Crucial Accountability | Joseph Grenny

so what we know is that at the heart of almost all chronic problems in our organizations in our teams in our relationships at the heart of almost all chronic problems are crucial confrontations we're either not holding or not holding well there are issues we haven't stepped up and addressed so we've done this research across many many different problem areas healthcare for example we went into healthcare organizations and asked the question are there chronic problems here and it turns out there are patient safety problems we have problems with mistakes and near mistakes year after year that kill literally tens of thousands of people in the United States and we wondered is there something at the heart of that that we're doing that is perpetuating these problems turns out there is it turns out that about 80% of healthcare workers say they work regularly hold your breath here they work regularly with people they would describe as incompetent you think that would create problems we found it does but that's not the problem the problem is not that we have people that work with those that they judge as less than competent at times for example we worked in an emergency room one time where they said there's a nurse here who is terrible at assessing patients now what do they do in emergency rooms this kind of this right we assess patients and we try to triage and diagnose and so on they said this nurse is terrible at assessment and I said we'll play that out for me tell me how this works out it's nurse said well just the other day I walked through the hospital and I saw that she was in a treatment room with one of the little children here in the hospital this was a pediatric hospital she said I walked by and I noticed she was checking him and later on when I came back I saw her coming out of the room and so I stopped her and I said how's the little boy doing this is the first sign of problems if in your organization's you have people double checking other people's worked it's a sign that you haven't resolved the real issue she says how's a little boy doing the other nurse says well I think he's going to be fine I'm moving on to the next patient she said I walked off to start my next assignment and just had that little nagging doubts consign of problems if you have nagging doubts about people's work odds are that there's a more chronic issue you haven't addressed she said so I went back into the room and I looked for the boy and he wasn't there she said I turned around to look and see if he wandered off but then sort of this thought struck me I looked over the table he'd fallen over backwards and had gone into cardiac arrest his heart had stopped she said I called for a crash cart we resuscitated him the boy was ok and and everything's going to be all right and I said so how long is this nurse been working here she said about a year and a half and then I asked her the crucial question here's what we know from our research we know that if a nurse in a health care organization is judged as incompetent the odds are less than one in eight that anybody is going to speak up and confront that competence problem do you think that contributes to errors oh yes in fact this is what drives errors in many cases if the person judged to be incompetent is a doctor the odds are less than one and a hundred that anybody is going to step up and have the crucial confrontation with that person at the heart of almost all chronic problems and organizations are crucial confrontations people have either not held are not held particularly well now we're talking about health care but this carries on to many many other kinds of organizations and this is the dynamic we ask them the question in these health care organizations not just have you spoken up and dealt with the issue but how long is this issue gone on with that nurse nurse it was a year and a half look at the statistics with doctors and is that trouble you look how many in how many cases the problems will persist for a year to five years or five years or longer and how many patients are treated or touched during those intervals what we're talking about here is the heart of organizational effectiveness the heart of personal effectiveness and if you and your organization's do not increase your capacity to confront discuss and resolve these kinds of crucial issues we pay an enormous price year over year over year so then we started to ask the question all right we know these issues have to be addressed but how do you do it how do you do it how do you do it well so we spent over 10,000 hours watching people in the course of crucial confrontations trying to figure out what they do that makes it either work or not work which ones go well and resolve problems which ones go poorly and end up causing the problems to worsen or persist what we found is there are a handful of skills that you can use that predictably repeatedly and sustainably create positive and effective crucial confrontations here's the first if you can learn to do this one there's almost nothing you can't discuss as we watch crucial confrontations we found that you could predict how the crucial confrontation would end by watching just the first 30 seconds we call these the hazardous half minute you ever been paralyzed with fear during those hazardous half minutes everybody that happened to you you ever just sort of sat there with your mouth opening and closing and not sure what to say so we put our microscope on those first 30 seconds when the crucial confrontation came out well and the first thing we found you have to do is this it's create safety your first job during a crucial confrontation in fact the job which if you do it well will give you a 97 write this number down 97% probability of a positive outcome you do this one well and so much good follows your job is to create safety let me illustrate what I mean by this I had studied this for many many years but there have been a few instances where it sort of found its way into the marrow of my bones personal experiences I've had one of them was a life-threatening situation in an airport in Bangladesh I'd spent a couple of weeks there on an assignment and I was exhausted road-weary anxious to get back home and I got to the airport in Dhaka an hour and a half early I was feeling very very responsible and as I walked into the airport feeling responsible feeling confident about my prospects for getting home and everything I noticed the airport was just jam-packed with people you ever had that happen and just a just a mess a giant massive humanity and I started looking around a little bit more panicked and I found my carrier and there are only two people doing check-ins and the line was sneaking out the door and and I thought oh my goodness but I got to the end of the line and and started dragging my bag forward a little bit at a time and trying to hurry the process along and since I had nothing else to do I thought I would start a time and motion study so I started calculating every five minutes how many people moved counting the people in line dividing it by the minutes left and and after about an hour in the line my spirit started a lift I started thinking it may actually make it I actually get there well as I was feeling a little bit more confident a woman comes into the airport pushing a big giant disorganized cart covered with luggage and shoves her way in line just a few people up in front of me look at her in kind of fun that's that's kind of annoying and she's probably going to take a lot of extra time because she's got to reorganize all of her junk there and I was feeling a little resentful about this when the guy that she cut in line right in front of just explodes he just goes ballistic he screams at the back of her head get out of line she turns and looks at him and she