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Driving Leadership Development in Healthcare:
The Challenges, The Opportunity, and Imperative
Marie E. Sinioris, National Center for Healthcare LeadershipRobert G. Riney, Henry Ford Health Systems
Allan L. Weisberg, National Center for Healthcare Leadership
October 9, 2007
SHRM Foundation Thought Leaders Retreat
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© 2007 National Center for Healthcare Leadership.
When we realize the everlasting truth of “everything changes”, and find our composure in it, we find ourselves in nirvana
- Shunryu Suzuki
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© 2007 National Center for Healthcare Leadership.
The Transformation Mandate
Healthcare leadership needs to be prepared for its biggest challenges with intensifying demands on the industry for excellent outcomes and better value
- Michael Porter, Redefining Health Care, 2006
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© 2007 National Center for Healthcare Leadership.
The significant problems we face cannot be solved at the same level of thinking we were at when we created them
- Albert Einstein
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© 2007 National Center for Healthcare Leadership.
Challenges in Healthcare Leadership
National Summit on Future of Education and Practice in Health Management and Policy, 2001 Industry Challenges (cost and quality) Succession/recruitment Mentorship declines Mid-advanced career education offerings Practitioner-academic collaboration Diversity
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© 2007 National Center for Healthcare Leadership.
NCHL Vision
Evidenced Based
Leadership Development
Improved Leadership
Improved Organizational Performance
Improved Health Status
Optimize the health of the public through leadership and organizational excellence.
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© 2007 National Center for Healthcare Leadership.
NCHL Strategy
Span the industry reaching comprehensively across: Career levels: career-entry, mid-career, advanced career Industry sectors: providers, suppliers, insurers, policy Professional disciplines: administration, nursing, medicine, behavioral
health, pharmacy Academia and Practice
Develop programs based upon sound research and global best practices
Focus on rapid development, testing, and deployment of programs
Accelerate adoption of best practices through learning collaboratives and benchmarking
Systematically evaluate programs to assess learning outcomes and performance improvement – evidence based management practice
Broad Dissemination to the field via collaboration
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© 2007 National Center for Healthcare Leadership.
What is unique about healthcare leadership?Values-based, mission-driven industry
Breadth of “customers” literally encompasses the entire population – local, regional, national, international
Demand and supply dynamics for critical talent requires that leaders create climates that attract and retain top talent in a highly competitive market
Complexity and mix of independent constituencies requires higher levels of influence and consensus-building than most leadership roles
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© 2007 National Center for Healthcare Leadership.
Social sector Leaders are not less decisive than business leaders . . . They only appear that way to those who fail to grasp the complex governance and diffuse power structures common to the social sectors.
— Jim Collins, Good to Great and the Social Sector: A Monograph to Accompany Good to Great, 2005
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© 2007 National Center for Healthcare Leadership.
COMPETENCYAny characteristic of a person that differentiates outstanding from typical performance in a given job, role, organization or culture
Behaviors
Attitudes
Values
Other Characteristics
SkillKnowledge
BaselineNecessary fortop performancebut not sufficient
Distinguishingcharacteristicsthat lead to longer-termperformanceand success
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© 2007 National Center for Healthcare Leadership.
The Competency Study Process
GENERIC MODEL
EXPERT PANEL + BENCHMARKING +
STRATEGIC INTERVIEWING
EXPERT PANEL
HYBRID MODEL (5-15 BEI’s)
FULL-SCALE BEI-
BASED MODEL (20+ BEI’s)
HEAVY DUTY
RESEARCH-BASED
MODEL (35+ BEI’s)
TARGETTIPPING POINT/
ALGORITHMR O I
CRITICALITY/PRECISION & VALIDITY OF RESULTS
INV
ES
TM
EN
T $
$$
Relationship between methods & validity of results
BENCHMARKING
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© 2007 National Center for Healthcare Leadership.
NCHL Competency Research
Future Vision
• IOM Agenda
• Futurists
What defines today’s best
health leaders?
In-depth Interviews
• 84 Total
• Career Stages
• Professions
What can we learn from
others?
+
Benchmark Findings
• Health
• Pharma/biotech
• Insurance
• Global Leaders
+What will the 21st Century require?
