Four premises to arrive at the autonomous organization of your team

Pere Vivó

Lack of agility, rigidity, slowness, excess of indicators, contradictory orders, ineffectiveness... are some of the historical and structural pathologies of the health care system, as Salvador Casado pointed out in the post "Primary Health Care Centres management notes".

The tension in the system caused by the coronavirus crisis has awakened latent leaders capable of providing organizational, imaginative, heterogeneous, fast and simple solutions, which is why projects such as the Autonomous Organization, started a few months ago by the Territorial Management of the city of Barcelona from the Catalan Institute of Health, acquire enormous relevance.

The Autonomous Organization began in some primary care teams with a vocation to improve the attention to citizens, working conditions and the satisfaction of professionals by involving them in the design of the organization. The pilot centres allowed professionals to adapt their working hours to the needs of the population (with seasonal criteria or their own needs), choose the distribution of tasks during the day and define the weekly offer of previous appointments and the type of visits (face-to-face, telephone or electronic consultations) to improve the accessibility of the equipment and its own. The project also incorporated, a year ago, the possibility of remote resolution of some consultation reasons in the form of remote work for all professionals.

But, to guarantee the success of a flexible, open and participated model, we have detected four essential premises that must be worked on previously:

1. Commitment: are all members of your team equally committed to the organization?

The starting point of the Autonomous Organization is based on an agreement signed by the team, which expresses the commitment to essential aspects for the sustainability of the organization, such as ensuring the quality of care, offering reasonable weekly accessibility, facilitating joint care by the doctor and the nurse, or fulfilling the annual working day, among others.

2. The purpose: why do you want to work on your team?

To join a project of these characteristics, we consider it important to establish the purpose, which consists of the intention or the spirit with which something is done, or the added sense that the professionals of a team feel regarding the meaning and impact of the result of collective work.

In the individual sphere, some authors define purpose as a necessary balance between the work mentality, which conceives work as an economic exchange; the professional, which focuses on increasing the sphere of prestige or power, and the vocational, which implies feeling committed to the project.

To specify the purpose, we should open a collective debate answering three questions that Florent Amion proposes: what do patients want to come to our health centre for? As a health worker, why do you want to contribute your talent to your work team? And, finally, what is the contribution of your team to society, beyond its care activity?

Business experts say that purpose is the key to overcome obstacles and blockages and to achieve optimal performance, while some psychologists describe it as the path that leads to happiness, even associating it with fewer propensities to suffer from diseases.

3. Leadership: do you exercise leadership in each of your actions?

The classic forms of leadership such as the promotion of participation, horizontal communication and equal opportunities, although necessary, are no longer sufficient and give way to new forms based on empowering teams and professionals and making them co-responsible for the results and project owners.

Therefore, the Autonomous Organization frames a very favourable environment to innovate and lead projects in a transversal way, giving leadership to each action of each member of the organization.

4. Trust: do you trust those around you? And you, do you promote trust among your team members?

It is very important to create a climate of trust based on the psychological protection of the members of an organization, generating comfortable environments where one can open up to their colleagues, guaranteeing confidentiality and respect and treating the error as a collective good, not hiding it but using it as a source of learning.

As catalysts of trust are the classic soft skills (as opposed to hard or purely technical) that constitute interpersonal relationship skills, respect for the work of colleagues or communication and appropriate language at all times, which allow us to interact successfully with others.

To conclude, the Autonomous Organization is a paradigm shift that goes beyond the purely technical aspects and tools that we have used so far. It can be an effective element to help us face the health challenge that lies ahead, improve collective well-being and also personal growth.

In one of John F. Kennedy's visits to NASA, as soon as he entered, he asked the concierge what work he did and he replied: "I help take the man to the Moon." This indicates that even the seemingly simple job can serve an extraordinary purpose.

Recommended reading:

Propósito, Sentido + Pasión. Harvard Business Review

Soñando con un Hospital Optimista. Florent Amion, José Fonseca