Answers to your questions about creating a culture of high performance.
I’ve been helping clinicians and administrators all over the world adopt the same debriefing protocol that every TOPGUN instructor pilot uses after every squadron event. Wherever it’s been implemented well, team performance is turbocharged and the organization makes rapid, sustainable improvements in the way it does business.
These five questions keep popping up:
Question 1: “I tried to debrief after one of our staff meetings but everyone just mutely looked at me. What do I do?”
Answer: The best response is to conduct training on debriefing. But if you are not willing to invest 45 minutes on training your staff, here are three other suggestions:
Set the stage for an end-of-meeting debrief by explaining at the beginning of the meeting that you will be asking for their comments at the conclusion of the meeting.
Call on someone by name when you are ready to start the debrief. Example: “Jane, what do you think went well in our meeting today? Is there something that we should do again because it was so effective?”
Start the debrief yourself by critiquing something you could improve for next time. Often, a public selfcritique by the leader will open the lines of communication. (Be sure to segue back into “What went well?” if you try this technique.)
Question 2: Do I need to debrief everything? Even those events where nothing of note happened?
Answer: Yes!!!! A thousand times “Yes!” You must develop the daily, consistent habit of debriefing. Yes, even when everything went according to plan. These debriefs will often only take a few seconds, but it is a few seconds well spent. If you don’t debrief every time, choosing only to debrief when things don’t go well, or when someone made a significant error, very quickly, your debriefing attempts will develop an excessively negative connotation among your staff. Subconsciously, they will think, “We only debrief when we screw up.” Debriefing = Mistake = Bad.
Make it a habit to debrief when times are good and it will be infinitely easier to debrief when significant events occur.
Question 3: “Our meetings are jam-packed. How can we squeeze in the time to debrief at the end?”
Answer: Schedule it. When you draw up the written agenda for your meeting, add the word “Debrief ” as the final agenda item. For extra effectiveness, save space after this item to insert two columns: one labeled “Well” and the other labeled “Improve.” Attendees can write their notes for the debrief here and be immediately ready to offer their inputs. It also provides a space where the notes from the debrief can be captured, which is important if you want to hold your staff accountable to make the improvements they said were needed.
By the way, this is the same tactic we use in the cockpit. The very last item on the very last checklist we run to shutdown the engines and get the airplane at the gate is the word, “Debrief.” This is a reminder for the Captain to conduct a crew debrief at the end of the flight.
Question 4: “How will our staff know anything is being done about the items they identify in their debriefings?”
Answer: You must tell them! This is why it is always best to have someone on the team capture in writing the items discussed during a debriefing. Some of the items discussed can, and should be, fixed by the individual such as: “Next time, I won’t dominate the discussion. I will ask others what they think first, before I offer my own comments.” But other items will be system issues and will need to be addressed by the organization’s leadership and managers: for example, “We really need a rolling cart set up with all the supplies we need to ensure a sterile field when we insert a central line.”
Unless system issues are written down and forwarded to someone who can fix them, they are not likely to be addressed.
The manager assigned to fix this issue must close the loop with the person and the team that raised the issue in the debrief, and let them know that it is being addressed. Without that feedback loop, staff will only debrief for about two weeks, then they will give up in frustration because “nothing ever changes around here.”
Question 5: “What is the single most important thing I can do to get my staff excited about debriefing?”
Answer: Have a structured system to fix the issues they identify in their debriefs. When staff see a direct connection between what they discuss and what gets fixed, debriefing will quickly become a habit. Unfortunately the converse is also true. When they take the time to debrief and nothing gets fixed, they will quickly learn they are wasting their time and stop debriefing.
This point is so critical that I advise our clients that if they are not going to implement a system to fix the issues that are identified, then they are wasting their time trying to get staff to debrief.
You can’t have one without the other. But when you have staff that are willing to debrief, in conjunction with administrators dedicated to fixing the items identified in the debrief, then some real magic happens.
You will be shocked at how quickly you can create a culture of high performance by creating a debriefing habit. You only need to watch the U.S. Navy Blue Angels, a Navy TOPGUN fighter pilot, or the Navy SEALS to see the positive effect of debriefing. (Can you tell I was in the Navy?)
