10 Ways Leaders Make Hard Work Harder

Leaders in the leadership contractVince Molinaro wrote a short leadership book called, The Leadership Contract: the fine print to becoming a great leader. Wiley, 2013.  It’s a quick read, full of great bits of wisdom.  I liked his list called ’10 Ways Leaders Make the Hard Work Harder.’

  1. Getting in over your heads.  Ask for help to prevent your organization being stuck at your level of incompetence.
  2. Confusing rough with tough.  Old-fashioned, army-style leadership values roughness.  Never mistreat people.
  3. Mistaking effort for results.
  4. Feeling like a victim.
  5. Being insecure.  You will come across as wishy-washy
  6. Needing good news.  If you ignore bad news, you get stuck.
  7. Winning at all costs.  Too much competition views everyone as an adversary.
  8. Waiting for permission.  YOU are the leader; get going.
  9. Driven to distraction.  Too many incomplete projects will vie for attention.
  10. Losing perspective. Don’t get mired in the details.

Have you read any good leadership books recently?  Feel free to share the title below!

 

Healthcare Leadership – Hiring Our Own to a Fault?

Healthcare LeadershipMedicare hires from within; we generally don’t look for outside talent.  Even when we try, it’s usually from crown corporations or government bureaucracy.  Other industries hire talent from outside.  Why don’t we?

Leadership career paths for senior hospital administrators seem to be very similar, almost identical.

Does this make Medicare stronger?

Healthcare Leadership Career Paths

Clinical path:

Start in clinical field: nursing, allied health, etc.  Become a clinical educator, then clinical coordinator, then clinical manager, then administrative program director, then VP, then Chief other-than-executive Officer (COO, CFO, etc.).

Finance path:

People seem to come into the finance department from business school or accounting programs.  Then they work their way up through the manager, director, VP, Chief streams ahead of them.

Facilities path:

From the little I know about facilities managers, they seem to follow a similar path up through the hospital system.

IT path:

Similar to finance, up through the hospital.

HR path:

Up through the system like the others.

There are notable exceptions, and everyone knows them because they are so rare.  (Over the last few years, some physicians are applying for VP positions in Ontario, but MDs rarely hold more than 1 or 2 of the VP positions, and in many hospitals there are no physicians on the senior team.)

Healthcare Leadership Fact:

Medicare hires its own. 

Nearly 100% of Medicare leaders have all their experience in a publicly run organization.

Would Medicare benefit from outside talent hired from other industries?  Selection committees often hire what they know, people with shared experience.  Should we change selection and interview processes to increase the chance of outside talent being successful?

Rebuttals:

It doesn’t matter if leaders come up through the system; all that matters is how they think.  Then how do we encourage staff to not think like everyone else in similar positions?

The system determines behaviour and approach; it doesn’t matter where staff come from.  I agree.  System change requires new thinking.  Do we really want change in Medicare?

Medicare leadership requires extensive knowledge, it’s fundamentally different.  I disagree.  If that were so, Medicare would pay for more physicians in senior leadership positions.  Smart nurse leaders know a ton about nursing.  And just as physicians don’t understand nursing like nurses do, nurses don’t understand medicine like physicians.

What do you think?   Should healthcare leadership hire more talent from outside?  Should bureaucrats have business experience from competitive industries? What will happen to Medicare if we continue to foster a ‘crown corporation’ mentality?

(photo credit: exchange3d.com)

Great Governance, Great Decisions

Effective GovernancePeople know great governance, even when they don’t have words to describe it.  Great decisions pass our sniff test.  But, organizations get into big trouble when governance stinks.  Glen Tecker, governance consultant, has helped over 2000 companies put words to corporate frustration and find better ways of working.  I wrote about a presentation he gave before.  Here are some highlights from a recent one.

Good Governance: Difference between Oversight, Supervision, and ‘Snoopervision’

Oversight concerns itself with what and whether we accomplish what we wanted.

Supervision concerns itself with what and how work is accomplished.

Snoopervision concerns itself with what, how, and who does what, which leads to ‘administrivia’.

Corporations need to ask:

What do we want to accomplish?

What sort of organization is required?

What resources do we need?

Governance Requires Clarity of purpose:

Consider a curling team.  What happens if everyone thinks the stone should land somewhere different?  Desired outcomes are impossible without clarity on what we need to do, what’s required to do it, and how we will get the job done.  The parts of a rocket must all pull together.  What happens if pieces decided on their own where they wanted to go?

Organizations need to decide whether they will fund:

A group

An activity

An outcome

If we fund groups, we need organizational charts.

If we fund activities, we need series of business lines.  We need to know about programs and business lines within the organization.

If we want outcomes, we need clarity on outcomes, first.  We must have clear, measurable goals, and a definite picture of what we don’t like about the current state before we can work at achieving an outcome.

Stakeholder needs, wants and preferences determine what we hope to accomplish.

We make decisions using available information, not timely, accurate, or relevant information.

Available information comes from experience, reading, and conversations.

Assumption becomes surrogate for truth; assumption based on available information.

Where does your mental model, for what a governance unit, or person, should be doing, come from?  Does your mental model fit with the current issue?

Form follows function and Function follows purpose.

How do you define Fairness:  everyone gets the same vs. everyone gets what they need?

Culture + process + structure feeds into governance.  Governance itself is authority, process, and capacity

Levels of engagement in decision-making:

  • A – decision
  • B – involved
  • C – consulted
  • D – informed
  • E – no involved

From Building Better Boards, by David Nadler, 2004 HBR