There are lots of ways we affect each other as we do our work. If you’re my team member I can make your tasks harder or easier depending on many things: the timeliness and accuracy of my communication; the sequence in which I deliver parts to you; or how I format a report, to name just a few examples.

Here’s another big one: what I say to patients or customers just before they see you. I can help them understand what you’ll be doing, or I can create unrealistic expectations that you’ll then have to deal with.

The performance of my team depends on how well our members are mindful of the rest of the team’s needs and roles, and how we can affect each other’s ability deliver our best. That’s interdependence.

Measuring interdependence

In a previous blog I described the Relational Coordination Survey, a useful and practical measure of a team’s ability to manage its interdependence. It gives team members a chance to rate each other on key factors that support interdependence:

• The frequency, timeliness, accuracy and problem solving (vs. blaming) nature of communication.
• The degree to which they have shared goals.
• How well they understand each other’s work.
• How much they respect each other.

The team’s overall score on the survey correlates highly with every dimension of performance: quality, cost, efficiency, safety, customer satisfaction, staff resilience, you name it.

Stuck in a dilemma

As I’ve used this survey with more and more teams, I’ve been learning that the biggest barrier to managing interdependence—and therefore to high performance—is our lack of understanding of each other’s work and of the impact we have on each other. As a result, we are constantly making each other’s work harder, in big ways and small, resulting in waste, error and frustration.

We don’t mean to do this; it’s more a matter of being stuck in a dilemma. On the one hand, the only way we can know how we are affecting each other’s work is to tell each other, to give each other feedback. How else could I know what report format or what sequence of parts would be most helpful to you?

On the other hand, it’s really hard to initiate these conversations. Unless you’re my boss, you may think it’s not your place to tell me how to do my work or worry that I might resent your unsolicited comments. So you don’t say anything. I continue to do my work unaware of what you need and you get increasingly frustrated with me for doing things that make your work harder. It’s a vicious cycle.

Breaking out

One of the best ways I’ve found to break out of this cycle is to help teams learn to have “conversations of interdependence.” To kick this off, I invite team members to take turns interviewing each other in one-to-one conversations using such questions as

• What are your deliverables?
• What do you find most meaningful about your work?
• What is it about how I do my work that helps you do yours?
• What could I do differently that would help you even more?
• When does our work seem to be well-aligned and when do we seem to be at cross purposes?

It never fails. People are astonished to realize how much they didn’t know about each other’s work, happy to have a new and broader understanding of the overall work process, and even happier to now have a way to talk with each other about things they couldn’t talk about before.

When teams make conversations of interdependence a regular part of their work routine, everyone gains a richer systems perspective, understanding how their own work fits into the larger whole. They also become more engaged and more self-managing, better able to improve work processes on their own.

Quality, efficiency and satisfaction grow.

Managing interdependence—learning to have regular, constructive conversations about how we are impacting each other’s work—is the secret ingredient for peak team performance.

Thanks to Jody Hoffer Gittell, Diane Rawlins and Terry McArdle for their help with the development and/or presentation of these ideas.

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Anthony L. Suchman, MD, MA, FACP is Senior Consultant, Healthcare Consultancy at the McArdle Ramerman Center. He is a practicing physician, health services researcher, and Clinical Professor of Medicine at the University of Rochester.

Tony’s work focuses on partnership process across all levels of healthcare. He works with clinicians, administrators, patient advocates and board members in health care organizations worldwide to advance the practice of Relationship-Centered Care. He can be reached via our contact page or by calling him at (585) 325-1210 x 302.

For more information about Tony, please click here.