Building a Culture of Leadership
Creating and Sustaining a
High-Performance Leadership Culture
Some Practical Perspectives
from SOMC Leaders1,2,3
Kendall L. Stewart, MD, MBA, DLFAPA
Six Disciplines Client Summit 2013
1Any
person who aims to speak about leadership must approach that task with fear and trembling.
will speak about leadership at SOMC, where I have more than 30 years experience.
3I hope my limited perspectives will be thought-provoking.
2I
Why is this important?
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Every leader says she wants to
create and sustain a culture of
excellence in her organization.
But only a minority of
organizational leaders are willing
to pay the price.
Complacency, impatience and a
natural resistance to change are
hard to overcome.1
Success is a huge barrier.
For those who are serious and
willing to pay the price, here are
some practical strategies that will
work.
The work is incredibly hard,
almost entirely thankless and
never done.
But we signed up for it.
1Persuading
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After listening to this
presentation, you will be able to
answer the following questions:
 Why is leadership excellence
such a challenge?
 What common leadership
flaws limit leadership
effectiveness?
 Why is physician leadership
such a challenge in health
care?
 What are some of our
expectations for SOMC
leaders?
 How are we sustaining our
culture of leadership
excellence?
 What are our results?
leaders to do what it takes is harder than teaching a man to be romantic.
Why is leadership excellence such a
challenge?
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There is no formula for producing successful leaders.
Every leader is flawed; the biggest flaw is that the leader
doesn’t see it.
There are all kinds of “successful” leaders including
negative, disruptive and evil leaders.
And there is a leadership Bell Curve too.
There are those who want to lead and can’t, and those
who could but won’t.
There is the inevitable leader turnover.
Leaders first try what worked in their last job; when they
figure out that approach is wrong, they master new skills
then move to the next level and repeat the same
mistakes.1,2
Leaders are always part of the solution and part of the
problem.
And this is the short list.
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Six Disciplines Client Summit 2013
1Your
2On
first day as a new leader is terrifying—unless you are completely stupid.
my first day as a read doctor, I took over a service of 30 crazy people.
What common leader flaws limit
leadership effectiveness?
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The fearful leader
The thin-skinned leader1
The perfectionist leader
The selfish leader
The entitled leader
The angry leader
The lazy leader
The naïve leader
The avoidant leader
The unrealistic leader
The complacent leader
The leader who keeps secrets
The leader who needs to please2
The leader who tells people what they
want to hear
The resistant leader
The coasting leader
The procrastinating leader
1Exceptional
2The
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The inflexible leader
The leader who does not walk the talk
The risk-adverse leader
The always-late leader
The blaming leader
The excuse-making leader
The passive-aggressive leader
The abrasive leader
The abusive leader
The clueless leader
The gossiping leader
The emotional leader
The impulsive leader
The unprepared leader
leaders expect and thrive on opposition; this is why salespeople usually make such poor leaders and Board members.
widespread notion that if anyone is unhappy the leader is to blame is particularly pernicious.
Why is physician leadership1,2,3 such a
challenge in health care?
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Our health care system is physician-centric;
physicians are highly influential leaders—ready
or not.
We trained in a feudal system; we expect to be
feudal lords and ladies of our own fiefdoms
within a few years of finishing our training.
Physicians want leadership titles and more
money, but we rarely want to actually lead.
We believe leadership is easy; we just show up
and tell people what to do.
And we have one prescription for everything;
just do whatever it takes to make physicians
happy.
Six Disciplines Client Summit 2013
1Physician
leaders are often elected by their peer for one-year terms; their job is to carry complaints to administration.
hospitals have physicians they employ, physicians employed by their competitors and independent physicians.
3Few physician leaders identify with administration or embrace any significant organizational perspective.
2Most
What are some of our expectations
for SOMC leaders?
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1 “This
We expect leaders to
focus on results.
We expect leaders to be
respectful team players.
We expect leaders to lead
by example.1,2,3
We expect leaders to hold
themselves and others
accountable.
We expect leaders to talk
to people instead of about
them.
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We expect leaders to
manage their emotional
arousal appropriately.
We expect leaders to have
servant hearts.
We expect leaders to grow
thick skins.
We expect leaders to field
the best-available teams.
