Guest Column | October 18, 2021

The Role Of Trust And Communication In Successful Medical Device Teams

By Eric Hinrichs, senior principal quality engineer (retired), Ethicon (part of the Johnson & Johnson Medical Device Companies)

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If you work in the medical industry, you know that new products, revisions, and updates to existing products are typically accomplished by teams. Teams can range from small groups of technical experts to elaborate team structures that are spread out over several company facilities and key suppliers.

But why do we experience teams that seem to start out well, then stumble throughout the project, resulting in delayed launches, product defects, and poor sales? How do they differ from teams that start out similarly and appear to seamlessly breeze through the project development and validation stages to launch a successful product that meets post-launch expectations?

Getting To The Root Cause

It is important to a medical device company that teams perform at optimum levels. Teams that underperform typically result in poor product quality or post-launch product issues. These can significantly hurt a company’s reputation, lead to unnecessary lawsuits, or result in patient or user harm –all good reasons for a company to desire high-performing teams. Companies try multiple methods to try to get all teams to function at an optimum level.

One technique employed is “lessons learned.” In this case, a team will assemble post-launch and discuss among themselves what went right and what went wrong in an effort to use this information to improve future team performance. Unfortunately, while this is a value-added effort, it falls short more often than not. This is due to companies failing to convey these lessons to others in the company or at suppliers and not integrating these lessons into procedures and policies. Teams performing this exercise often do not have any objective outsider involved in the process. As a result, teams can easily overlook the root cause(s) they were faced with. Across my long career, I have observed, more often than not, that teams will identify communication as the reason for obstacles or delays. While this is a fair conclusion, the real root cause goes much deeper than that.

Teams fail to see that communication is fundamentally based upon trust. Team members need to trust each other, including trusting that team members have each other’s back, that team members are looking out for each other, and that they are being mutually supportive. When trust is present among all team members, communication is abundant. Team members are willing to talk about the project and actively and immediately seek out other team members for their input when they perceive an issue is arising or could potentially occur.

A good analogy is a marriage. Healthy marriages have excellent communication between partners. They seem to know what each other is thinking. They trust each other to be supportive and empathetic. When a marriage is not working, you notice a lack of trust (where one of the partners is not being honest with the other, etc.). This lack of trust negatively impacts communications; partners stop talking to each other or convey the bare minimum of information. If trust is not instilled back into the marriage, the outlook is bleak for its survival. Teams function much the same way. If the team leader trusts their team members and the team members trust their team leader, then communication is heightened, team members are more engaged with each other and are more willing to speak up and provide their opinion, knowing it is valued and not dismissed.

How Trust Can Make A Difference In Teams’ Performance

I was once a team member on a project that had a team leader who was “always right,” and when anything went wrong, regardless of the reason, the team leader would automatically blame a team member and do it publicly in team meetings, often attacking the person instead of the issue at hand. You can imagine how team members reacted to this. No one wanted to be publicly chastised like that. If we could get a task done early, did we tell the team leader? No way. We would check and double-check our work and only hand in the task when the deadline was reached. This behavior only served to slow up the project, as everyone was doing this, causing delays. There was no trust with the team leader, so communication was at a minimum. No one volunteered information or suggestions. The team suffered. How did the project fare? We were late, we missed forecast, and we had manufacturing issues that caused customer complaints. These issues most likely could have been avoided if the team trusted the team leader and there was good communication. Teams that operate like this are often less than successful, have trust issues and poor communications, lack team empathy, and commitments are often late or incomplete, if they deliver at all.

On the opposite end of the spectrum, I was once on a high-performing team that was actually refreshing and exhilarating. We trusted the team leader; the team leader would ask for all of our input, and they would be in constant touch with us to see if we needed anything or had any issues they could help with. In turn, we trusted that the team leader would support us and respect our input and efforts. You can recognize teams that have trust and great communications. You see team members going to lunch together or getting together after work. They joke and seem relaxed. The work seems effortless and fun, yes, fun, because you feel like everyone appreciates your efforts on behalf of the team and team members recognize your work. You want to get your part done in time, so you don’t hold up other team members, and empathy is at a high level. As far as the project outcome: We finished the project ahead of schedule, on budget, without any post launch issues!

This high-performing team had trust, great communications, team empathy, and open and honest dialogue.

Who Is Responsible?

Team Leader

Team dynamics and culture start with the team leader. Do they have the people skills needed? Are they inclusive in discussions and are they supportive of team members? Team leaders should not hog the spotlight but give team members the recognition. Team leaders on effective teams should be almost invisible, working behind the scenes to help team members accomplish their tasks. In effect, they are getting the managerial and logistical hurdles out of the way ahead of time so team members can complete their assigned task(s). Team leaders need to do their homework and ensure there are no conflicts among team members. Do you have two team members assigned who dislike each other? Is there a dislike or competitive nature between departments that needs to be resolved up front?

Team Members

Are team members committed to the project? Do they have conflicts from their manager, who may have a different agenda that sets the project at a lower priority and instructs their associate to likewise de-prioritize their work on the project? This is a not-so-rare occurrence in large corporations and, often, at suppliers.

Management

Sometimes, teams have to report unforeseen issues back to management. In such cases, management must understand that these were unforeseen issues that the team needs to absorb and address in their schedule. These issues may cause a delay. In these cases, management has to trust the team leader to work with the team on a solution that will also adhere to the timeline as best as possible. Management needs to trust that the team leader understands the importance of the timeline and its impact on the company’s performance.

Conclusion

There is no magic solution to getting teams to perform well. Much like a sports team, there are many intangibles that separate a winning team from an underperforming team. But the common denominator is trust. Unfortunately, most companies foster internal competition between teams and/or departments. It can be difficult to turn off this competitiveness, and it can creep into a team’s dynamics, making it almost impossible to create a highly performing team.

What a good team leader can do is sit down with their management when forming a team. Do your homework. Identify what talent and expertise you need and which associates have the right attitude and aptitude to support your project, and actively advocate for them to be on your team. As a team leader, treat your team members as equally important and trust them to do the right thing. Have weekly informal meetings, like hallway conversations. I found having a few minutes of each day with team members to be valuable in picking up potential issues before they cause a problem.

Team members should be committed to the project. They need to know clearly what is expected of them and what they need to complete their task. They should not be afraid to bring up concerns, even if they are with aspects of the project for which they do not have responsibility; impacted team members should not view these concerns as an attack but as a supportive concern and that the team member is looking out for other team members.

If these elements are followed and addressed, your team should be successful.

About the Author:

EricEric Hinrichs has more than 31 years in the medical device field in research and development on new products and processes, in operations on improving processes, and in quality on leading process and product validations and performing data analysis. He developed and led the implementation of numerous process redesigns while at Ethicon to improve product support execution. He authored an ASTM standard, worked on updates to United States Pharmacopeia (USP) medical standards, and helped developed new medical standards for the European Association of the Surgical Suture Industry (EASSI) in Europe. He has also co-authored a medical standard for India that is currently under consideration for adoption. He recently released a book on career advice, Perceptions and Expectations.