The Pulse of Leadership    in HealthcareDeveloping the 21st CenturyHealthcare LeaderContributors:Douglas G. Stark, BBA, MA...
Executive SummaryMuch like leaders in other sectors, leaders in healthcare     • Generally leadership today can be distill...
IntroductionAt every turn in the healthcare industry, there are signs of      AchieveGlobal’s research on leadership princ...
Methodology: A Three-Phased Approach                   Central to this research                   study was the idea that ...
Central to AchieveGlobal’s research study was the idea        In terms of size of operations, just over 40 percent ofthat ...
Key Findings – All Participants            The Leadership Zone Model
The Leadership Zones                                       Leaders strong in the Society Zone:The core finding of the over...
• Create a work environment in which innovation can            Reflection helps leaders avoid pitfalls in other zones,  th...
PeopleIn this zone, a leader’s ability to connect with others on ahuman level realizes enormous benefits, including im-pro...
Healthcare Specific Findings           Healthcare leaders are being           called on to make major and           fundam...
Pressing Challenges for Healthcare Leaders                        within healthcare leadership, but also indicate opportu-...
Comparing Healthcare Leadership to                            The Zones of Leadership: Importance andLeadership in Other I...
This discovery might be attributed to the sample demo-         With major changes taking place in and around thegraphics, ...
Implications and Conclusion                                    Numerous recent scholarly studies and books that focus     ...
AppendixAppendix 1: Demographic                                   Figure 3. Organizational revenue in 2008Information—Heal...
Figure 5. Current Leadership Role in Organization        Appendix 2: Comparisons BetweenCurrent Leadership Role           ...
2.2 Most Pressing Challenges among Leaders                Appendix 2.3 Leadership Zone and Importancein Other Industry Org...
Appendix 3. Accuracy of the Six Zones ofLeadership ModelIn order to test how internally reliable and accurate theleadershi...
About The ContributorsDouglas G. Stark                                             Chris BlauthDirector Organizational and...
About AchieveGlobal      In the 21st century, the level of human skills will determine      organization success. AchieveG...
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The Pulse of Leadership in Healthcare

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Much like leaders in other sectors, leaders in healthcare organizations are now being called on to re-envision the roles they play in cultivating organizations that are faced with the need to develop new perspectives and new skills. AchieveGlobal's multi-phased, multi-level study examined how leadership within the healthcare industry must change to keep up with today's challenges.

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The Pulse of Leadership in Healthcare

  1. 1. The Pulse of Leadership in HealthcareDeveloping the 21st CenturyHealthcare LeaderContributors:Douglas G. Stark, BBA, MA, Director - Organizational Effectiveness,Training, & Recognition, UTMB HealthChris Blauth, Director of Product Strategy, AchieveGlobalCraig Perrin, Director of Solution Development, AchieveGlobalRosalyn Laves, Strategic Account Manager, AchieveGlobal
  2. 2. Executive SummaryMuch like leaders in other sectors, leaders in healthcare • Generally leadership today can be distilled into sixorganizations are now being called on to re-envision the “zones,” or groups of best practices, which the re-roles they play in cultivating organizations that are faced search identifies as Reflection, Society, Diversity, In-with the need to develop new perspectives and new genuity, People, and Business.skills. In the healthcare industry, though, the situational • Overall, leaders in healthcare ranked the six zonescontext is further complicated: Major legislative and of leadership (with the exception of the Diversitysystemic changes are turning technology and privacy zone) as being more important in meeting their or-into significant forces shaping the evolution of the in- ganizational challenges than did leaders in other in-dustry. Today’s leaders in healthcare organizations are dustries.often expected to skillfully navigate these majorchanges, even as economic turbulence emerges as an- • Survey participants representing the healthcare in-other contextual factor. dustry generally had more concern about the effec- tiveness of leaders in their organizations than didAchieveGlobal’s multi-phased, multi-level study exam- participants from other industries.ined how leadership within the healthcare industry mustchange to keep up with today’s challenges. Our broader • Healthcare leaders were rated as being more effec-research started out by identifying leadership issues out- tive in the “Diversity” zone.lined in peer-reviewed academic journals over a two- • Among healthcare leaders, the largest gap be-year period. At a later stage of the research, tween the importance of a specific zone and the ef-focus-group sessions facilitated development of a