#note/sourcereview #on/expertise #on/crisis | #on/performance #people/dandwerkis | #source/podcast Dan Dworkis What is the relationship between safety and excellence? - what are we trying to achieve? - What is excellence in an emergency team? Excellence is not "measurable" in itself, it is an organizational and individual habit and mindset - Excellence is situated in a context - Teams Competence is different than the sum of individual competence (Lingard, 2016) - can be competent and contain incompetent members - can be incompetent and contain competent members - is situated and context specific Proposed domains: (Mastery, Autonomy, Purpose, Connection, Mindset) - Meaningfulness of work (this is the job of high-level leadership) - Connection to others (this is the job of unit-based leadership, and levels up when sustained conflicts occur) - Psychological safety (cultural, job of leadership chain) - Feeling ready to succeed (individual and unit-based, organization needs to provide the opportunity to train) - Learning from difficulty (jobs of individual, culture, and unit) Measurement (what you measure, you focus on): - Edmondson psychological safety survey - Mayo leadership survey - Mindset assessment - Attendance at (with reasons why not collected) - daily pre-shift brief, post-shift debrief - Transparent changes made based on work of unit, assessment of workflows, barriers, and reductions of those barriers (work of leaders with input of workers) - Team-based trainings, and lessons learned from them Barriers to this working: - We have a management culture in this country that believes that describing work is more important than seeing work - All the way up the chain the need is to create reports for the people above you - The external pressures need to be rebalanced from a perception of economic survival to a perception of wellness and thriving Our work exists in a culture of perception of work, this is not unique to health care, the same trends are in teachers, bus drivers, police officers, lawyers. We've been through things like this before as a society when the transformation to industrial efficiency occurred in the early 1900s, the pushback needed to be unionization. We're at a period of time when workers rates are low, but the pendulum is possibly swinging back towards workers rights, only when the pressure from this movement becomes higher than the pressure fro, the financial and managerial reporting requirements to our external payers. My personal belief is that this is a temporary state as we learn as a culture and world to deal with transformation to computerization of work. I'm not saying it's going to get better from here just that it will continue to change. # Sources: Carol S. Dweck. (2006). _Mindset: The New Psychology of Success: Vol. 1st ed_. Random House; eBook Collection (EBSCOhost). [https://login.treadwell.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=nlebk&AN=737546&site=eds-live&scope=site](https://login.treadwell.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=nlebk&AN=737546&site=eds-live&scope=site) Dyrbye, L. N., Major-Elechi, B., Hays, J. T., Fraser, C. H., Buskirk, S. J., & West, C. P. (2021). Physicians’ Ratings of their Supervisor’s Leadership Behaviors and Their Subsequent Burnout and Satisfaction: A Longitudinal Study. _Mayo Clinic Proceedings_, _96_(10), 2598–2605. [https://doi.org/10.1016/j.mayocp.2021.01.035](https://doi.org/10.1016/j.mayocp.2021.01.035) Edmondson, A. C. (2019). _The fearless organization: Creating psychological safety in the workplace for learning, innovation, and growth_. John Wiley & Sons, Inc. Lingard, L. (2016). Paradoxical Truths and Persistent Myths: Reframing the Team Competence Conversation. _Journal of Continuing Education in the Health Professions_, _36_(1), S19–S21. [https://doi.org/10.1097/CEH.0000000000000078](https://doi.org/10.1097/CEH.0000000000000078) Studer, Q. (2015). _Healing physician burnout: Diagnosing, preventing, and treating_. FireStarter Publishing. [https://books.google.com/books?id=sAQvswEACAAJ](https://books.google.com/books?id=sAQvswEACAAJ) Womack, J. P., Jones, D. T., & Roos, D. (2007). _The machine that changed the world: The story of lean production - Toyota´s secret weapon in the global car wars that is revolutionizing world industry_ (1. paperback ed). Free Press. ![[CleanShot 2023-08-26 at 09.06.31.jpg]] ## Sources: https://soundcloud.com/emergencymind/episode-90?utm_source=clipboard&utm_campaign=wtshare&utm_medium=widget&utm_content=https%253A%252F%252Fsoundcloud.com%252Femergencymind%252Fepisode-90