Leadership in the ED: Being a Floor General for Your Team

In sports, the most successful athletes are not necessarily those that have had the best individual statistics, but are those that have managed to make their teammates better around them: Magic Johnson, Isaiah Thomas, or to use a hot new name – Jeremy Lin. 

These athletes epitomize selfless leadership on the court. While their own talent is unquestioned, their biggest success was, and in the case of Lin, is, how they influence their teammates, bringing out their best. They are floor generals. Even though they may be able to score alone, they understand when it makes more sense to pass the ball instead, as this can maximize the strength of the entire team. They make sacrifices to their own statistics, keeping the main goal in mind: to win.

Leaders at emergency medicine physicians groups are often faced with a similar challenge. In the Emergency Department, our team is made up of varied players: from healthcare providers, to clerical staff, to housekeeping. Each “player” needs to recognize his or her importance in making the team perform at optimal efficiency. Of course none of us can entice our teammates with multi-million dollar endorsement deals or contracts. So, financial incentives are usually not an option for us in providing motivation.

Add to that, everyone’s goals are not necessarily aligned. For example, we may set certain parameters for patient care and optimal efficiency, but what defines reasonable parameters is defined very differently by various members of the healthcare team. Agreeing on such goals and parameters is certainly a dilemma. It’s what frustrates us day in and day out. But succeeding despite the challenge is what gets us out of bed every day (and night).

Recently at Southern Maryland Hospital, I had an experience that demonstrated just how much can be achieved when everyone is striving toward a common goal. In our Rapid Medical Evaluation unit (also known as First Track), we post a number on a laminated sheet of paper and display it prominently. It represents the highest total number of patients that have been seen during a single First Track shift. Along with the number, the names of the members of team that accomplished the record are also posted.

One morning, I started my shift in First Track with a bold proclamation to my teammates: “Today we are going to beat the First Track record!” Most of our team snickered at this bold statement. “I’d like to see you guys try!”, “Yeah right!” were comments overheard. So we began our shift. Midway through the shift we printed out our census and again made an announcement. “We’re halfway there!” Suddenly the team began to take notice. The updates turned into hourly announcements, “25 patients to go!” followed by, “15 patients left!” The excitement level started to reach a feverish pitch. Techs and nurses began to run out to triage to look for potential patients to place into First Track. They began studying the computer screen intently; ready to pick off the first potential patient that walked through the door to add to our census.

We continued to provide this simple encouragement, and the staff began working at an unprecedented pace. “Did we beat it?” Soon the countdown started from 10, then to 5, until finally the record had been broken. The team couldn’t have been happier. They walked the halls with a sense of pride and even talked “a little smack” to those staff members whose previous record had just been broken. We paused for a moment, and took a picture of all involved staff to commemorate the occasion.

Being a part of the SoMD ED team that day was one of my most gratifying days. Together we were able to achieve what, in my mind, defines success as an ED leader: all staff members were working at peak performance to achieve a common goal. It is even more satisfying that the staff’s motivation wasn’t financial or anything complex, they responded to simple encouragement and positive reinforcement.

Since then, I wondered what the ripple effect would be, and if we’d be able to continue winning the game. I was soon given the answer: two days later, Dr. Banks and her team had beaten our record (handily too). But for me, we were ALL part of one winning team.