quan- fectiveness of leaders in that zone was in thetitative survey completed by 971 corporate leaders and People zone.employees in Europe, Asia, and North America. Surveyresults further supported development of a comprehen- • In the healthcare sector, leaders who are most ef-sive new model of leadership and a related individual as- fective recognize their own strengths and liabilities,sessment instrument. adjust their approaches, adopt new strategies, and maximize the strengths, while minimizing the liabili-Part of our global study included a selection of respon- ties of others in their organizations.dents who represented organizations in healthcare. Theresponses from these participants from healthcare • Leadership training is particularly critical in thehelped shape our definition of what constitutes effective healthcare sector and, when implemented effec-leadership in healthcare settings. They also provided in- tively, may provide a key to organizational growthsights into similarities and differences between leader- at a critical time for the industry.ship in healthcare and leadership across other industries.The literature review, focus groups, and surveys providecompelling insights into current challenges and bestpractices for leaders across the healthcare industry.Here are some of the key findings and conclusions:• Leadership in the 21st century is more than ever a complex matrix of practices, which varies from one healthcare organization to another, along the lines of organizational size, scope of operations, and revenues.2 | THE PULSE OF LEADERSHIP IN HEALTHCARE
  3. 3. IntroductionAt every turn in the healthcare industry, there are signs of AchieveGlobal’s research on leadership principles raisedreform. Fundamental ways of doing business are chang- important questions about leadership today:ing, as organizations across the industry ramp-up to transi- • What major challenges confront 21st century leaders?tion into the healthcare information superhighway. • What changes are necessary for leaders to keepA major goal for the U.S. healthcare industry is achieving pace?the complete interoperability of electronic medical records(EMRs), as stipulated in the American Recovery and Rein- • What leadership practices remain important and rele-vestment Act of 2009 (ARRA). Major components of this vant?are the new operating procedures for providers that re- • What new practices are emerging in response to shift-ceive Medicare or Medicaid reimbursements. In order to ing priorities?receive significant financial incentives from the U.S. federalgovernment, these organizations are now required to Healthcare industry leaders and other employees also par-prove that they make “meaningful use” of electronic ticipated in this study, and their responses provided key in-records, helping patients manage their health and con- sights into how these challenges affect healthcare leaders.tributing to overall improvement of population health. We also gained understanding of what skills and practices are important to successful leadership in the 21st centuryAt the same time, healthcare practitioners and their partner healthcare industry.companies are also being called on to observe stricter stan-dards of privacy and security in their handling of all patientinformation based on HIPAA and the Privacy Require-ments of the Healthcare Information T echnology and Clini-cal Health (HITECH) Act.If these transitions weren’t complex enough to navigate,healthcare organizations, like all companies, are facingtough economic times, and must therefore successfullyevolve, while keeping an eye on shrinking budgets. Withall of these factors playing into today’s realities, individu-als in leadership roles in healthcare are facing criticalchallenges from within their organizations, as well asfrom the entire industry. THE PULSE OF LEADERSHIP IN HEALTHCARE | 3
  4. 4. Methodology: A Three-Phased Approach Central to this research study was the idea that analysis of 21st-century leadership concerns among leaders and employees would help develop a model that highlights key leadership practices for 21st Century leaders.
  5. 5. Central to AchieveGlobal’s research study was the idea In terms of size of operations, just over 40 percent ofthat analysis of 21st-century leadership concerns among participants worked for organizations with fewer thanleaders and employees would help develop a model 500 employees globally, while 23 percent were from or-that highlights key leadership practices for 21st century ganizations with between 1,000 and 9,999 employees.leaders. This model would: Over 13 percent represented organizations of having• Give leaders a useful tool to allow them to visually 10,000 and 25,000 employees, while just over 6 percent identify what strengths they (or others in their work were from organizations having 25,000 employees or environment) already possessed, and could there- more. fore use, and which potential liabilities they had to Figure 1. Number of Employees in Respondent work on or eliminate. Companies• Allow leaders to track changes in their leadership strengths over time by revisiting the model. 0% 3% 4%• Provide leaders with a leadership profile, which re- flected a detailed picture of effective leadership in 14% the 21st century. 