By Sarah Evans

• Building an effective team takes time

• Adaptability is a key trait in new recruits

• Staff development is an evolutionary process

Evaluate where you are and what you need to implement

“Building a successful team takes time,” David Tenney, High Performance Director at Austin FC, told the Leaders Performance Institute while still serving in the same role at the Orlando Magic. He spoke about how he sees his role as a leader is in developing his team over time to problem-solve better, to become more resilient, and to grow. Tenney then explained how, ultimately, he wants to facilitate a process by which his people, as staff members, are able to say, “we are getting better, making good decisions and continue to grow as people and practitioners.” He also went on to highlight that “there will be a certain point when they can grow and move on and you start the process all over again.” Then, he made clear that it is of critical importance to take time to evaluate where you are and what needs to be implemented or changed. He said: “When new hires come in, everyone doesn’t know each other’s strengths and it takes time to build those relationships. The first three or four months will be messy, but that’s OK.”

Don’t just hire the best people

Tenney spoke about some of they key characteristics he looks for in the practitioners he brings onto his staff, and explained how adaptability was one of the most crucial attributes. He highlighted that he often looks to hire people from outside of the sport as they can bring in fresh new perspectives. “Putting departments together is really hard, as it is a dynamic structure,” he said. One hire can impact on who the other hires might be, therefore, “it’s not always about hiring the best person for each role – it’s really trying to figure out how they’re going to fit together”. Elite sport is exceptionally chaotic, and Tenney highlighted the need to be able to evaluate whether someone coming into the team has the emotional resilience to deal with the pressures of elite sport. He said that many of the practitioners are the first people the athlete will see in the morning, and so they “can set the emotional tone for the building the moment the athletes walk in. So if you’re tired and frustrated, and the athlete walks in and we’ve just lost five games in a row, you’re sending that message to the athletes. Not everyone can do that – it’s a key trait.”

Making staff feel invested is key to their development

Tenney stated that “staff development is an incredibly evolutionary process.” As staff teams get bigger and practitioners that used to be part-time consultants are now becoming full-time hires, there are more interactions. With this in mind, Tenney shared with the Leaders Performance Institute that “the hardest part of my role is to bring people together, make sure information isn’t lost, and make people feel invested.” Often the practitioners are so focused on connecting with the athletes, that they actually miss connecting with the other staff members. Thus, Tenney said: “it is really important to set an environment where we’re collectively acknowledging each other’s individual strengths over a period of time, and I think that makes people feel more invested and committed.”

“Our mission statement is probably a good place to start,” says Phil Church, “and it’s to increase the number of English-qualified leaders, which is managers, coaches and technical directors, working at the highest levels of the game.”

Church is the Senior Professional Game Coach Development Lead at England Football Learning, which oversees the Football Association’s [FA] education pathways for youth and senior coach development and technical director development.

He joined the Leaders Performance Podcast to discuss the FA’s suite of programmes and courses as it works towards fulfilling England Football Learning’s mission statement.

Within that discussion we also touch upon:

• The selection process for the courses [8:00];
• Talent mapping with a view to adding support and value for learners [12:00];
• Programmes for graduates to continue their CPD and to meet the needs of the game [17:40];
• Why diversity and inclusion still needs attention at the FA [28:00].

John Portch: Twitter | LinkedIn

Listen above and subscribe today on iTunes, Spotify, Stitcher and Overcast, or your chosen podcast platform.

A podcast brought to you by our Partners Elite Performance Partners

“Folks coming into the organisation, whatever their career aspirations may be or their vision of leadership, we want to help them find that, whatever is genuine and authentic to them.”

Ben Baroody, the Director of Leadership Development & Mental Performance at the Texas Rangers of Major League baseball, is discussing career and leadership development opportunities at the club in this latest edition of the Elite Performance Partners Industry [EPP] Insight Series.

EPP are a performance consultancy and search firm highly regarded across sport and, for this episode, EPP’s Founding Partner Dave Slemen and Managing Partner Anna Edwards posed the questions to Ben, who spoke of the Rangers’ processes and practices that enable the advancement of players and staff alike.

Also on the agenda were:

• How Ben and the Rangers make time for those leadership and career development opportunities [8:30];
• The club’s efforts to set people up to succeed by creating a development space [10:30];
• ‘Soft’ skills and the Rangers’ ability to track the development of players and staff [23:00];
• The renewed emphasis on the mental side of performance in the training environment [29:20].

Dave Slemen Twitter | LinkedIn

Anna Edwards LinkedIn

By Luke Whitworth

Recommended reading

Why Debriefs Are Such Effective Tools of Learning at Delta Airlines

Is Your Team a Good Learning Organisation?

How NASA Share Knowledge and Learn Faster

Framing the topic

Applying new learning or ideas continues to be a fascinating theme of discussion across the world of high performance sport, yet it remains a challenge. In this virtual roundtable which was led by Leaders Performance Advisor Bobby Scales II, we explored six points around this theme and then opened up discussions around key considerations and approaches of those on the call.

How to lift ideas off the page

1. Learning with intent: we read articles, listen to podcasts and attend conferences. Curious people acquire tons of information but are we learning for enhancement or are we learning for entertainment? When preparing to engage in a learning opportunity, what is it that you want to learn? It’s extremely important to learn in a purposeful and pragmatic fashion – follow up and make it impactful.
2. Focus: leaving the learning environment (speech, conference etc.) with several pieces that made significant impact. Focus on one or two that you can apply to your organisation. Utilise the flight or train home – that can be a vital period in reviewing what made an impact on you.
3. Process: quickly create a process by which you plan to implement those ideas. Formulating an actionable plan is key to making the knowledge that you acquired ‘sticky’. How can you dig deeper on what stood out to you?
4. Board of directors: share what you have learned and how you plan to implement your ideas with your ‘board of directors’, these are people close to you either in or outside of the organisation. People on your board of directors will hold you accountable because they care about you and your success on a personal level. This is a powerful way to debrief ideas and build them out further.
5. Be aggressive: this is where a lot of the learnings can get lost. Move quickly and decisively with applying the learning in your environment. The more time between information ingestion and action the more likely you will end up seeing the conference as a social gathering.
6. Keep lifting: it’s exceedingly easy for the learning and ideas to never leave the notebooks we write them in. The true test of lifting any idea off the page is to make it real. What you are really seeking is behaviour change, as such you must model the behaviour that you want.

