Driving Leadership Development in Healthcare: The

Challenges, The Opportunity, and Imperative

Marie E. Sinioris, National Center for Healthcare Leadership

Robert G. Riney, Henry Ford Health Systems
Allan L. Weisberg, National Center for Healthcare Leadership

October 9, 2007

SHRM Foundation Thought Leaders Retreat

When we realize the everlasting truth of “everything changes”, and find
our composure in it, we find ourselves in nirvana

- Shunryu Suzuki

© 2007 National Center for Healthcare Leadership.

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The Transformation Mandate

Healthcare leadership needs to be prepared for its biggest challenges

with intensifying demands on the industry for excellent outcomes and
better value
- Michael Porter, Redefining Health Care, 2006

© 2007 National Center for Healthcare Leadership.

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The significant problems we face cannot be solved at the same level of
thinking we were at when we created them
- Albert Einstein

© 2007 National Center for Healthcare Leadership.

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Challenges in Healthcare Leadership

National Summit on Future of Education and Practice in Health

Management and Policy, 2001
 Industry Challenges (cost and quality)
 Succession/recruitment
 Mentorship declines
 Mid-advanced career education offerings
 Practitioner-academic collaboration
 Diversity

© 2007 National Center for Healthcare Leadership.

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NCHL Vision

Optimize the health of the public through leadership and organizational

excellence.

Evidenced Improved Improved

Improved
Based Organizational Health
Leadership
Leadership Performance Status
Development

© 2007 National Center for Healthcare Leadership.

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NCHL Strategy
Span the industry reaching comprehensively across:
 Career levels: career-entry, mid-career, advanced career
 Industry sectors: providers, suppliers, insurers, policy
 Professional disciplines: administration, nursing, medicine, behavioral health,
pharmacy
 Academia and Practice

Develop programs based upon sound research and global best practices
Focus on rapid development, testing, and deployment of programs
Accelerate adoption of best practices through learning collaboratives and
benchmarking
Systematically evaluate programs to assess learning outcomes and performance
improvement – evidence based management practice
Broad Dissemination to the field via collaboration

© 2007 National Center for Healthcare Leadership.

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 What is unique about healthcare leadership?
Values-based, mission-driven industry
Breadth of “customers” literally encompasses the entire population –
local, regional, national, international
Demand and supply dynamics for critical talent requires that leaders
create climates that attract and retain top talent in a highly
competitive market
Complexity and mix of independent constituencies requires higher
levels of influence and consensus-building than most leadership
roles

© 2007 National Center for Healthcare Leadership.

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Social sector Leaders are not less decisive than business leaders . . .
They only appear that way to those who fail to grasp the complex
governance and diffuse power structures common to the social
sectors.

— Jim Collins, Good to Great and the Social Sector:

A Monograph to Accompany Good to Great, 2005

© 2007 National Center for Healthcare Leadership.

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COMPETENCY
Any characteristic of a person that differentiates outstanding from typical
performance in a given job, role, organization or culture
Baseline
Necessary for
Skill top performance
Knowledge but not sufficient

Behaviors
Attitudes Distinguishing
characteristics
Values that lead to
Other Characteristics longer-term
performance
and success

© 2007 National Center for Healthcare Leadership.

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The Competency Study Process
Relationship between methods & HEAVY DUTY
validity of results
RESEARCH-BASED
MODEL (35+ BEI’s)

FULL-SCALE BEI-
BASED MODEL (20+ BEI’s)

HYBRID MODEL (5-15 BEI’s)

INVESTMENT $$$

BENCHMARKING
EXPERT PANEL + BENCHMARKING +
STRATEGIC INTERVIEWING
GENERIC MODEL
EXPERT PANEL

TIPPING POINT/
TARGET ALGORITHM
ROI

CRITICALITY/PRECISION & VALIDITY OF RESULTS

© 2007 National Center for Healthcare Leadership.

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 NCHL Competency Research

What technical and behavioral characteristics create

outstanding performance?

Benchmark

NCHL Competency Model

In-depth Findings
Interviews Future Vision
• Health
• 84 Total
• IOM Agenda • Pharma/biotech
• Career Stages
• Futurists • Insurance
• Professions
• Global Leaders

What defines What will the 21st What can we

today’s best + Century require? + learn from
health leaders? others?

