Transformative Practices

Holiday Blessings

2006-12-23T14:29:00.000-08:00

Christ Light

YOU that come to birth and bring the Mysteries,
Your Voice Thunder makes us very happy,
Roar Lion of the HEART and tear us Open.
Rumi
IN SILENT WONDER*
The Wise see Him as
The LIFE**** flaming in ALL Creation.
The Upanishad
Star Bright, Holy Night,
Flame This Season and Evermore.
May the Light of This Flame Burn
Brightly in you this season and always.

What would it be like to see THE LIFE flaming in all creation?
What is needed within each of us that would promote true inner peace within and become a ripple to peace among all peoples, among all nations? The ancient Upanishad speak of the wise as seeing life itself as flaming everywhere if we have the eyes to see. What if we were to approach this holiday season not as one that is Christian or Jewish, or Muslim, but the holiday for the Heart? This time of year our longing for connection and true meaning becomes apparent, We long for the birth of something more authentic and true.
What if we were to turn inward and acknowledge our own longing to give birth to the divine within ourselves, to that which unites rather than divides. To THAT which indeed can save us from our own separation and bring peace and harmony. It is the mind that brings separation and division. It is belief that we cling to that often divides us from ourselves as we refuse to examine that which is divided within ourselves as well as the world into them versus us.
In Japanese there is one word for mind and heart,” Kokoro.” The Japanese ideogram for mindfulness depicts the heart and mind enfolded. It brings the heart and mind together in the moment. In Chinese, the word is “Shing” and means “heart-mind-now.” In Tibetan Buddhism, this place is known as “The Heart Essence of the Great Expanse.” “It takes a feeling mind and a thoughtful heart to enter this realm of paradox.”
What if this holiday season, the light of illumination were to illuminate our hearts. How would this illumination shine in the places in which we are knotted and divided? What if practicing a form of mindful living in the present moment with our mind and heart united became as essential as our daily bread?

In the Ocean of the Heart love opens its mouth and
gulps down two worlds like a whale
Hear from the heart wordless mysteries!
Understand what cannot be understood!
In man’s stone dark heart, there burns a fire!
That burns all veils to their root and foundation.
When the veils are burned away,
the heart will understand completely….
Ancient Love will unfold
ever fresh forms in the heart of the Spirit,
in the core of the heart. Rumi

Blessings!

Watch for upcoming new workshops and groups
in this coming new year!

The DaVinci Code

2006-06-17T06:03:00.000-07:00

The DaVinci Code

I loved the movie, -- it was so inspirational -- when it was over I was energized and said to my partner -- "I LOVE stuff like this" The "stuff" is that pointing to where the feminine has been lost in this world and, to some extent, in myself. We live in the patriarchy -- which is a problem for both men and women. More dialogue and discovery needs to happen. (By the way I read somewhere that if you hold up the hardcover version of the book to a mirror you can read the writing "a la' da vinci" and find out what the sequel is about. I did it and it works)

Judy Gibson

Hello Happy

2006-06-16T14:14:00.000-07:00

Hello Hello

new post

2006-06-08T14:30:00.000-07:00

Truth in the Workplace

Excerpt from Leadership BALM™ : Being a Healing Presence at Work

Losing an illusion makes you wiser than finding a truth.
Ludwig Borne

Have you ever been in a meeting where a leader stands up and states:

“We have all the brightest minds in our company here and I want to hear your ideas for taking our business to the next level. What are our challenges? What are your ideas for improvement? What are our opportunities for growth?”

With this type of invitation, do you tell the truth? Do you radiate your presence, share your wisdom and insights? Or are you guarded, fearing possible back lash if you share too much information, expressing only partial truths? Do leaders and staff in your business know and tell the truth? How much honest communication is demanded in relationships between employees, leaders and customers? Does the culture support continuous investigation into the deeper truth? Levels of truth continuously open up in a safe, inviting workplace; revealing areas of constriction, problems, and issues, as well as inspiration, revelation, creativity, ease and flow.

Highly functioning work groups are created based on the skills of the individuals. In organizations, as in life, people often have a limited capacity for knowing, speaking, and listening to their own current understanding of their truth. Even when expressed, it often causes triggers and reactivity in another and confrontation or differences occur. The ability to continue to maintain your own integrity and not allow your behavior to be determined by another’s reaction is a valuable skill in the workplace. A powerful skill is to realize the impact of your beliefs on your level of truth. Another is to be fully present in the moment with all of your attention, in your mind/body/emotions and spirit. Still another is to remain in the realization that your truth may not be THE truth. How do you live in and as Truth at work?

Here are a few suggestions to improve this capacity in yourself and your organization.

