challenges facing healthcare leaders: management competencies
TRANSCRIPT
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Challenges facing Healthcare Leaders:
Management CompetenciesOrganizational Complexity
Wallace Lockhart, University of Regina
Allen Backman, University of Saskatchewan
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Five core disciplines of Public Health• Epidemiology• Health Promotion• Biostatistics• Environmental Health• Health Policy and Management
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Need to re-think curriculum for Health Management Program
Is current program • providing the right competencies?• targeted at the right levels, • The right people?
Where should future program be focused?
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Need to re-think curriculum for Health Management Program Do we emphasize
• Leadership?
• Core areas (Hard skills)? Accounting and Finance Organizational Behaviour Marketing Human Resources
Management Strategic Planning
• Personal skills Emotional intelligence and
relationship management,
• Personal attributes Commitment, values and
motivation.
• Broader concepts Life-long-learning &
responsiveness.
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Why study management competencies? We have a variety of competency maps; We have lots of management programs; But our organizations have changed …
Are we keeping up with those changes? What you do is valuable!
• … despite popular political rhetoric (if you aren’t a care-giver, what label is given to you?)
• … and it is important to discuss this
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Project Parameters: Management is broad field: personal
attributes, leadership, EI, life-long learning
Our focus: Management competencies in 4 categories (care giving, strategy, core management, and financial / analytical).
3 levels: Front line, middle & senior
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Past Studies: MacKinnon (2003) Competencies, Gaps Hewitt (2006) – Human Resource Dilemma CCHSE (2006) – Discussion Paper
So what have we learned? That we don’t know enough!
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The Research
Quantitative & Qualitative – Triangulation Questionnaire Survey
• 266 CCHSE members – CEO, VP, HRM• Mix of CEO, VP, Manager / Director
Depth Interviews – Survey respondents Focus Group – at 2008 NHLC
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PART 1 - COMPETENCIES
1) How important are each of (list of 18 items), for managers at each level?
2) Current average competency level in your organization, for each item.
From these two, we extrapolate “THE GAP”
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Competency Areas for Research Caregiving
• General Knowledge• New Developments• Professional Practice
Managing Quality Knowledge of other HC Professions Strategic Thinking Decision-Making/Judgment Process Redesign Partnership, Collaboration &
Advocacy
Leadership Communications Organization/Human Resource
Mgmt Managing in a Team Environment Financial – Read & Interpret
Reports Financial – Budgeting Financial – Responsibility for
Budget Analytical Skills (Qual/Quantitative) Use of I.T./Technology Tools
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RESULTS – PART 1
We will scan Front Line & Senior levels Importance The GAP
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FRONT LINE: Important?
Most Important Communications Managing – team env. Care Giving skills Managing quality
Least Important Process Redesign * Financial & Analytical Strategic Thinking
*: take note!
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FRONT LINE: THE GAPGreatest GAPS Communications Managing quality Leadership Managing teams Process redesign! *
*: What? It’s not that important!
Least GAPS Partnership & collab Strategic thinking Care giving
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Part 1 Discussion – Front Line We promote strong clinicians to managers
• OR – we promote passion / leadership But they lack management skills; AND …
we don’t train them very well or give them time for school.
Larger organizations: less emphasis on financial, analytical & strategic.
Who provides training? CHA, not grad pgms
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Competencies of Front Line Managers: Compare based on Respondents' Years as a Manager
2.00
2.20
2.40
2.60
2.80
3.00
3.20
3.40
3.60
Caregiving Strategy Core Mgt Financial
Sc
ale
: 1
= V
ery
We
ak
; 5
= V
ery
Str
on
g
Up to 10 11 - 20 More than 20
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SENIOR MANAGERS: Important?
Most Important Leadership Strategic Thinking Communications Decision Making Financial - Budget
Least Important I.T. / tech tools Care giving
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SENIOR MANAGERS: THE GAP
Greatest GAPS Process Redesign Communications Managing Quality Strategic Thinking Analytical Skills
Least GAPS Financial – Budget Care Giving
How important were these competencies 25 years ago when we had smaller, simpler organizations?
