Running a hospital is an important and hard job. Running it well is even harder. Commanding a Navy ship or squadron is not unlike running a hospital; you have a staff, employees, physical spaces, budgets, operations and more, all of which you are expected to lead. But leadership — the ability to lead effectively — is not innate. While it's easier for some people to "be in command" than others, there is more to being an effective leader. The most effective leaders are those who study people, learn to manage relationships, are passionate about what they do and have a lot of experience.
To raise the level of your leadership ability, there are five tenets you should remember and put into practice every day. If you do, the rewards to your hospital will be plentiful and your organization will benefit.
- It's all about the people. If you subscribe to the theory that people are your most precious resource, which you should, then this is obvious. If it's not obvious, consider the capital investment your hospital makes in its people: salary, training, insurance, pension, etc. Some hospitals spend more than 50 percent of their operating capital on people. Given the large investment in people, it’s worth making sure you get it right. Depending on the size of your organization, it might be difficult to personally take care of everyone's needs. But, if you make sure the level below you is taken care of, and make sure they do the same for the level below them, and so on, then everyone benefits. And remember, you likely have multiple generations represented among your employees, who place importance on different ideals. Be flexible enough to understand and help them all.
- Lead from the front. Generally, people like to be led; it's human nature. So be visible. Spend time with and in front of your people. "Management-by-walking-about" is a common term for this. Get out of your office, maneuver the corridors of your organization and interact with your staff. Then take it a step further; communicate with your people regularly — in person, if possible. Let them know who makes the decisions that affect them, and more importantly, why. They may not agree with you, but they will respect you for explaining your reasoning.
- The rule of three. Running a healthcare organization can be broken down into three parts: what's going on now, plans for the future, and your people. In an ideal world you would be able to spend a third of your time on each area. But, ideals are just that — ideals. How you divide your time is the key, and there is no set answer or formula to determine the best ratio for your organization. In a larger organization, you may spend more time taking care of your staff and employees (because there are more of them) — which may mean you have less time for future planning (keeping your ship going in the right direction). To keep your organization on course, it is vital to have reliable people you can count on to help manage your daily operations.
- Make a decision. During the course of a day, a leader makes many decisions, some of which result in a major impact on their organizations. Leaders want to make the right decisions; but all too often they delay making a decision because it is difficult, they can't make up their mind or the outcome is unpopular. It can take a lot of time to ensure you have all the information you need to make a decision, and that you understand the issues and potential consequences. Your staff may spend even more time helping you prepare to make a decision. They can often see an obvious (to them) solution. They want you to see it too; this validates their hard work and empowers them to move forward. The result of not making a decision, however, can undermine your leadership and erode your staff's trust. So, for some decisions, 80 percent is good enough — make the decision. When you must delay a decision, explain your reasoning. Your people will respect you for the explanation. They will also gain a better understanding of the information you need and your point of view for future projects or decisions.
- Control your culture. The culture of an organization is vital to its success. A good culture will improve your retention and make your hospital more profitable and productive. So, what makes a good organizational culture? Frankly, it's having a leader who does the previous four things. But there are some questions you can ask yourself, and the answers may tell you if you are heading in the right direction:
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- Do you have a culture? (Do you wear jeans to work? Is that good? Do you have dress-down Fridays? Do you have mentor programs, or reward and recognition programs, etc.?)
- Are you compliant with federal and state laws? Are you doing the right and moral thing (can you look at yourself in the mirror every morning)? Is your organization following the rules of business ethics? Do you have a code of honor or ethics?
- Do your people enjoy working for you? Do they feel valued? Are they contributing members of the team? Do they want to have your job — because it's the best job in the organization?
- And finally, do you remember tenet no. 1? It’s all about the people!
Leadership can be learned, and good leaders can always get better. Spend some time out of your office, making the rounds. Rounding is an effective way for administrators to engage physicians and nurses and build trust. Ask questions. Ask employees for their input, and listen to their responses. Be open to change, be honest with your people, build trust, and they will respond in kind.
Captain Patrick Cleary is a retired naval officer who served multiple combat tours flying over Iraq and Afghanistan. During his career, Capt. Cleary gained experience on a number of major staffs and had several operational commands including command of Carrier Air Wing EIGHT. He now lives in Glen Allen, Va., and is president of the consulting firm Gold Wing Advisors LLC. He can be reached at: prcleary@goldwingadvisors.com.
J. Stephen Lindsey, FACHE, was CEO at HCA Henrico Doctors' Hospital for 16 years. He has served as an affiliate professor in the MHA program at Virginia Commonwealth University. Mr. Lindsey is a principal of Ivy Ventures, LLC, a consulting firm that helps hospitals grow outpatient service lines. He is a fellow of the American College of Healthcare Executives. He can be reached at: slindsey@ivyventures.com.
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