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Management Practices

Building an Exceptional Staff: The Research Hospital Model

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Although the Mayo Clinic facilities may not serve as a great model for other nonprofits, some of their practices might.
I had a conversation earlier this week with a friend whose dad has been suffering from intense gastrointestinal problems for months. Multiple doctors and tons of tests but nothing to show for it except ‘hang in there, maybe it’ll clear up on its own.’

After being hospitalized during a particularly severe bout, the doctor persuaded him to head to the Mayo Clinic in Minnesota. Four hours after arriving there, with zero new tests, his team of Mayo Clinic GI specialists figured out he was having an extremely rare allergic reaction to his blood pressure medication. They’ve seen only 15 other cases; it’s rare and new enough that there isn’t anything in the medical literature yet. One of the problems confounding the diagnosis: he’d end up in the hospital only when his symptoms were severe. His blood pressure would be unusually low as a result of those symptoms, they’d remove him from the blood pressure medicine, he’d feel better, and then after being discharged he’d start taking the drug again and the symptoms would return.

How was it that the doctors in Minnesota were able to figure this out – a complex and extremely rare condition – in a matter of hours while countless doctors before them failed? A big part of the answer is that through their role at the Mayo Clinic, which is essentially a teaching and research hospital, they collectively see a huge number of patients with an extremely wide array of challenging cases. Their breadth of experience, and especially with difficult diagnoses, meant they’d simply seen a much wider variety of conditions than most and their diagnostic skills were sharper as a result.

How does this relate to nonprofits? Most nonprofits don’t invest much of their intellectual capital or their resources into staff development, growing and stretching people through their tenure at an organization or over their career to help them become exceptional advocates and nonprofit leaders. Some of the best nonprofit folks incidentally end up with exposure to a wide variety of specific challenges and circumstances, and some figure out how to seek that breadth of experience out themselves, but most nonprofits could probably do a better job of deliberately exposing their staff to a wider universe of new challenges and difficult problems.

This doesn’t necessarily mean someone needs to spend time working across different fields, moving through fundraising, program management, administration, organizing, and other departments. The GI specialists at the Mayo Clinic are truly specialists in a very specific field. But it does mean figuring out how to exposure your team to a wide variety of challenges within that field, making sure they are building up loads of real experience problem solving (problem solving skills) and exposure to a wide array of circumstances from which to draw when troubleshooting problems and crafting strategies (“maybe this time we could use that strategy we tried that other time combined with this new idea I’ve been thinking about”).

A lot of nonprofit folks end up with this sort of exposure along the way, but I suspect most nonprofit managers could do a better job of deliberately making sure that their direct reports pick up a wide and challenging array of experiences.

Data Informed, Not Data Driven

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This Adam Mosseri talk about how Facebook uses data to make decisions is a little dated but his observations are still extremely useful. His key insight: clear metrics and strong data-driven feedback loops can be powerful, but they have their limits as well. Facebook often uses solid empirical data to make decisions about their website design, their products, and the workflows that users experience on Facebook. They can test two versions of a website design, for example, and if design option A produces higher engagement than design option B it’s an easy choice.

But Mosseri also explains how an excessive fidelity to data-driven decisions can privilege incremental and uninspired changes at the expense of innovation and ambitious thinking. Facebook sometimes is aiming not only for high levels of engagement but for more fundamental changes in the way people interact with it and with each other. Facebook’s Timeline, for instance, inspired anger and fierce resistance among many Facebook users and sharp derision from the press, and the use of a conventional data-driven decision process would have killed it before it got very far, but Timeline is now a central and deeply-valued part of the Facebook experience.

Most nonprofits don’t seem to rely much on data for their decision-making about their websites, email newsletters, programs, and fundraising efforts, and when they do those efforts aren’t often carefully crafted and executed (some do, of course, but for every one that does there are many, many more that don’t). The remedy isn’t to swap all the intuitive and qualitative decision-making for analytic feedback loops, but to find a good balance. “Data informed, not data driven,” as Mosseri says.

Director of Meetings

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The easiest job I’ve never had: Director of Meetings.

I’d ban them.

Cultivating Conflict

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I think we often do internal organizational conflict wrong. Plenty of nonprofit folks and organizations actively avoid conflict. Nonprofits collaborate, we don’t fight. It just feels wrong, so we do what we can to avoid it.

