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Effective Leader
IN Healthcare


Second Edition


Len Sperry, M.D., Ph.D.

Foreword by
Samuel Lin, M.D., Ph.D., M.B.A., M.P.A., M.S.

Baltimore • London • Sydney


Changes and Challenges in

Healthcare Leadership
Healthcare is changing faster than ever before, as witnessed by the
dramatic shifts in healthcare policy and practice that have occurred
since the first edition of this book published more than a decade
ago. There is every indication that the rate of change will continue,
placing increasingly greater demands on healthcare leaders to man-
age and adapt themselves as well as their organizations.
  Among the many new challenges addressed in this second
edition, the growing emphasis on employee engagement in the
workplace in general is a factor to be understood by healthcare
administrators and managers. Of particular challenge will be man-
aging millennial workers. With some 10,000 baby boomers retir-
ing every day, managers will have to engage millennials, who will
make up approximately 75% of the workforce by 2025 (Putre, 2013).
Healthcare managers will be expected to oversee orientation and
learning experiences, such as onboarding, and provide coaching to
foster engagement and increase productivity for those reporting to
them. These expectations, previously viewed by some as optional,
are rapidly becoming required job functions for managers.
  A decade ago, emotional intelligence and mindfulness were
fringe concerns among workplace leaders, whereas today they have
become mainstream, including within healthcare settings. Mindful-
ness was actually started in healthcare settings with Mindfulness-
Based Stress Reduction (MBSR) groups for patients with chronic
medical conditions in a single Massachusetts hospital (Kabat-Zinn,
2003). Today, most hospitals regularly schedule MBSR groups,
including many that are exclusively for healthcare workers to re-
duce stress and improve well-being. Disruptive behaviors, includ-
ing mobbing and bullying, are of increasing concern in corporate

xii Preface

settings and are particularly common in healthcare settings, espe-

cially among nurses. Furthermore, communications issues have
long been a concern for corporate managers, and medical errors
have become one of the greatest communication challenges for
healthcare managers today. These are but a few of the many exam-
ples of healthcare challenges and opportunities for managers that
are among the new topics addressed in this second edition.


Today, there is an emerging type of leader in healthcare settings.
These individuals are called healthcare managers, medical care
managers, health services administrators, healthcare administra-
tors, or healthcare executives. Their primary function is to plan,
direct, and coordinate medical and health services. They provide
leadership to an entire healthcare facility, including a medical cen-
ter, hospital, nursing home, or clinic, or they may manage a specific
clinical area or department or a group medical practice of physi-
cians. In whichever setting, they are charged with directing people
and policies in ways that conform to an ever-changing landscape of
technology, healthcare laws, and regulations.
  In 2014, these managers held about 333,000 jobs, with most
working in hospitals and in group medical practices. However, con-
tinuing changes in demographics and healthcare legislation is ex-
pected to increase the need for healthcare mangers. Specifically, as
the cohort of more than 70 million baby boomers ages and remains
active later in life, the demand for medical services will increase
significantly. According to the U.S. Department of Labor Statistics
(2016), employment of healthcare managers is projected to increase
by 17% between 2014 and 2024. This rate is considerably faster than
the average for all other occupations. By comparison, the demand
for managers and executives in other sectors is projected to increase
by only 6%. Besides being a profession with a very bright future,
salaries further increase the appeal of healthcare administration,
particularly for other healthcare occupations, such as nursing. In
short, the time has come for this relatively new area of leadership
and management, and the future looks very bright for health ser-
vices administration.
  Accordingly, it should not be too surprising that healthcare
management jobs remain open for extended periods of time in some
Preface  xiii

