True healthcare improvement requires better listening

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You’re short on ears and long on mouth.

~ John Wayne, Big Jake

Richard Branson brilliantly references this quote in his book “The Virgin Way” as he highlights the importance of listening.

As I was recently enjoying that read, I was brought back to my days leading a nonprofit research organization created to innovate healthcare delivery and improve the health and wellness of physicians and nurses, patients and families, and stakeholders throughout the healthcare system.

Much like Richard Branson, we learned very quickly that it was critically important to listen and to learn from one another if we were to achieve our mission–believing that each of us has much wisdom to offer.

For us, “Circle Process” was one of our means to instill the art of listening throughout our organization.

“The circle is an ancient form of meeting that has gathered human beings into respectful conversation for thousands of years,” Christina Baldwin and Ann Linnea explain on their website, Peer Spirit. “What transforms a meeting into a circle is the willingness of people to shift from informal socializing or opinionated discussion into a receptive attitude of thoughtful speaking and deep listening.”

Three key components of the process that we embraced included:

  • The Three Practices: To speak with intention, to listen with attention and to attend the well-being of all in the circle
  • The recognition that building relationships is equally as important as tackling difficult issues. In fact, what we found was with the strong relationships in place (and nurtured) facing challenges—together–became labors of love
  • The implementation of a tool known as a “talking piece.” The talking piece was passed around from member to member and only the person holding the piece at any given time was allowed to speak. The intention was to ensure that all present within the circle have the opportunity to speak as well as to truly listen. (I’d now prefer to call it the listening piece).

You may note in your meetings that contributions from individuals range greatly, be it due to an extroverted versus introverted preference or for other reasons, and thus wisdom within the room may be missed.

At the nonprofit, our “Research Circle” included a cross section of folks throughout the system: A physician researcher, psychiatrist, family practice physician, nurse practitioner, medical assistant, patients, family members, a business person and managed care executive, a research assistant and students, among others.

I remember intentionally using the “listening piece” (as I choose to now call it) and having the opportunity to truly listen to each of these individuals within this safe space as they contributed amazing insights and wisdom from such varied lenses and different perspectives with the sole intention of making things better.

It was powerful and led to innovative access programs, improved quality improvement initiatives, more meaningful research, and better outcomes for our clinicians, patients and families, staff, and community.

Today, as I reflect on Circle and the importance of listening, I am thinking about many lost opportunities where the varied perspectives and drivers of improvement in healthcare are not truly understood–and where the great many opportunities to move away from “shame and blame” and move toward “understanding and collaboration” are lost because we are not truly listening.

I have found Circle and Circle Process to be a powerful tool. And yet, like technology, it is only a tool. There are many ways to enhance our ability to lead and be of service to one another. To be open and to be vulnerable.
And yes, listening is key.

The next time you are engaging in a discussion to improve the healthcare system, I ask that you take a step back, ask a minimum of two clarifying questions, truly listen to the answers, and as Alan Alda famously said (paraphrased here): “Be open to be changed by the other person.”

Improving healthcare is not about any one of us being right; improving healthcare is about all of us coming together to make things better for others.

~ TD

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