To develop your capacity to see and express deep levels of truth, as with all skill development, begin with awareness. Sit quietly for a few minutes, imagine your workplace. How do you feel in your body? Do you notice any tightness in particular areas of your body? Are there places in your body that feel energized and open? Notice your breath. Take a deep breath in, energizing and relaxing those areas of your body that feel contracted. What thoughts come up? Is there wisdom and insight your body is telling you about your experience of truth telling at work?

To develop your capacity for truthful and authentic speech and listening, please refer to the previous post on authentic communication. In summary:

Components of Authentic Speaking

 This is what I experienced.

 This is how it made me feel.

 This is what I want.

Components of Authentic Listening

•Mirror: What I’m hearing you say is

…Is this right? Is there more?

•Summarize the essences.

•Validation: I can understand…It makes sense because…

•Empathy: I can imagine you must be feeling...

To develop your capacity to know continuously deepening levels of truth, begin to recognize your belief systems. Beliefs and ideas have a profound influence on our efficiency and effectiveness at work and in the world. Beliefs are accumulated and used in our awareness and it is important to be very clear of beliefs and their influence on our perception.

I am reminded of a story of a white egg that was placed on the center of a board room table during a meeting. Each participant of the meeting was given a pair of glasses, each containing a different color of lens. After putting on the glasses, the participant was asked to observe the egg and to convince everyone else around the table of its color. What would the experience be if the participants were unaware they were wearing glasses or what color they were? People at the table in business spend much of their time trying to convince one another that “the egg” is the color that they perceive it to be.

We invite you during the discussion about an exploration and examination of beliefs and ideas to become aware of the color of your glasses. Everyone has beliefs about what and how we perceive, and the meaning and value we attach to all experience as it is filtered through their belief systems. So you have this pure white egg which is just exactly what it is – it is completely ordinary, it is no more and no less than it is and we take it in and we move it through and filter it through our colored lens, our beliefs and ideas, and the true nature of the perceived issue or circumstance becomes…changed. It becomes something else in our perception and our perception is not clear.

Damage and suffering in relationship and on teams are caused when we are unaware of beliefs and experience our perceptions as truth.

Once aware, you have the ability to set your beliefs aside and experience the world, your organization, yourself, and the people in it as exactly what they are without your infused meaning and beliefs and ideas.

That said, there is a notion about belief, that the world will reinforce our beliefs no matter what they are. So if you believe for instance, as we already discussed, that people are ‘disposable’, i.e., not very valuable, not worth anything, what happens is that people behave badly. And in case you haven’t noticed, lots of people behave badly as their occasional condition all across the planet. So if you carry the belief that people are disposable, eventually people that work for you will behave badly in some way – make a poor decision, lose their temper, and therefore that behavior reinforces your belief that they are disposable and consequently in some cases are disposed of.

On the flip side you could carry the belief that people are an inherently valuable resource to your organization or institution. You will notice them repeatedly come up with amazing ideas and ways to save money and ways to be more efficient, with ways to increase your sales, and all kinds of amazing surprising things, that once again will reinforce our truths and belief about people being valuable. This is just an example of how the world will reinforce our beliefs and truths no matter what they are. And if again you can move into the perspective where you are looking at the egg without any colored glasses, or you can set your beliefs, ideas and filters down, and see in this case people exactly as they are, you now have a very valuable skill as a leader.

As you see clearly the baggage that comes with your team members, you see their wounds, you see their reactivity and their underdeveloped skills, and you are able to meet them exactly where they are, and take them one step further into development, into maturity. You can also meet them and their highly developed skills which require an entirely different kind of mentoring and encourage them to be even more creative or more ingenious with their ideas. If you can recognize the inherent value of people, not through beliefs that they are good or bad, and meet them exactly where they are in every aspect, you can ideally encourage, mentor, lead and develop them.

One thing that comes through very clearly in thinking and talking about beliefs is the fact that beliefs in and of themselves are not Truth, and yet acting upon those beliefs do create what can be a shared reality. This is another way of framing what Michele has just said. So it’s important to recognize that even though we think “I am always…whatever; he has always been a loser, she has always been a star”, those beliefs aren’t necessarily truth. We need to be certain that we bring awareness to our beliefs, because they are flexible and they should be flexible and they can change what is reality. Notice we’re not saying we can change what is truth, because that is all about perception, and everyone has a different truth. What we would like you to do is to examine those beliefs that you have set for yourself which have created a construct for you, which may have supported your development in many ways, and may also have held you back in many ways. And when you are able to recognize this and place awareness on it and really become conscious of how your beliefs have shaped your current reality, then you have a great opportunity and a wonderful opening in which you can change the course of your leadership and even your life.