41%The research involved both secondary and 23%primary research, including: 16%I. A literature review of peer-reviewed business and leadership journal articles and the development of a provisional leadership model Fewer than 500 10,000-24,999II. Testing of the provisional model with two focus 25,000-49,999 groups of leaders who responded to a preliminary 500-999 definition of leadership 50,000-100,000II. Further development of the leadership model and ad- 1,000-9,999 50,000-100,000 ministration of a survey in the United States, Mexico, India, China, Singapore, Germany, and the United Kingdom Taking the geographic scope of the healthcare organi- zations into consideration, almost 69 percent of partici- pants represented organizations that have domestic-Survey Demographics only operations (in only one country) and had 2008Among the 971 survey participants, there were 74 revenues of less than $50 million, while 14.9 percenthealthcare leaders internationally. One ostensible limita- were regional, 10.8 percent multiregional, and 5.4 per-tion to this report is that the sub-sample of healthcare cent of participants came from global organizations.providers comprised only 8.2 percent of the total sam-ple. However, our statistical analyses uncovered signifi- The healthcare leaders also described themselves incant differences between healthcare providers and terms of the number of direct reports, their currentleaders in other industries, suggesting that the industry leadership role, and the length of time they had beendifferences we found are likely valid. Additionally, the working at their current level. The largest group of par-sub-sample of healthcare providers was extremely di- ticipants had no direct reports, with the second largestverse, spanning four global regions, so the findings likely having between six and ten direct reports. The largestincorporate some degree of global generalizability. percentage of participants also had between two and ten years of experience at their current level.Healthcare participants were asked to identify the or-ganization in which they worked in terms of numbers of See Appendix 1.1 for further details on the demographicemployees globally, the geographic scope of their or- summary of healthcare participants.ganization, and their organization’s 2008 revenue. THE PULSE OF LEADERSHIP IN HEALTHCARE | 5
  6. 6. Key Findings – All Participants The Leadership Zone Model
  7. 7. The Leadership Zones Leaders strong in the Society Zone:The core finding of the overall research study was vali- • Act ethically to serve the larger good, not just todation that 42 practices—some behavioral, some cogni- obey the law.tive—are required to meet the challenges of • Encourage others to take socially responsible ac-21st-century leadership. The researchers sorted these 42 tion.practices into six categories, or “zones,” representedhere in a hexagonal model, in which each zone repre- • Openly challenge what they consider unethical de-sents seven unique practices, identified below. cisions and actions.Figure 2. The Leadership Zone Model • Take action to benefit others, not just themselves. • Recognize and reward others based on merit, not on politics. • Make fair decisions, even if they have a negative Business Reflection impact on the team. • Take steps to reduce environmental harm. Leaders strong in the Diversity Zone: People Society • Strive to meet the needs of customers representing other cultures. • Encourage collaboration among people from dif- ferent groups. Ingenuity Diversity • Display sensitivity in managing across cultural boundaries. • Collaborate well with people very different from themselves. • Effectively lead groups made up of very diverse people.Leadership Zone Attributes • Learn about the business practices of other cul-Leaders strong in the Reflection Zone: tures.• Take responsibility for their own mistakes. • Manage virtual teams with explicit customer-centric• Seek knowledge required to make sense of the big goals and practices. picture. Leaders strong in the Ingenuity Zone:• Examine what role they play in the challenges that their team faces. • Help other people to adapt quickly to changes.• Treat failure as a chance to learn and grow. • Help groups to develop a shared picture of a posi- tive future.• Reflect often on their performance as a leader. • Develop their associates with the goal of improving• Give serious consideration to opinions that differ overall group capabilities. from their own. • Solve real-world problems by thinking clearly and• Speak frankly with others to learn from them and engaging others. build trust. • Tell stories to motivate others toward strategic goals. THE PULSE OF LEADERSHIP IN HEALTHCARE | 7