parts of the country, nor that recruitment efforts have been stepped
up in most locales. We not only need more healthcare managers,
but also more highly skilled healthcare managers. Nor should it be
surprising that competition is increasing for admission to under-
graduate and graduate programs in health services administration.
The goal for these academic and other training programs will be to
prepare healthcare leaders who are highly skilled and capable of
meeting the inevitable challenges of the healthcare system of tomor-
row. It is my hope that this book, with its focus on the 12 essential
skills of leadership, will foster that exemplary goal.
  Like the first edition, this second edition is based on solid re-
search findings as well as my experience as a healthcare executive,
consultant, and course and seminar instructor. I remain as con-
vinced as ever that everyone in a leadership position in healthcare
today must learn and master the 12 essential skills highlighted in
this book. This new edition is a high-interest, high-impact, hands-
on approach to learning and will greatly enhance most health lead-
ership and management undergraduate and graduate courses as
well as continuing education workshops and seminars for health-
care managers. It should also appeal to individual managers who
are interested in using this book as a self-learning tool to increase
their own effectiveness by developing these skills.
  The structure of the book is straightforward and direct and con-
sists of three steps. Step I is preparatory and introduces the idea
of skill building in leadership development. It includes the Self-
Assessment of Essential Leadership Skills: Pretest, which provides
the learner with an initial assessment of his or her overall leadership
skills competence level. In Step II, the learner explores the principles
and practices of the 12 essential skill sets. Each chapter in the section
focuses on one skill set and includes case examples, skill develop-
ment exercises and activities, and a detailed self-assessment of that
skill set. The goal of these skill chapters is to assist the learner in
becoming a more effective manager. Finally, Step III progresses to
an action plan for continuing the journey of becoming an effective
manager and making the transition to being an effective manager;
that is, achieving and maintaining mastery of the 12 essential skills
of effective leadership. Step III concludes with the Self-Assessment
of Essential Leadership Skills: Posttest.

Becoming an Effective
Leader in Healthcare

“Effective healthcare managers are skillful healthcare managers.”

This statement captures the essence of this book. A quick glance

through the business and management section of a large bookstore
reveals a seemingly endless stream of titles on developing manage-
ment skills, improving effective leadership, identifying talented
managers, promoting leadership development, and the like. Why is
this? Because skillful, effective managers are in short supply today,
and many efforts are being made to address this situation. This
shortage is particularly keen in healthcare organizations but can
also be found in many corporations and organizations in America
today. Because of the unprecedented changes under way in health-
care, the need for effective healthcare leaders is probably more crit-
ical now than at any other time in recent history.
This book addresses the need for skilled managers by providing
the reader with a practical manual for developing and improving
the essential skills needed to become a more effective and successful
healthcare manager. This introductory section, Step I, sets the stage
for acquiring these skills. It begins by describing the role of skill
development in promoting effective leadership. It then describes
the basis for identifying the 12 essential skills, or more accurately
skill sets, of effective healthcare managers. Each of these 12 skill sets

2 Becoming an Effective Leader in Healthcare Management

is described briefly. Finally, there is an overview of the rest of the

book and instructions for taking and scoring the “Self-Assessment
of Essential Leadership Skills: Pretest” on pages 10–15. Before turn-
ing to these topics, it is necessary to clarify terminology, beginning
with the terms leadership and management, and then contrast leader-
ship skills with talents and competencies.


Since the 1980s, the issue of distinguishing between leadership and
management has been debated. Management typically has been
associated with how individuals function under conditions of sta-
bility, that is, in transactional activities such as accomplishing objec-
tives, monitoring compliance, and coordinating staff and workflow.
In contrast, leadership is typically associated with how individuals
function under conditions of instability and change, that is, in trans-
formational activities such as envisioning, galvanizing commitment,
and providing inspiration. Consultants to healthcare organizations
often highlight this distinction, emphasizing that leadership is es-
sential in revitalizing healthcare (Manion, 1998).
Research suggests that such distinctions are neither valid nor
useful because effective management and leadership cannot be sep-
arated (Quinn, 2000; Tichy, 1999). “Leading change and managing
stability, establishing visions and accomplishing objectives, break-
ing the rules and monitoring conformance, although paradoxical,
are all required to be successful” (Whetten & Cameron, 2015, p. 16).
From this perspective, leadership and management are comple-
mentary, a perspective that informs this book. Not surprisingly, the
skills necessary to be an effective manager are also necessary to be
an effective leader. Before turning to these necessary or essential
skills, it is useful to clarify and define some common terms.
Unfortunately, the terms skills, knowledge, talents, and competen-
cies are often used interchangeably. Because of their importance in
understanding effective leadership, it is helpful to define and differ-
entiate these key terms.
Skills are defined by Buckingham and Coffman as “the how-to’s
of a role” (1999, p. 82). Skills are capabilities that can be trans-
ferred from one person to another. For example, reading a balance
sheet is a financial management skill. Similar to skills is knowledge,
which is “what you are aware of” (Buckingham & Coffman, 1999,
p. 82). Knowledge can be differentiated into factual knowledge and
Becoming an Effective Leader in Healthcare Management 3

