Butterfly Leadership. Does It Keep You From Achieving Desired Results?

September 11, 2007

Debbie Cardello of the Studer Group, former COO of Baldrige winner Robert Wood Johnson University Hospital Hamilton (NJ), recently used the term “butterfly leadership.”  I asked her to write more on this important topic.  I hope you find her article interesting and helpful.  Your comments are appreciated. 

You are probably wondering, what is butterfly leadership?  And what does it have to do with achieving results?  Picture a butterfly as it flies from flower to flower, tree to tree, then quickly flutters away in search of sweeter nectar.  As healthcare leaders, we face similar temptations.


I think back to days (I should say years) gone by when I was very frustrated that quarter after quarter, patient satisfaction scores stayed the same.  Sometimes they even got worse, despite how hard we were working to improve.  What I ultimately realized was that the team’s actions weren’t always aligned with goals and the “flurry” of activities prevented us from focusing on what mattered most . . . patients, employees, and physicians.


Good leaders in good hospitals experience these challenges every day. We also know that there is no magic bullet; and as caregivers, we will always find problems to solve and systems to improve.  On the other hand, if our energy is consistently diffused, our ability to be an effective leader is at risk.  We could experience a decline in performance, burnout, or worse yet – leader turnover.


What can we learn from the example above to help us focus and align our priorities, accelerate our performance, and avoid “butterfly leadership?”


Use the 90-Day Plan to identify what matters most.  We’ve all heard this great advice: don’t confuse activity with results. It’s so easy to do in the busy world of healthcare. Begin by identifying what’s most important. This is where a good 90-day plan can help.


A 90-day plan that outlines three to four action steps is manageable and helps us focus on next steps that will move us closer to desired results. Review the plan monthly with your supervisor to ensure you stay on track, and to get and give feedback on how to best spend your time.  Ask yourself on a regular basis, am I spending my time on value-added action steps, or is activity simply finding its way on my calendar?


Use Rounding to hardwire behaviors that matter most.  We know that changing behavior is one of the most challenging aspects of being a leader.  Behavior rarely changes by writing an email, sending a memo, implementing a policy, posting a flier on the bulletin board, or communicating it once at a staff meeting.


It is a process that happens one day at a time, and one person at a time through our rounding on staff and helping them connect their work to the mission and goals of the organization.  Praise staff in the presence of others when you see them doing the behaviors that you are trying to hardwire. By doing so, you communicate what behaviors are most valued and important to patient care on our unit, and in our organization.


In order to reduce variation, we must manage performance.  Most likely, you’ve already recognized your high and some middle performers for using desired behaviors.  You also have a pretty good idea of who is not.

Next is a most important step if you are challenged by consistency issues.  This is the time when many of us get frustrated and are tempted to “flutter” away, try something new, move on to another initiative, or throw up our arms in defeat and accept average results. Average results in healthcare could mean that a number of patients could still contract an infection in the hospital or be harmed by a medication error which consistent improvement efforts could have prevented.

Circle back and visit staff members individually to clarify that using the desired behaviors is not an option, it is a requirement.  Give your staff an opportunity to discuss why he or she hasn’t complied – it may be due to a lack of understanding or training.

End the meeting with the understanding that the behaviors will need to become a regular practice to avoid further action.  In my experience, a leader would have to do this with only a few staff – the rest figure out how serious you are, what’s negotiable, and what’s not negotiable.

Use Reward and Recognition to communicate what matters most.  A simple rule to remember in communication is that once is never enough.  We all need to hear information multiple times and in a variety of ways in order to truly understand.


Reinforce desired results with fun and interactive exercises that reward and recognize key behaviors.  Share the top three organizational or department priorities at employee forums or department meetings.  Ask employees to talk about one action they could take in their department to get the desired result.  Encourage staff to share success stories.  Give out fun prizes to volunteer participants.  Employees are more likely to relate to important information when they can apply it to their own job.


While butterflies are most productive when they are “fluttering” from activity to activity, healthcare leaders could benefit from focusing their actions on identifying, rewarding, hardwiring and communicating what matters most. The result is so much more than meeting a goal or a score – it’s making a difference in the lives of those we serve.


Please add your comments to this blog and share your thoughts with our readers. We can all benefit from each other’s experiences.



8 Responses to “Butterfly Leadership. Does It Keep You From Achieving Desired Results?”

  1. Marcia Says:

    The article on butterfly leadership is insightful and from my experience very accurate. Often, leaders try to “look” busy to give the appearance that progress is being made when in fact the organization is just “spinning it’s wheels”. Picking your battles and chossing those action items that yield the most results is the key to an already over-taxed, over-worked organization. It is our job as leaders to be sure that we never assign busy work, but focus on those value-added initiatives.