What is the impact when there is a culture of continuously revealing deeper levels of truth? What impact does it have on you personally? What impact does it have on the relatedness of the people? What influence and impact does it have on the organization, the people, and the business? And what impact does it have on being whole, on the whole being?

One impact on you personally is your thoughts are clear. You are able to clearly articulate and communicate what you need and want. You are able to listen clearly and with your full attention. You are organized, it is easy to prioritize. You are more flexible, you are comfortable with change, knowing that change occurs naturally. Life is change. Growth is optional. Choose wisely, as Karen Kaiser Clark reminds us.

Creativity and inspiration flows, ideas come from this ground of being. You’re patient because you can recognize the immaturity and underdevelopment of skills and people and process. You can see the next step clearly and implement it. You are productive. You have plenty of energy. You don’t go home from the office drained. You don’t wake up drained. There’s enough.

In your interaction with people, in the interaction with people within the organization, there’s a flow, there’s an ease; there’s a safety and a trust. Problems are brought to the table immediately. They are discussed openly. Solutions come, not just complaining. Solutions are creative, they work and are easy to implement. The key people from all departments who need to participate in the brainstorming and the development of the solutions are present. There is buy in, there is commitment through out the organization to servicing customers, clients, or patients. All employees are behind the mission statement which is clearly articulated throughout the organization. They understand it; they understand their role and their function in contributing to the success of the mission and the company.

People are careful with resources. They ask for what they need, and when it’s necessary, it’s given. People are asked to defend their requests. People are held accountable for their behavior; if there’s a mistake they are called on it immediately, kindly, clearly, not from reaction. They’re able to listen and hear what is being said, they can receive the openheartedness of the concise clear direct ideas for performance improvement, for changing their behavior.

There is clear dialogue when mistakes are made, and commitment to corrective action assuring the mistake doesn’t happen again. Leaders hold their team accountable, and the team reporting to them expects consistency. There’s a culture of high personal and mutual accountability within oneself as well as between each other. Therefore the organization, the business, functions smoothly.

There is very little waste. It is efficient, it is effective. It is timely. Labor costs are in line because everybody’s duties and functions are well defined and trained. The systems are worked and reworked and honed, and polished and perfected, so the outcomes can be achieved in the least amount of effort, with the least amount of resources, and produce the greatest outcome. The organization flourishes because new ideas are continuously being generated in this culture of creativity, encouraging new thinking.

There is a culture in the organization of delight, in producing product or service that is well thought of in the community, the sales force is delighted and confident and trusts that your company can deliver what it promises. You get paid by your customers because the billing is timely, it is accurate, and all information that’s needed up front when creating an order or taking care of a patient is documented correctly. Bills go out the door, payment is made. We do things right the first time. We invest as a company in new technology. We stay on the cutting edge. We stay efficient; we have resources set aside for continual improvement. The whole being, the whole being of this living functioning team, is touched by the ease and grace and flow of the individual, of the relationships, of the organization. Everyone who comes into contact with anyone related to this organization can feel the genuineness, can feel the commitment, and can feel the expertise. They want to have relationship with you, be around you, learn and understand how it is you can function in the world in your competitive business, with this ease and grace. People want to come work for you; they want to experience what it’s like to be in a workplace filled with this kind of mutual respect.

This shifting on all levels within your organization deeply influences and impacts all that it touches. The rewards are great; work to embody these skills, identify where you are, and assess your condition – overall and in the moment. Understand and learn the practices and principles taught here. Practice them until they become a habit and until you embody them. When you’re ready, pick another one or two, and work with them, embody them. Let this way of being, this awareness, become the foundation of your organization.

The top and bottom line then take care of themselves; falling in line with the rhythm of this ease and flow and grace that now your organization embodies.