 Discussion points

• Aggression vs. intent: there can be a perception of being too proactive, whereas if you are in the right environment you can just be intentional with the idea or learning.
• External groups: this is hugely beneficial and powerful in their ability to hold you to account. Sometimes there isn’t a ‘bookshelf built for that book’ so how do you tell the story to build the shelf to brew the evolution of the idea into integration or implementation?
• How you are creating connection: when working with other athletes or staff, what are you doing to get on their level? Quality learning amongst peers of people is more impactful with an underlying foundation of connection.
• Desire to action: in high performance sport we have a huge action bias – we have all this information so how do we do this in our organisation? The real question becomes at what point does action become useless or a negative return on investment?
• What is your or our curriculum: how do we teach, learn and guide? What are the metrics that guide that curriculum that let us know there is progress in certain areas? For bigger ideas, create that ‘pilot’ space where we can figure out if it does or doesn’t work. Where is your ‘failure’ location to explore whether we decide to go deeper or not?
• Culture: do you have a clear culture around learning from the tip of the spear? There is only going to be so much you can do if the buy-in is only from a mid-management level. If you have a culture when rubber meets the road that there is fear to try anything or a ‘no safety culture’ where ideas are dismissed by management with the excuse of funds or time – you need an open culture to allow these things to work.
• Context is crucial: we like new and shiny things, there is a recency-effect. Often there can this notion of applying a similar idea into your context but the reality is that it can’t be lifted from one context to another, there are nuances. How do we mitigate the new and shiny? The real learning usually takes place when you bring an idea back and begin throwing it around in a smaller group setting – it begins to be shaped into something that has meaning.
• Power of reflection: don’t rush into things too quickly, give the idea or learning time to ‘marinade’ – a good idea is still a good idea a week down the line. Find the sweet spot between not leaving the idea too long, but giving enough time for you to get back into the environment and review how it might work in practice. Then ask yourself: would this still be impactful? Is it still relevant? Straight after a learning experience you are emotionally positive, so the power of reflection is important as you look to articulate it a more holistic way.
• Learning is a process not an event: this has strong alignment to the discussion point around culture – we want to strive for a sustainable learning journey.
• Individualisation: what is your personal way and process for learning and subsequently putting things into action?
• Create depth to the learning: what can you do to get further down the levels in terms of the idea, topic or theme? Sometimes when seeing some present or share a dynamic idea, it can be hard to replicate without the environmental buy-in as much as it is with the idea itself.
• Multiple processes to implementing ideas: it may be the case that there are multiple processes to implementing ideas as opposed to just one. If there is something that is perhaps more conceptual or theoretical, this process for implementation may look very different to something more structured or content-driven.
• Maximise impact: do your peers present back their learnings and findings after engaging in learning experiences? It creates discussion, room to create more depth and the ability to make learning contextual to your environment. Based on these ideas, notes or takeaways, what do others see, feel or hear? Not just read, see and heard around those ideas. A question you can focus on is ‘what are we going to notice that is different as oppose to what is it that you are going to commit to?’
• Teach & preach: the best way to learn ideas is to teach them. What has a member of the team learnt and, subsequently, how are they teaching and preaching that learning to others? What has been ingrained in the practice?

By Dr Meg Popovic

Being: “Think like a wise man but communicate in the language of the people.” William Butler Yeats

Doing: “The hen cannot lay eggs of crocodiles, and the crocodiles cannot lay eggs of hens.” African Proverb

A new competitive edge for world-class sport clubs is the ideation and integration of meaningful professional development for staff. This can be approached via organization, team-of-teams, and individual levels. Through conversations with many members of Leaders in sports around the globe, it seems as though the meso-level – team-of-teams – is the most challenging to do well within a professional or elite sports club.

This article is Step One: The What. It is a creative, pragmatic study of subcultural idiosyncrasies unique to four important staff departments. From this understanding, staff department leaders and management can design impactful professional development programs that are both customized for the department and align with the broader vision of the organization.

There are two categories of analysis below that require a pre-game warm-up. The first is coined ‘Shadow.’ Stemming from Jungian psychology, the shadow of every group holds ways of being and doing that are repressed or unacknowledged. That which lies in the shadows of a group could be from past history or manifested in the present, be negative or positive, and acted upon, latent, or omnipresent. The sole objective of naming what is within the shadow of each staff team is to move the group forward; thus, in bringing that which remains in the dark to light, growth will ensue. The next concept comes in a pair: ‘Conflict’ and ‘Dream Behind the Complaint.’ In a highly competitive, fast-paced environment, it is inevitable that staff teams rub up against other departments. Oftentimes these conflicts are not addressed or avoided; however, finding the essence of yearning that exists within the staff members who feel the conflict can bring healing and growth to the larger group if both spoken with, acknowledged, and received with respect and understanding.

Professor Popovic Teaching Tip:  As you read along, consider about what, how, and why these departmental subcultures are similar and different in your sports organization.

Medical / Performance Department

WHO:

Titles within organization: Athletic Therapist, Massage Therapist, Strength and Conditioning, Physiotherapist, Sport Scientist, Nutritionist, Team Chef, Mental Performance

SKILLS:

Capacities required to be great at tasks in these roles: an abundance of physical energy and mental endurance to foster positivity and healing for players every day. High level of discernment needed to take in all information, hold the emotions that come with being in a highly pressurized sport container, and make short- and long-term decisions for players entrusted within their care.

QUALIFICATIONS:

Professional training and education to obtain roles in department; undergraduate to Master’s degree, with continued education (courses, trainings, certifications) in individual areas of specialization.

TIME:

Hectic? Most free? Stressful? Busiest time is, well, the entire season. From the time players arrive before Training Camp, it feels like “3,2,1 GO!” and the workload doesn’t let up until the team is done with playoffs. The most relaxed time is off-season. The most stressful times are when injuries and return-to-play (RTP) players begin to add-up, and when major franchise players are injured.

COLLECTIVE HISTORY:

Describe the department 10 years ago: significantly smaller staff, such as 1 AT, 1 Assistant AT, and one part-time massage therapist for the entire team. A player-specific, reactive provision of medical/athlete services, versus the current holistic approach to high performance of both overall department structure and individualized care for players.

PASSION:

What lights up their collective fire? Being of service to players’ success, such as having a role in a player’s injury rehabilitation process, helping a player make huge S&C gains in off-season, educating and supporting a player commit to healthier sleep and daily nutrition habits.

CREATIVE:

If you could give this department a song, what would it be?

‘Fix you’ by Coldplay

When you try your best, but you don’t succeed
When you get what you want, but not what you need
When you feel so tired, but you can’t sleep
Stuck in reverse

And the tears come streaming down your face
When you lose something you can’t replace
When you love someone, but it goes to waste
Could it be worse?

Lights will guide you home
And ignite your bones
And I will try to fix you

WISDOM:

What is the key knowledge this group holds for the club? They are the Healers with the how-to knowing that brings athletes back to life from injury and pain, and builds players’ inner and outer strength to help them compete in the battles before them.

