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The Ultimate Measure of Workplace Trust: You Decide What to Work On

It’s a panic-striking emotional state: I’m not contributing! I’m not on the career trajectory I need to be on! I’m not learning the skills I need to be learning!

That “I’m not a contributing member of this organization” feeling can be vicious.

My first healthcare job was as an administrative fellow, a sort-of management training program intended to provide exposure to the breadth of administrative positions throughout an integrated delivery system. It was a terrific experience and the people I worked for and with get credit for creating the foundations of my management style.

But there was a point early on, maybe a month or two in, when I felt exceptionally useless. The program wasn’t particularly organized — which turned out to be a great thing over two years — and resulted in open days with little to do early in my tenure.

I was gripped by the feeling of uselessness for months and didn’t know what to do about it.

Somewhere, somehow the thought struck me to find projects to work on.

It didn’t come from my boss — the last thing I wanted to share was that I wasn’t busy enough.

It didn’t come from colleagues — I wasn’t close enough with anyone at the time.

It didn’t come from friends or family — “this new job is great!”

I just started finding projects: some were participation only, some allowed me to make small contributions, and some allowed me to explore my interests in the organization. But nothing was particularly useless.

There was no one breathing down my neck. No one looking over my shoulder. No one assumed the burden of becoming my task finder. I was just trusted to find work to do.

[A quick aside.]

Don’t get me wrong, it’s entirely possible that no one gave a shit about me as my status hovered around the level of “intern,” but I take solace in maintained professional relationships with the people in that organization.

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YOUR WORK IS HARD WORK.

GET A PEP TALK IN YOUR INBOX EVERY WEDNESDAY.

[Back to it.]

Trusted to find work. A novel concept.

By my second year I was finding projects to work on that were of strategic importance to the organization. More projects began to appear: from my boss, from the CEO, from managers throughout the system. The feeling of contribution! It’s a drug.

I’ve been coming back to that story lately because I recently started asking my employees to choose what they work on. Initially there was shock — a seemingly normal reaction to a different approach from any other previous school or job experience. After wading through initial resistance and a smidgeon of bewilderment, the experiment seems to have improved two persistent management problems left behind by industrial models of production.

The first is related to trust. We’ve been taught that employees must be managed. Create tasks. Fill their days. Ensure output. But management, in the traditional sense, left me with questions. What is an appropriate level of production in a workplace dominated by intangible things? How do you measure what someone should be producing when much of it is novel and creative thought? How do you trust that what employees do produce is the appropriate amount when no widgets are actually created? How much time should be spent in the office during the week?

The second is engagement. We’ve long abided by the idea that work must be cascaded down a hierarchy — that seems to be the secret to accountability: tell everyone what they work on and what the measure will be. Bosses know best. Do as I say. Why aren’t annual objectives being met? How do you rate an employee’s performance when the annual objectives set at the beginning of the year aren’t actually important any longer?

It turns out that everyone — me as a manager and they as an employee — benefits when employees get to choose what to work on. Here’s what we’ve found so far.

Employees choose work that interests them. We hire job candidates because of their experience and skills, which are manifested interests with documented results. The work that interests them is the work they are good at. It’s why they are working for the organization. It’s the work they want to get better at, too.

Employees choose work that helps the company. Employees deserve more credit for their instincts. They don’t need managers telling them what is the highest priority, although prioritization conversations can be helpful in figuring out what to work on first. Management, if anything, is creating the framework for knowing what is important and what isn’t. Employees know what needs to be created and improved because they work every day for the company. They see what the company needs.

Employees are engaged with the work. When employees lead the objective setting for the work they are demanding of themselves, highly accountable for results, and completely engaged in the work itself. Coaching becomes about helping each employee deliver the work. Reviews are about lessons learned and developed skills.

For managers it’s a win-win-win: trust comes easily, engagement happens naturally, and everyone is striving to move the company forward.

Engagement surveys continue to tell companies the same thing every year: employees aren’t. After years of failed engagement improvement initiatives, perhaps it’s time to point the finger at the organization’s structures and systems (i.e., how we do things around here…) as the culprit for low engagement. And perhaps it’s time to start experimenting with new structures and systems that create the workplaces we all desire. Maybe there are better ways.

Here’s to finding all of them.

“THANK YOU FOR SENDING THIS EMAIL EVERY WEEK.”

That’s an endorsement of my weekly pep talk email from my good friend Jade. She’s trustworthy. She’s a healthcare person. And she’s working to make healthcare better through the work. I’m betting you’ll find it valuable every Wednesday, too.

PEP TALKS, GOOD READS, & THINGS TO LEARN. FOR HEALTHCARE PEOPLE.

My philosophy on email: Don’t send a bad one.

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What did you learn at work today?

It’s a serious question. On the surface, it seems like it may produce as boring of a conversation as “What did you learn at school today?” would with a disinterested middle-schooler. Dig a little deeper and you’ll identify several bullet points that can bring the conversation to a close. Find

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The Transforming is (a name I invented for) the always-happening, always-unfolding state of change in your job, as a result of (big) market forces. Our jobs are a more meaningful representation of change than the industry and organizational change often discussed as healthcare transformation (and just as often as strategy), because

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Healthcare is changing. How we work hasn’t. And it’s holding us back.​

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