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Über dieses Buch

Recognizing that leaders in healthcare institutions face different questions and issues in different stages of their careers, this handy, practical title offers a comprehensive roadmap and range of solutions to common challenges in the complex and changing Academic Medical Center (AMC) and health care organization. Fully updated from the very well-received first edition and including new chapters, this concise handbook offers a guide for personal career development, executive skill acquisition, and leadership principles, providing real-world, actionable advice for faculty and executives seeking help on a myriad of new issues and situations. With a slightly modified title to recognize that leaders in academic medical centers and health care systems are not limited to medical faculty, this new edition maintains much of the content of the successful first edition with revisions based on feedback from readers and colleagues. New material has been added to reflect what is happening as health care undergoes major transformation. With a broader panel of renowned authors from a mix of healthcare institutions as well as nonmedical experts in leadership and management, the book again meets its primary objective: to provide medical faculty, healthcare executives and other leaders with a contemporary, directly relevant resource that emphasizes practical skills and leadership development advice, including personal improvement, which can be used at any stage of one’s career. With critical insights and strategies for both aspiring and seasoned academicians and health executives, Management and Leadership Skills for Medical Faculty and Healthcare Executives: A Practical Handbook, 2nd Edition is a must-have resource for faculty in AMCs and for anyone with a role in healthcare leadership.

Inhaltsverzeichnis

Frontmatter

Tools of the Trade

Frontmatter

1. Developing Yourself

Abstract
No leader can afford to march in place in the current context of complexity and increasing demand for greater contribution and impact on the organization. One of the key aspects of being a leader is developing yourself. The starting point is self-awareness regarding your current level of performance, effectiveness, and satisfaction. Once you are clear what you want to change or improve, your intention to have a different outcome becomes the basis for commitment to goals and actions. With daily focus and practice of the desired behaviors, you can literally hardwire your brain using the principles of neuroplasticity to achieve sustainable improvement in performance and effectiveness. Self-development is not an option; it is an undeniable responsibility of those who call themselves leader.
Rebecca Bradley

2. Communicating Effectively: Balancing Content and Connection

Abstract
Effective communication is a balancing act between content-rich messages and connection with individuals that results in a shared meaning. In the constantly changing environments of healthcare and academic medicine, understanding how to navigate the challenges of communication is vital for successful relationships with patients, students, and peers, as well as employees and supervisors. This chapter offers a series of best practices focused on the goal of effective communication (oral and written) for those in healthcare delivery, academic medicine, and medical education. The SBAR (Situation, Background, Assessment, Recommendations) template used in the medical community is highlighted as a practical approach. Also considered is how individuals can navigate the complex and fundamentally human process of communication through listening and personal interaction.
Chris Hamstra, Janine Blakeslee

3. Giving and Receiving Feedback

Abstract
The word “feedback” often elicits a visceral reaction of defensiveness and fear, making it difficult for the feedback receiver to listen and learn. If the foundation for feedback is carefully established between the giver and receiver, communication can flow naturally and comfortably in the conversation, helping the receiver learn nondefensively. This chapter draws from best practices in organizational psychology and leadership development for giving effective feedback—the kind people are open to receive, want to hear more of, and that changes their behavior accordingly. This chapter also uses actual case studies from a teaching hospital and references applicable resources from the medical literature.
Ellen Mohr Catalano

4. Managing Conflict

Abstract
This chapter describes accepted conflict management methodology and uses a sample situation from academic medicine leadership to illustrate core skills in conflict management. It points out that conflict is inescapable and not to be avoided, and that constructive management of conflict is a core leadership skill.
Sharon Hull, John Ragsdale

5. Managing Your Time

Abstract
Time is your most valuable resource. Managed poorly, “lack of time” will be a source of frustration, stress, self-doubt, and reduced productivity. Managed well, “extra time” will result in a productive career, possible leadership roles, and the ability to engage in things you enjoy outside of work. Becoming better at managing time, just like any behavioral change, requires effort and persistence. Using a behavioral change framework, this chapter gives you a roadmap to becoming more effective and efficient with your use of time.
Todd D. Zakrajsek, Anthony J. Viera