SHADOW:

What are some unresolved or unspoken qualities within this staff group’s collective shadow?

Sometimes staff members vie for players’ affection. This could be for various reasons, including wanting to be popular with star players, job security, a desire to be liked, or an innate personal competitiveness that goes a bit sideways in a group.

CONFLICT: What is the DREAM BEHIND THE COMPLAINT within the broader club environment?

The need to win can create a pressurized conundrum with player availability and injury-recovery timelines for athletes. The ways in which others (e.g.) some coaches react to hearing that a player is not ready rejoin the line-up for another day/week/month/unclear timeline, and this reaction brings undue (and unwarranted) stress to this department. The dream would be there is a respectful, clean line of trusted communication for all involved in player care, coaching, and in-game performance.

Scouting Department

WHO:

Titles within organization: Amateur Scout, Professional Scout, International or Global Scout, Area or Regional Scout, Player Personnel

SKILLS:

Capacities required to be great at tasks in these roles: ability to make high-quality inferences on players – now and their potential within the Club and sport in general. The word infer means to “carry forward.” Good scouts make inferences in reasoning, moving from premises to logical consequences by using observations and their background knowledge of the game to reach a pragmatic conclusion on a player. A secondary capacity for the role is personal autonomy, as the demands of this job require large amounts of time away from home, living in hotels, arranging your travel to align with games of potential prospects, and independence.

QUALIFICATIONS:

Professional training and education to obtain roles in department: traditionally, these roles were held by men with a love of the game who scouted in lower ranks and moved up over time through connections within the sport. Now the catchment for scouting is more expansive, including former professional or NCAA alumni, coaches or skill specialists, and those with knowledge of talent evaluation from other sports.

TIME:

Hectic? Most free? Stressful?

The busiest time of the year would be in the months leading up to the Draft when scouts are traveling to ensure they watch as many games as possible on the talent pool within their remit. Most free time would be when the leagues are in off-season and there are no games to watch. The most stressful could be the pinnacle moments when one’s scouting observations are brought to the light and connected to management decision making, including player trades and acquisitions and the Draft.

COLLECTIVE HISTORY:

Describe the department 10 years ago: More on-the-ground. No video. Reporting was less formal, including data management systems, writing of reports, communication with decision makers such as GM or head scouts. It was a phone call way of being, not a formal report and email culture. No challenges of opinion from analytics as R&D did not exist. Greater feeling of appreciation for the scout’s opinion and experience.

PASSION:

What lights up their collective fire?

Being part of the team’s success, such as finding a diamond in the rough from their region or a player they watched for years as a youth evolve into greatness at the highest level.

CREATIVE:

If you could give this department a song, what would it be?

‘A Long December’ by Counting Crows

Drove up to Hillside Manor sometime after two a.m.
And talked a little while about the year
I guess the winter makes you laugh a little slower
Makes you talk a little lower about the things you could not show her

And it’s been a long December and there’s reason to believe
Maybe this year will be better than the last
I can’t remember all the times I tried to tell my myself
To hold on to these moments as they pass

And it’s one more day up in the canyon
And it’s one more night in Hollywood
It’s been so long since I’ve seen the ocean I guess I should

WISDOM:

What is the key knowledge this group holds for the club?

They have an awareness and understanding of the sport beyond the team (players, teams, gossip, idiosyncrasies, trends). Scouts talk, they see, they travel, they extend to all parts of the world to do their jobs well. This knowledge may be buried within the scouts as even they may take granted what they glean from being out in the field, but with a few curiosity-infused questions, this can be unearthed to bring forth new insights and a competitive advantage.

SHADOW:

What are some unresolved or unspoken qualities within this staff group’s collective shadow?

Sometimes scouts take it personally when players from their regions are or are not drafted or acquired by the team. This leads to inner fears around job security and status within the group, which may consciously or unconsciously drive them to overzealously “fight for their players” against other scouts and a foster scarcity mindset within the staff team culture.

CONFLICT: What is the DREAM BEHIND THE COMPLAINT within the broader club environment?

Due to the nature of their work that requires them to be scanning the external landscapes, they may feel disconnected from and forgotten by the club that they are so proud to be affiliated with. They wear the logo on their chests when scouting, but their physical presence may be 1000km away from the stadium where the players play and day-to-day operations occur. The dream is to feel part of the team, even though they live and work far away.

Research & Development Department

WHO:

Titles within organization: Data Analyst, Developer, Software Engineer, {Sport} Systems, Video Analyst, Major/Minor League Operations, Player Personnel Analyst

SKILLS:

Capacities required to be great at tasks in roles

A problem-solving temperament with curiosity and excitement to find answers to complex challenges. They can connect facts to big ideas, dream of what’s possible, discern the changes to be made, and figure out ways to have systems and teams work more efficiently.

QUALIFICATIONS:

Professional training and education to obtain roles in department: university degree, typically in sport analytics or management, engineering, economics, or game theory.

TIME:

Hectic? Most free? Stressful?

Their workload ebbs and flow over a season depending upon trends in the game or managerial, strategic planning. Something more unique about this staff group is that they work together projects, distinct from the arc of the season cycle, either as a whole team or in smaller research groups. The most pressurized, times of the year would be the Draft, Trade Deadline, or Free Agency as their opinions will be asked and presented to the larger group to help make decisions for the team.

COLLECTIVE HISTORY:

Describe the department 10 years ago: this department typically did not exist within a major franchise a decade ago. There may have been a handful of staff who were fascinated and on the cutting edge of integrating this way ideation for team strategy and contract negotiations, however it was more ad hoc verses a department with an aim and a plan.

PASSION:

What lights up their collective fire?

Thinking. Nerding-out by jamming and jiving over problems that make them think. “Problems” are not seen as “a problem;” they are welcomed as opportunities to get better. This staff group has a limitless hunger to learn and will work tirelessly, together or individually, on any project they set their mind to.

CREATIVE:

If you could give this department a song, what would it be?

‘Mr. Roboto’ by Styx

You’re wondering who I am (secret secret I’ve got a secret)
Machine or mannequin (secret secret I’ve got a secret)
With parts made in Japan (secret secret I’ve got a secret)
I am the modern man

I’ve got a secret I’ve been hiding under my skin
My heart is human, my blood is boiling, my brain I.B.M.
So if you see me acting strangely, don’t be surprised
I’m just a man who needed someone, and somewhere to hide…

I’m not a robot without emotions, I’m not what you see
I’ve come to help you with your problems, so we can be free

WISDOM:

What is the key knowledge this group holds for the club?

