- Email: [email protected]
Engaging the next generation of health leaders: Perspectives of emerging health leaders
FEATURE ARTICLE
Engaging the next generation of health leaders: Perspectives of emerging health leaders Jennifer C. Hunt, MA, MHA, CHE; Emily Gruenwoldt, BAH, MHA; Adrienne Hagen Lyster, BComm, MPA
Abstract—Identifying and engaging the next generation of Emerging Health Leaders (EHLs) is a foremost challenge for the Canadian healthcare system. If intellectual capital is the currency of the 21st century, identifying and developing EHLs must be a strategic objective of innovative and progressive health organizations. We have integrated our experiential knowledge with some relevant findings from the literature and data collected from a cohort of EHLs to assist senior leaders and organizations with this challenge.
I
dentifying and engaging the next generation of Emerging Health Leaders (EHLs) is a foremost challenge within the context of the current Canadian healthcare system. The majority of senior leaders today are of the baby boom generation, many of whom are approaching retirement. Replacing their knowledge, experience, and expertise will require strategic conversations on talent management to ensure the next generation of leaders has been identified and is prepared to assume the healthcare leadership helm and the challenges they will face. This will involve investments of both time and money. Given our own professional experiences as EHLs and having engaged in informal qualitative research regarding career barriers and enablers, we have our finger on the pulse of EHLs’ preferred talent management strategies. We have incorporated our experiential knowledge with some of the relevant findings from the literature as well as data collected from a cohort of EHLs to ensure that current and future leaders are prepared to provide the best healthcare system to the Canadian public.
PERSPECTIVES OF THE NEXT GENERATION OF EHLS A brief survey was distributed to members of EHLs across the country to learn what they felt were effective organizational strategies to identify and develop leaders. (For additional information on EHLs, please visit www.emerging healthleaders.ca.) The survey was comprised of four From The Ottawa Hospital, Ottawa, Ontario, Canada (Ms Hunt); Emerging Health Leaders, Ottawa, Ontario, Canada (Ms Gruenwoldt); and Primary Health Services Branch, Saskatchewan Health, Regina, Saskatchewan, Canada (Ms Lyster). Correspondence: Jennifer Hunt, MA, MHA, CHE, The Ottawa Hospital, Department of Mental Health, 1053 Carling Avenue, Ottawa, ON K1Y 4E9, Canada (e-mail: [email protected]). Healthcare Management Forum 2011 24:4 – 8 0840-4704/$ - see front matter © 2011 Canadian College of Health Leaders. Published by Elsevier Inc. All rights reserved. doi:10.1016/j.hcmf.2010.12.001
questions (please see the Appendix for survey questions); we performed a thematic content analysis of their responses.
THE CHALLENGE OF IDENTIFYING EHLS Despite a steadily increasing demand for health system leaders, a leadership gap has emerged. As a result, health organizations are scrambling to establish complex talent management systems to help fill this void and to retain their EHLs. Far from being a “soft” initiative, talent management is the engine that drives success in today’s healthcare environment.1 Jim Collins, author of “Good to Great,” suggests that people are not your most important asset, the right people are.2 Post-secondary institutions and private industry have rightly identified the demand for executive leadership training as a multisector priority. If intellectual capital is the currency of the 21st century, identifying clinical and nonclinical EHLs must be a strategic objective of innovative and progressive health organizations. But who are these EHLs, and how are they most effectively prepared for senior leadership positions? When members were asked to identify the most effective ways for organizations to identify EHLs, they reflected on the importance of considering both the intrinsic qualities and extrinsic behaviours that young leaders may possess. Key characteristics that identify emerging leaders according to our survey data include valuing lifelong learning, having strategic vision and innovative ideas, and possessing strong communication skills. Extrinsic behaviours of emerging leaders include pursuing graduate education, involvement in professional development activities and associations, and a willingness to take on increased responsibility and risk. In the past, EHLs were identified largely based on qualitative measures. Literature from as recent as 10 years ago would identify a “keeper” as “an employee an organization would fight to keep.”3 Identifying EHLs, and talent management more broadly, is now a rigorous and quantitative science that begins with organizations
ENGAGING THE NEXT GENERATION OF HEALTH SYSTEM LEADERS: PERSPECTIVES OF EMERGING HEALTH LEADERS
engaging in a reflective exercise to identify the values, skills, and competencies that will enable them to realize their strategic priorities. Once these criteria are established, best practice would suggest that organizations engage in a cyclical (ie, annual) nomination or volunteer process to identify EHLs, facilitated by a rigorous performance review process. In larger organizations, securing broad engagement in the selection of candidates results in a stronger talent pool overall. A talent management committee comprised of the CEO (or senior management representatives), midlevel managers, human resources representatives, and patient group or frontline representatives (if appropriate) is ideally situated to review applications/nominations against objective organizational criteria. EHLs are recognized as a small group of individuals who embody the core competencies and values of the organization, have shown superior accomplishments, and have inspired others to attain superior accomplishments in line with organizational priorities (Berger and Berger).4 This best practice approach for the identification of EHLs closely aligns with survey data of members of EHLs. Respondents to the EHL survey suggested using the following formal and informal identification mechanisms: 1. Establish a framework for regular performance reviews involving goal setting and feedback. This allows management to monitor performance and to identify individuals with high leadership potential; 2. Create a database to document the breadth and depth of EHLs skills as they relate to organizational priorities; and 3. Use informal tactics such as recommendations and feedback from colleagues. The literature and survey data show that it is crucially important that EHLs are engaged in discussions regarding their identification as high potentials as well as in determining the appropriate next steps in their development, which will be further discussed. There should be no stigma attached to an emerging leader who, for any reason, declines to enter the accelerated development track for high potentials.