experiential knowledge. Factual knowledge represents concepts or

ideas that are available to anyone. For example, the various provi-
sions of the Americans with Disabilities Act (ADA) of 1990 (PL 101-
336) are pertinent factual knowledge for human resource managers.
Experiential knowledge is what we learn subjectively through first-
hand experience. Both types can be learned and transferred from
one person to another.
Talents are natural abilities that influence an individual’s
“recurring patterns of thought, feeling, or behavior” (Buckingham
& Coffman, 1999, p. 83). For example, precision is a talent associated
with effective accountants and computer programmers. These abil-
ities are inborn traits, which means that they cannot be learned. It
is possible to train someone who does not have a particular talent,
such as precision, to follow a protocol that may increase his or her
skill for attention to detail (which is one aspect of precision), but the
outcome of this training will never instill precision in an individual.
For example, in more than 30 years as both an executive and a
consultant, I have learned that good judgment is really an inborn
talent that cannot be approximated easily. I have observed that in-
dividuals with good judgment can intuitively make split-second
decisions under duress that turn out to be excellent decisions
about people or tasks. Other individuals who have been taught a
problem-solving protocol may be able to follow the protocol and
systematically think through a problem reasonably well when there
is sufficient time and little or no duress. However, these individu-
als are at a great disadvantage when they are forced to make quick
decisions under fire.
On the basis of their leadership research, Buckingham and
Coffman (1999) indicated that the capacity to discover talent in
others is an important capability for executives. They noted that
“the best managers are adept at spotting a glimpse of talent in some-
one and then repositioning him so that he can play to that talent
more effectively” (p. 83). Such leaders are talent hunters and talent
developers and do not confuse talents with skills. Jack Welch, the
retired chief executive officer (CEO) of General Electric (GE), who
described himself as GE’s best talent scout, exemplifies this view of
Competencies can be defined as capabilities that many corpora-
tions use to describe expected behaviors in leaders. Unfortunately,
Buckingham and Coffman noted that some competencies (e.g.,
“remaining calm when under fire”) may actually be talents, other
4 Becoming an Effective Leader in Healthcare Management

competencies (e.g., “implementing basic operational systems”) may

actually be skills, and still others may be “part skills, part knowledge
and part talent” (1999, p. 89). They urged executives to be very clear
about the actual requirements of specific competencies because if
a talent-based competency is specified as an expected behavior for
a given individual, unless the individual possesses that talent, the
expected behavior will never be achieved.
The ideal is to establish “pure” competencies, that is, those that
are primarily skill based and not talent based. It seems that the most
discerning and effective executives are those who establish skill-
based competencies. It is critically important for leaders to clearly
distinguish talents from skills and competencies when selecting in-
dividuals for positions and when doing coaching or planning lead-
ership development activities. In other words, the best leaders are
those who know how to search out needed talents in others and
coach for needed skills and competencies.

The Key to Corporate Success
Why do corporations consider leadership skills so important?
Because leadership skills are the key to a corporation’s success.
Mounting evidence has shown that skillful leaders are the key
determinant of corporate success. Whether organizations are public
or private, in the manufacturing, the healthcare, or the service sec-
tor, “research findings now make it almost unquestionable that if
organizations want to succeed, they must have competent, skillful
managers” (Whetten & Cameron, 2015, p. 4).
Although many would agree that competent leadership is an
important and significant factor in corporate success, some would
balk at the suggestion that skillful leadership is more important than
other factors, such as market share or assets. Surprisingly, research
does not support that viewpoint. For example, in a study of the fac-
tors that accounted for the financial success of corporations, five
factors were identified that predicted success: market share, capital
intensity, size of assets, industry average return on sales, and effec-
tive leadership. Interestingly, this research indicated that the ability
to manage effectively was three times more important than the other
four factors combined (Hanson, 1986). Successive studies seem to
offer further support for Hanson’s conclusion, namely that effective
Becoming an Effective Leader in Healthcare Management 5

leadership fosters corporate financial success, whereas ineffective

leadership fosters financial failure. One might reasonably conclude
that successful corporations are successful because they have man-
agers with well-developed leadership and management skills.
Surveys of CEOs and other executives and managers consis-
tently show that poor leadership is the factor most responsible for
business failure and that the best way to ensure corporate success
is to provide better leadership. The obvious question is, What is the
best way to provide better leadership? The answer is clear: Develop
effective leadership and management skills. Whetten and Cameron
(2015) insisted that management skills are more important than in-
dustry, environment, competition, or economic factors combined.

