Leadership Corner: “Do You Hear What I’m Not Telling You?” From Baldrige Coach
Check out this incredibly useful article on quality improvement through leadership, written by Kay Kendall of Baldrige Coach:
“The greatest threats to leadership aren’t found in urgent emails or broken processes. They’re found in what goes unspoken: the question that didn’t get asked, the idea someone hesitated to share, or the concern that was silently rationalized. And while not everything needs to be said, more needs to be heard.”
This quote came from a column in a recent Healthcare Executive magazine, and it immediately grabbed my attention. We have long noticed that the front-line staff of clients or while conducting site visits will often tell us about issues but not their own supervisors, managers, or leaders. I believe that it isn’t because we’re particularly charming but because we ask the right questions and they won’t have any repercussions from speaking up to us.
The Right Questions
Even if you round on your employees, they still may be hesitant to express concerns. That’s where a question like, “What do you need to make your job easier?” rather than, “Is everything okay?” comes into play. And if they still seem reluctant to share, probe for specifics, “Do you get communication in a timely manner?” “Are your supplies readily available?” “Do you need some cooperation from other departments?”
Another question we like to ask is, “If you had a magic wand and could change just one thing around here, what would it be?” Yes, sometimes we hear about pay and hours, but more often than not, we hear about the barriers that slow work down or impede teamwork.
Ambiguity Is the Killer of Execution
As a leader, do you have reliable feedback loops when you launch an initiative or change a policy? Do you make it easy for people to ask questions without seeming like they are challenging you? Do you quickly scan through the departments involved to see if the behavior(s) you sought to modify are actually present – and deployed across, up and down throughout the organization? In the same column, the author talks about inviting clarification, particularly when there is ownership shared across leaders and departments. “These are not ‘soft skills.’ They’re strategic corrections that improve throughput, reduce rework, and preserve trust.”
Speaking of Trust
Multiple studies across a variety of industries have shown that creating psychological safety in the workplace is key to high levels of safety, morale, and performance. In healthcare we sometimes hear about a “Just Culture.”
“Just Culture refers to a values-supportive system of shared accountability where organizations are accountable for the systems they have designed and for responding to the behaviors of their employees in a fair and just manner. Employees, in turn, are accountable for the quality of their choices and for reporting both their errors and system vulnerabilities.” https://www.justculture.healthcare/
If leaders are truly committed to a Just Culture, they need to be prepared for some initial “adverse” trends in critical metrics: near misses in safety, medication errors, reports of potential ethical breaches, and customer complaints. All of these increases are the result of employees being not only willing, but eager, to identify issues and get help from leadership in resolving them.
A Final Ingredient to Help Stop the Silence
Reinforcing your desire for more communication with greater transparency from your employees. How do you reward and recognize the brave staff member who shares a concern, reports a near miss or actual incident, raises the flag over a broken process, or identifies barriers – even in leadership behaviors – to more effective and efficient work?
What the Baldrige Excellence Framework Has to Say About Leaders and Listening
Item 1.1b asks, “How do senior leaders communicate with and engage the entire workforce, key partners, and key customers?” It also asks how senior leaders encourage frank, two-way communication. That phrase was added to the Framework in 2003 following the collapse of Enron and Tyco, due in part to their senior leaders silencing any negative news and intimidating potential whistle blowers.
How can you tell if you are encouraging frank, two-way communication? Ask yourself when was the last time an employee gave you bad news, and you didn’t shoot the messenger? What are you doing to promote a Just Culture? And when did you and your senior leaders ask for blunt feedback from each other and your workforce?
The closing thought in the column should cause pause for every leader, “Because what goes unnoticed doesn’t go away. It just waits – until it can’t be ignored.”


