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Directing and channelling your focus

Samantha Milat
Good evening everybody. And welcome to this evening’s webinar Suddenly I'm a Leader - directing and channelling your focus.
Tonight is the third webinar in this Suddenly a Leader series that we will be running. So, those that have attended previous ones, thank you for joining us again. Vicky Moriarty will be presenting this evening. So Vicki, over to you to get us started.
 
Vicky Moriarty
Thank you very much. Samantha.
Good evening, everybody. Thank you for joining us tonight.
First of all, I would like to pay my respects to traditional custodians of the land on which we were all meeting respectively and pay my respects to the elders past and present.
So my name is Vicki Moriarty. I run the Future Leaders and the mentoring program for the RACGP and we focus on developing leadership within general practice and run programs throughout the year.
So what we're going to focus on today is how do you channel your focus and achieve the maximum amount of productivity that you can for yourself in your day to day life.
And we're going to do that by talking about what affects your focus and then applying effective methods to increase your focus, as well as building techniques to increase long term performance.
And then we will have time for questions at the end as well. And just a short list of resources that you can refer to, if you want to dive a bit deeper into some of the content that we refer to today.
So what affects your focus? Well, first of all, business, is one of the key things that you has the potential to impact on your focus. We tend to make our lives overly busy and Covid has highlighted the extent to which we do that significantly.
This has been a feature of many of the discussions globally. And so one of the things that became apparent is that, as a consequence, either of not being able to work in an office or a practice environment and being based on the nature of the interruptions being different, Might have been kids in the background, for example, if you’re in telehealth, or you might not have had the constant interruptions that you would have had in a practice or miss environment.
The necessity of putting out fires as a consequence of interactions, maybe with staff in your practice and crises that emerged at work, whether that's to do with patients or dealing with other healthcare professionals is something that can also affect your focus, day to day.
Not having time for yourself is a critical part of managing your own focus. And this is something that we're going to talk about in a bit more detail shortly.
But primarily, lack of direction to where you lack direction, it's a bit like trying to play a footy match and not knowing which end of the pitch you're actually playing towards in terms of the goals. So, lack of direction is something that can significantly affect your focus. So how do you change that in order to channel your focus going forward?
Well, there were a few methods that are referred to and one of those is the Pomodoro technique. Now I'm going to be cautious about recommending this virtue, knowing how your days as GPs are structured. So the Pomodoro technique was developed by Francesco Cirillo in the 1980s. It's a time-management technique.
With a window of activity of 25 minutes, obviously, that doesn't work so well for your general practice, but the principle is that you have a fixed amount of time in which you work, you set an alarm and then after that, that window, you have a five minute rest break or a 15 minute food break.
And the idea being that you would have a series of these time slots throughout the day, which would maximize your productivity and ensure that that window in which you can maximize your focus, you're making the most of that window.
So from the point of view of general practice where you're doing sessions and obviously you're seeing between four and six patients in an hour, maybe occasionally more, that is very difficult to manage. However, it is a useful principle when you look at your week, for example, overall. If you map the amount of time that you spend in your practice, where you are contributing to other areas of work, for example, if you are a medical examiner or researcher and academic. If you are spending time supervising registrars. If you have to spend time driving the kids to and from school, doing homework with them, whatever it is.
 
