Health system CEOs' leadership styles are evolving

After the last few years of guiding organizations through the pandemic and facing extreme financial and operational challenges this year, health system CEOs are turning to a tried-and-true leadership tactic to balance growth and innovation with the realities of shrinking margins, workforce shortages and increased competition: authentic leadership.

Harvard Business Review defines authentic leaders as those who "have high standards of integrity, take responsibility for their actions, and make decisions based on principle rather than short-term success."

"I consider myself a collaborative leader who uses coaching techniques to develop my team while we problem-solve. However, leaders must be able to adapt their management styles to different situations," said Alexa B. Kimball, MD, president and CEO of Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Center in Boston. "During COVID, for example, our organization needed quick and decisive decisions in a crisis, so I adjusted my approach to be more centralized and declarative. That worked very well for us during the pandemic, but now that we're entering a new phase, I can switch back to my intuitive style so the organization can continue to thrive."

Authentic leaders create meaningful relationships while achieving their goals, according to HBR, which are tied beyond the bottom line to the organization's mission.

"I have worked and continue to work to build an organizational culture that is rooted and thrives on authenticity, kindness, vulnerability and transparency," John Couris, president and CEO of Tampa (Fla.) General Hospital told Becker's. "Each day I practice authentic leadership, where I strive to show up as my most authentic self, be transparent and communicate honestly and openly with my team, be vulnerable about my challenges, and show the level of kindness we all deserve as human beings. My expectation is that my team takes note of my approach and my behavior as a leader and reflects that back in the work they do with their team members and colleagues."

The healthcare industry is going through massive changes this year. A March 2 Fitch report estimated nonprofit hospital finances would get worse before they get better. Nonprofit hospitals had weaker profitability and liquidity last year than in 2021 and expenses increased while investments dropped. Margins aren't expected to hit pre-pandemic levels any time soon and labor shortages are expected to keep wages high.

Authentic leaders understand the difficulties, but won't let them stand in the way of meeting goals and creating a mission-driven culture.

And it doesn't happen overnight.

"People who are successful in leading others know that it’s a skill you practice every day, with the goal of continuous improvement over time," said Cliff Megerian, MD, CEO of University Hospitals in Cleveland. "It’s not something you’re just 'born' to – it takes dedication, a substantial amount of self-reflection and hard work. But the rewards are great. By constantly trying to better yourself as a leader through reading and self-study, you can then develop other leaders in your organization."

Dr. Megerian said his approach has been leading with humility, honesty and transparency, and he prizes careful listening to get caregivers' input on changes. He has an open-door policy to encourage candid discussions for moving the health system forward.

Holly McCormack, DNP, RN, president and CEO of Cottage Hospital in Woodsville, N.H., also considers herself an authentic leader focused on transparency.

"It is essential to be as transparent as possible," she said. "This transparency is vital to building and developing trust within a team. My strong sense of self and morality are key attributes typically associated with authentic leadership. I hope these characteristics help set the tone for my team and become the foundation of a healthy workplace culture. As we know, a positive workplace culture is paramount for recruiting and retaining an engaged workforce."

An engaged workforce trusts leaders to make decisions in the best interest of patients and the organization. Executives had to make many tough decisions over the last three years to keep patients and staff safe during the COVID-19 outbreaks and then play a crucial role in the vaccination efforts. Leaders earned the trust of their teams then, and strive to keep it by combatting burnout and redesigning their organizations as healthcare delivery evolves.

"The culture at Queen’s, as modeled by our entire leadership team, is one of collaboration and partnership," said Jill Hoggard Green, PhD, RN, president and CEO of The Queen's Healthcare System in Honolulu. "I encourage every leader within our organization to maintain close contact with their team members, and it is a priority for me as well. I am strengthened as a leader when I'm able to hear from our frontline caregivers first-hand about how we have and can continue to make a difference for the communities we serve."

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