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Lesson Plan CHL 330
Integrative Leadership for Central Sterile Supply Departments: Part I
[Reprinted from Communiqué: March/April 2012]

LEARNING OBJECTIVES: As a result of satisfactory completion of this section, readers will be able to: Explain the difference between “managers” and “leaders” and tell why those responsible for central sterile supply departments must be leaders Review the role of teamwork in integrative leadership Describe how effective communication supports integrative leadership

The concept of integrative leadership has traditionally involved tactics to coordinate the efforts of department managers in an organization to enable them to work together as a synchronized management team. The lessons in this two-part series are taking some editorial license with the traditional model. They will suggest how tactics designed to bring department managers together might also be used to make the work of managers within one department - the central sterile supply department (CSSD) – more harmonious.

Four basic principles and the procedures to implement them must be consistently practiced by leaders to build an integrative team. This lesson will explain the difference between managers and leaders and how leaders can maximize the contributions of their employees, and will discuss two of these principles; teamwork and communication.

All departments in a healthcare facility must interact closely as a team to attain the facility’s goals. In turn, the managers and supervisors in each department within the facility must also collaborate to achieve more specific objectives that are in concert with the goals of the facility.

Probably all useful management models emphasize the need for an effective leader with a supportive staff and common objectives. However, CSSD leaders implement integrative team management concepts because they know that effective communication is an integral component for success and so is their teams’ collective knowledge about what and how the work must be done.

Managers versus Leaders

The words “manager” and “leader” do not mean the same thing.  A “manager” has specific responsibilities and supervises the work of employees in efforts to address those responsibilities. In contrast, “leaders” use a variety of personal strengths, such as self-assurance, a passion to attain results, and personal integrity, to inspire their staff members to move ahead on the journey toward goal attainment.

Leaders don’t “manage” employees; instead, they provide staff members with knowledge, skills, equipment, tools, and other necessary resources, and then inspire them to work toward mutually agreed-upon objectives. The real leaders facilitate the employees’ efforts to address the objectives.  Leaders are able to move employees towards commitment, give them self-confidence, and generate a willingness to work closely together as a team to address objectives. To summarize; a leader develops the best possible team and helps members develop a shared, ongoing purpose to attain objectives.

The most effective CSSD leaders can help department managers and supervisors resolve problems. They also help them become leaders for the employees who report to them. Leaders know that they are always “on stage.” Others within the facility, and certainly within their department, expect that the words their leaders speak are consistent with their actions. They observe that their leaders have the highest levels of passion about getting the job done, and the integrity to not take ethical or other “shortcuts” as they do so.

Leaders consistently emphasize that no persons or functions within the CSSD are more important than any others. Every activity that is performed must be important or it wouldn’t be part of the process. Every person in every staff position is likewise important or that position would not exist.

A basic theory of motivation holds that leaders cannot motivate employees because motivation is an internal drive to attain personal goals. Therefore, as leaders get to know their employees, they learn more about what is important to them, and this information can be used to create a motivational environment.  For example, let’s assume that a CSSD objective is to reduce processing defects (unsuccessful sterilization or decontamination processes).  All facility employees want to help patients, so this objective should have universal “buy-in.” However, additional motivating factors could come from knowledge about each employee, such as whether a person needs to feel like part of a team, if the person will accept a challenge to meet or beat an objective, and/or if a person feels proud after attaining objectives. What encourages individual team members to attain specific objectives?  The CSSD leader should be able to answer this question for each employee.

By showing a genuine interest in departmental employees, the leader begins to build a relationship of trust and respect with the staff. Think about a CSSD leader whose basic human resources goal is to help the employees find pride and joy in their work. Wouldn’t the culture of that workplace be incredibly positive?  Wouldn’t that culture provide an environment in which everyone would want to work together to achieve common goals? The answers to these questions would most likely be “yes.”  Conversely, departmental cultures that treat employees as just those who “get the work done” are likely imposing work performance challenges that will never yield exemplary results.

Several simple tools can help CSSD leaders to learn more about departmental employees:

• A CSSD team manual – a directory of departmental employees can be developed to provide information volunteered by each employee including hobbies, their families, their goals,and what they like best about working in the CSSD.
• Orientation programs for new employees can include formal and informal “meeting and greeting” sessions with other departmental employees.
• On-boarding – activities that extend beyond a formal orientation period can be very useful to show new employees that their managers and team peers genuinely care about them and their success in the department. New employees can be welcomed into formal and even informal groups of persons with whom they share common interests.

As leaders work to emphasize the contributions of their staff members, they can begin to apply some of the principles of integrative management. The remainder of this lesson will address two of these principles.

