Collaborative Healthcare Leadership

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1 A White Paper Coaborative Heathcare Leadership A Six-Part Mode for Adapting and Thriving During a Time of Transformative Change By: Henry W. Browning, Deborah J. Torain, and Tracy Enright Patterson Issued September 2011

2 CONTENTS Introduction: A Leadership Mode for Heathcare Transformation Six Essentia Organizationa Capabiities The Payoff: A Cuture of Coaboration Concusion About the Mode: CCL s Research and Experience Impact Stories Additiona Resources About the Authors and Contributors

3 Introduction: A Leadership Mode for Heathcare Transformation For decades, U.S. hospita administrators and medica professionas have operated within a chaenging, rapidy changing and fragmented heathcare system. Today, this environment is even more compex as sweeping heathcare reform and market forces transform the way heathcare is deivered and managed. This profound shift is both structura and cutura. New aiances and unikey partnerships are beginning to emerge. Beief systems, vaues and attitudes are shifting. Creative thinking and agie, adaptive eadership wi be required to make hospitas, heath systems and networks sustainabe as the heathcare deivery andscape transforms. As this unknown future state unfods, one thing is a given: Incrementa responses wi not be enough. The competencies required of eaders and their organizations must continue to evove in order for both to thrive. Rapid innovation and adaptation to change require a coaborative, interdependent cuture and soutions that cut across function, region and profession. Leaders must earn to shift away from the individua expert mode so common in today s heathcare systems and move towards a mode that everages cross-boundary groups and teams and spans discipines, eves, functions, generations and professions. These new coaborative groups wi be abe to integrate knowedge throughout the system and to anticipate and sove unprecedented chaenges a whie deivering efficient, high-quaity, compassionate patient care across the continuum. 3

4 The Center for Creative Leadership (CCL ) has deveoped a mode that heath systems can use to adapt and thrive in uncertain times by creating direction, aignment and commitment. It is based on mutipe research studies, our in-depth invovement with a diverse group of hospita systems and networks and our eadership deveopment work with thousands of heathcare eaders from across the sector. Our mode focuses on six essentia organizationa capabiities that are a prerequisite for success in this new word order: Coaborative Patient Care Teams Resource Stewardship Taent Transformation Boundary Spanning Capacity for Compexity, Innovation and Change Empoyee Engagement and We-being We ve aso identified key eadership practices needed in each of these six areas in order to maximize effectiveness. Through this eadership ens, heathcare organizations can carify their business chaenges and become highy adaptive and innovative in response to change. They can shift their cuture and transform the business and mission of heathcare. In the white paper that foows, you find detais on CCL s mode, as we as the research projects and rea-word experiences that have ed to its deveopment. Six Essentia Organizationa Capabiities The successfu heathcare organization of the future wi deveop and impement a eadership strategy that systemicay addresses priorities and is supported by the eadership practices needed to achieve organizationa goas and to adapt to rapid change and uncertainty. CCL offers a six-part mode heathcare organizations can use to assess their own eadership strengths and weaknesses and to customize their eadership deveopment efforts. In a practica way, it matches up very rea needs with the eadership skis and capabiities that wi make the most difference with the common, underying thread of coaborative eadership. Heathcare organizations wi, as a resut, have the opportunity to approach eadership deveopment in a strategic, comprehensive way whie deaing with rea and immediate pressures. As an organization s commitment to coaboration becomes visibe and is reinforced, it wi see improvements in the abiity to set direction, estabish aignment and gain commitment. 4