The Building Blocks of Effective Leadership

What is the relationship between skills and effective leadership?
Leadership skills are the building blocks on which effective lead-
ership is based. Therefore, this book is focused on developing
leadership skills rather than talents, competencies, or even knowl-
edge. As building blocks, leadership skills are the means by which
managers translate their own leadership styles, talents, and compe-
tencies into practice.


What are the essential skills necessary for effective healthcare lead-
ership? This book focuses on several skills within 12 core skill sets.
A skill set, as the term implies, is a set or cluster of related skills. For
example, communication is a skill set consisting of several specific
skills such as listening, engagement, empathic responding, nonver-
bal communication, verbal presentations, and written communi-
cation. Similarly, the skill set of coaching involves several specific
skills, including engagement, listening, assessment, advising, edu-
cation, monitoring, and evaluation.
The 12 skill sets described and illustrated in this book were
chosen based on current research and survey findings. In a study
of the attributes associated with successful, effective leadership,
Whetten and Cameron (2015) found, to their surprise, that the most
common attributes of successful leadership were basic leadership
skills. They surveyed 402 managers who were rated as highly ef-
fective leaders by senior managers in their organizations. These
6 Becoming an Effective Leader in Healthcare Management

organizations represented the healthcare, business, education, and

government sectors. These highly effective managers were inter-
viewed to determine which attributes were associated with lead-
ership effectiveness. The 10 most frequently cited attributes were
all basic leadership skills: verbal communication, time and stress
management, decision making, problem solving, motivation, dele-
gation, vision and goal setting, self-awareness, team building, and
conflict management. Other studies suggest similar skills.
It is also instructive to note the results of studies focusing on
attributes of managers who are considered ineffective. A study of
830 managers’ perceptions as to why managers fail reported that
the most common reasons were skill deficits. The five most common
skill deficits, in order of magnitude, were ineffective communica-
tion skills, poor interpersonal skills, failure to clarify expectations,
poor delegation, and inability to develop teamwork. Comparing
these skill deficits with the skills of highly effective leaders (as re-
ported by Whetten & Cameron, 2015) provides an interesting pic-
ture. Basically, leaders who are ineffective and fail lack the essential
skills that highly effective leaders possess.
In my consulting experience with senior leaders in healthcare
organizations, I have informally surveyed hundreds of individuals
about the attributes of effective leaders. There seems to be consider-
able overlap between these attributes and the 10 skills identified in
the Whetten and Cameron (2015) study. Some of the senior healthcare
executives I surveyed mentioned that some additional skills were
essential for effective healthcare leadership. These included budget-
ing, financial analysis, coaching, counseling, and life–work balance.
Because many healthcare managers have risen through the ranks or
have clinical backgrounds, they are unlikely to have formal training
in accounting and financial management. The skills of budgeting and
financial analysis are essential skills for these managers. Also, unlike
other sectors of the workplace, in which coaching and counseling are
considered required leadership skills, healthcare is just beginning to
recognize the need for and value of such skills and skill sets.
Table I.1 identifies the 12 essential skill sets covered in this
book by type: operational, relational, and analytic. Table I.2 brief-
ly describes the 12 essential skill sets. Some contain very basic or
core skills that are requisite for the development of other skills of
effective leadership. For example, basic to the communication skill
set are active listening, two-way communication, and engagement,
which are requisite core skills for most skill sets, especially coaching,
Becoming an Effective Leader in Healthcare Management 7

Table I.1. Skill sets by categories


Galvanizing commitment and motivation

Maximizing team performance
Delegating to maximize performance
Managing stress and time effectively

Communicating effectively and strategically

Negotiating and managing conflict and difficult people
Coaching for maximum performance and development
Counseling and interviewing for maximum performance and development

Thinking and deciding strategically

Mastering the budget process
Mastering and monitoring financial and human resources
Assessing corporate and personal resources

team building, and delegation. Similarly, the strategic thinking and

decision-making skills are involved in most of the analytic skill sets,
particularly budgeting and finance. Furthermore, basic skills in the
skill set of commitment and motivation are essential for all other
skills that emphasize productivity and performance.


