How we organize our lives and our time -- both work and personal -- has a very direct impact on our leadership effectiveness. Every day, we have dozens of choices about how to use time, with lots of options for techniques routinely used by high achievers, successful leaders who focus on results, rather than just being busy. Employing these techniques improves the ability to function exceptionally well, even under extreme pressure. Taking control of time may just sacrifice the frenzy of activity and overload for the reward of achievement and lower stress levels.

Like most critical human behaviors, most of the principles of good personal leadership organization are not rocket science, we have heard about and maybe even used some of the techniques. But human behavior being what it is, we forget, get distracted, fall back on the easy way or old habits, and pretty soon our personal management of our leadership time has suffered. We need to be reminded of some of the best personal organization "tricks" to take full advantage of leadership opportunities.

So, how good is YOUR time management?

Do you ever run out of time? Every day? Once a week? Feel like the hamster on a treadmill constantly trying to keep up?

Does it seem like you never have enough time? In truth, people can generally make time for what they choose to do, and it is really not time but will that is lacking. So while time does fly, remember YOU are the pilot!

Time Management Self-Assessment

Understand the dynamics of how you organize and use your time by taking the TIME MANAGEMENT SELF-ASSESSMENT to help you to identify the aspects of use of time for which you need the most help. Your results will help you to select areas for self-development that you can immediately put to use . . . Do it now, so a year from now you're not still wishing for more time . . .

Assess Your Results for a Self-Improvement Plan

As you answered the questions, some thoughts probably began to form about where you might focus on your use of time. The results that were returned to you focused on five critical areas of attention:

Procrastination: "Just give me a few minutes!" . . . "I'll get to that later." . . . "I meant to do that and then forgot all about it!" Procrastination is a deadly habit that too often leads to work piling up to be virtually overwhelming. Recognizing that you procrastinate, and figuring out why is the first step to changing your behavior. Total your results for questions 2, 10 and 12 and compare to the possible total of 15. If your score suggests that there might be too many "laters" in your life, review the section on procrastination.

Goal Setting: Better time organization requires that you set some goals, guideposts to help you to know exactly what needs to get done, when and in what order. Many leaders tend to neglect goal setting because of the time it takes, totally overlooking the fact that a little time invested today can save an enormous amount of time, effort, anxiety and stress in the future. Look at your total for questions 6, 10, 14, 15 in comparison to the possible total of 20. If you scored low in this aspect of time organization, review the goal setting section.

Prioritizing: Setting relative priorities for goals and tasks tends to keep you from working very hard, yet not achieving the results you anticipate because you have missed the strategic value of the tasks. While most leaders have a to do list, too often they are simple an unstructured collection of things to do. Prioritizing means focusing your attention on the most important strategic and high value tasks. Tally your score for questions 1, 4, 8, 9, 13, 14, 15 and compare to the possible total of 35. Without good prioritization skills you may work very hard without significant progress toward the results you desire. Review the use of activity logs, to do lists and prioritization.

Scheduling: Knowing your goals and priorities, minimizing interruptions and overcoming the bad habit of putting off essential tasks leaves leaders with the need to master creating a schedule to keep on track and reduce stress. Scheduling for deadlines and priority tasks doesn't mean that you don't have to leave scheduled time for "interruptions", unanticipated events, unintended consequences and serendipitous events. Avoiding the chaos of the unexpected will greatly reduce stress and add to the balance of your life. What was your total score for questions 3, 7, 12 of the possible total of 15? If your score leaves room for improvement see tips for more effective scheduling.

Managing Interruptions: Planning and prioritizing your work is a good start, but you also need strategies for minimizing distractions, interruptions and activities that side track your leadership attention. While you will always need to be available, techniques for dealing effectively with interruptions can keep you focused without locking the door or scaring people away.Of a possible score of 20, how did you score on questions 5, 9, 11, 12? For improvement, review the Urgent/Important Matrix and tips for dealing with interruptions.

We'd all love to add a few hours to each day or another day to the week. Since that wishful thinking is not likely, leaders need to work smarter on the tasks of the highest priority, with a schedule that reflects our lives and priorities. By employing the leadership skills and tips in this section, you can improve your organization for leadership effectiveness, concentrating as much of your time and energy to the high value, high payoff aspects of your life. Use the time you have to your leadership advantage!

Staying Focused on What is Important

Busy leaders have two options on how to structure their work day: to be reactive to meet urgent demands, or to be proactive by focusing on what they decide is important.

In his seminal self-help book, The 7 Habits of Highly Effective People, Stephen Covey addressed three categories of "habits":

• Moving from dependence to independence, or self mastery
• Interdependence, and
• Self-rejuvenation

According to Covey, moving from dependence to independence involves three habits:

• Being Proactive
• Beginning with the End in Mind and
• Putting First Things First

All have time management implications for leaders. In a later book, First Things First, Covey suggests that time management is actually personal management -- the art of managing ourselves. Personal self-management demands organizing and executing around priorities, classifying all tasks as either urgent or not urgent, and then as either important or not important. Those screaming for action are urgent, and those critical tasks that contribute to mission, vision, values and high priority goals are important. Using a quadrant matrix, Covey defines four categories of tasks, in Quadrants 1 -- 4, as shown.

