Rethinking our Open-Door Policy

In our dedication to being approachable leaders, many of us have adopted an open-door policy. However, is it always beneficial? Our role as administrators demands a blend of addressing urgent needs and strategic foresight, which can be disrupted by a constant stream of interruptions, negatively affecting our focus and decision-making capabilities.

Research suggests it takes over 20 minutes to fully regain concentration after a distraction. It’s a tough dilemma in our field, where every decision impacts lives. How can we balance this?

It is also human nature to want to fix past shortcomings, whether they be from a previous poor survey, less-than-ideal community relations, a predecessor's reputation, or even rebuilding a relationship with an ombudsman. Yet, being perpetually available can impede our ability to focus on strategic tasks, diminishing our overall performance.

Psychology indicates that leaders caught in a cycle of short-term decision-making and crisis management ("putting out fires") can develop tunnel vision, limiting their ability to engage in long-term strategic thinking. This can lead to cognitive overload, increased stress, and decreased mental bandwidth, making it difficult to consider broader, future-oriented issues. It's essential for healthcare leaders to find a balance with our open-door approach that allows time for both immediate problem-solving and comprehensive strategic planning. This balance is key to preventing burnout, fostering more effective leadership, and ensuring our sharpness during high-stakes decisions.

I propose a strategic reevaluation of our open-door approach:

  1. Introduce Focus Blocks: Dedicate specific hours—daily or weekly—for uninterrupted deep work, a strategy championed by Cal Newport. This approach isn't about shutting our doors but strategically allocating time for tasks that demand intense focus. For example, use these blocks to delve into QAPI preparation or to dissect key performance metrics and trends. This ensures critical thinking isn't diluted by the day's urgencies, allowing for sustained, quality output on complex tasks.
  1. Flex Hours for Creativity: Reserve time specifically for brainstorming and exploring new ideas. This allows us to detach from daily operations and engage in innovative thinking, which is vital for long-term planning and staying ahead of industry trends. This could involve evaluating novel ideas from the management team or family members, even when the return on investment isn't immediately clear.
  1. Regularize One-on-Ones: Transition from spontaneous ‘drop in’ sessions to scheduled, meaningful interactions. Scheduled meetings foster richer communication and recognition, as every team member's voice is given the space to be heard. Carve out regular 15-minute slots for focused discussions with key personnel. This not only bolsters your capacity for deep work but also significantly boosts information retention and team morale, as evidenced by the tangible improvements seen in my time.

This shift may seem counterintuitive in an industry that often values constant presence. But remember, optimal leadership is not just about being present; it's about being operationally effective and keeping our ability to think fast and slow (as recommended in the book by Daniel Kahneman).

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Comments on "Rethinking our Open-Door Policy"

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Herminia Szasz - Tuesday, December 12, 2023

Great article for reflection. As a previous people manager of operations, I often fell into the cycle of quick decision-making and crisis management. These strategies are key and I will hold on to them as a soon-to-be HCA. I love what Mr. Armstrong noted in his daily routine too. Oftentimes leaders sit behind a desk and speak the open door policy, but how often does staff feel comfortable walking in or picking up the phone? Considering clinicians are prioritizing patients first, time is limited; therefore, visiting departments first thing is a great way to connect. Thank you for this practical read.

Robert B. Armstrong - Monday, December 11, 2023

As an Administrator I made it a point to visit every department first thing in the morning and to answer each department’s “burning question “ starting with the dietary department where I got my first cup of tea. This practice greatly reduced my morning interruptions

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