There are two critical ingredients in becoming an effective manager:
skills and fit. The first ingredient, skills, indicates that effective man-
agers are successful at what they do because they have developed
competence in the core set of leadership skills. The core set of skills
includes the various operational, relational, and analytic skills de-
scribed and illustrated in this book and the requisite technical skills
that are specific to the manager’s position. The second ingredient is
fit. The basic premise is that it is easier for an individual to function
as an effective manager if he or she is in the right place at the right
time and works with the right managers and co-workers. In other
words, although skills are a necessary condition for effectiveness,
having an adequate fit or match with a job and an organization that
prizes such skills is the sufficient condition. Truly effective manag-
ers are able to develop, increase, and maintain their leadership skills
because their work environment not only permits managers to use
these skills, but also requires and rewards their use. Over time, truly
8 Becoming an Effective Leader in Healthcare Management

Table I.2. The 12 skill sets of the effective healthcare leader

Engagement, commitment, Prepares the manager with several skills and strategies
and emotional for assessing the causes of decreased engagement
intelligence and motivation and for increasing motivation and
emotional intelligence in various ways, beginning
with onboarding.

Team performance Provides the manager with skills and strategies for
influencing the process of team development and team
building to maximize individual and team performance,
job satisfaction, and commitment to the organization.

Delegation and Provides the manager an understanding of

empowerment empowered delegation (i.e., a set of skills for
delegating or assigning an employee a task while
simultaneously empowering that employee to
successfully complete the task).

Effective, strategic Provides the manager several skills and strategies

communication for improving productivity, interpersonal
relationships, and job commitment through
strategic communication. This set includes core
skills such as engagement, active listening, and
interpersonal communication as well as advanced
skills of effective writing, verbal presentations, and
conducting effective meetings.

Negotiating conflict and Provides the manager with skills in assessing and
difficult people managing conflict and measures to prevent it. Skills
and strategies are also included for effectively dealing
with angry, negative, and uncooperative employees.

Coaching and development Prepares managers to improve their skills in coaching

employees to achieve optimal performance. Three
sets of coaching skills are described: skill-based,
performance-based, and developmental coaching.

Counseling and interviewing Provides the manager with specific interviewing skills
and strategies to maximize outcomes in employment,
exit, appraisal, disciplinary, and counseling interviews.

Strategic thinking and Provides the manager a strategy for learning to think
decision making strategically (i.e., “outside the box”). One related
skill is strategic planning, which is, in its best sense,
an application of strategic thinking.

Budgeting Provides the manager with the tools to convert operating

plans into financial terms and use this information to
exert the control component of management. It assists
managers in educating staff on the relationships
between revenue and expenses.

Monitoring financial and Provides managers with the knowledge and ability to
human resources continuously seek efficiencies in business processes
in order to meet strategic objectives and enhance
success within the concept of the new pay-for-
quality reimbursement models.

Becoming an Effective Leader in Healthcare Management 9

Table I.2. (continued)

Evaluating self–job and Provides the manager a strategy for assessing

organization–family fit various personal and organizational resources and
evaluating the impact of these resources—or lack
thereof—on the manager in terms of the degree
of fit between self, job, organization, career, and

Mindfulness and time and Increases the leader’s capacity to control and cope
stress management with work stress and job strain. It emphasizes the
strategies of mindfulness and time and stress

effective managers move from the “becoming” mode to the “being”

mode. These managers find that they have gained sufficient mastery
of the requisite leadership skills and apply them almost effortlessly.
Step III describes this shift from becoming to being an effective
manager. The section provides some suggestions and guidelines for
maintaining and improving the requisite skills for effective leader-
ship and also includes the “Self-Assessment of Essential Leadership
Skills: Posttest.”