  8. 8. • Create a work environment in which innovation can Reflection helps leaders avoid pitfalls in other zones, thrive. make the most of honest feedback, recognize the limits of their knowledge, and avoid repeating their mistakes.• Find ways to promote speed, flexibility, and innova- When leaders see their mistakes as a chance to learn tion. and grow, they gain the ability—and credibility—to help others adopt the same behaviors.Leaders strong in the People Zone:• Read a range of emotions in others and respond Society appropriately. In this zone, leaders apply principles—such as fairness,• Adapt to the leadership needs of different groups. respect, and “the greater good”—to balance individual and group welfare. Here, leaders attend to economic,• Help others resolve issues of work-life balance. environmental, and ethical matters that affect the larger• Make a daily effort to inspire the trust of customers society. and colleagues. Recent unethical business practices with worldwide con-• Minimize the negative human impact of decisions sequences highlight the need for leaders to serve and and actions. encourage others to serve a larger good. While every• Build and maintain a cross-functional task network. leader must achieve short-term goals, socially aware leaders know that some short-term goals sabotage• Communicate well with customers and colleagues long-term health—of the organization, the society, and at all levels. the planet.Leaders strong in the Business Zone: Diversity• Adapt quickly to changing business conditions. In this zone, leaders value and leverage human differ-• Manage the costs of operation. ences, including gender, ethnicity, age, culture, beliefs, and work styles. Here, leaders prove their ability to work• Learn new ways to make the business competitive. with diverse people and appreciate cultural perspec-• Develop and implement effective business plans. tives.• Analyze and use hard data to promote business re- This ability to derive value from human differences is a sults. core skill for 21st-century leaders. A global workforce re- quires a leader’s awareness of cultural nuances; a dis-• Manage customer acquisition, retention, and life- persed workforce requires structured yet flexible time value. leadership; a diverse workforce requires tailored collabo-• Add clarity to the organization’s vision and values. ration and coaching. All these tasks require leaders who balance their own strong identity with their daily effortA description of the six zones follows here: to understand people very different from themselves.Reflection IngenuityIn this zone, leaders assess their own motives, beliefs, at- In this zone, leaders offer and execute practical ideas.titudes, and actions. Reflective leaders look within and What’s more, they help others do the same by creatingask, “How can I make sure my own blind spots and bi- a climate in which innovation thrives.ases don’t cause me to make poor decisions?” and “Howcan I leverage my strengths to become a better leader?” Ingenuity is the currency of success in a capricious global economy. Closely allied is the ability to manage the changes—on both business and human levels—im- plied in every innovation. Ingenuity is vital as well to helping groups develop a motivating vision of future success.8 | THE PULSE OF LEADERSHIP IN HEALTHCARE
  9. 9. PeopleIn this zone, a leader’s ability to connect with others on ahuman level realizes enormous benefits, including im-proved communication of every kind.In part, leadership is getting work done through others –a real challenge without the skill and zeal to engagepeople in a team effort. Leaders effective in this zoneinspire trust and loyalty, weather difficulties through awide support network, soften the human impact of harddecisions, and encourage shared commitment to busi-ness goals.BusinessIn this zone, leaders develop strategies, make and exe-cute plans and decisions, organize the work of others,and guide effort toward predicted results.Yet 21st-century challenges demand more than text-book formulas. Beyond the hard skills of analyzing dataand managing costs, leaders must respond quickly tothreats and opportunities—a skill that requires close at-tention to key trends and events. Still vital is a leader’sability to shape the customer’s experience, but also tocultivate that customer’s lifetime value.Balancing these six zones can be daunting because it’snearly impossible to give equal attention to every zoneall the time. Even so, increased awareness of the zonesand activities can help leaders make conscious trade-offs in response to shifting conditions. THE PULSE OF LEADERSHIP IN HEALTHCARE | 9
  10. 10. Healthcare Specific Findings Healthcare leaders are being called on to make major and fundamental changes to how their organizations operate, especially as budgets shrink.
  11. 11. Pressing Challenges for Healthcare Leaders within healthcare leadership, but also indicate opportu- nities for making changes (such as leadership trainingLeaders within the healthcare industry who participated and development and succession planning) that wouldin the study were asked to identify the five most press- have significant impact on leadership effectiveness and,ing challenges that their organizations will face over the ultimately, organizational success. Its also worth notingnext one to three years. Not surprisingly, the challenge that deficiencies in the healthcare workforce further en-that received the highest ranking among leaders was hance deficiencies in healthcare leadership.