Driving Leadership Development in Healthcare: The Challenges, The Opportunity, and Imperative

Driving Leadership Development in Healthcare:

The Challenges, The Opportunity, and Imperative

Marie E. Sinioris, National Center for Healthcare LeadershipRobert G. Riney, Henry Ford Health Systems

Allan L. Weisberg, National Center for Healthcare Leadership

October 9, 2007

SHRM Foundation Thought Leaders Retreat

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© 2007 National Center for Healthcare Leadership.

When we realize the everlasting truth of “everything changes”, and find our composure in it, we find ourselves in nirvana

- Shunryu Suzuki

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The Transformation Mandate

Healthcare leadership needs to be prepared for its biggest challenges with intensifying demands on the industry for excellent outcomes and better value

- Michael Porter, Redefining Health Care, 2006

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The significant problems we face cannot be solved at the same level of thinking we were at when we created them

- Albert Einstein

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Challenges in Healthcare Leadership

National Summit on Future of Education and Practice in Health Management and Policy, 2001 Industry Challenges (cost and quality) Succession/recruitment Mentorship declines Mid-advanced career education offerings Practitioner-academic collaboration Diversity

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NCHL Vision

Evidenced Based

Leadership Development

Improved Leadership

Improved Organizational Performance

Improved Health Status

Optimize the health of the public through leadership and organizational excellence.

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NCHL Strategy

Span the industry reaching comprehensively across: Career levels: career-entry, mid-career, advanced career Industry sectors: providers, suppliers, insurers, policy Professional disciplines: administration, nursing, medicine, behavioral

health, pharmacy Academia and Practice

Develop programs based upon sound research and global best practices

Focus on rapid development, testing, and deployment of programs

Accelerate adoption of best practices through learning collaboratives and benchmarking

Systematically evaluate programs to assess learning outcomes and performance improvement – evidence based management practice

Broad Dissemination to the field via collaboration

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What is unique about healthcare leadership?Values-based, mission-driven industry

Breadth of “customers” literally encompasses the entire population – local, regional, national, international

Demand and supply dynamics for critical talent requires that leaders create climates that attract and retain top talent in a highly competitive market

Complexity and mix of independent constituencies requires higher levels of influence and consensus-building than most leadership roles

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Social sector Leaders are not less decisive than business leaders . . . They only appear that way to those who fail to grasp the complex governance and diffuse power structures common to the social sectors.

— Jim Collins, Good to Great and the Social Sector: A Monograph to Accompany Good to Great, 2005

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COMPETENCYAny characteristic of a person that differentiates outstanding from typical performance in a given job, role, organization or culture

Behaviors

Attitudes

Values

Other Characteristics

SkillKnowledge

BaselineNecessary fortop performancebut not sufficient

Distinguishingcharacteristicsthat lead to longer-termperformanceand success

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The Competency Study Process

GENERIC MODEL

EXPERT PANEL + BENCHMARKING +

STRATEGIC INTERVIEWING

EXPERT PANEL

HYBRID MODEL (5-15 BEI’s)

FULL-SCALE BEI-

BASED MODEL (20+ BEI’s)

HEAVY DUTY

RESEARCH-BASED

MODEL (35+ BEI’s)

TARGETTIPPING POINT/

ALGORITHMR O I

CRITICALITY/PRECISION & VALIDITY OF RESULTS

INV

ES

TM

EN

T $

$$

Relationship between methods & validity of results

BENCHMARKING

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NCHL Competency Research

Future Vision

• IOM Agenda

• Futurists

What defines today’s best

health leaders?

In-depth Interviews

• 84 Total

• Career Stages

• Professions

What can we learn from

others?

+

Benchmark Findings

• Health

• Pharma/biotech

• Insurance

• Global Leaders

+What will the 21st Century require?

NC

HL

Co

mp

eten

cy M

od

el

What technical and behavioral characteristics create outstanding performance?

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Three Domains of the NCHL Model

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Scaled Competencies

Competency levels increase by degree of difficulty

Influence

Deg

ree

of

So

ph

isti

cati

on

4. Develops behind the scenes support

3. Uses indirect influence

2. Anticipates impact of actions or words

1. Engages audience

TargetLevel

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NC

HL

Com

pete

ncy

Mod

el b

y C

aree

r Sta

ge

Integrated Learning Model

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NCHL Integrated Learning Model

Executive Level

Managing Managers

Managing Others

Lear

ning

Mod

aliti

es

PeopleTransformation ExecutionManaging

Self

© 2007 National Center for Healthcare Leadership & General Electric Co.