Or we fight in the wrong ways about the wrong things.

What we often don’t do is deliberately cultivate and encourage conflict, yet conflict is actually healthy and important, I think. That’s where teams really push each other, challenging each other’s assumptions, pushing back against each other’s ideas, probing for the flaws and the opportunities. Conflict, when done right, creates a “productive range of distress,” to use Ronald Heifetz and Marty Linsky’s term from Leadership on the Line: Staying Alive through the Dangers of Leading. The challenge isn’t to sterilize or repress conflict out of our office environments but to make sure we contain it and shape it so that it really does serve those sorts of productive purposes.

I don’t claim any expertise here, but I have noticed a few things that seem to help contain and shape it in useful ways:

  • The discussion is respectful even if heated … personal critiques and attacks usually aren’t helpful.
  • Establishing some ground rules about decorum. I don’t know that it matters much what those ground rules are, so long as the group feels some ownership over them and so long as they are consistently enforced.
  • Someone playing the role of facilitator, which might be the ED, or it might rotate, or with some other arrangement, but someone who’s job it is to make sure everyone has a chance to contribute, to pull back the tension if it climbs too high or push the conversation forward if it starts to stall.

How does your organization manage conflict? Does it ever cultivate conflict, and if so, how? How well does it work?

(Photo by Flickr user iansand).

Watching the Game Film (for Nonprofits)

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This post was originally published on Amy Sample Ward’s terrific nonprofit technology blog earlier this week.

For professional football players, the six days between games are jammed with practice, gym workouts, and travel. They also include time spent watching the film from the previous game, play by play, evaluating, learning, and preparing for the next game. I don’t know as much about other sports, but I’m guessing that professional basketball, hockey, baseball and other players have similar routines during their seasons.

It’s true that for pro athletes, everything they do during the week amounts to preparation for game day. Game day performance is what matters. It’s also true that many pro athletes are supported by extensive coaching staffs, sophisticated video recordings, and powerful analytic tools to help them understand what they did and how they might improve.

But a lot of what nonprofit folks do is similarly performance-oriented: every time you present on a panel at a conference, every time you pitch a prospective donor or funder, every time you talk to a reporter. You prepare (or not), and then you perform well (or not). And even without the same kind of evaluation and training resources at our disposal, we still have tools and capacity to carefully evaluate our performance and plug it in to fast-cycle feedback loops so we can continuously improve. Nearly every nonprofit has a video camera now, tripods are cheap, and it’s easy to set up to record right before you begin your presentation. When you talk with reporters, it’s easy to evaluate the print story or broadcast (not just reviewing it, which everyone already does, but studying it to figure out what you did well and what your screwed up). You may not have someone with you on every funder pitch, but it’s not hard to arrange at least some of those conversations with a colleague who won’t do too much talking during the meeting, so someone else can pay more attention to how well you do. For much of what you do, you can figure out ways to intentionally review your performance, identify what you did well and what you need to work on, and then craft a strategy for improving.

Incidentally, it’s the coaches who really immerse themselves in the film after every game, studying the game film on the flight home or first thing Monday morning, grading every player on every play, and then reviewing the films with the players. What if the more senior folks in your organization were explicitly responsible for coaching the newer members of the team? And what if their job evaluation was based partly on how effectively they are at coaching the more junior folks?

An organizational culture that emphasizes evaluation, feedback loops, learning, and intention improvement doesn’t happen by accident. For most nonprofit folks, the limitation isn’t about resources but about how serious they are about improving.

(Photo credit: Flickr rburtzel)

The “Hot Seat” (or, “Talk Less, Listen More”)

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As I worked my way through the Founder Institute’s startup incubator program last summer, my incubator classmates and I would frequently find ourselves on the “hot seat,” presenting a short pitch to a panel of mentors, after which the mentors would proceed to brutally critique our performance. Among the inviolate rules: even as the panel of mentors would lambaste our pitch, we had to simply stand there and listen. We weren’t allowed to respond, to rebut, or to push back. I’m told this is a conventional practice in architecture programs and art schools, but having attending neither it was new to me.

