Meetings that Build Trust and Achieve Results

Podcast Transcript

Michelle Lampton: Hello and welcome to Learning to lead, a leadership development podcast from Cleveland Clinic. I'm Michelle Lampton, and today we're going to be learning about a powerful leadership tool called thinking rounds. My colleague within the Mandel Global Leadership and Learning Institute, Laurie Miller, had the opportunity to speak with Dr. Brian Harte, the President of Cleveland Clinic Akron General. She got to talk to him about how he uses thinking rounds with his team. But before we dive into their interview, I invited Laurie to join me in our virtual studio to tell us more about what thinking rounds are. Hi Laurie!

Laurie Miller: Hi Michelle, how are you?

Michelle Lampton: I’m doing great! Thank you so much for joining us today. So I’m just jump right into it. What is a thinking round?

Laurie Miller: Terrific. And this is a great question. And this really is a great leadership tool. So thanks for putting light on this one in particular today. So here’s what thinking rounds are. They’re really a set of conditions under which people can think for themselves and think well together. We borrow these from a book called Time to Think by Nancy Kline. In the book, what she’s looking at is the way that we listen to people actually changes their ability to critically think. And this is what Dr. Harte talked about in my interview with him as he encourages the turn-taking, which is an essential part of the thinking round. People know that they’re going to be giving input into the topic they’re covering. So there’s not a situation where people can’t not speak. People are encouraged always to share their thoughts about it. It also encourages equality in the group. So if you have people as we call it in the hierarchy at different levels in the meeting, this sort of flattens that, because everybody gets the same amount of time to speak about the topic at hand. It also encourages people to practice paying attention. And while that sounds really simple, it’s not. The other thing that it does is it encourages appreciation. Let’s focus on what’s working. Let’s focus on building relationships. Those are the things I heard a lot in my interview with Dr. Harte. HE Heard a lot of relationship building, and encouragement of that team, that feeling of camaraderie by starting off a meeting with “How do you think the Browns are going to do this weekend?” Those kinds of things, when he knew that was an interest to his team.

Michelle Lampton: That’s fantastic and thank you for that introduction to Thinking Rounds. So, if I’m a new leaders and I’ve never actually done a thinking round before, how does it actually work? If I wanted to have one with my team or use one with my team, how would it work?

Laurie Miller: Great question, so here’s how it works. What you’ll do is, at your meeting, you’ll warn everybody before your meeting actually starts, “Hey, we’re going to run our meeting in a little bit more effective and efficient manner this time. Everyone is going to get up to two minutes to talk about a particular topic that I will put on the table.” So, for example, maybe it’s patient safety, maybe it’s length of stay, and then all of the diverse opinions are invited and each person at the table gets two minutes to share the thinking on their particular issue or concern. After each person gets two minutes, and everyone is able to be heard, there’s no cross-talk in that, there’s no interrupting, it really is just two minutes, next person, two minutes, next person, two minutes. When everyone’s finished, then there’s cross-talk. Then there is five or seven minutes of a dialogue. Maybe I ask a question. Michelle, maybe you say something really interesting and I say, “May I ask you a question about that?” “Could you say more about this?” so that we deepen our understanding, all of us, about where each person’s perspective originates. At the end, then people are invited to give one minute of, “Alright, here’s my current thinking on this now. This is what I’ve learned, this is what I understand,” and maybe, “This is what I’m grateful for,” or, “What I will do.”

Michelle Lampton: That is wonderful. Thank you so much, Laurie. I am really excited to hear how Dr. Harte uses this tool with his team, especially being the President of Cleveland Clinic Akron, I’m just very interested in how they make the space to use it with his group. So let’s listen to your interview with Dr. Harte to hear to hear more about how he uses thinking rounds in his leadership role.

Laurie Miller: May I add one more tip from Dr. Harte?

Michelle Lampton: Absolutely.

Laurie Miller: So, think of a typical board room and think of how people enter that room and where people tend to sit. People tend to sit in the same place year after year, sometimes decade after decade, same place in the same boardroom. And so one thing I really enjoy about what Dr. Harte does in those meetings is he doesn’t sit in the same place. He will move around and encourages other people to move around. It changes the environment, and remember, we’re looking with thinking rounds and thinking environments, that’s a different tool, we’re looking at the conditions that the leader sets. Shifting where they sit, is a part of that too.

Michelle: Awesome, Thank you so much. So let's go ahead and move into that interview and hear Dr. Harte’s experiences with thinking rounds.

Laurie Miller: Welcome to Learning to Lead, to our podcast. We really appreciate you being a guest here today, and I would love for you to introduce yourself to our listeners.

