As a leader in a healthcare organization, how often are you interrupted by situations that shouldn’t be on your radar, simply because a key leader or team member wasn’t aligned? Even with your thoughtful plans and clear metrics, you likely still periodically find yourself intervening and redirecting efforts.
In my career working with executive teams, I’ve seen countless examples of misalignment, from open hostility between executives to internal silos. For instance, I observed a Chief Medical Officer who was a genius and whose team consistently succeeded due to his support. In contrast, a COO on the same executive team consistently undermined his peers, creating an environment where success was only possible within his direct team, cutting off resources and productive partnerships for others.
After nearly 40 years of working with executive teams, I believe the single most essential skill in the workplace today is the ability to negotiate expectations with colleagues at all levels. Mastering this skill proactively sets up your direct team, your peers, and even your Board Members for greater success with significantly less effort. This is the key to becoming a strategic leader who is proactive and predictable.
Here are the steps I recommend you follow. The first step is to be thoroughly prepared. Before a meeting, go offline and conduct an honest self-assessment:
- Mindset: Are you in the right frame of mind?
- Belief in the Individual: Do you genuinely believe this person (direct report, peer, or Board Member) can be an “A” Player in this or another role? Your belief directly impacts their ability to step up.
- Self-Accountability: What role did you play in the current situation? Did you create or allow the lack of success to fester by failing to provide clear expectations or metrics?
- Clarity: Can you articulate expectations clearly, concisely, and fully? Can you define success in terms of roles, goals, and metrics?
- Value (If Confidence is Lost): If you have lost confidence, ask yourself: Where is this person currently adding value, and how might you acknowledge their contributions?
Step 2: Provide Critical Context
Context is vital for gaining buy-in and ensuring understanding. Be prepared to explain:
- Importance: Why is this role or goal important?
- Strategic Fit: How does this expectation align with the strategic plan and the team’s current objectives?
- Process Frame: Frame the discussion as a collaborative, multi-step process of negotiating expectations.
Step 3: Clarify Expectations and Objectives with Ownership
Schedule a time to meet and start by taking responsibility for the current situation. For example, say: “I’m sorry, [Colleague’s Name], you haven’t been as successful in your role as we both hoped. Looking back, I should have spent more time mapping out the right success metrics when you started or were promoted. I take full responsibility for these missteps. I want to do whatever it takes to turn this around and position you and your team for much greater success next quarter. Can we meet tomorrow at 2:00 to develop a new plan of action together?”
This approach is powerful. It removes blame and shame, allowing your colleague to feel safe and breathe a sigh of relief. This safety is critical, as historical events like the NASA crashes show: often, someone knew a plan should be aborted but did not feel safe to speak up. In healthcare, the stakes are equally high—patient lives depend on safe performance.
In the meeting, focus on recalibrating the project or role (using your knowledge of SMART goals to set clear expectations and timeframes). Share with your colleague:
- What is currently working?
- What could be improved?
- When addressing significant challenges, use direct but non-judgmental language, such as: “This does not work for me. What would work for me is…”
Ongoing Consistency and Follow-up
- Follow-up is Key: A few hours after the meeting, circle back to your colleague. You must remain consistently engaged over the next days and weeks to ensure full buy-in and to accurately assess their performance, maturity, and growth potential.
- Address All Concerns: Consistency is critical. Address even small concerns immediately. Do not rationalize or justify any error, delay, or sign of misalignment. Failing to address issues as they arise trains people to believe inadequate performance is acceptable, which ultimately robs them of career opportunities and creates a no-win environment for everyone.
Creating a Safe Space: Essential Language
To foster a safe environment where everyone feels comfortable speaking authentically and achieving alignment, use the following phrases:
- “This doesn’t work for me. What would work for me is…”
- “What would it take for you to be able to…?”
- “Context is the bowl you use to carry your message.” Ensure people understand the ‘why’—the strategic context—for a project or role. When they comprehend how their work fits into the big picture, they give 250% commitment. Without it, you get about 50%.
Questions for Re-alignment:
- “My recollection is different. Help me recall…”
- “I’m confused. Help me understand this.”
- “Tell me what that means for you.”
- “Say more about that…”
- “We need this level of performance so that…” (Use so that to provide context)
Ask questions and keep going deeper without providing the solutions yourself. This common language and experimental approach, applied consistently, is the foundation for building strong team alignment.
Katharine Halpin left her CPA career to fill a gap she saw every day. Leaders were focused primarily on the financial and legal aspects of corporate growth, but not on the key driver of growth, their people. She has worked with healthcare leaders for over 25 years to build work environments where everyone feels safe to step up and speak up. This ignites inclusion and innovation