Not a Good Start
I showed up in the small conference room at 1:00 PM as instructed. I had been assigned by the CEO to this multidisciplinary committee. I was the physician representative and liaison to the executive team. The chair had been assigned in a similar fashion and had added this responsibility to her many other duties as a director in the Patient Care Division.
When I arrived, there was only one other member present. The chair had not yet arrived. I wondered how our meetings were going to be structured. I wanted to review the charge of the committee, the schedule of meetings and format of the agenda. But little of that was addressed. By the end of the meeting, I was not confident in this team's future success. No agenda had been prepared. The meeting consisted of some informal brainstorming. Late arrivals had to be brought up to speed repeatedly. It ended as members lamented the fact that previous attempts to address the problem were unsuccessful and not well supported by administration.
This is More Like It
On another occasion, I attended a team meeting chaired by an up and coming leader in the IT (Information Technology) Department. He had hand selected the members. And he had previously sent out the charge of the team and a draft agenda for the meeting. The team members came prepared. They provided concise overviews of their particular components of the IT project being discussed. The chair actively engaged every member of the team and ended the meeting 5 minutes early. He reminded the participants to come prepared for the next meeting two weeks later. I was confident this team would accomplish great things.
Meetings, Meetings and More Meetings!
Meetings can become the curse of the healthcare executive. The longer you're in a leadership position, the more demands will be placed on your attention, the more staff will need your input, and the more meetings you will attend and chair.
It begins to seem that the time needed to plan, read, research, write, prepare presentations, etc. is squeezed out by ever more meetings. And the preparation for the meetings becomes another major time “hog”. It is, therefore, absolutely necessary that you properly manage your meetings. The most effective physician executives become masters at holding and running highly effective and efficient meetings. This is a skill that should not be taken lightly.
Now, the Really Bad News…
Unfortunately, the meetings that most physicians grow up on are the typical medical staff department meeting (or should we call it a “staph” meeting – because they swell and cause pain like an infection and can drain the life from you). In my experience, many medical staff meetings, while well-organized by the medical staff office, are inefficient, poorly attended, sometimes chaotic, and not very successful in terms of accomplishing meaningful goals for the organization. They can be very political in nature, dominated by assertive, self-righteous bullies and not well-managed. The chair may have been cajoled into serving, with good intentions, but poorly prepared. Not a good place to learn how to plan and run a meaningful meeting!
When meetings multiply in quantity, but suffer in quality, they definitely bring:
- Poor attendance
- Mediocre outcomes
- Frustration and anger at time wasted
- Lack of respect for the chair
- Duplication of effort
But properly planned and conducted meetings, can bring:
- Enthusiastic participation
- Creative idea generation
- Enhanced teamwork
- Respect for chair and members
- Outrageous success
- Great patient outcomes
So, it is critical that meetings be planned and run masterfully. Below are 9 Meeting Maxims that should be followed by every chair.
The Nine Meeting Maxims
1. Prepare Helpful Agenda.
Prepare an agenda that includes follow-up items from the previous meeting. Each item must have an assigned person accountable for the follow-up. This will help advance the goals of the team more quickly. Placing time estimates for each agenda item on the agenda, so participants will be prepared to make their points quickly. Any action item becomes and agenda item for the next meeting.
2. Send Out Minutes.
Send the minutes from the last meeting AND the upcoming agenda at least 2 days prior to the meeting. This is a reminder of the meeting AND and opportunity to maintain accountability for follow-up.
3. Be Timely.
Start the meeting on time. This shows respect for the persons who come on time, and teaches late comers that they will miss important discussions if they come late.
4. Maintain Control.
Do NOT allow any one person to dominate the discussion. As chair, you “recognize” potential participants before they are allowed to contribute. If necessary, place a 3 to 5 minute limit and interrupt, if necessary, if the team member starts to repeat his/her points (For example: “Thanks Bill, you made some very good points, and you are starting to repeat yourself, so let’s see if anyone else has anything to add”). And keep the agenda moving (“OK team, I think we have spent enough time on this topic. The consensus that I hear is …, so, let’s move to the next item on the agenda.”).
5. Take Pithy Minutes.
Be sure someone is taking concurrent meeting minutes. However, all of the details do NOT need to be captured. It is enough to state that discussion on a topic occurred and the specific action(s) taken for each agenda item.
6. Engage Members.
Actively engage ALL members of the team. Everyone has a different personality. Some are more assertive, confident, extroverted or gregarious, but not necessarily always insightful or wise. After the first one or two comments on a topic, stop and select others around the table to express their opinions (For example: “Pete, you have been fairly quiet during the meeting. I’m interested in hearing what your thoughts are on this topic.”). You don’t have to call on every member for each issue, but be sure to engage the quiet members at various times during the discussion. The more timid participants often have the most cogent observations, but they sometimes need to be drawn out.
7. Use a Parking Lot.
Avoid going down the “rabbit hole” of important but irrelevant issues. If discussion veers off into an important topic not on the agenda it can be helpful to keep a list of “Parking Lot” issues, sometimes on a white board or flip chart. At the end of the meeting, you and the team can decide whether to add the parking lot issues to the next meeting agenda, or they can be put aside for further discussion in another venue.
8. End On Time.
End the meeting early or on time. If the team is done earlier than expected, don’t allow members to sit around killing time. Formally close the meeting and allow members to leave. If they wish to remain behind and chat, that is fine. But not closing the meeting prevents other members from leaving if the meeting still seems to be rolling on. Five minutes before the planned closing of the meeting, stop, review any action items and assignments and confirm the date of the next meeting.
9. Kill Unnecessary Meetings.
One final thought: eliminate future meetings by assigning the objective of the meeting to an individual. Or convert the in-person meeting to an asynchronous virtual meeting using email. I once chaired a meeting that was charged with implementing a physician recognition program that we called the Golden Stethoscope Award. After the first few meetings, we decided to hold virtual meetings via email. By sending out questions, fielding and reviewing recommendations, and collating and tallying votes from our staff off-line, we were able to select our Golden Stethoscope Award winner twice a year for 10 years with virtually no in-person meetings.
I am sure I have missed some other fine ways to improve meetings. Please help your colleagues by adding those suggestions and other comments below.
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See you in the next post!