5 1 Coaborative Patient Care Teams Deivering safe, quaity, compassionate care is the primary mission of any heathcare organization. Given that roes within the patient-care team are highy interdependent in nature, coaboration skis are crucia. This is especiay true in acute care situations invoving doctors, nurses and the teams they manage. With heathcare reform, though, the patient-care team wi ikey extend to incude cinicians outside the hospita environment. Accountabe care organizations, integrated cinica networks and other new deivery modes wi pace a much greater emphasis on higher-order coaboration skis that go far beyond working we with others. Concrete group process skis are needed to promote open communication, earning, trust and quaity decision-making. Whie coaboration is important throughout the hospita, it is especiay important at the patient interface. The abiity to ensure patient care is determined not ony by technica expertise, but aso by the eadership effectiveness of a those invoved in soving the presenting medica issues. These individuas are eading the patient-care experience as they foster a new contract for working together. Often, true eadership is independent of forma roes and responsibiities. It aso shifts throughout the patient-care experience. Therefore, effective care depends on coaborative teamwork. This is especiay true between physicians and nurses. Whie diagnosis and prescription of treatment has traditionay resided with the physician, nurse practitioners and physician assistants have increasing responsibiity for carrying out the treatment pan. It wi be essentia that management systems take into account shifting responsibiities over the course of the patient s care. Whie new structures are evoving, ceary the distribution centers for care are expanding, and who is responsibe for impacting the patient s ong-term heath and we-being is changing. From a eadership deveopment perspective, the key to tacking these daiy team-effectiveness chaenges ies in greater empoyee engagement, coaboration and earning agiity. Leadership Practices Engaging doctors, nurses and other caregivers in shared ownership of the patient-care experience using concrete diaogue and istening skis across roes. Creating an environment that supports earning agiity and adapting to change. Coaborative probem-soving and decision-making with a members of the patient-care team. 5

6 2 Resource Stewardship In an age of increasing accountabiity, resource stewardship is both a big-picture, system-eve obigation and a series of daiy decisions. As heathcare reform unfods, new business modes and restructuring wi emerge to manage costs whie deivering compassionate, quaity care. On the macro eve, heathcare organizations must ook far ahead to understand how the unfoding future impacts their current structures and business modes. They urgenty need to seek out opportunities to reduce costs. Decisions about investments and partnerships are made knowing that trade-offs wi be required. Resource stewardship requires individua ownership and accountabiity for the decisions that wi utimatey aow the system to thrive and manage its resources judiciousy. At the micro eve, administrators, physicians, nurses and other stakehoders must manage the tension between individua patient care and operationa constraints. They need to adapt to new modes and structures and be innovative and visionary in their approach to cost-effective patient-care modes. Hospitas need both patient-focused business professionas and business-minded cinicians who can keep patient care top of mind. Ony through education and diaogue can comprehensive soutions be reached. Aignment is created when caregivers and business eaders reach a common understanding of the cinica strategy as we as the business strategy. To be effective resource stewards, eaders must have a soid understanding of performance metrics, incuding financia indicators, empoyee engagement, patient resuts and satisfaction. In addition, eaders need to identify key measures, appy data in strategic ways and identify, discuss and resove probems. Leadership Practices Accountabiity, transparency and integrity. Scanning the environment and seeking innovative soutions. Appreciating and combining compassionate care needs with business strategy. Entrepreneuria; generating new ideas and seizing opportunities. 6

7 3 Taent Transformation CCL s research shows that heathcare organizations need visionary eaders who can inspire and deveop empoyees, buid and mend reationships effectivey, ead and motivate teams, and engage in participative management. In addition to these core competencies, new and different eadership skis wi be required to see heathcare organizations through a change that has not been equaed since Medicaid and Medicare were estabished. (Jarousse, 2010; Doon 2010) Leaders of heathcare systems wi need to hire and deveop taented individuas who can see the next wave of pausibe soutions and innovations and ead transformationa change. Hospitas and heath systems are managing a transitioning workforce. The physician s roe is evoving from independent practitioner to hospita empoyed coaborator. The roes of executive nurse eaders are expanding and the responsibiities being eevated. As new staffing modes emerge, hospitas sti face an ongoing nursing shortage and an aging nurse and physician workforce. (RWJF Committee on the Future of Nursing, 2011; Buerhaus, 2009) As the taent poo shrinks and demands increase, hospita, outpatient and cinica workforces are stretched thin. An investment in eadership taent is one way to engage empoyees, buid bench strength and prepare for future eadership needs. (McAearney, 2010) Physicians and nurses who are promoted into eadership roes need support and deveopment as they make the transition, enabing them to approach the roe as effectivey as possibe. As in business, often the most technicay proficient individuas are promoted to manageria positions without the sefawareness, emotiona inteigence and other eadership competencies required for success. Throughout the system, eadership taent can be grown and supported in mutipe ways, incuding extensive use of feedback, coaching and deveopmenta assignments. As part of a we-articuated business strategy, heathcare organizations need comprehensive strategies for identifying, hiring, deveoping and retaining eadership taent. Buiding a cuture rich with assessment, chaenge and support heps to grow the taent pipeine. Buiding and growing a poo of peope capabe of taking on arger and more compex eadership roes can transform the organization. Leadership Practices Accessing a arger taent poo, beyond the traditiona arena of heathcare speciaty. Redefining a new eadership strategy in the face of the new structures and modes associated with reform. Identifying, deveoping and retaining the eadership taent needed to create and impement soutions in the face of rapid and evoving change. Creating a cuture that encourages and vaues mutua respect and professiona practice. 7