“Cost pressures.” This is reflective of the current envi-ronment in which healthcare leaders are being called on See Appendix 2.1 for further detail on how participantsto make major and fundamental changes to how their ranked organizational challenges over the next one toorganizations operate, even as budgets shrink. three years.The second highest ranked challenge was “Controlling Figure 3. Challenges Among Healthcare Leadershealthcare costs.” Since healthcare leaders are at thefrontlines, facing the challenge of controlling healthcarecosts, it comes as no surprise that this particular chal- Most Pressing Organizational Percent oflenge ranked so high among survey participants. In- Challenges over the Next 1–3 Years Leadersdeed, for healthcare leaders, this challenge is two-fold: Cost (e.g., margin) pressures 37.8The industry struggles to come to terms with address-ing the issue of controlling healthcare costs, while Controlling healthcare costs 35.1healthcare organizations (like other organizations) also Improving customer satisfaction 35.1try to find ways to control the cost of healthcare cover-age for their own employees. Quality of leaders 32.4 Growing the business 32.4Tied for the second-highest ranked challenge amonghealthcare leaders was “Improving customer satisfac-tion.” Since the goals of HITECH, HIPAA, ARRA, TheJoint Commission and the Magnet Program are cumu- Figure 4. Challenges Among Other Industry Leaderslatively to improve quality, efficiency and security ofhealthcare, it stands to reason that a focus on improving Most Pressing Organizational Percent ofcustomer satisfaction would rank high among health- Challenges over the Next 1-3 Years Leaderscare leaders. Cost (e.g., margin) pressures 33.2As identified by the participants, the third most pressingorganizational challenge for healthcare leaders was Growing the business 31.0“Quality of leaders,” suggesting that there are likely is- Competitors 27.8sues relating to recruitment, learning and development, Employee productivity 27.2and succession planning within healthcare organizations.As a likely result of these first four issues, healthcare Improving customer satisfaction 25.6leaders also noted that growing the business was a majorchallenge. This stands to reason, since cost pressuresand an expressed concern about a dearth of leadershipquality would logically affect the ability to grow business.Leaders also ranked the challenges of “retaining talent,”and “employee productivity” as being of significant con-cern. The challenge of retaining talent suggests thatthere is room for healthcare organizations to re-examinethe motivation of their leadership, and also how leadersare affecting employee morale and, therefore, produc-tivity. These facts in particular point to existing liabilities THE PULSE OF LEADERSHIP IN HEALTHCARE | 11
  12. 12. Comparing Healthcare Leadership to The Zones of Leadership: Importance andLeadership in Other Industries Effectiveness of Leadership PracticesOur survey also revealed compelling differences be- Generally, both healthcare and general-industry leaderstween leadership in the healthcare industry and leader- highly endorsed all six zones of leadership (Reflection,ship in other industries across a few distinct areas. Society, Diversity, Ingenuity, People, and Business) as being important in meeting their organizational chal-While healthcare leaders identify “cost pressures,” “con- lenges over the next one to three years. Of the sixtrolling healthcare costs,” and “improving customer sat- zones, both healthcare leaders and other leaders rankedisfaction” as the top three challenges confronting their the Diversity zone lowest, with healthcare leaders indi-organization, other industry leaders ranked “cost pres- cating that they saw that particular zone as being ofsures,” “growing the business” and “competitors” as even less importance than other industry leaders.being the most pressing challenges that their organiza-tions would face over the next one to three years. It’s ev- Figure 5. Leadership Zone and Importanceident that healthcare leaders are less focused oncompetitive positioning of their organizations, and more Importance of the Six Zones for Healthcarefocused on the operational realities of doing business, and General-Industry Leaders General Healthcareas well as on meeting employee and customer needs. 40Not surprisingly, for all organizations, “cost pressures”ranked highest of all pressing challenges, as the econ- 39omy continued to govern deep and dramatic shifts. Is- 38sues related to competition would also likely differ from 37market to market, depending on whether a healthcareorganization operates in a competitive, urban setting 36versus a non-competitive, rural environment. 35One surprise came in the area of “technology chal- 34lenges,” which other industry leaders ranked as morepressing than did healthcare leaders. In light of the Reflection Society People Ingenuity Diversity Businesschanges under ARRA and the HITECH Act, it seemsthat technology challenges would rank higher for health-care leaders, who might be confronted with decisionsabout, for example, which electronic medical records Figure 6. Leadership Zones and Effectiveness(EMR) vendor is best equipped to meet their organiza-tional needs, and how to get employees to adopt new Effectiveness in the Six Zones of Healthcare andworkflow and systems using new technology. It would be General-Industry Leaders General Healthcaretelling to repeat this part of the study at a later date, 40since some of the definitions tied to ARRA and 38HITECH continue to take effect at the time of publica-tion of this report. 36 34See Appendix 2.2 for further details about the challengesconfronting other industry leaders. 32 30 Reflection Society People Ingenuity Diversity Business12 | THE PULSE OF LEADERSHIP IN HEALTHCARE
