10 Traits of Top Healthcare Leaders

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Today's hospital leaders face a daunting task: keeping their organizations afloat and their employees happy while battling uncertain mandates of healthcare reform and fighting increased competition for patients, physicians and payor contracts. Paul Spiegelman, founder and CEO of The Beryl Companies, a technology focused patient experience company, discusses 10 traits of great hospital and health system leaders in the tumultuous healthcare climate.

1. Remember … you're in the relationship business! When Mr. Spiegelman speaks to a room full of executives, he often starts by asking, "What business are you in?" He says the responses vary: the woodworking business, people will say, or the hospital business. He very rarely hears the response he is looking for, which is "the relationship business." Being a good leader means focusing your energy on the relationships required by your position, he says.

In a hospital, this means relationships with your employees, your senior leadership team, your suppliers and vendors, your competitors and your patients. Make sure that you are focusing on building good relationships rather than simply reporting strong revenues; you'll find that the two go hand-in-hand and that financial stability is harder to achieve when you neglect the people you work with.

2. Hire superstars.
The scarcity of jobs in the current recession means there are a lot of talented people looking for jobs, Mr. Spiegelman says. "I don't think any organization should settle for having people in their organization that are not the best," he says. If your organization suffers from unmotivated or unskilled employees, it may mean you did not spend enough time recruiting the right people.

Don't hire employees quickly because you need to fill a position at the hospital; respect the recruiting process and make sure every person you hire is a good fit for the culture of your organization. Mr. Spiegelman says his company puts senior executives through as many as 17 interviews before they receive a job offer. This may not be practical for every nursing position at your hospital, but you should take the time to determine how many "rounds" are needed to ensure the best fit for each job.

3. Don't overlook the small things.
When leaders think of their jobs, they may focus on the big decisions: merging with another hospital, for example, or expanding the cardiovascular wing. But Mr. Spiegelman says the small, day-to-day tasks of an executive can be just as important in building a great organization. "It's the small things we do that can make an impact on people's lives," he says. "My whole focus is to start that impact internally with small gestures, personal note cards and acknowledgements. It's about going out and rounding and walking the floors. That's what makes people feel valued."

Mr. Spiegelman says some CEOs might feel these tasks are less important than major strategic decisions, but he feels that small gestures are directly correlated with the financial health of an organization. If employees feel appreciated, they are more likely to do their jobs well and follow organizational "best practices," potentially avoiding expensive clinical errors or damage to the organization's reputation. Employees who feel acknowledged are also less likely to leave their jobs, saving the hospital money in hiring and training new staff.

4. Never be a bottleneck.
Don't let emails, contracts and other important documents sit on your desk until a project has been delayed for weeks, Mr. Spiegelman says. As the CEO of Beryl, "I have to be the most responsive person in our company," he says. "There are plenty of ways for projects to slow down, and I don't want it to be because of me." He says there are many different tactics for stopping bottlenecks; one of his personal goals is to keep his inbox under 20 emails at all times. "If I have more than 20 emails in my inbox at the end of the day, I feel like I'm behind," he says.

If you are having trouble moving projects off your desk, you may not be delegating enough, Mr. Spiegelman says. A good leader should be able to trust his or her employees and colleagues to take charge of projects. "As an effective leader, I should be more of a traffic cop than a doer," he says. "I should be able to appropriately delegate most work that comes my way. Why should I have an inbox with 1,000 things to look at if I have a leader in every area?"  

5. Treat your organization as a reflection of yourself.
Make sure you understand the impact you have on your organization — both positive and negative, Mr. Spiegelman says. If your organization is struggling financially and employee satisfaction is low, look to your own actions before you blame the economy or your competitor across the street. On the other hand, if your organization is thriving and employees are proud to come to work every day, look at your recent work and take note of how you have contributed to that atmosphere.

6. Do what you say you're going to do — when you say you're going to do it. Accountability starts with you, Mr. Spiegelman says. He recently heard a speaker describe personal accountability as acting "above the line" or "below the line." In this analogy, acting "above the line" means taking responsibility for projects, owning up to mistakes, looking for solutions when things go wrong and taking immediate action.

Acting "below the line" means pointing fingers at other people, ignoring the situation or not doing adequate research into the problem to understand it. He says an organization can improve employee accountability by talking about these actions on a daily basis. "The concept of 'above the line' and 'below the line' is so simple in the way that it's structured that in two weeks, people will already say, 'I'm just going to go below the line for a second' or 'Let's all get back above the line' in meetings,'" he says.

7. Give your employees a voice.
As the CEO of an organization, you may have a lot of great ideas to improve finances, satisfaction and strategic direction. But if you take credit for every idea you feel is "yours," you risk losing employee loyalty because they feel undervalued. Instead of stating a solution yourself, ask your employees if they have suggestions. Even if they come up with the exact idea you had in mind, they will feel empowered by taking ownership of the idea. He likens the concept to Marriott International President and CEO Bill Marriott's famous quote: "The seven most important words a leader can say are: I don't know. What do you think?"

8. Weed the garden. Mr. Spiegelman sees employee engagement and performance issues as a "big problem in healthcare." When he walks into hospitals, he often sees veteran employees who are no longer contributing to the organization but are kept around because of bureaucracy, tenure or politics. "I think we have a responsibility as leaders to make sure we have the right people," he says. This means hiring the right people in the first place, but it also means letting go of underperforming employees once you identify a problem. He says the hospital should have a clear structure around warnings, discipline and firing. Employees should know exactly how well they are performing on a month-to-month basis, based on conversations with their superiors and performance reviews. "The biggest problem we have is that we don't let people know where they stand or put a timeframe around it," he says.

Mr. Spiegelman says underperforming employees should be able to shape up in 3-6 months. A bigger problem may be those employees who simply do not "fit" within the culture of an organization. "They could have skill but they just don't fit, in which case you have the responsibility to act immediately," he says. "If you know in your gut that the person is not going to be part of your organization long-term, you owe it to them to act now."

9. Get out of "the zone."
Every hospital CEO has "comfort zones" where he or she feels most secure, Mr. Spiegelman says. The trick to being a great leader is to regularly break out of those comfort zones and do something that makes you uncomfortable. Mr. Spiegelman says he is naturally introverted and would be most comfortable in his office, making deals with his feet up on the desk. However, he knows his presence "on the floor" is important to his employees, so he makes sure to walk around every morning and greet his colleagues.

If you're not sure where your weaknesses lie, you might benefit from a 360-degree evaluation, which takes into account the opinions of your subordinates, colleagues and bosses. "How your peers feel about you can be pretty sobering sometimes — but also very useful," Mr. Spiegelman says. Once you have identified a few problems in your performance through the 360-review, try to do a few things every week to combat those weaknesses.

10. Understand the personal vision of your employees.
CEOs spend a lot of time talking about the mission, vision and values of their hospitals, but they may go years without thinking about the mission, vision and values of their employees. Mr. Spiegelman says hospital leaders should try to understand how their employees' personal desires fit with the strategic direction of the hospital. In some cases, these desires may clash and cause problems for the hospital. If employees want to spend more time at home and the hospital is understaffed, the two needs will clash and likely force employees to compromise their family time.

Mr. Spiegelman says while a CEO can't realistically talk to every employee in his or her organization about their hopes and dreams, leaders can use a "cascading approach" to touch every department in the hospital. For example, the leader of the nursing department can conduct a survey to determine the priorities of the hospital's nurses. "No one's pretending that they know the personal vision of 2,000 people, but if you set the example with those you're closest to and demand that they do the same down the line, that's how you get feedback."

Learn more about Beryl.

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