They always believe in possibilities through solution-focused thinking for players and the team. They are willing to listen and learn from anyone who has something useful to teach them, disregarding authority and customary procedures that waste time and resources. Their drive to discover is grounded with a realist’s understanding of statistics, blending the x’s and o’s with a humanized who, why, and when answer for management to make important decisions.

SHADOW:

What are some unresolved or unspoken qualities within this staff group’s collective shadow?

Intelligence is a measure of success and status within the staff team itself. When challenged from the more traditional ways of doing and being, this group can slide into “superior-mind” when engaging with others from various departments outside of their own.

CONFLICT: What is the DREAM BEHIND THE COMPLAINT within the broader club environment?

As their modus operandi is to solve problems using innovative and alternative ways of thinking, they may see customary procedures and “the way it’s done” as unproductive, useless, or archaic. The conflict comes when their logical and fiercely independent thinking rubs up against staid sport cultural norms, leaving other staff members feeling threatened and defensive when opinions and expertise (and perceived job security) are challenged. These team members were often the brainy outcastes who loved sports but never participated in “jock culture.” They dream of being seen and respected for their knowledge of the game as they take pride in the ingenuity they bring to their work in sport, and deep down want to have a feeling of belonging within the team.

Equipment staff

WHO:

Titles within organization: Equipment Manager, Equipment Coordinator

SKILLS:

Capacities required to be great at tasks in roles: elite organization skills for such duties as individualization of player equipment, inventory management, shipping and receiving, packing for travel, player trades and acquisitions, and proficient relationships with brand representatives. On a more metaphysical level, this staff group embodies the essence of Servant Leadership. With the goal always being to serve the players and the organization, they tend to the details of others first to help them perform as highly as possible. They listen, stay attuned to that which they see and infer players need, show empathy, hold firm boundaries to keep the equipment room organized and tidy, and use foresight to plan ahead.

QUALIFICATIONS:

Professional training and education to obtain roles in department: they evolve in this role by working in the sport for decades. Often starting their careers as teenagers at amateur levels or in a sporting goods store, these staff members gain expertise and know-how through hands-on work, sweat, time, and commitment to their craft.

TIME:

Hectic? Most free? Stressful?

Game days are especially busy when games are bookended by plane or bus travel. Incredibly long hours with little sleep or rest. Something that also creates stress is when orders for products need to be made and they’re waiting for superiors to sign-off, or the third-party providers are late with their shipping and receiving. These delays clog the flow of the department and ability to serve the players, which they care deeply about.

COLLECTIVE HISTORY:

Describe the department 10 years ago: half the size, way less gear for the athletes, stronger bonds with individual players as more time was spent casually talking and bonding in the kit room during practice and game days.

PASSION:

What lights up their collective fire?

The Gear. These staff team members know the make, model, year, brand, variability, and functionality of every piece of equipment a player uses or wish to try out. They understand the engineering, while finding delight in the new trends in the market that have the potential to improve performance and evolve the sport. They are applied-historians of the industry and the trusted mechanics whom players rely on to tune up, repair, and remodel themselves as living, breathing, sporting machines.

CREATIVE:

If you could give this department a song, what would it be?

‘I Am a Real American’, the Hulk Hogan theme song

When it comes crashing down and it hurts inside
You gotta take a stand, it don’t help to hide
If you hurt my friends then you hurt my pride
I gotta lend a hand, it don’t help to hide

I am a real American
I fight for the rights of every man
I am a real American
And fight for what’s right
Fight for your life

Well, I stand strong about right and wrong
And I don’t take trouble for very long
‘Cause I got something deep inside of me
A courage is the thing that keeps us free

WISDOM:

What is the key knowledge this group holds for the club?

They’re always connected to the pulse of the players.

SHADOW:

What are some unresolved or unspoken qualities within this staff group’s collective shadow?

Lifting, packing, unpacking, emailing, washing, folding, hustling, bustling…. They meticulously prepare, present, then clean and pack-up-to-do-again-tomorrow, all the while responding to random player requests, changes in team schedule, and coordinating with myriad facility requirements when traveling to other teams’ facilities.  Sometimes like ghosts in the periphery, this staff groups’ diligence and commitment to detail is of utmost importance for the seamless, daily functioning of the players and the team as a whole. They’re the first ones in the building and the last staff to leave. Sometimes, their pride in long hours caring for athletes paired with a feeling that there’s always something else to cross off the To Do List, can lead to a neglect of self-care over time, especially for the physical toll this work takes on their bodies.

CONFLICT: What is the DREAM BEHIND THE COMPLAINT within the broader club environment?

This group wants to be (and should be) acknowledged personally for their long hours and often difficult, unseen efforts. A thank you, a coffee, or helping hand could quickly relieve resentment and amplify the energy flowing in this very important staff group.  Also, as they are of the giving-type, asking equipment staff how they’re doing could go a long way as their innate way of relationship is to be in the service of everyone else’s needs, requests, and demands.

A Leaders Performance Podcast brought to you by our Main Partners

“We want to be able to sustain excellence and in order to do that you have to move very precisely,” says John Wagle.

“It’s more so about connecting with people at the right time, having the right information, listening first, serving their needs, and then nudging towards whatever the process needs to look like.”

Wagle, who has just left his role as the Kansas City Royals’ Director-Performance Science/Player Development, reflected on his four years working in the clubhouse in the latest edition of the Leaders Performance Podcast.

Also on the conversational agenda were:

• Knowing when to listen and when to implement change [4:30];
• Learning how to learn – then learning how to lead [10:30];
• The challenge of integrating technology in player development [16:45];
• Why John says that players challenge him on a regular basis [21:00].

John Portch: Twitter | LinkedIn

Listen above and subscribe today on iTunes, Spotify, Stitcher and Overcast, or your chosen podcast platform.

By Dr Peter Brown and Dr Adrian Neal

This is the third and final instalment of our three-part series exploring the parallels between high performance sport and healthcare, drawing upon our experiences within the Aneurin Bevan University Health Board (ABUHB), which serves southeast Wales in the UK.

In our first piece, we described the context of operational delivery throughout the pandemic and the effect this has had and continues to have upon the workforce. We then provided comparisons between healthcare and performance sport, specifically in relation to performance plans and outcomes.

Then, for our second piece, we then moved on to present the opportunity for innovation within a crisis and the role of leadership within this to create the time, space and options for to enable novelty to emerge drawing upon the theoretical frameworks of complexity science and drive theory.

This final instalment wraps up our series by describing the potential route out of the pandemic in healthcare, or as is frequently coined, the ‘recovery’ from the pandemic. We will describe the new norm and the timescale and context of what recovery looks like for us and, importantly, the potential learning for and from performance sport.

Recovery: the impossible utopia for healthcare

There are many parallels between healthcare and performance sport, although one major point of difference is the ability for the performer and their support team to recover after training and performance.