Maggies column May 2006

2006-05-17T11:45:00.000-07:00

Transformative Practices..........On Living and Dying

Maggie’s Musings On Living and Dying

   I came to live with Lora about three years ago because of a dream. She saw me in dreamtime and found me effortlessly in Tucson where she was living at the time. I was ten weeks old and wouldn’t get off her lap. In spite of all of that she wasn’t going to take me home with her because of all of her imagined obstacles. She said, “I travel too much, I work most weekends, I don’t know how to raise a dog, what will I do with her when I’m gone?” Well, the truth is all of those “obstacles” where of her own making and came from some made up place inside her. It is so weird that humans do that. They just don’t let life live itself naturally through them. Anyhow-she went to work and her boss at the time said, “How wonderful you are thinking of getting a puppy, we would love to have a therapy dog at the retreat center. People volunteered-and still do to care for me if I can’t travel with her. Anyhow, get the point?   Do you listen to your dreams??? Pay Attention! Angels come in disguise. So all of this is a way to introduce myself.
   We moved to MN a little over a year ago because of another dream message. In addition to the work that Lora and Michele do with Transformative Practices, Lora is working for a new hospice in town. AND guess what? They heard she had a little dog that was used to working with her, so do you think I’m sitting home? No way! They thought it would be wonderful for hospice to have a therapy dog for some of the visits she makes and trainings she does. So I spend some of the days a week visiting very sick and dying people in homes and nursing homes. It makes my little heart sing! It was what I was created for.
   One day recently, we were visiting a woman in a coma and I just had to get on Lora’s lap and get close to Hazel. Finally, Lora paid attention to my signals and put me up close. I reached in between the side rails and licked Hazel’s hand. Guess what? She slowly woke up and just began to pet me like she had known me forever and it was the most natural thing in the world. I knew that would happen because I could feel the energy of her. I then wanted to get on her bed because I knew she needed to touch me all over, but Lora had put me on the floor. It took some time and convincing of this human companion of mine. Hazel couldn’t talk, but could squeeze Lora’s hand once for yes and twice for no. Finally, Lora understood what I wanted and asked Hazel if I should get on her bed and she squeezed a really hard, yes. So that day, I got to lay really still while Hazel, who was just coming back into her body laid and pet me smiling for all she was worth and making me smile inside.
   Another day, a woman with Alzheimer’s disease, who hadn’t talked in a really long time, stopped Lora in the hall and said, “That is the cutest little thing I have seen in a long time.” Lora asked her if she would like to hold me. Do you know she sat and told Lora the story of every dog she had ever owned and talked about love that day.
   I have also been present at death. People think that it is supposed to be scary or something, but that is because people think too much, and beliefs and stories people tell themselves get in the way of seeing what is really occurring. I don’t think I do that as much as humans do. For me, I’m just content being of a little comfort and service in the world. Lora is getting better at listening to my intuition and subtle language. It’s important that we all remember what Pablo Neruda said, “In the end, everyone is aware of this: nobody keeps any of what he has, and life is only a borrowing of bones.”   If we remember this maybe we can all remember that Life is living through us all of the time and each and every sentient being is an expression of Life ITSELF. Pay attention to your dreams, to the little things in life and begin to see all of the ways that you try to control life and don’t fully live it or appreciate it. We are just borrowing these bones—so be sure and take good care of them, eat well, sleep, relax, meditate and be sure and play and appreciate the four- legged creatures in your life, or better yet maybe get one.
   You can contact me with your own stories or questions by visiting the Blog

XOXO Maggie

Authentic Communication

2006-05-14T13:25:00.000-07:00

Authentic Communication:
Improving Efficiencies and
Reducing Stress

NHIA 15^th Annual Conference
March 11^th, 2005

Michele Okposo, R.Ph.

Transformative Practices

michele@transformativepractices.com

612-310-8876

Poor Communication

How does it decrease efficiencies and increase stress in YOUR workplace?

Effects of Poor Communication

•Activity needs to be done a second or third time

•Operational failures

•Legal problems: sexual harassment, discrimination

•Delayed and costly projects and meetings

•Patients and customers needs and wishes not met

•Wasted tasks performed

•Low productivity

•Unable to collect from payers

•Poor purchasing decisions

•Equipment mistreated

Communication Excellence

“Using excellent communication skills can work effectively to prevent misunderstanding and ensure reliability.

Organizations can gain a competitive advantage.

Doing work right the first time creates efficient production, outstanding quality and excellent service.

These qualities lead to increased market share, better customer relations, and significant savings.

If you reduce misunderstandings, you can end up saving more than you spend.” (1)

First Things First

Authentic communication begins with awareness.

–Bring your undivided attention to your conversation.

–Be fully present.

–Utilize all of your senses to capture what is being communicated.

“Quality communication requires exercising courage when given feedback and providing safety when receiving feedback.”

Eric Allenbaugh

Key Components of
Authentic Communication

•Open

•Honest

•Direct

•Sensitive

•Appropriate

Guidelines for Successful Speaking (2)

1. Planning

a. Why do I want to communicate?

(Being clear about intentions provides safety)

b. What do I want to communicate?

(Matches your concerns with how it makes you feel, messages are more accurately interpreted)

Guidelines to
Successful Speaking cont.

c. When could communication be most effective? (Timeliness is essential, usually close to event is best, “shovel while the piles are small!”)

d. Where could communication be most effective?

(Can contribute or detract from intended results)

e. How could communication be most effective?

(Care enough to select words that accurately reflect your message and feelings)

Guidelines to
Successful Speaking

2. Separate the person from the problem.

3. Provide safety while minimizing defensiveness, rationalization, and self-justification.

4. Don’t yield the floor until you feel listened to.

5. Don’t ask questions until you are prepared to switch to listen to the answers

Summary of
Providing Feedback

•Clarify your intentions.

