10 leadership lessons from "The Front-Line Leader"

Chris Van Gorder, CEO of Scripps Health, has been a remarkable leader for the San Diego-based, five-hospital system. After joining the system in 2000, at a time when the medical staff had voted no confidence in the previous administration and the system was losing millions, Chris led its remarkable $150 million turnaround. And he did so without any layoffs. Today, Scripps' facilities routinely appear in national hospital rankings, and the system recently opened a $220 million cancer center and has a $450 million cardiac center in the works.

If you ask him how he did it though, he's quick to correct you: He didn't do it, the more than 13,000 dedicated physicians and staff did. He just guided them.

In fact, guidance — through vision, purpose and empowerment — is a key theme of his new book, "The Front-Line Leader: Building a High-Performance Organization from the Ground Up" (Jossey-Bass, 2014).

The book provides numerous leadership lessons and stories that highlight the importance of inclusive but accountable leadership. Here are 10 of our favorites:  Frontlineleader

1. Leadership should be hands-on. You can't understand your organization, its challenges and opportunities by staying in your office all day. Chris is the epitome of a hands-on leader, visiting departments and asking to be bossed around, so he can understand the duties of each team. His efforts have led to his assisting in surgery and even using a floor polisher under the supervision of the environmental staff. Hands-on leadership breeds trust, which is critical to gaining the buy-in of employees.   

2. Great leaders have a passion for what they do. That is, they love the industry they're a part of, not just leading. Chris started his career as a police officer in California. He was hospitalized after a domestic disturbance call that ended in him being hit by a car. While in the hospital, he became in awe of the care he received from his nurses. He recovered, but his injuries left him unable to return to the force. He asked the hospital that treated him to hire him as director of security. He got it by agreeing to work for minimum wage for 90 days. He proved himself, and the rest is history: He earned his master's in healthcare administration from University of Southern California and began working his way up through the hospital administration ranks. The experience of being a patient made him understand the importance of healthcare to our society and engrained in him a passion to improve it. 

3. The best leaders recognize organizational success isn't about the top of the organization, but the bottom — the front-line leaders. The leadership approach Chris shares is somewhat counter-intuitive: Leaders lead down, not up. He advocates leading or managing "down," whereby each level of management ensures those below have the tools and support they need to do their jobs well.

4. Leadership success is largely due to communication. Having a vision for an organization is one thing, but achieving it requires the buy-in from front-line workers and their understanding of what behaviors are needed to reach it. How do you gain buy in? Through communication and education. Employees don't have to love every decision leadership makes, but they need to understand the 'why' behind it.

5. Being a good communicator requires being accessible and responsive. Chris is a brilliant leader and skilled communicator. He understands the importance of communicating with all stakeholders, especially employees, and hosts regular town halls to hear employee concerns and feedback. And he's a whiz at email. Try emailing him; you'll likely hear back in less than an hour. He responds quickly because he values others' input, and wants to demonstrate that.

6. Stories are powerful communication tools. "The Front-Line Leader" includes numerous stories, many of them personal, sharing lessons that have influenced Chris's leadership style. In the book's opening chapter, he shares a story from when he was a night security guard: He was in the basement of the hospital and no one was around, and he sees the CEO walking toward him. Excited for the opportunity to meet him and say hello, Chris adjusted he uniform and walked toward the CEO. The man walked right on by, as if he wasn't even there. Chris tells the story, some 30 years later, in an effort to convey the importance of personally connecting with employees. The message is powerful, and he uses the story approach to explain organizational decisions too, often drawing on patient stories to do so.

7. You can learn a lot from simply observing your organization. At Scripps, all vice presidents must do this, thanks to Chris requiring it: Sit in the lobby for an hour and just observe. Without a doubt, each VP comes back with a handful of ideas to improve processes and the patient experience.

8. Great leaders are humble. They understand their success comes not in isolation but from engaging and empowering others. He writes, "Physiological distance can by extremely dangerous for leaders" and emphasizes the importance of conveying the idea of working "together" with employees. We think he's on to something, as recent research suggests simply using the word "together" is a great motivator. Chris goes beyond that though, getting to personally know as many of Scripps' employees as he can

9. You can't always be nice. Great leaders hold people accountable. "Our new managers are nervous why they first hear my rule: Miss your numbers once, you won't be around to miss them a second time," he writes. Great leaders also hold themselves accountable. "Make no mistake: If I ever miss my numbers, I won't tell my board 'I couldn't have predicted' what happened. I will urge them to hold me and the team just as accountable for our performance as we do everyone else at Scripps.

10. Leadership isn't rocket science, but it is action. A lot of Chris' thoughts on leadership are not new. However, they resonate really well in part because of how well he has embraced and lived many of them. Anyone can read leadership lessons, but great leaders live them.   

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