In the recent Tokyo Olympic Games, teams were encouraged to decompress, which provides a time and space to adjust to a more relaxed state after the biopsychosocial stress of the event allowing the processing and acceptance of both positive / negative feelings and experiences to minimise maladaptive adjustments.

In healthcare, either on an individual level or an organisational level, recovery is not operationalised as an essential component of the performance cycle which might support biopsychosocial adaptation for sustainability. Instead, National Health Service [NHS] systems and the individuals within them are faced with a renewal of demands e.g.: political pressure to resume services and meet targets, public pressure to meet needs and address an increased acuity of patients linked to services not being accessible during the pandemic, budgets restrictions and, in some cases, cuts, the need to continue to provide Covid-related services, and increased staff absence and turnover.

The demands are relentless, leaving little space for recovery as a concept or as an essential component of sustainability and performance. Recent survey data from our Health Board demonstrate that significant numbers (>50%) of staff are physically and psychologically exhausted from the pandemic and are worried about how they can continue. In the eyes of many this situation represents a dichotomy, both an existential threat to the NHS but also an opportunity to motivate a system to change. Change the system to enable recovery of the people and the organisation, which may slow down services, or carry on as we are and risk staff leaving the profession, which creates even more disruption both fiscal and patient facing.

What we also know is that offering NHS workers a greater opportunity to have a positive experience of work is now an organisational priority. If we can help them do the work they have trained to do with purpose, reduce avoidable harm created through our processes, and at the same time help them feel like they are valued, we will have made radical progress – and desired ‘performance’ outcomes will increase.

From healthcare worker to healthcare performer

When considering the consistent demands placed upon healthcare workers, whether this be the porters and domestic staff preforming up to 30,000 steps per day, or the intense cognitive capacity required by surgeons to perform prolonged procedures, or the emotional demands faced by staff regularly exposed to distressed patients and demanding concerned relatives, maybe it’s time to reframe how we conceptualized this work.

Perhaps we should reframe healthcare staff as ‘performers’ not workers. When considering the athlete approach to performance in any given discipline, it considers the performance plan (see Part I) and the outcome ambitions that create focus, we consider the multidisciplinary performance science teams which surround the athlete planning. Then, we can adjust the environment for optimal training, including coaching, nutrition, sleep, mental preparedness and much more. Critically, this process revolves around optimising the athlete’s ability to be available to perform, to exert the appropriate effort in context and to recover, be ready to go again when it matters and, ultimately, to achieve the agreed and often very clear goals (i.e.: medals or improvements on previous performance).

There is little of this process present in healthcare. We have staff who regularly work 12+ hour shifts (in spite of evidence stating this is detrimental to their health), surrounded by poor quality nutrition, sometimes limited managerial and leadership support, often with insufficient staffing levels. Paradoxically this combination of factors almost guarantees high or sustained performance is not possible. If we consider the healthcare performer, we will need to re-engineer huge parts of the healthcare system, but perhaps now is the moment to do so.

A possible way forward might be to, rather than focusing on arbitrary goals or key performance indicators which are externally generated and often inherently political and perversely promote gamification and minimise intrinsic motivation/discretional effort, we focus on clear mutually agreed objectives in the present, and use this to shape how we optimise performance today, this week, this month.

We support this by co-creating meaningful performance measures which reflect the work being done by the people doing the work, and have a strong link to their sense of purpose and moral justice. If we focus on these factors within healthcare, as in the educational sector, for example, to be intrinsically motivated, their work has to give them meaning to be validating thus rewarding and internally motivating.

An irony within healthcare is that we know through research that many of the stressors faced by the workforce are not necessarily due to the work itself (primary stressors) but rather factors classed as secondary stressors (e.g.: bureaucracy without overt meaning, formal processes, management / leadership capability, psychological safety, inadequate job descriptions or role clarity). Left unchecked, many of these secondary stressors will have a negative impact on wellbeing and performance and have the added potential of creating unintentional harm to both individuals, teams and the organisation itself.

Changing both the narrative (workers as performers) as well as re-engineering the structures that are in place that maintains the identified performance inhibiting dysfunction is easier said than done clearly in the public funded healthcare sector, especially our Health Board which has nearly 15,000 employees. Notwithstanding this, there remains a pandemic-generated window of opportunity where we might be able use ‘recovery’ as a platform to initiate some of the changes we have highlighted and examine the way we support and develop our people, because we very much need to do it differently to enable the people of the NHS to thrive.

This message also serves as a call to arms for performance leaders in sport: are you providing an environment which enables your athletes to thrive, providing co-created measures of performance markers, with a strong focus on their internal sense of purpose, their sense of meaning gained from being an athlete and moral justice and not just the quantifiable performance per se (being mindful that the opposite of these psychological components being burnout)?

To bring together, our thoughts over this series of papers bringing together Organisational Development and Clinical and Organisational Psychology in a novel way, we are determined at the Aneurin Bevan University Health Bored to be different, to disrupt for a better future. What’s more, together between sport and healthcare, there is much we can learn together in order to create something which is compelling and will move the future of sport and healthcare to the next level.

Dr Brown is Director of Organisational Development (OD) at the Aneurin Bevan University Health Board (ABUHB) in South Wales and spent 10 years as the Head of Performance Knowledge at the English Institute of Sport.

Dr Neal is a Consultant Clinical Psychologist and Head of Wellbeing at the ABUHB and has researched and published widely across organisational health and wellbeing.

By Dr Peter Brown and Dr Adrian Neal

This is the second instalment of our three-part series exploring the parallels between high performance sport and healthcare, drawing upon our experiences past and present within the Aneurin Bevan University Health Board (ABUHB) which serves southeast Wales, UK.

In our first article, we described the context of operational delivery over the past two years of the pandemic, the effect this has had, and continues to have, upon the workforce in healthcare and the comparisons between healthcare and performance sport: specifically in relation to performance plans and outcomes.

The pandemic continues to have a significant impact upon the delivery of all NHS services in Wales and across the UK. Most services (clinical and corporate) are feeling the exhaustive pressure of increased demand for clinical services, disrupted service models, record levels of staff absence (linked to sickness or self-isolation) and the weariness associated with responding to the recent Covid surges.

However, like many disruptive forces it has also given opportunities for innovation and creativity and this instalment of our three-part series explores the key opportunities for innovation within the ABUHB in response to the pandemic.

