October 4, 2017

Disclosures Nihira

I have no relevant disclosures

Pickett I have no relevant disclosures

Steinberg I have no relevant disclosures

Learning Objectives

Recognize the elements of the Crucial Accountability model

Describe an expectation gap

Identify barriers that keep individuals from doing what is expected

Create an accountability conversation planner to hold other accountable

Following this activity a learner will be able to:

AGENDAIntroductions

Review of worksheet conceptsNihira Questions 3 & 4Pickett Questions 5 & 6Steinberg Questions 7 & 8

Roleplay

Crucial Accountabilitybased on the book by:

By Kerry Patterson, Joseph Grenny, Ron McMillan and Al Switzler

Mikio Nihira, MD, MPHClinical Professor of OB/GYNProgram Director UC Riverside OB/GYN Residency

NEW DEMANDS, INSUFFICIENT RESOURCES

Objectives Introduce tools to determining “What”.

Discuss “What” scenarios in regard to your professional environment.

Introduce tools to determine “If” accountability conversation should commence.

What? & How?

Ask yourself “What is the right problem?”

Approach: Unbundle Isolate Target Be Concise

CPR

Too

l Content

Pattern

Relationship

“What” DiscussionWas there an instance in which you chose the wrong “WHAT”?

How could you have identified you were addressing the wrong problem?

How could you apply CPR to redirect you accountability discussion?

Deciding “If” Hold Accountability Conversation?

Clearly a Broken Promise

Unclear or “Iffy”

Unclear and “Iffy”Not Speaking when you

Should

Acting out my concerns?

Conscience Nagging Me?

Choosing Certainty of Silence?

Convinced I’m Helpless?

Speaking when you Shouldn’t

Differentiate Yourself

No “Nanner-Nanner”

“If” DiscussionShare a situation in your professional environment where an expectation

is clearly violated?

Share a situation in your professional environment where an expectation was violated, but you were “Iffy” whether to pursue an accountability

conversation?

The Next Step“WHAT” & “IF” Established Successfully

NOW WHAT DO WE DO??

“Hazardous ½ Minute” Sets the Overall Tone of Interaction

See & Hear

Tell a Story Feel Act

Conclusions and Assumptions

Silence

Violence

Common System Errors

“Trail of Doom”

“Hazardous ½ Minute”SOLUTIONS

Tell the rest of the Story

Consider 6 Sources of Influence

Apply Sources of Influence

“Hazardous ½ Minute”Motivation Ability

Personal Want To Can Do

Social Peer Pressure Help from Others

Structural Carrots & Sticks Structures, Environments, & Tools

“Hazardous ½ Minute” Discussion

Is there a time where you lacked the ability to see your role in the accountability problem?

Final Comments“The best leaders and parents aren’t lax with accountability, nor do they

let themselves stew in a stupor of self-loathing”

“Step up and handle the promise when someone fails you”

Crucial Accountability What makes a conversation “crucial” vs. typical?

First, opinions vary Second, the stakes are high Third, emotions run strong

Crucial Accountability How do we typically handle crucial conversations:

We can avoid them We can face them and handle them poorly We can face them and handle them well

Crucial Accountability Why don’t crucial conversations tend to go well?

Emotions tend to rule Your body physically reacts We are under pressure We are stumped We act in self defeating ways

Crucial Accountability “Common” Crucial Conversations

Ending a relationship Asking a friend to repay a loan Giving the boss feedback about her behavior Critiquing a colleague’s work Talking to a team member who isn’t keeping commitments Talking to a colleague who is hoarding information or resources

Crucial Accountability Why it is important to master crucial conversation skills:

Kick Start Your Career Improve Your Organization Improve Your Relationships Revitalize Your Community Improve Your Personal Health

Crucial Accountability

There are 8 Principles and Skills

See your chart in the handouts

Review the Law of Crucial Conversations graphic

Get Unstuck Spot the conversations that are keeping you stuck

Hold the right crucial conversation with CPR

Get UnstuckPartner Discussion: What conversations am I not holding or not holding well?

Share an example of a conversation which is long overdue.

Am I holding the right crucial conversations?

Start with Heart Work on me first

Focus on what you really want

Refuse the Sucker’s Choice

Start with HeartActivity: Watch Video Clip, “The Apology”https://www.vitalsmarts.com/skillsvideo.aspx

What do I really want? Am I behaving in ways that move me toward what I want? Am I making Sucker’s Choices?

Learn to Look Look for when a conversation becomes crucialLook for silence and violenceLearn to look for your own Style Under Stress Activity: Watch video clips/ labelhttps://www.vitalsmarts.com/skillsvideo.aspx

Learn to Look Am I noticing signs that safety is at risk?

Am I moving to my Style Under Pressure?Activity: Take a few minutes to complete the survey independently.

- The survey can be submitted/scored on the VitalSmarts website.

Make It Safe Apologize when appropriate

Contrast to fix misunderstandings

Create Mutual Purpose

Make It Safe Have I established Mutual Purpose? Have I maintained respect?

Activity: Watch video clip. Share an example of how we can “make it safe” for our staff members.

https://www.vitalsmarts.com/skillsvideo.aspx

Master My Stories Separate facts from stories

Watch for three clever stories Victim, Villain and Helpless

Tell the rest of the story

Master My Stories Am I pretending not to notice my role in the problem? Why would a reasonable, rational, and decent person do this? What should I do right now to move toward what I really want?Activity: Watch video clip, how could this same example be applied

to a school setting?https://www.vitalsmarts.com/skillsvideo.aspx

STATE My Path STATE:

Share your facts Tell your story Ask for others’ paths (what) Talk tentatively Encourage testing (how)

STATE My Path Am I really open to others’ views?

Am I confidently expressing my own views?

Explore Others’ Paths Explore with added AMPPs:

Ask Mirror Paraphrase Prime

Explore Others’ Paths Am I actively exploring others’ views?

Move to Action Decide how to decide

Document who does what by when and follow-up

Move to Action What is the plan from here?

“Hazardous ½ Minute” Discussion

Is there a time where you lacked the ability to see your role in the accountability problem?

Final Comments“The best leaders and parents aren’t lax with accountability, nor do they

let themselves stew in a stupor of self-loathing”

“Step up and handle the promise when someone fails you”