8 4 Boundary Spanning At the beginning of a panning retreat, the president of a arge regiona hospita tod his staff, We ve soved a the probems we can by peope working in their functions and groups. The next wave of soutions wi have to come from peope working across boundaries to create innovative and nove answers to the compex probems in heathcare. Even within a singe hospita, numerous ayers of hierarchy, mutipe departments and a variety of service ines can serve as bureaucratic boundaries to systemic innovations. The hospita-empoyed nursing staff, technicians, assistants and physicians work around the cock, exchanging information and trading roes across shifts. Each department has its interna hierarchy and roes, but each reies on and interacts with severa speciaties to support even a singe patient. Further compicating the situation are the many and varied hospita/physician reationships. Hospita-owned physician practices and physicians in private practice who contract with the hospita (and may even partner with hospita competitors) a have demands and circumstances that make coaboration a significant chaenge. In such a fragmented system, boundaries (any form of us versus them ) are prevaent and powerfu. Whie these boundaries may have been frustrating or chaenging in the past, today they are serious iabiities that ead to arduous and sow processes and watered-down poicies. The roe of senior hospita administrators is to coordinate between and among these ayers in a broad way. But eaders at a eves must have boundary-spanning capabiities. The most pressing chaenges in hospitas and heath systems cannot be soved by one person, one speciaty or one organization. They require expertise, ideas and support from mutipe perspectives and stakehoders. Heathcare eaders must deveop the abiity to bridge departmenta, cutura, organizationa and industry divides. They must earn to break down barriers and sios and ead across traditiona boundaries. Boundary-spanning eaders draw on networks and reationships as they work systemwide to meet the mission of heathcare. Leadership Practices Expanding and everaging strategic networks to fast-track soutions. Thinking, acting and infuencing systemicay. Leveraging differences to drive innovation. Co-creating toos for practica appication and sustainabe change. 8

9 5 Capacity for Compexity, Innovation and Change The poitica, reguatory and marketpace forces driving heathcare reform have everyone guessing what the andscape wi ook ike when the process unfods. What is cear is that change is coming hard and fast. Heathcare eaders must navigate a continuous whitewater. Whie infuencing, monitoring and responding to unfoding change, they must respond to demographic shifts in the workforce and among patients, technoogica advances, the tumutuous nature of empoyee reationships, insurance and reimbursement processes and current reguatory practices. Compexity and change come from a directions: reguation and mandates, diagnostic and treatment protocos, technoogica advances and impementation of new systems (such as eectronic medica records). Hospita staff must adapt in the moment to the crisis at hand, whie ooking ahead to changes that wi come from new patterns of iness and emerging ethica and caregiving issues. Compexity is often ess about soving a probem and more about managing an organizationa, situationa or market paradox. Managing the paradox and the opposing camps of stakehoders is a highy speciaized ski set that is often deveoped in parae with organization savvy and wisdom. Effective eaders hep move popuations from od estabished processes to new modes of effectiveness. They understand the underying emotiona impact of change and how it varies by individua. They act with empathy and authenticity to hep individuas make the menta shift to embrace change rather than resist it. In addition to compexity and change, heathcare organizations aso must master innovation. Chaenges cannot be soved through heroic individua efforts. True innovation stems from coaboration across departments and functions interna and externa to the organization. To innovate, eaders must adapt ideas from outside their area of expertise within the hospita as we as from outside the industry. Reading and thinking more broady is the responsibiity of a those sitting in eadership positions. Interdependent eadership in support of a common purpose needs to become the cutura norm (not the exception) in order to get peope thinking more broady and more strategicay. Open and responsive eaders earn together to make coective sense of ambiguity and to find innovative soutions to compex probems. This is not just the strategic view at the top of the organization, but a way of operating at a eves, especiay on the frontine of caregiving. 9