  13. 13. This discovery might be attributed to the sample demo- With major changes taking place in and around thegraphics, since all of the participants represented healthcare industry, this gap is cause for concern. It’shealthcare organizations that had a domestic focus and worth pointing out that it takes strength within the Peo-were operating in only one country. However, this find- ple zone for a leader to be able to communicate the sig-ing also highlights what might also be a missed oppor- nificance of such issues as controlling costs andtunity for healthcare organizations: Leaders that are adopting new technologies into overhauled workflows.ill-equipped to take into consideration and leverage dif- Without key strengths in the People zone, leaders willferences of age, gender, ethnicity, cultural origin, or val- be ill-prepared to help other employees balance theues and beliefs are more likely to miss vital opportunities stresses of work with the stresses of life, or even earn theto draw on the opportunities that such diversity can respect and trust of their colleagues. Since the health-bring. On the other hand, leaders who are well care industry is focused on patient care more than everequipped to navigate and leverage diversity within the before, lacking leadership strength in the People zoneworkplace are better able to communicate across cul- also points to a lack of commitment to meet the needstural barriers, and put to work the real value of having of patients. Obviously, this draws further focus on thesuch diversity. point that leaders in the healthcare industry need lead- ership development that specifically builds strengthIts also worth noting that within the healthcare environ- within the People zone.ment, diversity is considered less important than forother industry leaders because of the already existing Our leadership research confirms that leaders whosetrends of diverse workforces within healthcare. For ex- strengths lie in the “Reflection” zone are betterample, a recent study in the journal Health Affairs indi- equipped to adjust to blind spots and to leverage othercates that 25 percent of all doctors in the United States zone strengths. Further, the better a leader is able toare graduates of foreign medical schools. recognize his or her own assets and liabilities, the better that person will be able to adapt new strategies, andOne discovery is that leaders in the healthcare industry recognize assets and liabilities in others. In the presentfeel that other leaders in their organizations were not as context, with increasing demands being placed oneffective as they should be, to a far greater degree than healthcare organizations, it would serve leaders withintheir other-industry counterparts. This suggests that these organizations well to develop their ability to re-while healthcare leaders are ranked as being generally flect on strengths and liabilities, and those of others.effective, there is room for improvement. Leaders would then be better equipped to build on strengths and minimize or eliminate liabilities within theOur research looked at the gaps between how partici- context of the overall strategic direction of the organi-pants rated importance of a zone versus how they rated zation.the effectiveness demonstrated by their organizationalleaders in that zone. Among healthcare participants, the With this in mind, leadership training is more relevantlargest discrepancy, or gap, showed up in the “People” than ever in the healthcare sector, as organizations learnzone, showing that while participants thought that it was how to navigate this time of critical change.very important that leaders should possess strengths inthe People zone, they rated their organizational leaders See Appendices 2.3 and 2.4 for more details on howas ineffective in this zone. healthcare leaders and other industry leaders ranked im- portance and effectiveness of the six leadership zones. THE PULSE OF LEADERSHIP IN HEALTHCARE | 13
  14. 14. Implications and Conclusion Numerous recent scholarly studies and books that focus on healthcare organization and management empha-Without question, the healthcare industry continues to size the significance of effective leadership withinexperience some of the most significant challenges it healthcare1. From navigating a global recession to gear-has faced in recent times. With federal regulations and ing up for major legislative change, healthcare organi-associated definitions still being finalized, leaders within zations face radical change and must positionhealthcare and healthcare-linked organizations will con- themselves to respond. Leaders within the healthcaretinue to redefine what constitutes effective leadership. industry play an integral role in how their organizationWe may also see changes in how they rate their own meets the needs of multiple stakeholders: from patientsleadership, in terms