Paul Armerding of Medical Compass discusses the opportunities and challenges of teaching leadership and management skills in the developing world.

1. Teaching Leadership &
Management in Developing
Countries
Paul L. Armerding, MD FACS
Medical Compass
CCIH Annual Conference, 8-10 June 2012

4. Medical Compass, Inc.
P. O. Box 1296
Missoula MT 59806-1296
www.medicalcompass.org

5. Medical Compass, Inc.
 A US 501(c)(3) non-profit organization
 Founded August 2009
 Work began February 2010
 Co-chair, CCIH Working Group for Christian
Hospitals
 Member, CMDA Continuing Medical & Dental
Education Commission

6. Medical Compass, Inc.
Coaching and teaching visits:
 Kenya: CMDE conferences Feb 2010 and Feb 2012
 USA: CCIH annual conferences 2010, „11 and „12
 Liberia (SIM): Jan-Apr 2011
 Dominican Republic (MMI): Dec. 2011
 Kenya (PCEA): Feb 2012
 Mongolia (MEI): Apr 2012
 Ghana (MMI): May 2012

7. Teaching Leadership &
Management
The challenges
 External (cultural)
 Internal (organizational)

8. External (cultural) challenges:
 Relationships vs. rules
 Immediate vs. long-term
 Survival vs. development
Remember, the modern science of
management is a product of the
industrial revolution in Europe
and North America.

9. Internal (organizational)
challenges:
 Educational deficits
 Experience deficits
 Relationships
 Inherent complexity of
organizations

10. Hospitals, clinics and
medical programs are…
 Complex adaptive systems
 So, what?

11. Complex adaptive systems…
…operate in [the] transition zone
between stable equilibrium points and
complete randomness. Poised between
solidity and precariousness, these regions
are typically referred to as the edge of
chaos. Neither stability nor chaos is
capable of exhibiting the characteristics of
complex systems – such behavior can
only exist balanced at the edge of chaos.
Boal& Schultz 2007

12. Stable Equilibrium
Systems
Job Descriptions
Policies & Procedures
Laws & Regulations
Best-practice Standards
Accreditation Standards

13. Complete Randomness, Chaos
Leadership Changes
Employee Turnover
Changing Expectations
Competition
New Technologies
New Methodologies

14. How do we resolve this?
By balancing…
 Leadership (chaos)
 Management (stability)
Our desire is to prepare leaders and
managers to function effectively at the
edge of chaos.

15. What do leaders do?
 Scan
 Focus, Define
 Align, Mobilize
 Inspire
Managers Who Lead: A Handbook for Improving Health
Services, 2005, Cambridge MA, Management Sciences for Health

16. What do managers do?
 Plan
 Organize
 Implement
 Monitor and Evaluate
Managers Who Lead: A Handbook for Improving Health
Services, 2005, Cambridge MA, Management Sciences for Health

17. Looking at both…
Manager
Leaders
s
 Scan  Plan
 Focus, Define  Organize
 Align, Mobilize  Implement
 Inspire  Monitor and
Evaluate

18. What else are we seeking
to accomplish?
“Creating Sustainable Performance”
Gretchen Spreitzer and Christine Porath
Harvard Business Review; Vol. 90; Nos. 1 &
2, January – February 2012; pp. 93-99

19. “Creating Sustainable
Performance”
 We desire for our patients thrive.
 How about helping our employees to
thrive?

20. Two components of
thriving…
1. Vitality: the sense of being
alive, passionate and excited.
2. Learning: the growth that comes from
gaining new knowledge and skills.
Spreitzer&Porath; HBR 90: 1 & 2, Jan– Feb 2012; pp. 93-99

21. How can organizations help
their employees to thrive?
1. Provide decision-making discretion
2. Share information
3. Minimize incivility
4. Offer performance feedback
Spreitzer&Porath; HBR 90: 1 & 2, Jan– Feb 2012; pp. 93-99

22. How do we
instruct
leaders and
managers?
Tools
Time
Techniques

23. Tools –
Resources
Managers Who
Lead
A Handbook for
Improving
Health Services

24. Tools - Resources
 Mansour, Vriesendorp, Ellis + 3 editors
+ 18 contributors
 Managers Who Lead: A Handbook for
Improving Health Services
 3rd edition; 2005; Cambridge MA
 Management Sciences for Health
 295 pp. + CD
 $40.00

25. Managers Who Lead
A Handbook for Improving Health Services
1. Leading and managing to achieve results
2. Leading teams to face challenges
3. Improving work climate to strengthen
performance
4. Moving up the leadership ladder
5. Reorienting roles in the health system
6. Leading change for better health
 Toolkit + CD with entire book plus

27. Tools –
Resources
Four Essential
Disciplines
A Training
Guide for
Healthcare
Leaders
Worldwide

28. Tools - Resources
 Kenneth M. Hekman
 Four Essential Disciplines: A Training
Guide for Healthcare Leaders Worldwide
 1st Edition, 2010, Holland MI
 Health Development International
 144 pp. (workbook available)
 $35 (also available as an e-book)

29. Four Essential Disciplines
A Training Guide for Healthcare Leaders Worldwide
 Leadership
 Management
 Sustainability
 Service

30. Environments of Grace…
 Bill Thrall, Ken
McElrath, Bruce
McNicol
 Beyond Your Best
 2003; San Francisco
 Jossey-Bass
 141 pp.
 $12

31. Time & Techniques
Teaching Coaching
 More people  Less people
 Less time  More time
 Less interaction  More interaction
 Less depth  More depth

32. Strategic thoughts…
 Teaching benefits many students
 Teaching is a way to be introduced
 Some students will request coaching
 Coaching will produce centers of
excellence
 Well-coached leaders and managers
will coach others

33. Conclusions…
 The need is great
 Teach some, but coach more
 Coaches are few and far between
 This is not rocket science
 Tools are available
 You, too, can teach the essentials

34. Thank you for your
attention.
 Paul L. Armerding, MD FACS
 Trainer, coach and consultant specializing in:
 Leadership
 Management
 Communications
 Medical Compass, Inc.
 www.medicalcompass.org
 paul@medicalcompass.org
 +1-480-703-6471