Urgent tasks include a screaming email that demands immediate attention, the impromptu request that will just take "a minute" but is finished two hours later, a report or spreadsheet that you have to have in hand before you walk into a meeting, the proposal for a just discovered business opportunity with a hard submission deadline. . . Urgent tasks can be characterized as firefights, busywork, short-term and typically "easier" than the intimidating project work that loads your to do list. We are distracted by and drawn to urgent tasks because they make us feel needed, provide closure quickly so we can cross something off the to do list, and can often make us feel important because we are able to personally resolve a problem. They keep us oh so busy. At the end of the day of dealing with urgent tasks, we are tired, a bit frustrated, out of time, and wondering why we feel so anxious about the still looming "real work" that still needs to get done.

Then there is important work. It doesn't always give you a rush of adrenaline. It typically involves a lot more thinking than doing, and honest assessment about where you are, where you want to be and options for getting there. It can be mentally draining, plain old hard work, that may not be immediately noticeable to those around you. In the middle of the important work, it is sometimes too tempting to avoid sneaking a quick look at something urgent -- like your email (there MIGHT be something urgent there to take care of!). Or, if your day involves you or those around you rushing around with "hair on fire" it may feel that it is impossible to focus on what's important versus what is urgent.

Quadrant I activities are urgent and important and they typically manifest as crisis, vital meetings, deadlines or demands for attention to critical emerging matters. Quadrant I focus can grow to overwhelm your life because the "urgency" can be almost addicting due to the temporary rush that accompanies solving urgent and important crises. The most effective leaders spend more time in Quadrant II than in Quadrant I, despite the "seduction" of Quadrant I. Too much time here means eventual stress and burnout.

Quadrant II activities are important but not urgent and are the core of personal time management, including preparation, prevention, planning, strategy, employee engagement, creativity relationship-building, intentional recreation and values clarification. This quadrant is key to short and long range planning, reading to expand your mind, professional development, physical fitness and exercise, leisure and recreation, systems thinking and design, and envisioning personal and work future, giving the leader vision, perspective, more control of the work situation and balance.

Quadrant III activities are urgent and not important, sometimes known as phantom activities. They can be (self)deceptively misclassified to Quadrant I items, and often waste our precious time. Some emails and phone calls, interruptions, some meetings, some projects, any activities to meet someone else's priorities that do not meet any of your own are examples that fall into this quadrant. Too much time here results in an exceedingly short-term focus, and the sense of being "out of control" and the victim of the system/organization.

Quadrant IV is our ESCAPE. Too much time in Quadrant I may cause us to drift to Quadrant 4 just to relief the pressure. This is typically trivial, time wasting STUFF such as net surfing, dealing with spam email backlog, office chit chat or coffee breaks, busy work, filing, etc. Some of this must eventually get done or it becomes Quadrant I crisis, but we need to recognize Escape Strategy for what it is. Time spent here tends to foster feelings of irresponsibility and dependence on others to make things happen.

Effective leaders stay out of Quadrants III and IV because they are not important. They work to shrink Quadrant I by spending more time in Quadrant II, allowing them to take advantage of proactive work by tackling issues before they become problems or crises.

Know How You Spend Your Time

Do you know how you spend your time? How much time talking to colleagues, processing mail, responding to email? Have you ever felt like you needed just one more hour in the day? Do you know when you are doing the most thoughtful and demanding work?

Most people have peak energy and effectiveness times in their work day, and it varies for individuals when that time actually is. Your effectiveness can also be influenced by blood sugar levels, the duration of concentration time, interruptions, stress and a host of other environmental factors. Know how you spend your time and when you take on challenging tasks is vital knowledge to maintain attention to the most important tasks. Believing we can manage that based on our recollection of where the time went is a fallacy that many leaders live by.

Keep a Log of Your Task Activity

Take several days to audit your activities, keeping a detailed log of every task and activity, noting the time each time you change what you are doing. Periodically during the day, make note of how you are feeling: alert and energetic, tired, distracted, preoccupied with something else. Once you have recorded activities for several days, analyze the data. Typically, people are surprised by the amount of time not dedicated to the most critical work and goals they have responsibility for. Energy peaks are likely to coincide with when you take breaks, what and when you eat, so take note of whether you might want to consider changing those patterns.

Some simple recommendations to consider:

• Identify tasks that you should probably not be doing at all. Can they be delegated to a more appropriate person? Are you using work time for personal activities that should be taking place outside of work? Reassign or eliminate those low impact activities that do not directly contribute to your work priorities.
• Determine when your energy is the highest and schedule the most important work in that time frame, saving less challenging tasks for those times when you are less focused.
• Minimized the number of task switchover during the day. You might consider checking and responding to email in the morning, mid day and late afternoon, rather than every half hour. Every time you switch tasks, you lose time in refocusing your attention and take the risk of additional time loss to distraction.