We expect leaders to
embrace (energizing)
discomfort.
is Physician Leadership Rounds, not Physician Blaming Rounds.”
problem in here is your problem”
3 “Anger is a leadership flaw; angry behavior is a leadership failure.”
2 “Every
What are SOMC’s top ten leadership
strategies?1
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Focus on results.
Become a process improvement expert.
Manage yourself first.
Field the best-possible team.
Remind yourself that most of the work in the world is
done by average people.
Extrude net-negative people.
Embrace discomfort.
Learn to manage crises while striving to prevent
them.
Think, innovate and act.
Lead physicians effectively.
Six Disciplines Client Summit 2013
1Twice
each year, the executives meet with all new leaders to go over these principles and to explain WHY and HOW.
How are we sustaining our culture
of leadership excellence?
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Leadership Rounds
Leadership Council
Leadership
Development Institute
Leadership Teams
BookNotes
Leadership Blog
Innovations Group
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Physician Leadership
Rounds
Physician Leadership
Council
Physician Leadership
Institute
Physician Executive
Fellowship
Administrative
Partnerships
What are our results?
Patient-Centered Perfection is the Goal
100%
89.9%
94.4%
93.3%
79.1%
80%
79.1%
87.2%
60%
40%
20%
0%
Safety
Safety

Quality
Quality

Service
Service
Relationship Performance
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Relationships
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Overall
YTD
Performance
What do our patients think1 about our
leadership culture?
1I
recently learned how quickly our patients expect us to respond from Amazon.
What do our employees think about
our leadership culture?
100
80
60
40
20
0
2009
2010
2011
SOMC Percentile Rank Performance
2012
What do our leaders think about
our leadership culture?1
100
80
60
40
20
0
2009
2010
2011
2012
SOMC Percentile Rank Performance
1In
our 2012 survey, a number of SOMC leaders made negative comments about our recent decisions not to hire tobacco
users.
What do our physicians think about
our leadership culture?1,2
99.4
Medical Records
98.5
Laboratory Services
97.2
Nursing Care
96.2
Surgical Services
Patient Safety
95.2
Emergency Services
94.8
91.6
Administration
Hospitalist Services
89.5
Anesthesia Services
89.0
Place to Practice
87.7
Quality of Care
87.6
77.2
Radiology Services
75.3
Pathology Services
0.0
1”Excellent”
20.0
Percentile Rankings
Research Consultants, May 2013
2Professional
40.0
60.0
80.0
100.0
What have you learned?
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Building and sustaining an organizational
culture of excellence is hard.
It cannot be done without leaders who are
passionately committed to excellence.
Most leaders are not; the top 10% is only
10%.
Fortunately, you do not need everyone; you
just need enough to get it done.
And if you look hard for potential, clarify your
expectations and give them the support and
tools they need over time, you can find
enough passionate leaders to do it.1
Six Disciplines Client Summit 2013
1As
an aspiring leader, I heard the voice of God in Kmart.
Where can you learn more?
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Download “Expectations for SOMC Leaders” and use this document as a
resource for your own expectations white paper.
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Join the discussion about practical approaches to more effective
leadership on the SOMC Leadership Blog.
Learn more about Southern Ohio Medical Center here.
Review and download this presentation and related presentations and
white papers here.
Read Results That Last: Hardwiring Behaviors That Will Take Your
Company to the Top to review some leadership strategies that
successful health care executives have embraced.
Learn more about how to confront others effectively by reading A
Portable Mentor for Organizational Leaders.
Learn more about how to execute these leadership strategies more
successfully by reading Six Disciplines Execution Revolution: Solving
the One Business Problems That Makes Solving All Other Problems
Easier.
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Six Disciplines Client Summit 2013
How can you contact me?1
Kendall L. Stewart, M.D.
VPMA and Chief Medical Officer
Southern Ohio Medical Center
Chairman & CEO
The SOMC Medical Care Foundation, Inc.
1805 27th Street
Waller Building
Suite B01
Portsmouth, Ohio 45662
740.356.8153
StewartK@somc.org
KendallLStewartMD@yahoo.com
www.somc.org
www.KendallLStewartMD.com
1Speaking
and consultation fees benefit the SOMC Endowment Fund.
Six Disciplines Client Summit 2013