6. Mindful Leadership

Abstract
Mindfulness has been shown to help promote patient-centered attitudes and build community among clinicians. Here, we propose a number of practical strategies that can be deployed by those working in healthcare as they seek to embody more mindful leadership. We discuss a range of skills, from deep listening to emotional self-awareness, and how they can be developed and enhanced by specific mindfulness practices.
Jillian Horton, Ronald M. Epstein

7. Prioritizing and Decision-Making

Abstract
Meeting the demand to improve population health and quality of individual care while lowering overall healthcare costs has created unprecedented challenges for healthcare educators, practitioners, and executive leadership to navigate. Leaders embracing this challenge must prioritize creativity and innovation while employing decision-making processes that are collaborative and agile enough to contend with resistance from those clinging to vanishing models of healthcare and full-throttle innovation currently underway. Without intention, prioritizing and decision-making became guided by the urgency of today’s crisis. Formal and informal processes for prioritizing and decision-making are needed to counterbalance default approaches, which lead heavily toward the status quo. This chapter offers practical approaches for setting and honoring priorities that envision a future that doesn’t yet exist and guidelines for charting a decision-making course to get there. Ultimately, prioritizing and decision-making require the alchemist’s audacity, the scientist’s relentless insistence on evidence, and a farmer’s consistent practicality.
Janet G. Hudson

Management

Frontmatter

8. Principles of Management

Abstract
The “Manager Imperative” is to get things done through assigned staff and administrative components. It asserts that there is no one best way to manage and that managers adapt their style to the situation. Effective managers continually hone their craft just like an effective medical professional continually works to be a more competent doctor, researcher, or teacher.
“Managerial Intelligence” (MI) requires knowledge and skill in 2 foundations (build positive relationships and clarify expectations) and mastery of the 3Rs: define Roles (i.e., job responsibilities) and Requirements (i.e., set staff accountability standards), and clarify Rank (i.e., formal authority).
Warren Blank

9. Running Effective Meetings

Abstract
It is critical that leaders know how to run a meeting that includes clear expectations, and good attendee input and engagement. Many types of meetings exist, generally defined by their purpose. An emergency meeting differs from a status report meeting, for example. In the former, discussion is kept to a minimum because time is short and the topic is urgent. Leaders and managers should consider eliminating unnecessary meetings that consist of routine report-outs, which may be considered irrelevant by attendees. Instead, set meeting agendas that cover critical topics that require intra- or inter-team collaboration. The intention is to make meetings efficient and value-adding to people’s work.
Ellen Mohr Catalano

10. Conducting Effective Retreats

Abstract
Creating and running effective, efficient, successful faculty retreats is both an art and a science. The best retreats are designed with the end in mind, understanding goals, objectives, and desired outcomes first. Timing is an important consideration, as is the content and who to include. A common challenge is managing dominant personalities, personal agendas, and power dynamics. Other important components to consider are whether to hire a facilitator, how to structure the agenda, and what to do to sustain momentum afterward. Understanding the fundamental components of a good retreat design limits damage and elevates successful outcomes.
Rob Kramer

11. Recruitment, Retention, and Dismissal

Abstract
Faculty are the single most important component of any academic department. They provide the innovation, skills, and experience needed to educate students, carry out research across the scientific continuum, and care for patients in the academic medical center. This chapter focuses on both the philosophical approach and pragmatics around recruitment, retention, and dismissal of faculty. Having effective control of these dimensions of departmental leadership are fundamental to maintaining an engaged, productive, and diversified faculty that functions toward a common mission.
Craig A. Buchman