Keep an Active To Do List for Action Planning

Do you ever completely forget to do something? Or lose track of an assignent because you missed a critical step in the process or a conference call to recap on the rest of the team's progress? A prioritized list of To Do assignments is essential to effective time management., and once you start to use one effectively and consistently, it can mean an enormous breakthrough in efficiency. You will forget less, see the critical path or sequencing of tasks more clearly, and will be able to clearly identify tasks that can be put off until later. Most importantly, those around you will see attentiveness and reliability in your performance instead of flaky forgetfulness.

Write down everything that needs to be completed. For more substantial tasks, break them down into component tasks that will take no more than 1 -- 2 hours to complete. Assign simple priorities: A (critical), B, or C (not important or immediately urgent). If you have too many A priorities, review and either move them to another category or subdivide into primary and secondary groupings (1 or 2 priorities). Then reorder the list in priority sequence. Whether you manage the list sequencing daily or weekly, continue to review and revisit the To Dos and priorities as you tackle and complete tasks. Focus on completing the most critical tasks first, and don't be distracted by a large or growing number of unimportant tasks.

When the number of tasks is large (and growing), a simple To Do list may not be robust enough for you because while it serves as a reminder, it does not serve as a roadmap for action. Where the detailed specific tasks are clear, it is easy to take action. But for more complex projects, the lack of detailed action steps makes it easier to delay, procrastinate or simply ignore them. Without the detailed steps, its easy to "get lost" in a big project as the total focus of your attention, losing sight of other important or urgent work, and making multitasking difficult.

Leaders always have multiple projects, many times very large ones, to manage simultaneously. Action Programs are To Do lists that incorporate short-, medium- and long-term planning of your time allocation, allowing you to keep track of commitments, focus on things that matter, highlight opportunities for delegation and manage multiple simultaneous tasks.

Develop an Inventory List

First compile a list of responsibility areas that demand your attention -- urgent or not, big or small, personal or work related. Think about your email, voicemail, snail mail and internal mail inbox as sources of items for the list. Think about ideas on your mind, face to face or phone conversations that result in you needing to do "something", scraps of paper or restaurant napkins scribbled with notes or "aha's" notebooks or diaries with ideas for future projects . . . Inventory them all in one place. While a challenging task, this will immediately reduce your stress from managing all those mental To Dos you struggle to keep track of, always wondering what you have forgotten, or not having critical pieces in place when you "plan" to start working on a task. Reducing distraction is the first immediate benefit.

Trim the List

Carefully review each item and determine if it is something you should take action on. If not important, urgent or relevant, delete it from the list. Delegate where you can. This task typically takes several hours initially but can be managed on your computer or PDA with relatively minor updating once the initial framework is established.

Organize

Group or "bucket" like items or related tasks into larger project categories. For example, if you are implementing a new CPOE system or bedside bar coding, cluster all the related tasks including requirements input, selection, testing, training, etc under a single project header. Once you begin to think about the relationships between individual To Do items, the organization patterns becomes much clearer.

Allocate a priority value to each project: A, B, or C that reflects what is most important. You can prioritize based on the basis of what needs to be done first, what requires the greatest attention or what needs the most resources.

Priorities always involve tough choices, sometimes conflict and controversy. And establishing the priorities opens the process to decisions of how to allocate resources, including time, frequently a delicate balancing act.

Focus on the highest priority items, and identify the next action steps that are needed to move the project forward. Some tips:

• If a next action step will only take a few minutes, complete it right away for progress toward completing your TO DO list, then return to the list.
• Use your judgment regarding how many items to keep on this list. You may be juggling multiple projects that all have next steps or you may focus on one that has more significance or a shorter deadline that commands the list.
• Keep items on the Next Action LIst small and achievable, requiring no more than 2 hours to keep you focused, keep your energy level high and provide a sense of accomplishment once the list is completed.

Keep that list within sight as you work through the day as a reminder of the tasks that need attention

Overcoming Procrastination

Do you procrastinate?

Most people do, just putting things off . . . don't want to buckle down, too many other things to do, or too many more tempting distractions, or something. Often we don't mean to procrastinate but before we know it . . . boom. Looming deadlines, not much time left to achieve, worries that we can't get it done right or at our best, but . . . deliverable due. Not really enough time to edit, proofread, revise, get it right. But if we had more time, it would be perfect.

It feels good when you get it done by the deadline, but is the procrastination worth the anxiety, burden of a building workload, the sense that your work is taking over your life, and the guilt that it could PROBABLY have been done better?

Everyone procrastinates, in fact 20% of people identify themselves as CHRONIC procrastinators, a lifestyle that crosses all aspects of their lives. (For example: chronically pay bills late, miss opportunities for social activities because they never get around to the planning or responding to invitations, don't use gift certificates or coupons because they expire, file for every tax extension then flirt with the final deadline, leave Christmas shopping for Christmas Eve . . . evening.)

