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<<addclass ".hideonstart" "hider">><<addclass "#passages" "startpass txtcover">><<nobr>> <div class="logodiv"><img src="images/SLlogo.png" alt="SimuLEADerShip logotype."></div><div class="devby fadein"><div class="authors">Matlow, A., Dickson, G., Van Aerde, J., DesRosier, K., Barton, G., McCarragher, K., Furstenburg, D., LeBlanc, C., Vogel, M., Rochefort, C. & Brien, S.</div> <div class="credits">Developed by the Royal College of Physicians and Surgeons of Canada and the Canadian Society of Physician Leaders in collaboration with LEADS Global</div> <div id="startopts"><<button "START">> <<script>> Fullscreen.request(); jQuery("#ui-dialog-body").addClass("dialog-marginfix"); Dialog.setup("SimuLEADerShip Profile Setup", "modal"); Dialog.wiki(Story.get("Signup").processText()); Dialog.open(); <</script>><</button>><<button "RESUME...">><<script>> jQuery("#ui-dialog-body").removeClass("dialog-marginfix"); jQuery(document.createElement('input')).prop('type', 'file').on('change', function (ev) { Save.import(ev); jQuery(".hideonstart").removeClass("hider"); jQuery("#passages").removeClass("startpass"); }).trigger('click'); <</script>> <</button>></div><div class="reversebutt"><<button "ABOUT">> <<script>> jQuery("#ui-dialog-body").removeClass("dialog-marginfix"); Dialog.setup("About", "modal"); Dialog.wiki(Story.get("About").processText()); Dialog.open(); <</script>> <</button>></div> <div class="mocinfo"><small><a href="https://cpd.royalcollege.ca/product?catalog=LEADS-EN">Continuing Medical Education Maintenance of Certification Information.</a></small></div></div> <<set $stage to 1, $progress to 1, $tutorial to true>><<masteraudio volume 0.70>> <</nobr>>
<<removeclass ".hideonstart" "hider">><<removeclass "#passages" "startpass">><<removeclass "#ui-dialog-body" "dialog-marginfix">><<script>>if (Dialog.isOpen()) { Dialog.close(); } setup.send_analytics("level_start","Level 1");<</script>><<audio "city" play>> @@.txtcentre; !!The Opportunity @@ It's <<print setup.year>> and guess what? Society and the environment haven’t collapsed, humankind isn’t at the cusp of extinction and we live in a time of equity, harmony and sustainable growth. The world truly is a magical place. Our story takes place at Pondview Hospital, where you have worked as a Neonatologist for the last 11 years. Even though society has advanced tremendously, there are still challenges in your facility. Challenges that require the strength of a leader and you, $sal $lname have always wanted to take on a formal leadership role. One day while on break you notice an internal job posting for an opening ... @@#choices;.choices; [[Continue...->Job Posting]] @@ <<script>>setup.send_analytics("level_start","Level 1"); document.title="SimuLEADerShip Level 1";<</script>> <<set $chap1access to 0; $stage to 1>> <<if $tutorial is true>><<timed 6s>><<script>>setup.runtour();<</script>><</timed>><<set $tutorial to false>><</if>> <<set $stage to 1, $progress to 1, $l1lock = false, $l1lockicon="fas fa-unlock", $l2lock = true, $l2lockicon="fas fa-lock", $l3lock= true, $l3lockicon="fas fa-lock", $l4lock= true, $l4lockicon="fas fa-lock", $l5lock= true, $l5lockicon="fas fa-lock">>
Later that day on you eat lunch silently wondering about what could have been. The opportunity may have pushed you to develop your personal leadership skills and you’ve been thinking about that for a long time! However, for this story its... <<include "Game Over">> @@#choices;.choices; <<nobr>> <<back [[Try Again|Introduction]]>> <<link "Debrief">> <<script>> Dialog.setup("Debrief", "modal"); Dialog.wiki(Story.get("Performance Feedback").processText()); Dialog.open(); <</script>> <</link>> <</nobr>> @@ <<script>>setup.logger("fb1");<</script>> <<timed 2.5s>><<script>>setup.logger("fb2");<</script>><</timed>> <<timed 5s>><<script>>setup.logger("fb41");<</script>><</timed>>
Pondview is a pretty large hospital and there are a quite a few people you think might be able to help you. The posting mentioned urgency and you aren't sure how to reach out to the people you need to in the most efficient way. You are part of the Pondview Facebook group and active on Twitter. You also have the phone number of several of the key people you might reach out to, so you could text. After thinking about it a bit you decide to... @@#choices;.choices; <<nobr>> [[Ask around in person.|Talk to Wilson]] [[Text anyone who may have more information.|Ask Text]] [[Use social media like the Kardashians.|Ask Social Media]] <</nobr>> @@
Back at home you talk to your droid <<link "Amulet 2031">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> to help with the application. Amulet seems a bit cantankerous today. "Alright.. what now? More MOC reporting…. Boring!" She says with irony. <img src="images/goforjob.png" alt="Amulet in living room looking exasperated."> You explain that you need help with a resume and cover letter for a position in the NICU. Amulet snaps to attention. "OK. Give me a second. I’ll whip something up. You are going to have to finish it though." After a few seconds a partially complete resume appears on your tablet. There are a few things to complete before you submit. @@#cover;.posting; !!$sal $fname $lname Apt 2345 - 3437 Neoxidale St. East, Pondview, Salli X7D FM34 Contact: 12-48390-S ---- <<set _cv_date = setup.curdate('-')>><<print _cv_date>> Hiring Manager Medical Director, Neonatal Intensive Care Unit Posting N823476 Pondview Health University Campus 294 Humanity Drive Pondview, Salli X38 908uND Dear Hiring Committee, It is with great humility that I submit my CV for consideration for the position of NICU director. While I've often been told by others that I would make a great leader or director, I typically take these comments with a grain of salt given my career is at an early stage. That being said, it's not often that a position that is so relevant and harmonized with my personal leadership aspirations presents itself so I don't want to miss this chance. My personal vision for the Director role at the Pondview NICU can be summed up with the following statement. <label for="textarea-mission">Enter your statement:</label> <<textarea "$mission" "" autofocus>> In addition during my clinical career I have accomplished several notable achievements directly related to the position including: * Leading the residency program through the CanMEDS 2028 update. * Acting as a key liaison in the implementation of the Vackers remote dialysis system. * Providing both formal and informal leadership to the Neonatal Transfusion Pairing Quality Improvement initiative. Please review the attached CV which further outlines my skills and abilities. Thank you for considering this application. I look forward to the opportunity to present my vision for the NICU to the search committee. Sincerely, <span class="signature">$fname $lname</span> Attachment $sal $lname, $fname CV @@ <div class="txtcentre"><<button "SUBMIT TO HIRING COMMITTEE">> <<script>> if (State.variables.mission !="") { Dialog.setup("Consent to Share", "modal"); Dialog.wiki(Story.get("Permissions").processText()); Dialog.open(); } else { Dialog.setup("Mission Required", "modal"); Dialog.wiki(Story.get("Mission Required").processText()); Dialog.open(); } <</script>> <</button>></div> <<set $progress to 5>><<script>>window.scrollTo(0,0);<</script>>
<<nobr>> <div id="ABT"><<button "ABOUT">><<script>> Dialog.setup("About", "modal"); Dialog.wiki(Story.get("About").processText()); Dialog.open(); <</script>><</button>></div><div id="prog-box" class="menu-panel"> <label for="progr_meter">PROGRESS</label> <progress id="progr_meter" @value=$progress max="100"> $progress% </progress> <button id="l1" class="link-internal macro-button lbutt" @aria-disabled=$l1lock><i @class=$l1lockicon></i> Level 1</button> <button id="l2" class="link-internal macro-button lbutt" @aria-disabled=$l2lock><i @class=$l2lockicon></i> Level 2</button> <button id="l3" class="link-internal macro-button lbutt" @aria-disabled=$l3lock><i @class=$l3lockicon></i> Level 3</button> <button id="l4" class="link-internal macro-button lbutt" @aria-disabled=$l4lock><i @class=$l4lockicon></i> Level 4</button> <button id="l5" class="link-internal macro-button lbutt" @aria-disabled=$l5lock><i @class=$l5lockicon></i> Level 5</button> </div><div id="capa" class="menu-panel"> <p>CURRENT CAPABILITIES</p> <div class="char-cap">LEAD SELF</div><div class="LScap char-capm"><meter @value=$LS min="0" max="16">$LS out of 16</meter></div><div class="char-cap">ENGAGE OTHERS</div><div class="EOcap char-capm"><meter @value=$EO min="0" max="16">$EO out of 16</meter></div><div class="char-cap">ACHIEVE RESULTS</div><div class="ARcap char-capm"><meter @value=$AR min="0" max="16">$AR out of 16</meter></div><<button "DEBRIEF">><<script>> Dialog.setup("Debrief", "modal"); Dialog.wiki(Story.get("Performance Feedback").processText()); Dialog.open(); <</script>> <</button>> <div id="blingpts"><span id="pts_span">TEST</span></div> </div> <</nobr>> <<script>> const l1butt = document.getElementsByClassName('lbutt'); Array.from(l1butt).forEach(function(element) { element.addEventListener('click', event => { Dialog.setup("Confirm Level Change", "modal"); Dialog.wiki(Story.get(element.id).processText()); Dialog.open(); }); }); <</script>>
@@#contacts;.fl; <<nobr>> <<if !visitedTags("Contact")>>You haven't met anyone yet but once you do your contact book will fill in.<<else>><<if visitedTags("amulet")>><div class="contact_card"><div class="cimage"><img src="images/amulet.png" alt="Amulet's profile picture."></div><div class="cprofile"><h2>Amulet 2031</h2><small>House duty droid - Kryotec Corp</small><p>You purchased Amulet 2013 right after getting your first full time placement after residency. At the time it was an expensive luxury and you were the envy of your friends. Amulet has been extremely useful with taking care of your needs around the house. That being said she is getting a bit crusty at times and newer models do exist.</p></div></div><</if>><<if visitedTags("rarmitrade")>><div class="contact_card"><div class="cimage"><img src="images/rarmitrade.png" alt="Dr. Armitrade's profile picture."></div><div class="cprofile"><h2>Dr. Robin Armitrade</h2> <small>Chief of Staff Pondview Hospital</small><p>Dr. Armitrade has worked at Pondview for many years. Her work in pediatric gastroenterology and intestinal transplant is well known throughout the Hospital and she has a reputation of being a nice person, but not necessarily someone who will rock the boat.</p></div></div><</if>> <<if visitedTags("vcaerde")>><div class="contact_card"><div class="cimage"><img src="images/vcaerde.png" alt="Van Caerde's profile picture."></div><div class="cprofile"><h2>Van Caerde 3745</h2> <small>Leadership Consultant - Genneroid Corp</small><p>Van Caerde was provided to you by the Pondview HR department to help with the hiring process and interview. He was purchased as a generalized consulting droid for hospital HR use and was further specialized to provide Leadership consulting.</p></div></div><</if>> <<if visitedTags("echan")>><div class="contact_card"><div class="cimage"><img src="images/echan.png" alt="Elaine Chan's profile picture."></div><div class="cprofile"><h2>Dr. Elaine Chan</h2><small>Staff Neonatologist, Chair NICU Quality Improvement Committee, Pondview Hospital</small><p>Your relationship with Elaine goes back several years and you admire her educational background. Oxford trained and holding an undergraduate degree in economics, she has a diverse set of skills and is an excellent clinician.</p> </div></div><</if>> <<if visitedTags("jlorimer")>><div class="contact_card"><div class="cimage"><img src="images/jlorimer.png" alt="Jerry Lorimer's profile picture."></div><div class="cprofile"><h2>Dr. Jerry Lorimer</h2> <small>Staff Neonatologist Pondview Hospital</small><p>Dr. Lorimer is a veteran neonatologist, on staff for 34 years. He is a bit ‘old school’ in nature and refuses to speak to or acknowledge androids. His professionalism has been questioned by peers, trainees and patient family members alike. He is valued as an experienced expert and relied on for difficult cases many times.</p></div></div><</if>> <<if visitedTags("jmoffat")>><div class="contact_card"><div class="cimage"><img src="images/jmoffat.png" alt="Josee Moffat's profile picture."></div><div class="cprofile"><h2>Josee, Moffat RN</h2><small>Pondview NICU Nurse Manager</small><p>Josee is the Nurse Manager in the NICU. She started as a staff nurse and is working on her MBA part time. Josee has been Nurse Manager at Pondview for 18 months and has a vast amount of experience from her 15+ years of nursing, having held various positions in the past.</p></div></div> <</if>> <<if visitedTags("pnadeau")>><div class="contact_card"><div class="cimage"><img src="images/pnadeau.png" alt="Pierre Nadeau's profile picture."></div><div class="cprofile"><h2>Pierre Nadeau PhD</h2><small>Manager Patient Experience, Salli Region</small><p>Pierre is a social worker by training and has worked on the pediatrics floor at Pondview previously. They have been the Manager Patient Experience for the Salli Region for the past 3 years working out of the Pondview Hospital where most family consultations take place.</p></div></div> <</if>> <<if visitedTags("fstcroix")>><div class="contact_card"><div class="cimage"><img src="images/fstcroix.png" alt="Francine's profile picture."></div><div class="cprofile"><h2>Francine St. Croix</h2><small>Director of Strategic Planning, Pondview Hospital</small><p>Francine is new to Pondview and leads a busy team of planners, business analysts and project managers who coordinate projects across many departments.</p></div></div> <</if>> <<if visitedTags("rwilson")>><div class="contact_card"><div class="cimage"><img src="images/rwilson.png" alt="Robert Wilson's profile picture."></div><div class="cprofile"><h2>Robert Wilson</h2><small>Staff Anesthesiologist, Pondview Hospital</small><p>Robert has been a friend since medical school. Both of your careers have followed similar trajectories although in different regions. A few years ago Robert joined the Pondview staff giving you the opportunity to reconnect and continue your friendship.</p></div></div> <</if>> <<if visitedTags("byeltzov")>><div class="contact_card"><div class="cimage"><img src="images/byeltzov.png" alt="Boris's profile picture."></div><div class="cprofile"><h2>Boris Yakmanov</h2><small>Director of Quality, Pondview Hospital</small><p>Borris has worked at Pondview for over 25 years in various administrative roles. His focus for the last 5 years has been in quality improvement initiatives at Pondview. Borris's team is a bit understaffed but recent budgeting changes have given Borris a new hope and his department is expanding.</p></div></div> <</if>> <<if visitedTags("zephyr")>><div class="contact_card"><div class="cimage"><img src="images/zephyr.png" alt="Zephyr's profile picture."></div><div class="cprofile"><h2>Zephyr 2642</h2><small>Integrity Monitoring Droid - Robotec HR</small><p>Zephyr was a recent purchase at Pondview to support the human resource integrity monitoring program. Zephyr features retinal pressure monitoring, networked android D2D communications and an integrated stereophonic sound system for those times when you just want to kick back with an HR droid and forget about integrity.</p></div></div> <</if>> <</if>> <</nobr>> @@ <<script>>setup.send_analytics("select_content","contacts");<</script>>
<<nobr>><div id="controller" class="menu-panel"><<button "FEEDBACK">><<script>> var commenturl = 'https://survey.alchemer-ca.com/s3/50128629/c60985e8016c?vrs=001EN&pn='+passage(); window.open(commenturl, "MsgWindow", "width=600,height=815"); <</script>><</button>><<button "SAVE/LOAD">><<run UI.saves()>><</button>> <<button "RESTART">><<run UI.restart()>><<script>>$("#restart-ok").click(function () { Save.autosave.delete(); });<</script>><</button>><span class="exit"><<button "END SIM">> <<script>> Dialog.setup("END SIMULATION", "modal"); Dialog.wiki(Story.get("EXIT").processText()); Dialog.open(); <</script>><</button>></span></div> <</nobr>>
<<script>>setup.updatefb();<</script>> <<set _arscore = setup.promaker(SugarCube.State.active.variables.AR), _lsscore = setup.promaker(SugarCube.State.active.variables.LS), _eoscore = setup.promaker(SugarCube.State.active.variables.EO), _lsreco = setup.recmaker(SugarCube.State.active.variables.LSSTART,SugarCube.State.active.variables.LS), _eoreco = setup.recmaker(SugarCube.State.active.variables.EOSTART,SugarCube.State.active.variables.EO), _arreco = setup.recmaker(SugarCube.State.active.variables.ARSTART,SugarCube.State.active.variables.AR)>> <div id="debrief" class="fl"><<nobr>> <h2>Personalized Feedback for $sal $fname $lname</h2> The SimuLEADerShip learning activity uses the first three domains in the LEADS in a Caring Environment framework for leadership development to structure your debrief. <h3>Domain Summary</h3> <div class="tg-wrap"><table class="ts"><thead><tr><th class="ts-1wig">Domain</th><th class="ts-1wig">Self Rating</th><th class="ts-1wig">Our Rating</th><th class="ts-1wig">Recommendation</th></tr></thead><tbody><tr><td class="str">Lead Self</td><<print $LSVERBSUM>> _lsscore _lsreco</tr><tr><td class="str">Engage Others</td><<print $EOVERBSUM>> _eoscore _eoreco</tr><tr><td class="str">Achieve Results</td><<print $ARVERBSUM>> _arscore _arreco</tr></tbody></table></div> <span id="summary"><<print setup.feedbacksummary>></span> <h3>Capability Detail</h3> <div id="capes" class="capabilities"> <div class="fbcaps"><h3>Lead Self (LS) <span id="LSprog"><meter @value=$LS min="0" max="16"></meter> $LS out of 16 possible points.</span></h3> <<print setup.LSfeed>></div> <div class="fbcaps"><h3>Engage Others (EO) <span id="EOprog"><meter @value=$EO min="0" max="16"></meter> $EO out of 16 possible points.</span></h3> <<print setup.EOfeed>></div> <div class="fbcaps"><h3>Achieve Results (AR) <span id="ARprog"><meter @value=$AR min="0" max="16"></meter> $AR out of 16 possible points.</span></h3> <<print setup.ARfeed>></div> <<print setup.feedbackrefs>> </div> <h3>Rationale</h3> During the initial setup, you were asked to rate your level of experience in relation to a series of questions. Each question is related to a domain and capability in the first three domains of the LEADS framework. We scored your responses ranging from 1 - 4 points (Beginner - Master) and then totaled your score in each domain as a baseline. As you participated in the simulation your choices either earn or subtract points in the three domains and associated capabilities, which are then used to make an estimate of your level of mastery in the domains as you move through the activity. While we realize that this rating system does not reflect real life, we hope that it will give you an idea of how the LEADS framework may help to guide your development as a leader and an indication of the LEADS domains and capabilities you may want to develop further using the guidance in the capability details to focus your future development efforts. <h3>Next Steps</h3> <<if $progress == 100>>At this point you have completed your SimuLEADerShip mission. We recommend that you end the simulation but you may also restart from the beginning. If you decide to restart you will lose your progress and this debrief will change unless you use the save feature.<<else>>At this point we recommend you continue your SimuLEADerShip journey but you may also elect to end the simulation at any time or restart. If you decide to restart you will lose your progress and this debrief will change unless you use the save feature.<</if>> <</nobr>> <div class="txtcentre noprint"><<nobr>><<button "PRINT">><<script>> setup.printDiv(); <</script>><</button>> <span class="exit"><<button "END SIM">><<script>> Dialog.setup("END SIMULATION", "modal"); Dialog.wiki(Story.get("EXIT").processText()); Dialog.open(); <</script>><</button>></span> <<button "CLOSE WINDOW">><<script>> Dialog.close(); <</script>><</button>><</nobr>></div> <<script>>setup.send_analytics("select_content","debrief");<</script>>
!!What is SimuLEADerShip? SimuLEADerShip is a serious game using interactive fiction that allows learners to take on a leadership position in a fictitious Hospital while using the LEADS in a Caring Environment Capabilities Framework as a guide. The game takes on the format of a story where your decisions gauge your capabilities in the first three domains of LEADS - Lead Self, Engage Others and Achieve Results. !!What is LEADS? The LEADS in a Caring Environment Capabilities Framework was initially developed in 2006 and has been revitalized on an ongoing basis. It has become the most widely adopted framework for leadership development in the Canadian healthcare context. As a distillation of and gateway to a vast array of methods and literature related to Leadership development, the domains and capabilities in the LEADS framework provide much-needed structure to the discipline of healthcare specific leadership. LEADS provides answers to questions physicians have as they begin or continue their leadership journey such as: *What is leadership and is it different from management? *How can I reach my potential as a leader? *How do we develop a collective vision?, and; *How do I make transformative change in the healthcare environment? Through its five domains, LEADS demystifies leadership and provides a roadmap for addressing its challenges. !!Do I need to know LEADS to enjoy this game? NO! The game provides a simulation of a typical leadership journey and uses the LEADS framework to inform many aspects of the game but you don’t need to know LEADS to enjoy it and learn something about leadership. That being said, as you engage with different leadership challenges you will want to apply leadership solutions and LEADS can help you make decisions to do so. Opportunities to learn more about leadership (i.e. LEADS), will present themselves as the game goes on. If you aren’t already familiar with LEADS there are many resources to expand your understanding, including: *[[By Physicians, for Physicians Leadership: The LEADS in a Caring Environment Capabilities Framework->https://rc-prescience-test.firebaseapp.com/SIMULEAD/leadsoverview-e.html]] *[[LEADS Global->https://www.leadsglobal.ca]] !!How does the game work? The overall goal of the game is to successfully navigate change at Pondview Hospital. Ideally, the choices you make are aligned with the principles of effective leadership embodied by the LEADS framework and act to increase or decrease your Lead Self (LS), Engage Others (EO) and Achieve Results (AR) capabilities. You can see how you are doing at any time by accessing the debrief panel, which keeps track of your choices and provides feedback about your leadership capabilities. Playing the game is intended to give a practical example of how the LEADS framework can be used to approach various leadership challenges. As a Royal College Section 3 simulation learning activity, it gives you some direct feedback on capabilities in the first 3 domains of LEADS while providing an opportunity for you to identify areas for improvement and plan for future learning about leadership. !!Who should play this game? The game was designed to appeal to any physician who seeks to learn more about leadership. Whether you are transitioning into practice from residency or have been practicing for many years we hope you find the challenges inspiring and realistic. You don’t need to be in a formal leadership position or even be considering taking on one in order to gain skills from the experience. While the game does try to reflect what it might be like to take on a leadership role in a Neonatal Intensive Care Unit at a community hospital, we consider most aspects of the story to be highly generalizable. We have made every effort possible to ensure the game is inclusive and can be enjoyed by physicians from any background. !!Development and Collaboration This game was developed by the Royal College of Physicians and Surgeons of Canada and the Canadian Society of Physician Leaders in collaboration with LEADS Global. <div class="txtcentre"><img class="logos" src="images/nascar.png" alt=""></div>The ideas, scenarios, advice and content presented in the game would not be possible without the gracious contributions of our esteemed authoring team. <div class="indent"><strong>Anne Matlow</strong> MD, FRCPC is a Professor in Medicine and Pediatrics and currently Faculty Lead, PG Leadership in the Temerty Faculty of Medicine at the University of Toronto. Her passion for leadership education stems from many leadership roles, most recently as founding member and past co-Chair of Sanokondu, the community of practice dedicated to fostering health professional leadership education worldwide. <strong>Graham Dickson</strong>, PhD , Professor Emeritus of Leadership Studies at Royal Roads University in British Columbia, and CEO of LEADS Global, is the recipient of the 2020 Distinguished Leadership Award from the Canadian College of Health Leaders. He is co-author with Bill Tholl (OC) of the LEADS book: Bringing Leadership to Life in Health and brings his knowledge and experience of health leadership to helping define the leadership challenges and developmental trajectory inherent in the SimuLEADerShip game. <strong>John Van Aerde</strong>, MD, PhD, FRCPC is a Neonatologist and physician leader who acts as the Executive Medical Director at the Canadian Society of Physician Leaders. He initiated the relationship with the Royal College to develop SimuLEADerShip, and provided insightful stories and brought life to the context in which SimuLEADerShip takes place. <strong>Kirk DesRosier</strong> is an Instructional Designer/Evaluator at the Royal College of Physicians and Surgeons of Canada and has a keen interest in serious play. For this project, he helped the team to tell a story of leadership with the hope of making the experience engaging and interesting while providing a meaningful learning experience. <strong>Glenn Barton</strong> EdD, RN is a curriculum designer with The Royal College. Dr. Barton is also a registered nurse and holds a doctorate of educational leadership from the University of Western Ontario with focused interests in applied learning engagement, organizational learning, and team leadership effects on high performance team learning. Glenn was a member of the scientific planning committee and co-author of this leadership gaming module. <strong>Kevin McCarragher</strong> is a New Media Design Specialist at the Royal College. He created a series of videos in the simulation that explain the LEADS framework as well as the sound effects. <strong>Dietrich Fűrstenburg</strong> MBChB, MM, CCFP(EM), CHE is a family physician with special interests in emergency medicine and medical leadership/administration. He has held various Health Authority leadership roles is a board member of the Canadian Society of Physician Leaders. Dr Furstenburg is now pursuing additional training in Anesthesiology at McGill University. <strong>Constance LeBlanc</strong> MD, CCFP, FRCPC, MAEd is a tertiary care Emergency Physician and Professor in the Department of Emergency Medicine at Dalhousie University. Her experience as Associate Dean for CPD, member of the Board of Directors of the Canadian Society for Physician Leaders, and co-chair of The International Summit on Leadership Education for Physicians, provided valuable leadership insight to the authoring team. <strong>Martin Vogel</strong> MBChB is a practicing physician and currently Deputy Chief of Health Protection, Medical and System Support at Public Health Ontario. He has held numerous leadership positions in the Canadian healthcare context at the local, provincial and national levels. His perspective on day-to-day leadership challenges enriched the simulation. <strong>Carol Rochefort</strong>, CAE has held the Director and Executive Director position at the Canadian Society of Physician Leaders (CSPL) since its inception in 1998. Prior to the CSPL, Carol was an Information Officer at the Canadian Medical Association for over 20 years. <strong>Susan Brien MD, FRCSC</strong>, Vice President, Medical, Research and Academic Affairs at the Horizon Health Network was the former director of the Practice Performance and Innovation Unit at the Royal College prior to her current position. Susan developed and fostered the relationship with the CSPL at the inception of the project and was instrumental in shaping the overall direction of SimuLEADerShip.</div> <<script>>setup.send_analytics("select_content","about");<</script>>
<<script>>if (Dialog.isOpen()) { Dialog.close(); }<</script>><<audio "dressing" play>> @@.txtcentre; !!Conclusion @@ <img src="images/conclusion.png" alt="Amulet looking surprised in a walk in closet."> It's a sunny day and you've decided to dress up a bit for your meeting with <<link "Dr. Armitrade">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>>. <<link "Amulet">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> is in your bedroom helping with the choice of what to wear. "Recent data in most trusted sources of fashion trends indicate that green is definitely out this year so you can't wear this." She says, tossing your favourite jacket into a pile. "Here, this outfit has an 84.73% chance with a 0.8 percent confidence interval of eliciting positive comments from your colleagues and your superior Dr. Armitrade. I'd suggest you try it on." You give it a try to appease her, but ultimately throw on your favourite green jacket on the way out. You are meeting Dr. Armitrade virtually in your workspace and could let the system choose an appropriate avatar for you but decide that using real-time apparel is more authentic and you are feeling that way today. At the set time the messaging system alerts you that Dr. Armitrade is ready to meet. @@#choices;.choices; <<nobr>> [[You begin the meeting.->Final Meeting]] <</nobr>> @@ <<set $stage to 5, $progress to 95, $l1lock = false, $l1lockicon="fas fa-unlock", $l2lock = false, $l2lockicon="fas fa-unlock", $l3lock = false, $l3lockicon="fas fa-unlock", $l4lock= false, $l4lockicon="fas fa-unlock", $l5lock= false, $l5lockicon="fas fa-unlock">> <<script>>setup.send_analytics("level_up","Level 5"); document.title="SimuLEADerShip Level 5";<</script>>
<<script>>if (Dialog.isOpen()) { Dialog.close(); } setup.send_analytics("level_up","Level 2"); document.title="SimuLEADerShip Level 2";<</script>><<audio "steps" play>> @@.txtcentre; !!The Interview @@ It's a beautiful day in the Salli Region as you head in for the interview and you manage to snag a parking spot close to the door - things are looking up. On the way to the HR Department you pass by the NICU and notice the purpose and values statement on the wall. @@.posting; .miss_vision_values; !Newborn Services and Neonatology Vision, Mission and Values !!Our Overall Purpose To provide state-of-the-art, evidence-based, and compassionate care for newborns, mothers, and their families, within a provincially-integrated system. !!Our Values Excellence Compassion Scholarship Inclusiveness Collaboration Stewardship @@ Although you've worked at Pondview for 11 years and seen these types of statements many times before the thought of becoming Director of the unit gives new weight to their importance. You find yourself thinking of how you might apply the values in your new role. On arrival at the Human Resources Department Leah, the HR receptionist, greets you politely and provides a seat. After a short wait, the Pondview Chief of Staff, <<link "Dr. Robin Armitrade">> <<script>>Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>><</link>>, greets you. You then... @@#choices;.choices; [[open the door.->HR Reception]] @@ <<set $stage to 2, $progress to 10, $l1lock = false, $l1lockicon="fas fa-unlock", $l2lock = false, $l2lockicon="fas fa-unlock", $l3lock= true, $l3lockicon="fas fa-lock", $l4lock= true, $l4lockicon="fas fa-lock", $l5lock= true, $l5lockicon="fas fa-lock">>
<<script>>if (Dialog.isOpen()) { Dialog.close(); }<</script>><<audio "hubbub" play>> @@.txtcentre; !!Stepping Up @@ Over the next few days you spend some time reflecting on your life and your goals. You want to frame the new experience of taking on a leadership role to situate it on your leadership development path. <<link "Doctor Armitrade">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> has asked that you start the day with her in the employee lounge. She wants to make an announcement to the staff about your new role and give you a chance to say a few words to them. After settling in to your office and planning your mini-speech you make your way to the lounge which has a nice view of Pondview and the surrounding plains. It's a clear day and you can even pick out the factory smoke rising from Streetsville, over 30 kilometres away. Dr. Armitrade makes a short introduction to the staff, providing your background and describes how wonderful it is to be able to find someone who has experience at Pondview who is able and willing to lead the team. As she motions to you to step forward, you hear a small smattering of applause. You look around. Although you have several friends in the unit that are smiling politely, your general sense is that people just want to get back to work. Some are looking at their comm devices, others seem to be sharing secret jokes and a few look outright angry or displeased. You step towards the small podium that has been set up, clear your throat and address the crowd. What do you say? <small>(You don't have to write verbatim, you can paraphrase!)</small> <div class="txtcentre"> <label for="textarea-speech">Enter your speech summary:</label> <<textarea "$speech" "">> <<button "ADDRESS THE UNIT" "Post Speech">> <<script>>setup.logger("fb42"); <</script>><</button>></div> <<set $stage to 3, $progress to 25, $l1lock = false, $l1lockicon="fas fa-unlock", $l2lock = false, $l2lockicon="fas fa-unlock", $l3lock = false, $l3lockicon="fas fa-unlock", $l4lock= true, $l4lockicon="fas fa-lock", $l5lock= true, $l5lockicon="fas fa-lock">> <<script>>setup.send_analytics("level_up","Level 3"); document.title="SimuLEADerShip Level 3";<</script>>
<<script>>if (Dialog.isOpen()) { Dialog.close(); }<</script>><<audio "jazz" play>> @@.txtcentre; !!Quadruple Problems @@ <img src="images/chap3.png" alt="Amulet slices bread."> After you settled into the Director role and felt more comfortable you decided to finally splurge and upgrade <<link "Amulet 2031">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> with the 3000A modification. Although she helped you with the research and purchase she seemed a bit distant about the idea. She never discussed it with you and hadn't really asked any questions until you were helping her prepare a meal for some friends that were over. "It won't hurt will it?" She said while slicing some bread. "I know this is an inadequate question since we don't feel pain in the traditional sense but my research indicates that there is a 2.45% chance of some memory loss. Does memory loss hurt?" It takes you a moment to realize that she is trying to process the upgrade you want to do. You explain to her that moderate memory loss is natural for humans but can also be a sign of disease and in a way, quite painful to go through. 'This won't be the case for you. I'll make sure we complete all the steps properly and when we are done you are going to feel like a new android!' She seems satisfied with your response and the evening goes quite well. @@#choices;.choices; [[Continue...->Lack of Time]] @@ <<set $stage to 4, $progress to 65, $l1lock = false, $l1lockicon="fas fa-unlock", $l2lock = false, $l2lockicon="fas fa-unlock", $l3lock = false, $l3lockicon="fas fa-unlock", $l4lock= false, $l4lockicon="fas fa-unlock", $l5lock= true, $l5lockicon="fas fa-lock">> <<script>>setup.send_analytics("level_up","Level 4"); document.title="SimuLEADerShip Level 4";<</script>>
Do you want to share your leadership mission with other activity participants? Note: This will reveal the leadership mission you wrote to other participants in this learning activity. <<button "YES" "Post Submission">> <<script>>setup.putdata("Provided Mission Statement",State.variables.mission,"MISS"); Dialog.close(); setup.logger("fb5"); setup.send_analytics("unlock_achievement","provided personal mission statement"); <</script>> <</button>> <<button "NO" "Post Submission">> <<script>>Dialog.close(); setup.logger("fb5");<</script>> <</button>>
The competitors and their leadership goals look formidable but you feel you’ve got a pretty decent chance. <div id="submissions" class="forumpanel" tabindex="0"></div> While you are perusing the competition you are interrupted by your comm device. Accepting the call, a hologram of a middle aged woman appears. "Hello $sal $lname, this is Leah calling from the Human Resource Department at Pondview Health. I'm calling about the resume and cover letter you provided. I have some good news. We would like to invite you to an interview for the Director NICU position." After a pause she continued. "I know this is abrupt, but the urgency of the situation requires a different approach than our usual process. We are hoping you might be able to come in for an interview next Thursday at 0800. Can you make it in by then?" How do you respond? @@#choices;.choices; <<nobr>> [[Sure sounds great!->Call Closure]] [[This is a bit too fast for me. I need to think it over and get back to you.->Think Interview]] <</nobr>> @@ <<set $progress to 6>> <<timed 1s>><<script>>setup.displayposts("MS","submissions",State.variables.mission);<</script>><<unset $mission>><</timed>>
"That's great." Leah says. "I almost forgot. To make sure each applicant has the best possible chance to succeed during the interview I'm authorized to provide you with a personal coach. The coach we've appointed to you will contact you shortly and can help with any questions you might have. See you Thursday 0800 sharp! Bye for now!" After you hang up you wonder what you got yourself into but move along with the rest of your evening plans regardless. After dinner as you are settling in to do some reading Amulet alerts you to an incoming holographic call. "Hologram, hologram." She announces in a monotone voice. "My sensors indicate the caller is friendly and not engaged in sales or other malicious activity". @@#choices;.choices; [[You accept the call->Coach Intro]] @@
You think it over for a while and ask <<link "Amulet">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> for perspective. "Humans. Sigh..." She says. "Do you realize that from the time you asked me what I thought about this and now I've processed the fiscal plan for the condominium ownership group, provided assistance to 3,456 other Amulets in the network, and determined the probability of you getting this position given the entire history of human career development and hiring protocols? And you need time to think. Sigh..." You would like to know more about the probability but you've had these types of conversations with her before so you decide to... @@#choices;.choices; <<nobr>> [[Call back and accept the interview.->Call Closure]] [[Call back and and decline.->Decline]] <</nobr>> @@
'It just didn't feel right. I'll know a good opportunity when it comes.' Although this thought gives you comfort you can't stop thinking it may have been a great chance to step forward. Persistence is a key ingredient of every successful leader so at some point the right opportunity may arise and the timing might be right for you. You commit to further focused study in leadership but for now it's... <<include "Game Over">> @@#choices;.choices; <<nobr>> <<back [[Try Again|Introduction]]>> <<link "Performance Feedback">> <<script>> Dialog.setup("Performance Feedback", "modal"); Dialog.wiki(Story.get("Performance Feedback").processText()); Dialog.open(); <</script>> <</link>> <</nobr>> @@ <<script>>setup.logger("fb1");<</script>> <<timed 2.5s>><<script>>setup.logger("fb2");<</script>><</timed>> <<timed 5s>><<script>>setup.logger("fb41");<</script>><</timed>>
<img src="images/v-caerde-intro.jpg" alt="Van Caerde hologram appearing in workspace."> You move to your home workspace and give the command to begin the call. A tall, well-dressed man apparates into your workspace. You aren't sure if it's a droid or not. They look so realistic lately that it’s hard to tell and the display lighting doesn't help. Regardless, you address him. "Hello, are you the leadership consultant from Pondview?" "Yes I am! Do you have a few moments to talk?" "Sure", you say as you adjust the display. The adjustments reveal that the coach is indeed a droid. 'Probably an expensive one' you think as he settles into a chair in his environment. "Nice to meet you $sal $lname. My name is <<link "Van Caerde 3745">> <<script>>Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>><</link>>. I'm the coach appointed to you by the Pondview HR Department. Thanks for seeing me on such short notice." @@#choices;.choices; <<nobr>> [[You're welcome->Sounds good]] <</nobr>> @@ <<set $progress to 7>>
@@#dossier;.fl; <<nobr>> <<if !visitedTags("Dossier")>>You don't have anything in your Dossier quite yet.<<else>><<if visitedTags("Triple-Aim")>><h2>Quadruple Aim Resources</h2> <ol><li>BMJ Article - [[The Quadruple Aim: care, health, cost and meaning in work.->https://qualitysafety.bmj.com/content/24/10/608]]</li> <li>A video explainer describing [[Quality Improvement in Healthcare.->https://www.youtube.com/watch?v=jq52ZjMzqyI]]</li> <li>A video from the Institute for Healthcare Improvement discussing how to [[adapt the Triple Aim Framework.->https://www.youtube.com/watch?v=Len-gDXY-e8]]</li></ol><</if>> <<if visitedTags("7-habits")>><h2><a href="https://www.franklincovey.com/the-7-habits/" target="_new">The 7 Habits of Highly Effective People</a></h2><p>An excellent resource for leaders seeking to be effective in reaching personal and organizational goals.</p><</if>> <<if visitedTags("AR-Overview")>><h2><a href="aoverview-e.html" target="_new">Achieve Results Overview</a></h2><p>A short overview of the Achieve Results Domain and capabilities.</p><</if>> <<if visitedTags("MVV")>><h2><<link "Mission, Vision and Values Statements">><<script>> Dialog.setup("Mission, Vision and Values Statements", "modal"); Dialog.wiki(Story.get("Initial Region and NICU MVV").processText()); Dialog.open();<</script>><</link>></h2><p>The mission, vision and value statements for the regional health authority and Pondview NICU.</p><</if>> <<if visitedTags("S1-Qualetrics")>><h2><<link "Pondview NICU Quadetrics Report Q1/2 <<print setup.year>>">><<script>> Dialog.setup("Dossier - Pondview NICU Quadetrics Report Q1/2", "modal"); Dialog.wiki(Story.get("Qualetrics Snap 1").processText()); Dialog.open();<</script>><</link>></h2><p>Pondview Quadetrics are released every 6 months and include key indicators that aid in decision making and focus.</p><</if>> <<if visitedTags("istat")>><h2><a href="istat-e.html" target="_new">Structuring Difficult Conversations (iSTAT)</a></h2><p>The technique for structuring difficult conversations that has been developed by the Pondview team.</p><</if>> <<if visitedTags("EO-Overview")>><h2><a href="eoverview-e.html" target="_new">Engage Others Overview</a></h2><p>A short overview of the Engage Others Domain and capabilities.</p> <</if>> <<if visitedTags("LS-Overview")>><h2><a href="loverview-e.html" target="_new">Lead Self Overview</a></h2><p>A short overview of the Lead Self Domain and capabilities.</p><</if>> <<if visitedTags("LEADSOverview")>><h2><a href="leadsoverview-e.html" target="_new">By Physicians, for Physicians Leadership: The LEADS in a Caring Environment Capabilities Framework</a></h2><p>This LEADS overview offers a quick view of the 5 domains of LEADS and associated capabilities. It also provides a detailed rationale for how LEADS is used to enable change within the Canadian Healthcare milieu.</p><</if>><</if>><</nobr>> @@ <<script>>setup.send_analytics("select_content","dossier");<</script>>
After sitting down <<link "Van Caerde">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> continues. "Based on your background I'm confident that you will do well in the interview tomorrow. Let me give you some background about the type of person the committee is looking for. They want someone who knows themselves, who has a good grasp of why they want to lead and how they can optimize their own skills and intentions to rally others toward the common goal of making Pondview a better place for staff and patients alike. I can see by your CV that you did your residency in Canada so you are familiar with the CanMEDS leader role. Other than that do you have any formal leadership training?" @@#choices;.choices; <<nobr>> [[Some, but it was way back in residency.->Residency Training]] [[Nothing to speak of.->No Leadership Education]] [[Yes, I've studied leadership extensively.->Studied Leadership]] [[Definitely, I also provide leadership education.->Studied Leadership]] <</nobr>> @@
"It's great that you are familiar with LEADS", he continued enthusiastically. "That means I won't have to spend much time going over it. As you must be aware, LEADS is a distributed leadership framework that offers a concerted, coherent, and sustainable strategy towards leadership development. I'll send a summary to your dossier that explains how LEADS can be used to guide change in Canadian Healthcare." @@#choices;.choices; <<nobr>> <<link [[You accept the document.->Asks about LS]]>><<script>>setup.hypecalls.playhype('document'); <</script>><</link>> <</nobr>> @@
"There are many who aren't familiar with the LEADS framework. In fact the capabilities in LEADS complement the competencies outlined in the CanMEDS framework. "You have also likely been exposed to some of these capabilities via leaders that you have engaged with at work or observed. I'm going to show you a short vizz I put together that introduces LEADS." With this, Van Caerde reaches into his pocket and projects onto your wall. <div class="vidcontainer"><iframe id="kaltura_player_1619034206" src="https://cdnapisec.kaltura.com/p/1688662/sp/168866200/embedIframeJs/uiconf_id/35312181/partner_id/1688662?iframeembed=true&playerId=kaltura_player_1619034206&entry_id=1_5tuxx6t8" width="800" height="450" allowfullscreen webkitallowfullscreen mozAllowFullScreen allow="autoplay *; fullscreen *; encrypted-media *" frameborder="0" title="LEADS Overview"></iframe></div> When the video finishes, Van Caerde resumes. "I've also transmitted a summary to your dossier that explains how LEADS is used as an enabler to create change in Canadian Healthcare." Your comm lights up to signify an incoming document. @@#choices;.choices; <<link[[You accept the document.->Continue to LS]]>><<script>>setup.hypecalls.playhype('document'); <</script>><</link>> @@ <<set $progress to 8>>
"OK. I won't bother you much longer then. I'll send a summary of the Leads Self Domain and capabilities to your dossier in case you want to review before the interview." He stands up and you follow suit. "Before I leave do you have any questions?" @@#choices;.choices; <<nobr>> [[Yes.->Questions]] [[Yes, but I'll keep them for the interview.->No Questions]] [[No. Not right now.->No Questions]] <</nobr>> @@ <<script>>setup.hypecalls.playhype('document'); <</script>> <<set $progress to 8>>
"Sounds good. Let's dig a little deeper into the Lead Self Domain." Van Caerde changes the vizz on the wall to a new segment. <div class="vidcontainer"><iframe id="kaltura_player_1619034206" src="https://cdnapisec.kaltura.com/p/1688662/sp/168866200/embedIframeJs/uiconf_id/35312181/partner_id/1688662?iframeembed=true&playerId=kaltura_player_1619034206&entry_id=1_5pg4mum7" width="800" height="450" allowfullscreen webkitallowfullscreen mozAllowFullScreen allow="autoplay *; fullscreen *; encrypted-media *" frameborder="0" title="Lead Self Overview"></iframe></div> When the video ends, Van Caerde starts packing up to end the call. "The vizz I just showed you should help you with the interview and hopefully provide a good foundation for your development. Good luck on your interview tomorrow. If you get the position I may be able to provide further coaching while you are on the job! I'll also send a summary of the Lead Self Domain and capabilities to you in case you want to review it before the interview." @@#choices;.choices; <<nobr>> <<link [[You accept the document.->Pre Departure]]>><<script>>setup.hypecalls.playhype('document'); <</script>><</link>> <</nobr>> @@
"That's fine. What you studied was probably within the Leader competencies of the CanMEDS Framework - it will provide a good foundation. The Leadership team at Pondview has adopted the LEADS in a Caring Environment Framework which complements what was covered in your training program and goes the next step in guiding your leadership development efforts. "LEADS is a distributed leadership framework that recognizes that all members of the team have something to contribute, and delineates the capabilities healthcare leaders can apply as they guide others towards systems transformation." <<include "LEADS?">>
"That's OK!" Van Caerde says with a gentle smile. "You are going to need to learn under pressure then, but you are in good hands - I'm here to help. As you know, medical education programs in Canada use the [[CanMEDS Physician Competency Framework, ->https://www.royalcollege.ca/rcsite/canmeds/canmeds-framework-e]] which includes competencies under the Leader role." He explained. "At Pondview we set leadership development as a priority and have adopted the LEADS in a Caring Environment Framework to inform our approach to leadership and leadership development for all healthcare professionals. LEADS is a distributed leadership framework that recognizes that all members of the team have something to contribute, and delineates the capabilities healthcare leaders can apply as they guide others towards systems transformation. The LEADS framework also acknowledges the contextual considerations required in enacting leadership capabilities. "LEADS is a distributed leadership framework that complements what was covered in your training program and goes the next step in guiding leadership development, helping to develop your leadership capabilities to enable health system change." <<include "LEADS?">>
"Perfect." He said. "Having a background in leadership is really going to help succeed in the interview. The management at Pondview has decided to adopt the LEADS in a Caring Environment Framework to guide leadership development." <<include "Leads Yes">>
Van Carde looks at you patiently waiting to hear your questions. @@#choices;.choices; <<nobr>> <<link "How quickly do they plan on hiring?">> <<replace "#vcresp">>"My understanding is that they are prepared to offer the position immediately. There is no waiting period or delay."<</replace>> <</link>> <<link "Why are they in such a hurry to fill the position?">> <<replace "#vcresp">>"I believe it's become apparent to management that a formal leadership role with someone who is an effective leaders is direly needed."<</replace>> <</link>> <<link "Can you tell me more about the role?">> <<replace "#vcresp">>"Other than what is described in the job posting I can't share any more details right now."<</replace>> <</link>> <<link "What's it like being a droid?">> <<replace "#vcresp">>"It has its benefits. Including a keen awareness of what type of question to ask at the correct time."<</replace>> <</link>> <span id="vcresp"></span> <</nobr>> [[Continue...->No Questions]] @@ <<set $progress to 10>>
Van Caerde stands to signify the meeting is over. "It's been great talking to you $sal $lname. I think you will do well. My contact info should be in your comm now in case you ever need to reach out to me again. Have a wonderful evening." As you watch him dissipate you are starting to feel more confident about the opportunity and enjoy the thought that you might be able to develop your leadership skills on the job. It seems that the role requires leadership skills, but nobody can master all these skills. The right vision and ability to garner engagement will be important - very exciting! The rest of the evening goes uneventfully, unless you call binge-watching VirtuaFlix eventful, that is. @@#choices;.choices; <<nobr>> [[Unlock Level 2->Chap1]] <<link "Debrief">> <<script>> Dialog.setup("Debrief", "modal"); Dialog.wiki(Story.get("Performance Feedback").processText()); Dialog.open(); <</script>> <</link>> <</nobr>> @@ <<set $chap1access = 0, $progress = 8>>
<<nobr>><span>© Copyright 2021 Royal College of Physicians and Surgeons of Canada</span><</nobr>>
<img src="images/hrreception.png" alt="Robert wilson smiling in a hospital changeroom."> <<link "Dr. Armitrade">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> begins the interview. "To start out I am going to let my esteemed colleagues introduce themselves. I believe you already know most of them." A tired looking man with lively eyes begins. "Hello, I'm Vihaan Kasbia, Director of the Neonatal transport unit. We know each other." A woman introduces herself as Dr. Lisa Martinez, Chair Outreach and Community Relations, followed by a late model droid. "Welcome. I am <<link "Zephyr 2642">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>>. I will be monitoring your integrity today." "And of course, I'm Dr. Robin Armitrade, Chief of Staff at Pondview and interim NICU Director. Should you get the position you will be reporting to me" Dr. Armitrade says, concluding the introductions. Everyone settles in and Dr. Armitrade continues. "Your Interview will consist of three separate rounds of questions. This first round is going to focus on your personal attributes and capabilities, while the second and third rounds are going to focus on how you work with others and past achievements. At this point I'm going to begin the first round of questions." @@#choices;.choices; [[Continue...->Interview Q1]] @@ <<set $interview_score_leads to 0>>
<<set _intq1_stem = "How many domains are there in the Leadership framework we've adopted here at Pondview?", _int_q1a = "Three.", _int_q1b = "Four.", _int_q1c = "Five.", _int_q1d = "Six.">> Dr. Armitrade kicks off the round of questions. You are a bit tense. The timer clock ticking in the room adds to your discomfort. "We'll start our questions now. _intq1_stem" @@#choices;.choices; <<nobr>> <<link [[_int_q1a |Interview Q2]]>><<script>>setup.logger("fb8",State.temporary.intq1_stem,State.temporary.int_q1a);<</script>><</link>> <<link [[_int_q1b|Interview Q2]]>><<script>>setup.logger("fb8",State.temporary.intq1_stem,State.temporary.int_q1b);<</script>><</link>> <<link [[_int_q1c|Interview Q2]]>><<set $interview_score_leads = $interview_score_leads + 1>><<script>>setup.logger("fb9",State.temporary.intq1_stem,State.temporary.int_q1c);<</script>><</link>> <<link [[_int_q1d|Interview Q2]]>><<script>>setup.logger("fb8",State.temporary.intq1_stem,State.temporary.int_q1d);<</script>><</link>> <</nobr>> @@
<<set _intq2_stem = "Can you tell me the underlying assumption behind the framework for leadership development we use here at Pondview?", _int_q2a = "That if everyone at Pondview develops their leadership abilities it will be poor for morale given there are only so many formal leadership roles.", _int_q2b = "That leadership can be learned by conscious and intentional effort.", _int_q2c = "That leadership is innate, but those with the right attitude can make some gains in their abilities with practice.", _int_q2d = "No, sorry I can't.">>Dr. Armitrade smiles but its hard to read why. "Another one. This time slightly harder. _intq2_stem" @@#choices;.choices; <<nobr>> <<link [[_int_q2a |Interview Q3]]>><<script>>setup.logger("fb10",State.temporary.intq2_stem,State.temporary.int_q2a);<</script>><</link>> <<link [[_int_q2b|Interview Q3]]>><<set $interview_score_leads = $interview_score_leads + 1>><<script>>setup.logger("fb11",State.temporary.intq2_stem,State.temporary.int_q2b);<</script>><</link>> <<link [[_int_q2c|Interview Q3]]>><<script>>setup.logger("fb10",State.temporary.intq2_stem,State.temporary.int_q2c);<</script>><</link>> <<link [[_int_q2d|Interview Q3]]>><<script>>setup.logger("fb10",State.temporary.intq2_stem,State.temporary.int_q2d);<</script>><</link>> <</nobr>> @@
<<set _intq3_stem = "Does the LEADS framework replace everything you may have learned about leadership in the past or is it complementary?", _int_q3a = "It replaces what was learned in medical school given the focus was on clinical team leadership.", _int_q3b = "LEADS is a subset of CanMEDS. If you were able to meet all the training competencies in medical school during your formal education you are already competent in the capabilities in LEADS.", _int_q3c = "Frameworks are conceptual and don’t apply in real life. From what I understand, taking on a formal leadership role like this one automatically provides stature and is enough to get things done.", _int_q3d = "It complements what was covered in my training program and goes the next step in guiding my leadership development, helping me to develop capabilities for system transformation.">>Dr. Kasbia now takes the lead. "Right, let's continue then, I have a couple more questions for you. The first one is theoretical in nature and is about your understanding of how the CanMEDS Physician Competency Framework, the foundation of the Royal College's Competency by Design approach to achieving competence in training in Canada, integrates with the LEADS framework - which we chose for leadership development here at Pondview. The question is as follows. _intq3_stem" @@#choices;.choices; <<nobr>> <<link [[_int_q3a |Interview Q4]]>><<script>>setup.logger("fb12",State.temporary.intq3_stem,State.temporary.int_q3a);<</script>><</link>> <<link [[_int_q3b|Interview Q4]]>><<script>>setup.logger("fb12",State.temporary.intq3_stem,State.temporary.int_q3b);<</script>><</link>> <<link [[_int_q3c|Interview Q4]]>><<script>>setup.logger("fb12",State.temporary.intq3_stem,State.temporary.int_q3c);<</script>><</link>> <<link [[_int_q3d|Interview Q4]]>><<set $interview_score_leads = $interview_score_leads + 1>><<script>>setup.logger("fb13",State.temporary.intq3_stem,State.temporary.int_q3d);<</script>><</link>> <</nobr>> @@
<<set _intq4_stem = "Describe the leadership model you feel we should strive for here at Pondview.", _int_q4a = "Distributed.", _int_q4b = "Command-control.", _int_q4c = "Heroic.", _int_q4d = "I'm really unsure.">>Dr. Kasbia raises his eyebrows and pauses before continuing. "_intq4_stem" @@#choices;.choices; <<nobr>> <<link [[_int_q4a |Interview Q5]]>><<set $interview_score_leads = $interview_score_leads + 1>><<script>>setup.logger("fb15",State.temporary.intq4_stem,State.temporary.int_q4a);<</script>><</link>> <<link [[_int_q4b|Interview Q5]]>><<script>>setup.logger("fb14",State.temporary.intq4_stem,State.temporary.int_q4b);<</script>><</link>> <<link [[_int_q4c|Interview Q5]]>><<script>>setup.logger("fb14",State.temporary.intq4_stem,State.temporary.int_q4c);<</script>><</link>> <<link [[_int_q4d|Interview Q5]]>><<script>>setup.logger("fb14",State.temporary.intq4_stem,State.temporary.int_q4d);<</script>><</link>> <</nobr>> @@
<<set _intq5_stem = "Why have you decided to apply for this job?", _int_q5a = "I’ve been a clinician for several years now. It’s a logical next step in my career. Since a young age I've been told I'm a born leader. Now is the time to really test that.", _int_q5b = "I enjoy my clinical work, but would like more authority to effect practice environment changes that are necessary. Just like patients need changes in plans of management, so too does this NICU. I can’t sit back any longer, I need to do!", _int_q5c = "Given my track record, I think I can contribute even more to the success of Pondview through a more formal leadership role. The new visitors policy our committee introduced is but one example of what I am capable of.", _int_q5d = "I share a vision with others in the NICU of what things could be like. I'd like the opportunity to provide more influence within the NICU as well as at Pondview as a whole to work together to improve the health and wellness of the patients we treat and staff.">> <<if $interview_score_leads == 0>><<goto "Bombed Interview">><<else>> "The questions will now increase in complexity by 22.583 percent." <<link "Zephyr">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> interjects as she begins the next question. "_intq5_stem" @@#choices;.choices; <<nobr>> <<link [[_int_q5a |Interview Q6]]>><<script>>setup.logger("fb16",State.temporary.intq5_stem,State.temporary.int_q5a);<</script>><</link>> <<link [[_int_q5b|Interview Q6]]>><<script>>setup.logger("fb17",State.temporary.intq5_stem,State.temporary.int_q5b);<</script>><</link>> <<link [[_int_q5c|Interview Q6]]>><<script>>setup.logger("fb18",State.temporary.intq5_stem,State.temporary.int_q5c);<</script>><</link>> <<link [[_int_q5d|Interview Q6]]>><<script>>setup.logger("fb19",State.temporary.intq5_stem,State.temporary.int_q5d);<</script>><</link>> <</nobr>> @@ <<unset $interview_score_leads>> <<endif>>
<<set _intq6_stem = "How do you manage the emotional stress of this work environment?", _int_q6a = "I find it important to be aware of my own emotions. If I am aware of them I can manage them. I ask myself; what am I feeling? Anger? Frustration? Joy? Then my brain just knows what to do. It’s become a reflex. I always know how to handle myself!", _int_q6b = "I always count to 10 before answering. I'll take 10 deep breaths and ground myself with my feet on the floor. One time a nurse called me on it. He said 'Hello! Hello! Are you still here?' I still chuckle when I think back on that.", _int_q6c = "I accept that in a high stakes environment I need to be adaptable and control my impulsive emotions. I've developed these skills over time through mindfulness techniques. In the moment I can apply these skills. I'm able to recognize my emotions non-judgmentally and manage them.", _int_q6d = "I do yoga every morning to de-stress before the day starts. It's become a reflective time for me and allows me to tap into a way of being mindful which helps me be aware of my feelings. Then I know what to do.">>"Thank you. Dr. Wilson will continue while I analyze your response to the questions so far. I'll be using the recently developed Martin-Hogar realm of integrity monitoring." Dr. Wilson looks sideways at Zephyr and seems to share your dislike for the non-human aspects of some droids. Unimpeded, she continues with the interview. "You've worked in an NICU for a long time. It is a stressful environment with sick babies, anxious parents, and a high workload. _intq6_stem" @@#choices;.choices; <<nobr>> <<link [[_int_q6a |Interview Q7]]>><<script>>setup.logger("fb20",State.temporary.intq6_stem,State.temporary.int_q6a);<</script>><</link>> <<link [[_int_q6b|Interview Q7]]>><<script>>setup.logger("fb21",State.temporary.intq6_stem,State.temporary.int_q6b);<</script>><</link>> <<link [[_int_q6c|Interview Q7]]>><<script>>setup.logger("fb22",State.temporary.intq6_stem,State.temporary.int_q6c);<</script>><</link>> <<link [[_int_q6d|Interview Q7]]>><<script>>setup.logger("fb23",State.temporary.intq6_stem,State.temporary.int_q6d);<</script>><</link>> <</nobr>> @@
A silence enters the room and the hiring committee stares at you. Time seems to go slower as you fidget nervously. Committee members are looking towards Dr. Armitrade to gauge her reaction. After a moment she speaks. "I'm sorry $fname. At this point I don't really see any reason for continuing this interview. I can tell by your responses that you aren't taking this seriously. Apparently you did not take the advice of the coach we appointed or prepare for this interview." The committee members gather their belongings and shuffle out of the room. Before leaving Dr. Armitrade thanks you for your time. <<include "Game Over">> @@#choices;.choices; <<nobr>> <<back [[Try Again|Chap1]]>> <<link "Debrief">> <<script>> Dialog.setup("Debrief", "modal"); Dialog.wiki(Story.get("Performance Feedback").processText()); Dialog.open(); <</script>> <</link>> <</nobr>> @@ <<script>>setup.logger("fb8");<</script>><<unset $interview_score_leads>>
<<set _intq7_stem = "There are times we become aware of a prejudice we or others hold toward a particular person or group. Can you share a situation where this happened at work and what you did about it?", _int_q7a = "I've never found myself holding any prejudices at work. In fact I don’t hold prejudices at all. I value fairness and I always look at the merits of the case. I am even willing to overlook some of the limitations women bring to their ability to dedicate themselves to the workplace. I know that I treat everyone equally. There is no room for prejudice in our business.", _int_q7b = "I've been at meetings where I've seen the suggestions of a female colleague overlooked, only to be lauded when a male comes up with the same idea. Why should a male opinion carry more weight? In those situations I always try to amplify the voice of my female colleagues.", _int_q7c = "I have long thought that new nursing grads don’t care for our patients as well as the seasoned nurses who have been here for years. The charge nurse has quietly suggested I see it as a mentorship challenge but frankly, I just don't have the time. It is a bias she will just have to put up with.", _int_q7d = "We see neonates admitted from Streetsville whose parents are substance-abusing teens. I’ve had to overcome the value judgment I ascribed to these mothers, that they were uneducated with little willpower to change. After reading and reflecting I now have a better understanding of the environmental influences that precipitate addiction. ">>Dr. Wilson continues. "_intq7_stem" @@#choices;.choices; <<nobr>> <<link [[_int_q7a |Interview Q8]]>><<script>>setup.logger("fb24",State.temporary.intq7_stem,State.temporary.int_q7a);<</script>><</link>> <<link [[_int_q7b|Interview Q8]]>><<script>>setup.logger("fb25",State.temporary.intq7_stem,State.temporary.int_q7b);<</script>><</link>> <<link [[_int_q7c|Interview Q8]]>><<script>>setup.logger("fb26",State.temporary.intq7_stem,State.temporary.int_q7c);<</script>><</link>> <<link [[_int_q7d|Interview Q8]]>><<script>>setup.logger("fb27",State.temporary.intq7_stem,State.temporary.int_q7d);<</script>><</link>> <</nobr>> @@
<<set _intq8_stem = "What would you say to a trainee who told you they ordered the wrong dose of a medication resullting in a baby becoming critically ill?", _int_q8a = "I am sure you feel awful about this... I know I did when I experienced a similar situation in my career. Shall we go speak to the parents now, or should we take a few minutes first to prepare ourselves for that meeting?", _int_q8b = "These things happen to all of us at one time or another. We’ll do a root cause analysis to identify what went wrong. There are usually systemic problems and healthcare workers are only one part of the issue.", _int_q8c = "Do you realize what you’ve done? This family in particular had a long history of infertility! I’m upset beyond words. I'll be reporting this to your program director. You can finish your NICU rotation elsewhere!", _int_q8d = "We need to talk to the parents. They have to be beside themselves. Are they even here? Has anyone phoned them yet? If they are here I’ll go with you to speak to them - we need to get our story straight. If not, come back and we can call them together.">>Dr. Wilson jots down your response. "Ok, next question. _intq8_stem" @@#choices;.choices; <<nobr>> <<link [[_int_q8a |Interview Q9]]>><<script>>setup.logger("fb28",State.temporary.intq8_stem,State.temporary.int_q8a);<</script>><</link>> <<link [[_int_q8b|Interview Q9]]>><<script>>setup.logger("fb29",State.temporary.intq8_stem,State.temporary.int_q8b);<</script>><</link>> <<link [[_int_q8c|Interview Q9]]>><<script>>setup.logger("fb30",State.temporary.intq8_stem,State.temporary.int_q8c);<</script>><</link>> <<link [[_int_q8d|Interview Q9]]>><<script>>setup.logger("fb31",State.temporary.intq8_stem,State.temporary.int_q8d);<</script>><</link>> <</nobr>> @@
<<set _intq9_stem = "Do you think there is a difference between leadership and management, and if so what is the key difference?", _int_q9a = "Yes, they are different but are in fact two sides of the same coin. They are both about being a boss so the buck stops with you. If your job description is Manager, you manage. If you are a CEO you lead.", _int_q9b = "No, I think the two terms are synonymous. Different places of work use different terminology; Manager or Leader but at the end of the day they get things done.", _int_q9c = "Yes they are different, and the situation determines whether one uses leadership capabilities or management practices. Leadership for change - management for stable processes.", _int_q9d = "Yes, they are different. Managers do the right thing and leaders do things right. Both are committed to quality improvement, but managers choose the proper path and leaders act ethically.">>Dr. Armitrade takes over the questioning now. We are almost done this portion of the interview. I have one final question", she says. "_intq9_stem" @@#choices;.choices; <<nobr>> <<link [[_int_q9a|Interview Rounds]]>><<script>>setup.logger("fb32",State.temporary.intq9_stem,State.temporary.int_q9a);<</script>><</link>> <<link [[_int_q9b|Interview Rounds]]>><<script>>setup.logger("fb33",State.temporary.intq9_stem,State.temporary.int_q9b);<</script>><</link>> <<link [[_int_q9c|Interview Rounds]]>><<script>>setup.logger("fb34",State.temporary.intq9_stem,State.temporary.int_q9c);<</script>><</link>> <<link [[_int_q9d|Interview Rounds]]>><<script>>setup.logger("fb35",State.temporary.intq9_stem,State.temporary.int_q9d);<</script>><</link>> <</nobr>> @@
<<masteraudio stop>>@@#posting;.posting; !!Pondview Hospital Internal Opportunity !!!Medical Director, Neonatal Intensive Care Unit Posting N823476 The Department of Pediatrics of the Provincial University and the Salli Regional Health Authority seeks a Neonatologist as the Medical Director of the busy level III NICU at Pondview Hospital. This position requires someone with strong clinical, operational and strategic leadership skills as well as experience in neonatal care, quality, and safety to lead the clinical service of this high acuity 37-bed unit. The Medical Director will join our group of 6 neonatologists, 4 Neonatal-Perinatal fellows, 6 advanced practice neonatal nurse practitioners, and a large multidisciplinary team of NICU care professionals. !!!! Responsibilities * High quality care for patients and their families. * Day to day management of the Neonatal Transport team. * Leading the outreach teaching program. * Collaborative projects with High-Risk Obstetrics and Perinatology. This NICU has an active surgical program for congenital anomalies of all systems except for complex cardiovascular surgery. * Academic activities including education and research in the Division of Neonatology. * Reporting to the department chair for issues related to clinical care, quality improvement, research, and education, and to the Regional Health Authority for administrative issues. !!!! Qualifications * Licensed or eligible to be licensed as a physician in this province. * FRCPC (or equivalent) in Pediatrics with additional training in Neonatology and/or Perinatology. * A minimum of ten (10) years of progressive clinical and leadership experience and a Canadian Certificate of Physician Executive (CCPE) are preferred. However, the incumbent may achieve these goals while in the position. * Canadian Certified Physician Executive (CCPE) is an asset. Given the importance and urgency of this position a personal leadership coach will be provided to all candidates. In view of the Regional Health Authority’s and the Provincial University policies on equality, diversity and inclusiveness (EDI), neonatologists representing all sections of the Canadian population are encouraged to apply. For further details, please contact the Recruitment Office at (999) 876-5432 - ext 10 or Recruitment@NOW.com. Please site the position number N823476 in any correspondence.@@ It looks like you meet the criteria they are looking for! What will you do? @@#choices;.choices; <<nobr>> [[Step back from the opportunity.|Shrink Wallflower]] [[Ask around about the position.|Ask around]] [[Think about it for a while.|Think about Position]] <<link "Go for it! After all, applying for jobs in the future is so much easier.""Go for the job">><<script>>setup.logger("fb39");<</script>><</link>> <</nobr>> @@ <<set $progress to 3>><<unset $tutorial>>
You must provide a leadership vision statement before you can continue. Note: Your response will be kept anonymous and you will have the option of whether to share your response with other participants. <<button "OK">> <<script>>Dialog.close();<</script>> <</button>>
<div class="animate seven"> <span>G</span><span>A</span><span>M</span><span>E</span><br/><span>O</span><span>V</span><span>E</span><span>R</span> </div> <<audio "gameover" play>>
<<masteraudio stop>> "Good morning $fname. Thanks for coming in on such short notice. I hope you were able to connect with our coaching delegate", she says while ushering you towards the interview room. Shortly after you sit down the three other members of the committee enter and acknowledge you. As they take their designated seats, Dr. Armitrade asks "Before we get started do you have any questions?". @@#choices;.choices; <<nobr>> <<link "Yes, can I take notes?">> <<replace "#raresp">>"Of course you can. Feel free to use whatever device you have on hand. I tried mentalBypass<sup>TM</sup> notes myself a while ago but it just wasn’t for me." <</replace>> <</link>> <<link "Why is the focus of the interview on Leadership skills instead of clinical expertise?">> <<replace "#raresp">>"All candidates being interviewed are recognized to be superb clinicians. What we are looking for is someone who has the ability to lead the group to fulfil our vision and mission." <</replace>> <</link>> <<link "Can you tell me more about the role?">> <<replace "#raresp">>"Yes. Apart from the responsibilities and duties listed in the job description the role requires being a leader. By this, I mean truly leading the NICU team to work as an integrated unit within the larger organization as we collectively make the changes necessary to better serve our patient and family population. This is more than just having a title or direct reports. The position is about change and how you will enable the unit to optimize its performance." <</replace>> <</link>> <span id="raresp"></span> <</nobr>> [[Continue...->No Interview Questions]] @@
The committee continues taking notes when they are interrupted by a knock at the door. Leah peeks in. "The next group is ready to continue the interview", she says. Dr. Armitrade explains that this first segment of the interview is complete and that another team will take over for the second round of questioning. As they leave the room you feel pretty confident about your answers. Dr. Armitrade stays in the room with you. "You're doing well. Keep up the good work", she says with a smile. @@#choices;.choices; [[You take a deep breath and prepare for the next round.|Interview Round 2]] @@ <<script>>setup.logger(State.variables.fbid,State.variables.intq9_stem,State.variables.intq9_resp);<</script>>
<<if $LS > 9>><<goto "interview all green">> <<elseif $LS < 6>><<goto "interview all red">> <<else>><<goto "interview mixed">> <</if>> <<set $progress to 15>>
You notice she is smiling enthusiastically but try not to read too much into it. "Let's go back to the interview room. Leah will join us in a moment", she says as she heads back . As you take a seat she continues. "I've got some good news for you $fname, you did very well in the interview. We were particularly impressed by your self-awareness and believe you possess the type of character we need here at Pondview." You both look at the door as Leah enters. She is holding a folder and gives a subtle nod to Dr. Armitrade as she hands the folder to her then sits down to join the conversation. <<include "Make Offer">>
You notice she looks tired but you try not to read too much into it given its been an exhausting morning. "Let's go back to the interview room. Leah will join us in a moment", she says as she walks back and takes a seat. "I've got some good news for you $fname. You did well in the interview. Based on what we saw and the results of the integrity monitoring we believe you are the right fit for the role. However, we want you to commit to continuing to develop your lead self capabilities. I believe the coach we appointed to you went over this with you but if not I'll put another copy in your dossier." You both look at the door as Leah enters. She is holding a small device and folder which she hands to Dr. Armitrade and then sits down to join the conversation. "In order for us to have the comfort level we need in moving forward with you as NICU Director we need an attestation that you will continue to develop your Lead Self capabilities." At this Leah leans forward with the biometric collection device. Its small and has a space for your pinky to fit in. 'Such an archaic process' you think as you... @@#choices;.choices; <<nobr>> [[Insert your pinky and agree to develop your Lead Self capabilities|Agreed Lead Self]] [[Explain that this is a little too much for you and that you don't agree|Disagree Lead Self]] <</nobr>> @@
You notice she looks tired but you try not to read too much into it given its been an exhausting morning. "Let's go back to the interview room", she says while walking. As you take a seat she continues. "I was hopeful that you would be successful in this interview but unfortunately you were not. Based on the interview and integrity monitoring the hiring committee feels that you lack the self-awareness, authenticity and emotional intelligence we were hoping to see. I'd like to thank you for your time and suggest that you try again in the future. If you focus on your personal development I am sure you will get the results you had hoped for and will make a great leader one day." You feel dejected, tired, upset and embarrassed. A whirlwind of angry responses pop into your mind but you decide to... @@#choices;.choices; <<nobr>> [[Learn from the experience and wait until the next chance.|Wait Chance]] [[Go back to your clinical work and avoid taking on any sort of leadership role.|Avoid Leadership]] <</nobr>> @@ <<set $progress to 15>>
Leah looks relieved. "I'm happy we got that out of the way. I just want to assure you that we promise not to share your biometric data with any other third party beyond the ones you agreed to in your initial contract at Pondview as listed on page 235 - 298." <<include "Make Offer">> <<script>>setup.logger("fb43");<</script>>
Leah and Dr. Armitrade look at you surprised. "I can understand that you have reservations about the biometric agreement." Dr. Armitrade says, trying to be accommodating yet looking a bit stressed. "Listen, I am OK without the formality, but I need the assurance that you will continue to develop yourself, if we are to move forward with you as a candidate." You think for a moment about the idea of developing yourself. Sometimes it can seem like a bunch of new age mumbo jumbo. After a long awkward pause in the conversation you decide to... @@#choices;.choices; <<nobr>> [[Give Dr. Armitrade your word that you will continue your self-development.|Convinced to Lead Self]] [[Explain that self-exploration isn't for you and you wish to decline the offer.|Avoid Leadership]] <</nobr>> @@
Van Caerde continues. "The next order of business is to determine how familiar you are with the LEADS in a Caring Environment framework for leadership development. Are you familiar with it?" @@#choices;.choices; <<nobr>> [[Yes. I am familiar with LEADS.->Leads Yes]] [[No. I've never heard of LEADS.->Leads No]] <</nobr>> @@
Van Caerde reviews his notes before continuing. "Given you are familiar with LEADS, this means you have knowledge of the Lead Self domain and the importance of leading yourself in order to lead others. Part of the interview will focus on determining how far along you are in your personal development using the Lead Self capabilities as a guideline. Do you feel you know the Lead Self domain well enough to be successful in the interview? If not, I can provide you an overview." @@#choices;.choices; <<nobr>> [[I know it well.->Knows LS]] [[I know it but could use a refresher.->Needs LS]] [[I really could use an overview.->Needs LS]] <</nobr>> @@
"Now that you have an idea of what LEADS is, I want you to focus on the Lead Self domain and capabilities since that is what the bulk of the interview will focus on. Are you ready to learn about Lead Self? @@#choices;.choices; <<nobr>> [[Yes.->Needs LS]] [[No. I'm a little short on time. Can you just give me a summary?->Knows LS]] <</nobr>> @@
Prior to ending the call Van Caerde looks you in the eye solemnly. "Before I leave do you have any questions?" @@#choices;.choices; <<nobr>> [[Yes.->Questions]] [[Yes, but I'll keep them for the interview.->No Questions]] [[No. Not right now.->No Questions]] <</nobr>> @@
The interview continued with two more groups of interviewers. It was stressful and a bit of a blur. You remember being aware that they were asking about the way you interacted with others and some of your past achievements but don't remember many details. Finally, after two hours the interview is over. Dr. Armitrade shows you back to the waiting room. "I'm going to step away and confer with my non-human colleague that sat in on your interview. Fortunately, due to their presence we can greatly speed up the whole process of determining whether to offer you the position or not so just give me a few minutes and I'll be right back. Make yourself comfortable and feel free to use the relaxation station. The machine is producing a new drink this week, it's called a seratochino, its delicious!" A few minutes seem to stretch forever but when you look at the clock you realize that only 20 minutes have passed. You try the unpronounceable beverage and she was right - tasty! As you finish it, Dr. Armitrade returns. @@#choices;.choices; [[You greet her as though you hadn't been waiting 20 minutes.|Interview Decision Brancher]] @@
<img src="images/wilsontalk.png" alt="Robert wilson smiling in a hospital changeroom."> You reach out to your friend <<link "Robert">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> who you've known for years. You explain to him that while you think you are qualified for the position there are times when you've become aware that your confidence isn't where it could be and are worried that people who report to you may see you as being weak. "I think it is OK to appear vulnerable, and to have the courage to show vulnerability", he explained. "I've also heard good things about your devotion to our patients and leadership skills. I would encourage you to apply." Feeling bolstered by his encouragement you enquire about the urgency surrounding the hiring process. "I've heard that <<link "Doctor Armitrade">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> is temporarily filling the role. She must be overwhelmed with work at this point so there is no wonder there is urgency." What will you do now? @@#choices;.choices; <<nobr>> [[Back away from the opening. There just isn't enough detail.|Shrink Wallflower]] [[Go for it!|Go for the job]] <<script>>setup.logger("fb3");<</script>> <<timed 2.5s>><<script>>setup.logger("fb37");<</script>><</timed>> <</nobr>> @@
Even though you have a large group of friends and contacts at Pondview, you devote your time to texting your extended network to see what they know. To others present in the room while you are doing this it looks like you are taking care of urgent patient-related matters. To the patients you are actually caring for it looks rude and unprofessional. At times, your texting takes precedent over actually talking to a person in your company who may be able to help you find out more about the position. Although you find out that the urgency is due to the fact that the Chief of Staff is backfilling the NICU Director role you lose the opportunity to truly engage with some of those around you. What will you do now? @@#choices;.choices; <<nobr>> [[Back away from the opening. None of your friends seem to know anything about the position.|Shrink Wallflower]] <<if not hasVisited('Ask Social Media')>>[[Crowdsource via social media.|Ask Social Media]]<</if>> [[Ask around in person.|Talk to Wilson]] [[Go for it anyhow!|Go for the job]] <<script>>setup.logger("fb4");<</script>> <</nobr>> @@
You use your comm device and ask your personal droid <<link "Amulet">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> to put out some posts about the position to see if you can find anything out. Before you are even finished asking her she cuts you off mid-sentence. "Happy to let you know that your new posts on Twitter, Linkedin, TikTok, Facebook, Reddit and Instagram enquiring about the position have generated over 835 views and 47 comments. A qualitative analysis of the comments indicates that while the position is new, there are several competing NBA teams tonight and that 6 years ago a similar position at Pondview was filled. It should also be noted that the new provincial government is excited about the introduction of stage 5 artificial intelligence into the healthcare workplace." "I see." You say politely, while thinking that maybe you had better do the 'qualitative analysis' yourself. So you decide to... @@#choices;.choices; <<nobr>> [[Back away from the opening. You always trust social media for information and since there is nothing posted the opportunity must not be real.|Shrink Wallflower]] <<if not hasVisited('Ask Text')>>[[Text some of the key people you know.|Ask Text]]<</if>> [[Ask around in person.|Talk to Wilson]] [[Go for it anyhow!|Go for the job]] <<script>>setup.logger("fb36"); <</script>> <</nobr>> @@
Several months pass and you reflect on your goals. Leadership is something you aspire to and there was a grain of truth in the suggestion of Dr. Armitrade that you focus on personal growth so you take the time to do a bit of reading and reflection. One day while you are passing the notice board near the cafeteria you notice the EXACT SAME job posting. @@#choices;.choices; <<back [[Continue...->Job Posting]]>> @@ <<set $progress to 15>>
While you take comfort in the fact that you don't have to 'work on yourself' - whatever that means, you can't help from wondering how your life might be enriched by learning more about leadership. <<include "Game Over">> @@#choices;.choices; <<nobr>> <<back [[Try Again|Chap1]]>> <<link "Debrief">> <<script>> Dialog.setup("Debrief", "modal"); Dialog.wiki(Story.get("Performance Feedback").processText()); Dialog.open(); <</script>> <</link>> <</nobr>> @@ <<script>>setup.logger("fb44");<</script>>
"I think this has been a fairly successful consultation. My internal indicators tell me that you are showing a 13.45% increase in visible signs of confidence related to the forthcoming Director's role. This is in line with normal human performance", he says smiling. "I now have a task for you. You can think of it as a challenge if you like. If you accept I will connect you with the other new NICU directors across the network in a v-forum and your challenge is to openly answer the question of the day. I think you will find it quite interesting." Your comm lights up with a notification. @@#choices;.choices; <<nobr>> <<link[[You accept the challenge.->Challenge 1 Process]]>><<script>>setup.hypecalls.playhype('v-forum'); <</script>><<set $c1=true>><</link>> <<link[[You defer the challenge.->Challenge 1 Process]]>><<set $c1=false>><</link>> <</nobr>> @@
You leave the HR office with a preliminary offer tucked firmly under your arm and feel relieved that the interview is over. In the hospital lobby you are surprised to see your friend <<link "Dr. Elaine Chan">> <<script>>Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>><</link>> who you thought was still on maternity leave. You can't quite remember how long ago she went on leave but it couldn't have been more than a couple of months. "Oh, hi $fname, I came back early", she says. "I'm sorry that I haven't had a chance to send you a thank you card for the wonderful baby shower gift - I've been very busy. The baby is finally sleeping through the night but it was so rough. I was dreading even the thought of trying to come back to work." @@#choices;.choices; <<nobr>> <span id="quesopts"><<link "I'm surprised to see you back so soon.">> <<replace "#ecresp">>"I'm surprised to see you back so soon." You say. <p>"Duty calls I guess - they weren't able to completely backfill my position so I got coerced into coming back early," she says as she rushes away to her next appointment. "Let's talk more later!"</p> <p> [[Continue...->Envelope]]</p> <</replace>><<remove "#quesopts">> <</link>> <<link "Only 5 weeks? And you are back at work already? What's going on?">> <<replace "#ecresp">>"Only 5 weeks? And you are back at work already? What's going on?" You exclaim. <p>"It's a sad story. Let's just say management didn't plan for me to actually stay home and care for my baby so I'm back at work", she says as she rushes off to her next call. "Let's talk more later!"</p> <p> [[Continue...->Envelope]]</p> <</replace>><<remove "#quesopts">> <</link>> <<link "Please don't worry about the thank you card. You seem to have so much on your hands right now!">> <<replace "#ecresp">>"Please don't worry about the thank you card. You seem to have so much on your hands right now!" You exclaim. <p>"You don't know the half of it," she says as she rushes off to her next call. "At least I don't have to send you a card. Let's talk more later!"</p> <p> [[Continue...->Envelope]]</p> <</replace>><<remove "#quesopts">> <</link>> </span> <div id="ecresp"></div> <</nobr>> @@ <<script>>setup.send_analytics("unlock_achievement","passed interview");<</script>>
You reflect on your encounter with <<link "Elaine">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>>. Conversations like this have become more typical around Pondview lately. As you drive home it occurs to you that Elaine will be reporting to you once you take on the Director role. Maybe that means you can do something to support her. After you arrive home you take the time to indulge in your favourite chocolate as a self-reward for getting the job. Settling into your workspace you take a look at the preliminary job offer. There is a 3 month probation period, which is a bit different than for the clinical position you held at Pondview, but you feel good about that since it will provide you some feedback as you develop. The pay increase is nice and you note that the randomized salary negotiation process is in play for this role - maybe you can upgrade <<link "Amulet">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> sooner than you had planned. In addition to the usual boilerplate material you smile as you notice a small brochure about the Leadership coaching program at Pondview and spot your acquaintance <<link "Van Caerde">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> in a hologram showing a cadre of Coaches available to help you in your new role. You are quite interested to find out that all leadership at Pondview are provided a coaching check-up at regular intervals. As you are pouring your second cup of coffee and thinking about how to develop your Lead Self capabilities your comm announces an incoming call from the Pondview HR. @@#choices;.choices; <<nobr>> [[Accept the call.->HR Job Offer]] <</nobr>> @@
"Hello, this is Leah again from Pondview HR." You greet Leah warmly and she returns the courtesy before telling you that all your references provided glowing reviews. "Everything checked out perfectly so we would like to make an official offer to you", she says. "To move forward with the offer we provided in the package, you can use the indicators in your comm to complete the transaction." At this your comm lights up with the incoming options for you to accept. @@#choices;.choices; <<nobr>> [["REJECT PONDVIEW OFFER 12879"->Reject Outright]] [["ACCEPT PONDVIEW OFFER 12879"->Accept Outright]] Note: Your selection is irrevocable. <</nobr>> @@
After you make your selection Leah returns to the call sounding surprised. "I'm sorry to hear that you have formally rejected the position $sal $lname. I sure hope you didn't accidently select the wrong button on your comm. I did that once with the vet and there was a horrible outcome for my pet spider Nancy." You hear soft sobbing on the comm for a moment and wonder if Leah is losing it. "Are you sure you meant to reject the offer?" @@#choices;.choices; <<nobr>> [[YES|Rejected For Sure]] [[NO|Stop Rejection]] <</nobr>> @@
After a few seconds Leah returns to the call. "Hello $sal $lname, I am so happy for your acceptance!" You share her enthusiasm and explain that you are looking forward to taking on the new opportunity. <<include "C2 Coaching Set-up">>
"I have a few more details to go over with you. Do you have time now?" Your start date as Director NICU at Pondview Hospital is in two weeks. Leah also informs you that the Leadership coach <<link "Van Caerde">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>>, will contact you prior to your start day for a brief consultation. After the call ends you reflect on what you have accomplished and feel positive. When you tell friends and family about the exciting news they provide lots of encouragement and wish you well. You aren't quite sure what this new role will be like or how your leadership skills might evolve but feel supported by the Pondview HR team and Management. They really seem to be making a commitment to change. The next day you make contact with Van Caerde and agree to meet at a nearby coffee shop. @@#choices;.choices; <<nobr>> [[Continue...->Coaching Round 2]] <</nobr>> @@ <<set $progress to 20>> <<script>>setup.logger("fb47");<</script>>
The Local Grind is bustling with customers and overly friendly android staff when you arrive. The smell of seratochino permeates the air. 'That drink is really taking off' you think as you notice <<link "Van Caerde">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> waving you over. "Hello $sal $lname I am happy to see you." He says as you sit down. "My suspicion is that you know this place well since it's so close to your home." You tell him that it's your favourite place to enjoy a coffee. "I am aware that humans get great joy from caffeinated beverages", he says. "No time to waste - let's get started. I am here to ensure you are able to perform at your highest level in the new role of Director. Your new Chief, <<link "Dr. Armitrade">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>>, tells me you will be busy when you start the position. She has prioritized several key meetings for you based on what she considers to be the most important problem at Pondview, which in turn effects your NICU. In a nutshell, you need to focus on building a healthy environment, where staff feel valued and able to contribute meaningfully to the vision of the hospital. You will find helpful strategies to meet this goal in the Engage Others domain of the LEADS in a Caring Environment Capabilities Framework. "Are you familiar with the Engage Others domain?" @@#choices;.choices; <<nobr>> [[No I am not.|No Engage Others]] [[Just from what you provided to me the last time we met.|Some Engage Others]] [[Yes, I'm very familiar with it.|Knows Engage Others]] <</nobr>> @@
"I see. The act of engaging others entails constructive joint action between leaders and followers to achieve a shared vision of high-quality patient care. You may remember from the first time we met and I provided an overview of the LEADS Framework. Engage Others is the second domain of the five LEADS domains and, like the others, has four capabilities. "While we all possess certain strengths for communicating, working with others and getting through the encounters of everyday life, the Engage Others domain helps to focus the development of a healthcare leader's capabilities in this area, ensuring they are maximizing the strength of teamwork and interdependence as they work together towards achieving their goals. "Have a look at this vizz. It provides a very high level overview of this domain", he says as he moves some cups aside and projects the vizz onto the table. <div class="vidcontainer"><iframe id="kaltura_player_1636727943" src="https://cdnapisec.kaltura.com/p/1688662/sp/168866200/embedIframeJs/uiconf_id/43767541/partner_id/1688662?iframeembed=true&playerId=kaltura_player_1636727943&entry_id=1_nuiq31rm" width="800" height="450" allowfullscreen webkitallowfullscreen mozAllowFullScreen allow="autoplay *; fullscreen *; encrypted-media *" frameborder="0"></iframe></div> When the vizz ends <<include "Provide EO">>
"That's good. We discussed it previously when we first met. In this domain the focus is on working with others and teams. While we all possess certain strengths for communicating, working with others and getting through the encounters of everyday life, the Engage Others domain helps to focus the development of a healthcare leader's capabilities in this area, ensuring they are maximizing the strength of teamwork and interdependence as they work together towards achieving their goals. "Have a look at this vizz to refresh your memory", he says as he moves some cups aside and projects the vizz onto the table. <div class="vidcontainer"><iframe id="kaltura_player_1619034206" src="https://cdnapisec.kaltura.com/p/1688662/sp/168866200/embedIframeJs/uiconf_id/35312181/partner_id/1688662?iframeembed=true&playerId=kaltura_player_1619034206&entry_id=1_nuiq31rm" width="800" height="450" allowfullscreen webkitallowfullscreen mozAllowFullScreen allow="autoplay *; fullscreen *; encrypted-media *" frameborder="0" title="Engage Others Overview"></iframe></div> When the vizz ends <<include "Provide EO">>
"That's excellent then. I won't spend any time detailing it then." <<include "Provide EO">>
"When you review the Engage Others domain and capabilities you will realize that being an effective communicator cannot be assumed just because you have a title. When you lead a group you work with multiple meanings, competing priorities and different interests. This requires recognizing and reflecting on your own mindset, exploring other peoples’ ideas and finding common ground across diverging points of view. It’s easy to be tempted to respond to turbulence and uncertainty by holding tight to your own ideas, seeing different views as wrong, misguided or poorly motivated, and avoiding difficult topics. "Given this dynamic, Dr. Armitrade asked me to determine the probability that you will have a difficult conversation in your first few weeks and the calculation came in at a 87.345% possibility. You may find this troubling but there is a tool I would like to provide that can help." Van Caerde points his finger at the table and a holo appears. <img src="images/istat.png" alt="iSTAT mnemonic with letters spelled out. Invite,Share, Tell, Ask, Talk Tentatively."> "At Pondview we have created the mnemonic 'iSTAT' to guide difficult conversations. It can be used at any time and consists of a simple pattern to follow to help structure your interactions. I will now provide you with it so that you are prepared in the coming days." At this your comm lights up again. @@#choices;.choices; <<link[[You accept the document.->EO Challenges]]>><<script>>setup.hypecalls.playhype('document'); <</script>><</link>> @@
Van Caerde's eyes flicker upwards indicating that he is probably preparing to send you something. "I've prepared an overview of the Engage Others domain and capabilities and will send it to your comm for further study." Your comm lights up to signify that you just got a reward perk from the Local Grind and that there is an incoming document. @@#choices;.choices; <<link[[You accept the document and perk.->On to iSTAT]]>><<script>>setup.hypecalls.playhype('document'); <</script>><</link>> @@
<<nobr>> <<if !visitedTags("vforum")>>You haven't been invited to any v-forums yet but once you are they will appear here.<<else>> You have been invited to the following forums. In order to access you must provide a response to the challenge question.<</if>> <<if visitedTags("challenge1")>><h2>V-Forum 1 Challenge Question</h2> Now that you are in the NICU Director role, how comfortable are you in your ability to initiate and conduct a dialogue with your new direct reports? How might you develop that capacity? <<if $c1answered is true>> <<timed 1s>><<script>>setup.displayposts("VF1","c1submissions",State.variables.c1_response);<</script>><</timed>> <div id="c1submissions" class="forumpanel" tabindex="0"> </div> <<else>><p><label for="textarea-c1-response">Enter your response:</label><br> <<textarea "$c1_response" "" autofocus>></p> <p><<button "SUBMIT RESPONSE">></p><<script>> if (State.variables.c1_response !="") { Dialog.setup("Consent to Share", "modal"); Dialog.wiki(Story.get("Challenge 1 Permissions").processText()); Dialog.open(); } else { Dialog.setup("Response Required", "modal"); Dialog.wiki(Story.get("Response Required").processText()); Dialog.open(); }<</script>><</button>> <</if>><</if>> <<if visitedTags("challenge2")>><h2>V-Forum 2 Challenge Question</h2> At this point you can see the demands piling up in our story. Can you offer a suggestion on how you might avoid burnout? Feel free to think of wild ideas the future may afford or ways that you personally use to cope right now. <<if $c2answered is true>> <<timed 1s>><<script>>setup.displayposts("VF2","c2submissions",State.variables.c2_response);<</script>><</timed>> <div id="c2submissions" class="forumpanel" tabindex="0"> </div> <<else>><p><label for="textarea-c2-response">Enter your response:</label><br> <<textarea "$c2_response" "" autofocus>></p> <p><<button "SUBMIT RESPONSE">></p><<script>> if (State.variables.c2_response !="") { Dialog.setup("Consent to Share", "modal"); Dialog.wiki(Story.get("Challenge 2 Permissions").processText()); Dialog.open(); } else { Dialog.setup("Response Required", "modal"); Dialog.wiki(Story.get("Response Required").processText()); Dialog.open(); }<</script>><</button>> <</if>><</if>> <</nobr>>
<<if $c1 is true>><<script>>Dialog.setup("V-Forums", "modal"); Dialog.wiki(Story.get("V-Forums").processText()); Dialog.open();<</script>><</if>> <<if $c1>>"I can see you are enjoying the challenge. Fortunately I am not offended by humans that spend a lot of time looking at their comm devices while in the company of androids. It is part of our programming."<<else>>"I completely understand that this isn't the time or place for you to engage in the v-forum but I do hope you will spend time looking at it prior to your start day."<</if>> He says as he begins to stand. He offers his hand to you and wishes you luck in your first few weeks. "I am sure we will be talking more. This adventure you have chosen will lead to great growth for you and Pondview." You return the courtesy and tidy up the table before you leave. As you walk home, you can't help but think about how swiftly this has happened. The support provided by Van Caerde gives you comfort, but you still can't shake that odd feeling in the pit of your stomach - 'must be nerves'. @@#choices;.choices; <<nobr>> [[Unlock Level 3->Chap2]] <<link "Debrief">> <<script>> Dialog.setup("Performance Feedback", "modal"); Dialog.wiki(Story.get("Performance Feedback").processText()); Dialog.open(); <</script>> <</link>> <</nobr>> @@ <<set $chap2access to 0, $progress to 25>>
You must provide a response to the challenge question before you can view other responses in the network. Note: Your response will be kept anonymous and you will have the option of whether to share your response with other participants. <<button "OK">> <<script>>Dialog.setup("V-Forums", "modal"); Dialog.wiki(Story.get("V-Forums").processText()); Dialog.open();<</script>> <</button>>
Do you want to share your challenge response with other activity participants? <<button "YES">> <<set $c1answered = true>> <<script>> Dialog.setup("V-Forums", "modal"); Dialog.wiki(Story.get("V-Forums").processText()); Dialog.open(); setup.putdata("Answered V-Forum 1",State.variables.c1_response,"VF1"); setup.send_analytics("unlock_achievement","posted to v-forum 1"); <</script>> <</button>> <<button "NO">> <<set $c1answered = true>><<script>> Dialog.setup("V-Forums", "modal"); Dialog.wiki(Story.get("V-Forums").processText()); Dialog.open();<</script>> <</button>> <<script>>setup.logger("fb46");<</script>>
<<masteraudio stop>> When you finish your short talk and look around you can see the mood has shifted noticeably. There are a few smiles and some direct eye contact. You no longer notice anyone behaving in a distracted manner. After some brief applause, the staff shuffle out of the lounge. A few people approach you to provide encouragement, including <<link "Doctor Jeremy Lorimer">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> who you've known since you were a resident doing a rotation at Pondview. "I can't help but wondering how we could be so lucky to have you as our director now $fname." He says, while extending his hand in congratulations. "I'm not sure whether it's good luck or bad. Whichever it is, at least it's another roll of the dice. The big wigs around here seem to have a gambling addiction... maybe we should get <<link "Pierre Nut-dough">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> our Patient Experience Manager to talk to them," he says as he walks out of the lounge. Biting your tongue, you give him a thin smile and are thankful it was a short exchange. Jeremy is not exactly your favourite neonatologist in the NICU. Doctor Armitrade walks with you towards your unit. "You did well! I thought the staff seemed very enthused by your talk. I took the liberty of broadcasting the announcement to the rest of the staff that weren't here today and embedded your message as a hologram," she says as you arrive at your office. "I must go now. I have several other appointments this morning but we have time booked together this afternoon. I want to discuss some matters that have come into prominence." @@#choices;.choices; <<nobr>> [[Continue...->Settling In]] <</nobr>> @@
You take a few moments to clear your mind and consider what the position might mean to you, to Pondview as an organization, and to the patients and families served by the hospital. You come to realize that part of what is driving your interest in taking on a leadership role is how much change you've seen over the last five years. Unfortunately, most of the change has been negative. It's hard to put a finger on it. It seems like a lot of little things. The people you work with seem less interested in the day-to-day work and unmotivated to meet new challenges. Pride in their work is missing. There has also been a steady rise in patient safety errors. Not enough to raise many alarms but certainly not as many as you remember when you started. It’s like normalization of deviance has set in. Another thing you notice when you look around is the high rate of turn-over. Most of your colleagues and nursing staff that worked at Pondview with you for many years are now gone. You just don't hear about 10 and 15-year employees of Pondview Hospital anymore. On a personal level you feel ready to take on a new challenge even though it scares you a bit - the thought that you might fail is not something that sits well with you. 'Failure is not an option' has always been your internal motto. In your personal life things have recently changed freeing up some time - you feel you have the extra energy needed to pursue the opening. After reflecting for a while you... @@#choices;.choices; <<nobr>> [[Decide not to apply.|Shrink Wallflower]] [[Ask around about the position.|Ask around]] [[Go for it! You feel grounded in your decision.|Go for the job]] <</nobr>> @@ <<script>>setup.logger("fb38"); <</script>>
The messaging system responds to your secret phrase and reveals a list of prioritized and categorized messages that have come in for you since last time you looked. There are several holograms of congratulations from various friends and colleagues wishing you well and offering any help you might need and a few sales messages related to equipment upgrades that must be forthcoming. As you are looking through the list a new hologram comes in from <<link "Van Caerde">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>>. He zaps into focus. "Welcome to day one $fname! I was forwarded your team address this morning and thought I would take some time to provide a small teaching moment. The topic is leadership style and its effect on the current environment in the NICU. The key point here is that one style is not always going to be better than another. As a leader, you need to be comfortable being nimble enough to use different styles depending on the context. Have a look at your speech." His hologram then morphs into a transcript summary of your speech. <div class="speech-display">$speech</div> Now have a look at this table. <<nobr>> <div class="tablecontainer"> <table class="tabularinfo" tabindex="0"> <thead> <tr> <td> </td> <td> Commanding </td> <td> Visionary </td> <td> Affiliative </td> <td> Democratic </td> <td> Pacesetting </td> <td> Coaching </td> </tr> </thead> <tbody> <tr> <td> The leader’s modus operandi </td> <td> Demands immediate compliance </td> <td> Mobilizes people toward a vision </td> <td> Creates harmony and builds emotional bonds </td> <td> Forges consensus through participation </td> <td> Sets high standards for performance </td> <td> Develops people for the future </td> </tr> <tr> <td> The style in a phrase </td> <td> “Do what I tell you.” </td> <td> “Come with me” </td> <td> “People come first.” </td> <td> “What do you think?” </td> <td> “Do as I do, now” </td> <td> “Try this.” </td> </tr> <tr> <td> Underlying Emotional intelligence competencies </td> <td> Drive to achieve, initiative, self-control </td> <td> Self-confidence, empathy, change catalyst </td> <td> Empathy, building relationships, communication </td> <td> Collaboration, team leadership, communication </td> <td> Conscientiousness, drive to achieve, initiative </td> <td> Developing others, empathy, self-awareness </td> </tr> <tr> <td> When the style works best </td> <td> In a crisis, to kick start a turnaround, or with problem employees </td> <td> When changes require a new vision, or when a clear direction is needed </td> <td>To heal rifts in a team or to motivate people during stressful circumstances </td> <td> To build buy-in or consensus, or to get input from valuable employees </td> <td> To get quick results form a highly motivated and competent team </td> <td> To help an employee improve performance or develop long-term strengths </td> </tr> </tbody> </table> </div> <</nobr>> Can you tell what leadership style you used during your initial introduction? This exercise is a good example of the link between the 'Manage Themselves' capability within the Lead Self Domain and the Engaging Others domain in the LEADS framework. Reflect on this for a minute or two and then indicate which style you used. You may have used more than one but for now just pick the predominant style you used. Bye for now - Van Caerde A series of buttons then appear in the messaging system. @@#choices;.choices; <<nobr>> [[COMMANDING->Messaging Part 2]] [[VISIONARY->Messaging Part 2]] [[AFFILIATIVE->Messaging Part 2]] [[DEMOCRATIC->Messaging Part 2]] [[PACESETTING->Messaging Part 2]] [[COACHING->Messaging Part 2]] [[CAN'T TELL->Messaging Part 2]] <</nobr>> @@
The system accepts your choice. You have a feeling this info is going to come up in your integrity monitoring review at some point, but for now you have other things to worry about. @@#choices;.choices; [[Continue...->Settling In]] @@ <<script>>setup.logger("fb48");<</script>> <<unset $speech>>
"Psst." You call out and make the <i>look</i> gesture with your fingers towards the mortalshark. <<link "Pierre">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> snaps to attention and looks a little bewildered. Eventually they look at the mortalshark and turn closer to get a better view as the mortalshark slurps its prey up. "Amazing! I've never even seen one of those, let alone see it eat," they say softly. "I heard they only eat maybe twice a year so thanks for pointing that out." You let them know it was your first time seeing one as well and then... @@#choices;.choices; <<nobr>> [[Ask if it's a good time to talk.->iSTAT Bingo i]] [[Mention that Dr. Lorimer had mentioned him this morning.->Pierre Gossip]] [[Ask how things are going lately.->How Are Things?]] <</nobr>> @@ <<set $progress to 30>>
You walk a little closer to <<link "Pierre">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> and see that they are deep in their thoughts. They don't seem to notice you or acknowledge your presence at all. 'Must be meditating' you think as you notice the mortalshark snap up its prey. Walking back to your bench you decide to... @@#choices;.choices; <<nobr>> [[Leave Pierre alone.->Leave Pierre Alone]] [[Break the ice and tell them Dr. Lorimer mentioned them this morning.->Pierre Gossip]] [[Ask if it's a good time to talk.->iSTAT Bingo i]] <</nobr>> @@
It looks like this might not be the best time to chat, so you get into your workout clothes and find a free exercise bubble. You quickly get your groove on as the bubble blasts music and presents a set of workout challenges that are just right for you. The illusion of working out in a bubble at sea never gets old - the time flies! As you shower after you work out you notice <<link "Pierre">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> has left the changarium. You did not see them in the workout bubbles either so maybe they changed their mind about a workout after all. @@#choices;.choices; <<nobr>> [[Continue...->Post Workout]] <</nobr>> @@ <<script>>setup.logger("fb49");<</script>>
"Jerry was at it again this morning." You tell Pierre about the odd welcome <<link "Dr. Lorimer">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> gave you after your speech this morning. "He referred to you as 'Nut-deau' again," you mention, explaining that you thought he had already been reprimanded for similar comments. "It's unfortunate Jerry chooses to continue in his ways. I'll be honest with you, after I went on stress leave a couple of years ago it's been very hard to shake the feeling that people don't think I'm able to handle the position I'm in anymore. When I hear about comments like these it adds to my paranoia", they say as they stand to pack up their equipment. "I'd really love to keep talking but I need to move on to my next appointment. You may have heard about the epinephrine problem in the PICU? I need to talk to the family personally. They are in quite a bit of distress over it ; one of the new social workers tried to talk to them and made matters worse. Legal wants to attend and are suggesting we provide a droid– it’s going to be a complicated discussion with them before I even get to see the family. They have no place in that room!" On the way out Pierre looks at you directly as they leave and says "I think you will have your hands full in your role and hope you do well. Personally I find it amazing that a child can be on a vent for 2 days after the incident and still no one has stepped forward with any details on how this happened. Accidents like this are just waiting to happen around here. I hope you can be the one that helps to change the situation." <<include "Bubble Workout">> <<script>>setup.logger("fb51");<</script>>
Pierre briefly looks skyward as though thinking, with a neutral expression. "I'd be lying if I told you everything was perfect. I've got some new things happening in my life and it's been very busy here at Pondview but things are headed in a positive direction. Stars are aligning. Right now I'm concerned about an upcoming family meeting I need to attend. I was going to work out to clear my mind but ended up sitting on this bench the whole time. Now I'm running a bit late so I need to go prepare." They say as they begin gathering their equipment. "I am also very happy for you $sal $lname. I saw your introduction this morning and think you may be the right person to make some needed changes in the NICU. Congratulations!" You ask if its a good time to talk. <<include "iSTAT Bingo i">>
<img src="images/postworkout.png" alt="Cupcake with candle in number one shape on desktop."> You have just enough time to grab a seratochino and sandwich in the executive cafe before heading back to your office. Upon arrival you find a small surprise at your desk. Leah and the rest of the HR team have left a 'Happy Day One' cake and holo-card. 'Nice touch' you think. Enjoying a slice while you finish your drink you dive into the work. Your first task is getting a handle on transport issues in order to prepare for the intra-region transport meeting coming up. After reviewing some of the recent cases and how babies flow throughout the region you can see that it's a real challenge to even understand the data. Policies, terminology and criteria for transport are variable across the region making the data in your opinion useless. This will certainly give you something to discuss at your first transport meeting as lead. The scope of what you need to focus on seems overwhelming as you look into the various details. You are so busy with your review that you are surprised when <<link "Dr. Armitrade">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> appears at your door for your afternoon meeting. "Is this a good time to meet?" she asks. @@#choices;.choices; <<nobr>> [[Yes, come in.->Armitrade Update]] <</nobr>> @@
You head towards the aquarium tube system looking at the different zones of life as you rise and fall in altitude. At one of the viewing areas you sit down together and Pierre addresses you. <<include "Pierre Story Engage">>
You explain to Pierre that you don't have time for a longer talk and absolutely need to get your workout in. They understand your commitment but look a bit dejected. "Maybe we can find the time at some point then. I know you must be very busy as you get into your new role so perhaps once you settle in a bit more we can find time. I'll ask your assistant to schedule something." Pierre packs up their belongings and heads out towards the workout area. "So long my friend, congratulations again on your new role," they say with a small bow of the head. <<include "Bubble Workout">>
Pierre accepts your offer to meet tomorrow and you agree that the Local Grind coffee shop near your home will be mutually convenient. "That works for me. It will give me time to further collect my thoughts." Pierre gathers their belongings and heads out of the changarium. <<include "Bubble Workout">> <<script>>setup.logger("fb53");<</script>>
After they leave you get into your workout clothes and find an exercise bubble. You are able to put the conversation out of your mind, although it's hard because you wonder if you handled it the right way. The bubble blasts music and presents a set of workout challenges that are just right for you all while giving the illusion that you are floating at sea. Even though these bubbles are considered old-tech now you are still amazed at how much fun you have and how fast the time goes by. @@#choices;.choices; <<nobr>> [[Continue...->Post Workout]] <</nobr>> @@
You talk for a bit longer and eventually Pierre regains composure. You discuss Pierre's career options further but they won't make a decision right away. "I'm going to sleep on it $fname. Thank you for listening," they say as you part. <<if visitedTags("pierre-delay")>><<addclass "body" "coffee-shop-2">>The walk back to your home provides a little time to reflect on the day. It's been busy and you are used to that from the clinic however, the diversity of issues and range of ways you could approach things feel much different. Some of the conversations, especially the one with Pierre were uncomfortable but you responded with honesty and didn't try to be someone you are not. Returning to your workspace you feel refreshed. @@#choices;.choices; <<nobr>> [[Continue...->Time Passes]] <</nobr>> @@<<else>>As uncomfortable as the conversation was, you leave feeling positive about being as honest as possible and head back to your unit. <<include "Post Workout">><<addclass "body" "workspace-pondview">><</if>>
<<link "Dr. Armitrade">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> pulls a chair up to your workspace. "You look very busy already! I won't take up too much of your time. I want to make sure your priorities are straight as you begin your work and give you a little news that will help you to make sense of things. May I take over your desk?" She takes out her comm and then displays a file showing a holographic display of the Salli region with the main healthcare facilities labelled. <img src="images/map.png" alt=""> "As you are aware, Pondview is just one facility in the Salli region. Our services are integrated with the City Hospital downtown, the Holmes Hospital to the East, and the Minobimaudiziwin Network which serves the outlying region. I've just returned from a revitalization meeting at regional headquarters. It's one of several meetings that I've been involved with over the last two years - the talks have become more focused on centralized services for Obstetrics and Women's health. "To make a long story short, the City hospital and Province have begun to assemble funds that include private and federal money with the aim of 'revitalizing the health of women and children' in our region. From my perspective this seems like a political flagship that the current party wants to make happen before the next election. While I agree that improving the quality of services in this region is in order, the plan they are talking about seems very short sighted and may wreak havoc on the Region and Pondview." Dr. Armitrade pauses for a moment to let you reflect. You resume the conversation by asking... @@#choices;.choices; <<nobr>> [[What types of change are they suggesting?->Change Pondview]] [[How is Pondview affected?->Change Pondview]] [[Can you tell me more?->Change Pondview]] <</nobr>> @@ <<set $progress to 35>>
Dr. Armitrade closes the map on the deskplay and continues, looking at you directly. "Well for starters, I want to tell you that none of what you will hear has been finalized. There is still an opportunity to influence the proposed change. I want you to agree that you will keep this a secret because part of the reason that last director of the NICU left was because rumors spread, grew and morphed into something he was unable to confront." You respond with.. @@#choices;.choices; <<nobr>> [[Sure, you have my word. ->Secret]] [[I'm not so comfortable with this.->No Secret]] <</nobr>> @@
<img src="images/secret.png" alt="Dr. Armitrade gazes out the window of her office looking at a city skyline."> Dr. Armitrade stands and gazes out the window as she speaks. "The provincial government wants to double the size of the City Hospital, even though its already the largest in the region, and centralize services for Obstetrics and Women's health there. "As a result, Pondview will no longer provide Obstetric services and your NICU would be closed within 3-5 years. The new centre will have a state of the art NICU." She says returning to sit with you at your desk. She looks very distraught and you can see the beginning of a tear forming in her eye. Dr. Armitrade continues. "I think this is a bad move on many levels. Most importantly, it will push services away from the main area in the City where they are needed, the outlying hospitals will lose connection to the communities they serve, and families will be required to travel even further to receive care to a part of the city that's already congested! "What's even more harmful is that they want us to continue in our plans to enhance our Pediatric Cardiovascular Surgery capabilities so we will end up with a situation where we would be transporting infants between the two hospitals at their most vulnerable times. These changes are completely out of tune with what the regional values and mission are supposed to be!" Although you have heard rumours along these lines in the past, this is the first time you've heard it from a source of authority and it seems deflating. Your hopes were that you could help Pondview make some needed changes, especially in the NICU but it now seems like there are much larger issues that you are not even sure you can deal with. After a short pause you ask... @@#choices;.choices; <<nobr>> [[This is important. Don't you think we should tell the staff?->Tell Staff]] [[You said we could influence this change. Can you tell me more?->Health Org]] [[You failed to mention any of this when you hired me. It may have affected my decision.->Me Me Me]] <</nobr>> @@
She seems surprised and raises her eyebrows. "That's the first time anyone ever told me they did not want to hear a juicy secret. You are something special indeed! I respect that. Secrets and lies have gotten us to where we are today at Pondview so let's focus on the truth instead. <<include "Health Org">> <<script>>setup.logger("fb54");<</script>>
"Yes, that is a consideration. You are right, so I will let you choose whether to let the people you talk to know about this. From my perspective I did not want to rock the boat. I feel like we are in turbulent waters already and I'm just not sure how this would have affected the staff. As well, I tend to focus on facts rather than unconfirmed ideas and there is still time to affect this change. Let's have a look at the facts... <<include "Health Org">> <<script>>setup.logger("fb55");<</script>>
"Well nothing is official yet but I do acknowledge that you may not have pursued the position if you had known. Now that you know I'll give you the option to step down or continue to work with me and hear more about what I think we can do." @@#choices;.choices; <<nobr>> [[Inform Dr. Armitrade that you wish to step down.->Step Down]] [[Listen to her plans.->Health Org]] <</nobr>> @@
You politely tell Dr. Armitrade that given this new information you choose to step away from the NICU Director role and focus on your clinical duties. She is able to gracefully explain to the staff that your commitment to the position was a clerical error and apologizes to them profusely. Over the next several months a new NICU Director is hired and you are able to connect with them at a level you are comfortable with. Ultimately Pondview Hospital does shift in its purpose and the larger 'revitalization' plan takes place. The change is too much for you to deal with though and it seems as though patient care continues to take the back seat so you take a new position far away from Pondview and its problems. You are happy with what you learned about leading based on this experience and see it as a step in a journey that may have its ups and downs. For now though its... <<include "Game Over">> @@#choices;.choices; <<nobr>> <<back [[Try Again|Chap2]]>> <<link "Debrief">> <<script>> Dialog.setup("Debrief", "modal"); Dialog.wiki(Story.get("Performance Feedback").processText()); Dialog.open(); <</script>> <</link>> <</nobr>> @@ <<script>>setup.logger('fb57');<</script>>
<<nobr>> <table class="qualetrics"> <tbody> <tr> <th colspan="3">Pondview NICU Quadetrics</th> </tr> <tr> <th colspan="3">NEONATAL OUTCOMES</th> </tr> <tr> <th>Indicator</th> <th>Benchmark</th> <th>Q1/2 <<print setup.year>></th> </tr> <tr> <td>Survival to discharge (%)</td> <td>National Data</td> <td> </td> </tr> <tr> <td>< 27 weeks</td> <td>72</td> <td>63</td> </tr> <tr> <td>27-31 weeks</td> <td>95</td> <td>93</td> </tr> <tr> <td>≥ 32 weeks</td> <td>98</td> <td>97</td> </tr> <tr> <td>Late Onset Sepsis (per/1,000 pt. days)</td> <td>35.3</td> <td>57.8</td> </tr> <tr> <td>Central Line Infections (per 100)</td> <td>1.2</td> <td>7.3</td> </tr> <tr> <th colspan="3">PARENTAL FEEDBACK</th> </tr> <tr> <th>Indicator</th> <th>Benchmark</th> <th><<print setup.year-1>>-<<print setup.year>></th> </tr> <tr> <td>Post-discharge Experience Survey (Likert and open comments)</td> <td>Aim is >99% for Likert 3 & 90% >4 Comments addressed as needed</td> <td>Likert ≥ 3: 80% Likert ≥ 4: 67% Comments on lack of respect and family-centered care</td> </tr> <tr> <th colspan="3">COST ALLOCATION EFFICIENCY</th> </tr> <tr> <th>Indicator</th> <th>Benchmark</th> <th>Q1/2 <<print setup.year>></th> </tr> <tr> <td> <p>Median cost of hospitalization before NICU discharge</p> </td> <td>National Data</td> <td> </td> </tr> <tr> <td>All Infants</td> <td>$20,184</td> <td>$32,118</td> </tr> <tr> <td>Gestational age 33-36 weeks</td> <td>$11,810</td> <td>$17,756</td> </tr> <tr> <td>Gestational age 29-32 weeks</td> <td>$30,572</td> <td>$42,751</td> </tr> <tr> <td>Gestational age <29 weeks</td> <td>$100,440</td> <td>$134,216</td> </tr> <tr> <th colspan="3">STAFF MONITORING</th> </tr> <tr> <th>Indicator</th> <th>Benchmark</th> <th>Q1/2 <<print setup.year>></th> </tr> <tr> <td>Short Term Disability due to safety incidents</td> <td>Total number for this NICU</td> <td>17</td> </tr> <tr> <td>Android to Human Ratio</td> <td>Federal benchmark to be determined</td> <td>1:10</td> </tr> </tbody> </table> <</nobr>>
"I'm good - but sad. I have to tell you that I just put in my notice. I'll be leaving Pondview next month. Wife got a new job elsewhere and she's getting transferred. Moving up and we are moving out I guess." You exclaim that you are sad to hear he is leaving but are happy for the new promotion. "Ya, its good but we have to find new schools for the kids and I guess I won't be part of Pondview anymore. I'm really gonna miss this place." It never occurred to you that someone in housekeeping might miss working at Pondview. You respond to Willie... @@#choices;.choices; <<nobr>> [[I've always admired the work you do. Pondview won't be the same without you. ->Lie to Willie]] [[I never would have imagined that you would miss this place. Especially with all the rumours floating around.->Willie Rumours]] [[What is it about Pondview that you will miss?->Probe Willie]] <</nobr>> @@
As you dart down the hall to exit the building you notice that the administrative area seems so empty at this time of day. Being accustomed to working in the NICU, which has a round the clock schedule, it's unusual for you to see an empty workspace. The drive home goes smoothly and you are able to enjoy an evening out at the new gallery nearby. Your partner makes you swear that you will never be late again. It's a true pinky swear this time, no biometrics involved, unless you count what happened later in the evening, but that is not for this story. @@#choices;.choices; <<nobr>> [[Continue...->Day 2]] <</nobr>> @@ <<script>>setup.logger('fb58');<</script>>
"Really? Well, I admire what you do to. I especially admire the fancy seratochinos you all get to drink for free when I gotta pay $4.50 for a cup of crap they serve in our lounge", he says with a wink. You can tell he is pulling your leg, but you aren't quite sure. You smile politely and explain that you have to run. "Me too", he says. "I gotta get the clinic ready for tomorrow. If I don't see you around - have a good one." <<include "Bypass Willie">>
"Well you can't believe everything you hear", he says. "Or what you read on the papers and things people leave in their offices..." he snickers. "Just kidding! I would never do that. Anyhow, so long $sal $lname. I've got to get back at it." With that Willie pushes his cart down the hall and your mind immediately jumps to wondering if you left anything on your desk but it's an over-reaction. You say your good bye and leave in a hurry. <<include "Bypass Willie">>
"The housekeepers and personal support workers here may not be considered ‘professionals’, but we know we are important. It means a lot to me to work in the NICU. I look at the babies and parents and think back to when my son was born. It must be so hard for them day after day with their sick babies. I work hard to make things pleasant for the babies, the parents, and anyone else who works here. I'm going to miss all that." He looks a bit wistful and you are happy you took the time to ask because what he said inspired you. You wonder if you can get any more thoughts from him so you continue the conversation... @@#choices;.choices; <<nobr>> [["From your vantage point, and from what you would hear from the PSWs, what do we do well in the NICU?"|Do Well?]] [["In my new role as Director, is there anything you think I could be doing to add to what we do well there?"|Add to what we do?]] <</nobr>> @@ <<script>>setup.logger('fb59');<</script>>
Ever since COVID-19 and the advent of high-fidelity holographic imaging, the choice of whether to conduct meetings in person or via technology now rests with the AI coordination team at Pondview. Given you already know all the people you are meeting with today and they are also in various locations in the city - plus other factors in the algorithm you don't quite understand, you will be working from your home workspace today. Fresh coffee in hand you ask <<link "Amulet">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> to give you the daily HR feed as you settle into your workspace. "The Pondview HR news for today is shiny and bright!" She announces in her best newscaster voice. "Word of the day is 'Incendiary', first person to use it in a staff-facing communique or meeting wins 1 month free access to the Gymnarium. For the list of staff news we have Dr. Frank Morner celebrating his 5th year at Pondview, a new RT starting next Thursday - Janet Morriseau, <<if visitedTags("missed-pierre")>><<link "Dr. Pierre Nadeau">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> tendering their resignation with departure from Pondview 2 Fridays henceforth,<</if>><<if visitedTags("missed-willie")>> long-time employee in housekeeping Mr. Willie Yee departing Pondview for new opportunities next Wednesday,<</if>> and a reminder that deliveries to the roof-top car fetch of non-clinical items for personal use or consumption are strictly prohibited." <<include "Lorimer Prep">> <<set $progress to 50>>
You smile and let Willie know that you are glad he took the time to talk to you as you turn to leave. As you walk to the car-fetch you think about what Willie said and decide to... @@#choices;.choices; <<nobr>> [[Ask HR to start a recognition program for your unit tomorrow.->Continue Home]] [[Start an informal recognition program tomorrow and make Willie the first recipient.->Continue Home]] [[Look into the value of starting a staff recognition program before the next NICU team meeting. Then speak to the team about whether they also see its value and what would make it meaningful for them?->Continue Home]] <</nobr>> @@
You drive home and enjoy an evening out at the new gallery you have wanted to get to. Your partner makes you swear late will not be the new normal. It's a true pinky swear this time, no biometrics, but that will change later and is another story. @@#choices;.choices; <<nobr>> [[Continue...->Day 2]] <</nobr>> @@
<<link "Elaine">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> pops into view across from your desk. The slight sheen to her representation is the only indication she isn't really in your office. You greet her warmly and fill her in on your new position. You enquire about her quick return from maternity leave now that you have a bit more time to talk. "I'm coping", she begins. "I wanted to take the full year off but it seems that with you moving to the Director position and a few other departures from the unit that our available clinical hours are far too short to meet the workload. They mentioned that they might possibly be able to share a Neonatologist from outside the region but the costs of shuffling that person back and forth are ridiculous and it was also implied that my position as Chair may no longer be available if I take too long to return. So here I am." You can see that she still looks tired and a bit frazzled as you respond... @@#choices;.choices; <<nobr>> [[That must be difficult for you.->Acknowledge Chan]] [[This isn't right. How can we fix this problem?->Fix Chan Problem]] [[Its a bit ironic that we are supposed to be helping families and here we are pretty much forcing a new mother to return to work early, isn't it?->Chan System]] <</nobr>> @@
You use the time that you had planned to meet discussing some options to help Elaine gain a better work-life balance. Maybe you can squeeze in a few more clinical hours to relieve Elaine. You discuss how Elaine might be better supported by reducing her own workload, especially the duties involved in being Chair of the NICU Quality Committee. "You know, I also feel that maybe I should just stick to my work assignment for the next while. I'll get the job done but hold back on going the extra mile. It sounds harsh, but sometimes it's about self-preservation. A lot of the time I get emotionally involved with work and it takes its toll. For the next while I will focus both on patient care and self care,” she says, as you end the meeting on a positive commitment. Unsure whether that was exactly the right thing to do, you at least feel that you are tackling an important issue at a micro level and setting a standard of caring for your team - especially your friends. <<include "Chan Full Closure">> <<script>>setup.logger('fb78');<</script>>
"You know, I never thought about it that way", she says. "It is ironic how we are treating staff so poorly and yet announce to the public that we are helping families and are one of the 'pillars of the community' during our fund raising campaigns. Now that we are looking closer at it, I can think of tons of situations where we just don't treat our people well. It's sickening!" You feel Elaine is getting fired up and start to think that maybe you pushed the wrong button (figuratively and literally). You want to de-escalate and get back on track so you... @@#choices;.choices; <<nobr>> [[Ask her to be professional and consider the facts. "Tons of situations" sounds a bit like an exaggeration.->Bombed Elaine]] [[State that things must be hard for her, but you need her help to start working on a strategy to change things in the NICU.->Acknowledge Chan]] [[Explain that Pondview is still a pillar of the community and although she sees the issues very clearly, things aren't as bad as she imagines. ->Bombed Elaine]] <</nobr>> @@ <<script>>setup.logger('fb95');<</script>>
<img src="images/lorimermeetintro.png" alt="Jerry Lorimer appears as a hologram in the workspace dressed in boxer shorts and looking at his comm."> Dr. Jerry Lorimer fizzles into life in your workspace. He is dressed in boxers only and holding his comm awkwardly. "Hello, hello," he says looking into and under his comm as though expecting something to come out. 'Jerry - I'm over here' you say - he looks at you bewildered. "Oh - yes, excuse me - I thought this was a voice-only discussion", he says. "Let me grab something to cover up. Good thing for you I chose to wear something at all last night. It's still a bit cool at this time of year isn't it? Nice to see you $sal $lname. After a short pause Dr. Lorimer returns in a robe. "Imagine this - you were my resident oh so many years ago and now things have evolved, the world has turned and it is I who find myself getting my performance review by you and those idiotic androids. My how things have changed." Taking the pause in his speech as a sign to move on you... @@#choices;.choices; <<nobr>> [[Frame the meeting by stating the facts of his review.->Frame Review]] [[Ask Jerry if he has had a chance to review the 360 feedback.->Plus Delta]] [[Wait to see if Jerry has anything else to say. ->Jerry Listen 1]] <</nobr>> @@
Elaine shakes her head and looks at you. She is silent for a moment and appears to be looking at something in her own home. She seems to be struggling to control her emotions but then returns calmly to the conversation and speaks slowly. "What you just said offends me at the deepest level. We are friends but going forward I will only discuss things with you via messaging or formal reports. I have other items to attend to at home right now so I'll put my recommendations for how we should prioritize quality initiatives into a report and send it to you soon. Good bye $fname." With that she disappears from your workspace. You manage to make it through the rest of the day but things go downhill from this point. Several months later, you resign because the team just does not seem to be responding to your leadership style and you need to stick to your values. On the whole, this attempt at leadership has certainly helped you to grow as a person but for now it's... <<include "Game Over">> @@#choices;.choices; <<nobr>> <<back [[Try Again|Chap3]]>> <<link "Debrief">> <<script>> Dialog.setup("Debrief", "modal"); Dialog.wiki(Story.get("Performance Feedback").processText()); Dialog.open(); <</script>> <</link>> <</nobr>> @@
Elaine considers your idea. "Maybe it is time we stopped thinking about money alone. Did you know that they started charging the nursing staff for electricity when they need it? We get it for free from the roof condenser and everyone knows that. I think your approach is the right thing to do. I'm committed to working with the team to establish a healthier workplace environment which will lead to happier staff and better outcomes. I'll have my assistant arrange a time to meet with you." <<include "Chan Full Closure">> <<script>>setup.logger('fb76');<</script>>
Elaine looks puzzled and then responds to your comment. "I am surprised to hear you say that given that ‘excellence’ and ‘compassion’ are our stated values. That being said, I know the BABIT program is what we need and I am sure we can find the money. Did you know the nurses are using a lot of biotricity for their personal devices? If we charged for it, I'll bet it would be lucrative. "I'll see what I can do about rounding up a group to move forward with and let you know when we can present something to you." <<include "Chan Full Closure">> <<script>>setup.logger('fb75');<</script>>
Elaine looks skyward and takes a breath before responding. "I’m glad to hear you say that though our comptroller may not be so happy! I'm not quite sure HR can deal with some of the deeper issues in this place but perhaps that is the way to go. I'll support you when you need me." <<include "Chan Full Closure">> <<script>>setup.logger('fb73');<</script>>
Elaine stares at you blankly without moving. For a moment you think that maybe something is wrong with the holo sytem but then she responds. "Regrettably it’s hard to forget the past as there are a lot of wounded souls out there. I hope you are right going forward and I'll look for your next directive to the Quality Committee to action it. Given our current agenda and items we need to work through, we may be able to get something in front of the group for initial conversation in the next fiscal year." <<include "Chan Full Closure">> <<script>>setup.logger('fb74');<</script>>
Ending the meeting, you reach out to shake Elaine's hand, forgetting that she is a hologram. She reaches out as well and you both laugh at the moment before her image dissipates. You have time in the morning to work on a few more reports and have begun to review the upcoming guideline changes that will be affecting your unit's operations. It's been a productive morning and as you make your way to Pondview you reflect on the problem of data once again. To you it feels like the data and indicators you have to work with just aren't meeting your needs or the needs of the people you work with. Especially Elaine. It seems like a daunting task to rework the key indicators and even at that, you aren't sure if the focus would be any better without the entire team contributing to the effort. You arrive at the familiar HR waiting room and at the set time, <<link "Zephyr">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> comes out to bring you to the review room. It's time for your first integrity 360 review. @@#choices;.choices; [[You let her in.->Integrity 360 Review]] @@
You quickly refresh yourself on your first meeting of the day with <<link "Dr. Jerry Lorimer">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>>. It’s an annual meeting to go over his integrity 360 review - although this one has been delayed by 2 months given the gap in hiring a new Director for the NICU. The review is assembled through both patient, learner and staff feedback and AI monitoring of Jerry's work. Key points are that his parent reviews are atrocious and two recent residents have filed complaints against him. This is not to mention the Nursing Union notices filed against his recent outburst in the NICU. As you are reading the details of the incident your comm gives you the alert that Dr. Lorimer is ready to meet. @@#choices;.choices; <<nobr>> [[You begin the meeting.->Lorimer Meet Intro]] <</nobr>> @@
You politely explain that the purpose of the meeting is to go over his Integrity 360 review. Sticking to the facts, you then list off the issues that have been brought up in relation to his work with parents and staff at Pondview. You finish by explaining that his behaviour leads you to believe he doesn’t really care about the patients and their families, that work has become just a 'job' to him. In an attempt to elicit a response, you then ask what he thinks of all the information you have provided. <<include "Jerry Defensive">>
You look at Dr. Lorimer kindly and ask if he has had a chance to look at the integrity 360 review. Dr. Lorimer looks at you and replies "Shut the front door! Yes, I've looked at it - in between dealing with my protection agency, the nursing union complaint and trying to put in extra shifts given our current shortfall in hours. I've looked at it indeed!" Feeling his hostility rising you ask... @@#choices;.choices; <<nobr>> [[Was there anything you would like to discuss?->Discuss Review]] [[Would you like to consider developing a performance improvement plan with me?->Jerry Loses It]] [[How would you interpret the review? ->Jerry Defensive]] <</nobr>> @@
Jerry remains quiet for a brief moment and then continues. "During the review I watched the recordings of my performance and I was reminded how difficult it is for some of our parents . They just do not know what can happen or go wrong. They assume that when a child comes into this world, despite all the difficulties, the challenges, clinical circumstances and limitations of medicine, even in this day and age, that they will not be disappointed. And when they are, they act surprised and want someone to blame... "I've been reading my review and there are a few things that don't line up. A few things where I feel like a paradigm has changed." Dr. Lorimer pauses and you wait for him to continue. He looks lost in thought so you restart the conversation with... @@#choices;.choices; <<nobr>> [[Do you feel that parents are blaming you for the outcomes you've had?->Parents Blame]] [[What kind of paradigm has shifted for you?->Jerry Paradigm]] [[I wonder if there is any way we can use the review to help you line things up? ->Discuss Review]] <</nobr>> @@
Dr. Lorimer leans back and places his hands behind his head. "Well, it is very interesting indeed and a fulsome indication that the money we spent on all that high-powered technology is helping us to make some wonderful mistakes. Again. As well, your naiveté in this new role reflects you the same naivety you showed as a resident. Plesson v. Almorton 2023 taught us that artificial intelligence could not provide court-admissible evidence. Given that Pondview continues to collect data via these obnoxious algorithmic methods I will continue to completely disregard it. That leaves the actual complaints from parents and staff - which I have reviewed and will discuss. "First the resident complaints. Put succinctly, dumb residents kill babies. There I said it. "When I gripped that trainee by the scruff of his neck and pulled him from what he has doing it saved the life of that innocent neonate. He was about to do a lumbar puncture in the mid-thoracic area which could have resulted in a life of paraplegia for the baby and likely caused his family to go bankrupt. It is unfortunate that the nurse in the room had to witness the incident. I may have used too much verbal and physical force at the time. "As for the parental complaints, I have no defense. I have personally reviewed the holographical video tapes of my interactions with them and what I see in the recordings, the things I say in the recordings do not reconcile with my memory of the conversations. I am convinced that the video recordings may be altered 'deep fakes' as they say, by Pondview and perhaps the provincial authorities so that they may build their case and I assume that is what you are here to do today." @@#choices;.choices; <<nobr>> [[Let's focus on what we agree with then. You need to treat parents better. Will you develop a performance improvement plan with me?->Jerry Loses It]] [[What did you see in the recordings that didn't make sense?->Jerry Paradigm]] [[Facts don't lie. Let's look at the issues one-by-one.->Jerry Loses It]] <</nobr>> @@
"I've looked at the review and feel there are more than a few anomalies.", he begins. "For starters, I disagree that I am treating the residents too harshly. I need them to take the utmost care when handling neonates and will not tolerate any short cuts or lack of foresight. I choose to call out their mistakes firmly and forcefully in keeping with how I was trained. "As for the parental reviews, I would like to improve my performance during family conversations. They don't seem to be going as well as I would like. That being said, when I review the holographical video tapes of my interactions with parents - what I see in the recordings, the things I say in the recordings do not reconcile with my memory of the conversations. I am at a loss to explain this and would like to understand more about how the recordings are created, what the editing process is and if any elements of the conversations have been omitted." His summary of the issues and some of the plans he list make sense but you want a more complete plan so you... @@#choices;.choices; <<nobr>> [[Ask whether he might consider attending some training on working with residents and mention that you can provide him the technical details about how the integrity monitoring is performed.->Middle Ground]] [[Tell Jerry his plans for change aren't complete and ask if he would consider developing a comprehensive performance improvement plan?->Jerry Loses It]] [[Ask Jerry what he thinks might go differently when he talks to parents? ->Jerry Paradigm]] <</nobr>> @@
At this point Jerry used some words that we can't really repeat in a learning activity. He was able to achieve the rare trifecta of insulting, entertaining and humiliating you in a way that made you want to hide in the bathroom. His main, unrepeatable, points were that you lacked the authority and experience to coach him in any way and that he would process the information in the integrity 360 report in a way that he sees fit - if and when he chooses to do so. Fortunately, your recent efforts in personal development related to work on your Lead Self capabilities allow you to recognize the anger and defensiveness boiling up inside. Instead of going on a counterattack, you take a deep breath and decide to... @@#choices;.choices; <<nobr>> [[Accept Jerry's perspective and try again.->Jerry Regroup]] [[End the meeting quickly so you can reflect on it later.->Jerry Reflect]] <</nobr>> @@ <<script>>setup.logger('fb61');<</script>>
"Yes $fname, I do feel they are blaming me. But then when I talk to them about the details and explain the current literature, the science, the statistical probability they typically become silent. I've learned how to deal with their blame as all good clinicians do. "Now, this review is supposed to be about me and not about me telling you my techniques. You are not a resident anymore and don't need to hear this. Instead I will stick to explaining to you what I think of my review. <<include "Discuss Review">>
He looks at you and seems to be at a loss for words. "It seems like when I talk to them that I am not saying what I want to say. I want to tell them that I've been in their shoes. I want to tell them, that I lost a child who was pre-term. I want to reach out to them and cry with them but somehow I lack the ability to do so. When my wife and I lost ours I was still a resident myself. Things were a lot harder back then. It was much more demanding so when we lost our child I went back to work the next day. I'm thankful my wife had a good support network and was able to make sense of things. We have 3 healthy adult children now." Dr. Lorimer sits still and seems to have a tear forming in his eye although it's hard to tell with the fidelity of the holograph. When he then makes a small sniffling noise you feel compassion for him. Staying silent you wait until he speaks further. "Do you think it's possible that maybe I haven't processed something from that time? Do you think that I might be saying one thing to parents yet thinking another? So much so, that I'm actually hiding it from myself?" You explain to Dr. Lorimer that you've heard of situations where people create a reality to compensate for something they can't acknowledge but admit that this goes way beyond your personal expertise. The conversation with him seems to become easier and you are able to suggest that he talk to a professional to work through what he is feeling. You feel relief when the conversation returns to the other issues and are able to work out a rough outline of some things the both of you can do to help him improve in his performance. Your to-do list is to recommend some educational resources to help Jerry work more respectfully with residents. Time moves fast and before you know it there are 5 minutes before your next meeting. Before dissolving, Dr. Lorimer looks you in the eye and says "Thank you for listening $sal $lname. I did not think you had it in you but you do." Taking a moment to collect yourself, you review the key points of the next meeting. <<include "Josee Setup">> <<script>>setup.logger('fb60');<</script>>
The meeting is with <<link "Josee Moffat">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> to discuss nursing resource levels. You don't have much else to go on given the meeting had been set up for you by <<link "Dr. Armitrade">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>>.<<nobr>><<if visitedTags("pierre-delay")>>Remembering that you are also going to meet with <<link "Pierre Nadeau">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> after talking to Josee you grab a quick bite in between meetings.<</if>><</nobr>> At the scheduled time your comm lets you know that Josee is ready to meet with you. @@#choices;.choices; <<nobr>> [[Start the meeting with Josee.->Josee Meet]] <</nobr>> @@ <<set $progress to 55>>
He looks at you thoughtfully and considers your plan. "Well, I don't really think I'll learn anything from the training on working with the residents but given how you turned out under my tutelage maybe it's time to change. Just kidding! You turned out fine $fname. You may be the one to make things work here. "As for the technical details, don't bother. I've already reviewed them. It appears there can be no alterations made to the data. I already have a plan to improve the accuracy though. I will use my own device to make a backup of the next few parental conversations I have with the goal of trying to identify whether there are differences. Maybe I can figure out a different game plan for talking to parents. Or maybe I’ll just use a droid like the province is considering. Then I can focus on clinical care and may even be able to get home at a reasonable hour!" The meeting draws to a close and you are surprised that you seem to have made some progress with Dr. Lorimer. You manage to end the interview with him on a sort of positive note as he promises to give you a chance to do better when his next review rolls around. Taking a moment to collect yourself, you review the key points for the next meeting. <<include "Josee Setup">>
<img src="images/joseemeet.png" alt="Josee Moffat appears in scrubs."> Josee Moffat is a long term pediatrics nurse who has worked almost every unit at Pondview. She took on the Nurse Manager role in the NICU roughly a year and half ago. Dressed in scrubs, she appears to be communicating with you from inside the hospital. "It's nice to be able to formally congratulate you on taking on this new position $fname." You accept her congratulations and realize that Josee is a relatively new leader at Pondview as well so you ask her if she has had any of the leadership coaching and materials that you have. "Yes", she responds. "It's helped a lot but in some ways it's made me realize how much I have to learn. I feel good though. I can do this. How about you? What is your comfort level with leading so far? I know it's only been a day or two but what are your first impressions?" You tell her... @@#choices;.choices; <<nobr>> [[I feel good.->Josee Main Points]] [[I'm undecided. A lot of it is new.->Josee Main Points]] [[I'm not so sure this is for me. ->Josee Main Points]] <</nobr>> @@
"That's interesting", she says. "Sounds a lot like where I was on day 2. Things changed for me over the first several months. Some days I feel great while others not so much. That's life though. I feel that now I am in a position where I can work at a different level and I like that. It's also why I wanted to talk to you today. I asked Dr. Armitrade to get me on your agenda as soon as possible to talk because I am at wit's end. The NICU is a mess and I’m starting to lose sleep over it. A significant number of our senior nurses, our most expert providers, are quitting. They prefer to take early retirement rather than be subjected to the long hours and rampant incivility. Sick days and leaves of absence are climbing. The quality of care may already be suffering. "This mess is also affecting in my balance sheet. Take a look at these numbers", she says as she shares her nursing metrics with you on your deskplay. "I tried to bring this to the attention of the previous Director, but was told to stop functioning above my rank and pay scale. I’m not surprised senior management finally gave him the boot. I’m relying on the nursing agency too much and it’s costing us a fortune." 'More problems' you think as you respond to Josee with... @@#choices;.choices; <<nobr>> [[Do you have any ideas on what might help?->Josee Ideas]] [[I think we need to focus on staff wellbeing. What do you think?->Josee Wellbeing]] [[How long has it been like this? Are you sure of the reasons why the nurses are retiring?->Josee Analysis]] <</nobr>> @@
"I have some ideas. I've been working on an MBA part-time and I think we could apply some of what I've learned." Josee then elaborated at great length on how she might be able to change the nursing supply pipeline and economics of providing nursing staff to the NICU. While she acknowledges that losing senior nurses is not ideal in terms of patient care, she feels that the cost benefit of having a greater number of new nurses on staff, who may also be more tolerant, could in time help to change things. You listen attentively and let her know that... @@#choices;.choices; <<nobr>> <<link "Perhaps she should focus a little less on her MBA and little more on how to help you change the culture in the NICU." "Josee Angry">><<script>>setup.logger('fb67');<</script>><</link>> [[Her ideas may help but that you also want her to help you generate some ideas about how to improve the way the staff are treating the nurses.->Josee Help]] [[You are glad she is working on an MBA, mentioning that if the NICU can reduce its financial shortfall, staff and parents will be happier. You ask to book an hour with her to review the balance sheets.->Josee Balance Sheets]] <</nobr>> @@
"I can see how staff wellbeing is at the centre of some of my issues but I think the way to deal with it is through the balance sheets" she says. <<include "Josee Ideas">>
"It seemed to start when I became the nurse Manager. I knew things weren't perfect but when I started to talk to the other nurses during their reviews and heard about how they want to retire, leave or work elsewhere it made me realize the extent of the problem. No matter what I try, it seems to have little effect so that is why I am talking to you." Josee's description of the last 18 months reminded you that you had also heard some rumblings from the nurses. However, some of their issues seemed to be related to Josee and how she minimizes their ability to express themselves to the staff physicians. Taking all this into account you explain to Josee that... @@#choices;.choices; <<nobr>> [[Open communication, discussion and dialogue are important. You then go over how the nurses might be empowered to resolve issues with staff constructively.->Josee Reacts]] [[You really appreciate her bringing it to your attention. "Senior staff are our most valuable resource but I still need help in setting up a meeting with them as the first phase in identifying the problem and turning things around."->Josee Help]] <<link "Maybe she is trying too hard and that with time, things will improve. Turnover is normal and after all, the nursing staff are quite senior." "Josee Angry">><<script>>setup.logger('fb66');<</script>><</link>> <</nobr>> @@
She seems satisfied and thanks you for your time. At least you are going to be able to work with her, but it may take some time to explore the merits of her approach while seeing if she can embrace the area of focus that you feel is important - staff wellbeing. <<include "Josee Brancher">> <<script>>setup.logger(['fb64','fb65']);<</script>>
"That is ridiculous, and not a solution", she says raising her arms. I've been waiting for a new Director to talk to for 2 months and this issue is critical. We don't have enough experienced nurses and patient care is suffering. What can you do to help me?" You reflect on the situation and tell Josee... @@#choices;.choices; <<nobr>> [[That it is vitally important to focus on building a healthy organization.->Lose Josee]] [[That she is right and you don't have a solution but hope you can continue to work together to see this through. ->Josee Help]] [[To give you more time to think things through.->Lose Josee]] <</nobr>> @@ <<script>>setup.logger('fb68');<</script>>
"Well, I'll help you if you continue to consider my ideas. Maybe the solution is a blend of some different approaches." You agree to move forward together but remind Josee that it's going to take time. Change doesn't happen overnight and only sustained focus will help some of the larger problems improve. <<include "Josee Brancher">> <<set $progress to 60>> <<script>>setup.logger('fb63');<</script>>
"Here we go. Blame, blame, blame. Essentially what you are telling me is that if the nurses would accept more abuse we would all be fine! I really don't have time for this $sal $lname!" <<include "Josee Recover">>
This isn't exactly how you wanted the conversation to go but you realize you are at an impass with Josee. You end the meeting cordially and ask her to reach out to you again when she has more time explaining that you want to help the NICU and nursing is a key piece of the puzzle. @@#choices;.choices; <<nobr>> [[Continue...->Josee Brancher]] <</nobr>> @@
At this Josee stands up, appears to walk across the room she is in and violently kicks something. Josee grimaces in pain. You manage to hold your expression and are a bit dissociated from your own emotions given you also feel horrible that you caused this outburst in some way. "Look at what you have made me do!" she says. Thinking fast you respond... @@#choices;.choices; <<nobr>> [[I am so sorry. My comments weren't meant to be incendiary.->HR Word of the Day]] [[With a silent nod, acknowledging her anger.->Josee Recover]] [[I'm not responsible for your emotions Josee. Get a grip.->Josee GO]] <</nobr>> @@ <<set $progress to 60>>
You give her a bit of time to recover and she apologizes for her outburst. "I'm just feeling so much pressure $sal $lname. I know you can't always say everything I need to hear - I'm going to give you a chance though. For now I need to collect myself." <<include "Self Help">>
At this, your comm device bursts out in a short tune and announces that you have won the HR word of the day contest - you will receive one month free access to the Gymnarium! Unfortunately Josee hears the announcement too and you hear her shouting obscenities before she dissolves from view having closed the connection. The prize is little consolation given you feel horrible about your mistake. As well, Josee uses the incident to showcase how HR and upper management are just playing games with people at Pondview. Staff wellbeing continues to deteriorate although you try hard to learn more about how you might be a better leader. 'Oh well, there will be other chances' you think, but for now it's... <<include "Game Over">> @@#choices;.choices; <<nobr>> <<back [[Try Again|Chap2]]>> <<link "Debrief">> <<script>> Dialog.setup("Debrief", "modal"); Dialog.wiki(Story.get("Performance Feedback").processText()); Dialog.open(); <</script>> <</link>> <</nobr>> @@ <<script>>setup.logger('fb69');<</script>>
While it is true that Josee needs to control her emotions, she has been pushed to her limit and ends the call abruptly. She spends the next several months taking her anger out on you through subtle and overt actions that impede any progress you might want to make with the nursing staff. You are unable to come to terms with her and step down from the position. Your leadership ride has been an incredible learning experience but for now it's... <<include "Game Over">> @@#choices;.choices; <<nobr>> <<back [[Try Again|Chap2]]>> <<link "Debrief">> <<script>> Dialog.setup("Debrief", "modal"); Dialog.wiki(Story.get("Performance Feedback").processText()); Dialog.open(); <</script>> <</link>> <</nobr>> @@
<<if visitedTags("pierre-delay")>>You are thankful that the meeting with Josee ran short since you need to get over to the Local Grind to meet with Pierre. You make it there just in time and are able to find a quiet spot to talk since it's not as busy as usual. You make some small talk with Pierre and note that they seem more confident than when you last saw them. You mention that they wanted to tell you something yesterday and ask what it was. @@#choices;.choices; <<nobr>> [[Continue...->Pierre Story Engage]] <</nobr>> @@<<else>>You are thankful that the meeting with Josee ran short because you need a little time to reflect on the morning. It's been busy and you are used to that from the clinic however, the diversity of issues and range of ways you could approach things feel different. It's not as intuitive to you. You decide to relax a bit and spend the next hour strolling to the Local Grind to grab a coffee before returning to your workspace feeling temporarily refreshed. @@#choices;.choices; <<nobr>> [[Continue...->Time Passes]] <</nobr>> @@<</if>> <<set $progress to 60>>
<<if visitedTags("pierre-delay")>><<addclass "body" "coffee-shop-2">><<addclass "body" "fadein">><</if>>"I want you to know that just before your appointment was announced, I was offered a new job at the City Hospital. I haven't accepted the position yet but the truth is, I’ve been thinking about leaving for a while and when a job came up at City hospital I decided to apply. Although I won't be at the same level, I'll be leaving Pondview and that is my main goal. To be honest with you this place is not good for my mental health. As a social worker I always felt I could make a difference and have been gratified to be able to help patients and families transition to an optimized setup on discharge. But in my role as Manager Patient Experience at Pondview I am getting despondent." Pierre starts to choke up a bit while explaining this to you. "From what I hear our patient care is slipping and mistakes are happening, especially in the NICU. Staff tell me that if they see something wrong, they don’t bother to report it for fear they’ll get punished by their supervisor. Medication errors, blood stream infections, those little babies in the NICU are so vulnerable and it breaks my heart. Parents come to my office crying. Staff have forgotten about what it means to ‘care’. All this despite the fact that the NICU lists excellence and compassion among its values. I tried hard to communicate my concerns to the previous Director prior to them leaving, but it fell on deaf ears. I just can’t go on this way. I have to get out of here for my own sanity." Pierre is crying now and you feel unprepared to deal with such raw feelings. Over the years you have been in emotional situations related to patient outcomes with team members and families but this seems more complicated and you aren't sure how to respond so you tell Pierre... @@#choices;.choices; <<nobr>> [[I am sorry to hear how upset you are. How long did you say you’ve been feeling this way? It must be hard to go home every day carrying this load.->Post Pierre Talk]] [[I am so sorry. I’ve enjoyed working with you but can't promise you that change will come fast. If you decide to take the position and see anything at City Hospital we can learn from, please send me a note.->Post Pierre Talk]] [[Thanks Pierre. You have identified a problem that needs to be fixed. If only I knew who to direct this issue to, but I don’t. It’s too big for one person to tackle alone. Good luck to you, whatever you decide.->Post Pierre Talk]] [[I share your concerns and feel your pain. I know this is a problem and I am committed to working with the team to fix it. Now can I talk you into staying and helping me?->Post Pierre Talk]] <</nobr>> @@
