ACHE Seminar 108:�Gimme SHELDR!�Prepping for �Strategic Health Leadership �(SHELDR)

30 March 2017

0900-1200PM

Administration and Workbook� ���

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Disclosure Of Relevant Financial Relationships

The following faculty of this continuing education activity has no relevant financial relationships with commercial interests to disclose:

• Douglas E. Anderson
• David E. Womack

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Faculty

• Douglas E. Anderson, DHA, CPHQ, FACHE

University Adjunct Faculty and Healthcare Consultant

MBO Partners

13454 Sunrise Valley Dr #300�Herndon, VA 2017

Douglas.E.Anderson57@gmail.com

• David E. Womack, MHA, FACHE

SVP, Area Manager - Kern County

Kaiser Permanente�5055 California Ave., #240�Bakersfield, CA 93309

David.E.Womack@kp.org

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Learning Objectives – Fast and Interactive

• Understand why and how strategic health leadership is imperative to your success
• Assess yourself using the Strategic Health Leadership (SHELDR) competencies
• Refer to the Workbook for Competencies
• Apply ideas to “begin or refine” development of a personalized: 
• Leadership philosophy (PLP) &
• Leader development plan (LDP)

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A Great Way to Gather and Organize Your Thoughts and Ideas From This Week!

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Agenda to Support the Learning Objectives

• Introduction – WHY – Apply What You’ve Learned
• Share insights on cohort of senior leaders
• Complete “Honest” Self-assessment
• Personalized Leadership Philosophy (PLP)
• Develop Leadership Philosophy outline 
• Customized Leader Development Plan (LDP)
• Draft Your Leader Development plan
• Session Summary and Discussion
• Leadership Toolkit (Resources) to Sustain You!

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Fast Paced, Interactive. Challenging

Reference the Workbook (i.e., Competencies)

Check In = Short Time Outs and Nudges

Take a Comfort or Stretch Break at Any Time

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Warning: Therapy Session .. Crucible of Experience? Growth Moment? Thoughts?

• Think about a leader you know
• “Positive” traits, attributes, actions, imperfections? OR
• Toxicity to create a “toxic” experience? How? Why? Impact?
• Ask yourself about this crucible:
• Why did I choose a ”positive” or “toxic” leader or situation?
• What are my assumptions?
• What influenced my assumptions?
• How will I perform in a more dynamic environment?

How do I develop myself to be or not to be “THAT LEADER”?

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“I experienced poor leadership early on...my mentor helped me. I decided, if I stayed in the [Service] I would be the leader everybody expects to have” ~Study Participant

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Session 1: Introduction to the Strategic Health Enterprise Leadership (SHELDR) Study� ���

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Session 1: Overview

• Strategic Health Leadership (SHELDR) Study
• Opportunity, Proposition, the Study
• Leadership Gaps
• SHELDR Model
• Self Assessment
• See Workbook
• SHELDR Study Insight
• Summary

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Opportunity, Proposition, the Study

• Opportunity: Leaders must be adept at mastering VUCA-driven turbulence; gaining insight from successful strategic leaders is a start
• Volatility, Uncertainty, Complexity, and Ambiguity (VUCA) fueled by exponential change (and opportunity) = new norm … “wickedness”
• 1000s of publications on leadership exist, few focus on the environment of healthcare and their cohorts of , especially at the strategic level
• Proposition: Studying senior health leaders will result in better leader development; leads to transforming the healthcare system at any level to be most reliable health system with the healthiest population in the world!
• The Study: Study cohort of strategic leaders (former military Surgeon Generals (SG)) on application of strategic leader competencies; compare and contrast to panel of experts to identify leader development actions

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“We go to the same medical schools and read the same leadership books, yet many think we are different” ~Study Participant

Call to Action: Health System Challenges, Strategic Leadership, Leader Development Literature Synthesis

3. Must Leverage the Future With Modern Leadership Theories and Principles

2. Outdated Leadership Models

And

Gaps

In

Leader Development

Senior Leaders Recognize Gaps in Leader Development and Leadership

• 2008: ACHE Survey determined leader development programs were variable from organization to organization; about ½ had or thinking of developing a leader development program
• 2012: Harvard University Center for Public Leadership Poll: 70% of Americans blame leadership as factor in economic decline
• 2014: Deloitte Business Confidence Survey: C-level executives did not think their direct reports had the skills for greater leadership roles
• 2015: ACHE Professional Development Task Force: identified core and emerging leadership competencies needed by healthcare executives to succeed in a rapidly evolving healthcare environment (read: transformational and complexity leadership)

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According to the 2001 IOM report, 98,000 Americans die each year from preventable errors. Yet by 2010, a NEJM study found no substantial progress citing invisibility of error, inertia, and incentives as the culprits. This was confirmed by the IOM in a 2012 report and called for Continuously Learning Leadership leading to the CEO’s High Value Checklist.

Federal Health Sector is Addressing the Gaps and Solutions Too

• 2011: RAND Corporation: reviewed health care leadership competency models—Joint Medical Executive Skills Program (JMESP). Identified several leader development opportunities:
• Understand stewardship, context in which the organization operates and global health environment (i.e., systems approach & thinking)
• Need federal health agencies to coordinate organizational leader development, partnering, and learning across agency boundaries
• 2012: Federal Health Futures Group identified 12 skills required of leaders at the enterprise or multi health system and interagency level.
• 2015: Department of Veterans Health Administration (VHA): independent assessment noted the health systems faces a “crises in leadership and culture” in addition to other systematic problems

“I experienced poor leadership early on...my mentor helped me. I decided, if I stayed in the [Service] I would be the leader everybody expects to have” ~Study Participant

Strategic Health Enterprise Leadership (SHELDR) Competency Framework Development

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Refer to Competencies in Workbook

• 1. Foundation for Study (Literature Review):
• Used strategic-level leadership references
• Bass Transformational Leadership Model (BTLM) is most reliable, used, validated, and criticized model … leaves off key elements
• 2. Method (Qualitative Research Software):
• Analyzed 76 documents; categorized (coded) 2,045 words/phrases into common competencies for strategic leadership
• BTLM enhanced with Complexity and Collaborative leadership theories
• Result: 17 Strategic Health Enterprise Leadership (SHELDR) competencies
• 3. Crosschecked With Similar Leaders:
• Analyzed 22 interviews of CEOs or CEO equivalents published in the Journal of Healthcare Mgmt., ACHE, 2010-2015
• Incorporated association and author’s strategic level competencies into results

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Learning Activity #1: Complete SHELDR Competency Self Assessment Survey (~20 min) �

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• Step 1: Do the Assessment
• Reference competencies
• 4 SHELDR Categories (A-D)
• 17 Total Competencies
• Refer to scoring items
• Novice | Improve| Aspire| Sustain
• 1 2 3 4
• Score each statement
• Total score by Category (A-D)
• Catch your AhHas, Ideas, Insights
• Step 2: Transpose Scores
• Step 3: Circle Category
• Step 4: Prepare to share your assessment

Refer To Self Assessment

Stretch Yourself! Time permitting, answer 8 Participant Interview Questions

Step 1 (4x)

Step 3

Step 2

Check In: Honest? Have A’ha Moment? Actionable Insight? See a Pattern? Connect a Dot?

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Competencies Applied by Participants and What Experts Observe Most Often (~Top 5)

“ I selected TRUST as #1; it is an outcome of developing an alternative future, influencing others to be part of the solution, and helping them succeed as leaders” ~Study Participant

Leaders Differed

Summary and Tool Kit “Preview”

• Transformation requires strategic and systems minded leaders
• Significant gaps in leader development exist
• Participants provided insight on application of the SHELDR model
• Consistent with Expert Panel Member (EPM) inputs
• Results of your self assessment provides a baseline for action

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“I was always looking for gaps and seams in the process or between functions . ” ~Study Participant

Session 2: Importance of a Personal Leadership Philosophy (PLP)��

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“Between stimulus and response, there is a space. In that space is our power to choose our response. In our response lies our growth, freedom, and character.”

~Victor Frankl

Session 2: Overview

• SHELDR Study Insight
• Crucibles
• Why A Philosophy
• Components
• Learning Activity #2
• Brainstorm
• Write
• Share
• SHELDR Study Insight
• Benefits
• Summary

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Crucibles: Events Or Persons That Shaped Study Participant’s ’s Leadership Styles

• 24% of the participant’s crucibles happened in early-mid career; 28% had help of influential individuals
• Most participants were developing their SHELDR competencies early on informally and formerly
• System approach, critical thinking, life long learner, challenge the status quo, and strategy execution accounted for 42% of the SHELDR competencies applied throughout formative years

“As I reflect back, I really hadn’t realized how much my leadership skills were being developed … I was just doing my job to the best of my ability … ” ~Study Participant

What is, and, Why Develop a Personal Leadership Philosophy (PLP)?

• Answers these critical questions:
• WHO AM I AS A LEADER?
• WHAT I BELIEVE?
• WHAT DO I STAND FOR?
• Challenges you to explore and reflect on your personal values, assumptions, experiences and beliefs about leadership
• Introspective investigation of your principles, knowledge or conduct
• Outcome: Written foundation to guide actions, behaviors, thoughts, aspirations
• Provides centeredness and character
• Enhances authenticity and resilience

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The Foundation and Starting Point For An “Authentic” Personal Leadership Philosophy

• Values
• Principles
• Beliefs
• Behavior
• Attitude
• Theory
• Leader Development
• Aspirations

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Learning Activity #2A: Brainstorm (~12 min)

• Values: Which values do you refuse to compromise? Consider grounds for quitting?
• Principles: How comfortable are you with who you are? What are your principles of leading?
• Beliefs: What is my reason for being beyond my paycheck and bonus?
• Behaviors: What is the single most important competency to you? Why this competency?
• Attitude: Am I opportunistic, a healthy skeptic, or risk adverse? Early adopter? Fence sitter?
• Theory: What is your theory of business?
• Leader Development: What’s your plan to coach, guide, and mentor your team?
• Aspirations: What is your vision? Purpose?

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Choose 1-3 Areas Below To Define YOU in the Context of the SHELDR model!

Check In: Out of Your Comfort Zone Yet? Stuck? Need a Jolt?

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See Appendix C: Example Leadership Philosophies: Reflect The Authentic You?

See Appendix D: Additional Tips On Developing Your Leadership Philosophy

Learning Activity #2B: Write It Out (~15 Min)

• Write from the lip-heart-soul!
• Get it on paper!
• Go beyond the proverbial “Mission 1st, People Always”
• Don’t sound hollow!
• You decide the format:
• 2-3 paragraphs or
• 10-12 short statements

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How I Think, Act, and Decide

• Leadership is a life long developmental journey.
• We balance work, success, and recharge time.
• I help people capitalize on their strengths and talents.
• Leader development is example, enthusiasm, passion.
• Integrity is a make or break proposition responsibility.
• I respect diversity of talent and different perspectives
• I strive to actively listen with respect and gratitude.
• I’m a staunch advocate for community health integration, innovative thinking, and action

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Feedback Always Welcome!

CEO-X: What I Believe

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I believe universal coverage will improve health the most and ultimately be more cost effective than leaving millions without care. I also believe it is a legitimate role of government to shape competitive markets for the good of society - especially the healthcare market. And where there are no private competitors in a market I believe it is a legitimate role for government to provide coverage.  

Imagine ...

1. Selected for highly visible project
2. An interviewer asks you to describe your leadership style
3. Address your C-Suite staff on Day 1
4. New CEO to provide guidance during new staff orientations (30 min)
5. You meet a brand new department chief on the elevator for 1 minute ride
6. The media places a microphone in front of you unexpectedly on a merger

Learning Activity #2C: Share Your Leadership Philosophy (~10 Min)

Facilitative Questions

• What is your vision and purpose?
• What values need to be added?
• Clarify your theory of business?
• Does it describe you or someone else?
• Do you have purpose beyond your paycheck or bonus?
• Can you practice your principles?
• What is the single most important leadership competency or strength?
• What’s your plan to coach, guide, and mentor your team? Yourself?

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Is This Really Me (You)?

See Appendix C: Example Leadership Philosophies: Reflect The Authentic You?

