Decision-making power rejuvenates, inspires staff

But still set boundaries with employees

The idea is a popular one in reengineering models: Empower employees to make decision on the front line.

Yet breaking out of the traditional hierarchy doesn’t come easily for either managers or staff, warns LuAnn Zieba, RN, BSN, interim manager, maternal child services, at Yuma (AZ) Regional Medical Regional Center.

"A common fallacy is that teamwork and leadership will happen with just a little bit of effort," she says. "That’s just not true."

Zieba learned several lessons about fostering team development during a recent transition to a shared-decision making model:

1. Expect to expend energy.

"If you are driving the process, you will be completely engulfed in it — especially in the early stages," she says. "You can expect to spend enormous amounts of time coaching and facilitating during the first four to six months." However, there are appropriate tools a leader can use to coach teams along during different stages of team development. Knowing what to do and when to do it is a critical part of the process."

Without such an investment and commitment from the unit leader, your employees will sense it. "They must know and see your unwavering faith in the process," she says.

2. Serve selflessly.

"One of the keys to success is that you have to be willing to be completely selfless. And that’s the very reason such a transition isn’t successful in many organizations. Many people who embark on this journey have their own agendas," Zieba observes.

Using the redesign as a ploy for political power or promotion won’t last, she warns. "You’ll run out steam. If you have any agenda other than driving the successful implementation of teams forward, you don’t need to be in this position."

3. Be physical and visible.

Your physical presence on the unit is vital, Zieba says. "At first, some of the teams were suspicious and wondered why I was making rounds. Was I checking up on them?" she remembers. "I told them, No, I’m here to remove barriers to make your job easier. So how’s it going?’"

That response often opened the door for critical dialogues with employees, and gave them a chance to reveal frustrations that would have normally gone unsaid. "If they said things were lousy, I asked them, What things? And how are they lousy?’" she says. "I’d peel away the concern to get to the real issues."

4. Articulate clearly — and often.

Be prepared to state the desired outcome as many times as necessary. "You have to constantly let employees know there is a world out there beyond what they know — that they can indeed make decisions as a team," she says. "You may find you’re repeating yourself, but that’s okay. Help them keep their eyes on the vision."

5. Be gentle with yourself.

"When I look back, I don’t think I would have done anything differently, except not to be so critical of myself. Sometimes we are our own worst critic," she says.

For example, Zieba found it especially difficult when teams were going through a normal process called "storming" — a rocky period immediately after forming in which they hash out fundamental issues. "It’s easy to soak up the dynamics because you are so concerned, but you must be able to step outside that circle and set any frustrating feelings aside and push forward," she says. "You also have to know how and when to challenge teams to move them out of the storming process."

6. Get support.

Because being the mover and shaker of major change requires such an emotional commitment, having a support system is critical. "You must have the support of senior leadership and your peers. It can’t be done in a vacuum," she warns.

Zieba also points out that having a competent consultant who lived the same experiences made all the difference. "Just because you’re the mentor and coach for everyone else doesn’t mean you don’t need one, too," she stresses. "In fact, for those days when you just want to say, I don’t know if I can do this anymore,’ an objective observer can be a sanity saver."

For example, after Zeiba facilitated meetings, she would immediately hold a debriefing. "We discussed what went well, and what I could have done differently," she explains.

7. Set clear boundaries.

Explain what’s negotiable and what’s not under the new redesign. For example, recommending what type of capital equipment to purchase could be a team decision. Whether to operate as teams is not.

"Especially in the early stages, the boundaries need to be very clear. You want to tell them, you can make decisions using these parameters,’" Zieba explains.

8. Relax boundaries as the project advances.

As the teams start to mature, they’ll be ready for wider parameters in which to make decisions. Zieba points out that team development consists of five stages: Forming, Storming, Norming, Performing, and Transforming. "Remember that everyone progresses along that continuum at a different rate, and it’s up to you to help them move along," she says.

9. Don’t rest on your laurels. Even after teams become more mature and begin to perform, the work isn’t over. "Although much has been done, the process never ends," she says. "You have to continue to climb and never lose sight of the vision and outcomes."


Yuma Regional Medical Center, 400 South Ave., Yuma, AZ 85354-7170. Telephone: (520) 344-7198. Fax: (520) 341-7617.

John Hunt, LUMEN, 1355 Terrell Mill Road, Building 1482, Suite 200, Marietta, GA 30067. Telephone: (770) 988-3059. FAX: (770) 984-0110. Web site: