Want progress at work? Allow employees to push back

The ability to ask tough questions is not a “soft” skill. It’s essential. Any organization looking to grow and progress needs employees who are willing to evaluate what’s happening around them and challenge what they do.

When we encourage people to ask questions, it gives us a chance to pause and rethink. That’s the moment when growth happens.

Our health system, for example, grows when our experts have enough room to push back on norms. In some cases, it leads directly to better patient options and outcomes.

David Hirsch, MD, DDS, FACS asked how he might be able to decrease the number of surgeries needed to reconstruct a jaw and teeth after tumor removal. He found a way to turn multiple surgeries over months or years into a one-day process. His innovative thinking improved patients’ outcomes, minimized their trauma and reduced costs to both the patient and hospital.

Concerned about teens’ chances of becoming addicted to opioids as adults, Vishal Sarwahi, MD asked whether teens undergoing complex scoliosis surgery might be able to manage their post-surgical pain with fewer opioids. Challenging the status quo and considering another dimension of their future drove Dr. Sarwahi to work with anesthesiologists, nursing staff, patients and their families to manage post-surgical pain effectively—he was able to reduce opioid use associated with the procedure by 80 percent.

But to challenge our approaches, we need a work environment that makes it possible. An organizational culture has to be both strong enough and flexible enough to support employees asking those tough questions. Here are three steps to creating a work culture that encourages tough questions:

• Foster trust: Solutions like those that Drs. Hirsch and Sarwahi created come about when a workplace fosters trust. We need to trust those with specific knowledge, expertise and experience because they know what’s needed. Medical teams work closest to their patients and their loved ones; they’re most likely to know what their patients need. They understand exactly where procedure and processes need to change—or, sometimes, stay the same—and which questions they need to ask.
• Engage in meaningful listening: Listening also helps create a culture that boldly questions norms. We need doctors listening to their colleagues to learn about different approaches to the problems that need solving. They also need to listen to patients so they know where to place boundaries around the new processes and procedures they create, or where to push further. Listening can tell us where we need to improve.
• Transparency: To build a workplace where people are comfortable enough to challenge and ask questions, we also need transparency. It creates a safety net for the reasonable failures that come with experimentation. We need to feel secure enough to admit when we’ve made an error and can do better. Failure is a memorable and meaningful teacher that, coupled with transparency, can position us to ask more questions that will, ideally and ultimately, propel us to improve.

When effective leaders create a workplace culture that builds trust, engages in meaningful listening and encourages transparency, the whole organization can better serve both the clients (in our case, patients) and the workplace itself. It allows employees at all levels to feel secure enough to question and assess what they do and how they do it.

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