Dr. Brain Harte: Thank you. I'd be happy to. My name is Brian Harte, I'm an Internal Medicine Physician. I've been with Cleveland Clinic now a little over 16 years. And I'm currently, and for the past four years, have been the President of Cleveland Clinic Akron General here in Akron, Ohio.

Laurie Miller: So we're going to talk today a little bit about serving leader tools. Which one would you like to start with to talk about the impact that it has had, first of all, in the way that you lead?

Dr. Brain Harte: So the one that I find easiest and have really established within my team, are several variations on the thinking rounds. So all of my executive team agendas begin and end with a round. And we start the meeting with what's present for you.

And then we usually try to come up with some variation on a clever or novel or interesting question. And sometimes it's something to just sort of take the tension down a little bit. If we're in tough times, like what's your least favorite food or something. Sometimes it's something more substantial a question to sort of think about that might have to do with the business or strategy. So we always start with an opening round, and my executive team is about 10 people. So it can take 5 to 8 minutes, but it's always time well spent. And I find that it just sort of level sets a few things at the very beginning of a meeting. Number one is it slows the pace down, and in our harried lives, particularly now that we've been on Corona time for 7 or 8 months, so all of us have fairly harried and stressful lives.

So it takes the tempo down and to make sure that the meeting starts with everybody having contributed equally within the first 10 minutes. And I found those to be excellent ways to at least get things off to a good start. And by the same token, we would close with closing round. And there's again, several ways to do that. But the most common we do is probably going to be familiar to those that are listening, which is what's present, what's missing and or an appreciation. So, that's probably the tool that in my toolbox that I resort to most. It's become kind of an expectation here, and it's fairly easy to do. And once you've done it a couple of times, it really becomes hardwired into the structure of my meetings. And I think the team appreciates that.

Laurie Miller: So I hear a couple of things in your use of a thinking round, you do the business of the business, and also there's a piece of it that's relationship strengthening, it sounds like. Can you talk about those two purposes and how they advance your work?

Dr. Brain Harte: Well, sure. So there's a few rules that we sort of set. One is it has to be, from a business standpoint, it has to be of necessary interest to at least half the group. So if it's just something related to nursing or medical operations of, in this case Akron General, or if it's just an issue with the physicians, with Dr. Davis and PPG or the Institute and me, that doesn't need to come to the executive team for the most part. We can share that from an informational standpoint. So we try to bring forward things that are broad interest to the group. So it's important to get into frame of mind, I think, of open conversation and potentially conflict management or resolution. And so, like I said, it's important for everybody to sort of be warmed up 10 minutes into the meeting because sometimes we bring forward some issues that require real meaningful thought.

And I think what makes our jobs most enjoyable and the part of it that we build up equity every single day are the relationships. The challenges we face in healthcare, especially in the year 2020, although it's really every year, it's just that 2020 has been even more so, really demand that if we don't have both personal and professional relationships with the people that we work with, and that we can continue to invest in those, even if it's just for a couple minutes to an executive team meetings. During an opening round, during closing round, or some other tools that we might use by continuing to invest in those, I think we make our team stronger and by the same token, therefore able to manage conflict better. And not just about conflict, of course, also able to leverage each other's strengths better too.

Laurie Miller: So I want to ask about slowing the pace, Dr. Harte. You mentioned that thinking rounds help you to slow down the pace of the meeting. And I'm wondering what you see as the benefits of that different pace.

Dr. Brain Harte: I've actually come to believe that pacing of, especially at our executive team level, of what we discuss and how we discuss it, is actually critical. And it's a Goldilocks phenomenon, right? Not too fast, not too slow, not too little, not too much. Early in my leadership life. I was putting too many things on agendas, which by necessity means you're either rushing through things or simply talking so quickly that you're not actually have... You don't really have time for thought. As I said before, I have some guidelines on what comes to my executive team. One of them is that it has to be of interest to most of the people in the room. The other is there has to actually be meaningful substance or complexity to the issue. If it's something that Sheila Miller, our chief nurse here, and I can solve with a sidebar conversation at the proverbial water cooler then that's how we're going to solve it.

So for a two hour meeting, I try to only have about three things on the agenda. And it's important to both and although it might seem like a lot of time for a very few things, the things that come forward are complicated and you don't want to go too slow either. Because otherwise people tune out and start checking their email, or just stop paying attention, or things get bogged down. So I've actually come to believe that pacing is important. And then afterwards getting feedback on how things went so you can modify over time. So the purpose, one of the things that the opening round does accomplish, is it sets a tone that we're going to do a few things. One is we're going to be deliberate. We're going to listen to each other. That I am going to make sure that everybody has a chance to at least offer input and not let the loudest voice, the strongest opinion dominate the conversation. And all of that is what I consider part of pacing to have as much time to listen and think as there is to speak and disagree at times.

Laurie Miller: Really good. So you see this as a tool to support thinking?

