on everything; instead, collaboration needs to be the oil that greases the wheel of innovation, rather than the sand grinding it to a halt, the authors write. Collaborative leaders need to develop the skills that will harness the power of all of their human resources by using their influence, rather than their authority, to initiate collaboration. They also need to be ready to shut down unproductive discussions and politicking and to make final decisions. “Effective collaborative leaders assume a strong role directing teams,” the authors write. “They maintain agility by forming and disbanding them as opportunities come and go—in much the same way that Hollywood producers, directors, actors, writers, and technicians establish teams for the life of movie projects. Collaborative efforts are highly fluid and not confined to company silos.” Likewise, in radiology, collaborative efforts must not be confined to the department, the practice, or the institution.