NC
HL
Co
mp
eten
cy M
od
el
What technical and behavioral characteristics create outstanding performance?
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© 2007 National Center for Healthcare Leadership.
Three Domains of the NCHL Model
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© 2007 National Center for Healthcare Leadership.
Scaled Competencies
Competency levels increase by degree of difficulty
Influence
Deg
ree
of
So
ph
isti
cati
on
4. Develops behind the scenes support
3. Uses indirect influence
2. Anticipates impact of actions or words
1. Engages audience
TargetLevel
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© 2007 National Center for Healthcare Leadership.
NC
HL
Com
pete
ncy
Mod
el b
y C
aree
r Sta
ge
Integrated Learning Model
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© 2007 National Center for Healthcare Leadership.
NCHL Integrated Learning Model
Executive Level
Managing Managers
Managing Others
Lear
ning
Mod
aliti
es
PeopleTransformation ExecutionManaging
Self
© 2007 National Center for Healthcare Leadership & General Electric Co.
Confidential & Proprietary Information
Institute for Transformational Healthcare Leadership
Preparing leaders to innovate and drive high
performance
Leadership development programs “equip”
healthcare leaders to be successful throughout
their careers
Front-Line Managers
Senior Executives
Managers of Managers
Operating Cycle
Strategic Alignment
Performance
Management
Talent Review &
Succession
Values & Competencie
s
NCHL’s evidence-based approach to leadership development focuses on action learning for healthcare leaders
GE’s proven approach to leading change and sustaining a performance culture
One system grounded in world-class research and execution of leadership
development:
Recruitment &
Selection
Learning & Developme
nt
Nursing Medicine Administration
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© 2007 National Center for Healthcare Leadership.
Critical Success Factors
Shared vision – leadership and organizational transformation Accountability for learning and performance outcomes Information for evaluation, continuous feedback and
benchmarking Commitment of resources, time, and energy
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© 2007 National Center for Healthcare Leadership.
Greatness is not a function of circumstance. Greatness, it turns out, is largely a matter of conscious choice, and discipline.
— Jim Collins, Good to Great and the Social Sector:
A Monograph to Accompany Good to Great, 2005
Henry Ford Health Systemand
National Center for Healthcare Leadership
Robert G. RineyExecutive V.P./Chief Operating Officer
Henry Ford Health SystemOctober 9, 2007
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© 2007 National Center for Healthcare Leadership.
Coming together is a beginning;
keeping together is a progress;
working together is success.
-Henry Ford
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© 2007 National Center for Healthcare Leadership.
Henry Ford Health System Overview
Henry Ford is one of the nation’s leading comprehensive health systems, providing acute, specialty, primary and preventative care services, backed by excellence in research and education.
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© 2007 National Center for Healthcare Leadership.
Creating the “Leadership Development Experience” at Henry Ford Health System
In 2003 HFHS joined NCHL as a LENS member.Recently we had the opportunity to more fully leverage the power of that relationship.Over the last 7 months HFHS and NCHL have come together to create a Leadership Development Experience for the Executive team at HFHS.By integrating with internal programs we have been able to offer a comprehensive approach to leadership development.Our leaders are enthusiastic and engaged and there appears to be a renewed spirit around the importance of leadership development and talent management.
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© 2007 National Center for Healthcare Leadership.
“Leadership Development Experience”
The “Leadership Development Experience” process encompasses the identification of competencies, leadership simulations, 360-degree feedback tools, climate surveys, group and individual development plans, and executive coaching opportunities.
Each of these elements will be linked to performance management, talent reviews, and succession planning.
This process incorporates many of our own initiatives and is managed internally to create a true sense of ownership and sustainability within our organization.
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© 2007 National Center for Healthcare Leadership.
“Leadership Development Experience”
As our Executive team progresses through their own “Leadership Development Experience” we have the opportunity to create a stronger culture of openness around leadership and coaching.
Currently we are completing the assessment phase and have begun the executive coaching feedback sessions.
We will conclude the initial phase in October with a clear development plan for our leadership team.
Together the Executive team and the HR leaders will evaluate this process and determine how to best roll out the experience to other levels of leadership within the organization.
The following slides outline our current Leadership Development process for our executive team.
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© 2007 National Center for Healthcare Leadership.