The leader’s choice within a crisis

Without using the phrase lightly, the NHS is operating within a crisis. As an organisation, many of our clinical and administrative teams have been redeployed from their normal roles to mass vaccination clinics and/or to help on wards with various tasks. We’ve been pulled from pillar to post both metaphorically and often literally. But despite this context, there is a choice to be made by leaders. Do you a) roll over and admit defeat or b) use it to your advantage and harness the opportunity a crisis brings. In the ABUHB Organisational Development and Wellbeing Teams, we’ve stood up to this disruptive force, looked it square in the eyes and chosen to use it to our advantage and innovate.

When working in a crisis, it’s no good doing the same old things in the same old ways. You need to be able to flex, adapt, and evolve to the situation.

Two key theoretical frameworks have supported and enabled our thinking during this: i) complex adaptive systems and ii) Three Motivation System model[1]. What is fascinating is that the optimal way to function in a crisis and complexity according to complexity science is somewhat opposite to people’s and organisation’s natural autonomic response. Complex adaptive systems present us a novel lens of making sense of our environment in order to act within it. Specifically using the Cynefin framework which is part of the naturalising school of sensemaking tools, we know that we operate within one, multiple, or the liminal spaces of multiple systems. These systems may be ordered where cause and effect are linear, known and repeatable with robust or governing constraints; complex where cause and effect are only known in retrospect and enabling constraints are present and, lastly, chaos, where there are no effective constraints.

By knowing the system you are in at a given time and the relative distance from the other systems by understanding the constraints of your environment, you create coherence enabling your leaders, people and the organisation to act with maximal understanding and minimal energy cost.

Innovation within a crisis

Our present situation in this pandemic throws the NHS well and truly into chaos where there are (at times) no effective constraints. The absence of constraints has enabled us to act and try new ideas shifting us from a system of chaos to one of complexity. For leaders, this can be worrying and energy-sapping, on the other hand, it’s also liberating. The absence of constraints makes innovation possible, it allows ideas to emerge rapidly, for us to learn through self-organisation, rapidly adjust to our environment and to navigate our world by maximising our contextual understanding. It allows us to create some form of coherence within our system and nudge it back to a space where we have elements of control. Within ABUHB we have taken advantage of this creating several game changing interventions such as:

• #PeopleFirst #CynnalCynefin project – reconnecting with the workforce using naturalising sensemaking and narrative capture to shift positive change to the adjacent possible and maximising peoples effectiveness and purpose at work.
• Test, trace and jab – rapid reorganisation and repurposing to support new and essential services, vaccination of over 600,000 people in a matter of weeks pre-Christmas 2021 due to Omicron.
• Stepping away from bureaucracy – streamlined decision making during the early high peaks of the crisis.
• Better understanding the factors that help create and sustain working environments for thriving not just survival (in principle).
• Using the opportunity to innovate to shape our thinking about multi-systems pandemic recovery.
• Develop a model of how we can minimise unintentional harm to our workforce and systems.
• Develop a model of moving away from death rates, waiting lists to survival rates, surgical successes.

Linking motivation with complex systems

The second key theoretical paradigm shaping our work is Three Motivation System model (Gilbert, 2009). This evolutionary psychology model identifies that humans self-regulate their emotions (their autonomic nervous system) in three distinct ways;

i) by initiating a threat response and rallying social and intrapersonal defences;

ii) harnessing action or drive such as by focusing on detail, being productive and trying to exert control over the environment;

and iii) by soothing via meaningful contact with others or relying on one’s own internal recourses.

For people, this model supports evidenced-based psychological treatments for a range of mental health difficulties (e.g.: types of eating disorder, depression, shame, perfectionism, and psychological trauma). However this theory also has powerful relevance when applied to an organisational or system context. For example we can see how the two most common (and least adaptive) motivations manifest as omnipresent behaviours within an organisation such as the NHS i.e. the compulsion for increased control (grip) through detail and increased bureauocracy and social aggression (bullying, passive aggression and territoriality) which are in opposition to the naturalising sensemaking approach where the constraints of the system govern behaviour, not the other way around. This may also present in performance sport such as in the high performance training environment, the construction of performance plans or in the lead up to a major event.

Motivation, psychology and innovation

Emerging from a crisis, in the context of our people, the Three Motivation System model suggests that innovations that can be used to increase the frequency and quality of prosocial (soothing) interactions will help both individuals and systems to regulate their emotional states – leading to more prosocial behaviour, increased productivity and psychologically safer working environments.  What’s more, this model encourages us to better understand the core conditions that allow humans to thrive, which has in our context led to the development of our Employee Experience Framework with its six core conditions focusing on peoples sense of: control, feeling cared for, purpose, fairness, belonging, and having value (most of which are determined by social context and culture).

We are now starting to see how the Three Motivation System model and naturalising sensemaking can help us shape our organisational recovery plans, by identifying the working conditions that will promote the most positive and adaptive means for our workforce to start to recover from the unprecedented biopsychosocial demand of the past two years and navigate the challenges to come.

For leaders in performance sport, knowing the system(s) which you are operating within at a given time and the psychological frameworks underpinning and governing the organisation and the people that operate within it, you can begin to apply the right nudges to people, processes and behaviours to accelerate performance through innovation at an individual, team, organisational and system-wide level to create the right conditions for the emergence of the outcomes we believe are favourable.

Table 1 describes some of the innovations we within the Aneurin Bevan University Health Board have begun since the pandemic hit using these frameworks.

Table 1. Innovations, target problems and progress so far for the Aneurin Bevan University Health Board.

Summary

In summary, both complex adaptive systems and the Three Motivation System model provide an evidence-based theoretical frameworks that might allow an NHS organisation and performance sport, it’s people and networks to thrive. At Aneurin Bevan University Health Board, we are pushing the boundaries in these areas unlike any other NHS organisation. In the context of the NHS, and perhaps some elite sports functions, we also must hold in mind the magnitude of the ambition; to help an organisation recover in the least maladaptive way following a period of unprecedented chronic crises, especially since the situation was already fragile before March 2020.

In many ways, what we are endeavouring to do is radical but is borne out of a realisation that change is vital for sustainability, possibly even survival. It is perhaps apt that we are drawing upon a psychological model from evolutionary psychology literature and models of sensemaking from the natural sciences. We need to evolve to survive and to do so will require a degree of transformational thinking, while also being fully aware that the delivery of essential services cannot at any time stop.

We ask this question to leaders across sport: how much of what you do is the same now as 1, 5 or 10+ years ago? How may you be able to use the models suggested here to at least review and think about what’s possible? This may be radical change, or subtle shifts to the adjacent possible; what is the current state and the most plausible next step to take for change. To what extent is doing what you always have done self-perpetuating and missing significant emergence of factors which could be game changing for you and your athletes?