  2. Becky Hewitt Says:

    I often feel that I am “flitting” from task to task because there are so many
    requirements and tasks assigned by others. Setting priorities is hard because each department and supervisor believes that his/her priorities ought to be my highest priority.
    How do we communicate that some tasks and activities might be needed but cannot be our highest priorty. What words can we use which will foster good relationships but make our point in a meaningful was?

  3. Kristi Bradley Says:

    What a great article. I find that I am most successful when I am on the unit at least 5 hours out of 8 rounding on staffs as well as patients. Unfortunately, meeting schedules don’t allow time to do this every day. I had cut out most of my meetings and was spending the majority of my time on the unit with staff and patients. We had just implemented hourly rounding and I was spending a great deal of time to ensure compliance by staff. In addition to interviewing patients, we had implemented a rounding log in each room that staff were expected to check off when they left the room. In the two months I was consistent with this, we had 74 days without a fall, 83 days without a skin breakdown, 0 medication errors and 2 patient complaints (that 1% mean factor!). We had a fall, and it felt like someone had put a pin in the balloon of success. I felt it when I arrived on the unit and the results were immediate. I was given a second unit to manage and couldn’t spend every day on the first unit and our problems began surfacing again. I am now back on the unit and I can tell how much of a difference it makes. I don’t think it’s because I am so important, but the staff feels the support and concern my presence invokes.

  4. Tommy Says:

    How do you deal with a manager that uses 30 year old management techniques but claims to use the Studor Group method? I see no evidence of them using what we learn at Studor Group meetings. They pick and choose what seems to fit their style and objective. Everyone who has attended, is frustrated with this style.

  5. Mike Tamisiea Says:

    Butterfly Manager was a great article. I have found as I have developed my 90 plans how important it is to really look at what you are doing in your account, what the hospital is striving for and what short term goals you can achieve line up with these goals. It is the difference between creating additional non productive work through goals that sound good but don’t really match up with what you are striving to accomplish on a day to day basis.

  6. Stephanie Baker,RN Says:

    Tommy, I am a coach with the Studer Group and wanted to give you my thoughts in reponse to your question about how to deal with a manager that uses 30 year old management techniques, but claims to use the Studer group method. First of all, I always go back to the health care flywheel. As leaders, we must all hold up the mirror and ask ourselves if we want to have purpose, worthwhile work and make a difference, do we have the fortitude to show the passion and implement the principles (prescriptive to-do’s) “as prescribed” in order to get the bottom line results we want to achieve? I have been a nurse for 20 years and know that if a medication is not given as prescribed, that the patient has less chance of being compliant, getting well and staying well. Role modeling the expected behaviors is the first role of the leader. Secondly, I go back to the evidence-based leadership slide that references aligning goals through leader evaluation and leader development, aligning behavior through implementation of the Must Have behaviors and identifying the performance gap, and aligning process through standardization and accelerators. We find if the leader is not held accountable for meeting their evaluation goals and development requirements that they are less likely to implement the Must Have behaviors “prescriptively.” The reverse is true as well. If the Must Haves are not implemented “prescriptively” the leader is less likely to get desired results. Lastly, achieving and sustaining results requires relentless focus (not the butterfly approach) and a “no excuses” culture. Senior leaders have the opportunity to mentor those leaders who are resistant to change or are modifying the prescriptives to re-connect them to the “why.” I find that most leaders desire to do an excellent job, yet oftem struggle to fit it all in. My method has always been to work smart, using tools and tactics that are known to get results ans that’s what the Studer Group offers. Thank you for the question and best of luck on your journey to excellence. As Quint always says, never underestimate the difference one person can make…keep being that difference maker!

  7. great, short article. we can all gleam insight from these pearls. i like to be associated with butterly management

  8. Cathy Christensen Says:

    I have been doing quality assurance statistics for many years in our lab. Sometimes the kinds of desired changes defined by leadership were not popular with the front line people.

    Persistant publication of objective and statistically valid data eventually won out and the improvements seen have been a source of pride for our team. Ninety days may be enough time to implement something, but my experience has been that it takes much longer than that to hardwire a desired change. The things we measured were essentially individual team member actions as documented in a variety of ways. Tedious, yes. Time-consuming – not bad once the measurement process was in place.
    Department meetings have been good forums in how to achieve consistency.

    Because details were available to leadership on a timely basis, individual shortcomings were addressed in a ethical manner. I think of QA activities as a communications and hardwiring tool that help leaders effectively use their time and energy.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s

%d bloggers like this: