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
Based
Leadership
Development
Improved
Organizational
Performance
Improved
Leadership
© 2007 National Center for Healthcare Leadership.
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Improved
Health
Status
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
Skill
Knowledge
Baseline
Necessary for
top performance
but not sufficient
Behaviors
Attitudes
Values
Other Characteristics
© 2007 National Center for Healthcare Leadership.
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Distinguishing
characteristics
that lead to
longer-term
performance
and success
The Competency Study Process
Relationship between methods &
validity of results
HEAVY DUTY
RESEARCH-BASED
MODEL (35+ BEI’s)
FULL-SCALE BEIBASED MODEL (20+ BEI’s)
INVESTMENT $$$
HYBRID MODEL (5-15 BEI’s)
BENCHMARKING
EXPERT PANEL + BENCHMARKING +
STRATEGIC INTERVIEWING
GENERIC MODEL
EXPERT PANEL
TARGET
CRITICALITY/PRECISION & VALIDITY OF RESULTS
© 2007 National Center for Healthcare Leadership.
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TIPPING POINT/
ALGORITHM
ROI
NCHL Competency Research
What technical and behavioral characteristics create
outstanding performance?
In-depth
Interviews
Future Vision
• 84 Total
• Career Stages
• Professions
• Health
• IOM Agenda
• Pharma/biotech
• Futurists
• Insurance
• Global Leaders
What defines
today’s best
health leaders?
+
What will the 21st
Century require?
© 2007 National Center for Healthcare Leadership.
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+
What can we
learn from
others?
NCHL Competency Model
Benchmark
Findings
Three Domains of the NCHL Model
© 2007 National Center for Healthcare Leadership.
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Scaled Competencies
Influence
Degree of Sophistication
4. Develops behind the scenes support
3. Uses indirect influence
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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Target
Level
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
Managing Managers
Managing
Others
Transformation
People
© 2007 National Center for Healthcare Leadership.
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Execution
Managing
Self
Institute for Transformational Healthcare Leadership
Leadership development
programs “equip” healthcare
leaders to be successful
throughout their careers
Senior
Executives
One system grounded in worldclass research and execution of
leadership development:
Managers of
Managers
 NCHL’s evidence-based
approach to leadership
development focuses on
action learning for
healthcare leaders
 GE’s proven approach to
leading change and
sustaining a performance
culture
Front-Line Managers
Nursing
Strategic
Alignment
Medicine
Operating
Values &
Cycle
Competencies
Recruitment Learning &
& Selection Development
Administration
Performance Talent Review &
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”
ASSESSMENTS
INDIVIDUAL
FEEDBACK
GROUP
FEEDBACK
DEVELOPMENT
AND
ONGOING
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
© 2007 National Center for Healthcare Leadership.
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3) People
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
GROUP
FEEDBACK
INDIVIDUAL
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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ASSESSMENTS
GROUP
FEEDBACK
INDIVIDUAL
FEEDBACK
DEVELOPMENT
AND
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.
National Center
for Healthcare Leadership.
•© 2007
Leaders
incorporate
90-Day Action Plan activities into annual Performance
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., crossorganizational 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
(including non-financials)
Actual organizational performance, used as a calibrating
mechanism
Organizational Strength
Determine ability of current team to successfully create and
implement strategic/operational plan, includes hire, fire,
development plans
Replacements/Back-ups &
Vulnerability
Likelihood of vacancies, ready now, ready later, need for
development/external recruiting
High Potential Review
Ensure the retention and development of high performers
and high potentials, and appropriate movement
Leadership Pipeline
-- Retention
-- College recruiting
-- Cross-organizational
movement
-- Interns/external recruiting
Determine whether progress is being made, ensure
appropriate pipeline of talent
© 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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