•Tailor feedback to the individual.

•Give feedback as close as possible to the event.

•Be specific and descriptive.

•Focus on actions or behavior not the person.

•Pause and check for understanding.

Coaching Steps (3)

•Explain purpose and importance of what you are trying to teach.

•Explain the process to be used.

•Show how it is done.

•Observe while the person practices the process.

•Provide immediate and specific feedback (coach again or reinforce success).

•Express confidence in the person’s ability to be successful.

•Agree on follow-up actions.

Straight Talk:
A Three Step Strategy (2)

•This is what I experienced.

•This is how it made me feel.

•This is what I want.

Exercise

•Choose one difficult subject you would like to discuss with someone at work.

•Choose one difficult subject you would like to discuss with someone outside of work.

•Write down:

–This is what I experienced.

–This is how it made me feel.

–This is what I want.

Listening

Definition:

“Listening is the complex, innate and learned human process of sensing, interpreting, evaluating, storing and responding to messages.” (4)

Effective Listening

•“Seek first to understand, then to be
understood.” Stephen R. Covey

•Listen with the intent to understand, don’t listen with an intent to reply.

•Reduce blocking feedback behaviors as they result in decreased trust and lack of communication.

Awareness Checks-
Do I block feedback by: (2)

•Criticizing other’s comments.

•Becoming defensive, reacting emotionally?

•Waiting to talk rather than listening?

•Being “too busy”?

•Preparing my rebuttal: “yes, but…”

•Keeping score - looking to get even?

•Interrupting, talking?

•Finding flaws in other’s ideas and perceptions?

Awareness Checks-
Do I block feedback by:

•Switching to my own agenda?

•Explaining, intellectualizing?

•Focusing on personalities, missing issues?

•Initiating premature closure?

•Locking onto my position?

•Rolling eyes, sighing, tapping fingers?

•Checking out - glazed eyes?

•Placing conditions on my availability to talk?

•Leaving when things get sensitive?

Methods of decreasing resistance to receiving feedback:

–Pause

–“Tell me more”

–Ask a question

–LISTEN

–Find something to acknowledge

–Reward feedback

Five Levels of Listening:

•Ignoring

•Pretending

•Selective Listening

•Attentive Listening

•Empathetic Listening

Listening Respectfully (2)

•Listen with a Head-Heart connection - pause.

•Listen with the intent of understanding.

•Listen for the message and the message behind the message.

•Listen for both content and feeling.

•Listen with your eyes - your hearing will be improved.

•Listen for others’ interests, not just their position.

Listening Respectfully

•Listen for what they are saying - and not saying.

•Listen with empathy and acceptance.

•Listen for the areas where they are afraid and hurt.

•Listen , as you would like to be listened to.

Key Principles

•Maintain or enhance self-esteem.

•Listen and respond with empathy.

•Ask for help and encourage involvement.

•Check for understanding.

•Make procedural suggestions.

•Set follow-up date.

Listening Facts (5)

•Listening is our primary communication activity.

•Listening is innate, learned and improvable behavior.

•Poor listening is costly. Effective listening is rewarding.

•Responsible and active listeners are productive team members.

•Listening can only be commanded to the degree developed.

Components of
Authentic Listening

•Mirror: What I’m hearing you say is…Is this right? Is there more?

•Summarize the essences.

•Validation: I can understand…It makes sense because…

•Empathy: I can imagine you must be feeling...

Excersise for Authentic Listening:

•You are explaining what you would do differently if you were president.

•You are convincing the other that Santa Clause is real.

•You want to have your lunch break schedule changed.

•You want to change one thing about your workplace.

•You want to split up chores at your house differently.

“Clarity in expression, including feelings, can help minimize job stress if it leads to greater understanding and smoother working relationships.”

Valerie O’Hara

Superior Organizational Communication Creates Value (1)

“Systems that ensure clear communication increase the operational efficiency and thus create value for the organization. Better operational procedures and processes can be built upon the base provided by these systems. A result may be a better good, service, system or idea. Another result may be better relationships within the organization and between the organization and its customers, clients and anyone else in some relationship to it.”

“Life is change,

growth is optional.

Choose wisely.”

-Karen Kaiser Clark

References

•Heyman, R. Why didn’t I Say That in the First Place: How to be Understood at Work. Josey-Bass. 1994.

•Allenbaugh, E. Wake Up Calls. Bard Productions. 1992.

•Byham, W. Zapp: The Lightening of Empowerment. Harmony Books. 1988.

•Kaye, K. Workplace Wars and How to End Them: Turning Personal Conflict into Productive Teamwork. Amacom Publishing. 1994.