12. Managing Managers

Abstract
Managing managers requires a number of competencies leaders utilize to effectively direct, deploy, and develop the members of their leadership team. The competencies associated with managing managers contribute significantly to the success of any leader and the organization they lead. As a foundational strategy for effectively managing their executive team, leaders must first clearly and simply communicate their leadership philosophy. They must then provide consistent coaching, mentoring, feedback, decision-support, and in some instances redirection, all with the goal of empowering managers. This chapter elevates the importance of managing managers by providing insights into these various functions, and also provides a number of practical strategies for managing managers.
Kyle P. Meyer, Janet M. Guthmiller

13. Promoting Professionalism and Professional Accountability

Abstract
Committed leadership, effective planning and teamwork, and reliable implementation are essential elements of successful healthcare initiatives, clinical outcomes, and research endeavors. Lapses in professional conduct at any level may undermine the teamwork necessary to achieve goals in safety and outcomes. Therefore, Academic Medical Center (AMC) leaders need means for identifying lapses and addressing unnecessary variation in professional performance. This chapter discusses application of self- and group-regulation—hallmarks of professionalism—to a hypothetical AMC faculty member, “Dr. A,” recruited to create a Coordinated Clinical Care Center, an important programmatic need for the department. Despite his department Chair’s expectations that Dr. A will implement a multidisciplinary approach to patient care, evidence accumulates that Dr. A’s performance is undermining attainment of the Center’s goals. The chapter describes an evidence-based plan and process by which AMCs may promote professionalism and restore full and effective functioning (“redeem”) physicians—both leaders like Dr. A and non-leader colleagues—who model conduct inconsistent with organizational values and a culture of safety.
William H. Swiggart, James W. Pichert, S. Todd Callahan, Thomas F. Catron, Lynn E. Webb, Martha E. Brown, Betsy Williams, William O. Cooper

14. Creating a Culture of Inclusion Through Diversity and Equity

Abstract
This chapter focuses on the importance of equity, diversity, and inclusion (EDI) as critical workforce and leadership issues in health care. It highlights the business case for EDI, and shows how inclusivity leads to employee engagement that directly impacts services and outcomes. Inclusive leadership is offered as the best practice in optimizing diversity and creating cultures of inclusion where all people are valued equally with proportional representation and equitable inclusion. Four inclusive leadership competencies are singled out to be of particular importance in the health care context, namely: (1) engagement through relational practice, (2) enablement by creating environments for others to flourish, (3) empowerment by building confidence and communities, and (4) recognizing and developing talent. This chapter also features examples of everyday workplace triggering events that make inequity or discrimination noticeable, that might spark diversity-based conflict, and poses corrective boundary spanning organizational strategies to deal with these conflicts. The section on managing inequities and insensitivities focuses on practical applications dealing with LGBTQi issues and sexual harassment in the workplace and concludes with a case study of action taken by an exemplary health care institution in an effort to raise awareness about unconscious bias in light of the #MeToo movement. Lastly, this chapter identifies pearls and pitfalls in leading EDI and concludes with a clear message: The absence of effective EDI practices comes at a significant cost. Courageous and bold inclusive leadership action is needed to develop and sustain a strong EDI culture in the health care industry.
Lize A. E. Booysen, Priscilla Gill

Leadership

Frontmatter

15. The Leadership Stance

Abstract
Effective leadership requires understanding and operating within 3 intersecting “circles”: (1) sharing a vision and goals, (2) adapting to context or situation, and (3) gaining willing followers. These 3 characteristics distinguish leadership from management, although leadership also often involves some managerial functions. To be successful, the leader needs to be attentive, self-aware, resilient, proactive, and have a clear sense of when to lead and when to manage. Especially important for the leader in a medical faculty environment is the ability to adapt to new situations and contexts.
Rob Kramer, Anthony J. Viera

16. Leadership Presence

Abstract
There is a common misnomer that “leadership presence” refers to a person’s charisma, public speaking acumen, or overall gravitas. Rather, it entails the quality of focus, attention, curiosity and awareness the leader gives to others; how present the leader is in the moment and the impact that presence has on others and on moving the organization forward. This chapter will provide insights, tips and strategies to becoming a more present, more interpersonally connected leader—one who engages with genuine interest and impact on people, morale, culture, and organizational success.
Rob Kramer

