UNSENTIMENTAL EDUCATION

Transcription

1 VOLUME 12 ISSUE 12 DECEMBER 2004 ISSN INSIDE THIS ISSUE UNSENTIMENTAL EDUCATION Unsentimental PAGE 1 Education Today s Emerging Healthcare Managers Need Practical, Hands-On Training More Than Ever Before, But Few Actually Receive It TODAY S EMERGING HEALTHCARE MANAGERS NEED PRACTICAL, HANDS-ON TRAINING MORE THAN EVER BEFORE, BUT FEW ACTUALLY RECEIVE IT By Betty J. Noyes Many of us remember our own first days in management and the angst of taking administrative calls, appearing before the board, presenting our first budgets and other milestones. We were all novices at one time. A PUBLICATION OF AMERICAN GOVERNANCE & LEADERSHIP GROUP

2 U N S E N T I M E N TAL EDUCATION CONTINUED FROM PAGE 1 But these days, it seems the transition period f rom novice to seasoned veteran has telescoped interm i n a b l y. Having spent 30 years in senior h e a l t h c a re management positions, I know that I was most successful when I had a s t rong, experienced, talented and trained managerial staff supporting me. The fro n t l i n e s perf o rmance is the only way to achieve excellence in patient care and finances. Quite simply, the more complex the healthcare system has become in the past decade, the more we have tended to jump onto complex or critical issues, leaving the practical skills-training and their application behind. As a result, the skills foundations of our management teams are often weak and unrealized. In my previous careers as hospital chief executive officer and chief nursing o ff i c e r, I had to ensure the success of my p romoted managers by personally becoming their coach, mentor and teacher. I wish I had a stru c t u red program like the ones my o rganization delivers; I would have had fewer 15-hour workdays. s k yrocketing number of step one employee grievances only to discover their linkage to a manager s insecurity in dealing with shop stewards and conflict resolution. Conversely, I remember when all p e rf o rmance evaluations from certain managers rated every employee as exceeding expectations and worthy of only accolades. A senior healthcare manager will invariably face at least one such dilemma during their career, and more likely all of them. Yet such managers currently face a serious conundrum that continuously divides their time between the grind of daily operations and the fire f i g h t- ing duties inherent in crisis management. Quite simply, the more complex the healthcare system has become in the past decade, the m o re we have tended to jump onto complex or critical issues, leaving the practical skills-training and their application behind. As a result, the skills foundations of our management teams are often weak and unrealized. Those front-line workers who were staff yesterday and managers today are then left in a sinkhole of insecurity, s t ress, burnout, and lack of staff re t e n t i o n. I can vividly recall critical times in the budget review process with deadlines looming, only to encounter a floundering manager who caused me to redo all the calculations and have misgivings about the assumptions. I can recall a suddenly PRIMARY CULPRIT: CHANGING TIMES, PACE In the old, slower-moving days, we could aff o rd to promote new managers and let them learn managerial skills on the job. H E A LTHCARE LEADERSHIP REPORT DECEMBER 2004 PAGE 8

3 But today p a rticularly in an era of continuous post-redesign and re - e n g i n e e r i ng most tables of organizations have been flattened. As a result, many education d e p a rtments have been relegated to pro v i d e only necessary in-service and orientation p rograms, and there exists a lack of supportive and practical management education. With the mandated learning curve becoming similarly flat, the inevitable result is a 50% manager attrition rate and large numbers of resignations from staff re p o rting to those failing managers. And when a managerial vacancy occurs, senior administration wants an immediate skilled replacement available so that time, money and policy initiatives are not lost. Despite such a dire personnel situation, we ironically desire our managers to envision themselves as retention off i c e r s. We logically expect that their staff s attrition rates be kept low and that their staff is i n f o rmed, motivated and supportive of the o rg a n i z a t i o n. Given the circumstances, it is little wonder that 85% of staff leave their jobs because of dissatisfaction with their immediate superv i s o r. I have surveyed more than 700 participants enrolled in my firm s managerial skills program and have come to recognize their lack of self-confidence and knowledge and their own personal dissatisfaction with their roles. I am convinced that much of that dissatisfaction and stress is simply because they do not know how to do what is being asked of them. On the face of it, the development of such a loggerhead seems obvious. Yet many o rganizations have, sometimes for decades, re w a rded good clinicians and technicians by placing them into management roles. These new managers were then expected to miraculously acquire expert skills in the areas of finance, human re s o u rce management, conflict resolution, process impro v e m e n t, labor relations and more. WHAT SENIOR EXECUTIVES WANT VERSUS WHAT THEY ACTUALLY GET Most of us in executive positions know that what we really wish for are 10 s t rong managers. We then wish that those managers would work together eff e c t i v e l y, p roviding employees, patients, physicians, d e p a rtments and re f e rral organizations with consistent interactions. And of course, we wish them to maintain missions and marg i n for the organization. The reality is that experienced staff do not make experienced managers. The skillset is different, and transformation does not occur overnight. Even individuals who appear to be seasoned in a given organization will be faced with a myriad of new challenges the day they become managers. Ask yourself some simple questions: when was the last time you stopped and s u rveyed your managers to pass a simple finance test to illustrate their understanding of your budget and variance re p o rts? When did you last observe them conducting a hiring interview or disciplining an employee? How was their level of self-confidence? You might be shocked by the answers. Based on the pre - p rogram testing my firm administers to the personnel of our client h e a l t h c a reorganizations, we know that 50% of managers will fail a very basic knowledge test. A similar percentage will rate themselves low on self- PLEASE TURN TO PAGE 10 H E A LTHCARE LEADERSHIP REPORT DECEMBER 2004 PAGE 9

4 U N S E N T I M E N TAL EDUCATION CONTINUED FROM PAGE 9 confidence in 67 typical areas of first line managerial re s p o n s i b i l i t y. The conclusion is clear: the eff i c i e n t use of management education dollars is a priority for all healthcare org a n i z a t i o n s. Yet the core question remains: to ensure successful managers, how do we identify managerial educational needs, and targ e t those needs to receive the scarce dollars re q u i red? My firm strives to determine how to s u p p o rt managers within organizations to be e ffective discharging their re s p o n s i b i l i t i e s, building a strong skill base and the self-confidence to tackle leadership and managerial responsibilities. Here are some of the ways to achieve such goals: 1. Start with an assessment of the current managerial skills of front-line managers. It is essential to measure both knowledge and levels of self-confidence. A manager can know the answers but lack the self-confidence to complete the task. Self-confidence can be clearly effected by not only lack of skill and practice but also encumbered by lack of comfort to take on the task within the given organization s culture. Novices tend to be risk-avoidant. 2. Customize your program content. Yo u r re q u i red perf o rmance is based upon your org a n i z a t i o n s protocols, pro c e s s- es and forms. Providing theory that does not match your manager s daily tasks will not be effective. 3. Have faculty that are healthcare leaders. C redibility is critical to the novice. T h e o ry is great from a pro f e s s o r, but what the novice wants is someone to show them the real world who has walked in their shoes, and can re l a t e their battle stories in an informative way. 4. Assign a mentor to each novice. T h i s element often re q u i res careful pairing, monitoring and teaching mentors the skills of mentoring, which are very diff e rent than direction and supervision. 5. C a reful tracking of the mentoring re l a- t i o n s h i p. Mentoring re q u i res time and commitment to provide valuable opportunities, open doors and provide safe havens for practice of skills and experiences. Having a meeting that lasts for five minutes in the corridor is not going to have the impact that is re q u i re d. Conversation guides are essential to both the mentor and the protégé. 6. P rovide causes for celebration and recognition of achievement. F re q u e n t l y, novices have not succeeded and been recognized in their new role by the senior administrative team. Tr a n s- f o rming what a novice manager knows into a new process that will result in an e n e rgized and positive experience is an essential element to the coming of age of a novice. 7. S t ru c t u re your educational program so that it provides for a non-thre a t e n i n g e n v i ron ment that is very interactive. Engage the participants in frequent ro l e - playing, exercises and discussion. Avoid lectures presented by good operational people but who are often poor teachers. Likewise do not have good p rofessors who are not good operational people. H E A LTHCARE LEADERSHIP REPORT DECEMBER 2004 PAGE 1 0

5 The reality is that experienced staff do not make experienced managers. The skill-set is different, and transformation does not occur overnight. Even individuals who appear to be seasoned in a given organization will be faced with a myriad of new challenges the day they become managers. 8. M e a s u re your results, particularly on the bottom line. Impact is the final i n g redient in the success of a management education program. If your p rogram fails to have a measurable impact on business results, it has failed. You will not have had a leader with a successful learning experience. Another indication of the success of a management education program is the change in the tone of feedback you get f rom your managers. If you re hearing quotes such as I have been given the tools now to do my job, ; This has helped me to better understand the full scope of being an e ffective leader ; (We) have never had p rocess improvement explained so clearl y ; I never understood finances and now I get it ; I no longer fear Dr. I now know I can talk with him ; my staff has a team commitment and we are sticking to it it has been a great help ; It is taking me less time and I have more e n e rgy ; I now believe that I will stay in healthcare management I believe I can do the job, then you re obviously on the right track. Novice managers should have the opportunity to have a c redible impact on the business of your organization and be intimately familiar with the change process, stakeholder involvement and be ready for their next career step. We all were there once, and we have an obligation to get the next class of graduates over the hump. s Betty J. Noyes, R.N., M.A., is President of Noyes & Associates Ltd. Based in Bainbridge Island, Wash., the firm specializes in healthcare management education, recruitment and consulting. She may be contacted at (206) , or by at noyes@noyesconsult.com. H E A LTHCARE LEADERSHIP REPORT DECEMBER 2004 PAGE 1 1