ASSESSMENTSINDIVIDUAL FEEDBACK
GROUPFEEDBACK
DEVELOPMENTAND
ONGOINGPERFORMANCE MANAGEMENT
Performance Management: Aligning and developing leader competencies and skills to enhance overall capabilities in
achieving individual and organizational goals.
“Leadership Development Experience”
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© 2007 National Center for Healthcare Leadership.
- Group Simulation Experience (teams of Executive Leaders) - Group Feedback Sessions (same teams from Simulation)
Provided by The LEAD Center
ASSESSMENTS
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© 2007 National Center for Healthcare Leadership.
The LEAD CenterIn 2006 HFHS invested in developing our own leadership simulation center. This center is referred to as: The LEAD Center (Leadership, Evaluation, Assessment, and Development).
The Center is a “Cognitive Simulation Center” aimed at assessing and developing leaders’ decision-making skills as they pertain to strategic thinking, creativity, vision integration and execution, and crisis response.
The LEAD Center specifically addresses innovation, teamwork, conflict resolution, the act of engaging stakeholders, change management, crisis resolution, and strategy development.
This Leadership Development Framework will incorporate the use of the LEAD Center as both an assessment tool for group feedback and as a development tool for individual growth.
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© 2007 National Center for Healthcare Leadership.
- Leadership 360 Degree Evaluation- Organizational Climate Survey (cultural audit)
Provided by NCHL
ASSESSMENTS
- Group Simulation Experience (teams of SET members) - Group Feedback Sessions (same teams from Simulation)
Provided by The LEAD Center
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© 2007 National Center for Healthcare Leadership.
National Center for Health Care Leadership (NCHL)
NCHL’s vision is that an integrated leadership development system model will lead to improved leadership and organizational performance resulting in improved health status.
NCHL’s mission is to be a catalyst for industry-wide collaboration to assure that high quality, relevant and accountable health management leadership is available to meet the needs of 21st century health care.
In 2003 HFHS made a commitment to work with NCHL as a member of the Leadership Excellence Network (LENS) to further develop HFHS leadership capabilities. NCHL works with a collaborative group of progressive healthcare systems across the country all dedicated to evidence based learning and development.
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© 2007 National Center for Healthcare Leadership.
The leadership competencies that are assessed in the 360 degree evaluation are categorized into three categories:
1) Transformation 2) Execution 3) People
NCHL Continued
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© 2007 National Center for Healthcare Leadership.
NCHL Continued
The Organizational Climate Survey assesses a Leader’s skills as it relates to creating a culture of:
Flexibility
Responsibility
Standards
Rewards
Clarity
Team Commitment
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© 2007 National Center for Healthcare Leadership.
NCHL Leadership 360 Degree Evaluations Organizational Climate Survey (cultural audit)
- Preference Indicator SurveyMYERS BRIGGS TYPE INDICATOR (MBTI)
ASSESSMENTS
- Leadership 360 Degree Evaluation- Organizational Climate Survey (cultural audit)
Provided by NCHL
- Group Simulation Experience (teams of SET members) - Group Feedback Sessions (same teams from Simulation)
Provided by The LEAD Center
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© 2007 National Center for Healthcare Leadership.
Myers Briggs Type Indicator (MBTI)
This tool assess individual preferences in order to provide better awareness regarding individual style and team dynamics.
The MBTI reports preferences on four dichotomies, each consisting of two opposite poles:
Extraversion and Introversion (Where you prefer to get your energy)Sensing and Intuition (How you prefer to take in information)Thinking and Feeling (How you make decisions)Judging and Perceiving (How you deal with the outer world)
This assessment will be used to enhance the awareness and understanding of team dynamics and enhance an individual’s ability to flex to other preferences.
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© 2007 National Center for Healthcare Leadership.
ASSESSMENTS INDIVIDUAL FEEDBACK
INDIVIDUAL LEADERSHIP DEVELOPMENT
HFHS will provide all Leaders with a written comprehensiveDevelopment Package which will include:1) Results from all Assessments (NCHL, LEAD Center, MBTI)2) Individual Development Plan a) Executive coaching opportunities b) Current HFHS University offerings c) Additional learning opportunities/programs3) 90 Day Action Plans
NCHL will provide a facilitated feedback session to review the Development Package with each Leader in a coaching and feedbackSession to create their Individual Development Plan.