Dr. Brain Harte: That's exactly right.

Laurie Miller:  So you mentioned earlier, you were comparing yourself as a leader now to yourself as a leader when you first got into leadership. And you were describing how your agendas were always packed and now you have maybe 3 or 4 items on your agenda and that's all. And so I'm wondering, given thinking rounds and other experiences you've had that have supported your growth, how have these things changed the way you lead?

Dr. Brain Harte: I've been very privileged in the Cleveland Clinic to be a leader at some level now for about 12 or 13 years. And I think over that time, my leadership has evolved in a few ways.

One is I think, I would like to believe, that I'm a much better listener. When you lead teams and especially in an operations setting, most, if not all of the people on the team are better at something than you are. And that might sound sort of patronizing, but it's actually meant to be quite the opposite. When you're in a hospital setting and you've got terrific expertise from pharmacy, and housekeeping, chemical engineering, and nursing, and the many other parts of the organization, your job is not necessarily to direct everyone in what they do. Which is often what it was like to some extent as a physician leader in a patient care setting.

But rather my job becomes more setting the vision. Making sure that I'm doing whatever I need to coordinate activities, and then stepping back and letting the experts do their job. And a big part of that is listening to the conversation.

The second is I would like to believe I'm a lot more attentive to how we're managing conflict. Because again, I'm surrounded by some of the smartest people that I've ever come to know in my personal or professional life. So any challenge that we have in terms of getting where we want to go is almost certainly not because we don't have enough brain power. It's because the problems are complicated. And one of the barriers to solving complex problems is conflict. And so I think I, I would like to believe I suppose, that I'm much more attuned than I used to be for how conversation is proceeding and how complex situations are being thought through. As opposed to inserting my opinions about how things should be done. And I think that has to do with listening and conflict management.

And third is, I think I would hope, again I'm willing to be more vulnerable. A lot of about leadership is about not just confidence in me being able to understand how what kind of decision-making mechanism is appropriate for our current situation, right? Because a length of stay problem is very different than a crisis.

So part of it is understanding what kind of decision needs to be made and how to guide the group or how to make that decision. But also part of it is showing vulnerability. Whether it's in making sure that your team knows that you don't know everything, and maybe you're not the right person to even be involved in the direct decision-making, but also emotional vulnerability. Because, I think that actually helps build up the team.

Laurie Miller: Speaking of emotions, have these tools given you greater ease as a leader?      

Dr. Brain Harte: Yes, and let me elaborate on it. At first it actually is, getting back to vulnerability, it was a bit discomforting, I think at first. So it's actually for a very short period of time, maybe a few weeks to a month, a little difficult to implement, because most of us have not served on teams where even things like thinking routes or thinking pairs are actually used and implemented. So once the expectation has been established, it's made my job as a leader... I think it's brought a lot of ease to that role.

But at first it's actually created a fair amount of anxiety, because you have to decide if you're going to kind of go out there and on a limb and do something a little bit different and strange. At least based on from prior experience. That being said, the teams that I've always been on, and I don't think people are hesitant to tell me otherwise. These are things that once you role model... These are tools that once you role model them are rapidly, in my experience, adopted by the members of your team.

Laurie Miller: So this is your wild card. And that is there something that we haven't asked about those two tools that you really want to be able to share in the last few minutes?

Dr. Brain Harte: I don't know that it's something that you haven't asked Laurie, as much as it is maybe offering just a touch of advice, which I don't normally like to give. But as a recommendation, I would say actually two things.

Number one is be fearless in your implementation and your experimentation with these tools, because they really are powerful ways to bring your team into a new way of working together or perhaps a different way of working together, which can be very gratifying.

And the second is like every other skill, whether it's driving a stick shift or throwing a football or speaking a foreign language, if you do not use them, they will atrophy and you will forget about them. And it can be hard. You don't have to memorize and remember every single tool that you've learned, you just need a quiver of 2 or 3 that you use consistently. And once you get into the habit with your team, you can always add to that if you choose, but you don't even need to do that.

So don't let these skills atrophy, because you've invested a lot of time, and the organization has invested a lot of time in you and us in our development. So don't let that go to waste.

Michelle Lampton: That's a fantastic place to end it. Laurie, thank you again for joining us today on Learning to Lead and for speaking with Dr. Harte. It’s been great having you.

Laurie Miller: I couldn’t be happier to be a part of this, Michelle. Thanks so much for inviting me.

Michelle Lampton: And a huge thank you to Dr. Harte for taking the time to share with us how he uses this really valuable tool. Caregivers, if you would like more information about thinking rounds, go only to Connect Today and search for thinking rounds, there are a lot of resources there to support you from Mandel Global Leadership & Learning Institute.

That's it for us at GLLI. Stay curious and keep learning!