With the constantly changing healthcare landscape, developing effective leaders is a challenge. And, many healthcare delivery organizations already are operating with scarce resources. Not planning ahead, however, could cause bigger problems in the future.

Leadership development is an “investment worth making. There is no question in my mind,” says David G. Javitch, PhD, program director of the Harvard University School of Public Health’s (HSPH) “Leadership Strategies for Evolving Health Care Executives.”

‘Be visionary’

Healthcare differs from other industries because it is highly regulated and “change is legislated,” says Javitch. As such, leaders need to be “on the forefront of what’s happening” and, “to some degree, be visionary to try to get ahead of the curve.”

Keeping up and understanding the opportunities and requirements is challenging, says Javitch. For example, people can “hitch their future to the wrong stars.” He cites the 40 times bills were introduced in Congress to overturn the Affordable Care Act. Those who believed any of those bills would prevail and held off on preparing for the new laws were already “very much disadvantaged,” he points out.

“There’s a role for leadership in terms of being able to identify what is going to happen and lead organizations effectively into that future,” says John E. McDonough, DPH, MPA, program instructor, professor of public health practice at HSPH and director of its Center for Public Health Leadership.

Change appropriately

Leadership stems from good change management processes, says McDonough, which many organizations don’t have. For example, he says the overwhelming majority of physicians have been able to circumvent what the computer tells them not to do. “Change is done inappropriately. There are easy ways to motivate employees that will decrease resistance to change. That’s a kiss of death—organizations that don’t effectively bring about change fail.”

Those kinds of risks draw people to the HSPH course which is limited to 60 people, about half of which are physicians. The program has sold out each of its past 12 years. “People sign up because our evaluations show that what we’re sharing is exactly what they need,” says Javitch. That includes strategies for organizational behavior, leadership, motivational and organizational change and conflict resolution.

Students learn about common misconceptions. For example, “conflict shouldn’t be eradicated. Some is healthy and productive and leads to innovation. We teach students skills on how to deal with conflict and how to negotiate.”

Healthcare also isn’t concerned with the average customer, Javitch says—another way it differs from other industries. Patient safety and patient satisfaction play important roles in quality, a driving concern in healthcare. Students review use cases and perform exercises such as resolving an issue based on what they’ve learned. Many leaders are asked about financial management even though they may have only basic knowledge of budgets and profit and loss. Javitch helps his students understand the information they receive from accountants and financial officers and how to raise the right questions.

The National Center for Healthcare Leadership also is working to help healthcare systems best invest their scarce time and resources in leadership development. The center has established a database of the efforts of more than 100 organizations—what has worked and what hasn’t. “The database brings together organizations to learn from each other,” says Andrew Garman, PsyD, NCHL CEO. “Eighty percent of challenges are common.”

‘Learn by doing’

Most healthcare organization leaders learn by doing, says Garman. “They come into their roles with no training.” Organizations need a better appreciation of the competencies associated with good leadership so they can prepare for the future and new leaders can “hit the ground sprinting.”

Many of these organizations use the excuse of being too busy with other responsibilities to put much focus on leadership development, he adds. Healthcare experiences no slow periods that allow for reflection and the payoff of a leadership development program is not immediate. However, “if it’s part of the fabric of an organization, it will enhance the organization’s capability to adapt and transition.”

Leadership development doesn’t happen naturally, says Garman. And, not having a hardwired program that also assesses leader effectiveness leads to organizations developing “a vision that’s typically not accurate.”

There’s never a good time, Garman admits, but worse is the unexpected loss of a key person that has a big impact. “Prevent that from happening. Identify those people who are close to retirement or have a good chance of being recruited away. That can make a compelling case for focusing on leadership development.”
Leadership competencies can be taught and developed, Garman says. “There is value in that.”

Leadership development has to be part of an ongoing process, Javitch says. Not all organizations need to establish an internal program when there are programs like his available, and sending people to such training can be motivating. “They will be able to do more than when they left. It’s a win-win for everybody.”

Training is worthwhile, says Garman, because less effective leaders tend to be underengaging, which results in less forward motion and direction for the organization, or overengaging, which can lead to more employee turnover.

Leaders need to stay on top of the latest strategies as well. For example, Garman says helping employees understand change and how it impacts them is more effective than mandating. “Many CEOs are still using command techniques to motivate, lead and develop employees.”

With all the challenges facing healthcare, there will be a need for strong leaders for many years to come.