•Steil, L and Bommelje, R. Listening Leaders, The Ten Golden Rules to Listen, Lead, and Succeed. Beaver Pond Press. 2004.

2005-12-17T17:21:00.000-08:00

Employee Retention: How to Keep the GREAT Employees

By Michele Okposo, R.Ph.

Life is change, growth is optional. Choose wisely.

–Karen Kaiser Clark

Your organization just hired the “perfect” home infusion employee. What can you do to increase your chances of retaining him or her?

A recent Infusion article, “Recruiting and Retaining Employees” (Rollins, September/October 2005), reminds us that companies are more successful in their recruitment and retention efforts when they foster an atmosphere of trust and openness, team spirit, opportunities for growth, and high morale. But all too often, training and development dollars are allocated to task competencies, leaving ongoing professional and process skill development unaddressed.

The costs related to nurturing such “soft skills,” often appear on the budget chopping block as items that an organization “can’t afford.” However, with professional development so integral to building and maintaining strong functional teams, the bean counters might be wiser to ask, “Can we afford NOT to invest in customer service, team building, problem solving, and excellence?”

Beyond “Feel Good”

Building a quality team and developing its members is not simply a feel good proposition. If done well, it can contribute to an organization’s bottom line.

As an operations manager for Apria Healthcare for more than 10 years, I had the opportunity to build a team and create a working environment through professional and skill development. Year after year, our region had one of the lowest employee turnover rates and one of the highest profit margins within our company. Exhibit 1 shows how personnel issues can affect revenues and expenses.

Exhibit 1

Personnel and the Bottom Line

Revenues Ç

Expenses È

Excellent customer service skills

Lower labor costs for recruitment, orientation, and training

Cross-trained team members who are able to eliminate bottlenecks in daily workflow

Root cause identification and successful implementation of cost savings ideas

Empowered employees who make quick and experienced decisions

Buy-in from staff in development and implementation of financial performance improvement measures

Flexibility with hours to meet the ebb and flow of work volumes

Greater error prevention and thus customer dissatisfaction

Reduced errors and disgruntled customers due to high personal and team accountability

Decreased on call labor

Full support and cooperation with sales team

Full support and cooperation with billing team

Experienced intake teams, which result in fewer write offs

How can you contribute to improving an atmosphere of trust and openness, team spirit, opportunities for growth, and high morale in your home infusion company? The following four skills directly contribute to these factors and will be discussed here:

* Effective communication

* Effective stress reduction

* Effective problem solving

* Effective team building

Effective Communication

We work in a fast-paced, high-tech, complex, emotionally charged environment where—despite our best efforts--mistakes are sometimes made. Incomplete intake information can thwart billing and delay payments, a late delivery causes a nurse to wait at a patient’s home before beginning her visit, a missed refill means that medication isn’t reordered, an incorrect supply order prompts a second delivery, and so on. These familiar scenarios can and do happen.

The question is how does your organization deal with them? Are your employees open and trusting in their communication with each other? Is there a team spirit that encourages everyone to pitch in and solve the problem? Or is your team fraught with an attitude of blame or indifference.

Effective communication fosters an atmosphere of trust and openness, which can go a long way toward problem solving and improved efficiency. There are two equally important sides to effective communication: articulate speaking and attentive listening (see Exhibit 2). I have found that each becomes more challenging when topics that create conflict or confrontation—even if it’s only perceived conflict—are involved.

Exhibit 2

Guidelines for Articulate Speaking and Attentive Listening

Articulate Speaking Don’t:

* Fail to let team members know what your topic is and why it’s relevant

* Ramble, change topics, follow tangents

* Talk in general terms without examples

* Plow through without checking listeners’ understanding/reaction

* Forbid feedback

* Make it personal

* Speak from emotion

Articulate Speaking Do:

* Clarify your intentions

* Tailor feedback to the individual

* Give feedback as close as possible to the event

* Be specific and descriptive

* Focus on actions or behavior, not the person

* Pause and check for understanding

Attentive Listening Don’t:

* Criticize team member’s comments

* Become defensive or react emotionally

* Wait to talk rather than listening

* Be “too busy”

* Interrupt

* Find flaws in others ideas and perceptions

* Switch to your own agenda

* Explain, intellectualize

* Focus on personalities and miss issues

* Initiate premature closure

* Roll your eyes, sigh, tap fingers

* Check out – glazed eyes

* Place conditions on your availability to talk

* Leave when things get sensitive

Attentive Listening Do:

* Listen with the intent of understanding

* Listen for the message and the message behind the message

* Listen for both content and feelings

* Listen with your eyes – your hearing will be improved

* Listen for others’ interests, not just their position

Listen, as you would like to be listened to

Take a moment to consider the courage one must find to engage in articulate speaking about a sensitive or controversial issue. When you listen with blocking behaviors (active listening don’t), it greatly diminishes effective communication. Almost all work cultures have made—either by choice, or lack of attention--at least one of these examples acceptable. Pick one or two you engage in, and work to change your behavior. If a colleague or boss engages in a particular blocking behavior that limits your openness and honesty, find a time to discuss the issue and ask for a commitment to improve.

