7/18/2006
People Skills: The Art of Relationships In Organizations Leads to Success
Leslie Ann Fox, MA, RHIA, Patty Thierry Sheridan, MBA, RHIA, CCS
Thank you to Advance Magazine for permission to use this article

Leslie: I just finished reading one of the most recent American Health Information Management Association (AHIMA) practice briefs: "Essential People Skills for EHR Implementation Success." The article encourages HIM professionals to hone their people skills, in particular their communication and change management skills. There is a simple quote in the practice brief related to change management that I liked and want to share with you and our readers.

Patty: It's an interesting title for a practice brief and I think a departure from some of the more technical briefs being created. I think exceptional people skills will help us to flourish during the HIM Renaissance. What is the quote Leslie?

Leslie: Change management is the "process by which an organization gets to its future state, its vision."

Patty: You are keying in on the word process aren't you?

Leslie: Exactly. Change management is not always communicated in the electronic health record (EHR) implementation literature as a process or a set of strategies. It is often described as a task or something you do to manage scope creep. But it is much more than that. It's a separate discrete body of knowledge essential for successful change initiatives. It's a body of knowledge in which HIM professionals must excel to advance their agendas, and to lead or participate in EHR and other initiatives that result in significantly changing our world of work.

Patty: You and I look to John Kotter, a change leadership guru on this topic. He observed that in fact, change management is a process consisting of eight steps that successful organizations implement with some concurrency.

Leslie: The unique value of Kotter's eight steps is that taken in combination, they are more than simply a series of management tasks; they embody a winning attitude and an approach to change. The approach inspires a "will" to make change happen and takes into account an organization's emotional system. Kotter and his colleagues have observed how people's emotions affect change initiatives. We might more commonly refer to people's emotions, as Kotter observed them, as the "people issues" one encounters when implementing change.

Patty: The AHIMA leadership program for which we are faculty, "Renaissance for the 21st Century: Leading the Way to e-HIM" and Leading the Change to Coding Innovations™, teaches Kotter's eight steps as an approach to leading change. Now in our third year of teaching these concepts, it's been very rewarding to hear from seminar attendees about how invaluable Kotter's concepts have been to them as they work to advance HIM initiatives and participate in or lead aspects of EHR change projects. In 2005, tools were published to further assist Kotter change advocates in implementing change. I highly recommend these tools, which can be found in the Heart of Change Field Guide Tools and Tactics for Leading Change in Your Organization by Dan. S Cohen, a co-author with John Kotter in the Heart of Change: Real Life Stories of How People Change Their Organization.

Leslie: The tools are great Patty. It's important to read the Heart of Change: Real Life Stories first before picking up the Heart of Change: Field Guide however.

Patty: I would agree. The Heart of Change: Real Life Stories provides the context one needs to use the change tools. Attending the "Renaissance for the 21st Century" program also provides a good introduction to applying Kotter's steps in HIM and the book is included in the program.

Leslie: I would like to talk more about the practice brief. The brief ends by noting that "dealing with complex human beings can be much more difficult than dealing with new technology." This drives home the point that while the HIM body of knowledge is important, people skills, our ability to implement change strategies and the quality of the working relationships we build during that process, in the end determine our success as HIM professionals.

Patty: I believe that in today's more collaborative and often competitive environment it is your people skills and attitude that determine the outcomes of your HIM initiatives even more than your technical HIM knowledge and ability. All things being equal in terms of technical expertise, superior people skills will triumph.

Leslie: How do you define people skills Patty? There is so much in the literature on this topic from Dale Carnegie's 5 Essential People Skills to Stephen Covey's The 7 Habits of Highly Effective People. And in the end isn't it all about leadership?

Patty: When I think of people skills, I do think of leadership. To me people skills means first and foremost being a skilled communicator, which includes "active" listening skills, bringing the best out in others and being able to manage ones' own reactivity, especially in times of conflict or when your own initiatives are going in the wrong direction or are stalled. What about you Leslie, what do people skills mean to you?