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© 2007 National Center for Healthcare Leadership.
ASSESSMENTS
GROUP LEADERSHIP DEVELOPMENT PLANNING SESSIONS (SET)
HFHS and NCHL will co-facilitate a Group Leadership Development Planning Session with all SET members to:
1) Review the composite results and identify strengths and opportunities for improvement in relationship to HFHS strategic goals and values.
2) Create a Group Development Plan, organize priorities and determine action items to support organizational strategies,
goals and outcomes.
GROUPFEEDBACK
INDIVIDUAL FEEDBACK
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© 2007 National Center for Healthcare Leadership.
ASSESSMENTSGROUP
FEEDBACKINDIVIDUALFEEDBACK
DEVELOPMENTAND
ONGOINGPERFORMANCE MANAGEMENT
Leaders participate in ongoing development opportunities identified within their Individual Development Plan.
Leaders participate in a customized Individual Simulation session from the LEAD Center. (one time experience)• Simulation will focus on Leader’s specific strengths and opportunities for improvement as part of a development opportunity.• Leaders participate in an individual feedback session.• Results will be incorporated back into their Individual and 90-Day Development Plans.
Ongoing Performance Management• Leaders review 90-Day Action Plan quarterly with development Coach (TBD).• Leaders report results of their development progress back to their respective Senior Leader for additional feedback.• Leaders incorporate 90-Day Action Plan activities into annual Performance Evaluations. All development activity should align with Leader’s key goals and objectives.
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© 2007 National Center for Healthcare Leadership.
Next Steps
In addition to our Executive Team members we currently have 9 high potentials from each of our Business Units participating in the Leadership Development Experience.
Following the completion we will evaluate this process and determine how to roll out this experience as part of our overall Succession Planning strategy.
Competency-based Succession Planning
Allan L. Weisberg, Senior Vice President
National Center for Healthcare Leadership
October 9, 2007
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© 2007 National Center for Healthcare Leadership.
Succession Planning at Johnson & Johnson
Long history, 40+ years Disciplined approach, business cycle process, i.e. financial, strategic
planning, business planning Accountability of leaders, no longer need to justify the why “Bottom up” process goes from operating company to the Executive
Committee Matrix view, i.e. operations, marketing, research, etc., cross-
organizational moves Internal executive search process – cross-organizational,
functional/geographic movement is encouraged and expected Talent is a “Corporate Asset”
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© 2007 National Center for Healthcare Leadership.
Elements of Succession Planning at Johnson & Johnson
Element Why
Strategic/Operational Plan Organizational/people/competency implications
Organizational Metrics(including non-financials)
Actual organizational performance, used as a calibrating mechanism
Organizational Strength Determine ability of current team to successfully create and implement strategic/operational plan, includes hire, fire, development plans
Replacements/Back-ups & Vulnerability
Likelihood of vacancies, ready now, ready later, need for development/external recruiting
High Potential Review Ensure the retention and development of high performers and high potentials, and appropriate movement
Leadership Pipeline-- Retention
-- College recruiting
-- Cross-organizational movement
-- Interns/external recruiting
Determine whether progress is being made, ensure appropriate pipeline of talent
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© 2007 National Center for Healthcare Leadership.
Observations about Healthcare
Why? No shareholder equity Careers governed by function as opposed to organizations Healthcare systems from individual hospitals Mentality of “buying it” rather than “developing it” Tenure of CEOs “Business processes can’t work here” mentality
For a long time, talent management was not valued?
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© 2007 National Center for Healthcare Leadership.
Healthcare organizations are getting the message that great leadership is vital to great results
Incredible healthcare challenges Outside boards Shortage of current and future talent Success rate of “external” hires Exposure to other organizations, i.e.
GE Johnson & Johnson IBM 3M
Need for more business focus and accountability
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© 2007 National Center for Healthcare Leadership.
What will it take for healthcare organizations to be successful in developing and retaining great talent? CEO commitment, backed up by a great HR leader, i.e.
actions vs. words Sticking to it with discipline and rigor Accountability of all leaders Talent as a “system-wide” asset Get started “do a little, learn a lot”