Effective leadership in healthcare: Learnings from NASA
Effective leadership in healthcare: Learnings from NASA Rachel Marley
Quick Takes
- The business of healthcare and space share many similarities due to their high-risk nature and critical need of a cohesive team under good leadership to be successful
- Effective leadership in either industry is reliant on the development of admiration and respect for your team to enable trust
- Trust goes beyond personal relationships and should also be applied to trust in your training among other factors to help overcome the fear of failing
Space missions are known to recruit the best astronauts who have to undergo intensive training in order to deal with the responsibilities that come with flying into space. Healthcare is no different. Every day, doctors, nurses, and everyone within the healthcare system hold the responsibility of patients in their hands, some of whom are in a life-or-death situation.
Today, we speak with Mike Massimino, retired NASA astronaut to hear his insights about effective leadership as it relates to operating in high-risk, high-intensity environments, and what healthcare leaders can do to ensure they are leading effectively.
The similarities between NASA and healthcare
HT: Some of our readers might be reading this article, thinking why should I be listening to a NASA astronaut? What does he know about healthcare? What would be your answer to that?
Mike Massimino: There are more similarities between healthcare and space than you might think. One of which is that we are team-focused at NASA. We have astronauts, but we also have an entire network of support teams and people that get us ready for a mission including our instructors and control team. You must work as a team to be successful and as a result, you also need to have strong leadership.
Another similarity is that they are both high-risk industries. In the space business, we cannot afford to make tragic mistakes. We try to avoid them but still it happens, we have had accidents and lives have been lost. People getting hurt is never a good thing and it can happen a lot more when you don’t have good leadership and teamwork.
This is the same for the healthcare industry. You have people’s lives in your hands, and as a result, people have to help each other, to check on each other, to look over each other’s shoulders to make sure we’re doing well. Good and effective leadership and teamwork are how you minimize the risk in these high-risk industries, such as the healthcare industry.
The key to effective leadership in space and in healthcare
HT: What are key leadership lessons that you learned from your time at NASA and during your time in space?
Mike Massimino: One of the key lessons I learned at NASA was actually from my friend Alan Bean. He was a painter, an artist as well as an astronaut, who dedicated his life to painting after his flying and space days were over. Alan was the fourth person to walk on the moon and became a mentor of mine after listening to him speak early in my astronaut training. He taught me that the most important thing and rule number one in leadership is to find a way to care for and admire everyone on your team.
When you have a leader who cares about you and admires you, you know you’re going to be taken care of if something happens. It doesn’t matter if something goes wrong, or you need help, that leader is going to be there to support you because they care about you. It’s not just a work relationship, it goes beyond that. You’re a teammate, you’re like a family member, and you want them to know that.
The fundamental skill of a successful leader
HT: What would you say is a fundamental skill that every person has to have to be a successful leader?
Mike Massimino: A successful leader needs to be able to listen to the team, especially if there is something that is brought to them. In the healthcare industry, it could be anything that has to do with patient or staff safety or the health of the individuals that you’re caring for or the products you provide. For us, it usually means the safety of our crew or the crew of our colleagues.
If it’s a safety concern, people need to feel like they are in a safe enough environment that they can raise those issues even when a mistake was made. What we did at NASA was if someone made an error, particularly if it had something to do with safety, you needed to come forward with it and confess. That is the team, the teammate, and the team players’ obligation. But the leader needs to set that tone and has to be able to listen with an open heart.
When someone comes forward with a concern, you have to listen and address it. If someone comes forward with something they did wrong that they want others to learn from, they need to feel that they can without being judged. The leader needs to accept that and not overly penalize that person coming forward. As an astronaut, much like a doctor, you learn lessons quickly. When anyone makes a mistake, even if it goes unnoticed, it is critical that whoever makes the mistake feels comfortable to come forward so that the whole squad can learn.
Mistakes can happen to anyone, even those who are the most experienced, talented, and skilled people. Having a healthy dialogue around mistakes is so important, which is the same in healthcare. It’s when you keep mistakes to yourself that they can come back to bite you, and not only that, it can also have serious repercussions. The worst of which is that you get labeled as someone who cannot be trusted.
I made my fair share of mistakes over the years but as long as I told people about them, it was forgiven. When people try to hide things, especially when it had to do with safety or someone’s life at risk, you were never forgiven for that.