10 From the care of an individua patient to managing the restructuring of a mutisystem organization in response to heathcare reform, heathcare organizations are pressed to buid their capacity for compexity, change and innovation. Leadership Practices Driving innovation and risk-taking in the midst of ambiguity and uncertainty. Transforming the cuture from dependent to interdependent. Leading both the structura and human side of change and transition. 6 Empoyee Engagement and We-being Why are empoyee engagement and we-being eadership issues? Both impact the very mission of a heathcare organization. Research on heathcare effectiveness, suggests that quaity of care is positivey infuenced by nurses being satisfied with their jobs and feeing empowered in their roes. (Regan & Rodriguez, 2011) Frontine supervisors often do itte eading and serve mainy as information conduits for a myriad of new reguations, poicies, procedures and mandates. To compound this probem, nursing shortages and ong shifts have heathcare professionas strugging to maintain their own heath and we-being. Those working in hospitas are often pagued with a host of medica probems reated to the physica and menta demands of the job. Energy drain and staff burnout create safety and iabiity probems for organizations, imiting effectiveness and innovation. One goa of heathcare reform is to increase the engagement of the patient, the heath system and the community in preventive measures. Hospitas must begin to mode the way forward through the support they provide to their own peope. Empoyees are most productive and committed to their organization when they are engaged emotionay, mentay and physicay. Without a proactive focus on empoyee engagement and we-being, the chaenges of the next few years have the potentia to create new eves of burnout within the rank and fie. Heathcare organizations cannot afford for patient care to suffer due to ack of ideas, skis, time and taent. They have no choice but to adapt, change and innovate. Organizationa eaders must take an integrated approach to heping empoyees maintain heath, maximize their energy, and fee both connected with their work and aigned with the organization. 10

11 Energy is a specia concern in heathcare, with around-the-cock needs and high-intensity work in an emotionay charged setting. Human energy is essentia for fu empoyee engagement and satisfaction, both personay and professionay. Lack of energy cannot be resoved through time-management efforts aone, though. The probem is often systemic. For exampe, adequate staffing can be a critica component so patient-care teams are not stretched too thin. Energy is optimized when both eaders and organizations vaue the whoe person, inking individua heath and we-being to organizationa heath and webeing through purpose, integrity and accountabiity. The utimate goa is for the organization to create a cuture in which peope care as much for themseves and each other as they do for their patients. This type of cuture has true bottom-ine impact by increasing retention, reducing grievances and minimizing costy errors. Leadership Practices Creating an integrated approach to engagement and we-being. Maximizing human energy and potentia in service of the organization s mission. Fostering a cuture in which the peope who work in the organization are treated as we as the peope they serve. (Incudes encouraging a heathy work/ife baance, sustainabe staffing modes.) The Payoff: A Cuture of Coaboration Coaborative eadership is the coective activity of setting direction, seeking aignment and buiding commitment. (Drath, McCauey, Paus, Van Vesor, O'Connor & McGuire, 2008) We use the word coective because eadership does not reside within the individua, but rather is the shared responsibiity of a required to fufi the mission. CCL s eadership mode for heathcare transformation focuses on the deveopment of six organizationa capabiities that can hep to create a coaborative eadership mindset. It is based on the utimate goa of deveoping an interdependent eadership cuture that wi ead to quaity, compassionate patient care in the face of the adaptive chaenge. The cuture must be experienced and the vaues must be practiced at every eve in the system, from frontine care providers to top-eve executives. In hospitas and heath systems, there are two key areas in which coaboration is especiay critica. The first is the reationship among caregivers at the bedside, which impacts patient care and heath outcomes. The second is the reationship between cinica services and business operations, which is critica to the overa sustainabiity of the entity. 11