Indirect communication—talking around a team member—can quickly lead to internal conflict. You can choose not to take part in indirect communication. Direct team members to address the person with whom they have an issue. Avoid confrontational communication by encouraging communication as soon as is reasonably possible (due to the situation or your composure), and in private.

Effective Stress Reduction

Stress is major contributor to low morale and team spirit. Studies show that stress-related illnesses have a severe impact, costing American businesses an estimated $150 billion per year in absenteeism, low productivity, and lost workers.1

The body’s stress response includes more than 1,400 physical and chemical reactions and 30 different hormones and neurotransmitters.- That’s great if you’re jumping out of the way of a speeding bus, but when a body is subjected to this response on a regular basis due to chronic stress, it produces a variety of undesirable physical, mental, emotional, and behavioral symptoms adding further to our stress and lack of productivity.

Experts agree that a few small every day steps can help us avoid chronic stress at work (see Exhibit 3). By encouraging self-care in reducing stress for yourself and others in the workplace, you continue to build an environment of trust, openness, and morale building.

Exhibit 3

Small Steps to Stress Relief at Work (2)

* Exercise. A brief stretch, walk around the building, or just getting up and walking to the break room for some water can change your perspective from overwhelmed to manageable. Do you have some movement built into your day when you are not at work?

* Manage your time. There is so much multitasking and constant interruption in a work environment, how do you keep track of what is urgent and important? Be sure to prioritize tasks and stay organized while allowing flexibility for all those issues that come up.

* Don’t be a martyr. When it’s time to ask for help, another team member or leader is there to pitch in. They will know that you’ll be there for them when they are overwhelmed.

* Reduce avoidable interruptions. Are you and your team members in the habit of interrupting when a new piece of information comes across that could be communicated without interrupting? Can you check your e-mails a few times a day instead of continually?

* Watch what you eat. Many of us react to stress by eating sugar, drinking caffeine, or going hours without eating or drinking. Bring healthy snacks to work so you are not stuck with the vending machine when you thought you would have time to get out and pick up lunch. Eat small amounts of healthy snacks every two to three hours and avoid heavy lunches that can slow you down in the afternoon.

* Take a short relaxation break. Take a few quiet minutes, close your eyes, take a few deep breaths, and remember that last vacation when you felt totally relaxed. Read the comics in the newspaper, laughter is healthy too!

Effective Problem Solving

One major way to promote growth and development is by involving all team members in effective problem solving. Conversely, ineffective problem solving can have devastating consequences in your attempt to retain those GREAT employees, so the process is important.

Here is one example of effective problem solving. While at Apria Healthcare, I was fortunate to work with Rad Dillon, R.Ph., C.Q.M., and have learned first-hand some of the techniques he shares in his Quality Management column. Following Rad’s instructions, my region was able to implement good problem solving skills that dramatically improved job satisfaction and outcomes.

By reviewing our call log, we noticed an excessive number of calls from patients and nurses regarding missed supplies. This problem--our opportunity for improvement—“cost” the organization in several ways; impacting our top and bottom line:

* Decreased patient satisfaction

* Deceased nurse satisfaction

* Poor feedback to referrals sources

* Additional on call labor

* Additional delivery (often after hours)

From here we performed a root cause analysis involving every staff member who might possibly contribute to the current situation and its solution (for more on root cause analysis see the July/August 2005 issue of Quality Management). Several possibilities were offered: incomplete supply lists, incorrect data entry, picking errors, lost supplies, etc. Our analysis pointed to picking errors in the warehouse.

We then drilled down on how the errors might have occurred, asking questions about every possibility and eliminating those that didn’t prove out. We discovered two root causes. First, there was confusion about who should be double-checking supply orders, sometimes resulting in that step being missed. Second, as supplies were being picked, the warehouse clerk was putting large check marks next to the items to track what he had picked. He would often be called away for another urgent task and upon return to the order, was unclear which line had been checked off and picked, resulting in missed supplies.

While the causes of—and solutions to—this problem were amazingly simple, the process and its result greatly benefited the team. A source of great frustration was removed, participating in a successful effort bolstered team members, and supply errors decreased by 80 percent.

Effective Team Building

Building a healthy and functional work group is a continuous process. A team is defined as a group of people with complementary skills who are equally committed to a common purpose, performance goals, and working approach for which they hold themselves mutually accountable.3 See Exhibit 4 for more on effective teams.