But if you feel that you are in the 95th percentile, take heart. There is hope and help, this is a bad habit that can be overcome. Just don't be lulled to thinking this is an easy fix, since there are no silver bullets!

Procrastination is learned behavior, one that can emanate from resistance to controlling behavior that stems from reaction to parenting styles, even may even represent a form of rebellion ("You can't make me do that." or " You are not the boss of

Procrastinators support their habits with excuses:

• I'll be more ready to get this done tomorrow after a good rest.
• I work better under the pressure of a deadline.
• My creativity is stimulated more thought time.

Most procrastinators actively look for and use distractions -- checking and responding to email is the classic example -- but the reasons for procrastination differ.

• Thrill-seekers enjoy the "recovery" and the thrill of pulling through at the last minute.
• Avoiders are often driven by fear of failure or -- perversely -- of success, engaged fully in what others think of them and their ability.
• Decisional procrastinators can't make a decision, "absolving" them from the outcome of negative effects.

Procrastinators work as hard and long as others, sometimes longer, but they focus attention on the wrong tasks. That misplaced activity may be the result of confusing urgent and important tasks, responding to the loudest and most vocal demand. Not knowing where to begin or simply feeling overwhelmed the task and their own ability -- including decisionmaking and organization skills -- is a critical factor. And, at times, perfectionism lends an influence: without all the skills and resources required, the outcome can't be perfect so why not score some triumphs on easier, quicker tasks.

Procrastination has lots of implied costs, surely to your work, but also to your health, sleep patterns and to personal and workplace relationships. The key to controlling and overcoming procrastination is to recognize this destructive habit when it occurs, understand why and take action for better personal behavior management.

Recognize Your Procrastination

Knowing when you procrastinate requires that you understand the priorities of your work. Use tools like the Action Priority Matrix, illustrated below, to identify your priorities, and work from a Prioritized To Do List. Focus on quick wins (Quadrant 1) and major projects (Quadrant 2). Delegate low impact, low effort projects that may not require your attention or treat them as "fill in" work (Quadrant 3.) Avoid -- to the extent possible -- the Thankless Tasks (Quadrant 4.)

Be aware of personal choices in how you fill time and take note when you begin procrastination behaviors:

• Filling your day with low priority tasks
• Reading an email or document that is already on your Prioritized To Do List more than once, without taking action or deciding when to start.
• Beginning a high priority task, and immediately switching to checking your email, making a phone call, grabbing a soft drink . . .
• Keeping a really important task on your To Do List for a long time, despite its importance.
• Automatically agreeing to do unimportant tasks others request even if it keeps you from important work.

Figure Out Why

While there are lots of reasons, they come down to two categories:

• You don't want to do it because you basically don't like the task, or
• The task is overwhelming.

Which is it?

Take Action

If you just don't want to do it because you find the task unpleasant, consider delegating. If you can't delegate the task, figure out how to motivate yourself to action. Some possibilities:

• Make up your own personal reward for completing the task
• Think about the unpleasant consequences of not completing the task (eg embarrassment, reprimand, warning, rejection of proposal, etc.)
• Identify the lost opportunity to your organization and team for your failure to complete the work

If the task is simply overwhelming:

• Break it up into smaller more manageable tasks
• Create an action plan the identifies phased steps for accomplishment
• Pick out some aspect of the project that allows for quick achievement to get you moving toward completion

Create a productive environment. Find a place where you are likely to focus your attention on the task. This does not mean: cleaning your office, desktop or home first; refurnishing your desk with new supplies, or refiling all of the papers that are in your path. While these are worthy tasks, if you are only tempted to do them when you are facing a deadline, you are procrastinating.

Think about the times of day when you are most productive, can best concentrate and focus on being productive, then schedule your time to focus on the most challenging tasks when you are most attentive.

Get a new attitude. Avoid negative self-talk about how awful, unfair, impossible, boring . . . the task at hand is. Just get started.

Ask for help. Turn to someone who is well organized and focused and ask their assistance in thinking through the project, keeping you track and checking in to make sure you are making progress. Sometimes just talking through the task helps to identify a logical path for completing it successfully. You can also pair up with a peer and work on the task together. Choose someone who will benefit from the outcome, has insights to the process or unique expertise to contribute.

Make yourself accountable and set a schedule for yourself to maximize the effectiveness of your time.

Start your day as early as possible. Even a half-hour earlier can make a difference. The idea of planning to get two tasks completed by noon and actually finishing three or four is very compelling and energizing.

Cluster and tackle smaller tasks back to back. This strategy will help you clear your task list and c clustering similar tasks keeps your active mind in similar thought processes.

Don't count on the advantage of "the final push." Too often, it is easy to divide a project into smaller tasks but to leave a huge proportion for the final work. Instead, divide up a project so that the longest/hardest is first and that each successive task is smaller -- hence perceived to be -- easier to complete. Otherwise you might still meet the deadline but be "dead on your feet", letting other tasks slip in the process.

