Navigating Consensus in Healthcare - The Seven Pillars
Consensus is a creative and expansive way of reaching agreement in a group. It involves discovering solutions that all parties support or can live with, respecting all needs and opinions, and building a stronger team. The process involves several steps, including defining or explaining the problem that needs a solution, giving everyone a chance to suggest potential solutions, discussing the suggestions, and deciding on the best solution to the issue. Likewise, creating an implementation plan with a process in place for accountability and modification is paramount to consensus success.
Consensus consists of the following seven elements. You need all seven to reach a true consensus :
Trust. Trust is a cornerstone to consensus. It supports the open and honest conversations that are needed for all voices to be heard and roadblocks to be resolved. Without it, you will achieve subpar results, including further erosion of trust and team member turnover.
Foster authentic communication. Leaders must allow space for their team’s concerns, doubts, and uncertainties so they can be heard and dealt with in the most open, honest, authentic, and productive way.
Collaboration. Ensures there is a shared purpose and a decision that meets the concerns of the majority.
Cooperation. Participants in an effective consensus process should strive to reach the best possible decision for the group and all its members.
Inclusion. As many stakeholders as possible should be involved in the consensus decision-making process.
Openness. The proposal under consideration should be disclosed to all stakeholders.
Productive conflict. Consensus decision-making processes should encourage open and constructive discussion that leads to creative solutions and better decisions.
How do you create consensus in seven steps?
Before these seven elements can be implemented, it is critical to clarify the issue at hand. This may seem trivial, but often what seems like the issue to one person may not be the issue to another. Once you have identified the issue(s), ensure everyone has access to any relevant background information to fully understand all aspects of it. This will help focus the discussions and ensure everyone is working in the same direction.
Next, create a safe space and take the time to allow everyone to share their feelings, needs, and opinions, before trying to find a solution. Recognizing all the different components of the issue at hand, and how each person perceives those components, is essential for finding a solution which suits everyone. Resist the temptation to solve the issue at this point in the process. If ideas on how to solve the issue come up, listen briefly and then park them for the next stage.
Collect and explore all the ideas for moving forward, including their pros and cons, and allow the group to gauge if these ideas address their needs and concerns. Once a potential solution is identified, check for agreement within the group, and assess if there are any concerns that the solution does not address. If you don’t have consensus at this stage, go back to an earlier step in the process and work forward until consensus is reached. Finally, work out how to implement the decision. Acting on group decisions is essential for building trust in the group; plans that collect dust on a shelf do more harm than good.
Finally, holding yourself and team members accountable to implementing the plan is critical to consensus success. When there is an implementation plan in place, it allows for the accountability conversation to remain neutral and objective and less personal. At HCP, this is a part of the Consensus Compact. It includes agreed upon behaviors (how we will engage one another); the agreed upon actions and a change protocol that describes what happens if there is a change.
Listening to one another at all times is a non-negotiable detail of the consensus process. Hold back from interrupting, talking over, or thinking about what you will say next when someone is speaking. Listen for understanding, not just the words that are being spoken. Always build upon others’ ideas and seek common ground. Use the phrase, “yes, and…” instead of “yes, but…”
Why is Consensus important?
When everyone understands or agrees with a decision they are more likely to support it. In the long run, people are also more likely to stay involved in an organization that is committed to hearing their views and meeting their needs. This is particularly important in highly competitive markets, where some people will leave and work for a competitor if they don't feel valued and respected.
Consensus is an inclusive process that enables minority needs and opinions to be heard. By definition, no decision is made against the will of an individual in the consensus process. If significant concerns remain unresolved, a proposal can be blocked and prevented from moving forward. This means that the whole group has to work hard at finding solutions that address everyone's concerns, rather than ignoring or overruling minority opinions.
Trust is established and experience is gained on handling challenging conversations in a productive and constructive manner.
When a conversation is authentic and open, people are more inclined to change their minds and trust the collective wisdom of the team. In this conversation, people build on each other rather than being combative. As a result, the team can reach a much bolder conclusion and decision much faster. This doesn’t only lead to a higher level of clarity of direction, it also takes the team unity and sense of being “in this together” to a higher level.
References
Healthcare Consensus Partners Consensus Building Process
Short guide to consensus decision making - Seeds for Change
Don’t confuse 'consensus' with 'alignment' | Quantum Performance Inc