12 Successfu heath systems must strive toward bridging the divide and work toward a more coaborative and equa reationship among caregivers in service of the patient. At the organization eve, eaders must manage and bridge the paradoxica reationship between the business and cinica forces invoved in fufiing the mission of each heathcare organization. Whie these two strategies can often be at cross purposes, system eaders must be dutifu about minimizing the negative impact that the paradox can have on the patient experience. They must take on and internaize the charge of managing both the mission and the margin. Rather than making patchwork, incrementa changes, innovative thinking is needed to find ways to transform how work is done. Cuture is a hidden power in a organizations and rooted in traditiona roes, hierarchies and systems. A hospita s cuture is often created out of managing the tensions between the cinica and business sides of the organization. Cuture is aso inextricaby inked to business strategy and drives outcomes. When the business side changes and new strategies are required, the organizationa cuture needs to shift as we. If it does not, the traditiona cuture the beiefs, the practices and the way things are done around here wi override the new direction and prevent innovation and positive change. Leadership Practices Enacting the tasks of eadership: Direction-Aignment-Commitment. Working interdependenty to achieve the mission of heathcare. Creating a cuture of coaboration and mutua respect. Concusion The U.S. heathcare system is considered by many to be broken, fractured and unsustainabe. Yet, the system hods exampes of what works we and what the future wi ook ike. Some hospitas, heathcare systems and innovative organizations are showing tremendous success in transforming their cutures and providing efficient, quaity care and superior patient outcomes. At CCL, we see coaborative eadership as a powerfu ever for change, transformation and sustainabiity. By carifying organizationa needs and eadership chaenges and by deveoping these capabiities with a coaborative mindset, we are heping our heathcare cients understand the interconnections between their business strategy and their eadership strategy. 12

13 When organizations strengthen individua eaders and expand their coective eadership capabiity, they begin to pry oose some of their most intractabe, resistant probems and uncover new directions, soutions and opportunities. Coaborative eadership has the power to transform hospitas and heathcare organizations, improving the system today and for the future to the benefit of patients, famiies and caregivers. Why Care about Cuture? In its most basic form, cuture is a mechanism for sustainabiity and surviva. It aso has the hidden power to derai strategic change initiatives. In fact, research shows the majority of strategic change initiatives utimatey fai because they don t address cuture. A cuture is formed by beiefs that drive behaviors. New beiefs ead to new behaviors and new possibiities emerge. Change the eadership mindset and you change the organizationa cuture. About the Mode: CCL s Research and Experience For more than 40 years, CCL s eadership deveopment research and practice have heped heathcare organizations address their most pressing eadership chaenges. In the past decade aone, more than 400 heath service organizations have turned to CCL to deveop eadership skis and transform their abiity to achieve desired business resuts. In some instances the work has been short-term or has invoved individua eaders who have benefited from our programs. In other instances we have been invoved in ong-term, in-depth partnerships that have yieded significant resuts for cient organizations. This work and reated research conducted by our CCL team have informed the creation of the eadership mode described in this white paper. We have seen firsthand the impact when heath systems focus on and invest in the transformation of their eadership. Individuas gain communication, infuencing and confict-resoution skis. Groups and teams improve performance and respond more effectivey to change. Senior teams work more effectivey to aign the organization and drive strategic change. Deveoping individua eadership skis and organizationa eadership capabiities creates a more coaborative cuture that can have a direct impact on patient care outcomes and organizationa practices. Cients have reported that CCL-faciitated eadership deveopment programs have heped improve cinica effectiveness, patient safety and patient satisfaction and have contributed to strong gains in empoyee satisfaction and engagement. 13

14 We have aso observed that high-performing hospitas and heathcare systems share severa key characteristics: Physicians, nursing eaders and staff at a eves are engaged in their work. Communication is cear, direct, honest and open. Coaboration is proactive and effective; organizationa sios do not get in the way of the work. Recruitment and retention processes resut in a staff that is highy committed to compassion, quaity and safety. Innovative practices fow throughout systems. Continuous earning is encouraged and rewarded. Leaders and empoyees act strategicay and decisivey in times of chaos and ambiguity. A high-energy environment heps empoyees manage stress and maintain heathy ifestyes. Of course, achieving these high-performance outcomes is difficut, and maintaining them is equay chaenging. To suppement our experientia knowedge within hospitas and heathcare organizations, CCL conducted in-depth, muti-year needs assessments between 2006 and 2009 with five diverse hospitas and heath systems. The goa was to understand their current eadership chaenges and future eadership needs based on their respective business strategies. The organizations incuded one community hospita and four arge heath systems, incuding an academic medica center, a nonprofit mutistate system, a nonprofit regiona organization and a arge for-profit mutistate heathcare system. The needs assessments invoved 164 eaders. Data on key chaenges were gathered via surveys and interviews and then vetted and refined through faciitated diaogue. Severa cear themes emerged through this work. Organization-eve chaenges were primariy strategic and operationa: Market forces (economy, heathcare reform, etc.) Resource management (budgets, peope, processes, technoogy) Managing priorities, carifying roes and responsibiities Strategic issues Decision-making Panning and execution Taent management processes Business process management Heathcare eaders aso recognized the need to strengthen eadership and communication, improve organizationa cuture and hep empoyees find a better work/ife baance. 14

