Develop The Big Picture

January 5, 2022

Deborah Kumar

You are a month into your interim assignment as a healthcare leader.  In this first month, you have observed your team in action, met with every one of them to learn about their work and met with the department leaders who support your team.  What do you do next? How can you develop the big picture to appreciate, recognize and celebrate what is working?


Have you been documenting everything?  As you conduct your observations, back them up with notes: who, what, when, and where.  As you conduct your one-on-one meetings, take notes.  As you meet with the department leaders, get data and take notes. Now is the time to dive into all the notes and pull them together into themes and actionable items.


The key is identifying the themes, both positive and opportunities.  You can start with the themes identified by the leadership that has engaged your services.  They will have given you goals to achieve. Examples could be productivity, staff turnover, patient satisfaction.   Move on to include any themes identified by other departments, and finally, all the themes introduced by the team that were not already identified.


Under each theme, list all the supporting evidence.  For example, the department may be missing productivity goals.  Now, what have you observed?

  1. Data from supporting departments – for example, HPPD (hours per patient day).
  2. Observations:
    1. How well does the teamwork together?
    2. How efficient is the workflow?
    3. Are there insufficient supplies and added steps?
    4. Are there scheduling issues?
  3. Information
    1. What comments and ideas have the team members themselves presented about their productivity and workflow?


As you review this information, certain themes will stand out. List the themes (I like to work in an excel file), and under each theme, list the details and give a number to the times the supporting ideas pop up.  This is especially helpful when presenting the information to staff and the executive team.   It allows you to create data.  For example, you may find that 90% of staff complain about workflow and unit efficiency while leadership sees productivity issues.  Now, you will be able to join the dots.


Data is very powerful.  It is eye-opening when staff feedback supports issues that the leadership have also pointed out.   Both leadership and staff are equally surprised:  neither felt that the other understood the challenges.   Finding this congruence creates the best atmosphere for you to begin the work toward change.


Your goal is to do two things.  First: this must be presented to the executive or leadership team, a topic to be addressed in February.  Second: Only after this step and direction from the leadership team will you present to your team.  How well you collect and present this information and data makes the subsequent steps possible and ensures your success in enlisting the support of leadership and your team.


The next article in this series will walk you through the preparation and presentation to the leadership and/or executive team.



February Blog:    Presentation To The Executive/Leadership Team

March Blog:         Presentation To The Department Team.

April Blog:            Using I2E2:  Involving The Team And Creating A Vision

May Blog:            Creating Change That Continues After The Assignment Ends