If you work on larger blocks, and consider everything that it is that you have to put into a week, it is a useful model to refer to.
So if, for example, you sit down and you map out your entire time and you discover that you need more than 24 hours in the day, in order to do all the things that you're required to that you have committed to, as well as get some sleep, not to mention, loo breaks, then clearly you have a problem. And that's not going to be effective for you going forwards.
And it's an interesting exercise to do this with something that I did myself last year. So as well as working for the RACGP, I was working as a board director and had numerous commitments to mentoring various professionals around Australia and also a four year old child. I realised that I was operating at a deficit of about two to three hours a day so clearly something had to give. And this is a very straightforward way to examine how you can actually structure your time.
Mindfulness, obviously, is something that is mentioned a great deal. Now mindfulness is as simple as being present, it doesn't mean that you have to meditate, but it is that act of being present in the moment is something that we tend to forgo in our busyness. And so the act of simply sitting in your seat and being aware of being connected to the seat, how your body feels and engaging that way, as well as breathing techniques is very useful in generating mindfulness in your day and it's something that you can do in a very short window of time in the shortest two minutes if you have that opportunity.
So creativity is something that there is increasing focus on. The discussions that have emerged in terms of achieving mindfulness have also connected to left brain, right brain thinking and how do you switch between the two throughout the day. The act of engaging in something artistic in terms of painting or writing, music, singing offers you the opportunity to do that. It also generates mindfulness, you're connected in the moment to the activity that you're doing.
And things like journaling, for example, are a creative and practical way to be mindful and reflect on what has occurred throughout the day. Getting out in nature is really important as well for mental health, just that greenery and the opportunity, depending on where you are, to breathe fresh air and just getting outside. And again, having that opportunity to connect is really important in terms of connecting to the natural world.
One of the key things, however, in terms of direction, which I mentioned before is goal setting. So how do you set goals in order to move forward? And I'm sure that where you have, if you for example, have been through fellowship exams recently, this has been a key focus in terms of what you're doing. But how do you translate that into life after fellowship?
And do you make a small goal or make it a large goal? And how do you structure it: well, that's we're going to look at next. So the smart model refers to a way in which you structure a goal in order to make it one that works: one that you can achieve and smart stands for specific, measurable in this one says attainable, but I usually refer to it as achievable, relevant and time bound. So if, for example, you want to inject some time for yourself into your life, you could make that a goal. You could say that by the beginning of January 2021, I would like to have carved out some time in my day for myself in which I am engaged in activity that will increase my mindfulness, for example.
So is that specific? Yes it is? Can you measure it? Well, you can measure it by the amount of time that you have allotted and whether or not you actually engage in that activity.
Can you achieve it? Well, that's down to you individually in terms of knowing whether or not you can achieve it. Is it relevant? Yes, and is it time bound? So, by setting the date against which you will meet that goal, yes, you have made it time bound. So that's just one small example.
Another example of a goal setting is if you wanted to develop specific clinic sessions within the practice that you're in. So you might, for example, and I'm just going to come out of this slideshow here.
I can't whiteboard in this session, unfortunately, I apologize. So what I'm going to do is just bring up a blank slide.
And show you how you might set a goal for a clinic session. And if there's any goals that you would want to work towards, feel free to pop them in the chat and Samantha, I'll just ask you to read them out to me if they come up in the chat.
 
Samantha Milat
 Absolutely.
 
Vicky Moriarty
So first of all, what I'm going to do is bring up a text box and put this in here. So just remembering SMART goals. Specific, Measurable, Achievable, Relevant and Time bound. So you want to set up a clinic, for example, a mother and baby clinic, so that you can review new babies with mum and you want to run that on Thursday mornings. So what you would need to do is specify that setting up of a mum and bubs clinic to run each Thursday with support from practice staff starting January 2021, to be
So in terms of is it specific? Yes, it is. Is it measurable? Well, if the clinic is running and patients are coming through then those are two measures that you have, and the frequency in terms of the Thursdays is another measure as well.
Now, in terms of achievability or attainment, the support from practice staff is really critical here because only you will know whether or not that is achievable through conversations within your practice. So you will need to do that in a way that ensures that (we've referred to this previously in terms of communications) that everyone understands what the purposes of those clinics and how they would be set up and run.
This is time bound and obviously it's relevant for your practice if that's something that you wanted to do or as part of your general practice work. So that's a very quick example of how you can set a goal. Samantha, are there other any other examples that have come through?
 
Samantha Milat
We haven't had any come through. Oh, we've just got had one come through. So a goal to take a 30 minute lunch break each working day starting from tomorrow. Okay.
 
Vicky Moriarty
Thank you. Take a 30 minute lunch break each working day starting Wednesday 9 December. So it's very specific. It's measurable based on the amount of time that you spend, is it achievable?
Only you will know that so what will you have to put in place in order to make that work? And there may be things that mean that you can't do that because your time has been scheduled within the practice.
In a way that means that you have no breaks between patients. So that's a potential barrier for you achieving that goal. So then what you need to do is plan ahead so that practice staff know in terms of scheduling that you always have that window opportunity to take that lunch break.
 