© 2007 National Center for Healthcare Leadership.

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Three Domains of the NCHL Model

© 2007 National Center for Healthcare Leadership.

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Scaled Competencies
Influence

4. Develops behind the scenes support

Degree of Sophistication

Target
3. Uses indirect influence Level

2. Anticipates impact of actions or words

1. Engages audience

Competency levels increase by degree of difficulty

© 2007 National Center for Healthcare Leadership.

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 NCHL Competency Model by Career Stage

© 2007 National Center for Healthcare Leadership.

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Integrated Learning Model
 NCHL Integrated Learning Model

Executive Level

e s
iti
al
od
M

Managing Managers
ng
ni
ar
Le

Managing
Others

Managing
Transformation People Execution Self
© 2007 National Center for Healthcare Leadership.

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Institute for Transformational Healthcare Leadership

Leadership development programs One system grounded in world-class

“equip” healthcare leaders to be Senior Executives research and execution of
successful throughout their careers leadership development:
 NCHL’s evidence-based
approach to leadership
Managers of development focuses on
action learning for
Managers healthcare leaders
 GE’s proven approach to
leading change and
sustaining a performance
culture
Front-Line Managers

Nursing Medicine Administration

Strategic Operating Values & Recruitment Learning & Performance Talent Review &
Alignment Cycle Competencies & Selection Development Management Succession

Preparing leaders to innovate and drive high performance

© 2007 National Center for Healthcare Leadership & General Electric Co.
Confidential & Proprietary Information
Critical Success Factors

 Shared vision – leadership and organizational transformation

 Accountability for learning and performance outcomes
 Information for evaluation, continuous feedback and
benchmarking
 Commitment of resources, time, and energy

© 2007 National Center for Healthcare Leadership.

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 Greatness is not a function of circumstance. Greatness, it turns out,
is largely a matter of conscious choice, and discipline.

— Jim Collins, Good to Great and the Social Sector:

A Monograph to Accompany Good to Great, 2005

© 2007 National Center for Healthcare Leadership.

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 Henry Ford Health System
and
National Center for Healthcare Leadership

Robert G. Riney
Executive V.P./Chief Operating Officer
Henry Ford Health System
October 9, 2007
Coming together is a beginning;
keeping together is a progress;
working together is success.

-Henry Ford

© 2007 National Center for Healthcare Leadership.

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 Henry Ford Health System Overview

Henry Ford is one of the nation’s leading

comprehensive health systems, providing
acute, specialty, primary and preventative
care services, backed by excellence in
research and education.

© 2007 National Center for Healthcare Leadership.

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Creating the “Leadership Development Experience” at
Henry Ford Health System

In 2003 HFHS joined NCHL as a LENS member.

Recently we had the opportunity to more fully leverage the power of that
relationship.
Over the last 7 months HFHS and NCHL have come together to create a
Leadership Development Experience for the Executive team at HFHS.
By integrating with internal programs we have been able to offer a
comprehensive approach to leadership development.
Our leaders are enthusiastic and engaged and there appears to be a
renewed spirit around the importance of leadership development and
talent management.

© 2007 National Center for Healthcare Leadership.

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“Leadership Development Experience”

The “Leadership Development Experience” process encompasses the

identification of competencies, leadership simulations, 360-degree
feedback tools, climate surveys, group and individual development
plans, and executive coaching opportunities.

Each of these elements will be linked to performance management,

talent reviews, and succession planning.

This process incorporates many of our own initiatives and is managed

internally to create a true sense of ownership and sustainability within
our organization.

© 2007 National Center for Healthcare Leadership.

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“Leadership Development Experience”
As our Executive team progresses through their own “Leadership
Development Experience” we have the opportunity to create a stronger
culture of openness around leadership and coaching.

Currently we are completing the assessment phase and have begun the
executive coaching feedback sessions.

We will conclude the initial phase in October with a clear development

plan for our leadership team.

Together the Executive team and the HR leaders will evaluate this
process and determine how to best roll out the experience to other levels
of leadership within the organization.

The following slides outline our current Leadership Development

process for our executive team.
© 2007 National Center for Healthcare Leadership.

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 “Leadership Development Experience”

DEVELOPMENT
AND
INDIVIDUAL GROUP
ASSESSMENTS ONGOING
FEEDBACK FEEDBACK
PERFORMANCE
MANAGEMENT

Performance Management: Aligning and developing leader

competencies and skills to enhance overall capabilities in
achieving individual and organizational goals.
© 2007 National Center for Healthcare Leadership.