Our intension is clear, there is no fixed pre-determined or prescribed destination or goal, rather a well thought out direction of travel to allow us to discover new and emergent things along the way. This approach makes most NHS veteran managers, high performance coaches and directors deeply uncomfortable and may well trigger their drive and / or threat responses. We are however certain that the transformation we seek cannot be achieved by a linear task and finish approach alone with rigid constraints, to do so would risk missing vital context and emergent opportunities to learn and simply be a re-enacting of past maladaptive patterns which only service to meet short term and emotionally driven motivations, i.e.: to allow us to feel less anxiety for a short time.

In our third and final edition of this three-part series, we explore what’s next for healthcare as we begin to emerge out of this crisis, what scares has been left behind as an organisation and on its people and finally the parallels between recovery in healthcare and performance sport.

Dr Brown is Director of Organisational Development (OD) at the Aneurin Bevan University Health Board (ABUHB) in South Wales and spent 10 years as the Head of Performance Knowledge at the English Institute of Sport.

Dr Neal is a Consultant Clinical Psychologist and Head of Wellbeing at the ABUHB and has researched and published widely across organisational health and wellbeing.

[1] Turner et al. Systems, 2022

By John Portch

Though sport is full of technically accomplished practitioners, the industry, from a performance standpoint, has been relatively poor at developing the leadership skills of its people.

The Leaders Performance Institute sat down with Jon Bartlett, the Elite Basketball Performance & Program Operations Advisor at the NBA, to discuss this enduring trend. “Formal training and degree programmes are all technical in content, it’s all about delivery and performance – there is little content related to leadership development,” he says, in the second part of our interview.

While these may be difficult to change, Bartlett believes that sporting organisations can promote leadership development through better people development and management, a theme he also touched upon in the first part of our interview.

“People management does not always have an emphasis on people learning within their current role,” he continues. “If you shape this in the right way, with the right processes, you can learn and develop in specific areas every day, not just thinking ‘I need to do a course, conference, seminar or webinar to learn – I can learn every single day if I have the right process set up for reflection, review and evaluation.’”

He cites the popular ‘70:20:10’ model, which suggests that 70 percent of learning is done from experience, experiment and reflection; 20 percent is learning from working with others; and 10 percent is learning from formal interventions and planned learning solutions. “Most focus on the 10 percent and organisations support the 10s and the 20s, but how many processes are set up effectively to support the 70 percent?”

Bartlett argues that sport can be better at career planning for staff, including succession planning for departments. “If you’re employed in a role, it’s a given that your time and effort goes into maximising results within your role,” he says, “but how can you impact and influence further without authority and status?

“If you think of it as impact and influence without having the role of ‘leader’, now you’re working on things such as giving direction, accountability, how to support, being empathetic, being a good listener, how to build trust, how to solve problems. Eventually, when you move into a leadership position, all those skills and traits are well developed. You know exactly the different themes and bits and pieces you need to manage people and processes effectively.

“It is a surprise to me that succession planning in sport is not catered for more, especially when change is inevitable. You know there’s going to be change and you can probably guess which roles will change and turnover when things don’t go right.

“If certain staff members demonstrate some leadership traits, you can put these staff members on a career and learning development plan. When the opportunity arises, they’ll be in a great position to step into a leadership role versus those that have no training and have to learn on the job. I think that learning on the job is where other industries are different because they do have development plans for people who say ‘I want to go and spend time in this area or that area.’”

Bartlett readily admits that the concept of self-development, learning and leadership is a passion of his. “This is a piece missing in sport,” he says. “Is there a shared understanding within your organisation of what learning and development is? It sounds like a simple question but it’s actually quite complex when you break it down. The initial thing to recognise is that it’s a shared responsibility between the organisation and the individual staff member. It’s not just the responsibility of the staff member or the responsibility of the organisation. We are responsible for engaging in our own development, but organisations have to take responsibility for investing time and resource into their staff.”

That investment can be budget related and it can also be embedded into performance reviews and management. “Organisations can consistently provide opportunities, tailored towards each staff member, and you can visit progress on a frequent cadence. It could be monthly, quarterly or biannually. Often, performance reviews in sport are done on an annual basis. Now, if you’re just going annually, and you’re on a three-year contract, you basically only have two touchpoints on your development. Some contracts only operate on a 12-month cycle. So how can an organisation focused on the development of their people make it more tangible? Bake the whole process into your system on a daily basis. For example, something as simple as after-action reviews. They have a massive part to play in learning and development. They can be as simple as: ‘what were the intended outcomes? What actually happened? What’s the gap between those two? And how can we bridge that?’ You might have one or two outcomes. We’ve learnt what worked well, we learnt what didn’t, and so we can apply those outcomes next time. We know from adult learning pedagogy that learning takes place through reflection and making meaning of experiences, whether that’s individual or shared. The final hurdle is achieving a critical mass of people who are bought into that process of driving the learning and culture of ‘I want to learn more. How can we have done this better next time?’

“Quite a lot of organisations have someone employed in a people and culture role. However, they’re often more involved in recruitment and HR of the wider organisation, therefore sitting outside the sporting department/front office. And so how can there be alignment throughout the organisation of the philosophies, the ideas that come from a people, and a shared understanding of culture? And how can you have champions within each department within a sporting organisation that drive this daily?

“It’s no good if it just comes from one person and you’ve got 250 people in your organisation because it’s difficult for them to align all the different verticals. Leaders have got to promote this mindset of curiosity and asking questions without feeling threatened because what we want to do is learn together.”

“All in all, that cycle of where we first started, looking at people, process and people management. We circle back and it all starts with that focus on vision, strategy, plan, skills, experiences, mindset; you set up those processes from a leadership point of view and then over time they shape the culture and how things are done thus feeding themselves over and over.”

Dr Peter Brown and Dr Adrian Neal

When you strip it all back, all the politics, the labels, uniforms and statistics, healthcare has many parallels to performance sport.

Within healthcare we have multidisciplinary (MDT) teams working together, problem solving quickly and using various interventions in order to maximise the probability of positive patient outcomes. In sport, we have MDTs working together to problem solve performance and use a variety of interventions in order to maximise the probability of achieving optimal performance in the moments that matter.

However, there is one significant difference between the two: the gift of the performance plan and periodisation within elite sport. Regardless of the sport and the level of competition, following any major event such as a World Cup, a world championship or the Olympic and Paralympic Games, there is always a full stop, a closing parentheses of the performance plan, a break to rest, recover, decompress biologically, socially and psychologically.

In healthcare, however, the stark difference is that there is no end, no rest, no full stop and no decompression or recovery. There may well be a period of rest and recovery for the patient but not the clinical support staff. Another significant difference is the variability and visibility around agreed objectives within healthcare; there is rarely a shared line of sight within an objective across an organisation. Objectives can change rapidly leaving little time to recalibrate an MDTs team’s shared sense of purpose or expectation of their work. What’s more, there is rarely a performance plan which factors in milestone events to support performance beyond KPIs. Instead despite delivering world class care to patients daily, the pressure only builds, the demands increase; the treadmill gets faster and the gradient steeper.