And that may mean that patients, the last patient is actually scheduled one hour prior rather than at the 30 minute mark.
So it's time bound. And what I would say here is that effective tomorrow, you might need a bit of prep time in terms of talking to staff in the practice about how it works. So the achievability of that may be affected.
And we're going to explore a bit more about the actions that the model that you can use in order to put actions in place to achieve these goals but Samantha, was there another one?
 
Samantha Milat

Yes, we've had another one that's just come through ‘allocate four hours for studies, starting from tomorrow’.
 
Vicky Moriarty
Okay, four hours to study starting Wednesday 9 December. Okay, so again, specific, measurable and is it achievable? I would say that achievability is the key question here. So, for example, do you have barriers or obstacles to putting these goals in place?
And that might be, for example, the number of patients, could be family commitments, or other roles that you have and commitments to those roles that might represent a barrier.
Anything else about that before I move on, Samantha, to the next slide, which is relevant to…
 
Samantha Milat
So we did have one more that came through and that was to set up a quality data group in our practice. The sender of that that goal did not indicate a time frame for that but let's go with ‘as soon as possible’.
 
Vicky Moriarty
To set up a quality data group in our practice.  So, in terms of being smart, even if you were to put as soon as possible, and as you suggested, I would say that that is not time bound because what that does is in terms of directing your focus it actually gives you leeway to push things out without an end date.
And that's where if you don't have those dates in place, even if they have to be moved for a specific reason. If you don't have them in place, there is a lack of opportunity for you to engage your focus as strongly as you need to and bring people with you so that they know what you're working towards as well, because as soon as possible for you might be tomorrow for your practice manager, it could be April 2021 and that's where you want to make sure in having conversations with people about goal setting that everyone understands what's the date that you're working towards in terms of achieving it.
Now, in terms of being specific. Well, to set up a quality data group in our practice: is it specific enough? Because do you need to, for example, specify which groups within the practice, whether it's doctors, nurses and admin or just doctors, as opposed to all of the staff in the practice, and that might require some more specificity in there.
And how would you measure this and what outcomes would you be looking for in order to… what would the quality data group be delivering?
And obviously, it's relevant because it's relevant to general practice. So I would say there is some work to be done in terms of making this goal smart.
To help you with that, I'm just going to bring up the next slide and I will share this back with you after the session as well.
It can be useful to use the GROW model. So the GROW model was developed some time ago by, I believe, Sir John Whitemore and colleagues of his in order to improve performance at an individual level. And this is typically used as a coaching and leadership model so GROW refers to setting the goal. So you need to set a SMART goal. And you also need to examine the reality in which you're operating. So what is your current situation now and what might be the options or obstacles to you achieving that in the future?
So if we think back to the example around study, what are the obstacles? What might stop you doing your study and what options do you need to generate in order for that to allow you to put that goal in place. For example, if you have kids, and you need to juggle time in terms of getting them to and from school. Do you have options to get additional childcare support?
 
Or if there is a barrier in terms of the amount of time that you're seeing patients, do you have an option to reduce your number of patients or the number of patients you see per day?
And what you then need to do is articulate a way forward. So this is the action. So what do you need in terms of will? And what is the way forward? So is the way forward a conversation with your practice manager or is the way forward sourcing childcare? And you specify that in that column there and you can have a number of goals and you can have sub-actions related to those goals in order to achieve them. But the goal itself needs to be smart, in order to maximize your effectiveness.
Samantha, were there any comments there, additional comments because I moved on from the last slide before I move on?
 
Samantha Milat
From the last slide, there was another goal that had come through that was journal meetings weekly, but in regards to this slide, we don't have any further comments at the moment.
 
Vicky Moriarty
So journal meetings weekly, did you say? What I'm going to ask is, was that in terms of practice meetings or other meetings. I just wanted to understand that bit more if the person who popped it in can just enlighten me there. If not, I will move on to the next slide.
 
Samantha Milat
Educational.
 
