Across the healthcare sector, patient care is at the center of all that we do. Based on our leadership development and executive coaching work with health systems, we know that authentic and collaborative leadership is the key to providing and advancing high-quality, value-based care.
We also know that, beyond the baseline goals of reducing errors and adverse events, outcomes are defined and measured differently by healthcare systems, patient groups and clinical specialties. For example, palliative medicine will prioritize patients’ quality of life and symptom management, while the outcomes for sports medicine center on restoring patients to their former level of activity.
The Institute for Healthcare Improvement (IHI)’s quadruple aim of improving the health outcomes for patient populations, enhancing the patient experience, reducing the per capita cost of care, and improving the doctor and provider experience has been tested in 2021 as our healthcare industry adapts to pre- and post-COVID system shakeups and changes. We believe that strong system leadership matters more than ever. Healthcare leadership is central to how or if organizations achieve the quadruple aim.
“Significant positive associations between effective styles of leadership and the ability to meet the quadruple aim have been reported in the literature,” says Dr. Robert Simpson, a recent presenter in our “Future of Work” learning series.1 “Effective leadership is among the most critical components that lead to organizational successful.”
Based on our work and experiences across the health ecosystem, we have selected the top four leadership traits and leadership practices that determine how well organizations can advance cost, quality, value, and engagement in 2021 and beyond.
Investing in Talent
American healthcare has a persistent and predicted staffing shortage and is challenged in the area of attracting and retaining qualified talent. This directly impacts the continuity and quality of patient care.
Remember that old adage about how employees quit their managers not their jobs? It’s true. It’s also true that employees jump ship when those managers provide few or no opportunities for skill development and career growth.
So it seems like a simple and logical formula: Supported employees = higher retention rates = consistent and better patient care.
At the center of this formula are visionary leaders who collaborate with their peers and with their HR departments to assess, plan, deploy and oversee effective talent and team development initiatives.
Equity, Diversity and Inclusion
Only 5% of American doctors are Black, while 5.8% are Hispanic. Black executives held only 8.5 percent of healthcare CEO roles. From frontline providers to the boardroom to the C-Suite, it’s clear that the healthcare industry has a documented diversity problem. In addition, in terms of patient care, the documented underrepresentation of minorities contributes to systemic health inequities for lower income groups and patients of color.
According to health-disparity reports from the Institute of Medicines and the Agency for Healthcare Research and Quality, African Americans are more likely to receive sub-par medical care. Meanwhile, in a California-based patient study, Spanish-speaking respondents reported being more dissatisfied with their medical care than dual-language patients and non-Latina, English-speaking patients.
As medical schools, companies and health systems actively commit to more diverse recruitment, retention and inclusion strategies, we see some real positive trends—but there’s still a long and steep trajectory to a more diverse and inclusive provider and work environment.
Across the healthcare ecosystem, we have found that diversity and inclusion initiatives begin and end with leaders who are strategic and deliberate about making these initiatives happen. In other words, these leaders go beyond corporate diversity statements to actually ‘walk the talk’ by aligning diversity and inclusion with their organization’s service area and patient populations. These leaders put meaningful and effective systems in place to create and sustain equitable workplaces where everyone enjoys a sense of inclusion and psychological safety. In turn, these teams are equipped and empowered to deliver more culturally-appropriate and linguistically-accessible healthcare services.
Authentic and Relational Leadership
After a year of reduced revenues and patient volume, fiscal responsibility and long-term financial sustainability really matter. So do interpersonal skills and team relationships. In their “Academic Medicine” article on healthcare leadership, the authors cite the importance of leaders cultivating strong relationships between all members of their teams:
“The role of the leader is to diagnose the relational health of the team, as well as the degree of alignment of the team toward a common mission and goals. Once relational health and degree of (team) alignment are determined, specific tactics can be deployed to cultivate relationships, team work, alignment and a shared sense of purpose.”
At TLD Group, we embrace an authentic leadership philosophy that builds a high degree of leader-to team, leader-to-leader, and sector-to-sector trust and collaborative partnerships. Authentic leaders have and model emotional intelligence, fairness, accountability, self-regulation, systems thinking, empathy and self-awareness.
Also, relational and authentic leaders recognize and motivate their teams by reaching beyond quantitative metrics such as patient volumes and revenue cycle management to highlight, cite and recognize their team’s measurable contributions to patient care and wellness.
“Transformational leadership … is characterized by creating and inspiring supportive relationships and motivation among staff members. It is cited in the literature as strongly related to the implementation of effective management that establishes a desired culture of patient safety,” writes Dr. Robert Simpson, a recent presenter in our “Future of Work” learning series.
Empowering for Systems Change
Read any healthcare Quality Improvement (QI) case study. Behind the QI’s published results and aggregated improvement metrics are a group of curious and change-agent leaders who know how to ask, “How can we do this better?”
“Creating, sustaining and achieving systemic change efforts is in large part a function of leadership,” says Tracy Duberman, Ph.D., founder and President of TLD Group.
Here’s an example: In one of his preventive-health explainer videos, Dr. Mike Evans, founder of the Reframe Health Lab (his consumer-health videos have 16 million worldwide viewers), and a former associate professor of family medicine at the University of Toronto, showcases one QI initiative at his Toronto-based hospital.
Having established a defined timeline and targeted patient-care outcomes, the inter-departmental initiative aimed to shorten the pre-surgical wait times for elderly patients with fractured hips. Through analysis, planning, and inter-departmental collaborations, this QI initiative resulted in 66% - 90% of patients being admitted to surgery within 48 hours (of hospital admission). The project yielded proven post-surgery outcomes, including reduced patient recovery times, lower pain and reduced risks for delirium and depression.
“Changing the system requires having change agents,” says Dr. Evans. “Systems thinkers are perpetually curious and don’t have all the answers.”
Also, change-agents empower and excite their teams toward outside-the-box thinking and innovation. They gather and present quantitative and qualitative data to make the case for how much their teams’ quality improvements directly impact the per-encounter cost and quality of patient care.
In his recent article at the American Association for Physician Leadership, Dale Benson, MD, CPE, FAAPL wrote: “A transformational leader is able to motivate the organization to take a deep breath and make the big leap, believing that the new paradigm, chosen by its leaders, is the right thing to do and, in fact, is the only thing to do.”