Knowing yourself, and understanding your work behavior is an important first step in managing yourself for effective leadership. 

Goal Setting

Goal setting focuses attention to personal aspirations, personal vision and the "ideal future state". It is hard to be successful without goals, a lot like trying to sail to a destination without a compass, not knowing what direction we are traveling, when or where the "destination" might be reached. Without personal goals, we effectively abdicate our futures to others who will set goals for us if necessary, or to the random events of the environment. External goals may be effective, but they are not necessarily personally beneficial.

Exploring and knowing what you want to achieve helps you to set a course of action to focus your efforts, and to help you to avoid frustrations and distractions might detract from your achievement. Focused attention to the specifics of what you aspire to will enable you to organize your time and resources, and to create the balance of interests that a healthy and happy life is based on. Moving from "big picture" concepts to incrementally more discrete and refined elements of what will be needed to achieve the broader aspirations allows you to develop a personal plan and to begin to build toward completion.

Think BIG

Think first about what makes your life meaningful and where you see yourself focusing attention in setting lifetime goals. What do derive pleasure from? What would you do if you did not have to "work"? Because this should not be just about your immediate work life, consider some of these categories as you do your planning:

• Career, including what you envision as the apex of your career -- the perfect job, position title or situation into the future, and some alternative paths for getting there
• Education and life-long learning -- what do you still need or want to learn, where should you focus attention to build knowledge and skills, to develop mastery, and to acquire the wisdom and perspective to help others grow
• Family, including decisions about family aspirations, work life balance and priorities, how to guide work decisions coordination with other aspects of your life
• Professional goals including aspirations to leadership at work, in professional association circles and in mentoring and coaching others
• Attitude -- are there aspects of your personality that are inhibiting your development, are any behavioral traits encroaching on your development?
• Financial goals including stability, wealth, security, retirement and how you plan to move toward those financial goals
• Physical, including specific activity and athletic achievement goals, health and wellness,
• Spiritual regeneration, including how you recharge, energize and replenish your inner strength, your core
• Pleasure -- what activities do you enjoy that you want to establish within the framework of your life: travel, study, artistic endeavors, etc
• Community service and philanthropy -- how do you plan to give back, schedule time to share your time and talents with others and to contribute to the world around you

Think about these components of your life, brainstorm with yourself and others. Set broad goals for lifetime achievement based on this reflection, then incrementally begin to establish sub-goals within shorter time frames: 5 years, 1 year, 6 months, one month to identify specific steps toward the lifetime goals that will allow you to make progress every day. From these lists, establish entries for your to do list that move you another step in the right direction. Periodically review and revise the plan as your perceptions change and as you make progress toward goals.

A few thoughts:

State your goals as positive growth statements to strengthen their motivational impact, and be as discrete in defining the goal as possible to clarify the achievement you are seeking.

Put your goals in writing to clearly articulate them and to solidify the commitment you are making to achievement. Having a goal "in mind" is fleeting, simply won't last. Written goals are five times more likely to be achieved than those we "think about." The best time to record your goals is when your mind is most powerfully engaged, without distraction: when you first wake up, or just before you go to sleep. Short term goals should not exceed 20, and long term goals lists should not exceed 50. Keep them with you and review them frequently. Visualize achieving your goals every day to increase attractor awareness to situations and attributes that will help you to achieve your goals sooner.

Set performance goals, as opposed to outcome goals, to manage your realistic ability to meet your personal expectations and to avoid being sabotaged by circumstances outside your control. By focusing on your personal performance you increase the sense of accomplishment and satisfaction you can realize when they are achieved. To motivate, goals must be clear, measurable and unambiguous, represent a challenge to stimulate the best effort possible, mutually agreeable to stimulate commitment and offer the opportunity for feedback for immediate and long-term skills and performance improvement, all intended to facilitate personal success.

SMART Goal Setting

SMART goals represent a technique to assure that your goals are Specific, Measurable, Attainable, Relevant, Timely, and Engaging. And SMARTEST goal setting, adds Engaging, Shifting and Team-focused as equally critical factors.

For a goal to be accomplished, it needs to be SPECIFIC, defining at a level of detail what you are actually intending to accomplish. The goals should answer the who, what, when, where, why questions related to each goal. As an example, I am going to apply for and complete the ASHP Foundation Pharmacy Leadership Academy curriculum in 2011.

MEASURABLE goals allow you to define your career outcome destinations, with a clear understanding of how much further progress is needed. Measurability is easier to achieve if you target a time frame for achievement, keeping you on track for achievement and marking opportunities for success celebration.

Goals that are most ATTAINABLE are those most important to you because their significance drives you to finding creative ways to identify more opportunities, particularly those that might have been overlooked, ignored or rejected if your goals did not highlight their importance.

We all set goals related to things we aspire to achieve. Those that are unrealistic set unreasonable and unachievable expectations that lead to disappointment and dissatisfaction, effectively demotivating personal development. Choose your RELEVANT goals realistically and wisely as you are the only person who can establish, work toward and realize goals that are within reach, but always a stretch.

