Why It Matters
A year ago, after we published the IHI Framework for Improving Joy in Work white paper, I was often asked why we talked about our work in terms of promoting joy and not preventing burnout.
I believe that deceptively simple shift in mindset — from burnout to joy, and from focusing on deficits to celebrating assets — is powerful.
Sometimes, however, focusing on the positive can lead to misunderstandings. For example, creating and supporting joy in work doesn’t mean people aren’t allowed to express doubts, share concerns, or have a bad day. It doesn’t mean ignoring or avoiding conflict.
In my view, conflict is inevitable. I can’t envisage any group of people — much less a whole team or entire organization — that won’t at some point experience some disagreement or difference of opinion. What matters is how we choose to react to conflict.
Healthy Conflict
When conflict emerges in our workplace, we must make sure it’s in service of a shared sense of who we are, who we aspire to be, and what we want to achieve as an organization. This doesn’t mean conflict has to be enjoyable, but it can be constructive.
Leaders have a crucial role to play in fostering healthy and respectful responses to conflict. Consider adopting these three actions:
- Support speaking up — There’s a clear relationship between psychological safety and joy in work. If health care providers don’t feel able to voice a counter-opinion or point out problems without fear of appearing silly, incompetent, negative, or disruptive, it’s both demoralizing and a safety problem for both patients and providers. Leaders must create and promote a climate in which people feel they can speak their minds.
- Encourage civility and what Edgar Schein would call “humble inquiry” — dissent must be expressed respectfully. You can’t effectively pursue joy in work without a spirit of camaraderie and common purpose. Leaders should model being inquisitive when sharing their thoughts. “Would you help me understand why you’re doing it that way?” “Can you show me what our guidelines suggest we should do?” Leaders must also receive feedback in the same way. “Would you tell me a bit more about why you’re raising that concern?” “Would you help me understand why you think this approach isn’t realistic?” The more we encourage inquiry-based dialogue, the more likely we are to make our conflicts productive.
- Strive for understanding — Leaders don’t need to agree with all opinions, but we should do our best to listen so that people feel heard. Staff often tell me that they don’t expects leaders to do everything they ask, but they appreciate getting a fair hearing and knowing how their concerns are going to be addressed.
The Risks of Too Much Consensus
One way we measure joy in work at IHI is our online employee survey that we issue every other month. A question on the survey asks whether IHI is “going in the right direction.” While it’s gratifying to see a high number, I would be really worried if 100 percent of our staff responded “agree” or “strongly agree.”
That might seem counterintuitive. To me, unqualified consensus would be a strong suggestion that we’re not being ambitious enough. If some people in the organization don’t feel that our efforts to improve health and health care worldwide are challenging their comfort zone, then I have to question if we’re really at the leading edge.
Too much apparent agreement can also be a sign that we’re not hearing from people with a variety of perspectives. In the language of Parker Palmer’s Five Habits of the Heart, it’s important to appreciate “otherness,” which, for me, means appreciating the importance of those who have a different take on things. If someone disagrees with me, I want to hear and understand their views. I want to discuss what changes they would suggest. I can learn things from them that I may never have considered otherwise.
It is inherently disruptive to pursue joy in work because it challenges the status quo. But leaders don’t have to fear the disagreements that always accompany this kind of change. Indeed, leaders should welcome a diversity of perspectives and ideas because no health care organization ever improved without them.
Editor’s note: Look for more from IHI President and CEO Derek Feeley (@DerekFeeleyQI) on leadership, innovation, and improvement in health and health care in the “Line of Sight” series on the IHI blog.
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