Confidential & Proprietary Information

Institute for Transformational Healthcare Leadership

Preparing leaders to innovate and drive high

performance

Leadership development programs “equip”

healthcare leaders to be successful throughout

their careers

Front-Line Managers

Senior Executives

Managers of Managers

Operating Cycle

Strategic Alignment

Performance

Management

Talent Review &

Succession

Values & Competencie

s

NCHL’s evidence-based approach to leadership development focuses on action learning for healthcare leaders

GE’s proven approach to leading change and sustaining a performance culture

One system grounded in world-class research and execution of leadership

development:

Recruitment &

Selection

Learning & Developme

nt

Nursing Medicine Administration

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Critical Success Factors

Shared vision – leadership and organizational transformation Accountability for learning and performance outcomes Information for evaluation, continuous feedback and

benchmarking Commitment of resources, time, and energy

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Greatness is not a function of circumstance. Greatness, it turns out, is largely a matter of conscious choice, and discipline.

— Jim Collins, Good to Great and the Social Sector:

A Monograph to Accompany Good to Great, 2005

Henry Ford Health Systemand

National Center for Healthcare Leadership

Robert G. RineyExecutive V.P./Chief Operating Officer

Henry Ford Health SystemOctober 9, 2007

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Coming together is a beginning;

keeping together is a progress;

working together is success.

-Henry Ford

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Henry Ford Health System Overview

Henry Ford is one of the nation’s leading comprehensive health systems, providing acute, specialty, primary and preventative care services, backed by excellence in research and education.

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Creating the “Leadership Development Experience” at Henry Ford Health System

In 2003 HFHS joined NCHL as a LENS member.Recently we had the opportunity to more fully leverage the power of that relationship.Over the last 7 months HFHS and NCHL have come together to create a Leadership Development Experience for the Executive team at HFHS.By integrating with internal programs we have been able to offer a comprehensive approach to leadership development.Our leaders are enthusiastic and engaged and there appears to be a renewed spirit around the importance of leadership development and talent management.

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“Leadership Development Experience”

The “Leadership Development Experience” process encompasses the identification of competencies, leadership simulations, 360-degree feedback tools, climate surveys, group and individual development plans, and executive coaching opportunities.

Each of these elements will be linked to performance management, talent reviews, and succession planning.

This process incorporates many of our own initiatives and is managed internally to create a true sense of ownership and sustainability within our organization.

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As our Executive team progresses through their own “Leadership Development Experience” we have the opportunity to create a stronger culture of openness around leadership and coaching.

Currently we are completing the assessment phase and have begun the executive coaching feedback sessions.

We will conclude the initial phase in October with a clear development plan for our leadership team.

Together the Executive team and the HR leaders will evaluate this process and determine how to best roll out the experience to other levels of leadership within the organization.

The following slides outline our current Leadership Development process for our executive team.

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ASSESSMENTSINDIVIDUAL FEEDBACK

GROUPFEEDBACK

DEVELOPMENTAND

ONGOINGPERFORMANCE MANAGEMENT

Performance Management: Aligning and developing leader competencies and skills to enhance overall capabilities in

achieving individual and organizational goals.


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- Group Simulation Experience (teams of Executive Leaders) - Group Feedback Sessions (same teams from Simulation)

Provided by The LEAD Center

ASSESSMENTS

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The LEAD CenterIn 2006 HFHS invested in developing our own leadership simulation center. This center is referred to as: The LEAD Center (Leadership, Evaluation, Assessment, and Development).

The Center is a “Cognitive Simulation Center” aimed at assessing and developing leaders’ decision-making skills as they pertain to strategic thinking, creativity, vision integration and execution, and crisis response.

The LEAD Center specifically addresses innovation, teamwork, conflict resolution, the act of engaging stakeholders, change management, crisis resolution, and strategy development.

This Leadership Development Framework will incorporate the use of the LEAD Center as both an assessment tool for group feedback and as a development tool for individual growth.

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- Leadership 360 Degree Evaluation- Organizational Climate Survey (cultural audit)

Provided by NCHL

ASSESSMENTS

- Group Simulation Experience (teams of SET members) - Group Feedback Sessions (same teams from Simulation)


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National Center for Health Care Leadership (NCHL)

NCHL’s vision is that an integrated leadership development system model will lead to improved leadership and organizational performance resulting in improved health status.

NCHL’s mission is to be a catalyst for industry-wide collaboration to assure that high quality, relevant and accountable health management leadership is available to meet the needs of 21st century health care.

In 2003 HFHS made a commitment to work with NCHL as a member of the Leadership Excellence Network (LENS) to further develop HFHS leadership capabilities. NCHL works with a collaborative group of progressive healthcare systems across the country all dedicated to evidence based learning and development.

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The leadership competencies that are assessed in the 360 degree evaluation are categorized into three categories:

1) Transformation 2) Execution 3) People

NCHL Continued

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NCHL Continued

The Organizational Climate Survey assesses a Leader’s skills as it relates to creating a culture of:

Flexibility

Responsibility

Standards

Rewards

Clarity

Team Commitment

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NCHL Leadership 360 Degree Evaluations Organizational Climate Survey (cultural audit)

- Preference Indicator SurveyMYERS BRIGGS TYPE INDICATOR (MBTI)

ASSESSMENTS

- Leadership 360 Degree Evaluation- Organizational Climate Survey (cultural audit)

Provided by NCHL

- Group Simulation Experience (teams of SET members) - Group Feedback Sessions (same teams from Simulation)


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Myers Briggs Type Indicator (MBTI)

This tool assess individual preferences in order to provide better awareness regarding individual style and team dynamics.