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Part 1 Discussion – Middle Mgrs Competency ratings low across the range. Large gaps in the most important areas Position challenge: between the top and the
front (communications are key – and weak) Process redesign is key – and very weak!
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Part 1 Discussion – Senior Mgrs(We are just the messengers, don’t shoot us .. these are
views of senior managers, many of you!)
Gaps are smaller than other levels, but still some important concerns.
Many have graduate management degrees, yet major GAPS in strategy, analytical skills, communications … why?
(Hmmm … ummm, come to think of it, we’re the teachers. Never mind; ignore this; let’s move on …)
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Part 1 – Other discussion Looking up / looking down Financial: Either important – or not! Leadership: Definable? Learnable? Accreditation: Competencies vs Attributes Universities: Core competencies, part-time,
flexible, perhaps certificate programs?
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PART 2: ORGANIZATION FACTORS
This is where the fun part starts! Just a few insights – for now!
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The Questionnaire – Part 2Organizational factors that may influence a manager’s ability to do their job.
Sufficient skills? Sufficient authority? Analytical support? Time! Training / Succession
ORG: do P&P help? Org structure – help? Span of control Org complexity
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SMALL ORGANIZATIONS ARE INEFFICIENT. BUREAUCRATIC.
BIG IS BETTER.
RIGHT?
Re-Regionalization
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Number of Employees: The complexity of our organization constrains managers' effectiveness
0%
10%
20%
30%
40%
50%
60%
70%
80%
UNDER 2,000 2,000 - 5,000 5,000 - 10,000 OVER 10,000
Agree / Strongly Agree
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2727
Organization Factors, Compare by Organization Size (# Employees): "Organization structure gets in the way of communication"
0%
10%
20%
30%
40%
50%
60%
UNDER 2,000 2,000 - 5,000 5,000 - 10,000 OVER 10,000
Agree / Strongly Agree
2828
Number of Employees: Our organization has sufficient management training opportunities
0%
10%
20%
30%
40%
50%
60%
UNDER 2,000 2,000 - 5,000 5,000 - 10,000 OVER 10,000
Agree / Strongly Agree
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YOU AND YOUR MANAGEMENT TEAM SEE THINGS IN THE SAME
WAY, RIGHT?
Hey, Boss …
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Different Perspectives: Our organization's policies and procedures give clear guidance to
managers
0%
10%
20%
30%
40%
50%
60%
70%
CEO VP Mgr/Dir
Agree / Strongly Agree
3131
Differing Viewpoints: Organization structure gets in the way of communication
0%
10%
20%
30%
40%
50%
60%
CEO VP Mgr/Dir
Agree / Strongly Agree
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A few more …
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Clinical vs Non-Clinical Managers: Line managers' span of control is too broad to ensure effectiveness
0%
10%
20%
30%
40%
50%
60%
70%
CLINICAL NON-CLINICAL
Agree or Strongly Agree
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Will Management Succession Be Problematic? Compare responses based on years as a manager
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Up to 10 11 - 20 More than 20
Agree / Strongly Agree
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Conclusions – Part 1 We have a better sense of strengths & GAPs
• Process redesign; managing quality; analytical skills; strategy … doesn’t that come from engineering and business schools?
Front line managers – the greatest GAPs What can we do about it?
• Healthcare organizations• CHA – provides / supports core mgt programs• Universities – opportunities, non-trad’l programs
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Observations – Part II Organizational factors are at least as important as
management competencies. Regional healthcare organizations continue to
evolve … We have to make sure we have people with the competencies needed to manage them!
Integration of complex, diverse services is a complex organizational and operational challenge.
Big, complex organizations aren’t working!
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So … What do we do about this? Universities:
• What can/should we teach? • How much conceptual vs experiential?• Should we train the front-line managers?
Healthcare organizations:• Do org systems let managers manage?• Why would strong clinicians take mgt job?• Do you provide needed training opportunities?
