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Leadership Development and Healthcare

Lead and inspire people. Don’t try to manage and manipulate people. Inventories can be managed but people must be lead. —Ross Perot 

Over the last seven years I’ve had an opportunity to interact with hundreds of healthcare leaders, from board presidents, to CEOs, to front line nurse leaders.  During this time, I’ve been struck by the wide disparity in leadership skills; some “get it” and many clearly do not.  I remember a comment a CNO made to me several years ago when asked to what she attributed the improvement in their physician satisfaction scores.  She said “the new CEO is in the physician lounge every morning at 7:00 a.m. … he gets out of his office to meet the physicians and speak with them.”  It was as if she was surprised that a hospital CEO would leave his office to greet physicians on their turf. Sounds to me like that CEO was one of those leaders that “gets it.”  Unfortunately, though, I have met many leaders who do not. 

Be a yardstick of quality. Some people aren't used to an environment where excellence is expected. – Steve Jobs 

What is it that good leaders “get?”  What are the traits of successful leaders?  While there are many definitions and examples of good leaders, I like the five simple leadership elements of Paul “Buddy” Bucha, a 1965 West Point graduate and Medal of Honor recipient:  honor, confidence, competence, compassion, and humility. I’ve often wondered why I see so many leaders in healthcare that struggle with some of the basics of leadership.  Is it a lack of compassion or competency?  The vast majority of healthcare leaders I’ve encountered are extremely compassionate and highly competent in their fields, so that’s not it.  Is it because traits like honor, confidence and humility are missing, or is it something more fundamental?  Could it be that what’s missing is the process of developing healthcare leaders like we see in the military or other industries?  

Leaders aren’t born, they are made. And they are made just like anything else, through hard work. And that’s the price we’ll have to pay to achieve that goal, or any goal– Vince Lombardi, legendary football coach 

I agree with Coach Lombardi that it takes hard work to mold someone into a leader.  As a graduate of the United States Military Academy at West Point, the foremost leader development institution in the world, and with 22 years as an Army officer, I have experienced leadership development up close.  What’s missing in healthcare is a framework similar to the West Point Leader Development System the USMA faculty uses to develop 18-22 year old cadets into leaders for our Army.  It is interesting to hear the insightful responses from a group of cadets when asked recently what leadership skills they had learned in their nearly four years at West Point.  From this group of young men and women came observations such as genuine concern for others, being personable, providing consistent and honest feedback, empowering subordinates, delegation, emotional intelligence, patience, resilience, trust, and reflection.  Do they “get it” already, even with their limited life experiences? Leadership Development Training for Healthcare from HealthStream

Whatever you are, be a good one. —Abraham Lincoln 

Some may argue that developing an Army officer preparing to lead soldiers in combat is completely different than preparing a nurse manager or CEO for their leadership challenges.  However, if you look closely, there are a number of similarities between the two professions.  Combat and healthcare leaders work in an environment where ambiguity is the norm, the daily pace creates chronic stress leading to burn out, and decisions that impact life and death are made daily.  Technical competency is a requirement for both professions.  While nurses may not be ducking for cover or lifting heavy rucksacks, many lift obese patients and walk miles every day in the course of taking care of their patients.  We like to think the healthcare profession is unique, but I contend that there is a kinship with those protecting our freedom and there is much to learn about developing leaders from those in military uniforms. 

I start with the premise that the function of leadership is to produce more leaders, not more followers. —Ralph Nader 

A few healthcare organizations today have formal leadership development programs.  Some incorporate programs like HealthStream’s Frontline Nurse Leader program for charge nurses, team leaders, and assistant managers, or the American Association of Critical-Care Nurses’ Essentials of Nurse Manager Orientation.  For many organizations, however, leadership development consists of identifying the best clinician for the next open leadership position and then learning as you go.  If that describes your organization, you may want to consider creating a leadership development program or formalizing the program you have in place already.  A good place to start in creating a leader development program is to think what your end product should look like.  The ten desired outcomes of the West Point Leader Development System provides a good place to start. 

  • Lead and inspire to complete the mission
  • Embrace your role
  • Demonstrate a broad perspective that is open to new ideas and experiences
  • Understand ambiguous situations and solve complex problems
  • Make sound and timely decisions under stress
  • Communicate effectively with all audiences
  • Demonstrate proficiency in (healthcare) skills required to succeed
  • Demonstrate mental and physical toughness
  • Demonstrate the respect for others and work effectively with different cultures and people
  • Live the Army values 

While the last outcome is unique to West Point and its Army mission, the first nine relate well to the role of healthcare leader.  Whether you are developing charge nurses or future healthcare executives, the West Point Leadership Development System can be adopted and modified to provide a framework for a successful program. 

In today’s healthcare environment, where transformation has become the norm, strong leaders are needed now more than ever at every level within the organization.  It’s time to examine the process of creating leaders to ensure they will have the tools to face the challenges ahead of us.  Will your organization be ready to meet the challenge?

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