says no I'm not gonna get out of line and now he says you get out of line right now she says look I've got to make my flight my children are going to be waiting for me in San Francisco there's not another flight I could get on for another three days please just cut me some slack and let me stay here in line to which he said if you want to get in line you get in line like the rest of us you go back to the end of the line she said I am NOT getting out of line and turned back around now he yells again at the back of her head you get out of line around pushing you out of line now she turns looked him full in the face and says you will not he steps out of line and he starts to push her luggage car out of the way so she goes to the other side of the luggage cart and starts to push it back in he starts to push she starts to push him pretty soon it's getting pretty energetic and I'm standing back here watching this whole thing escalate thinking oh my goodness when all of a sudden he pulls his leg out of the way so her luggage cart slides down she starts to trip downward he lifts his hand up and starts to swing it down to slap her on the way down onto the ground now again I'm just a few feet away from this commotion and I looked at my watch and I thought to myself I got nothing better to do I think I'll get involved it actually wasn't a conscious process it was just sort of a reflex I rushed forward and positioned myself right between him and hers it's a good idea this is not a good idea but I didn't know what else to do and I didn't want to get hit and and so I'm standing here and this man at first is sort of caught off guard he steps back a couple steps and he looks a little bit confused and I thought I had the element of surprise going for me but he very quickly recovered he lifts up both his hands his eyes bug out of his head his face turns purple is this a crucial confrontation yes so here's my question to you you're the nurse in this emergency room and have what you believe to be an incompetent colleague how do you start that crucial confrontation right you've got a colleague who continually lets you down you have a spouse or loved one who's behaving in ways that are creating problems in your family how do you start that crucial confrontation well let me tell you how you don't start it my temptation in this situation is to start by diving into the issue my temptation is to start by telling my complaint that's how we want to begin you screwed it up with that little boy you almost killed him that's how we want to begin my temptation right now might be to say back off buddy you know you're not going to hit her so slow down take a breath here what I want to start doing is describing my complaint or concern wrong place to begin we know from our research that if you do that the odds of the crucial confrontation going well drop precipitously so what do you have to do well first the promise here's what we know what we know from 10,000 hours of observation is something very very remarkable something counterintuitive what we know is that the riskiness of the issue that you have to address does not predict your success or failure think about that for a moment most of us labor under the misconception that if something is just too hard to talk about if something is just too difficult to discuss that the conversation just can't go well we think the size of the issue that the difficulty of the topic itself is the predictor of success or failure we know from our research that just isn't true how many of you are in your personal lives with a loved one or spouse have found yourself arguing over the stupidest most trivial little issue before has that ever happened to you raise your hand if you're with me how about toilet paper hangs you know we blow up here whether we should break a one dollar bill or not you know it doesn't matter which restaurant we had to go to some trivial little thing can amplify into some huge conflagration the size of the issue does not predict your success or failure what predicts your success or failure is your capacity to create safety period how do you do that there are two things you have to do in those first 30 seconds and if you learn to do these there's almost nothing you can't discuss your first responsibility is to create what we call mutual purpose it's to help the other person know now please don't miss this this isn't a trick this isn't a technique this isn't a gimmick your first responsibility during that crucial confrontation is to help the other person know in their guts that you care about their problems that's your job and if you do that well I'll tell you what you'll see if you do that really well you'll watch them physically do this they'll go and then you start telling them the truth about your concerns and they'll be able to hear you they may not like what you're saying they may not agree with what you're saying but they'll be able to hear you your second responsibility is to help make sure not just that they know that you care about their problems but that you care about them when they know those two things their defenses drop and they start to hear you when they don't believe that the defenses go up and it doesn't matter what you have to say they won't hear it they won't hear it so I'm standing here and his fists are up and his eyes are bugging out of his head and his face is turning purple and the first thing I said to him was that was unfair for her to cut in line in front of you looked a little confused I said you've been standing here in line for over an hour and she comes in cuts in line it puts your flight at risk I said that's unfair and his hands dropped down I said she cut in line in front of me too and that's not working for me either his face turns back to a normal color I said I could get somebody from the airport over here we can try to figure out how to solve the problem I think we can make this work his eyes go back into his head what just happened yeah now did I take him off the hook for his misbehavior no I didn't I'm about to put him on the hook but I can't put him on the hook until he can hear me I can't hold him accountable for what he's done until he feels safe enough to hear me describe what he's done that isn't workings that makes sense that makes sense so now he can hear me and that's when I said and this was life-changing for me that's when I said and sir I can't go ask for help until I have your word that you're not going to hit her you had your hand up you were swinging down on her and I said and that's just wrong you don't get to do that now I don't know that the way I said that was the right way to say that but what I want you to hear was his response he went like this said I'm sorry said I'm sorry it's it's been an awful week he said it's just been horrible I've got to get home he said this is not me he said and then he didn't want to look at me he tried to look past me to this woman over here and he says ma'am please forgive me he said I wouldn't have done anything he said I just I just this is not me now here's my question to you how safe would you have to feel to be able to publicly admit that you were an idiot how safe would you have to feel how safe would you have to feel to be able to hear from somebody that you were incompetent in your job how safe would you have to feel to be able to hear from somebody that some of your behavior was inappropriate or ineffective the predictor of your success or failure in a crucial confrontation is not how risky the issue is it's your capacity the green suit

Channel: Crucial Learning Speakers

Views: 76,865

Keywords: VitalSmartsSpeakerVids, vitalsmartsvideos, Crucial Conversations, Influencer, Crucial Accountability, Change Anything, Crucial Confrontations, Joseph Grenny

Id: AOiRKkCPBAY

Length: 15min 53sec (953 seconds)

Published: Mon Dec 17 2012