See Appendix D: Additional Tips On Developing Your Leadership Philosophy

Resilience Feeds Your Character, Reinforces Who You Are, Creates the Authentic Stronger You!�

• Responses varied on the set back types; very emotional and personal
• What was clear was how many reached for their faith, clung to their ethics and standards, engaged in self “positive” talk and became more resilient

Summary: Benefits of a Personallized Leadership Philosophy – Do You Agree?

• Causes self-reflection, signals seriousness
• Provides personal clarity and objectivity
• Provides courage, confidence, conviction
• Makes followership and collaboration easier
• Provides predictability of direction, accountability, expectations
• Causes you to mean what you say
• Builds your character to be centered, grounded, authentic, and resilient
• Assures you (and others) won’t get lost in a dynamic and VUCA driven world

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Session 3: Leader Development Plan (LDP) (Focus on SHELDR)

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Session 3: Overview

• Challenge of Leader Development
• Educational Gaps
• SHELDR Study Insight
• Learning Activity 3
• SHELDR Insight
• Benefits
• Summary

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Many Organizations Have Great Models, Frameworks And Competencies … The Hard Part Is Actually Developing A Personalized Leadership Development Plan … And Developing Leaders

Leadership Development Programs “Equip” Healthcare Leaders To Be Successful Throughout Their Careers

Source: National Center for Healthcare Leadership (NHCL)

Abundance of Leader Development Models, Theories, Programs (Secret Sauces?) Exist

SEE APPENDIX E: EXAMPLES OF SHELDR DEVELOPMENT METHODS FOR DEVELOPMENT IDEAS BY SHELDR CATEGORY AND COMMENTARY ON LEADER DEVELPOPENT

Gaps: Initial Education Programs Are the Foundation to Becoming a Life Long Learner

Interviews by Dr Regina Herzlinger, Harvard University, Author of Who Killed Healthcare and Consumer Driven Healthcare

“25% of the CEOs noted they were dissatisfied with traditional health care administration education they developed their own training programs and would rather hire and train good candidates with little health-related education than accept the “ready-made” graduates of most academic programs.” ~from the Survey

Expert Panel Member (EPM) Recommendations on How to Develop Strategic Health Leaders

• Strategic leadership development requires more focus on critical thinking, removing individual blinders, creating the future with simulation, exposure to complex projects.
• Self development & coaching should be supplemented with introspection and reflection

“We take promising executives, expose them to real-world situation or futuristic plans. We provide oversight and a lifeline to let them to thrive with increasing levels of complexity by pairing them with professional mentors” ~EPMx

Learning Activity #3: Create DRAFT SHELDR Leader Development Plan (LDP)

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• Step 1: What are your SHELDR Competency Development Goals?
• Step 2: What Actions Will Help You Become a Better SHELDR?
• Step 3: How Will You Sustain Momentum And Move Forward as an Aspiring SHELDR?

“Training reinforces the need to search for a specific answer. Development helps individuals recognize the opportunity, take responsibility, and be creative in their approach to situations opportunities” ~EPMx

SEE APPENDIX E: EXAMPLES OF SHELDR DEVELOPMENT METHODS FOR DEVELOPMENT IDEAS BY SHELDR CATEGORY

Refer to the SHELDR Competencies and Your Self Assessment & Philosophy

STEP 1: What are your SHELDR Competency Development Goals?

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What Do You Need To FOCUS On?

Suggestions

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Check In #1: Are You Challenging The Status Quo? Your Own Status Quo?�

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“My passion to provide better ‘Care-in-the Air’ started with my experience during the 1983 Marine Corps Barracks bombing” ~Study Participant

SEE APPENDIX E: EXAMPLES OF SHELDR DEVELOPMENT METHODS FOR DEVELOPMENT IDEAS BY SHELDR CATEGORY

STEP 2: What Action Steps Will You Take to be a Better SHELDR? Immersive Learning?

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What Are Some CREATIVE Actions and Options You Can Seize?