15 When study participants were asked to identify high-priority organizationa capabiities and eadership deveopment needs, severa common themes emerged: Big-picture thinking. System-eve panning and thinking, and strategic thinking. Coaboration. Leading across boundaries, coaborative probem-soving and consensus-buiding. Managing change. Adapting to changing needs, systems and processes. Managing paradox. Cuture change. Creating an environment of trust, continuous earning and support. Leading teams. Buiding effective teams, providing cear direction and creating aignment. Commitment: Being accountabe for resuts. Communication skis. Sharing and communicating vision. Transparency and specificity. Deveoping taent. Mentoring, coaching and giving feedback. Engagement. Empowering empoyees and generating foow-through and commitment. Organizationa knowedge. Understanding heathcare best practices. Stewardship of resources. Abiity to address power and poitics. This research provided much of the rationae for a mode that coud transform heathcare systems through coaborative eadership. The mode was further informed by additiona CCL research, incuding a Leadership Gap study that anayzed a sampe of 34,899 eadership-effectiveness evauations conducted between 2000 and These data came from peope working across the heathcare sector, incuding empoyees of arge hospita systems, regiona providers, insurance firms, state and federa heathcare agencies, pharmaceutica firms and medica device manufacturers. Respondents had been asked to evauate the eadership competencies of a boss, peer or direct report using CCL s Benchmarks 360-degree feedback survey. Key findings of the CCL Leadership Gap Study are: Adapting to change and meeting business objectives are strengths of heathcare eaders. They are resourcefu, straightforward and composed, fast earners and wiing to do whatever it takes. The top priorities for eadership deveopment in the heathcare sector are to improve the abiity to ead empoyees and to work in teams. Heathcare organizations aso need to create strategies to provide current and future eaders broad, cross-organizationa experiences and earning. Heathcare eaders have gaps in severa areas that are essentia for earning and ong-term success: having a broad functiona orientation, sef-awareness and career management. 15

16 Detais of this study are described in CCL s 2010 White Paper, Addressing the Leadership Gap in the Heathcare Sector: What s Needed When it Comes to Leader Taent? Additionay CCL reviewed data from 1,000 eaders in heathcare organizations who participated in our openenroment and custom programs from 2006 through The participants were asked to identify the three most important chaenges they face as eaders. We ooked at responses that refected chaenges specific to the heathcare sector and then coded and anayzed a random sampe of 300. The fina sampe incuded eaders at the midde, upper-midde and executive eves, with 61 percent working in upper-midde to executive eadership roes.the foowing top five chaenges emerged: Leading teams and individuas Cuture change/organizationa transformation Taent management Leading across boundaries Buiding effective reationships Coectivey, these studies confirmed what we earned through our direct experience with heathcare organizations about the themes and pressure points faced. Furthermore, the mode is supported by a broader body of CCL s most current research on organizationa eadership deveopment. 16