17. Forming—and Reforming—Workplace Culture

Abstract
Our cultures form us, and we form—and reform—them. As a workplace leader, part of your role is to understand the culture of your organization. Assimilating into a culture, and leading change within a culture, often hinge on how well you understand your group’s basic shared assumptions. The leader who has absorbed an organization’s values and embodies what is best about the shared culture is well positioned for effective cultural stewardship.
David Nelson

18. Coaching and Mentoring

Abstract
Coaching and mentoring are powerful disciplines for developing emotional intelligence, self-awareness, and superior interpersonal skills needed in academic medicine. These skills are increasingly important in an environment where—in addition to technical expertise—innovation, collaboration, teamwork, and effective leadership are needed more than ever before. Coaching and mentoring result in more resilient, agile, and effective individuals and teams, which ultimately improve patient experience. This chapter touches on newer concepts including reverse mentoring and micro-mentoring and then dives deep into the essence of a coaching mindset before ending with practical tips for using coaching in everyday conversations. The goal is to help you begin applying coaching skills immediately and to heighten your awareness to non-traditional mentoring opportunities in academic medicine and health care leadership.
Chuck Ainsworth

19. Leading Up

Abstract
Influencing senior leaders or people in positions of higher authority is a nuanced process. There are numerous complexities to consider, including (but not limited to) credibility, context, balancing productivity and relationships, time constraints, politics, and, ultimately, trust. This chapter focuses on key aspects of assessment, decision making, perception awareness, and the tools of communication, power, and influence to effectively lead up in the complex academic medical setting.
Rob Kramer, Matthew Mauro

20. Leading Without Line Authority

Abstract
Leading without line authority is a creative process that pursues change through the cultivation of new relationships outside of the existing organizational chart. It is an emergent process. Non-line authority leadership is often at play when undertaking new initiatives that fall outside of the existing structures and hierarchy of an institution. The motivations and drivers are academic and professional for the non-line authority leader more than they are financial and authority based. The institutional value package of vision, mission, and goals serves as the magnetic force to create new values. Value rather than cost drives discussions and negotiations. Non-line authority leaders rely less on policies and procedures and more on listening and persuasion to create new shared purpose. These leaders must be socially fearless. They identify, cultivate, and align existing constituencies around the new value and purpose. They create a common vocabulary through listening. Simple communication tools are presented that can assist those leading without line authority to achieve new goals.
Paul Roman Chelminski

21. Political Savvy

Abstract
Political behavior is human and is an inevitable part of the landscape of any organization. Political savvy involves accounting for differences in power, status, and interests of stakeholders within and without an organization. Leaders must discern, navigate, and ultimately influence the organizational landscape, which includes political behavior. Effective leaders seek to transcend gamesmanship and engage stakeholders in efforts to advance organizational vision. In complex organizations where authority is dispersed among many leaders and experts, leaders need to develop skills to “lead without telling people what to do.”
Tom Stevens

22. Moral Courage

Abstract
Moral courage involves taking principled but unpopular positions. Leaders often encounter situations in which they must speak out or act for what is right, even at personal risk of criticism, reprisal, ostracism, and even dismissal. While there are numerous individual and institutional barriers to acting with courage, leaders also have the power to create organizational cultures that promote integrity through transparent values, clear communications, courageous followership, and groupthink prevention. Leaders must also build their own capacities for courage by understanding the barriers to courage, identifying supports and role models, and cultivating the ability to broach difficult conversations.
Kim Strom