And it was awesome. We each had to learn, in a humbling and publicly painful way, to shut up and listen. It didn’t matter what my intention was, or how right I was, or what I knew that they didn’t … they were the audience, and if they understood something differently than I had intended, or if they didn’t buy my argument, or if my story wasn’t persuasive, the challenge for me was to listen intently enough to understand what they heard. Only by keeping my mouth shut, and not defending, challenging, or explaining, was I able to really hear them and consequently improve my pitch.

I think the key was grasping that the success of my pitch wasn’t about me, it was about them. It didn’t matter how right I might have been, or how compelling I thought my arguments were. If they weren’t persuaded, then I had failed, and the only way to learn where my powers of persuasion had fallen short was to shut up and listen.

Anyone who has spent time fundraising or campaigning knows this to be true, but even when we know it in the abstract it can be tough to remember in the heat of an actual pitch to an actual prospect, or when a colleague or (gasp!) employee is telling you what they think you did wrong, or when you are trying to sell a story to a reporter or an idea to an elected official.

Talk less, listen more.

The Counter-Intuitive Secret About Hiring

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Most people view the hiring process as the opportunity to screen candidates, learn what you need to know about them, and select one lucky enough to join your team. And yes, of course that’s one goal of a hiring process.

But here’s the part that’s easy to miss: Persuading them that they want to work for you is at least as important as deciding whom you’d like to bring on board. The very best candidates in your pool, even in a buyer’s market, are likely to have other options. Whatever you weave into the hiring process to help you assess skills, experience, and cultural fit, don’t forget that your candidates are also interviewing you.

Your job, in other words, is as much or more to persuade them that your organization is truly amazing and worthy of their talents as it is about you figuring out who you want to hire. Your hiring process amounts to a marketing campaign (in the best sense of the term), and the most successful efforts not only result in a great hire but also leave all of your other candidates – including all of the folks who didn’t get the job – talking about how awesome it would be to work for your organization.

People and the future of organizations

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Our organizations (and their budgets) are made up mostly of people. What we do, what we plan, how well our programs work, how much we spend are all functions of people.

Organizations rely on people for inputs and actions. Image: Bartolomeo Eustachi: Peripheral Nervous System, c. 1722 via @brain_blogger, Flickr.

Think of organizations as organisms and the staff (or team members) as organs and limbs. The organization might act and speak collectively but voice, touch, sight and hearing are all based on the people that make up the eyes, heart, fingers, and toes.

Each individual needs to excel on her own and in the system for the organization to be healthy. Creating and maintaining a healthy system is hard stuff that takes up much (or most, at times) of an organization’s resources. Our nonprofits (and businesses) spend hours and hours (sometimes most of the day) coordinating, planning, collaborating, conference calling, managing and generally trying to figure out how to maximize the system’s function.

Meanwhile, communications technology, databases, social networks, email and the Internet have altered the landscape in which organizations and their staff operate. Organizations are more exposed to the public (members, donors, media, everyone). The tools of organizing and fundraising for social change are more readily available to everyone – reduced friction means change makers don’t need to rely on organizations. The 24/7 news cycle (most of which happens on social networks) also means that fingers and eyes can’t wait for the rest of the body to figure out how to react.

Are Organizations Ready for People?

At last month’s Nonprofit Technology Conference we had opportunity to meet Maddie Grant and talk with her about her new book, co-written by Jamie Notter. The book is called Humanize: How people-centric organizations succeed in a social world. This is an important book that we hope you’ll read.

How to “get more likes on Facebook” or even “how to engage your social network followers” might be the most common blog and discussion topics of the day but mostly miss the mark. We firmly believe that organizations that are people-ready will have few concerns with getting likes, creating useful engagement ladders, finding volunteers, and getting meaningful support in a networked world.

A few days ago, Maddie Grant posted The Future of Work: A Manifesto which, in some ways, focuses in on how the web, social networks, and changing cultural and economic experiences are altering the role of organizations and people in them. The organizational body is evolving due to external conditions and pressures. But organizations still need people and people still need organizations (though perhaps to a lesser extent?).

The Future of Work speaks primarily to businesses but if you are in or fun a nonprofit we hope you will read, think carefully about and discuss it. Nonprofits don’t produce or sell widgets (or apps) and don’t get feedback from the market. This means that they rely heavily on the people in and around the organization. Questions of how those people – especially staff but also members, fans, donors, followers – fit in the organizational body will dictate success more than ever.