Author + information
- Christopher M. O’Connor, MD, Editor-in-Chief, JACC: Heart Failure∗ ()
- ↵∗Address for correspondence:
Dr. Christopher M. O’Connor, Editor-in-Chief, JACC: Heart Failure, American College of Cardiology, Heart House, 2400 N Street NW, Washington, DC 20037.
The small country of New Zealand, with <5 million people and one of the last areas of the world to be inhabited by humans, is home to 2 of the greatest sports teams in the history of competition: the men’s and women’s rugby teams. How is it that the men won 3 World Cups, and the women won 4 of the last 5 World Championships and had victories in over 75% of their matches? What can we learn from the culture of these teams in providing heart failure care and leadership in the communities that we serve?
A study of the New Zealand rugby teams is a lesson in leadership. It begins by setting a culture of excellence. The “All Blacks” and the “Black Ferns” have had such consistent success on the field that many have attempted to understand the “why.” The culture of success begins with character. The New Zealand men’s rugby team, affectionately known as the “All Blacks,” received this nickname after storming Europe in 1905 with their dominant play. The press wanted to acknowledge that they played like “all backs” with their superb ability to pass amongst all players on the field (that is what backs do well). However, a typo resulted in the term “All Blacks” which coincided with their black jerseys and black pants. Thus, it became the nickname for this team, and they have dominated this sport over the last 100 years.
After each game, mostly wins, the team is briefed by its coaches attempting to understand the challenge to continue to improve, and to always get better even when you are at the top of your game. When all of the players and coaches have left, the captains pick up a brush and long handled broom, and sweep the room known as the sheds. They sweep the sheds and do it properly so no one else has to, because no one looks after the “All Blacks” as they look after themselves. By doing so, they demonstrate personal discipline. It teaches one not to expect things to be handed to them; character and culture triumphs over talent, strategy, and tactics. If one attempts to develop a winning heart failure team with a focus on getting the culture right, results will follow.
The following 15 lessons in leadership come from the national rugby team’s 15 principles that set the stage for a culture of excellence (1):
1. Sweep the sheds. Never be too big to do the small things that need to be done for the heart failure team.
2. Go for the gap. When you’re on top of your game, change your game. Don’t be compliant and complacent with victory, excellence, and national standards and rankings. Be innovative.
3. Play with purpose. Ask why you are doing what you are doing each day.
4. Pass the ball. Leaders create leaders. In the best leadership training, leadership development and leadership culture are necessary to pass on the jerseys. Create the next generation of heart failure leaders with pride.
5. Create a learning environment. A commitment to lifelong learning is critical to success and fostering leaders of the next generation.
6. No outliers. When recruiting your team, invest in recruiting team members of character who are committed to a culture of excellence.
7. Embrace expectations. Aim for the highest peaks. Do not shortchange your objectives.
8. Train to win. Practice under pressure to develop consistency and maintain high quality. Reduce variation by performing at the highest level each and every day and providing feedback.
9. Control your attention. Keep your focus. You cannot be all things to every person.
10. Keep it real. Stay centrally focused. Establish a clear mission, vision, and values.
11. Sacrifice. Understand what we are doing. In the field of cardiovascular medicine, it is a privilege to care for patients and provide an opportunity to improve not only the quantity of life, but also the quality of life. It is a profession worth the sacrifice to be the best.
12. Invest in a language. Establish the mission, vision, and values of your heart failure team.
13. Ritualize to actualize. By following the previous lessons, you create a culture of excellence.
14. Be a good ancestor by planting trees that you will never see. As leaders, recognize that you may not see the full development of the investments you make, but these investments will create sustainable success.
15. Write your legacy. Look backwards at your life, organization, time and leadership, and determine how you would want history to view your team, mentors and mentees, and contributions to your patients.
The lessons we can learn from the 2 most successful sports teams in the history of competition are lessons that we can integrate into our heart failure team, heart failure organizations, and heart failure leadership. Why? Our patients deserve it.
- 2020 American College of Cardiology Foundation
- Kerr J.