The same goes for new ideas. If someone has a new idea, it may be a crazy idea, or it may not be a good idea, but if they have it, the leader should never squash those ideas. As a leader, you want to say, “thank you for bringing that forward to me, but this is why we’re not going or able to do that.”
Explain it so you don’t squash the thought process or the creativity that people have. That comes down to listening and being open to listening and being open to new ideas and understanding that everyone has a voice, and you need to listen to them.
Key advice for upcoming leaders: Bring diversity into the team
HT: What key piece of advice would you give to anybody moving into a leadership position?
Mike Massimino: To anyone moving into a leadership position, I would have the following piece of advice: Bring diversity into your team. Diversity comes in many different forms. You don’t want everyone to think the same way, to behave the same way. You want people with different ideas, different thoughts, with different backgrounds.
You might not always understand why someone says or acts the way they do. Don’t look at it as if you don’t like them, look at it as if you don’t know them well enough. That was another lesson that Alan taught me.
I learned in my years after becoming an astronaut and getting leadership experience on various projects and on my spacewalks, that our success was dependent on everyone on the team contributing – all our engineers, instructors, flight controllers as well as the astronauts and all the folks who were helping us.
On my second flight in particular, there was this one engineer who was always considered to be a little different. He was on the team, but we all thought, “what’s the story with that person?” Then I remembered Alan’s lessons, so, I took the extra time to get to know that person and I realized that even though he had a different personality, he was a dedicated person with lots of good ideas. I enjoyed getting to know them better. I noticed after that he felt free to speak up with his ideas and I made sure that they were always heard.
Getting to know each other outside of work, if possible, can help the team as well. After we did all our training runs at the end of the week, we would go out and have a beer together. I had people over for barbecues, and occasionally we would go out for dinner, and we would meet socially. That was something that served me well.
You can’t afford to have someone on your team who seems to be an outlier or that other people don’t like that much. You can’t have any of that. You can’t be pointing a finger at people and excluding anyone. You have to really make the effort to make sure everyone is cared about and that they know that you care for and admire them. The only way that’s going to happen is if you get to know those folks and take the time to get to know everyone on your team so that they know you care about them. That is one of the key things to remember when ensuring effective leadership in healthcare.
I call it the bank of good thoughts. You want to have good thoughts about everybody on that team. It’s particularly useful when you have to talk about something that might not be pleasant, you put the good thought in your head first before you address the issue.
The importance of failure and how it makes you stronger
HT: How do you separate the fear of failure from clouding or distracting you from the mission at hand?
Mike Massimino: As an astronaut you fear many things – mainly while looking up at the spaceship right before launch – but the fear of failure was the worst one. Fear can come in many different forms. Rear for your life or your health or fear for someone else’s well-being or fear of failing.
What helped me (and still does) was to remember the three trusts.
Trust your gear. You have to trust the equipment and the technology. Whether it’s a computer, a wrench, something you’re using in the healthcare industry, whatever those tools are, you have to trust that they’re going to work. They are there to help you do your job and to take care of you.
Trust your training. You have to trust that you are qualified to do whatever it is that you’re going to do, even though you might not think so. Right before my first space flight, I was about to go into quarantine because they don’t want you to get sick before you go into space. I was at home getting things ready for the next day, when I got a visit from my friend Steve Smith, who was a senior astronaut and one of my mentors. He said, “I want you to remember two things: remember that you are well-trained and you’re ready to go even if you don’t think you are. We would not let you go unless we felt you were ready, and we know better than you.”
I was trained, whether I believed it or not, and my training was there to help me. The other thing he said was, “remember it’s an open book test. If you need help while you’re out there, you just ask and people will help you.” In life that’s important to remember.
Trust your team. You’re not in this alone. I knew when I was going to execute the missions that it wasn’t just me. It was my crew mates, all the folks in the control center, and everyone else out there to help.
Those are the three trusts, and from the leader’s perspective, they need to instill that in the team. It is that “hey, we’ve got the tools to do this, we are well-trained to do this and we’re going to take care of each other.” This demonstrates effective leadership and that goes for any situation in healthcare too, whether it’s launching a new product, performing an experiment, or a procedure in the emergency room. Whatever it might be, know that your team is there for you and then suddenly you find yourself less fearful about it.
Want to learn more about being a leader in healthcare, then check out The top 10 healthcare leadership books you need to read for working in a post-COVID world.