Abstract
Healthcare systems are embarking on efforts to improve organizational leadership as a lever to promote organizational efficiency. Such efforts have a solid base of research attesting to their effectiveness, and some view them as particularly cost effective. This chapter fills an important gap in the literature on healthcare systems leadership by presenting (1) a rationale and approach from the perspective of a healthcare systems chief executive officer for understanding the strategic planning, resources, and expenditures associated with efforts to prepare, hire, evaluate, develop, and support clinical leaders; (2) a theoretical foundation and framework for a systems approach to an organizational healthcare leadership pipeline; and (3) a sample case study describing the observed outcomes of a strategically developed leadership pipeline. The case study highlights the resources required to put in place and operate clinical leadership pipelines—pipelines for preparing, hiring, supporting, and managing clinical leaders—based on one large healthcare system.
TopSection 1
In this section the authors present a rationale and approach from the perspective of a healthcare system’s CEO for understanding the strategic planning, resources and expenditures associated with efforts to prepare, hire, evaluate, develop, and support clinical leaders.
Rationale
Healthcare much like the law, education and engineering requires esoteric knowledge. The cultures of these professions are well established and attempts to reform them must come from within or the resistance will be strong. Most of healthcare reform has come from the outside trying to use payment methodologies to change behavior, but fundamentally people want the same healthcare delivered, but they want it for less. Unless the model of delivery changes it is unlikely that sufficient change will occur to bend the cost curve. It seems that the most effective way to change a profession is to empower enough critical mass of providers to both create and embrace change.
Efficient healthcare delivery requires a multi disciplinary, well-coordinated clinical team in which each member has an important and orchestrated role in ensuring that patients are properly cared for. Some of the roles such as physician and nurse are historically synergistic, mostly complementary, and require a great deal of professional respect for the boundaries between them. Whereas newer relationships such as physician administrator - developed as a result of the complexities of modern healthcare and the business model - frequently lead to perceptions of turmoil amongst an organization's bureaucratic culture due to the focus on expertise rather than seniority.
Key Terms in this Chapter
Dyad: A dyad model includes a physician leader as well as a manager that partner together to run the practice.
Intensivist Care Model: Physicians and providers that are trained in critical care medicine create a model of care for the ICU patient that recognizes early and important changes in the critically ill patients.
Clinical Collaboration: Interdisciplinary conversations create the necessary collaboration of care and individualization of care for each patient. The quality, reduction of patient harm, and improved team member success and engagement results.
Leadership Development: Expansion of a person’s capacity to be effective in leadership roles and processes is considered leadership development: those that facilitate setting direction, creating alignment, and maintaining commitment in groups of people who share common work.
Competency: Competencies are specific knowledge-based skills, abilities, or expertise in a subject area. When these skillsets are shared across a profession, they are said to have core competencies.