Achievement is best framed within the context of time. Without a timeframe, it is all too easy to lose track of the importance of the goal, losing attention, interest and the opportunity to achieve. TIMELY goals allow you to focus, measure progress and achieve steady incremental gains.

SMARTER goals add a few more concepts to think about . . .

Whatever your goals, they need to be sufficiently challenging and stimulating to be ENGAGING enough to keep you attentive and focused over time. With the world around us changing continually, goals need to be big enough and challenging enough to maintain interest and commitment, despite the incremental life and work changes. . . focus on strategic and longer term change issues to increase the likelihood your commitment will not be diminished over time.

Truly, life today is all about change . . . SHIFTING sands beneath our feet. It is one constant we can count on that continually influences what we see, think, believe and do. Keep touch with your environment and the forces that change it. Nothing is static, so be aware of change vectors, agents and influences so you can adapt your goals, shifting your focus and attention as the world around you changes. Your goals need to shift with the changing environment.

The days of individual contributors, triumphing independently, are past. We live in a complex world where no one individual can house enough knowledge to understand and resolve the totality of problems, particularly in the complex world of healthcare. Integrated TEAM-BASED efforts, with the messy and diverse opinions of many players -- engage the broad knowledge and insight that can improve process and avoid error -- are essential.

Goal setting is an ongoing activity, not just a means to an end. By setting incremental goals, you are defining what you intend to achieve and setting the course of action to get there.

Prioritization

If you are going to make the best use of your own and your teams resources -- time and otherwise -- you need to master the skill of effective prioritization. In the current healthcare environment the demands seem limitless, time is in short supply and resources are a moving target, making dynamic prioritization even more important to day to day and longer term success. When you prioritize effectively your path is clear and logical, with prioritization you are subject to the whim and chaos of the loudest voice, competing demands and random choices.

Setting Simple Priorities

At a most basic level, you can prioritize based on constraints, relative profitability, benefit to completion or the pressure factor of the demand for a completed task.

• Prioritization based on value or profitability -- quantitative or qualitative -- is commonly used and provides a rational basis for differentiating and ordering priorities.
• Time constraints are a valuable assessment measure when others are depending on your work, when it is an intermediate task in a larger critical path development or where you can invest a small amount of time for a larger return and accomplish the task quickly.
• If the pressure for completion comes from your boss and it is not unreasonable, that is hard to resist as a measure of priority.

In most cases, these simple measures of priority work for us on a day to day basis, but there are other, more sophisticated ways to prioritize projects, tasks and priorities.

Prioritization Tools and Techniques

The role of prioritization is to help you to achieve the desired strategic results with a little effort as possible, using the resources -- including time, which is not replenishable -- as efficiently as possible. That requires evaluating projects and tasks in terms of their importance and their drain on our resources, including time.

CARVER

Criticality, Accessibility, Return, Vulnerability, Effect and Recognizability -- is a acronym for a military method of target selection. Rigorous use of the process applies a Likert like value of 1 to 5 to each element of the matrix, summing the values for each target, or project/task. This score represents relative priority, and the higher the score, the more important the target. Consider these aspects in the context of prioritizing your work.

Criticality: How critical is the target with respect to your overall goals, objectives and strategic purposes? Will it move you significantly closer to goals or your vision, or is it insignificant in relation to those larger aspirations? Is completing the task going to make a difference in your life?

Accessibility: Is the task achievable and does it link to the main objective? Will it move you closer to your goal(s)? Can you successfully complete the task independently or are there prerequisites that require the cooperation of others/

Return: How great is the return on commitment of resources?

Vulnerability: What commitment of overall resource is required for full achievement? The shorter the time frame for delivery and the higher the cost in resources, the more vulnerable the effort.

Effect: What will the impact be if you achieve the task successfully? What will be the effect on your life and that of others around you? Is the impact worth the effort?

Recognizability: Is the target achievement visible or is it a moving target or envisioned poorly? Is the definition crystal clear or fuzzy: How easy is it for you to recognize the steps that will be involved in successful completion, and do you have experience with this type of task? Clear goals with a clear path to achievement score higher that ambiguous goals with an uncertain methology.

Creating a matrix and assigning values to the component valuations is simple and straightforward. The total numbers should tell the story of the priorities, separating those projects worth the effort and those that are not, IF YOU HAVE A CHOICE. It also helps to identify when to reach for a piece of low hanging fruit or alternatively to kick off a really big project first. But don't get carried away with hours of analysis, this is a quick and dirty application to give you the next best step in the right direction.

Grid Analysis or MAUT Analysis

Sometimes the number of options available confuse us or slow down decision making, but Grid Analysis can help to sort through the decision, an you only need a pen and a piece of paper. Grid analysis is a technique designed to take options into account, factor in details and come out with an optimal choice. It is an ideal technique to use for important decisions where there isn't a clear and obvious preferred solution. It is also known as Decision Matrix Analysis, and as Multi-Attribute Utility Theory Analysis.