<<set _eoscore to 0>>The rest of the day goes by in a whirlwind with more meetings and a fair amount of paperwork to attend to.<<if !visitedTags("missed-pierre")>><<set _eoscore to _eoscore + 1>> A few days later <<link "Pierre Nadeau">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> sends you a message to let you know they have decided to stay at Pondview, lifting your spirits. 'One small win', you think.<</if>> <<nobr>> <<if !visitedTags("missed-willie")>><<set _eoscore to _eoscore + 1>><</if>><<if !visitedTags("missed-josee")>><<set _eoscore to _eoscore + 1>><</if>><<if !visitedTags("missed-lorimer")>><<set _eoscore to _eoscore + 1>><</if>><<if _eoscore <= 2>><<include "Armitrade Feedback Engaged 0 or 1">><<elseif _eoscore > 2 && _eoscore < 4>><<include "Armitrade Feedback Engaged 2 or 3">><<else>><<include "Armitrade Feedback Engaged 4 or 5">><</if>> <</nobr>>
The following days and weeks are a blur as you learn to blend your clinical duties with the extra demands of your new role. Unfortunately you keep having challenges with a few people you met with on your very first days in the new role and their issues take up what little time you have when not dealing with pressing emergencies and your clinical duties. While you know that being a leader means taking on new responsibilities, it seems like every decision has to go through you and the staff still seem disengaged. Morale remains low and departures continue. Although you try as hard as you can and emulate some of the great leaders from the past, nothing seems to work so you decide to step down at your three month review when <<link "Dr. Armitrade">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> sits with you to discuss your performance. Reflecting on the experience you realize that you need to spend more focused time on self-development and learning how to engage others to be successful as a leader. For now it's... <<include "Game Over">> @@#choices;.choices; <<nobr>> <<back [[Try Again|Chap2]]>> <<link "Debrief">> <<script>> Dialog.setup("Debrief", "modal"); Dialog.wiki(Story.get("Performance Feedback").processText()); Dialog.open(); <</script>> <</link>> <</nobr>> @@ <<script>>setup.logger('fb70');<</script>>
<<masteraudio stop>> During the next week at work you have less protected time than usual due to new residents coming onto rotation, clinical training you must attend and a small vacation that you and your partner had planned. Overall the ability to balance the demands on your time have always been challenging but more so this week. Today is no different and seems busy again. It starts with an early meeting with your friend <<link "Dr. Elaine Chan">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> to discuss quality initiative prioritization, followed by your integrity 360 review at the Pondview Human Resource Department. It is hard to believe it has been six months since you took on the Director role. The HR staff put the review meeting into your schedule over a month ago and it's a 2 hour meeting. Following that you have your regular monthly meeting with <<link "Dr. Armitrade">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>>. You reflect on how these meetings are so important in your goal to grow workplace wellness, even though other important tasks have to wait a little longer. Although busy it will be nice to reconnect with <<link "Elaine">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>>. At the set time for the meeting you comm indicates she is ready to meet. @@#choices;.choices; <<nobr>> [[You begin the meeting.->Chan Meet Intro]] <</nobr>> @@
"I know this is a lot to take in but I want to congratulate you on your performance so far. Before we go, do you have any questions for us?" <<link "Van Caerde">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> says while waiting patiently for your response. @@#choices;.choices; <<nobr>> <<link "I feel like I've achieved results already. What do you mean by the Achieve Results domain?">> <<replace "#vcresp">>"Excellent question. To a certain extent you have achieved results in what you've done so far. However, you may not be aware of some of the underlying capabilities you used to achieve those results and how you might develop them further. That is what the Achieve Results domain in the LEADS in a Caring Environment Leadership Development Framework helps with."<</replace>> <</link>> <<link "Do you have a video overview of the Achieve Results domain? I really liked the other ones.">> <<replace "#vcresp">>"Of course", Van Caerde says as he projects the vizz into the integrity 360 workspace for you to view. <div class="vidcontainer"><iframe id="kaltura_player_1619034206" src="https://cdnapisec.kaltura.com/p/1688662/sp/168866200/embedIframeJs/uiconf_id/35312181/partner_id/1688662?iframeembed=true&playerId=kaltura_player_1619034206&entry_id=1_41g0yeq9" width="800" height="450" allowfullscreen webkitallowfullscreen mozAllowFullScreen allow="autoplay *; fullscreen *; encrypted-media *" frameborder="0" title="Achieve Results Overview"></iframe></div> <</replace>> <</link>> <<link "How does the Achieve Results domain link to the Lead Self and Engage Others domain?">> <<replace "#vcresp">>"Good question! Let's look at an example from your review. When you met with Dr. Lorimer, it was a test of your Lead Self capabilities of Demonstrate Character and Manage Themselves. Without developing these capabilities your interaction with Dr. Lorimer may have become even more inflammatory, preventing any level of engagement. In turn, organizational results can't be achieved without 'engaging others' in the operational processes that the Achieve Results domain outlines."<</replace>> <</link>> <<link "You seem so wise and the coaching you have provided has helped so much. Why don't we use Androids as leaders here at Pondview?">> <<replace "#vcresp">>"Sigh... One day, maybe that will occur my friend."<</replace>> <</link>> <<link "How will I know when I've become an effective Leader?">> <<replace "#vcresp">>"You should be able to identify your impact in measurable ways but the work of becoming a leader never truly ends. The dynamic nature of healthcare, changes in society and even changes to leadership theory predicate a need for constant development and learning amongst leaders."<</replace>> <</link>> <span id="vcresp"></span> <</nobr>> [[Continue...->Coaching Reflection]] @@
<img src="images/joseeholo.png" alt="Francine appears as a hologram"> <<link "Francine">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> appears in miniature on your deskplay. With a thick French accent, stylish clothes and jazzy, electric white hair she makes quite the impression. You feel energized by her presence. "Bonjour $fname! I know we haven’t had the opportunity yet to meet, but I look forward to the opportunities. Dr. Armitrade suggested I talk to you about future directions of the NICU as it relates to the strategic direction of Pondview. I would be pleased to do so. Can we meet in the next couple of days to go over your situation? If you give me a couple of times you are available I will send a meeting invite. À bientôt!" Eager to respond you ask your desk to pick a tired-looking representation of yourself as you dictate a holographic reply. "Bonjour Francine!... @@#choices;.choices; <<nobr>> [["... Your perspective on navigating the administration here and satisfying Dr. Armitrade’s needs would be helpful given I’m not really a political person. Frankly I am really pressured by work right now and find it difficult to see how Dr. Armitrade’s wishes can be accommodated with such short notice. I can only put aside an hour for you. Is that enough to get me up to speed? How does 1630 next Tuesday or Thursday sound? Let me know." ->Francine Time Yellow]] [["... I look forward to meeting and particularly want to know more about how my unit fits into the strategic priorities and future direction of Pondview, and how I might improve the performance of my unit. But I am reluctant to bother my NICU colleagues with the work involved. Can you pull something together for me as a first draft before we meet? I can put aside an hour or so next Tuesday morning or Thursday afternoon to review. Please let me know what works for you." ->Francine Time Red]] [["...I need to understand what you and your team do and how I and my team can help revitalize our indicators to improve the performance of our unit. I need some advice on applying principles of strategy and operations to realizing that. How much time is needed? I am free Tuesday morning or Thursday afternoon, and if we need more time, we can explore subsequent meets. Please let me know what works for you."->Francine Time Green]] <</nobr>> @@ <<set $progress to 85>>
The next day you meet with <<link "Dr. Armitrade">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> to present your plan. After several questions and clarifications she smiles and nods her head in approval.. <<include "Think we Have a Plan">> <<script>>setup.logger(['fb89','fb90']);<</script>>
With a strong idea of how the strategic planning process will unfold you decide that it would be a good idea to make a formal announcement about it to the staff, outlining how you will involve them and families and what you hope the outcomes to be. When you approach Francine with the idea she gives it her blessing. "On y va!" she exclaims, agreeing that it is a good idea. <img src="images/ar-graphicstep3.png" alt="Take action to implement decisions."> With the help of <<link "Amulet">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> you put together a short hologram for the staff with some key points. including. #The outcomes you are hoping to achieve from the process, #How the initial retreat will be run; and #What the follow-up meetings and work will consist of. In closing, you appeal to their commitment to help improve the work that the NICU provides to the community and ask that they engage themselves in the strategic planning process - providing insight, opinion and open dialogue. You hesitate before sending the message to everyone, apprehensive that it won't be well received but Amulet urges you on. "Since the upgrade my new integrity monitoring capability has become very useful and can see that the authenticity and commitment you are revealing in this message is very high. I think the staff will be supportive." You send the message and after a few days it is evident to you that she was right. <<if !visitedTags("missed-chan")>><<link "Elaine Chan">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> lets you know that you have her full commitment and that she feels that refreshing the indicator framework is long overdue.<</if>> <<if !visitedTags("missed-jerry")>><<link "Dr. Lorimer">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> mentions the initiative one day when you are working together in the clinic. "I've been through a lot of planning and visioning meetings in the past $fname and I must say that they are typically useless. However, this time I think the right person is here to lead us and I'm especially thrilled with the way you are asking for ALL of our input. I hope to be a big contributor at the retreat. I will even put my comm away for the day - no distractions!"<</if>> <<if !visitedTags("missed-josee")>><<link "Nurse Manager Josee Moffat">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> responded to your initial announcement and let you know that she has been seeing some positive changes since you came on board and is looking forward to seeing how the strategic planning will play out. "I'm so very happy that both staff and nursing will be represented. We need this type of planning to get together on the important things as a team and stop acting in isolation."<</if>> <<if !visitedTags("missed-pierre")>><<link "Pierre Nadeau">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> sends you a quick note to let you know they are supportive and will help however they can, especially in working with the families to make things more understandable during the retreat and subsequent planning activities.<</if>> @@#choices;.choices; <<nobr>> [[Continue...->Plan Implementation]] <</nobr>> @@ <<script>>setup.logger('fb92');<</script>>
The following days and weeks are a blur of activity as you learn to blend your clinical duties with the extra demands of your new role. At times, you are able to reflect on the new skills required and use the LEADS framework to guide your exploration of literature in both the Lead Self and Engage Others domains. You feel certain your capabilities are growing but it's hard work and there is no easy way to measure whether you are doing everything right - at least not directly. You do notice that when you apply some of the leadership theories that interest you to your conversations they seem to go better than they had in the past. The more you take time to journal and reflect, the easier it becomes to make decisions that align with your values and vision for the NICU. When <<link "Dr. Armitrade">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> meets with you for your three month review it is generally positive, although she urges you to continue to work on your ability to engage others. Overall, she feels that there is a positive change in some of the key indicators for the unit and wants you to continue the good work. <<include "Armitrade Closure">> <<script>>setup.logger('fb71');<</script>>
The following days and weeks are a blur of activity as you learn to blend your clinical duties with the extra demands of your new role. It seems to be going well though. You are able to leverage the strength of the team in ways you never thought possible. Even <<link "Dr. Lorimer">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> seems more positive and you hear from Josee that his attitude towards the nurses has improved. At times, you are able to reflect on the new skills required and use the LEADS framework to guide your exploration of literature in both the Lead Self and Engage Others domain. You feel certain your capabilities are growing but it's hard work and there is no easy way to measure whether you are doing everything right - at least not directly. You do notice that when you apply some of the leadership theories that interest you to your conversations that interactions with others become fertile ground for examining your own performance after the fact. The more you take time to journal and reflect, the easier it becomes to see how your decisions are tied to your core values and vision for the NICU. When <<link "Dr. Armitrade">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> meets with you for your three month review it is very positive. She indicates that you are becoming an important part of the leadership core at Pondview and that there is a positive change in some of the key indicators for the unit. <<include "Armitrade Closure">> <<script>>setup.logger('fb72');<</script>>
"I'm seeing some positive signs coming from the NICU when I speak to people and look at the early data. The last two quarters of Quadetrics data are being officially released soon and there are some improvements in your NICU. If we keep working at it I think we can continue to improve staff wellness but I'm not quite certain it's going to help if the regional authority continues with its plans. I also need better data and I'll talk to you in greater detail about that soon. "I'll be looking at you to help me achieve some meaningful results and I'm asking all the Directors at Pondview to make this same commitment." Unsure of what she might be thinking, or if you will have the time and energy to contribute, you give Dr. Armitrade your assurance that you are committed to the work of the NICU and Pondview on the whole. As you reflect on your first 3 months its clear to you that you've made a difference and look forward to the new challenge ahead. @@#choices;.choices; <<nobr>> [[Unlock Level 4->Chap3]] <<link "Debrief">> <<script>> Dialog.setup("Performance Feedback", "modal"); Dialog.wiki(Story.get("Performance Feedback").processText()); Dialog.open(); <</script>> <</link>> <</nobr>> @@ <<set $progress to 65>>
"There is one more thing to mention", Van Caerde says. I've noticed that between your scheduling, hours worked and future commitments that your integrity 360 Burn Out Meter is indicating that you are heading into a danger zone." "Pondview Hospital takes physician burnout seriously and provides a range of interventions to help you, we can see that you have not been utilizing them as much as you could." Zephyr continues. "I know you might not have time right now, but I've given you access to a new <<link "v-forum challenge">> <<script>> Dialog.setup("V-Forums", "modal"); Dialog.wiki(Story.get("V-Forums").processText()); Dialog.open(); <</script>> <</link>> and it relates to physician burnout. You may want to have a look and engage with some of your colleagues on this issue. There are some brilliant ideas in the discussion that may prompt you to use your time differently." Van Caerde and Zephyr thank you for your time and attention and provide a few final words of encouragement. "You are doing great $fname, now you need to lead with the mindset of what can be achieved by the team as they continue to grow and learn under your coaching." You wish them well also and decide to review the Pondview metrics. They seem to be better recently but you are still finding it challenging to see how they really indicate any true change or reflect the greater mission, vision and values you hear about at your meetings with Dr. Armitrade. 'Maybe it's a fluke?' you think as you look at the numbers. Could my actions be helping these indicators to change? How can I ensure there is lasting change? There isn't much time to dwell on the subject before your meeting with Dr. Armitrade. As you make your way to her office the seeds of doubt grow stronger. Although you are working at being a leader and have seen some positives it doesn't necessarily feel like the NICU is any different. @@#choices;.choices; [[Continue...->Armitrade Setup]] @@ <<set $progress to 75>> <<script>>setup.hypecalls.playhype('v-forum'); <</script>>
<<link "Zephyr">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> brings you to the integrity 360 room where <<link "Van Caerde">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> is waiting. They situate themselves in the control area with the other technicians while you choose to lie on the couch. "The integrity 360 review is at the forefront of human resource management and coaching", Zephyr begins. "Given the expense, we reserve this process for executive staff only. "You can think of it like a three dimensional analysis of your performance that an elite athlete might receive from their coach", Van Caerde says. "By now you've probably realized that developing your leadership capabilities is more akin to a marathon than a sprint. You need to train each day and week and this review will greatly help you to habituate some specific methods tailored to your needs into your training regimen. The idea here is that we are honing your performance, which is already good." Zephyr takes over the controls and walks through the multimedia review. At the conclusion, you feel excited about the ideas and approaches Van Caerde wants you to work on. "I'd also like to remind you of the utility of the LEADS in Caring Environment Framework", Van Caerde continues. "I feel that you are at the point where your work will focus on using your personal Achieve Results domain capabilities so I would like to provide a summary of the domain to you for further reflection. @@#choices;.choices; <<link[[You accept the document.->AR Coaching]]>><<script>>setup.hypecalls.playhype('document'); <</script>><</link>> @@
<img src="images/arminoffice.png" alt="Dr. Armitrade smiling"> Arriving at <<link "Dr. Armitrade's">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> office you greet her warmly. Although she does not interact with you on a daily basis, she has been available from time-to-time to answer your questions. Her primary method to support you has been to introduce you to many of the other Directors at Pondview, who face similar problems, facilitating the development of a great network of support. In the short period of time that you have reported to her, each interaction has been positive - she truly values your input and continually encourages your personal growth and development. "Welcome $sal $lname", Dr. Armitrade says. Once you sit down she begins your monthly meeting. “I want to commend you on reaching six months in the Director role. I can see the growth in your leadership practice every time we meet. I have also been watching the NICU’s progress. "Speaking informally to the staff, the overall mood is better and that is reflected in the marginally improved staff monitoring indicators. Costs are trending in the right direction but there is still a long way to go. Staff absenteeism persists, although that may be a lagging indicator, and residents are still dissatisfied - Pondview isn't exactly the number one choice for rotation placement. Many of the quality measures we track continue to fall below benchmarks - patient outcomes are suboptimal and families remain unhappy. "We have not yet seen a wholescale improvement and it is clear to me that we are in a precarious position. The revitalization plan that the region is considering is still steamrolling forward <<if visitedTags("Secret")>>and the performance of the unit might well determine whether it exists into the long-term future.<<else>>and there could be a ramification on your unit, especially if the indicators reflect poorly.<</if>> "I'd like to ask you a question. What do you think of the way we are looking at NICU performance? Do you feel confident that the data are meaningful?" You consider her question for a moment and then respond. @@#choices;.choices; <<nobr>> [[Yes, the data are very clear to me and help in my decision making.->Data Perfect]] [[Some items seem relevant while others could use some work. It's not always clear to me but provides a general guideline.->Data Needs Work]] [[Its just data. I focus on what matters and know the numbers will work out in the end.->Doesn't Use Data]] <</nobr>> @@
<<set _CEO_gender to random(1, 13)>> "Our CEO is working hard on the problem of meaningful indicators as well and <<if _CEO_gender == 13>>they have<<elseif _CEO_gender < 7 >>he has<<else>>she has<</if>> built a consensus amongst the executive staff that it's time to look at the framework we use to manage the important data in our hospital. "A number of years ago we adopted the Triple Aim Framework from the Institute for Healthcare Improvement and supplemented it with indicators that helped us look at staff wellness moving to a Quadruple Aim approach. As time passed we made subtle modifications and had issues with the data so adjustments were made. "I'll send more information about the Quadruple Aim framework to you for future reference", she says while manipulating her comm. After a brief moment your comm indicates an incoming set of documents. @@#choices;.choices; <<link[[You accept the documents.->Armitrade Plan Timing]]>><<script>>setup.hypecalls.playhype('document'); <</script>><</link>> @@
"I find it interesting that you would say that. I felt that way in the past but the more I think about it, the less sure I am that they reflect where we need to go. <<include "Armitrade Demands a Plan">> <<script>>setup.logger('fb80');<</script>>
"I agree. While the current indicators are helpful, we may be losing focus on what truly matters. <<include "Armitrade Demands a Plan">> <<script>>setup.logger('fb81');<</script>>
"I like your focus on what matters but can you be sure what matters to you reflects the mission, vision and values in the NICU and Pondview on the whole? In this day and age it's extremely difficult, if not impossible, to manage without data but you are right, data alone does not provide direction and clarity of purpose. <<include "Armitrade Demands a Plan">> <<script>>setup.logger('fb79');<</script>>
"To be clear, I am not telling you to 'cook the books'. I am asking you to contribute your ideas, with the NICU specifically in mind, on how we might restructure our indicators with the input of your team. During your deliberations, don't forget that the NICU is a member of Pondview and also within the Salli region so you need to think at least organization-wide as the plan is put together. A home-run would be to incorporate the region somehow. "I know this is a lot of work and may be new for you so I've asked our Director of Strategic Planning, <<link "Francine St. Croix">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> to reach out to you to help. I also have budget to allocate before the end of the quarter in 8 days so this request comes with some time pressure. In very short order I need you to have an outline of what your plan may consist of and we’ll meet next week to discuss. I need to see what you have in mind before I can allocate the funds to help you and if we miss this window it may be some time before we can move forward on this." Feeling a bit stunned, you ask Dr. Armitrade a few more questions about what ideas might be acceptable but she does not provide detailed answers. "I believe you are ready to take on this task and don't want to limit or influence your ideas. I have complete trust that you can do this." Wishing that you felt as confident as she was you... @@#choices;.choices; <<nobr>> [[Return to your workspace.->Return Workspace]] <</nobr>> @@ <<script>>setup.logger('fb82');<</script>>
"I see", she says. "I admit that we have been plan-heavy in the past several years and have not always stuck to our commitments. While I respect that you are trying to minimize the impact on your team there is no way we can move forward without their input. Our current CEO is also serious about making real change this time and there are funds available to do what is needed. "However, I can't force you to do this work so if this is your final decision I am going to have to ask you to tender your resignation from the Director role." You consider your options and decide to... @@#choices;.choices; <<nobr>> [[Resign.->Resignation]] [[Reconsider.->Reconsider]] <</nobr>> @@
"You are showing quite a bit of self-awareness in your assessment of how you feel about this. I'm glad you could tell me that." Dr. Armitrade then calls up an image from her comm and displays it to you. "This was me, all those years ago when I took on my first major leadership role. Oh how time flies. When I took on the role of Chief of Staff I also felt tentative. Through a lot of reflection I realized that I was dreadfully afraid of failing and in a lot of ways I still harbour that fear. It's not easy to be a leader when you have those sorts of feelings because they can hold you back. "I know you can do this but you may need to look deeper inside to find out what is making you uncomfortable. I love the saying 'losers fail once, while winners fail many times.' I use it as my mantra. Maybe you can find your mantra. We won't be able to solve this right now so let's talk more about the details of what I need. <<include "Plan Requirements">>
"I'm disappointed in your decision and although we are losing a good Director, perhaps we are regaining a Neonatologist with enhanced leadership skills. It may take some time to get things in place but I hope you can support the next Director of the unit." Dr. Armitrade extends her hand to signal departure and you grasp hers and show her to the door. After several months a new Director steps forward and you are able to support them with a deeper knowledge of not only how to lead but how to be an effective follower, so you participate fully in developing a new plan for the unit. In terms of continuing your formal leadership role as NICU Director at Pondview its... <<include "Game Over">> @@#choices;.choices; <<nobr>> <<back [[Try Again|Chap3]]>> <<link "Debrief">> <<script>> Dialog.setup("Debrief", "modal"); Dialog.wiki(Story.get("Performance Feedback").processText()); Dialog.open(); <</script>> <</link>> <</nobr>> @@ <<script>>setup.logger('fb83');<</script>>
"I'm glad you are going to reconsider. Let's work together to overcome any barriers you might have." You then spend the next 15 minutes working through some of the issues and realize together that it's a matter of confidence. You admit that you lack the confidence to proceed and this helps define a path forward. <<include "Plan Confidence Builder">>
You shuffle off to your next meeting and try to study for your upcoming training session in between the meetings that follow. Later that day you receive a follow-up from Francine to schedule the planning session later in the week. She mentions that you may need more time but there isn't much you can do and hope that you can put something together quickly with Francine's input in the time you have. <<include "Amulet Upgrade Interlude">> @@#choices;.choices; <<nobr>> [[Continue...->Francine Strategy Yellow]] <</nobr>> @@ <<script>>setup.logger('fb86');<</script>>
You feel happy that you found a quick solution that might allow you to balance what little time you have to work on this in the next week. Given Dr. Armitrade feels so strongly about Francine's work you are confident she will provide a high quality plan and you can further guide her. <<include "Amulet Upgrade Interlude">> @@#choices;.choices; <<nobr>> [[Continue...->Francine Strategy Red]] <</nobr>> @@ <<script>>setup.logger('fb84');<</script>>
You feel great that you are giving this the attention it needs but you are a bit frustrated that Dr. Armitrade hadn't put this on your radar a bit sooner. You make a mental note to discuss this with her in the future. There are a few things you might be able to juggle to get more time, so you... @@#choices;.choices; <<nobr>> [[Defer the upgrade you had planned for Amulet tonight as it was going to take up the entire evening.->Defer Amulet]] [["Ask around to see if any of your clinical shifts could be traded with another Neonatologist." ->Trade Shift]] [["Skip the training and see if you can learn about the new procedure from a colleague later on."->Skip Training]] <</nobr>> @@ <<script>>setup.logger('fb87');<</script>>
You meet in Dr. Armitrade office at the set time hopeful she will approve your plan. Unfortunately things do not go well. "I may have put too much pressure on you. To me this kind of plan indicates that either you aren't willing to engage with the process or just do not have the bandwidth to apply yourself. I must apologize for putting you in this position. "I won't be able to put this into my budget so we will have to hope for the next window of opportunity. I want you to use this time to keep working at the high level you are." You never do get the chance to come up with another plan because in the following months you receive the unfortunate news that the ministry is going to merge the City Hospital services with Pondview's and your NICU will be shut down in 3 years. The metrics they rely on just aren't strong enough to convince them otherwise. While you use your leadership capabilities to help the team through this unfortunate situation you can't help but think that getting more engaged with the planning process would have been the right move. You feel dejected but also want to use this as a learning opportunity. 'Maybe there is a way to navigate this and I'll get there - but not just yet'. For now it's... <<include "Game Over">> @@#choices;.choices; <<nobr>> <<back [[Try Again|Chap3]]>> <<link "Debrief">> <<script>> Dialog.setup("Debrief", "modal"); Dialog.wiki(Story.get("Performance Feedback").processText()); Dialog.open(); <</script>> <</link>> <</nobr>> @@ <<script>>setup.logger('fb85');<</script>>
That evening you and your partner set out the plan with <<link "Amulet">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> after dinner. 'Tonight is the night you've been waiting for Amulet', you say. 'We wanted to surprise you so we kept this a secret. Your upgrade component has arrived and we are going to install it this evening. From what we understand it will take a few hours but I'm a Neonatologist and my hands are very steady - everything will be fine.' Amulet pauses for a moment and then provides a glowing smile. "I'm ready", she says. "This is really going to help in the long run. I'll be able to do more for the both of you and I was concerned you might replace me with a newer model rather than actually do the upgrade on your own. I'm very happy about what this means." The three of you manage to make small talk while getting a make-shift OR ready for the procedure. When you give Amulet the command to turn off she blinks out of commission silently. You and your partner dive into the work...