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ASSESSMENTS

- Group Simulation Experience (teams of Executive Leaders)

- Group Feedback Sessions (same teams from Simulation)
Provided by The LEAD Center

© 2007 National Center for Healthcare Leadership.

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 The LEAD Center
In 2006 HFHS invested in developing our own leadership simulation center.
This center is referred to as: The LEAD Center (Leadership, Evaluation,
Assessment, and Development).

The Center is a “Cognitive Simulation Center” aimed at assessing and

developing leaders’ decision-making skills as they pertain to strategic
thinking, creativity, vision integration and execution, and crisis response.

The LEAD Center specifically addresses innovation, teamwork, conflict

resolution, the act of engaging stakeholders, change management, crisis
resolution, and strategy development.

This Leadership Development Framework will incorporate the use of the

LEAD Center as both an assessment tool for group feedback and as a
development tool for individual growth.
© 2007 National Center for Healthcare Leadership.

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ASSESSMENTS

- Group Simulation Experience (teams of SET members)

- Group Feedback Sessions (same teams from Simulation)
Provided by The LEAD Center

- Leadership 360 Degree Evaluation

- Organizational Climate Survey (cultural audit)
Provided by NCHL

© 2007 National Center for Healthcare Leadership.

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National Center for Health Care Leadership (NCHL)

NCHL’s vision is that an integrated leadership development system model will

lead to improved leadership and organizational performance resulting in
improved health status.

NCHL’s mission is to be a catalyst for industry-wide collaboration to assure

that high quality, relevant and accountable health management leadership is
available to meet the needs of 21st century health care.

In 2003 HFHS made a commitment to work with NCHL as a member of the

Leadership Excellence Network (LENS) to further develop HFHS leadership
capabilities. NCHL works with a collaborative group of progressive healthcare
systems across the country all dedicated to evidence based learning and
development.

© 2007 National Center for Healthcare Leadership.

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 NCHL Continued

The leadership competencies that are assessed in the 360 degree

evaluation are categorized into three categories:

1) Transformation 2) Execution 3) People

© 2007 National Center for Healthcare Leadership.

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 NCHL Continued

The Organizational Climate Survey assesses a Leader’s skills as it relates to creating a

culture of:

Flexibility
Responsibility
Standards
Rewards
Clarity
Team Commitment

© 2007 National Center for Healthcare Leadership.

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ASSESSMENTS

- Group Simulation Experience (teams of SET members)

- Group Feedback Sessions (same teams from Simulation)
Provided by The LEAD Center

- Leadership 360 Degree Evaluation

NCHL
- Organizational
Leadership
Climate360
Survey
Degree
(cultural
Evaluations
audit)
OrganizationalProvided
Climate Survey
by NCHL(cultural audit)

- Preference Indicator Survey

MYERS BRIGGS TYPE INDICATOR (MBTI)

© 2007 National Center for Healthcare Leadership.

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Myers Briggs Type Indicator (MBTI)
This tool assess individual preferences in order to provide better
awareness regarding individual style and team dynamics.
The MBTI reports preferences on four dichotomies, each consisting of
two opposite poles:
Extraversion and Introversion (Where you prefer to get your energy)
Sensing and Intuition (How you prefer to take in information)
Thinking and Feeling (How you make decisions)
Judging and Perceiving (How you deal with the outer world)
This assessment will be used to enhance the awareness and
understanding of team dynamics and enhance an individual’s ability to
flex to other preferences.

© 2007 National Center for Healthcare Leadership.

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ASSESSMENTS INDIVIDUAL
FEEDBACK

INDIVIDUAL LEADERSHIP DEVELOPMENT

HFHS will provide all Leaders with a written comprehensive

Development Package which will include:
1) Results from all Assessments (NCHL, LEAD Center, MBTI)
2) Individual Development Plan
a) Executive coaching opportunities
b) Current HFHS University offerings
c) Additional learning opportunities/programs
3) 90 Day Action Plans

NCHL will provide a facilitated feedback session to review the

Development Package with each Leader in a coaching and feedback
Session to create their Individual Development Plan.
© 2007 National Center for Healthcare Leadership.