of the importance they place on to technology suppliers, the federal government and, ofspecific practices, and how effectively they achieve the course, their own employees. Even more fundamentally,criteria of successful leadership. they play a role in helping to improve overall populationThrough all of this, leaders—and specifically healthcare health, a broader goal of recent changes in regulation.leaders—are most effective when they are actively aware Ultimately, healthcare leaders must remain sensitive toof the complexity of multiple challenges they face, and all of these factors, even as they guide their organiza-the spectrum of practices that are important to success tions toward success.at the individual, organizational, and industrial levels. Aswith leaders in other industries, healthcare leaders mustbe fully cognizant of their own strengths and liabilities.They also need to possess the skills and determine thecombination of leadership practices required to build onthe strengths while minimizing the liabilities of others, sothat they can ultimately build organizations that canweather the shifts and navigate the changes unfoldingaround them.There is also the issue of succession in healthcare andthe fact that in healthcare organizations there may be atendency to promote within organizations. Added tothis, there are issues related to licensing requirementsthat further add complexity of hiring, succession, andleadership training. 1 See for example the book, Leadership in Healthcare by Richard Gunderman, and the arti- cle, “Managing in a Downturn: How do you manage in a global financial recession?” in Journal of Healthcare Management. May, 2010.14 | THE PULSE OF LEADERSHIP IN HEALTHCARE
  15. 15. AppendixAppendix 1: Demographic Figure 3. Organizational revenue in 2008Information—Healthcare Participants 2008 Revenue PercentThe following tables provide summaries of how partici-pants described their organizations and themselves. Less than $50 million 56.8Figure 1. Number of Employees Globally $50 million–$250 million 20.3# of Employees Globally Percent $250 million–$500 million 10.8Fewer than 500 40.5 $500 million–$1 billion 4.1500–999 16.2 More than $1 billion 8.11,000–9,999 23.010,000–24,999 13.5 Figure 4. Number of Direct Reports # of Direct Reports Percent25,000–49,999 2.7 None 27.050,000–100,000 0.0 1–5 20.3More than 100,000 4.1 6–10 18.9Figure 2. Geographic Scope of Operations 11–20 10.8Geographic Scope Percent 21–30 1.4Domestic (operates in only one country) 68.9 31–40 5.4Regional (operates in one global region) 14.9 More than 40 16.2Multi-regional (operates in severalglobal regions) 10.8Global (operates in all major global regions) 5.4 THE PULSE OF LEADERSHIP IN HEALTHCARE | 15
  16. 16. Figure 5. Current Leadership Role in Organization Appendix 2: Comparisons BetweenCurrent Leadership Role Percent Healthcare Leaders and All Other LeadersNo direct reports 32.4 2.1 Challenges Among Healthcare LeadersManage first-line associates 28.4 Figure 1. Most Pressing Organizational Challenges Over the Next 1-3 Years, as Percent of Leaders inManage first-line managers or supervisors 12.2 Healthcare Organizations Most Pressing Organizational Percent ofManage the managers of first-line managers Challenges over the Next 1–3 Years Leadersor supervisors 6.8 Cost (e.g., margin) pressures 37.8Manage one or more major areas of the Controlling healthcare costs 35.1organization 10.8 Improving customer satisfaction 35.1Manage the entire organizational unit 9.5 Quality of leaders 32.4 Growing the business 32.4 Retaining talent 28.4Figure 6. Time at Current Level in Organization Employee productivity 27.0Time at Current Level Percent Driving sales growth 24.3 Technology challenges 21.6Fewer than 2 years 21.6 Expanding into new markets 20.32–10 years 35.1 Attracting talent 20.3 Competitors 17.610–20 years 18.9 Achieving operational excellence 16.2More than 20 years 24.3 Product/service innovation 14.9 Gaining access to capital 12.2 Regulatory environment 12.2 Ethical leadership practices 10.8 Responding to changing customer buying patterns 10.8 Lack of trust among leaders and employees 9.5 Insufficient talent overall 9.5 Being perceived as “green” (environmentally responsible) 9.5 Changing methods of distribution 9.5 Creating virtual workplace structures 8.1 Demonstrating corporate social responsibility 6.8 Insufficient number of leaders 6.8 Diversity in the workforce 5.4 Succeeding with mergers and acquisitions 2.716 | THE PULSE OF LEADERSHIP IN HEALTHCARE