Fortunately you never mentioned that all the components for the upgrade had arrived to <<link "Amulet">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> given her previous apprehension about the procedure so you keep it under your hat. <<include "Strategic Planning">> <<script>>setup.logger('fb88');<</script>>
You are able to trade some shifts but have to cancel your weekend plans with your partner who is completely understanding. After all you've worked very hard to maintain a good work-life balance since you started the position and have managed to build up a fair amount of goodwill. <<include "Strategic Planning">> <<script>>setup.logger('fb88');<</script>>
You're quite upset that you won't get to suervise the biotechnical task trainers while staff practice the new procedure. The fidelity is so high that there is no way you could replace the experience you will gain, especially since this particular procedure is new, expensive and to be used in only the rarest of circumstances. Regardless, you cancel your enrolment and are able to find an offering in the next month in a nice location outside your region. You should be able to have your partner join you as well, so it's a temporary loss but a longer term win. Unless a neonate with pistilitis of the coccyx comes along in the next month that is. <<include "Strategic Planning">> <<script>>setup.logger('fb88');<</script>>
The next day you meet with <<link "Dr. Armitrade">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> to present your plan. "I think it's almost there and I like it but you are forgetting two key elements - the Families your unit serves. I'd suggest you include them in defining the vision mission and values and then I can get behind this and provide both the funding and time you will need to fulfill the plan. Working together you adjust the final plan to... Adopting a mini-strategic plan approach for the unit, enabling staff, clinicians and some families to identify the vision, results, values and evidence-informed strategic and operational priorities for action. Once defined you will ask the staff to agree to work with you to implement the changes and refine the indicators. You both feel good about the plan this way given it relies on engagement of not just staff, but also patients and families and operationalizes three adages that guide planning work at Pondview. #"People support what they help create." #"Alignment of action achieves results." #"Results should drive decision making and action.” <<include "Think we Have a Plan">> <<script>>setup.logger('fb91');<</script>>
The remainder of the week goes by quickly and you are able to meet briefly with Francine. She lets you know that it will be difficult to proceed without your full engagement but provides a draft plan you can approach Dr. Armitrade with. The plan consists of using an external consulting firm, who possess experience in this sort of work. "They should be able to run with the project from beginning to end and need only minimal input. I've worked with them before. They are tres bien! I can give you an outline of their proposal for your review. Bonne Chance $fname!" It's not a perfect plan but it's the best you have for now. You are able to tweak it a bit to include some of the buzz words you hear in the executive missives you receive in your message stream on a regular basis. @@#choices;.choices; [[You thank her for assistance and present the plan to Dr. Armitrade the next day.->Armitrade Plan Rejection]] @@
The rest of the week moves quickly and you have very little time to work with Francine on the plan. In between your other commitments and vacation you are able to sketch out two plans. The day before you are to meet with Dr. Armitrade you need to decide on which one to present. @@#choices;.choices; <<nobr>> [[Plan A - Adopting a mini-strategic plan approach for the unit, enabling staff and clinicians to identify the vision, results, values and evidence-informed strategic and operational priorities for action. Once defined you will ask the staff to agree to work with you to implement the changes and refine the indicators.->Armitrade Plan with Mods]] [[Plan B - Working with the Director of Quality to give the unit a list of three or four ‘measurable results’ that operationalize the missing elements of the current Pondview metrics framework. The unit will adopt them, setting clear expectations to staff to work towards improving the results, along with the good work they are already doing.->Armitrade Plan Rejection]] <</nobr>> @@
You use the extra time to get a better sense of how strategic planning works in practice with an eye towards developing your personal knowledge of the capabilities described in the Achieve Results Overview that <<link "Van Caerde">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> provided. Although the next few days are still quite busy you feel more prepared when you meet with Francine via hologram in your home workspace later in the week. You welcome <<link "Francine">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> and describe some of the background work you've done. She describes the role of her unit - to carry out the strategic planning functions of Pondview but also to provide, as needed, guidance to Directors such as yourself who are grappling with integrating their work into the strategic directions of Pondview. She emphasizes that the LEADS framework has helped guide how she developed the strategic planning approach and what is emphasized in Pondview as it relates to ongoing operational practice and improvement. In particular, she says, we have three fundamental principles that guide our work. #"People support what they help create. That includes, by the way, a recognition that patients, families and communities are part of the creation process." #"Alignment of action achieves results." #"Results should drive decision making and action.” <img src="images/ar-graphicstep2.png" alt="Strategically align decisions with visions, values and evidence."> Francine then further describes what those principles mean, providing a short explanation as to how the domains of LEADS are consistent with those principles, and how the process of developing Pondview’s strategic plan and the plan itself operationalizes those principles. She then asks you to describe your understanding of the challenge put to you by Dr. Armitrade. @@#choices;.choices; <<nobr>> [[You explain what you understand and are able to make the connection to the principles she outlined.->Plan Development]] <</nobr>> @@
You spend the next hour and several subsequent sessions creating four draft plans with Francine. The day before you are to meet with Dr. Armitrade you need to decide on which plan to present. Francine asks you to choose the one you feel most strongly about... @@#choices;.choices; <<nobr>> <<link "Plan A - Reinforcing the vision you articulated when you applied for the position as the plan and aligning the indicators with your values, then informing the rest of the staff and developing some operational strategies to achieve the vision you had set forth.">> <<replace "#vcresp">>"Francine shakes her head. Now that I look at the different plans we came up with, I don't think this is the strongest and can't support it. You need the team to be involved. A personal vision is not a shared vision."<</replace>><<script>>var myDiv = document.getElementById("passages");myDiv.scrollTop = myDiv.scrollHeight;<</script>> <</link>> <<link "Plan B - Adopting a mini-strategic plan approach for the unit, enabling staff, clinicians and some families to identify the vision, results, values and evidence-informed strategic and operational priorities for action. Once defined you will ask the staff to agree to work with you to implement the changes and refine the indicators.">> <<replace "#vcresp">>"Yes! This is the one", Francine says "It relies on engagement of not just staff, but also patients and families and operationalizes all three principles I mentioned." <p> @@#choices;.choices; [[You thank her for help assistance and present the plan to Dr. Armitrade the next day.->Armitrade Plan Approval]] @@</p><<script>>var myDiv = document.getElementById("passages");myDiv.scrollTop = myDiv.scrollHeight;<</script>><</replace>> <</link>> <<link "Plan C - Working with the Director of Quality to give the unit a list of three or four ‘measurable results’ that operationalize the missing elements of the current Pondview metrics framework. We will adopt them as a unit, setting clear expectations to staff to work towards improving the results, along with the good work they are already doing.">> <<replace "#vcresp">>"No I don't think this is the best one either. It takes a <em>'command and control'</em> approach and foists measures on the unit that may, but likely will not, resonate with clinicians and staff. It might not be meaningful to families and parents either. It does operationalize the principle that ‘People support what they help create’ and ‘Results should drive decision making’, but not necessarily the alignment principle. Just telling people does not create alignment."<</replace>><<script>>var myDiv = document.getElementById("passages");myDiv.scrollTop = myDiv.scrollHeight;<</script>> <</link>> <<link "Plan D - A retreat with my most trusted colleague in the unit to come up with a revised vision for our team. We will also identify a couple of indicators that speak to the missing Triple Aim components. With those we will develop a plan for the unit. I will then communicate the plan to the unit members and also the Director of Quality so she can develop any further indicators we need. Then it is full steam ahead.">> <<replace "#vcresp">>"Sorry, I know I helped you come up with this but it seems wrong now. You need the full team involved, not just hand selected people. Although this operationalizes the affiliative leadership style it does so with only one person and does not operationalize ‘People support what they help create’. While it does recognize need for measurable results to drive action, and partially, the alignment principle 'develop a plan', imposing it doesn't create collective ownership so I don't think this is the best plan."<</replace>><<script>>var myDiv = document.getElementById("passages");myDiv.scrollTop = myDiv.scrollHeight;<</script>> <</link>> <</nobr>> @@ <span id="vcresp"></span> <<set $progress to 90>>
Over the next month or two your focus is on operationalizing the plan. While it was a busy time, Francine helped immensely by providing you the name of a facilitator of strategic planning, Morris Zuckermann. Morris is skilled at realizing the principles of Pondview’s strategic planning work and was pivotal in organizing and planning the initial retreat ensuring the involvement of members of your staff, patients, and public. Your ability to establish a healthy work-life balance also improved because you decided to focus on doing what you truly need to do in order to have the time, patience and energy to get through this new process. While giving yourself the mental and physical time needed to deal with the additional work was counter-intuitive because you had so much to do - you were able to stick to your habits and continued to exercise, journal and use mindfulness techniques to improve your effectiveness. 'There are only so many hours in a day', you think - although you feel like you are making those hours effective and setting up healthy limits to what can reasonably be achieved in the given time. <<if visitedTags("Defer-Amulet")>>You even manage to find time to perform the upgrade on Amulet.<<include "Amulet Upgrade Interlude">><</if>> @@#choices;.choices; <<nobr>> [[Continue...->Team Brief]] <</nobr>> @@
"I think we have a plan for the NICU!" Dr. Armitrade says. "I'll work with Finance to provide the funds for you to realize it and want to remind you that in six months we will have a review to see if it has helped cyrystalize both our hospital-wide metrics framework and further improve the performance of your team. Great work $fname!" @@#choices;.choices; <<nobr>> [[Continue...->Taking Action Setup]] <</nobr>> @@
With Dr. Armitrade's looming deadline of a 6 month review on the horizon you feel good about what you and the unit have accomplished. It's no small feat to get an entire unit onboard with such a high-level plan but the fact that you were able to pay attention to the performance measures during the process, kept an air of practicality to proceedings. The plan was well-grounded but you wanted to ensure it remained vital so you decided to review the plan going forward with Francine. "There are four other departments at Pondview that have a role in operationalizing your strategic directions. The Strategic Planning Department, the Department of Quality, the Department of Research, and the Department of Community Outreach. I think we can leverage all of them going forward and have a few ideas of how you may want to structure an oversight committee." Francine then provides a set of four possible structures, asking for your input on which might work best... @@#choices;.choices; <<nobr>> <<link "Structure 1 - One small committee comprised of one of your closest neonatologists, one nurse, one pharmacist, one social worker, and a representative from the Quality Department; to meet monthly.">> <<replace "#vcresp">>"Maybe, but it lacks community involvement. What do you think of the other plans?"<</replace>><<script>>var myDiv = document.getElementById("passages");myDiv.scrollTop = myDiv.scrollHeight;<</script>> <</link>> <<link "Structure 2 - Two different groups. One comprised of internal staff representatives, and one of individuals representative of other departments in the hospital, including a patient representative, meeting monthly.">> <<replace "#vcresp">>"It's not terrible, but I think the needs of the patient population might be underserved in this model." <</replace>><<script>>var myDiv = document.getElementById("passages");myDiv.scrollTop = myDiv.scrollHeight;<</script>> <</link>> <<link "Structure 3 - One large group, comprised of internal staff reps, reps from other departments in the hospital, and parent/community representatives. To meet biannually.">> <<replace "#vcresp">>"I'm not so sure about this one", Francine says. "The frequency doesn't seem right and with such a large voice I am sure one group may dominate over another."<</replace>><<script>>var myDiv = document.getElementById("passages");myDiv.scrollTop = myDiv.scrollHeight;<</script>> <</link>> <<link "Structure 4 - Three different groups. One comprised of internal staff representatives, one of individuals representative of other departments in the hospital, and one of parents/community members. To meet separately once monthly; and together, once every three months.">> <<replace "#vcresp">>"Yes! Out of the different ways we could do it I think this is the best. It gives all stakeholders a voice and community members are less likely to be co-opted."@@#choices;.choices; [[You both decide this is the best structure and close the meeting.->DoQ Setup]] @@<</replace>><<script>>var myDiv = document.getElementById("passages");myDiv.scrollTop = myDiv.scrollHeight;<</script>> <</link>> <</nobr>> @@ <span id="vcresp"></span> <<set $progress to 93>>
<img src="images/ar-graphicstep4.png" alt="Assess and evaluate."> With a month to go prior to the NICU performance review you feel confident in the progress and some of the monthly indicators seem to be moving in the right direction. However, the Family Experience metrics still seem to need improvement. <<if !visitedTags("missed-jerry")>>Even though you feel that Dr. Lorimer has improved his performance with families you still are not quite sure of what the problem might be. <</if>> You decide to discuss the issue with <<link "Boris Yakmanov">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>>, the Director of Quality at Pondview over lunch at the cafeteria. "As you know, our oversight team approved how to effectively measure our key indicator entitled, Quality of Our Patient Experience, and to report it out so we can respond depending on how well we are doing. I have been providing reports to you and the oversight team at our monthly meetings and as you know, that particular indicator has hovered in the ‘amber’ zone... not good, not bad, room for improvement , keep working on it. "Over the past month it has dropped precipitously into the red zone. According to our charter you and your team are obligated to do something about that." Reflecting on the situation you ask... @@#choices;.choices; <<nobr>> [[Can you provide any insight into why it might have declined so precipitously? Does our data collection process give us a clue?->PE Detail]] <</nobr>> @@ <<script>>setup.logger('fb93');<</script>>
The quality director speaks while reviewing the data. “As you know, the Quality of Our Patient Experience indicator is a combination of three contributors. First, the results of the patient experience survey we conduct with each parent when their child leaves the hospital. Second, the number of unsolicited formal complaints we receive and that are logged on the unit, and third, a short two-question survey we do of patients/families six months after discharge. "In reviewing the three elements it's clear that a major issue is two-fold. Responsiveness of staff and communication with clinicians. Now, these numbers aren’t horrible overall but are affected by the performance of one of your physicians which I've anonymized given our charter. "This chart shows the complaints and comments from the surveys in terms of frequency of occurrence by clinician over the past two months. Notice that N2 is a tremendous outlier compared to the other four. N2 is up at 10 complaints per 25 patient interactions while the others are in the 0-2 realm. It's clear to me at least that one of the physicians is causing the lion’s share of problems.” You consider the problem and decide to... @@#choices;.choices; <<nobr>> [[Press the Director of Quality more to find out who the person is.->Press DoQ]] [[Put the results of the Key Indicator information in front of the Oversight Group to discuss potential ameliorative steps with them.->Discuss Oversight Group]] [[Meet with each of the Neonatologists individually using the data you were just provided to pinpoint the problem->One on One]] [[Call a meeting with the Neonatologists as a group to discuss the data.->Group]] <</nobr>> @@
You ask the Director of Quality if they could clarify who the outlier might be explaining that it will help you with how to proceed. "I just can't do that. It will break the trust that the team has in the way we are using this data and things are going so well right now. "Why don't you meet with them as a team and show them both the indicator results and the relative distribution, as well as some of the comments that characterize the nature of the complaints. Then ask them to discuss what behaviours will best mitigate these issues going forward. Ask them to take ownership of the problem, and indicate you will monitor it further before taking any action. "This will get them involved in not only taking the problem seriously but helping to define a solution." You consider the suggestion and... @@#choices;.choices; <<nobr>> [[Call a meeting with the Neonatologists as a group to discuss the data.->Group]] <</nobr>> @@
You decide to send a message to the chair of the oversight group to ask if you could put an item on the next meeting agenda to discuss the troublesome indicators and potential remedies. They explain that this isn't within the group's mandate and suggest that perhaps you discuss the matter with the Neonatologists as a team. You consider the suggestion and... @@#choices;.choices; <<nobr>> [[Call a meeting with the Neonatologists as a group to discuss the data.->Group]] <</nobr>> @@
Over the next month or so you have informal discussions with the six physicians in the unit one-on-one. During the discussions you describe the indicator results and the relative distribution, as well as some of the anecdotal statements that characterize the nature of the complaints. Although they are interested, you find it difficult to gain their attention given their busy workload. Some of them try to attribute the issue to other factors. "In all honesty it just seems like a bad string of luck. The case mix lately has been very difficult and outcomes are not as we desired." Others seem defensive and you make little progress. You decide to take a new approach and... @@#choices;.choices; <<nobr>> [[Call a meeting with the Neonatologists as a group to discuss the data.->Group]] <</nobr>> @@
A week later you take the results to a meeting of the unit’s six physicians and show them both the indicator results and the relative distribution, as well as some of the anecdotal statements that characterize the nature of the complaints. Treating the meeting as a brainstorming session you ask them to discuss what behaviours will best mitigate these issues going forward. A long list of ideas is created and the team narrow the list down to the top four. The group decides to take ownership of the problem and implement the ideas that were brought to the top but want you to follow up with them at the next Neonatologist meeting to review whether there is any improvement. You agree and feel confident that not only is the plan working, a feedback loop is starting to form. People really seem to be taking an interest in achieving results and those results are aligned with the needs of Pondview, the patient population and your own values. 'This type of leadership feels good', you think as you finish out the week. @@#choices;.choices; <<nobr>> [[Unlock Level 5->Conclusion]] <<link "Debrief">> <<script>> Dialog.setup("Performance Feedback", "modal"); Dialog.wiki(Story.get("Performance Feedback").processText()); Dialog.open(); <</script>> <</link>> <</nobr>> @@ <<set $progress to 95>> <<script>>setup.logger('fb94');<</script>>
<<masteraudio stop>> <<link "Dr. Armitrade">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> appears in your workspace and comments on your jacket. "I like your jacket! But you had better watch out - I hear green is going to be out soon", she says laughing. Can you believe the silly things they predict? Someone may have hacked the androids to drive sales. I'm not sure what the world is coming to sometimes!" The meeting with Dr. Armitrade continues and she mentions that the method you have used to both energize your team and revitalize the key result areas is going to be used by other teams as an exemplar. She is very happy with the results you've achieved. "I'd also like to inform you $sal $lname, that the Regional Authority has taken notice. The media picked up a story about one of the families that your staff worked with recently. Do you remember the triplets with the very low birth weight? Not only was it a medical triumph, the family spent a lot of time talking about the care they received. They provided a glowing account of caring and thorough doctors, nurses and providers in your unit. Dr. Lorimer was interviewed as well and he actually seemed happy! "The media then followed up with the patient advocacy group who further described how involved the community is in defining values and drivers of care in the Pondview NICU. It came off like a huge advertisement for Pondview and specifically you unit. "Due to the press and some of the numbers in the latest quarterly submission to the ministry I have a feeling that my voice at the revitalization table will be given more weight. "I can't thank you enough! You work and leadership have been a key catalyst for the type of change we need here. "How do you think your leadership skills can help Pondview go to the next level? What should we consider?" You think for a moment and respond with... <div class="txtcentre"> <label for="textarea-final">Enter your thoughts:</label> <<textarea "$final" "">> <<button "SUBMIT">><<script>> if (State.variables.final !="") { Dialog.setup("Consent to Share", "modal"); Dialog.wiki(Story.get("Final Permissions").processText()); Dialog.open(); } else { Dialog.setup("Statement Required", "modal"); Dialog.wiki(Story.get("Final Required").processText()); Dialog.open(); } <</script>> <</button>></div> <<timed 4s>><<script>> document.getElementById("textarea-final").focus(); <</script>><</timed>>
!!!What Others Have Said <div id="future" class="forumpanel" tabindex="0"></div> Great work $sal $lname! Your willingness to take on a leadership position at Pondview and thoughtful decisions have given Pondview Hospital a real chance to make lasting change. We hope your journey through SimuLEADerShip helped you to uncover your potential and shine a light on new areas of growth as you continue your leadership studies. At this point you have completed the simulation. If you haven't already viewed your personalized debrief we recommend you do so now. Alternately you may complete the post-activity evaluation in order to receive your certificate of completion. Thank you for being a brave SimuLEADer! <div class="txtcentre"><<button "VIEW DEBRIEF">> <<script>> Dialog.setup("Debrief", "modal"); Dialog.wiki(Story.get("Performance Feedback").processText()); Dialog.open(); <</script>> <</button>> <<button "POST-ACTIVITY EVALUATION">> <<script>>window.open('https://survey.alchemer-ca.com/s3/50122119/SimuLEADerShip-Post-Evaluation?sguid='+State.getVar("$sgid")+'&prog='+State.getVar("$progress")); <</script>> <</button>></div> <<set $progress to 100>> <<timed 1s>><<script>>setup.displayposts("FS","future",State.variables.final);setup.send_analytics("level_end","level 5");<</script>><</timed>>
@@.posting; .txtcentre; !Salli Regional Health Authority Vision, Mission and Values !!Vision Healthy citizens in healthy communities !!Mission To provide patient and family-centered healthcare for each in an accessible and sustainable healthcare system toward wellness for all. !!Values Compassion, excellence, equity and safety @@ @@.posting; .txtcentre; !Newborn Services and Neonatology Purpose and Values !!Our Overall Purpose To provide state-of-the-art, evidence-based, and compassionate care for newborns, mothers, and their families, within a provincially-integrated system. !!Our Values Excellence Compassion Scholarship Inclusiveness Collaboration Stewardship @@
<<nobr>> <table class="qualetrics"> <tbody> <tr> <th colspan="5"> Pondview NICU Quadetrics </th> </tr> <tr> <th colspan="5"> HEALTHY NEONATES </th> </tr> <tr> <th> Indicator </th> <th> Benchmark </th> <th> Q1/2 <<print setup.year>> </th> <th> Q3/4 <<print setup.year>> </th> <th> Q1/2 <<print setup.year+1>> </th> </tr> <tr> <td> Survival to discharge (%) </td> <td> National Data </td> <td> </td> <td> </td> <td> </td> </tr> <tr> <td> < 27 weeks </td> <td> 72 </td> <td> 63 </td> <td> 65 </td> <td> 67 </td> </tr> <tr> <td> 27-31 weeks </td> <td> 95 </td> <td> 93 </td> <td> 94 </td> <td> 94 </td> </tr> <tr> <td> ≥ 32 weeks </td> <td> 98 </td> <td> 97 </td> <td> 98 </td> <td> 98 </td> </tr> <tr> <td> Late Onset Sepsis (per/1,000 pt. days) </td> <td> 35.3 </td> <td> 57.8 </td> <td> 52.3 </td> <td> 49.5 </td> </tr> <tr> <td> Central Line Infections (per 100) </td> <td> 1.2 </td> <td> 7.3 </td> <td>6.2</td> <td>3.6</td> </tr> <tr> <th colspan="5"> FAMILY EXPERIENCE </th> </tr> <tr> <th> Indicator </th> <th> Benchmark </th> <th> Q1/2 <<print setup.year>> </th> <th> Q3/4 <<print setup.year>> </th> <th> Q1/2 <<print setup.year+1>> </th> </tr> <tr> <td> Complaints by Parents in Patient Experience Office (n) </td> <td> We aim for zero Each complaint is taken seriously </td> <td> 29 </td> <td> 23 </td> <td> 17 </td> </tr> <tr> <td> Parent Orientations (per 100 admissions) </td> <td> Aim = 100% </td> <td> 80 </td> <td> 85 </td> <td> 93 </td> </tr> <tr> <td> Post-discharge Parent & Patient Experience Survey (Likert and open comments) </td> <td> Aim is >99% for Likert 3 & 90% >4 Comments addressed as needed </td> <td> Likert ≥ 3: 80% Likert ≥ 4: 67% Comments on lack of respect and family-centered care </td> <td> Likert ≥ 3: 83% Likert ≥ 4: 69% Comments on continuity of care and lack of respect </td> <td> Likert ≥ 3: 87% Likert ≥ 4: 74% Comments on the inappropriate use of androids </td> </tr> <tr> <th colspan="5"> COST EFFECTIVENESS </th> </tr> <tr> <th> Indicator </th> <th> Benchmark </th> <th> Q1/2 <<print setup.year>> </th> <th> Q3/4 <<print setup.year>> </th> <th> Q1/2 <<print setup.year+1>> </th> </tr> <tr> <td> <p>Median cost of hospitalization before NICU discharge</p> </td> <td>National Data</td> <td> </td> </tr> <tr> <td>All Infants</td> <td>$20,184</td> <td>$32,118</td> <td>$29,215</td> <td>$26,834</td> </tr> <tr> <td>Gestational age 33-36 weeks</td> <td>$11,810</td> <td>$17,756</td> <td>$17,034</td> <td>$15,472</td> </tr> <tr> <td>Gestational age 29-32 weeks</td> <td>$30,572</td> <td>$42,751</td> <td>$40,891</td> <td>$39,004</td> </tr> <tr> <td>Gestational age <29 weeks</td> <td>$100,440</td> <td>$134,216</td> <td>$130,593</td> <td>$127,911</td> </tr> <tr> <th colspan="5"> STAFF WELLBEING </th> </tr> <tr> <th> Indicator </th> <th> Benchmark </th> <th> Q1/2 <<print setup.year>> </th> <th> Q2/3 <<print setup.year>> </th> <th> Q1/2 <<print setup.year+1>> </th> </tr> <tr> <td> Engagement Survey </td> <td> National NICU’s (% of staff engaged) Target = 80% </td> <td> -- </td> <td> -- </td> <td> 35% </td> </tr> <tr> <td> Short Term Disability due to safety incidents or burnout </td> <td> 5 </td> <td> 17 </td> <td> 15 </td> <td> 12 </td> </tr> <tr> <td> Evaluation by residents and fellows </td> <td> --- </td> <td> --- </td> <td> Poor </td> <td> Fair </td> </tr> </tbody> </table> <</nobr>>
<<nobr>><div id="hdr-title" class="hdr-logo"><img src="images/sl-icon.png" alt=""><a class="skip-link" href='#passages'>Skip to content</a><h1>simuLEADerShip</h1></div><div id="hdr-stage" class="hdr-stage"><h2>Level $stage</h2></div><div id="hdr-prog" class="hdr-help"><<button "TUTORIAL">> <<script>>setup.runtour();setup.send_analytics("select_content","tutorial");<</script>><</button>><a href="javascript:SugarCube.setup.togglefs()" tabindex="0"><img src="images/outline_aspect_ratio_black_24dp.png" alt="Toggle Fullscreen View"></a></div><</nobr>>
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<<nobr>><div id="toolchest"><div class="lstools"><div id="docuicon"><img class="flycons" src="images/docuicon.png" alt=""></div><div id="chaticon"><img class="flycons" src="images/chat.png" alt=""></div><<button "Contacts">><<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); setup.run_anim(); <</script>><</button>><<button "V-Forums">><<script>> Dialog.setup("V-Forums", "modal"); Dialog.wiki(Story.get("V-Forums").processText()); Dialog.open();<</script>> <</button>> <<button "Dossier">> <<script>> Dialog.setup("Dossier", "modal"); Dialog.wiki(Story.get("Dossier").processText()); Dialog.open(); <</script>> <</button>></div><div class="rstools"><<button "Rewind Time">> <<if $rewindwarn == true>><<script>>Engine.backward();setup.send_analytics("select_content","rewind no warn");<</script>><<else>><<script>>Dialog.setup("Warning", "modal"); Dialog.wiki(Story.get("Rewind Warning").processText()); Dialog.open();<</script>><</if>> <</button>></div></div><</nobr>>
"Yes, I have a bit of time." Pierre smiles kindly at you and shows interest so you take that as a sign to proceed. You let them know that you've started in your new role and were shocked to see that some of the data you can view now are supporting your general sense that Pondview is in bad shape. "Are the other hospitals in the region like this as well?" You ask. "Well, things have been difficult with the constant reshuffling of provincial priorities which has affected the other hospitals in our network. That being said, Pondview seems to be worse off than the others. In fact, it’s also why I wanted to talk to you today. How about skipping your workout and having a walk through the tubes with me? Maybe we can find one of the keepers and tell them about the mortalshark." @@#choices;.choices; <<nobr>> [[You decide to skip the workout and take up their offer.->Pierre Talk]] [[You defer until 'later' since you really need to get your workout in.->Pierre Defer]] [[You decide to workout but ask to meet tomorrow.->Pierre Tomorrow]] <</nobr>> @@ <<script>>setup.logger("fb52");<</script>>