This section began with the statement, “Effective healthcare manag-
ers are skillful healthcare managers,” and it ends with the same dec-
laration. There is no question that the demand for highly effective,
skillful leaders in healthcare far exceeds the supply. Developing the
essential skills of effective leadership should be one of the top pri-
orities of senior management in healthcare today. Unfortunately,
developing these skills has yet to achieve that status in many parts
of the healthcare sector. Instead, senior healthcare managers seem
to be more focused on low census, low productivity, poor employee
morale, and high turnover rates and are apparently unaware of the
role that highly effective leadership has in reversing these situa-
tions. At Intermountain Healthcare, a healthcare organization based
in Utah with more than 37,000 employees, highly effective leader-
ship has fostered high levels of productivity, quality, morale, and
employee commitment, and turnover is very low. Modern Health-
care, a business news weekly, honored Intermountain Healthcare
in January 2000 as the number-one integrated healthcare system in
the United States. I hope this book can help you become a similarly
effective healthcare leader.
10 Becoming an Effective Leader in Healthcare Management


Directions: This assessment will help you evaluate your current level of
skill and attitudes regarding several leadership skills. Use the following
statements to assess your attitudes and skills by circling the number that
is closest to your experience: 1 = never, 2 = sometimes, 3 = often, and
4 = always. Respond in a way that reflects your skills today, rather than
those you hope to have in the future. Answer as honestly and realistically
as you can because this inventory will help you tailor your learning to your
particular needs. Instructions on scoring and interpreting the results are
provided in the analysis section at the end of the assessment.

1. I try to persuade and influence employees rather 1 2 3 4
than force them to do what I want.

2. I design work assignments so they are 1 2 3 4

interesting and challenging.

3. I strive to match an employee’s ability and 1 2 3 4

talent with job responsibilities.

4. Knowing that employees have different needs and 1 2 3 4

wants, I try to personalize rewards and feedback.

5. I provide immediate positive feedback and other 1 2 3 4

forms of recognition for work that is well done.

6. Many of my professional needs are met in 1 2 3 4
my current job.

7. I would not be satisfied working for another 1 2 3 4

healthcare organization.

8. I try my best and give full effort in my current job. 1 2 3 4

Becoming an Effective Leader in Healthcare Management 11

9. Emotionally, it would be difficult for me to leave 1 2 3 4

my current job.

10. Other healthcare organizations can’t compare 1 2 3 4

with mine.

11. I allow the team to have input in any decision 1 2 3 4
that affects team performance.

12. I strive to show team members that I trust 1 2 3 4

them implicitly.

13. I set high standards of team performance 1 2 3 4

and outcomes.

14. I strive to foster a culture that values teams and 1 2 3 4

team development.

15. I lay out a clear vision and specific short-term 1 2 3 4

goals of what our team can accomplish.

16. I try to do only the work that must be done by 1 2 3 4
me and delegate the rest.

17. I am regarded by my superior as a good delegator. 1 2 3 4

18. I delegate with the thought that it helps staff 1 2 3 4

grow to their fullest potential.

19. When I delegate responsibility, I make sure that 1 2 3 4

staff have the full authority to perform the task

20. I review my job every 3–6 months to see whether 1 2 3 4

I can increase my delegation to staff.
12 Becoming an Effective Leader in Healthcare Management

21. I strive to be an “active listener” by using eye 1 2 3 4
contact, head nods, smiles, “uh-huhs,”
restatements, and leaning forward.

22. If staff haven’t understood my message, it means 1 2 3 4

I haven’t communicated effectively.

23. My staff members tell me about bad news (e.g., 1 2 3 4

problems, mistakes, delays) as well as good news.

24. I draft reports that are clear, concise, persuasive, 1 2 3 4

and well structured.

25. Throughout my presentation, I make eye contact 1 2 3 4

with all segments of the audience.

26. In attempting to resolve a conflict, I look for 1 2 3 4
common areas of agreement.

27. When there is conflict, I try to clarify the interests 1 2 3 4

of both parties and create an agenda for resolving
the dispute.

28. I try to keep the discussion focused on problems 1 2 3 4

rather than on personalities.

29. I encourage parties to generate possible solutions 1 2 3 4

and spell out the benefits of each.

30. I help the parties to come to agreement on 1 2 3 4

the best solution.