The MBTI reports preferences on four dichotomies, each consisting of two opposite poles:

Extraversion and Introversion (Where you prefer to get your energy)Sensing and Intuition (How you prefer to take in information)Thinking and Feeling (How you make decisions)Judging and Perceiving (How you deal with the outer world)

This assessment will be used to enhance the awareness and understanding of team dynamics and enhance an individual’s ability to flex to other preferences.

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ASSESSMENTS INDIVIDUAL FEEDBACK

INDIVIDUAL LEADERSHIP DEVELOPMENT

HFHS will provide all Leaders with a written comprehensiveDevelopment Package which will include:1) Results from all Assessments (NCHL, LEAD Center, MBTI)2) Individual Development Plan a) Executive coaching opportunities b) Current HFHS University offerings c) Additional learning opportunities/programs3) 90 Day Action Plans

NCHL will provide a facilitated feedback session to review the Development Package with each Leader in a coaching and feedbackSession to create their Individual Development Plan.

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ASSESSMENTS

GROUP LEADERSHIP DEVELOPMENT PLANNING SESSIONS (SET)

HFHS and NCHL will co-facilitate a Group Leadership Development Planning Session with all SET members to:

1) Review the composite results and identify strengths and opportunities for improvement in relationship to HFHS strategic goals and values.

2) Create a Group Development Plan, organize priorities and determine action items to support organizational strategies,

goals and outcomes.

GROUPFEEDBACK

INDIVIDUAL FEEDBACK

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ASSESSMENTSGROUP

FEEDBACKINDIVIDUALFEEDBACK

DEVELOPMENTAND

ONGOINGPERFORMANCE MANAGEMENT

Leaders participate in ongoing development opportunities identified within their Individual Development Plan.

Leaders participate in a customized Individual Simulation session from the LEAD Center. (one time experience)• Simulation will focus on Leader’s specific strengths and opportunities for improvement as part of a development opportunity.• Leaders participate in an individual feedback session.• Results will be incorporated back into their Individual and 90-Day Development Plans.

Ongoing Performance Management• Leaders review 90-Day Action Plan quarterly with development Coach (TBD).• Leaders report results of their development progress back to their respective Senior Leader for additional feedback.• Leaders incorporate 90-Day Action Plan activities into annual Performance Evaluations. All development activity should align with Leader’s key goals and objectives.

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Next Steps

In addition to our Executive Team members we currently have 9 high potentials from each of our Business Units participating in the Leadership Development Experience.

Following the completion we will evaluate this process and determine how to roll out this experience as part of our overall Succession Planning strategy.

Competency-based Succession Planning

Allan L. Weisberg, Senior Vice President

National Center for Healthcare Leadership

October 9, 2007

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Succession Planning at Johnson & Johnson

Long history, 40+ years Disciplined approach, business cycle process, i.e. financial, strategic

planning, business planning Accountability of leaders, no longer need to justify the why “Bottom up” process goes from operating company to the Executive

Committee Matrix view, i.e. operations, marketing, research, etc., cross-

organizational moves Internal executive search process – cross-organizational,

functional/geographic movement is encouraged and expected Talent is a “Corporate Asset”

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Elements of Succession Planning at Johnson & Johnson

Element Why

Strategic/Operational Plan Organizational/people/competency implications

Organizational Metrics(including non-financials)

Actual organizational performance, used as a calibrating mechanism

Organizational Strength Determine ability of current team to successfully create and implement strategic/operational plan, includes hire, fire, development plans

Replacements/Back-ups & Vulnerability

Likelihood of vacancies, ready now, ready later, need for development/external recruiting

High Potential Review Ensure the retention and development of high performers and high potentials, and appropriate movement

Leadership Pipeline-- Retention

-- College recruiting

-- Cross-organizational movement

-- Interns/external recruiting

Determine whether progress is being made, ensure appropriate pipeline of talent

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Observations about Healthcare

Why? No shareholder equity Careers governed by function as opposed to organizations Healthcare systems from individual hospitals Mentality of “buying it” rather than “developing it” Tenure of CEOs “Business processes can’t work here” mentality

For a long time, talent management was not valued?

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Healthcare organizations are getting the message that great leadership is vital to great results

Incredible healthcare challenges Outside boards Shortage of current and future talent Success rate of “external” hires Exposure to other organizations, i.e.

GE Johnson & Johnson IBM 3M

Need for more business focus and accountability

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What will it take for healthcare organizations to be successful in developing and retaining great talent? CEO commitment, backed up by a great HR leader, i.e.

actions vs. words Sticking to it with discipline and rigor Accountability of all leaders Talent as a “system-wide” asset Get started “do a little, learn a lot”

Documents

Driving Leadership Development in Healthcare: The Challenges, The Opportunity, and Imperative