Suggestions

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Check In #2: Competencies Participants Applied During Their Formative (Crucible) Years, Then Accomplishments Later in Their Career

“I love turbulence. Turbulence brings opportunity. I’m convinced the skills I learned as a safety and acquisition officer helped me with the MHS (Quality of Care, Reliability, and Patient Safety) review” ~Study Participant

STEP 3: How Will You Move Forward to Sustain Momentum as an Aspiring SHELDR?

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Competencies Participants Wish they Had More Of and What Experts Say SHELDRs Need More Of

• Participant and EPMs generally agree on 9 of 17 competencies
• Critical thinking was common in the competencies most applied and throughout the interviews
• Trust and develops leaders cited by EPMs as most needed
• Participants may value trust and development of leaders as a strength thus creating an opportunity to learn from them

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“I could’ve been a better active listener, however I caveat that with the need to be able to sort through the signal-to-noise and chaff such competing agendas and tribesman-ship. I had to make the right decisions” ~Study Participant

“Building and sustaining trust allows for movement forward of the entire team. This action helps the leader to overcome resistance to change and meld the diversity of individual talent throughout the organization.” ~EPMx

Session #3 Summary – Re-Review Your Plan Frequently

• Refer to your self assessment
• Determine how to utilize or sustain your strengths
• Identify opportunities to IMPROVE | ASPIRE | SUSTAIN
• Think about admirable leaders you want model or talk to
• Define your plan with SMART-E “actionable” terms (Specific, Measurable, Action oriented, Realistic, Time bound, Elastic)
• Competency: Knowledge, Behavior, Skill, or Attribute
• Jot down action steps to help you reach your goal and assign a completion date to each one
• Assess obstacles and how to overcome them
• Identify resources available to you or you need to obtain
• Set a date to evaluate your progress towards your goal

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“A culture of innovation constitutes the reservoir foreseeing the future, challenging the status quo, and generating meaningful change. If it does not exist, they must create it. If they don’t, they will fail, and do” ~EPMx

GIMME SHELDR Session Summary

• Learning from cohorts of strategic leaders and experts provides insight
• Development of a PLP is a beginning of a journey
• Drafting a LDP is a must do and it requires updates persistence and updating
• Toolkit will sustain you between events

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Don’t Be THAT Leader!

Thrive with Purpose, Passion, Professionalism, Performance!

Closing Thoughts To Sustain Your Journey

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Health As A National Strategic Imperative and Dialogue!

Help Others Develop The Most Innovative and Reliable Health System And Create the Healthiest Population In The World

Better Equipped Strategic Minded Health Leaders (SHELDR) are Needed

Discussion and Toolkit

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Douglas E. Anderson, DHA, CPHQ, FACHE

Douglas E. Anderson is a consultant and adjunct professor. He earned his Doctorate in Health Administration (DHA) and International Health certificate from Central Michigan University (CMU). While earning his DHA, he was involved in leader development training, federal health facility evaluation, strategic communication, and business development projects. Doug is a retired Colonel of the Air Force (AF) Medical Service Corps. Prior to retirement, he served as the Director of Strategic Communication and Strategy for the AF Surgeon General (SG) and spent one-year in Afghanistan helping the Afghanistan National Police SG build their health system. He has been a CEO, COO and Corp. Staff officer working a variety of transformational initiatives. He also holds a Master's Degree in Strategy & Leadership from the Air War College, MBA from Central Missouri University, and an MA from CMU. He is a Fellow in the American College of Healthcare Executives. Phone: 703-282-7669. Email: Douglas.E.Anderson57@gmail.com .

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David E. Womack, MHA, FACHE

David Womack is the Senior Vice President, Area Manager for Kaiser Permanente in Kern County. Prior to joining KP in 2011, he served as the CEO of Whitman Hospital in Colfax WA and COO of Greenville Regional Hospital in Greenville IL. David is a retired Colonel of the USAF Medical Service Corps. He holds a Master's Degree in Strategy & Leadership from the Air Force War College, a Master's of Health Administration from Baylor University and a BS with double majors in Communications and Business from Oral Roberts University. He is a Fellow in the American College of Healthcare Executives. David is active in the community and currently serves as the Vice Chairman of the Kern Economic Development Corporation and is on the Board of the Kegley Institute of Ethics. Phone: 661-864-3392 / Email: david.e.womack@kp.org

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