You explain to Jerry that what he has said has been interesting but also remind him that it is your job to engage him in a dialogue about his performance. You explain your commitment to discussing his performance in a positive manner and suggest taking a little time, to both reflect on today's meeting and what the data says. Ending the meeting, you inform Jerry that you will be meeting with him again, in two weeks' time. <<include "Josee Setup">>
Explaining that you have no time left right now you end the meeting. On reflection you feel that at least you made a point that he must do something about his performance. You are also surprised that he knows the issues as well as he does - maybe you can try a different approach next time. Taking a moment to collect yourself, you review the key points of the next meeting. <<include "Josee Setup">>
Willie looks thoughtful and then responds. "You docs and nurses work so hard!! Such dedication!! You are all committed to getting the babies better and sending them home, and the parents for the most part appreciate that. Except they are not happy with Dr. Lorimer. He’s nice to some parents but doesn’t have the time of day for others... I’ve also heard them say that they would like to hear the odd ‘thank you’, or ‘great job’. Wouldn't we all?" <<include "Rewards Program">>
"Not too sure. A 'thank you' goes a long way," he explained. "Just like we take care of the patients, we need to take care of everyone who works here! I really like what we started to do in housekeeping. It was the boss's idea. Every month we recognize a housekeeper or PSW who has gone above and beyond. I’m sure there is someone in the NICU who you could recognize the same way." <<include "Rewards Program">>
"As you engage with staff and hear their concerns I want you to keep the objective of staff wellness at the top of mind. The LEADS framework includes a capability called 'contributing to the creation of healthy organizations' that will be helpful in guiding you as well. I won't have time to meet with you very often but will have <<link "Zephyr">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> give me an integrity 360 report for your work in 6 months. I need to see the needle move on the overall wellbeing of our staff here at Pondview and it starts with properly engaging them in each unit. I know you can do it but it may take some growth on your part to move from a purely clinical focus to one that reaches further." With that she stands and offers her hand. You grasp it and shake firmly, giving a sign of commitment to this new goal. After Dr. Armitrade leaves you return to your work and begin analyzing the data that might help you meet the goal. Time flies and you realize that its 18:30. You had promised your partner that this new job wasn't going to take over your life and already on the first day you are running late so you... @@#choices;.choices; <<nobr>> [[Make like a banana and split.->Head Out]] <</nobr>> @@
<img src="images/headout.png" alt="Willie Yee, a member of the cleaning staff at Pondview stands behind his cart in a hallway."> Just as you are heading out the door, Willie Yee from housekeeping is trying to get by your office and the hallway is too narrow. His cart of cleaning equipment awkwardly blocks your way. "I'm sorry, they don't make these hallways as wide as they used to," he says stepping back to let you pass. You recognize Willie since he has been with Pondview for quite some time. You smile and respond... @@#choices;.choices; <<nobr>> [[No worries at all Willie. How are you?->Engage Willie]] [[Sorry about the mess! I left some cake crumbs on the deskplay. The HR crew forgot to leave napkins! Gotta go!->Bypass Willie]] [[No problem, I think the architects were trying to echo the journey of birth. See how the light shines at the far end of the hall and the passage gets wider there...->Bypass Willie]] <</nobr>> @@
After leaving her office you feel a moment of panic. This type of leadership is very far removed from what you know of leading a clinical team or working with families and you aren't quite sure you are ready. Although you feel uncomfortable about the task at hand it dawns on you that given what you've learned about leadership and the methods described in the LEADS Framework, the way to approach this is to be honest and act from your own personal values while engaging the NICU staff and families. Although you feel alone in your mission at the moment, the power of what can be done rests in the ability to influence others and truly lead the team through this process. 'It will be different this time' you think. The problem of having enough time to properly do all this is a different issue. You feel sick with the thought that you may have to cancel your weekend plans to fit this all in - either that, or skip training... again. There must be a solution. Hoping for a miracle you review your messaging stream to see if someone might want to trade clinical hours. No luck - you do see a hologram from Francine St. Croix. Interested to see what she has to say you... @@#choices;.choices; <<nobr>> [[View Francine's holo.->Francine Initial Contact]] <</nobr>> @@
"Based on your performance throughout the interview we are prepared to offer you the position as NICU Director." Dr. Armitrade says. "Leah was able to put together this official offer." She then hands you the envelope. Leah is smiling happily. "We won't ask you to decide right this moment but I'll follow up with you after I've verified your references to see if you accept. On behalf of Pondview Hospital, I am very happy to welcome you to our leadership team. I hope you accept the position!" @@#choices;.choices; <<nobr>> [[Continue...->Post Interview]] <</nobr>> @@
Leah looks relieved. "I'm happy we got that out of the way." <<include "Make Offer">> <<script>>setup.logger("fb43");<</script>>
<<nobr>> <table class="qualetrics"> <tbody> <tr> <th colspan="4">Pondview NICU Quadetrics</th> </tr> <tr> <th colspan="4">NEONATAL OUTCOMES</th> </tr> <tr> <th>Indicator</th> <th>Benchmark</th> <th>Q1/2 <<print setup.year>></th> <th>Q3/4 <<print setup.year>></th> </tr> <tr> <td>Survival to discharge (%)</td> <td>National Data</td> <td> </td> <td> </td> </tr> <tr> <td>< 27 weeks</td> <td>72</td> <td>63</td> <td>65</td> </tr> <tr> <td>27-31 weeks</td> <td>95</td> <td>93</td> <td>93</td> </tr> <tr> <td>≥ 32 weeks</td> <td>98</td> <td>97</td> <td>98</td> </tr> <tr> <td>Late Onset Sepsis (per/1,000 pt. days)</td> <td>35.3</td> <td>57.8</td> <td>52.3</td> </tr> <tr> <td>Central Line Infections (per 100)</td> <td>1.2</td> <td>7.3</td> <td>6.2</td> </tr> <tr> <th colspan="4">PARENTAL FEEDBACK</th> </tr> <tr> <th>Indicator</th> <th>Benchmark</th> <th colspan="2"><<print setup.year-1>>-<<print setup.year>></th> </tr> <tr> <td>Post-discharge Experience Survey (Likert and open comments)</td> <td>Aim is >99% for Likert 3 & 90% >4 Comments addressed as needed</td> <td colspan="2">Likert ≥ 3: 80% Likert ≥ 4: 67% Comments on lack of respect and family-centered care</td> </tr> <tr> <th colspan="4">COST ALLOCATION EFFICIENCY</th> </tr> <tr> <th>Indicator</th> <th>Benchmark</th> <th>Q1/2 <<print setup.year>></th> <th>Q3/4 <<print setup.year>></th> </tr> <tr> <td> <p>Median cost of hospitalization before NICU discharge</p> </td> <td>National Data</td> <td> </td> </tr> <tr> <td>All Infants</td> <td>$20,184</td> <td>$32,118</td> <td>$29,215</td> </tr> <tr> <td>Gestational age 33-36 weeks</td> <td>$11,810</td> <td>$17,756</td> <td>$17,034</td> </tr> <tr> <td>Gestational age 29-32 weeks</td> <td>$30,572</td> <td>$42,751</td> <td>$40,891</td> </tr> <tr> <td>Gestational age <29 weeks</td> <td>$100,440</td> <td>$134,216</td> <td>$130,593</td> </tr> <tr> <th colspan="4">STAFF MONITORING</th> </tr> <tr> <th>Indicator</th> <th>Benchmark</th> <th>Q1/2 <<print setup.year>></th> <th>Q3/4 <<print setup.year>></th> </tr> <tr> <td>Short Term Disability due to safety incidents</td> <td>Total number for this NICU</td> <td>17</td> <td>15</td> </tr> <tr> <td>Android to Human Ratio</td> <td>Federal benchmark to be determined</td> <td>1:10</td> <td>1:10</td> </tr> </tbody> </table> <</nobr>>
After a moment and few more sniffs Leah continues. "I see. Well, thank you for your time and while we would have been very excited for you to take on the Director role we need to move forward, so I will accept your rejection and wish you well." You feel confident you made the right choice. Some call it 'cold feet' but you always trust those last minute feelings. You also proved to yourself that you do have what it takes to be a leader and while this isn't quite the right time you have achieved some valuable insights towards your leadership abilities. <<include "Game Over">> @@#choices;.choices; <<nobr>> <<back [[Try Again|Chap1]]>> <<link "Debrief">> <<script>> Dialog.setup("Debrief", "modal"); Dialog.wiki(Story.get("Performance Feedback").processText()); Dialog.open(); <</script>> <</link>> <</nobr>> @@ <<script>>setup.logger("fb45");<</script>>
"Phew. I am so glad that you have reconsidered. I wish I had that chance with my Nancy. It rained for the next week", she says. You share her regrets and explain that you are looking forward to taking on the new opportunity. <<include "C2 Coaching Set-up">>
Do you want to share your challenge response with other activity participants? <<button "YES">> <<set $c2answered = true>> <<script>> Dialog.setup("V-Forums", "modal"); Dialog.wiki(Story.get("V-Forums").processText()); Dialog.open(); setup.putdata("Answered V-Forum 2",State.variables.c2_response,"VF2"); setup.send_analytics("unlock_achievement","posted to v-forum 2"); <</script>> <</button>> <<button "NO">> <<set $c2answered = true>><<script>> Dialog.setup("V-Forums", "modal"); Dialog.wiki(Story.get("V-Forums").processText()); Dialog.open();<</script>> <</button>>
<<nobr>><<if $progress < 10>><<set _hours to "We do not recommend that you claim any credit hours at this point.">> <<elseif $progress < 20>><<set _hours to "We recommend that you claim 30 minutes of Royal College section 3 continuing medical education in MAINPORT.">> <<elseif $progress < 30>><<set _hours to "We recommend that you claim 45 minutes of Royal College section 3 continuing medical education in MAINPORT.">> <<elseif $progress < 40>><<set _hours to "We recommend that you claim 1 hour of Royal College section 3 continuing medical education in MAINPORT.">> <<elseif $progress < 50>><<set _hours to "We recommend that you claim 1 hour and 15 minutes of Royal College section 3 continuing medical education in MAINPORT.">> <<elseif $progress < 60>><<set _hours to "We recommend that you claim 1.5 hours of Royal College section 3 continuing medical education in MAINPORT.">> <<elseif $progress < 70>><<set _hours to "We recommend that you claim 2 hours of Royal College section 3 continuing medical education in MAINPORT.">> <<elseif $progress < 80>><<set _hours to "We recommend that you claim 2.5 hours of Royal College section 3 continuing medical education in MAINPORT.">> <<else>><<set _hours to "We recommend that you claim 3 hours of Royal College section 3 continuing medical education in MAINPORT.">><</if>> Great work! At this point you have completed $progress% of the SimuLEADerShip learning activity. _hours<</nobr>> If you haven't already reviewed your personalized debrief we recommend you do so now. <<button "VIEW DEBRIEF">> <<script>> Dialog.setup("Debrief", "modal"); Dialog.wiki(Story.get("Performance Feedback").processText()); Dialog.open(); <</script>> <</button>> If you have, select the Post-Activity Evaluation button to end your SimuLEADerShip session. You may return to this website at any time to review your results or restart the simulation. <<button "POST-ACTIVITY EVALUATION">> <<script>>window.open('https://survey.alchemer-ca.com/s3/50122119/SimuLEADerShip-Post-Evaluation?sguid='+State.getVar("$sgid")+'&prog='+State.getVar("$progress")); <</script>> <</button>> <<button "CANCEL">> <<script>> Dialog.close(); <</script>> <</button>> <<script>>setup.send_analytics("select_content","exit sim");<</script>>
Do you want to share your statement with other activity participants? Note: This will reveal the statement you wrote to other participants in this learning activity. <<button "YES" "Next Steps">> <<script>>setup.putdata("Provided Future Statement",State.variables.final,"FS"); Dialog.close(); setup.send_analytics("unlock_achievement","advised pondview on leadership"); <</script>> <</button>> <<button "NO" "Next Steps">> <<script>> Dialog.close();<</script>> <</button>>
You must provide a statement before you can continue. Note: Your response will be kept anonymous and you will have the option of whether to share your response with other participants. <<button "OK">> <<script>>Dialog.close();<</script>> <</button>>
<<if $stage == 1>>Are you sure you want to return to the beginning of this level? Your progress and feedback will be reset to the beginning of Level 1. <<nobr>> <<if passage() is "Introduction">><<button "YES">> <<script>>Dialog.close();<</script>> <</button>><<else>><<back [[YES|Introduction]]>><</if>> <<button "NO">> <<script>>Dialog.close();<</script>> <</button>> <</nobr>> <<else>>You've already completed that level and cannot return. Would you like to restart the entire simulation from the beginning? <<nobr>> <<button "YES">><<run UI.restart()>><<script>>$("#restart-ok").click(function () { Save.autosave.delete(); });<</script>><</button>> <<button "NO">> <<script>>Dialog.close();<</script>> <</button>> <</nobr>><</if>>
<<if $stage < 2>>You don't have access to this level yet. You must complete the previous levels in order to access. <<button "OK">><<script>>Dialog.close();<</script>><</button>> <<elseif $stage == 2>>Are you sure you want to return to the beginning of this level? Your progress and feedback will be reset to the beginning of Level 2. <<nobr>> <<if passage() is "Chap1">><<button "YES">> <<script>>Dialog.close();<</script>> <</button>><<else>><<back [[YES|Chap1]]>><</if>> <<button "NO">> <<script>>Dialog.close();<</script>> <</button>> <</nobr>> <<else>>You've already completed that level and cannot return. Would you like to restart the entire simulation from the beginning? <<nobr>> <<button "YES">><<run UI.restart()>><<script>>$("#restart-ok").click(function () { Save.autosave.delete(); });<</script>><</button>> <<button "NO">> <<script>>Dialog.close();<</script>> <</button>> <</nobr>><</if>>
<<if $stage < 3>>You don't have access to this level yet. You must complete the previous levels in order to access. <<button "OK">><<script>>Dialog.close();<</script>><</button>> <<elseif $stage == 3>>Are you sure you want to return to the beginning of this level? Your progress and feedback will be reset to the beginning of Level 3. <<nobr>> <<if passage() is "Chap2">><<button "YES">> <<script>>Dialog.close();<</script>> <</button>><<else>><<back [[YES|Chap2]]>><</if>> <<button "NO">> <<script>>Dialog.close();<</script>> <</button>> <</nobr>> <<else>>You've already completed that level and cannot return. Would you like to restart the entire simulation from the beginning? <<nobr>> <<button "YES">><<run UI.restart()>><<script>>$("#restart-ok").click(function () { Save.autosave.delete(); });<</script>><</button>> <<button "NO">> <<script>>Dialog.close();<</script>> <</button>> <</nobr>><</if>>
<<if $stage < 4>>You don't have access to this level yet. You must complete the previous levels in order to access. <<button "OK">><<script>>Dialog.close();<</script>><</button>> <<elseif $stage == 4>>Are you sure you want to return to the beginning of this level? Your progress and feedback will be reset to the beginning of Level 4. <<nobr>> <<if passage() is "Chap3">><<button "YES">> <<script>>Dialog.close();<</script>> <</button>><<else>><<back [[YES|Chap3]]>><</if>> <<button "NO">> <<script>>Dialog.close();<</script>> <</button>> <</nobr>> <<else>>You've already completed that level and cannot return. Would you like to restart the entire simulation from the beginning? <<nobr>> <<button "YES">><<run UI.restart()>><<script>>$("#restart-ok").click(function () { Save.autosave.delete(); });<</script>><</button>> <<button "NO">> <<script>>Dialog.close();<</script>> <</button>> <</nobr>><</if>>
<<if $stage < 5>>You don't have access to this level yet. You must complete the previous levels in order to access. <<button "OK">><<script>>Dialog.close();<</script>><</button>> <<elseif $stage == 5>>Are you sure you want to return to the beginning of this level? Your progress and feedback will be reset to the beginning of Level 5. <<nobr>> <<if passage() is "Conclusion">><<button "YES">> <<script>>Dialog.close();<</script>> <</button>><<else>><<back [[YES|Conclusion]]>><</if>> <<button "NO">> <<script>>Dialog.close();<</script>> <</button>> <</nobr>> <<else>>You've already completed that level and cannot return. Would you like to restart the entire simulation from the beginning? <<nobr>> <<button "YES">><<run UI.restart()>><<script>>$("#restart-ok").click(function () { Save.autosave.delete(); });<</script>><</button>> <<button "NO">> <<script>>Dialog.close();<</script>> <</button>> <</nobr>><</if>>
You command your desk to bring up the most recent Mission, Vision and Values statement for the region and it chimes to indicate the document is available to view. <<include "Initial Region and NICU MVV">> You don't really see anything out of alignment between the regional and the NICU purpose and values but you suspect that your unit may need to refresh their commitment to these values at some point. These types of statements have always seemed so high-level to you in the past but now you begin to form ideas about how they might become more relevant in the day to day work of the NICU staff. @@#choices;.choices; <<link[[You save the Mission, Vision and Values to your dossier.->Settling In]]>><<script>>setup.hypecalls.playhype('document'); <</script>><</link>> @@
Dr. Armitrade continues discussing the help she needs. "As you will see in the documentation I just sent, the Framework is well defined and useful. However, The feeling now here at Pondview is that our indicators don't properly support the needs of Directors like you or help us to definitively improve our areas of weakness. <img src="images/ar-graphicstep1.png" alt="Set direction"> "Given this direction, I need you to develop and then implement a plan over the next six months on restructuring our indicators and improving the performance of the NICU. I'm asking for both a plan and results. Can you do this for me?" @@#choices;.choices; <<nobr>> [[No. Sorry, but I've seen too many useless plans and I'm not going to put my team through that.->No Plan]] [[Yes, but I feel this is beyond my ability right now.->Plan Confidence Builder]] [[Yes, but can you tell me more about what you need?->Plan Requirements]] <</nobr>> @@ <<set $progress to 80>>
<<set $rewindwarn = true>>Are you sure you want to rewind time? While it will allow you to go backwards and make a different choice it may reduce the relevance of your debrief. <<nobr>> <<button "NO">> <<script>>Dialog.close();<</script>> <</button>> <<button "YES">><<script>>Engine.backward();Dialog.close();setup.send_analytics("select_content","rewind warn");<</script>><</button>> <</nobr>>
<img src="images/calendar.png" alt="Busy schedule"> Upon your command your comm displays your schedule for the week on your desk. It looks like today may be your last leisurely day! You are now on every committee at Pondview, have several staff reviews to do and also some training to meet regulatory standards related to your role. Notably, you see that tomorrow you have a series of meetings starting with your first intra-region transport meeting representing the Pondview NICU, a performance review with <<link "Dr. Jerry Lorimer">><<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> to discuss his most recent integrity 360 results, and a meeting with <<link "Nurse Manager Josee Moffat">> <<script>> Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>> <</link>> for a discussion about nursing resource levels. @@#choices;.choices; [[Continue...->Settling In]] @@
<<nobr>> <<if !visited("Review Qualetrics") && !visited("Review Schedule") && !visited("Review Messaging")>><<addclass "body" "fadein">>Settling in to your new office, you quickly take care of some routine paperwork that has been brought to your attention. The HR department is also on the ball and has begun recruiting a new Neonatologist to replace you but no applicants have arrived yet so there is nothing to review just yet. You marvel at how much time you seem to have. 'Maybe it's the calm before the storm' you think as you look at your options of what to do next. After a stroll to the coffee machine you return and decide to... <<elseif visited("Review Qualetrics") && visited("Review Schedule") && visited("Review Messaging")>>Feeling satisfied with your morning you decide to head over to the gymnarium for a workout.<<else>>With that task finished, you decide to...<</if>> <</nobr>> @@#choices;.choices; <<nobr>> <<if !visited("Review Qualetrics")>>[[Review the NICU quadetrics.->Review Qualetrics]]<</if>><<if !visited("Review MVV")>>[[Review the Mission, Vision and Value Statements.->Review MVV]]<</if>><<if !visited("Review Schedule")>>[[Take a look at your schedule.->Review Schedule]]<</if>><<if !visited("Review Messaging")>>[[Go through your incoming messaging.->Review Messaging]]<</if>> <<if visited("Review Qualetrics") && visited("Review Schedule") && visited("Review Messaging") && visited("Review MVV")>>[[Go to the Gymnarium.->Gymnarium]]<</if>> <</nobr>> @@
You decide to take a more focused look at the hospital Quadetrics on your deskplay. On your command, the desk morphs to provide a view of the quadetrics. From what you understand they are collated every 6 months for internal use and the official report goes to the Board annually. While they have been brought up many times in staff meetings you haven't paid much attention when the issue did not directly affect your practice. When it did, you found it easy to poke holes in the data but were able to make small changes that may have helped anyhow. Was it good luck or good judgment? Putting aside your skepticism, you have a look at the key indicator descriptions for Pondview. <<include "Qualetrics Snap 1">> Your first impression is that the numbers don't seem to tell you very much. Your concerns about families and patients seem very hard to validate with the information at hand. It would be nice to make this more meaningful but you aren't sure how to do that yet. For now you can manage by instinct. @@#choices;.choices; <<link[[You save the Quadetrics to your dossier.->Settling In]]>><<script>>setup.hypecalls.playhype('document');<</script>> <</link>> @@
Although it's in an older part of the building and smells a bit like a mix of sushi and old hockey bag, the Gymnarium is one of your favourite places at Pondview and you've kept up your membership even though the monthly fee is pricey. The long tubular passageways through the fish tanks are uncrowded today and you spot several empty workout bubbles as you make your way to the changarium. <img src="images/gymnarium.png" alt="Pierre Nadeau sits at a bench in the gymnariuum locker room. An aquarium window spans the wall behind."> While changing you notice <<link "Pierre Nadeau">> <<script>>Dialog.setup("Contacts", "modal"); Dialog.wiki(Story.get("Contacts").processText()); Dialog.open(); <</script>><</link>> across the room on a bench. 'It must have been a hard workout,' you think because Pierre is staring at their hands. As you look a little closer you notice that Pierre isn't sweating and is still in street clothes. You want to ask them about how Pondview compares to other hospitals in the area in terms of its culture because you remember they work across the region in some of the other hospitals. Maybe they have a perspective that can help you to better understand some of the Quadetrics. You wait for the right opportunity to break the ice and then notice one of the large, rare, mortalshark stalking its prey right behind Pierre so you... @@#choices;.choices; <<nobr>> [[Alert Pierre to the mortalshark.->Pierre Mortalshark]] [[Walk over and see if you can catch their attention.->Walk a Little Closer]] [[Decide it's probably not a good time to talk.->Leave Pierre Alone]] <</nobr>> @@
"I believe you are familiar with our Pondview Quadetrics. If you aren't, you should take a look at them again. These are the key indicators we use to help manage each unit and the facility on the whole. I'll put it bluntly. When you look at the data, the picture they paint is murky and not even comprehensible. "Your NICU quadetrics form part of this picture and there are many concerns but I think the one you need to focus on the most in these first few weeks is creating a healthy organization - don't get lost in the rabbit hole of data. To me it’s clear that the top priority is to treat people better. When staff are healthy and feel valued the care they deliver to patients is superior. While the data are hard to interpret, if you engage staff in discussion it is clear that we are in a precarious state. The wellbeing of our staff is affecting patient outcomes. "Although there are other things that may seem more pressing, focusing on creating a healthy organization has become an emergency. Normally I try to focus on things that aren't as urgent but are important; that helps keep the emergencies to a minimum. Once we improve the health of our organization we can turn to the nonurgent but important issues. "If you haven't read Stephen Covey's work on highly effective habits I would suggest you do so - Its quite old but still very relevant. I'll send a reference to your dossier." @@#choices;.choices; <<link[[You accept the document.->Health Org Engage]]>><<script>>setup.hypecalls.playhype('document'); <</script>><</link>> @@ <<set $progress to 45>> <<script>>setup.logger('fb62');<</script>>
"Yes it is but I feel like I'm caught between a rock and a hard place", she says. "I just don't understand it. Maybe we can discuss the cost issues when we go over the Quadetrics. It appears to me that the costs associated with back-filling my role could easily be recovered in other areas if we stop wasting so much money!" You agree that it's a good time to review the quadetrics with Elaine so you vizz the Quadetrics into the conversation. <<include "Qualetrics Snap 2">> Elaine takes the lead to discuss the data. "Let me start by saying I’ve been here 10 years and it’s not like it used to be. As we have gotten bigger we have stopped working with the single common objective of best care for the patients and their families while providing a supportive workplace for staff. "Let’s go through the new data for the last two quarters that we just finished. The facts speak for themselves. "Neonatal Outcomes - high blood stream infection rates, due to central line infections; high number of accidental extubations; longer length of stay for all gestational ages as compared to other NICU’s in Canada. "Parental Feedback - complaints about not being spoken to directly on rounds, insensitivity toward indigenous and immigrant people resulting in suboptimal care. "Cost Allocation Efficiency - I don’t have an exact breakdown of costs but high costs may reflect excessive use of agency staff, infection control requirements and antibiotic costs... We remain well above the national average. "Staff Monitoring – The morale around here is poor. We know there are patient safey events happening but they are underreported. I doubt these numbers reflect the total number of people on disability. Including the android to human ratio as a federally mandated indicator also makes no sense to me. It seems like yet another way to push the agenda on utilizing more androids in the workplace." When she is finished going through her view of the quadetrics you ask her what she feels the top priority for quality improvement should be in the NICU, given all these challenging problems. @@#choices;.choices; <<nobr>> [[Continue...->Chan's Suggestion]] <</nobr>> @@ <<script>>setup.logger('fb77');<</script>>
<img src="images/echanholo.png" alt="Elaine reflects on the information."> Elaine reflects on the information she just presented and you close the quadetrics vizz. "In the past, most of the focus has been on cost reduction, but I don't think we have gone far enough or maintained focus. Maybe I am a bit biased here but I still think if we control costs and spend effectively then the other indicators should fall in line. Most importantly, the extra money will allow us to implement Broad-spectrum AI-Based Inclusiveness monitoring and Training - the BABIT program that we have been trying to get funding for. That will really help how we treat families." You weigh her suggestion carefully and respond. @@#choices;.choices; <<nobr>> [[I had no idea the issues were so complex and I can see how cost reductions might help but patient safety and family-centered care are our number one concern. If we work on a just culture of safety we can improve the overall culture here. Do you think we could pull a group together and strategize?->Close Chan Meeting Green]] [[I’m not worried about how the families feel. They will always need a place to deliver their babies. Do you know any other staff here that feel the same way about this BABIT program? We can put them on a working group to see about how some budget might be shifted.->Close Chan Meeting Red]] [[Cost is not my #1 concern for now. If we focus on staff wellness and patient safety the dollars will follow. I'd like to get our human resources people involved. They have the knowledge and expertise to deal with unhappy staff and that will free us up to focus on other things.->Close Chan Meeting Yellow 1]] [[Let’s forget the past. I’ve been given the position of NICU Director because senior management trusts me to do the right thing to turn things around! We need to focus on staff wellbeing. Let’s get going!->Close Chan Meeting Yellow 2]] <</nobr>> @@ <<set $progress to 70>>
Over the next three months an inclusive process of involvement, utilizing face-to-face meetings and virtual dialogues helped generate a vision, mission and values statement for the NICU unit and a set of refreshed performance metrics. The most contentious subject was the mission, vision and values statement. Everyone wanted to make sure their views and feelings were heard as the vision was defined so it was a challenge to make sure everyone’s ideas were captured. The final resultant statements resonated with everyone involved. @@.posting; .miss_vision_values; !Newborn Services and Neonatology Vision, Mission and Values !!Vision Neonates and their families experience optimal opportunities to thrive. !!Mission. To provide state-of-the-art, evidence-based, and compassionate care for newborns, mothers, and their families, within a provincially-integrated system. !!Our Values Excellence Compassion Scholarship Inclusiveness Collaboration @@ For the results metrics, the existing scorecard was reviewed and staff committed to using a set of enhanced "Quadetrics" to guide future performance. #Healthy Neonates #Family Experience #Cost Effectiveness #Staff Wellbeing <<include "Qualetrics End of Story">> The newly revitalized staff wellbeing indicators would be given the same amount of focus as the other indicators and enhance the existing methods of viewing staff wellbeing. Based on the team input and quite a bit of number crunching your team was able to provide a set of revised quadetrics and back-fill some indicators to the present period providing a great baseline for the team to rally around. The final NICU strategic plan was approved at a meeting arranged virtually with all retreat participants. An integrity poll of all staff after the final meeting indicated a high level of support for the vision, mission and values and refreshed performance indicators. Although all the work was strenuous, it represented more of a starting point than a finish line... @@#choices;.choices; <<nobr>> [[Continue...->Plan Oversight]] <</nobr>> @@