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ASSESSMENTS INDIVIDUAL GROUP
FEEDBACK FEEDBACK

GROUP LEADERSHIP DEVELOPMENT PLANNING SESSIONS (SET)

HFHS and NCHL will co-facilitate a Group Leadership Development

Planning Session with all SET members to:

1) Review the composite results and identify strengths and

opportunities for improvement in relationship to HFHS strategic
goals and values.

2) Create a Group Development Plan, organize priorities and

determine action items to support organizational strategies,
goals and outcomes.

© 2007 National Center for Healthcare Leadership.

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 DEVELOPMENT
GROUP INDIVIDUAL AND
ASSESSMENTS FEEDBACK FEEDBACK ONGOING
PERFORMANCE
MANAGEMENT
Leaders participate in ongoing development opportunities identified within
their Individual Development Plan.

Leaders participate in a customized Individual Simulation session from the

LEAD Center. (one time experience)
• Simulation will focus on Leader’s specific strengths and opportunities
for improvement as part of a development opportunity.
• Leaders participate in an individual feedback session.
• Results will be incorporated back into their Individual and 90-Day
Development Plans.

Ongoing Performance Management

• Leaders review 90-Day Action Plan quarterly with development Coach
(TBD).
• Leaders report results of their development progress back to their respective
Senior Leader for additional feedback.
•© 2007
Leaders incorporate
National Center 90-Day Action Plan activities into annual Performance
for Healthcare Leadership.

Evaluations. All development activity41should align with Leader’s key goals

and objectives.
 Next Steps

In addition to our Executive Team members we currently have 9 high

potentials from each of our Business Units participating in the
Leadership Development Experience.

Following the completion we will evaluate this process and determine

how to roll out this experience as part of our overall Succession Planning
strategy.

© 2007 National Center for Healthcare Leadership.

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Competency-based Succession Planning

Allan L. Weisberg, Senior Vice President

National Center for Healthcare Leadership
October 9, 2007
Succession Planning at Johnson & Johnson
 Long history, 40+ years
 Disciplined approach, business cycle process, i.e. financial, strategic
planning, business planning
 Accountability of leaders, no longer need to justify the why
 “Bottom up” process goes from operating company to the Executive
Committee
 Matrix view, i.e. operations, marketing, research, etc., cross-
organizational moves
 Internal executive search process – cross-organizational,
functional/geographic movement is encouraged and expected
 Talent is a “Corporate Asset”
© 2007 National Center for Healthcare Leadership.

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Elements of Succession Planning at
Johnson & Johnson
Element Why
Strategic/Operational Plan Organizational/people/competency implications
Organizational Metrics Actual organizational performance, used as a calibrating
(including non-financials) mechanism
Organizational Strength Determine ability of current team to successfully create and
implement strategic/operational plan, includes hire, fire,
development plans
Replacements/Back-ups & Likelihood of vacancies, ready now, ready later, need for
Vulnerability development/external recruiting
High Potential Review Ensure the retention and development of high performers and
high potentials, and appropriate movement

Leadership Pipeline Determine whether progress is being made, ensure appropriate

-- Retention pipeline of talent
-- College recruiting
-- Cross-organizational movement
-- Interns/external recruiting
© 2007 National Center for Healthcare Leadership.

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Observations about Healthcare
For a long time, talent management was not valued?

Why?
 No shareholder equity
 Careers governed by function as opposed to organizations
 Healthcare systems from individual hospitals
 Mentality of “buying it” rather than “developing it”
 Tenure of CEOs
 “Business processes can’t work here” mentality

© 2007 National Center for Healthcare Leadership.

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Healthcare organizations are getting the message that
great leadership is vital to great results
 Incredible healthcare challenges
 Outside boards
 Shortage of current and future talent
 Success rate of “external” hires
 Exposure to other organizations, i.e.
 GE
 Johnson & Johnson
 IBM
 3M
 Need for more business focus and accountability
© 2007 National Center for Healthcare Leadership.

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What will it take for healthcare organizations to be
successful in developing and retaining great talent?
 CEO commitment, backed up by a great HR leader, i.e.
actions vs. words
 Sticking to it with discipline and rigor
 Accountability of all leaders
 Talent as a “system-wide” asset
 Get started “do a little, learn a lot”

© 2007 National Center for Healthcare Leadership.

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