Using Grid Analysis will enable you to make a decision relatively quickly when others around you might be struggling to sort out options and has been used successfully as a technique for evaluating formulary product selection decisions.

List your options as rows on a table and the factors to consider as columns. Score each option/factor combination, weighing the score, then add scores to give an overall score to the option.

Work your way across the columns to determine the relative importance of the factors in your decision, showing numbers from 0 to 5 where 0 means the factor is absolutely unimportant and 5 means it is very important. These values will reflect your preference or confidence in the factor's significance.

Next work your way down the rows of the table to score each option for the factors, with the same 0 to 5 scoring values.

Multiply the factor scores by the option scores to determine the weighted values. Add the weighted scores for each option to identify the "optimal" decision.

Grid Analysis is the simplest form of MAUT, useful as a quick decision tool to evaluate complex decision options. Sophisticated MAUT involves highly complex modeling of scenarios and sophisticated mathematical analysis.

Action Priority Matirix

The Action Priority Matrix, also known as the Impact Feasibility Matrix is a simple approach to diagramming the relative importance of activities and hence their priorities. It is particularly useful since most leaders have far more on their radar screen than there is time available -- lots of great ideas, wishful thinking, interesting possibilities and a range of "must do" activities. Selecting those activities to focus on most wisely allows leaders to be more effective and to better use time make the most of efforts. By choosing badly, leaders can become bogged down in less meaningful, but time consuming efforts that thwart movement toward goals.

Use a matrix, illustrated at left, each activity is evaluated based on its potential impact and the effort involved, allowing you to quickly see relative value, the greatest return on effort and to move quickly to initiate that decision or activity. This allows you focus on the tasks with the highest impact by avoiding crowding them out by dedicating your time to less valued work.

Using your best judgment, plot the activities in the matrix based on the information available and input from trusted colleagues.

Quadrant 1 represents Quick Wins, "low hanging fruit" that offers a quick return for minimal effort

Quadrant 2 gives good returns, but they can take a long time to complete, so one activity in Quadrant 2 can obviate time for many in Quadrant 1. Be attentive to completing these activities as quickly and efficiently as possible, and be cautioned to avoid failure to disengage as soon as possible.

Quadrant 3 is Fill In Work to be done in spare time, and put back on a rear burner if more valued options come along.

Quadrant 4 represents the proverbial Thankless Tasks. Try to avoid them. They take time from other important work, show poor impact returns, minimize opportunity to take on more valuable work and often fall in the category of "no good deed goes unpunished."

Boston Matrix (or Boston Consulting Group Matrix)

The Boston Matrix, also known as the Growth-Share Matrix, provides a visual display and vivid category descriptions, useful in looking at available opportunities, and analyzing which opportunities are a good fit with the strategy and which are not. That allows leaders the opportunity to prioritize the investment of resources, in this case time, to maximize advantage achieved. The measures at the attractiveness of the opportunity and the relative advantage offered, two critical determinants of potential profitability or value. The vivid imagery of "stars", "questionables", "cash cows" and "dogs" allows for rapid categorization of the tasks at hand, and subjective evaluation to prioritize, divest, invest or kill the initiative. This technique is helpful in sorting out those projects to take on or not, allowing leaders to quickly focus attention to most attractive opportunities with the highest potential for successful impact.

Nominal Group Technique

When prioritization becomes a group task, we often see the loudest and most vocal participants, or those with the most perceived power, setting the priorities, rightly or wrongly. Nominal Group Technique (NGT) is an easy to use approach to gain input and consensus from a group meeting face to face, with all members participating freely and with minimal influence from other participants. The process prevents domination by a single person, encourages everyone to participate and results in a set of prioritized solutions or recommendations that represent the entire group's preferences. Open group dialog assures discussion of all of the relevant issues before the evaluation of priorities occurs, then each member of the group is asked to "nominate" priority issues by ranking on a scale of 1 to 10.

Begin by identifying the stakeholders to the issue at hand.

Summarize topic and objectives and ask the group to explore the topic, ask questions, raise issues and clarify understanding of the implications of the issue, allowing time for thoughtful consideration of all aspects of the issue.

Ask each stakeholder to write down their priority issues or projects, and give time for each participant to present and elaborate on reasoning.

Maintain a master list on a flip chart to record the dialog, working with the group to combine, as appropriate, and to eliminate redundancy. Reduce the list to a maximum of 5 -- 10 issues or projects agreed upon by the group, then ask each individual to rank the list in priority order. Collate the lists and provide a merged ranking to the group. The highest priority is the highest score.

Scheduling

Scheduling is the process of planning how you will use your time and is really a 5-step process:

Identify the time available for work.

Block in the essential tasks you must complete, including relationship time like coaching, mentoring, communicating and dealing with emerging issues.

Schedule in high priority, urgent tasks and essential logistic tasks that you have identified on your to do list.

