Building Alignment to Support Initiatives

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

51921152 - alignment word on keyboard button — 51921152 – alignment word on keyboard button

I recently spoke with a nurse leader colleague who told me that she was having challenges in building alignment on her own team related to structural changes that her organization was pursuing. She told me that she understood the anguish being experienced by both leaders and staff because it involved a change in patient populations on several units. The changes were needed to confront the challenges the organization faced with value-based reimbursement and a reduction in revenue. Her problem is not unusual. When you think about the key leadership responsibilities of establishing a vision, building alignment and then executing the plan – building alignment is the people-centric because it needs to happen at both a rational and emotional level. Yet we know that without alignment, initiatives have a high rate of failure.

Straw, Scullard, Kukkonen and Davis identify three component parts of building alignment in their book The Work of Leaders. These include:

Clarity – Leaders strive to be clear in their communication but often send mixed messages in explaining the rationale for change with communication that is not well structured. It is easy to forget how little context staff may have when they receive these messages. I often ask staff nurses that I speak to – what does value-based purchasing mean? They usually can’t answer the question and know little about the financial drivers behind organizational decisions that may seem perfectly rationale to leaders but appear arbitrary to their followers. There has never been a time where clarification has been more needed than today. Starting with the clear WHY can help to explain the change, avoid uncertainty and reduce the chaos that staff may feel. The authors suggest that leaders need to work hard to be straightforward and transparent. Begin by considering the issue from the viewpoint of staff and monitor their reactions. Messaging really matters so develop brief, crisp talking points and repeat them consistently over time.

Dialogue – It is not unusual for leaders to conduct town halls or staff meetings to deliver messages during which there is no real dialogue. Conducting an effective dialogue involves a willingness to exchange perspectives and being receptive to what is said. This is best done in an open and relaxed atmosphere where the leader practices reflective listening. You should want to hear honest feedback although it might not change anything in the plan. Employee satisfaction research indicates that the highest correlation with job satisfaction is a chance to have one’s opinions heard.

Inspiration – Inspiration is an important part of creating buy-in. For my nurse leader colleague, a key message to her team is how much they are valued and contribute to the organization’s success. Talking points that speak to the heart matter when the change is perceived as disruptive to the work of the organization.

Alignment is a key part of gaining long-term buy for almost any initiative. If you simply pressure people to change and skip this step, you may win the battle but lose the war.

Read to Lead

Straw, J., Scullard, M., Kukkonen, S. & Davis, B. (2013). The Work of Leaders: How Vision, Alignment and Executive will Change the Way You Lead. San Francisco: Wiley Publishers.