Effective teamwork can easily be blocked by a variety of behaviors, such as accepting assignment and not following through, discounting others’ ideas, feuding, interrupting others, hidden agendas, side conversations, reluctance to participate, and use of seniority or experience to dominate, just to name a few. Since teams are comprised of individuals, each with his or her own issues, the likelihood of these behaviors occurring is high. Good leaders should be on the lookout for signs of blocking behavior and address them immediately.

Exhibit 4

Effective Teams

Characteristics

〈 Produce results

〈 Have a clear purpose

〈 Members are invested in success of team

〈 Have fun

〈 Have clearly defined roles for each member

〈 Nothing is under the table

〈 Engage in candid discussion

〈 Able to keep sight of goal through ups and downs

Environment that supports team building

* Mistakes are viewed as learning experiences and responsible failure is a legitimate part of the process

* Product/services are improved continuously through experimentation

* Collaboration, compromise, and consensus building are core skills

* Status, control, and regimentation are de-emphasized

* Everyone has input--collaboration yields investment

* Individual self-expression is nurtured

* Diversity is encouraged

* There is respect at all levels

* Information is shared continuously

This is by no means an exhaustive examination of skills contributing to an atmosphere of trust and openness, team spirit, opportunities for growth and high morale. I invite you to continue the dialogue with your work group or with me.

Remember, you can learn and improve these skills, but they require practice just like inserting a PICC line, entering a new patient into the computer system, or calculating TPN components. Having a good coach or mentor greatly increases the likelihood of permanent success. Good luck!

Michele Okposo, R.Ph., is a consultant in personal and team growth and development based in St. Paul, Minnesota. She is a veteran home infusion pharmacist and has worked for Apria Healthcare and University Park Pharmacy, a local hospital based home infusion company . She can be reached at Michele @transformativepractices.com, on her web site www.transformativepractices.com or 612-310-8876.

References

1. (info on 1&2 are from the same article. Here is the reference):

Randolfi, E. Developing a Stress Management and Relaxation Center for the Worksite. AWHP’s Worksite Health. 1997; Vol. 4, No. 3, 40-44.

2. (Added reference)Adapted from Winslow, D. Dealing with Stress at Work: Workplace Wellness Tips. Wellness Junction. 2005; online Newsletter: www.wellnessjunction.com.

Childre and Martin 1999 (I got this off a slide from the Center for Mind Body Medicine. I called and they do not have any more info on the source. This information is factual and widely published so I would eliminate this information as referenced.)

3. Katzenbach, J and Smith, D. The Wisdom of Teams : Creating the High Performance Organization. Harper Business Essentials, 1993. (I do not have the page numbers)

Can you use complete references here? Using this article as an example, our format is” Okposo M. Employee Retention: How to Keep the GREAT Employees. Infusion. 2006;12(1):page numbers. For books, it’s: Crosby P. Quality is Free. NY: McGraw-Hill. 1979.

BOX

Learn More

Come see Michele Okposo, R.Ph., at NHIA’s 15th Annual Conference!

Authentic Communication: Improving Efficiencies and Reducing Stress

Saturday, March 11

3:15 – 4:15 p.m.

2005-11-17T22:53:00.000-08:00

Dare to Live Like a Harp

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³Dare to live like a harp left in the wind, such unexpected beauty comes
from being plucked by all the things that are not us. Mysteriously, when we
can be who we are and stay open to more than just ourselves, the impulse of
our gift and call becomes apparent. For the song that comes from life
moving through us is how we know what¹s next. It¹s how we know what will
feed our souls.²

Mark Nepo author of The Exquisite Risk

This is the new blog for transformative practices

2005-11-17T20:30:00.000-08:00

Transformative Practices is an organization dedicated to empowering individuals and groups to discover new levels of awareness, self care and skill development that have the power to transform life. The spiral of the chambered nautilus symbolizes the commitment of the organization to teach practices designed to reshape life around resources that reside deep within and promote care of the mind, body and spirit.

Transformative Practices offers:

• A way to learn, implement and integrate natural techniques to moderate stress. that interferes with clarity, competence, inherent potential and over all well being

• A way to improve focus and concentration, deepen the ability to listen, evoke more authentic relationships and clean clear communication

• A way to assess the genuine condition of your personal/and or professional life and access inner resources to enhance self awareness and self care

• A way to increase clarity, competence, inherent potential and overall wellbeing

• A way to recognize the role that belief systems play in shaping life; by increasing your options or limiting them

Transformative Practices uses a transpersonal approach that facilitates a richer understanding of the whole person, is multifaceted and encompasses all aspects of the body, mind and spirit.