17 Impact Stories Cathoic Heath Partners: Creating a Resuts-Focused Leadership Academy Cathoic Heath Partners (CHP) is one of the argest nonprofit heathcare organizations in the U.S. In partnership with CCL, the organization aigned its strategic priorities with five critica eadership factors needed to meet them: a passion for the mission and vaues; a commitment to servant eadership; the abiity to hande compex menta processes; a bias for action; and the abiity to deveop others. Together, CCL and CHP created the Leadership Academy, a 14-month process that combines cassroom time, individua and team coaching, and action earning projects. Improvements were seen in cinica effectiveness, patient safety and patient satisfaction as a resut of action earning projects. Learn more about CHP and its transformation through eadership at our website, You wi find a case study, video and ink to a free on-demand webinar. Cape Fear Vaey Heath: Coaborating to Manage Growth Cape Fear Vaey Heath (CFVH) is among the argest and busiest heath systems in North Caroina. The organization experienced rapid growth over the previous decade, propeing it from a sma county hospita to a fu-fedged heath system. Recenty, CFVH s executive team coaborated with CCL to design and deiver a five-day eadership skis-buiding and coaborative eadership deveopment process for five cohort groups made up of the top 125 eaders in the heath system. CFVH s senior VP for Human Resources described the impact of this initiative: As a arge regiona heathcare system, we face new chaenges every day. Working with CCL heped us strengthen a strong eadership team by providing the eadership toos to perform our jobs more effectivey. As a resut, we are more agie in deaing with tough chaenges ike patient satisfaction and other operationa issues. We are now faster at getting to the root of probems and deveoping creative soutions to sove them. That makes a rea impact on our bottom ine! Learn more about CFVH and its eadership deveopment initiative at our website, Nationa Association of Community Heath Centers: Coaching for Impact The Nationa Association of Community Heath Centers (NACHC) administers a year-ong EXCELL eadership deveopment program for executives of member faciities - not-for-profit heath centers across America that provide care for poor, migrant and homeess communities. More than 140 individuas have graduated from EXCELL since its inception in To ensure appication of what participants were earning to the reaities of the workpace, the Center for Creative Leadership worked with the EXCELL facuty and eadership to buid a coaching component into the program. Participants judge coaching among the most beneficia eements in their deveopment, and retention rates are very high among graduates of the program. Learn more about NACHO and its eadership deveopment initiative at our website, 17

18 Lenoir Memoria Hospita: Revitaizing Leadership When Lenoir Hospita set a goa of becoming the provider of choice in its competitive eastern North Caroina marketpace, the not-for-profit medica center recognized that success woud require a huge commitment to change as we as a new eadership mode. The desire was to create a eadership process capabe of bringing about an organization-wide cuture shift. The Kinston, NC hospita worked with CCL to create a two-year process for 65 executives, directors, managers and supervisors, buit around a framework of a shared vision, a eadership strategy and a capabiity of connected eadership needed to continue moving forward. As a resut of this process, eaders at Lenoir reported a marked sense of openness and engagement in the organization s day-to-day operations. Scores on both the hospita s empoyee-satisfaction survey and the customer satisfaction survey soared. As a resut of the initiative s emphasis on the concept of distributed eadership, Lenoir Memoria estabished a eadership academy to retain top young taent and imbue them with the strong professiona eadership skis the hospita wi need in generations to come. Learn more about the Lenoir Memoria eadership deveopment initiative at Additiona Resources For more information on coaborative eadership and CCL s work with heathcare organizations, pease visit us onine at Among the resources you wi find in our onine Leader Library are the foowing white papers: Addressing the Leadership Gap in Heathcare: What s needed when it comes to eader taent? Boundary Spanning Leadership Transforming your Organization Deveoping a Leadership Strategy Creating Coaching Cutures: What business eaders expect and strategies to get there References: Jarousse, L. (2010). Leadership in the Era of Reform. H&HN: Hospitas & Heath Networks, 84(11), 32. Doon, T. C. (2010, September/October). Leadership Skis for Heathcare Reform. Heathcare Executive, p. 6. Committee on the Robert Wood Johnson Foundation on the Future of Nursing, a. t. (2011). The Future of Nursing: Leading Change, Advancing Heath. Washington, D.C. The Nationa Academies Press. Buerhaus, P. I. (2009). The Recent Surge in Nurse Empoyment: Causes and Impications. Heath Affairs, McAearney, A. S. (2010, May/Jun). Executive Leadership Deveopment in U.S. Heath Systems. Journa of Heathcare Management; 55 (3), p Regan, L.C., & Rodriguez, L. (2011). Nurse Empowerment from a Midde-Management Perspective: Nurse Managers' and Assistant Nurse Managers' Workpace Empowerment Views. The Permanente Journa, 15(Winter 2011), 1-6. Wifred H. Drath, McCauey, C. D., Paus, C. J., Van Vesor, E., O'Connor, P.M.G., & McGuire, J.B. (2008). Direction, aignment, commitment: Toward a more integrative ontoogy of eadership. Leadership Quartery, 19,