  17. 17. 2.2 Most Pressing Challenges among Leaders Appendix 2.3 Leadership Zone and Importancein Other Industry Organizations Importance of the Six Zones for HealthcareFigure 2. Most Pressing Organizational Challenges and General-Industry Leaders General HealthcareOver the Next 1-3 Years, as Percent of Leaders in Other 40Industry Organizations 39Most Pressing Organizational Percent of 38Challenges over the Next 1-3 Years Leaders 37Cost (e.g., margin) pressures 33.2 36Growing the business 31.0 35Competitors 27.8 34Employee productivity 27.2Improving customer satisfaction 25.6 Reflection Society People Ingenuity Diversity BusinessTechnology challenges 25.1Driving sales growth 24.8 Appendix 2.4 Leadership Zones andExpanding into new markets 23.9 EffectivenessProduct/service innovation 21.9Retaining talent 19.6 Effectiveness in the Six Zones of Healthcare and General-Industry Leaders General HealthcareQuality of leaders 18.8 40Achieving operational excellence 16.6 38Responding to changing customer buying patterns15.3 36Attracting talent 14.7 34Controlling healthcare costs 12.6 32Gaining access to capital 12.1 30 Reflection Society People Ingenuity Diversity BusinessLack of trust among leaders and employees 11.2Regulatory environment 9.9Being perceived as “green” (environmentallyresponsible) 9.8Changing methods of distribution 9.3Diversity in the workforce 9.1Succeeding with mergers and acquisitions 8.0Ethical leadership practices 8.0Insufficient talent overall 7.2Demonstrating corporate social responsibility 6.9Insufficient number of leaders 6.5Creating virtual workplace structures 6.4 THE PULSE OF LEADERSHIP IN HEALTHCARE | 17
  18. 18. Appendix 3. Accuracy of the Six Zones ofLeadership ModelIn order to test how internally reliable and accurate theleadership instrument was in measuring leadership inter-nationally in the healthcare and general-industry sec-tors, a Cronbach’s alpha was calculated for each sampleon both the “Importance” scores and the “Effectiveness”scores. The alphas for the healthcare “Importance” and“Effectiveness” scores were .982 and .986 respectively,and the alphas for the general-industry “Importance”and “Effectiveness” scores were .975 and .980 respec-tively. All of these alphas are truly outstanding (1.0 isperfect), suggesting that the instrument is very reliablein its ability to measure leadership in both the health-care and general-industry sectors. Additionally, all sixsubscales of the leadership instrument correlated veryhighly with each other in the “Importance” and “Effec-tiveness” components for both the healthcare and gen-eral-industry samples. All correlations except one wereabove .50 and are considered large-sized effects. Thesehigh correlations suggest that the six domains of leader-ship tapped by the instrument all triangulate on a largerleadership construct. In other words, the six-zone ap-proach in which leadership was conceptualized in thisinstrument is likely very accurate for both healthcareand general-industry leaders internationally.18 | THE PULSE OF LEADERSHIP IN HEALTHCARE
  19. 19. About The ContributorsDouglas G. Stark Chris BlauthDirector Organizational and Workforce Development - Director of Product Strategy, AchieveGlobalUniversity of Texas Medical Branch Chris, Director of Product Strategy, spearheadsDoug and his team support over 12,000 faculty and AchieveGlobal’s efforts to develop and maintain prod-staff in academic medicine. Since 2000, he has played a ucts that will prepare leaders at all levels of an organiza-critical role in developing a leadership academy ad- tion. Chris holds a B.S. in Accounting and Finance fromdressing the development needs of leaders at all levels the University at Buffalo, and an MBA in Marketingand launched an on-line training system that houses from Canisius College.over 80 courses. Doug holds a BBA in Marketing and aM.A. in Organizational Communications from Western Rosalyn LavesMichigan University. Strategic Account Manager, AchieveGlobalCraig Perrin Rosalyn works with companies around the world to buildDirector of Solution Development, AchieveGlobal customer loyalty, improve sales performance, and build leadership skills. Her clients tend to be focused in theAs AchieveGlobal’s Director of Solution Development, healthcare industry, and she serves as the strategic or-Craig is a thought leader who works cross-functionally chestrator for all of BlueCrossBlueShield relationshipsand with clients to guide creation of a range of responses with AchieveGlobal. Prior to joining AchieveGlobal,to market needs. Since 1986 he has played a central role Roz worked as an Assistant Director for Outpatientin developing the company’s flagship programs in lead- Care at UT M. D. Anderson Cancer Center. She holdsership, sales, and customer service. Craig holds a B.A. B. A. and M. Ed. degrees.and M.A. from San Francisco State University. THE PULSE OF LEADERSHIP IN HEALTHCARE | 19
  20. 20. About AchieveGlobal In the 21st century, the level of human skills will determine organization success. AchieveGlobal provides exceptional development in interpersonal business skills, giving com- panies the workforce they need for business results. Lo- cated in over 40 countries, we offer multi-language, learning-based solutions—globally, regionally, and locally. We understand the competition you face. Your success depends on people who have the skills to handle the challenges beyond the reach of technology. We’re experts in developing these skills, and it’s these skills that turn your strategies into business success in the 21st century. These are things technology can’t do. Think. Learn. Solve problems. Listen. Motivate. Explain. People with these skills have a bright future in the 21st century. AchieveGlobal prepares you for that world. World Headquarters 8875 Hidden River Parkway, Suite 400 Tampa, Florida 33637 USA Toll Free: 800.456.9390 www.achieveglobal.com© 2010 AchieveGlobal, Inc No. M01346 v. 1.0 (10/2010)

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