The past two years or so, since Covid officially struck within the UK, have exacerbated these ‘normal’ pressures and context. Accordingly, this three-part series of articles aims to provide:

1. A guided tour of the experience of the pandemic for individuals, teams and organisations delivering healthcare within the NHS at the Aneurin Bevan University Health Board (ABUHB) with a provocative comparison to performance sport.

2. The interdisciplinary innovative response from this health board to overcome some of this context so that we ensure performance of our healthcare staff.

3. What the future holds for the NHS in Wales and importantly the principles at play which performance sport can learn from within our novel approach to optimising performance of our healthcare workers.

The reality of burnout in healthcare provision

The Aneurin Bevan University Health Board (ABUHB) employs ~15,000 people and is the largest employer in the south east Wales county of Gwent. Approximately two thirds of these staff are patient facing, with ~600+ consultants, over 1,000 hospital and general practice doctors, 6,000 nurses, midwives, allied health professionals, health care scientists, community workers, and estates and facilities workers. All of this functions within a range of primary care provisions, five enhanced local general hospitals and a new acute care hospital. The past two years have been unprecedented within the Health Board, with the entire service provision turned on its head in 24 hours, with mass redeployment of staff to critical administration, control, coordination roles and deployment to mass vaccination clinical hubs across the county of Gwent.

The reliability of our understanding of the impact of the pandemic on the NHS workforce is rapidly improving. Initially during the first wave (March to June 2020) there was an emphasis on predicting a major mental health crisis especially around PTSD. Data from meta analyses is now rewriting this prediction even though rates of reported anxiety and depression in the workforce have risen. What has become apparent is that the impact is more diffuse and less overtly clinical in nature. Disengagement and burnout is now more of a reality and potentially a threat to performance in the NHS than diagnostic levels of mental illness, though distress is commonplace.

Burnout is categorised by the World Health Organization as a syndrome resulting from chronic workplace stress that has not been successfully managed. It is identified as having three dimensions: feelings of energy depletion or exhaustion, increased mental distance from one’s job (or feelings of negativism or cynicism related to one’s job) and reduced professional efficacy. Burnout has been linked to workplace performance since it was coined in the 1970s, however is not a new phenomenon in the NHS with pre-pandemic rates within Critical Care estimated to be as high as 20 per cent.

Measuring psychological wellbeing

Within ABUHB one attempt to measure broad psychological wellbeing has been monitored via a survey carried out five times since April 2020 and has now had over 15,000 individual responses. The survey asks about coping, fatigue, as well as factors considered foundational to psychological workplace wellbeing including one’s sense of fairness, control, effectiveness, belonging and others. Early in the pandemic the survey observed a pattern which suggested a third of the workforce were doing well, a third OK, and the remaining were struggling across all domains. Then, surveys conducted 21 months into the pandemic (July and November 2021) suggest this pattern has progressively worsened. Put simply, we are seeing data to suggest that at least half of our workforce are experiencing psychological difficulties and are also relating to their work and peer groups differently. Many report feeling the work they loved has changed, that they feel like they no longer make a difference, are demotivated as a result and, importantly, that they do not feel connected to or a part of the wider organisation.

This data and lived experience represents a major threat to the organisation given NHS services often rely excessively on a workforce with high intrinsic motivation, willing to offer extra discretionary effort to function let alone high performance, or any performance unremittingly.

Comparing performance measures in healthcare and sport

From a human factor perspective, the pandemic inevitably has and will continue to have an impact on NHS performance on an individual, team and organisational level, however an artifact of how performance is commonly framed in the NHS may make it even more challenging and requires closer examination especially when you juxtapose to elite sport.

When it comes to the performance and performance outcomes of performance support staff and athletes, elite sport have excelled in contrast with healthcare. Within sport there is normally a clear alignment between performance outcomes and capability of the athlete(s) and / or the service provision provided by the performance support team due to the investment and robustness of the performance plan and multidisciplinary dissection of performance through a performance backwards approach. In healthcare, it’s a little less clear with a lack of agreed and shared objectives across organisations and teams.

Table 1 below provides an example of the comparison of definitions and measurements of performance between healthcare and elite sport.

Table 1. Comparison of performance measures in healthcare and sport.

Within healthcare, there is the obsession with key performance indicators (KPIs) which, in turn, are politicised performance targets rather than outcome focused measures of success. Performance management in healthcare is failing to measure performance and succeeding in gaming the data to achieve a given (sometimes malevolent) purpose.

Within all aspects of health and social care, we currently have a perfect storm. Rising waiting lists, greater than ever patient acuity, Covid restrictions, mass redeployment of staff from all corners of the organisation to support vaccination centers, rising staff absence, hundreds of patients clinically ready to be discharged to community but without the necessary support to leave the hospital and the numbers waiting for referrals, diagnostic tests, therapies and treatments on the rise.

The Welsh government have provided several hundred million pounds of additional funding across Wales to support the recovery from the pandemic, but the pandemic continues with wave after wave of mutated variant which doesn’t align to financial years. At 8pm every Thursday throughout the lockdown of wave one of the pandemic in the UK, the general public stood on their door steps and applauded the NHS workers and the windows of family homes were smudged with the finger prints of children who proudly displayed their paintings of rainbows to support the NHS and key workers. It feels like those days are gone. We now face increasingly high expectations from the public and government alike.

But it’s not all doom and gloom and our next instalment of this series describes how through a close collaboration of Organisational Development and Organisational Wellbeing / Clinical Psychology at the ABUHB, we are truly embracing the complexity of the situation we find ourselves in to address the key performance issues affecting our workforce. At least for us on the ground, moving away from arbitrary performance outcomes, numbers and dashboards to truly defining and understanding where we are today individually as teams and as an origination, the counterfactuals of our situation, and the adjacent possible to move towards a better future.

Dr Brown is Director of Organisational Development (OD) at the Aneurin Bevan University Health Board (ABUHB) in South Wales and spent 10 years as the Head of Performance Knowledge at the English Institute of Sport.

Dr Neal is a Consultant Clinical Psychologist and Head of Wellbeing at the ABUHB and has researched and published widely across organisational health and wellbeing.

1] Aneurin Bevan University Health Board; see abuhb.nhs.wales

[2] UK Sport; see uksport.gov.uk

[3] Performance to Paris: GB Boxing Strategy 2021 to 2025; see gbboxing.org.uk

[4] Olympic medal target for the Tokyo Games