19 About the Authors and Contributors Henry W. Browning is a Senior Facuty Member at the Center for Creative Leadership with expertise in individua, group and organizationa performance deveopment. Henry focuses on heping individuas improve their impact in eadership roes and processes, deveoping high-performing management and project teams, and working with senior executive teams eading organizationa change. He has ed numerous eadership deveopment initiatives with hospitas and heathcare systems in his facuty roe with CCL. Deborah J. Torain is a Senior Account Manager with the Center for Creative Leadership s Business Deveopment Group and eads the CCL heathcare sector team. Deborah serves as a reationship manager who gains insight into the business and eadership needs of cients and heps to customize the appropriate eadership deveopment soution. She has managed a number of the Center s top cient reationships with a focus in heath and heathcare services with a cient base that incudes Cathoic Heath Partners, Medtronic, St. Joseph s Heath System, WePoint, Trinity Heath and Bon Secours Heath System. Tracy Enright Patterson is Director of CCL s Evauation Center, a group responsibe for deveoping knowedge, methods and approaches to the evauation of eadership deveopment. She has designed and impemented program evauations for the eadership deveopment initiatives of severa of CCL s heathcare cients, incuding Cathoic Heath Partners, WePoint, Medtronic, Cape Fear Vaey Heath, Trinity Heath and two programs funded by the Robert Wood Johnson Foundation: Ladder to Leadership and Executive Nurse Feows. Contributors: Heather Champion, CCL Senior Research Facuty Joan Gurvis, CCL Managing Director Courtney Harrison, Former CCL Senior Facuty Acknowedgements: The authors woud ike to thank the foowing peope for their review and feedback on the paper as it was deveoped: Jon Abees, Senior Vice President Operations Exceence, Cathoic Heath Partners; Wiiam Pryor, Senior Vice President, Cape Fear Vaey Heath; Rick Vanasse, Senior Vice President and Chief Learning Officer, Bon Secours Heath System; Cindy McCauey, CCL Senior Feow; Nancy Probst, CCL Adjunct Facuty; Amy Martinez, CCL Senior Facuty; Key Hannum, CCL Senior Research Facuty; Eizabeth Guette, CCL Senior Facuty. 19

20 About the Center for Creative Leadership The Center for Creative Leadership (CCL ) is a top-ranked, goba provider of executive education that acceerates strategy and business resuts by unocking the eadership potentia of individuas and organizations. Founded in 1970 as a nonprofit educationa institution focused excusivey on eadership education and research, CCL heps cients wordwide cutivate creative eadership the capacity to achieve more than imagined by thinking and acting beyond boundaries through an array of programs, products and other services. Ranked among the word's Top 10 providers of executive education by Boomberg BusinessWeek and the Financia Times, CCL is headquartered in Greensboro, NC, USA with campuses in Coorado Springs, CO; San Diego, CA; Brusses; Moscow; Singapore; Pune, India and Addis Ababa, Ethiopia. Its work is supported by 500 facuty members and staff. CCL Americas One Leadership Pace PO Box Greensboro, NC p: f: e-mai: CCL Europe, Midde East, Africa Avenue de Tervueren 270 Tervurenaan B-1150 Brusses, Begium p: +32 (0) f: +32 (0) e-mai: CCL Asia-Pacific 89 Science Park Drive Singapore Science Park I The Rutherford Lobby B, #03-07/08 Singapore p: f: e-mai: Other campus ocations: Coorado 850 Leader Way, Coorado Springs, Coorado, 80905, USA, p: Caifornia 8910 University Center Lane, Tenth Foor, San Diego, Caifornia, , USA, p: Africa Unity University, Sub-City: Boe, Kebee: 11, House No: 632, PO Box 6722, Addis Ababa, Ethiopia, p: India 238 Regus Connaught Pace, Leve 2, Kumar Connaught Pace, Bund Garden Road, Pune , India, p: /10 Russia 8th Marta Street 10, Buiding 14, Moscow, Russia , p: The Center for Creative Leadership is committed to a poicy of equaity of opportunity for the admission of a students regardess of race, coor, creed, sex, age, nationa origin, sexua orientation, or disabiity, and does not discriminate on any such basis with respect to its activities, programs or poicies. Center for Creative Leadership, CCL, and its ogo are registered trademarks owned by the Center for Creative Leadership Center for Creative Leadership. A rights reserved.

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