Teamwork is Required

One working definition of a team is that it is a small group of persons with complementary skills who are committed to common objectives. Team members also develop a common approach to attain the goals and hold themselves accountable for doing so. Members of an effective team know that “none of us is as smart as all of us.” The collective wisdom and productivity of a good team almost always out-performs even the most talented and motivated individual.

CSSD leaders work with their department’s managers and supervisors to develop a departmental mission statement. It is a broad statement that suggests what the department will do to help the healthcare facility achieve its overall mission. The CSSD mission statement provides the guiding purposes for the departmental teams. It provides a vision of what the department wants to be and discusses very generally how the department intends to achieve related objectives. The mission statement must be general enough to provide discretion to those planning the journey to move toward it. At the same time, it should provide some guidance and purpose to the CSSD employees.

Once developed, the departmental mission statement must be communicated to all members of the department. Then, plans can be developed and evaluated in terms of “will this plan, if achieved, bring us closer to attaining our mission?”

The best mission statements probably can never be attained for two reasons. First, they are an expression of an ideal, and we all live and work in an imperfect world. Secondly, a mission evolves according to the needs of the facility, which in turn change in response to numerous external factors including economics, governmental regulations and societal pressures.

CSSD personnel need plans to help them move toward their missions, and leaders know that plans encourage staff members to work together and influence the future. The best plans specify the exact steps that are required and include deadlines by which specified activities should be implemented. These departmental plans should be developed with input from managers, supervisors and employees so that everyone will have “ownership” in the plans that are developed. They will want “their plans” to succeed because they were developed to address employee-related concerns.

For example, consider the objective of reducing processing defects noted earlier. What specific steps will be taken to reduce defects? By what date will the tactics be implemented?  By what amount will processing defects be reduced if the plans are effective? How will progress be reported? Sharing the news about reduced defects will encourage CSSD team members and can serve as an incentive to reduce processing errors even more.

Leaders Communicate Strategically and Thoughtfully

It is not possible to enjoy the benefits of integrative team management without ongoing and very effective communication. Ideally, a facility’s communication channels will provide a way to share news about successes and activities of the entire healthcare facility; but at the very least, they should be able to consistently update CSSD employees about the activities and successes of their own department.

Communication should begin at the time of employee recruitment and selection, with the message that this CSSD is a great place to work. The new employee’s initial on-the-job observations and experiences will hopefully help to confirm a positive first impression.

An effectively developed employee handbook can make new employees feel like they are part of the CSSD team. The CSSD mission statement should be stated at the beginning of the handbook and emphasized throughout. An overview of the department’s mission-driven plans can also be included.  The plans may require occasional updating (but this is a good thing to do anyway). The handbook should also contain departmental rules and guidelines. While these are commonly included in employee handbooks, the expectations and benefits of a CSSD with integrative leadership may be quite different from other CSSDs.

The CSSD team manual mentioned earlier can also be an effective team-building and communication tool. For example, it can contain personal interest features that highlight team members’ interests and contributions to the department.

Calendars can also be used as a resource in the leader’s communication tool box. Perhaps team members can contribute photos, recipes, or monthly human interest stories for the calendar. They may be in hard copy or electronic format, and can list:

• Planned dates of team meetings, including training sessions;
• Facility and/or departmental social activities; and
• Local meetings of professional associations

Scheduled departmental employee meetings are another excellent communication vehicle. It is probably not possible for every employee to be available for every meeting, but creative scheduling can ensure that all employees have frequent opportunities to “catch up.”  Paper or electronic copies of meeting minutes can be posted. Leaders in large-volume departments can schedule separate meetings that follow, in part, a standardized agenda so all employees will be updated about general departmental issues.

E-mail messages are yet another effective communication tool. Information between meetings can be shared, and new information that will be presented at future meetings can be previewed. Also, operational reports that measure progress toward departmental goals can be shared.

Leaders must be effective communicators, whether they are conducting informal coaching, formal training, performance appraisals, or pre-shift meetings, or using any other method to provide job-related information. Furthermore, the quality of their leadership can be seen in the manner in which they request and use information for problem-solving and decision-making, the way they answer questions, and how they interact with staff members as they “manage by walking around.”

Leaders know that communication involves more than just speaking. It also involves listening, which is not the same as “hearing.” Good leaders spend a significant amount of time listening to their staff members. They make earnest efforts to analyze and organize what is being shared and use that to drive their communication exchanges and plans.

In Conclusion

This lesson introduced the topic of integrative team management as it applies to the CSSD.  Department leaders who understand the value of encouraging teamwork and applying strategic and effective communication can accomplish a great deal in their CSSDs and potentially throughout their healthcare facilities. The discussion of integrative team management will conclude in Part II of this series with an introduction to the other two principles of integrative leadership: accountability/commitment and visibility.

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