Assessing Leadership in the New Era of Healthcare Delivery: 5 Key Questions to Ask

Hospital and health system leaders today face myriad challenges unique to the current healthcare environment that are often more demanding than the challenges faced by leaders of the past. Ten or 15 years ago, healthcare leaders were primarily judged by the operating margins of the facilities they oversaw, and hospitals were less frequently judged by their performance against various clinical and quality performance measures, says Quint Studer, founder of Studer Group. Today, hospital senior executives are juggling a handful or more overall organizational goals, and increased transparency means poor performance is identified and dealt with more quickly.

In order to be as prepared as possible for the obstacles they'll face, healthcare leaders should assess their capabilities as a leader by asking themselves the following five questions, which reflect key behaviors of successful healthcare leaders.

1. How well am I able to align the organization toward common goals? Healthcare executives must be able to set strategy and goals for the organization and then ensure they are executed, which means aligning each and every employee in the organization toward meeting those goals. To successfully align employees, Mr. Studer says leaders should connect desired outcomes to the organization's values. "If we can connect values to desired outcomes, then it becomes too uncomfortable for employees not to meet the goals," he says.

Leaders can increase the likelihood of driving the behavioral changes required to meet these goals by explaining the "why" behind the change. "Healthcare employees aren't robots — nor do you want them to be — who will do some action just because a healthcare leader asks them to," says Mr. Studer. "They're smart people; I find most people will adjust behavior or repeat desired behaviors if you explain why the change will help the organization [meet its goals]." For example, nurses that are asked to perform hourly rounds on patients may question the new requirement at first, but are likely to become advocates of the change if they learn it improves patient satisfaction scores and are reminded increasing these scores by a certain percent is a core goal for the hospital.

2. Do all employees in my organization have the same urgency toward meeting these goals?
While aligning the organization toward goals builds a strong foundation for organizational success, the best healthcare leaders don't stop there. They also ensure all employees have the same urgency as the senior leadership team, says Mr. Studer. "Many senior leaders assume employees see the world in the same way they do," he says. However, that's often not the case. A recent survey by Studer Group found that 31 percent of front line managers believed that if the organization kept operating the same way it is currently, it would stay the same, be better or much better. This is at odds with senior healthcare leaders, many who understand staying the same is likely to spell disaster for a hospital.

"Leaders need to explain the environment to provide the right amount of urgency. The goal isn't to paralyze [employees], but to get everyone working at the pace needed to achieve goals in the right amount of time and get the organization where it needs to go," says Mr. Studer.

3. Are the organization's goals cascaded down throughout every level of the organization and incorporated into every employee's individual performance measures?
In addition to communicating organizational goals and driving alignment through more macro-level communication, healthcare leaders also need to ensure each employee understands his or her specific role in meeting the organization's goals. This means larger institutional goals should be cascaded down into individual employee performance measures. For example, a hospital with a goal of decreasing admit times might require its housekeeping staff report to a room within a certain agreed-upon timeframe after a patient is discharged to turn the room over. Employees who fall short on performance measures should be provided with training, resources and other development opportunities to enhance their skill sets. "If someone is not meeting goals, it's normally not for a lack of trying or passion," says Mr. Studer. "It's more a lack of skills."

Mr. Studer also recommends performance measures for mid- and senior- level healthcare leaders assess performance against standardized "leadership" behaviors, such as performing weekly rounding on departments the leader oversees, which can help keep alignment in check. He also says senior-level leaders need to be very careful about the behaviors they're modeling. "If I'm not passionate, I bet the people below me won't be passionate. If I'm not confident we can solve an issue, the issue probably won't get solved," he says.

4. Am I adequately mentoring and developing colleagues and others for future healthcare leadership? Development and mentoring cannot be relegated just to the human resources or organization development department, says Mr. Studer. Instead, the best healthcare leaders take an active role in mentoring others within and outside their organization. He shares the following example to illustrate how many leaders have fallen short in mentoring: Senior leaders rank their ability on various leadership skills, such as running a meeting effectively or hiring appropriate candidates, very highly, while the leaders rate those they manage lower and lower as they move down the hierarchy. "Leaders need to ask, 'Why I haven't developed the person below me to run a good meeting or hire well?'" he said.

Mr. Studer also recommends healthcare leaders reach out to local healthcare management graduate programs and the Association of University Programs in Health Administration, which he says are always eager for professional contacts and feedback on which skills are most valuable to the students' future employers.

5. To what extent have I helped the organization achieve its desired outcomes?
Most importantly, leaders should assess their ability to ensure the organization meets its strategic goals, an idea Mr. Studer borrows from Jim Collins, author of "Good to Great." The book describes the highest level of leadership, referred to as a Level 5 leader, who are those leaders that achieve the desired outcomes of the organization. "Leaders should really take this personally," says Mr. Studer. He encourages leaders to relentlessly pursue organizational goals and refuse to accept pushback from those within the organization who aren't making the goals a priority.

How to improve

Leaders who are concerned about their answers to the above questions should begin by developing the core skills that are needed to reach these outcomes, such as communication skills, business and financial skills and knowledge of the healthcare environment, by assessing where they are now and identifiying one or two core skills to address first. "You can't do all at one time," says Mr. Studer. "Pick one or two at a time. For example, if you really focus on communication, that ties in with a lot of issues."

The American College of Healthcare Executives publishes a competencies assessment for healthcare executives that can serve as a good starting point to help leaders decide which areas to target first. It can be downloaded at

More Articles Featuring Quint Studer:

Quint Studer: Mastering the Fine Art of Follow-Up
Quint Studer: One Simple, Powerful Way to Improve Communication at Your Hospital
Quint Studer: Raising HCAHPS Is About More Than Better Service…It's About Better Quality

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