Effective meetings: Building alignment, accountability and trust in your practice

Meetings may take a toll on the daily work schedules of healthcare leaders, especially when the time commitment extends beyond the actual meeting.

Beyond the meeting itself, the time commitment includes deciding when to schedule the meeting, inviting the right people to the meeting, setting an agenda, following the agenda and ending it — on time, ideally — with everyone in the room aware of their responsibilities and next steps.

A May 29 MGMA Stat poll found that 39% of practice leaders say they spend zero to five hours in meetings each week, while 40% report spending six to 15 hours. On the other hand, 14% say they spend 16 to 25 hours in meetings a week and 7% say they spend more than 25 hours a week in meetings.

The amount of time you spend in meetings is just as important as their effectiveness. When asked if their meetings were productive and effective, MGMA Stat poll users offered a variety of opinions:

• “Absolutely! We openly discuss how to make improvements in our office and things we should watch out for and follow up on. We have agendas and take minutes including action plans and who is responsible.”
• “Meetings are productive. Many of my meetings are via Skype and I find those to be very productive. They save travel time and I find people are less chatty.”
• “It just depends. Sometimes it is the only effective way to get stakeholders together. Other times you are added to a meeting merely because of your role, title or department and aren’t really needed. I would say it’s 50/50.”
• “I do not always feel productive during meetings, especially when decisions to do something or to move one way or the other are not made.”
• “No, meetings are a terrible waste of precious time and resources. The more administrators, the more meetings, the more cost, the less productivity.”

When assessing the meetings you organize or attend in your practice, always begin by asking, “why?” In many cases, meetings are scheduled because they’ve always been part of the workflow, so they are not questioned. Imagine if you took that approach to any other part of your business.

Daniel Stover, senior leadership consultant with Integrated Leadership Systems LLC, Los Angeles, said in a recent MGMA webinar that organizations spend a lot of money on meetings that may not be productive because attendees aren’t engaged or aren’t sure why they have been invited.

Start by assessing the cost of each meeting. Consider using the Harvard Business Review meeting cost app, which estimates the true cost of meetings based on their length, number of attendees and those attendees’ salaries. For example: A 15-minute meeting of six employees who average $40,000 in annual salary has a cost of about $42.

Chances are, you have many meetings, not all of which are quick huddles, that include higher-earning members of the practice. The amount those meetings cost in salary alone may be considered even costlier if they do not result in either increased revenue generation or savings.

But before you focus too much on an estimated spend, consider how your team members view meetings. As Stover said, meetings should create alignment, accountability and trust throughout the organization — without those components, rapport is difficult to build, silos can arise between individuals and teams may head in different directions that do not serve the organization.

A good way to open each meeting is with an agenda that includes a mission statement or other method of conveying the importance of the meeting. Annual studies of workplaces by Gallup show that about half of workers do not know their organization’s goals. Stover outlined four reasons to hold a meeting:

• To organize a group for the launch of a new project, product or service
• To provide information to help teams make informed decisions as they work on shared goals
• To quickly and appropriately share complex or emotionally charged information to manage reactions and mitigate the office rumor mill
• To offer a forum for participants to provide ongoing feedback regarding strategy and goals

Regardless of the meeting’s purpose, there are three pillars of a productive meeting:

1. Structure: This includes sending a clear agenda before the meeting, as well as establishing ground rules for discussion.
2. Facilitation: Guiding discussion will keep the meeting on track, so a leader should know when to allow discussion and when to move on.
3. Accountability: Designate a note-taker to record the discussion, decisions, commitments and deadlines that will be shared after the meeting.

Adhering to these pillars will help minimize factors that can make a meeting unproductive, such as lack of organization or side conversations. Meeting organizers and practice leaders can also develop rules about tardiness and engagement to mitigate the impact of late arrivals or attendees who spend time on their phone or other devices when they should be focused on the discussion.

As the facilitator of a meeting, you are:

• Responsible for the process and how the meeting goes, not necessarily the content
• Responsible for creating the structure for ideas and planning for your team members
• Responsible for confronting disruptive behavior in an emotionally intelligent manner, with a gentle but firm approach

Facilitator positive self-talk makes a meeting more effective. If you are confident about the value you bring to a meeting and provide a safe and supportive environment, then others will feel more empowered to speak up and the meeting will be more impactful. This encourages engagement and reduces what author Patrick Lencioni calls “sneaker time” — the hours we spend after a meeting on emails, voicemails and walking down the hall to clarify issues or decisions that should have been clear and confirmed at the meeting.1

Effective facilitators tend to:

• Lead with questions rather than answers
• Steer communication away from coercion, blame or attacks
• Steer communication toward healthy debate, conflict resolution and commitment

If you create the right structure and environment, your meeting will run itself. Your job is then to listen, redirect tangents and personal discussion, call for consensus and ask for commitments before the next meeting.

Stover also recommends considering the size of your meeting. A group of 25 attendees or fewer can be facilitated by one person. Beyond 25, you need a second facilitator to keep people engaged. The more attendees, the more potential disruptions, so you need help addressing your ground rules.

As Stover mentioned, “we teach people how to treat us,” so setting expectations on how we want to do business is important. Practice leaders need to walk the talk on this issue to boost meeting productivity and limit wasted time regardless of how much time is spent in meetings each week.   

Integrated Leadership Systems (ILS) group meeting ground rules

1. Please challenge the behavior, not the person.
2. If you have a criticism, please offer a solution.
3. Listen to criticism via active listening and try not to get defensive.
4. Please do not interrupt each other except to ask questions.
5. No person should speak more than five minutes without getting feedback from the other person(s).
6. Reiterate what the first person has said to demonstrate you understand.
7. At the end we will try to come to some agreement as to how to proceed from here.
8. Please let your facilitator run this meeting.

Note:

1. Lencioni P. Death by meeting: A leadership fable … about solving the most painful problem in business. San Francisco: Jossey-Bass, 2004.

Additional resources

• “The three reasons to hold a meeting” (Wharton Magazine)
• “How to run a meeting” (Harvard Business Review)