Leslie: I don't usually think of interpersonal functioning as a skill set. To me, successful relating in the workplace is dependent more on one's awareness of self and others, and a way of managing self in a relationship system. For example, knowing how much you can challenge someone else and knowing when to back off is extremely important in managing self in a work system. This level of functioning requires self-knowledge, sensitivity to the needs and wants of others, and the capacity to balance both as you work to advance initiatives in the best interests of the whole organization.

Patty: That is really insightful. Please go on.

Leslie: Start with self reflection. It is important to know your values and to be very clear with others about those values. It's also very important to know your own position on any significant issue, to put it out there, and then to know how long and hard to push it before you back off. Listening mindfully to the perspectives of others and being willing to change your position when new facts emerge is also a critical piece of higher level human interaction.

Diplomats and international peace negotiators working toward solutions on highly volatile and sensitive world issues are examples of individuals who must identify, comprehend and balance multiple perspectives, competing priorities and various motivations of stakeholders. My point is that the health care industry is in the midst of enormous challenges to the status quo, and HIM professionals involved in leading their organizations and their departments through the EHR and e-HIM transformations need to function in very diplomatic ways.

Patty: It can get pretty discouraging in the trenches. Initiatives can get derailed even when you take a position. Sometimes you can find yourself at the mercy of someone else's initiatives. Sometimes you think you have authority or control only to find out you don't.

Leslie: And sometimes it is just the hierarchical nature of organizations that undermines the success of those lower in the hierarchy. However, hierarchy is a fact of life in organizations. The important thing is not to get discouraged. Remain positive and keep working at your initiatives, provided they are the right ones to be fighting for, and be sure you see things through the eyes of others and not just your own. Keep finding opportunities to create urgency, and most important of all, meet people where they are and bring them along.

I also don't believe we lack control completely, as we always can have control over ourselves, how we think and how we behave in challenging situations. We may not always achieve our desired outcome but we do have choices. For example, how we choose to react to others is a choice. Our attitudes and how we manage ourselves are choices. Thinking of oneself as completely powerless in a relationship doesn't lead to a higher level of functioning. Learning to see the big picture and knowing your options is a better path to success in leading change in organizations.

Patty: You always talk about leadership being an art. Do you think of it the same way in relation to people skills?

Leslie: Yes, I believe people skills are more of an art than science. And to be clear, when it comes to relating to people, I don't like the word skill. I prefer to think about this topic as the art of relationships. Particularly in terms of knowing when to push and when to back off as I mentioned earlier. Another thing to consider is that most of us don't spend too much time in one-to-one relationships in the workplace, but rather we all are part of relationship triangles and interlocking triangles, parties of three or more. When you are in a triangle, it's helpful to look at the role you play. Do you amplify anxiety? Do you shut down? Do you bring about calm?

Patty: The ADVANCE Web site (www.advanceweb.com/him) has several articles on the topic of triangles for our readers interested in thinking more about this concept. Two that I think our readers would find particularly useful are "Emotional Process is Played Out in Triangles" and "Where Are You in Your Triangles," both published in 1999. They can be found online at www .advanceweb.com/him. Just follow the link to Hands-On Help.

Leslie: Well Patty this has been a bit of a departure for us to talk about people skills, but I think it is congruent with our leadership and change management discussions and important to EHR implementations as described in the practice brief.

Patty: It's been timely for me to reflect on the AHIMA practice brief messages and the concept of people skills. Many of our biggest HIM challenges require excellent people skills, not only to realize successful outcomes but to achieve balance and happiness in our work lives.

Leslie: Call it people skills, excellent relationships or communication skills; today's successes are all about excelling at leadership, be it leading a project, a function, a department or a whole organization. Leadership skills often trump HIM skills and are a critically important core competency today regardless of the functional position an HIM professional holds in his/her organization.

Leslie Ann Fox is chief executive officer and Patty Thierry Sheridan is president of Care Communications Inc., a national HIM consulting and staffing company headquartered in Chicago. They invite readers to send their thoughts and opinions on this column to lfox@care-communications.com or pthierry@care-communications.com .