23. Leading Change

Abstract
Occasionally, despite trying every solution you can think of, the organizational change you are trying to lead is not making progress. Employees may be confused, or key players may actively resist the change. Communication techniques and management skills will only get you so far if one of the key leadership traits required for successful change needs polishing. Self-awareness, perspective, compassion, and willingness to work hard are core character traits that enable successful change leadership. Awareness of one’s limitations is the first step to personal growth and acquisition of new skills. With proper perspective, you are able to see seemingly unrelated factors and communicate to others so they see their place in the change. Compassion for yourself and others in the face of much uncertainty and willingness to work hard and do what is necessary—even when it is really uncomfortable—are key in making change management skills and techniques successful.
Elizabeth B. Upchurch

24. Thinking Strategically

Abstract
Health system leaders continue to be driven by changes in consumer behavior, demographics, reimbursement models, organizational initiatives, market consolidation, competition, and regulatory guidelines. In response, leaders in academic health systems need to marshal the very best of their raw processing power and discernment (i.e., intelligence) to recognize the immediate and future effects of their actions. Furthermore, leaders must manage “polarity thinking” in cases where complex issues are not problems that have definitive solutions, but rather contain interdependent, often opposing elements that must each be optimized at a point in time toward a strategic end. And as clinician leaders are increasingly called upon to become health system thought leaders, one of the most critical skill sets to be effective in this environment is thinking strategically. Thinking strategically is a skill business leaders use to effectively and proactively respond to the increased rate of environmental change.
Christopher J. Evans

Advancing Your Career

Frontmatter

25. Growing in Your Current Role: Reaching the Next Rung on the Ladder

Abstract
This chapter focuses on growing and progressing in your current role while simultaneously looking toward the next steps of professional achievement. Whether that next step will be another position internal or external to the institution, or new duties or responsibilities, there is a need to obtain balance and achieve success. It is commonly said that “success breeds success.” Hence, there is a patient persistence that you must seek at each stage of your career. In order to avoid overload but assume new challenges, you have to carefully balance current responsibilities with new opportunities that cross your path.
Mary Jane Rapport

26. Faculty Development and Promotion in Academic Medicine

Abstract
The careers of physicians in academic medicine go through many phases. The typical “life cycle” of a faculty member begins with the search for a position as a clinical instructor or assistant professor. Promotion to full professor is a potential crowning achievement. Along the path from prospective faculty member all the way to retirement, there are many developmental milestones. This chapter will highlight key career issues at each phase.
Warren P. Newton

27. Moving Out to Move Up

Abstract
This chapter discusses the timing and processes of assuming a more advanced leadership role. Personal and leadership growth are ongoing investments and one should look for clues within oneself and from others to determine readiness to pursue a different role. Mentors and networking play pivotal roles in career development and identification of potential career growth opportunities. Sometimes leadership opportunities may be within your existing institution. Often, an opportunity is found at another institution and one participates as a candidate in a search process. Regardless of whether you ultimately secure the new position, sincerely participating as candidate can be a growth opportunity. Once a position is landed, timing of the move is important as are first impressions a new leader brings to a new institution.
Janet M. Guthmiller

28. Executive Development

Abstract
Executives in healthcare have a vast array of responsibilities from ensuring operational excellence, developing strategies to improve health and wellbeing of patients and the community where they serve, and providing visionary leadership for leaders leading high-performance teams. In contemporary healthcare, there are myriad political, social, and historical issues that must be carefully navigated. The skills necessary for executives to be successful are rarely intuitive, and in fact require ongoing effort to develop and refine. The leader, as a continuous learner, has emergent competencies that will be refined through executive development. In this chapter, we describe a model for executive development focused on: knowing yourself, developing yourself, and knowing and growing others. Knowing yourself focuses on how each executive has great skills, knowledge, and perspective that have been recognized and rewarded by ascending to an executive role. However, those same skills, knowledge, and perspective are not necessarily going to ensure success for the executive. Developing yourself refers to embracing a growth mindset, so the executive is building the requisite skills to solve emergent and complex problems. Knowing and growing others illustrates and differentiates the roles of mentorship and sponsorship to develop new leaders while also inspiring seasoned executives.
Lilicia Bailey, Dave McIntosh

Backmatter

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