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Insights

How to Speak So Leaders Will Listen

Why It Matters

You may only have two minutes to make your case for QI.
 
 

I hear it all over the world. Health care professionals in the US, Europe, Africa, and Asia often ask me the same thing:

How do I get my leader’s attention?

They say things like:

  • “I have this improvement idea, and I can’t get our leaders engaged.”
  • “I’m doing work that’s really important, but I don’t know how to get leadership support.”
  • “How can we can get leaders to pay attention to quality improvement?”

Years ago, when I was an up and coming manager, I used to think that evidence was all I needed to get a leader’s attention. I assumed that if I could just show enough proof to support my way of thinking, I would convince a leader to agree to whatever I was proposing.

Over time, I came to see that evidence is important, but insufficient. You must also understand context. Leaders want to know what others think of your proposal. They want to know how it fits with other work your organization is doing. Is your proposal achievable? Can it be implemented beyond your ward, unit, or team? Just having data will only take you so far if you ignore context.
 

If you haven’t been able to get the attention of leaders in your organization, consider doing the following:

  • Practice your elevator pitch — Leaders are busy people who might hear 20 ideas a day. How are you going to make what you say stand out? What is it that he or she needs to know? If you can’t explain in two minutes what you’re doing and why you need your leader’s help, then keep practicing it again and again until you can. Stand in front of a mirror and rehearse. Ask a trusted colleague to listen and give you candid feedback. You’ll need more than a minute or two to make your entire case, but you’ll only have that long to convince a leader they want to hear more.
  • Connect — When you’re pitching your idea, connect it to something you know the leader is passionate about. Don’t try to influence your leader in a vacuum. Try to understand what the leader thinks is important. Say things like, “I heard your remarks about health equity. I have an idea that may help you.” “Here’s something we can do that would help with the implementation of our strategic plan.”
  • Appeal to their humanity — All too often, I see people trying to influence leaders on a purely intellectual level. Leaders are human. Engage them on an emotional level. Tell them a story about a patient or a staff member who has been influenced by the problem you’re trying to address or the change you’re trying to make. “The popularity of the weekday group physical therapy sessions keeps growing. We need more resources to allow patients and families to participate in sessions on the weekends.” “Our employee satisfaction scores have been going up since we’ve been providing quality improvement trainings. I need your support to spread the trainings beyond our main campus.”
  • Be personable — There’s a large body of evidence about what influences people, and research indicates that likability is one of the key characteristics of good influencers. Bring your best self to the conversation. Don’t try and be somebody that you’re not. Be authentic. Try to stay positive. Don’t spend the first 30 seconds of your elevator pitch telling your leader how everything is terrible.

When you’re frustrated, it’s often easy to forget that what matters most to the vast majority of health care leaders is the same thing that matters to nurses, physicians, or other dedicated professionals: We all want to make care better for patients. As we encourage dialog between staff and leaders about important improvement opportunities in our organizations, it’s essential to remember that we share that common ground.

Editor’s note: Look for more from IHI President and CEO Derek Feeley (@derekfeeleyQI) on leadership, innovation, and improvement in health care in the “Line of Sight” series on the IHI blog.

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