Vicky Moriarty
Ah ok, so journal educational meetings. Fantastic.
Okay, so what you want to be able to do is if that's your goal is to journal educational meetings, you want to make that smart. So is that something that you're going to do on a weekly basis? And what is the reality for you doing that? Are the meetings informative enough to allow you to journal them and if not, what options can you use in order to be able to change that, for example, do you need to, if you're the one holding the meetings, do you need to have an agenda, for example, in which you make it clear what information is going to be imparted or actions are going to be followed up or discussions that need to take place.
What obstacles might there be to journaling them and what ways forward can you use in order to get there?
And so you can use this at an individual level for yourself. You can use this GROW model in terms of coaching other team members within your practice and you can use it for larger scale initiatives as well.
So moving on to building techniques. So techniques to help you build your focus.
The first thing is to take a step back. So you want to be able to take a view from the balcony and survey the environment around you.
What is happening around you and what do you need to focus on in order to move forward? So there could be many, many distractions and in FOMO world (fear of missing out), we tend to say yes to lots of different things for people who are very high performers very intelligent. There is also often a desire, and altruistic as well, so altruism is something from a values perspective, we talked about last time, which can also lead to taking on too much as a consequence of being willing to give so much.
So when you take a step back in the balcony view, are there things that you need to say no to?
And do you have it or other obstacles say, for example, do you consider yourself to be letting people down if you say no?
Or are you avoidant of conflict? If that's the case, what do you need to do, considering that GROW model. What is a way forward, that will allow you to have those conversations in which to say no.
Boundary setting is really, really important. It can be as simple as unfortunately I simply don't have the time or the capacity to take on this additional area. So I'm very grateful for the suggestion, but this is my situation moment. I won't be able to commit in the way that you need.
There are different ways in which to have that conversation.
So saying no is a critical part of being able to channel your focus at delegating and delegating to the right people.
It's no good if it's going to bounce right back at you. So knowing who you can delegate work to and also not holding on to how perfect it is.
There's a good enough approach that some people who have a tendency towards perfectionism may want to consider. So it might not be done the way that you would like it done, but fundamentally, if it's done and the person receiving it is happy, then that's good enough.
Another consideration is building up, step by step. So if you are making changes in terms of your focus and how you structure your time, you are better to do one thing at a time, then change everything all at once, and particularly where you're, for example, if you are introducing activities such as exercise that you build up rather than trying to do a wholesale change to entire life. Some people are very good at that, which is fantastic.
But in order to bed something in, taking the time to do it and doing it in a structured way, so, for example, doing something once a week for four weeks, and then after four weeks doing twice a week for four weeks so that you're building up and you are not overburdening yourself with additional activities.
So some resources to refer to if you're interested in understanding a bit more about the Pomodoro technique and how it can be applied, then this is the website that you can go to and we can share the slides with you afterwards. If you want to look at the origin of the GROW model, which is a very simple straightforward model and there is a book on that whole performance, coaching for performance side of things, which is very useful as a leader and this is the title of the book.
In addition, you may want to consider getting a mentor or a coach, so a mentor… For example, the RACGP runs a mentoring program for new fellows, it will be reopening again next year from March and that is a way to get guidance from someone with more experience than you and advice on based on their own lived experience.
A coach is somebody who may not be in your area of work but is good at helping you focus and structure your time and asks you the right questions in order to be able to move forward. A coach, though, is typically a paid relationship whereas a mentor, mentee relationship is a voluntary relationship.
So that's it from me for today. Are there any questions before we wrap up for tonight?
Samantha Milat
So I've just put a call out to the audience via the chat box. So hopefully anyone with questions is typing away. We'll just wait a little bit longer, and then I'll let you know what we have come through.
 
Vicky Moriarty
Thank you very much. As I said, if you haven't mentioned at the beginning of the broadcast, that if you have an interest in a mentoring program we are open from March 2021 and the future leaders program will also be running again in 2021 but later in the year. We are currently undertaking a quality review that process for applications will open late January, February, as well.
So any questions, Samantha?
 
Samantha Milat
‘Sometimes I have the time. But when I get it, I have trouble focusing brain working too hard.’
 
Vicky Moriarty
Yes, so this is again where that balcony approach is really important. Being able to step back and review if your brain is working too hard.
I'm certainly one of those people who find myself on occasion waking up at two o'clock in the morning with my brain racing and 16 different thoughts running through it. Usually the technique that I use is to make a note of things ideally, on paper, and not on the phone because, of course, the light from the phone is not good for sleep. But if I am starting to do that, I know that I have slipped away from my routine in terms of a hygienic approach to life in terms of good sleep, half hour walk that I do in the mornings with my dog, and that's not actually an exercise that's just movement and it's literally fresh air movement, the time to think and no one can call me or interject into my way of connecting with nature and just taking a bit of a break and for each person that's different for some people that might be reading a book for half an hour, that might be watching a bit of TV for half an hour for each person. It's very much individual.
And I would recommend though, that rather than being engaged on your phone or TV, that is something which you have the opportunity to be present, so you're very aware of your surroundings and how you feel within that those surroundings as well. That will help with the busyness in your head, by connecting to the moment.
 
Samantha Milat
And is there any methods or advice you can give, Vicky, on what we can use to measure whether we've been successful in focusing?
 
Vicky Moriarty
So this is an interesting one. What we tend to focus on in terms of measures are scientific methods of measure.
But how you feel, day to day, he says is a good measure of whether or not you're actually achieving success, more than anything else. So you may want to articulate that: do I feel relaxed come Saturday morning, for example? And again, that will be very individual, but by specifying what that measure will be even if it's an emotive measure, not a scientific measure, and that is just as valid in terms of goal setting.
 
Samantha Milat
That's great. And we are at time, but we've just had one more question come through that I think is a good one. So how can we diplomatically, get our peers or juniors to work towards sustainable goals in a team, especially when we do not see positive responses from them?
 
Vicky Moriarty
Okay, so, first of all, the discussion around goals, if you're doing, for example, if you're wanting to set goals as a team, it's really important that you go into the conversation seeking to understand where it is that they want to get to and explaining where it is that you want to get to, because you may not be aligned. What you what you need to do in that compensation is seek the common agenda. What is it that you want to achieve overall? And once you have identified that then work back and specify a SMART goal that will allow you to get there and achieve that outcome.
In terms of commitment to doing that, commitment is generated as a result of the trust that exists within the team. So it's, again, the same concept in terms of spending time together and understanding each other and the direction that you want to head in.
Without that trust you're unlikely to have that level of commitment and unity in order to achieve that goal going forward. So those conversations up front are really, really important and patience with the process as well.
 
Samantha Milat
That's great. Thanks so much, Vicki that does bring us to 7:32 which is our time for the evening. So thank you very much. Vicki, and also to everybody that joined us.
Just on a side note, so the next Suddenly I'm a Leader webinar will be held on the second of February in the New Year. We’ll send you an email with the registration link to that in the coming week so we hope to see you back again in the New Year. Thanks and good night, everybody.
 
Vicky Moriarty
Thank you everyone.
 

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Originally recorded:

8 December 2020

Do you struggle with picking a directions and effectively channelling your focus?

Join us for the third installment in the ‘Suddenly I’m a leader’ series, the activity will focus on:

  • Understanding what effects your focus
  • Applying effective methods to increase your focus
  • Building techniques to increase long term performance

Learning outcomes

  1. Be aware of what affects your focus
  2. Apply effective methods to increase your focus
  3. Discuss techniques to increase long term performance

Presenter

Vicky Moriarty

Vicky Moriarty runs the RACGP’s Future Leaders, Alumni and Mentoring Programs. After studying Human Resources and Business Management in French, she worked principally as an HR professional and software trainer in Europe. Since moving to Australia in 2006, she has worked solely in healthcare and community services in the following roles: HR Manager for IPN in 2008, with responsibility for recruitment and placement of overseas trained doctors in rural and remote locations for both general practice and occupational health; then with her own HR Consultancy, during which time she advised and helped set up a number of independent general practices in Western Australia; finally, as a Senior HR Business Partner managing a national team remotely before joining the RACGP more than 5 years ago. Vicky lectures on leadership and was invited to speak at the UK’s Leaders in Healthcare Conference 2018, run jointly by the British Medical Journal and the Faculty of Medical Leadership and Management, on the action learning methodology used in the Future Leaders program.

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