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Listening - Importance of this Skill

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Listening - Importance of this Skill

What is it and how can it help me?

When you are carrying out improvement work, it is easy to overlook the importance of making time to pay attention to what colleagues are saying. Staff involved in organisational change may have questions, concerns and grievances they want to air. Open and sensitive discussion can help to resolve areas of potential conflict before they impact upon the improvement process. It is important that you promote understanding, involvement and constructive discussion throughout.

Active listening can help you to determine the nature of the intervention needed and help to ease the introduction of any changes by identifying and addressing the concerns that people have before they block the process.

When does it work best?

You may have already made a lot of improvements to your service, so the next phase of improving services will not be easy (the easy stuff has already been done). This means that you may encounter more resistance.

We often feel too busy to spend time listening properly, but this investment of time and attention could prevent problems and reduce resistance later on. Listening to staff is one of the ways you can diagnose the nature of a problem or issue. It helps you to identify whether it is a people, process or technology issue.

Active listening can also be a way of determining the nature of the intervention needed. You should be asking questions and seeking suggestions from your team - the best ideas often come from those who live the process!

How to use it

Define the terms - You need to clarify technical terms, codes and jargon as well as discussing the different assumptions people have about meanings. If you can all agree on definitions at this stage, you should avoid surprises or resistance later on.

Paraphrase - Repeat back what the other person is saying in your own words - this will help you make a more thoughtful response and prevent you hearing ‘only what you want to hear'.

Listen between the lines - Watch body language: eyes, tone of voice, posture, pace of speech.

Don't interrupt - It is important to give people space to talk freely and to recognise that arguing will not get at the issues beneath the surface. Don't assume that silence means agreement - build in time for people to say all that they want to.

Listen for all levels of resistance - You need to ensure that you hear the speaker on all levels - words, feelings, assumptions, values, wishes and fears. Use your instincts to consider if this person means what they say. Be alert to how language or body language can project feelings e.g. ‘I took the bullet'might sound like a macho response, but can indicate hurt.

Feed back impressions - You can check observations with simple assumption statements e.g. ‘If I were in your shoes, I might be thinking...' and see if they agree. To develop trust, you need to show interest, provide a safe environment and listen openly. Factors may affect colleagues trust in you e.g. ‘having been let down by management'.

Active listening isn't enough - You must be prepared to be influenced by what you hear, but don't act like you care when you don't: this will fool no one in the long run.

Guidelines for good dialogue - not always easy!

  • Maintain confidentiality
  • Avoid inflammatory comments
  • Avoid trying to convert others to your point of view before you have listened to their views
  • Show respect by listening attentively and responding appropriately
  • State your intent at the beginning
  • Acknowledge contributions that people make
  • Accept responsibility for your actions, be prepared to take blame or apologise where necessary
  • If colleagues surprise you, express your surprise - then ask them to explain (without telling them they are wrong or trying to reason them round to your viewpoint)
  • Make guesses based on your assumptions, then ask them to confirm
  • Ask questions in a spirit of curiosity - not judgement
  • Bracket interesting points of the conversation and return to them later
  • Move gently, especially on personal/risky topics - watch out for signals that you need to back off
  • Take care not to escalate resistance
  • Stay excited about your idea, and stay connected with the other person
  • Make your short-term goal to listen and explore - avoid knee-jerk reactions
  • Once you have listened and explored, you can move on to the next objective, e.g. ‘seek mutual gain', ‘cut losses' or ‘rethink the idea

What next?

The art of listening is essential to all stages of a project, as communication is key to identify problems, staff perception, getting patients' perspectives, finding solutions (overview of creativity) and gaining co-operation building trust, human barriers to change, addressing uncertainty to implement and sustain change.

Additional resources

Kline, N. 'Time to Think: Listening to Ignite the Human Mind', Cassell Illustrated,1998

Adapted from Maurer, R., The Art of Listening, available at:

© Copyright NHS Institute for Innovation and Improvement 2008