Block in contingency time for unpredictable interruptions. Based on your experience, or the data from an interruption log, you can identify how much time you can normally anticipate on an average day for essential unanticipated occurrences that demand your attention and block out sufficient time so that you can deal with them, confident in the flexibility of rearranging your schedule.

Schedule activities for personal priorities and goals.

Managing Interruptions 

Interruptions can be a significant barrier to your success. Phone calls, emails, software notifications, pagers, PDA auditory cues, drop-in visitors distract and more importantly, cause a loss of focus. And in a culture of constant connectivity, we are available and interruptable at virtually any moment. While these gadgets are intended intended to help us multitask, they often outstrip our mental capacity to manage the diversity of self- and other-induced interruptions. The effect is an enormous drain on focus and concentration, and ultimately the ability to perform. We become so distracted by managing the inputs and outputs of interruptions, that becomes a primary focus of attention, rather than the important work that needs our concentration. The key to controlling interruptions is to know what they are, whether they are necessary and how to plan them into your daily schedule to minimize disruption. A recent study found that workers are interrupted once every 11 minutes on average during the work day. Other studies suggest that leaders seldom get more than 6 minutes before being interrupted by other tasks.

First, keep an interrupter log for a week, cataloging the date and time of interruptions, who caused it, a brief description of the nature of the interruption and whether it is valid and/or urgent in nature. With a weeks worth of data, analyze patterns, in particular, identifying those interruptions that were valid and actually deserved your attention. For non-valid interruptions, plan a proactive strategy to assertively discourage those types of interruptions, or to avoid their occurrence by planned opportunities to avoid the cause, for example regular times that you are accessible to colleagues and coworkers to deal with their issues of concern. For interruptions that are both valid and urgent, you know you must deal with them, so calculate how frequently they are occurring and the amount of time that is typically involved in a work day and plan that much "interruption time" into your schedule. If interruptions by colleagues is a routine problem, signal in whatever way you can when you are not available (closed door, wearing headphones, or some other identifiable "do not disturb" signal that coworkers will recognize.)

Too often, our interruptions are self-induced. If the phone rings we have to answer it. Or, there might be email that is urgent that demands immediate response, so let's check it every 5 minutes. A quick glimpse at the browser home page cues us to some breaking event, so take just a minute to read the full story. A push email blog is intriguing, so stop to read it and research some of the hyperlinked sites. Controlling some of these personal options that cause wasted time is an important strategy for reducing interruptions. Use your voice mail to screen calls. Forward your phone to voice mail, turn off your cell phone and either shut down your instant message capability or set your status to "busy" when you need to concentrate on a specific task. Shut down your email, or set it to eliminate audio and visual alerts. If you are working on your computer, keep only the programs you need for the task at hand open. Clear your physical desktop, and your digital one of the most likely distractions, visual temptations to derail your attention and focus from the task at hand.

When you do encounter an interruption, don't necessarily rush to resolve it. Take a minute to clear you head, take a breath and consider if it needs your immediate attention. Learn to say no, consider delaying the issue to a later and more convenient time if it isn't urgent, or to delegate if it really is an issue for someone else. Make sure you maintain accessibility by establishing "available time" and regularly scheduled check-in times with key coworkers. Schedule regular meetings in a conference room for a fixed time frame so you can leave at the conclusion, without the concern of how to get people to leave your office. For interruptions that you must deal with, set parameters (I have 5 minutes to address this now, but we can revisit it later) and don't extend the interruption with other issues or casual conversation.

It takes approximately 15 minutes of uninterrupted time to get into "the zone", that sense of pure attention and intense productivity that lets you focus totally on the task at hand and perform extremely well. Modern psychologists refer to this state focus on task as being "in the flow," the state of complete absorption in an activity for its own sake, without ego. Time flies, skills are totally engaged and it all comes together. To get to that state, you need to minimize distractions, manage interruptions and stress. Being more productive, driving personal performance are common quests, but there is there is no single life changing secret that is a quick solution. There are hundreds of tips, ideas and tricks that you can use to reduce interruptions, get into and stay in the flow and be more productive, all small changes and adaptations of your behavior that can make a huge difference.

Who's Got the Monkey?

Management Time: Who's Got the Monkey is a classic article that appeared in the Harvard Business Review in 1974. Written by William Oncken and Donald Wass, this seminal article made the critical point that leaders deal with three kinds of time: boss imposed time, system-imposed time and self-imposed time. Often the boss- and system-imposed time requirements are "a given."

But the self-imposed time, including both discretionary time and subordinate imposed time, represents the point of time leverage we have control of. Using the metaphor of a monkey on the back, the authors describe our human propensity to assume other peoples' (time consuming) issues and problems, and the more we get caught up, the more we fall behind. Spending time on things that are urgent but not important will trap you in an endless cycle of dealing with other people's monkeys, while the gorillas take over. Getting control of the timing and content of how time is spent is essential to effective leadership. More discretionary time, and less subordinate or coworker imposed time, will allow you to increase your leadership leverage.

Take charge of your time. Recover your leverage. Reduce your stress. Get the leadership results you target.

 

 

 

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