melissa horn building a real team with trust
Building a Real Team With Trust
According to Melissa Horn, changing a culture takes three years. She would know. Melissa has had the unusual leadership challenge of being “the fixer” for four different clinics at University of Utah Health as director of outpatient women’s clinics. Accelerate learned how Melissa creates authentic teams (hint: it’s hard work and there are no shortcuts).

Tips for Building Authentic Teams


would say that changing culture takes about three years. I know that if I try to rush in and immediately start changing things, the change can take even longer.

We have to start with a shared vision, building a relationship and investing in making things better.

#1 Know each other

My first focus is getting to know my team. You’re not a team without relationships, and people don’t feel loyal to me or trust me just because of my title. I have to build trust. I don’t call them into my office for a one-to-one. I’ve learned one-to-one meetings with your new boss feels intimidating and causes unnecessary anxiety. I often walk up to the group in clinic. Maybe they are already chatting about a movie they saw, or something they did last night, and I ask them about it. We talk and joke (especially since I haven’t seen a movie recently because I have a three year old). I want to get to know them, and I want them to get to know me. I look around the clinic to see what personal things people have displayed so that I can learn about their lives. This personal connection leads to staff-initiated one-to-one meetings, and when the staff initiate the meeting, they are more open with me.

Learn about the power of building personal relationships: Cultivating trust behavior #6: Build personal relationships—A Google study found that managers who show interest in and concern for people outperform others. When people care about one another, they perform better because they don't want to let teammates down. When people build social ties at work, trust increases.

My goal is to get to know my team personally and professionally. I spend a lot of time watching the team work, and sometimes doing simple work with them, like cleaning rooms. I ask them questions and I’m genuinely curious. I ask, what do you do? What are the barriers that obstruct your work? I’m aware it can be intimidating and people often wonder why I’m questioning them. I explain that I’m curious and I just want to understand how processes work here. I don’t have clinical expertise so I can ask a lot of questions. I feel that often staff simply want to know you care and are listening.

#2 Build loyalty through passion

If they think this is just a job for me, then it can be just a job for them. I’m passionate about health care. A hospital is like a second home for me because my mom received cancer treatment from when I was 9 until I was 15. That experience shaped my belief that I never want patients to feel alone in their health care. When I’m asked to lead a new clinic, I talk about the experiences of patients and how much they value individual staff. I explain that as great as our care is, there are things that could go more smoothly. I share personal experiences of walking into clinic, being unsure and wondering what would happen. I earn their loyalty through each individual relationship, and then we can build a shared vision of making things even better.

Learn about security through vulnerability: Cultivating trust behavior #8: Show vulnerability—High-trust leaders ask for help instead of just telling people what to do. Asking for help is a sign of a secure leader—one who engages everyone to reach a goal. Asking for help taps into people's natural impulse to cooperate.

I don’t want someone to take the job just for the paycheck. I want them to feel like this is the place they are meant to be. I’ve mentored employees who didn’t feel that connection, and I help them find a better place. I had a medical assistant interview with me who I really liked but we both knew that OB/GYN wasn’t the best fit for her. Now she is in geriatrics and when she talks about her patients, she just lights up. She thanked me for pushing her to find the right spot. It is my hope that my employees see my passion and connection, and they know I want that for them too. Life is too short to miss that connection at work.

#3 Tackle Tough Conversations

Everyone deserves the chance to receive honest and compassionate feedback about their performance. All leaders should have these tough conversations. For me, I start with compassion and the belief that every employee can change. They should be given that opportunity to change. It’s my job to pull a person aside and speak with kindness and honesty. Not every supervisor is willing to talk directly with employees about how their behavior impacts others. It is uncomfortable. I’ve found that many people may not even know how others perceive them. It’s hard to confront people but I believe that everyone deserves the chance to change. (Learn the importance of whole-person growth.)

Learn the importance of whole-person growth: Cultivating trust behavior #7: Facilitate whole-person growth—High-trust managers invest in both the personal and professional growth of their people. Professional growth happens with clear goals, the autonomy to reach them, and consistent feedback. Personal growth happens through discussions about work-life balance, family and recreation. Investing in the whole person positively effects engagement and retention.


Melissa Horn

Director, Outpatient Services, University of Utah Health

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