31. Being a manager means coaching employees. 1 2 3 4

32. I revise performance plans with the employee 1 2 3 4

and provide additional coaching as needed.
Becoming an Effective Leader in Healthcare Management 13

33. I communicate a positive attitude when coaching 1 2 3 4

to convey my belief in employees’ ability to
achieve their goals.

34. When coaching, my focus is on current 1 2 3 4

performance and potential achievement.

35. My superiors consider me to be an effective coach. 1 2 3 4


36. During interviews, I put the individual at ease and 1 2 3 4
attempt to maintain a relaxed, friendly tone.

37. I start interviews by being direct and specific 1 2 3 4

about my agenda or my concerns.

38. I try to listen actively and use good eye contact 1 2 3 4

and positive body language to communicate my
respect, interest, and concern.

39. I view the outcomes and success of counseling as 1 2 3 4

dependent on the individual’s involvement, so I
encourage his or her full participation.

40. To avoid any possible misunderstanding on my 1 2 3 4

part, I check out my perceptions of the situation
or concern with the individual.


41. I follow a multistep decision-making model to 1 2 3 4
ensure a sound decision.

42. I make my decisions in a timely fashion and 1 2 3 4

ensure that they are implemented.

43. My superiors consider me a strategic thinker. 1 2 3 4

44. I combine analytical methods and creative 1 2 3 4

approaches in making decisions.
14 Becoming an Effective Leader in Healthcare Management

45. I constantly check to ensure that my team 1 2 3 4

operates within the strategy.

46. I develop my goals and objectives for the 1 2 3 4
coming year before I prepare my budget.

47. I adjust my budget periodically to correct for 1 2 3 4

changes in projections.

48. I study the budget manual and follow it closely in 1 2 3 4

preparing my budget.

49. I prefer a flexible budget so that my projections 1 2 3 4

can be corrected for changes.

50. I communicate budget issues directly with my 1 2 3 4

staff and get their input.


51. I use management accounting reports to 1 2 3 4
manage my unit.

52. I use benchmarks in monitoring performance. 1 2 3 4

53. I use accounting ratios to analyze financial 1 2 3 4


54. I know how my organization’s mission and goals 1 2 3 4

relate to its overall financial management.

55. I can read and analyze my organization’s 1 2 3 4

financial statements.


56. I maintain balance in my personal and professional 1 2 3 4
life by pursuing hobbies and interests.

57. I can arrange my work life so it doesn’t spill over 1 2 3 4

into my personal life.
Becoming an Effective Leader in Healthcare Management 15

58. I have made the most of my talents and abilities. 1 2 3 4

59. My values match the organization’s core values. 1 2 3 4

60. There is a good fit between me and my job, family, 1 2 3 4

and organization.


61. I feel reasonably calm and centered even if 1 2 3 4
I am under pressure.

62. I undertake only as many tasks as I can handle 1 2 3 4

at once.

63. I know and practice several immediate stress 1 2 3 4

reducers such as mindfulness and deep breathing.

64. I deal with tasks by prioritizing my workload. 1 2 3 4

65. I would say that, for the most part, I am able to 1 2 3 4

cope with my workload.

Self-Assessment Analysis: Global

Add your circled scores together to arrive at your total score. Then, refer
to the following scoring ranges to identify your level of skill and attitudes
toward leadership. For the assessment as a whole, if you scored in the

221–260 You are in the top quartile.

191–220 You are in the second quartile.

120–190 You are in the third quartile.

119 or below You are in the bottom quartile.

16 Becoming an Effective Leader in Healthcare Management

Self-Assessment Analysis: Specific Skill Sets

Now compute your scores for the specific set of skills. Enter each score
on the line provided.

1. Engagement, Commitment, Motivation

2. Team Performance

3. Delegation

4. Communication

5. Negotiation

6. Coaching

7. Counseling and Interviewing

8. Strategic Thinking and Decision Making

9. Budgeting

10. Financial and Human Resources Monitoring

11. Organizational and Personal Resources and Fit

12. Time and Stress Management

Interpretation of Scores
For each specific set of skills, the following scoring ranges suggest that

16–20 You appear to have highly developed skills in this area.

11–15 You appear to have reasonably well-developed skills in
this area.

10 or below Your skills in this area appear to need improvement.