DEVELOPING EMERGING HEALTH LEADERS: THE ACE MODEL Two of the four survey questions asked respondents to indicate how senior leaders and their organizations can retain EHLs and, more specifically, what steps their own organizations could take to develop these individuals for current or future leadership opportunities. The responses revealed that organizational strategies should address three key areas, which we have termed the ACE Model: Achievement, Continuing education, and Engagement. A
third question was posed to learn about “current myths” (Table 1 outlines the details below).
Achievement A common characteristic among EHLs is their strong orientation toward achievement. EHLs take pride in their work and appreciate the opportunity to disseminate the results to others. The chance to translate knowledge or theory into practice appeals to them, particularly when strategic analysis or consideration for environmental context is required. Stretch goals, those “that cannot be achieved by incremental or small improvements but require extending oneself to the limit to be actualized,”5 are therefore an important strategy to use with this group.6 Equally significant, EHLs need and want to be held responsible and accountable for their work. If organizations regularly delegate authority or accountability to others, EHLs may feel undervalued and/or frustrated, leading them to seek out external opportunities. Providing recognition is another strategy that will assist in contributing to a sense of achievement. EHLs, typical of Generations X, Y, and the Millenials, value informal and formal acknowledgment of their accomplishments. Withholding recognition until such time as an annual performance appraisal is a critical mistake; Table 1. Five myths about EHLs 1. EHLs are not loyal to their organization. EHLs are incredibly loyal, provided employers find ways to recognize them for their achievements and, furthermore, offer opportunities for continuing education. EHLs want to engage and be engaged to make a difference. 2. EHLs do not put in the hours. EHLs work just as hard as baby boomers; they may just work differently. Rather than working rigid 9 to 5 hours, EHLs value the opportunity to work in a flexible environment. Loosen the reins on traditional policy and watch your EHLs thrive working at home or working non-traditional hours. 3. EHLs think they know it all. Quite the opposite! EHLs are looking for opportunities to be mentored and coached by senior leaders, within their organization or beyond. EHLs value hearing about the experience you have had, even though they may find alternate paths to achieve the same success. 4. EHLs want more money. EHLs value recognition for their accomplishments. Financial incentives are motivating for some EHLs but not all. Many would place value in flexible work hours, opportunities for continuing education, or verbal recognition privately or before their peers. 5. EHLs are not interested in leadership positions because they are too focused on work-life balance. Work-life balance is important to EHLs but so too is career satisfaction. Finding creative solutions for EHLs to have both career achievement and family opportunities will increase their organizational loyalty.
Healthcare Management Forum ● Forum Gestion des soins de sante´ – Spring/Printemps 2011
5
Hunt, Gruenwoldt, and Lyster
instead, provide them with timely and specific recognition for their accomplishments. Career advancement is perhaps the ultimate achievement for EHLs. Survey respondents indicated that they would like their organizations to clearly identify the skills and abilities that are required and valued in order to advance. A tool such as the Canadian Health Leadership Network’s “LEADS in a Caring Environment” framework provides individuals and organizations with a shared understanding of the key competencies and skills to lead in today’s healthcare sector.7 Within the context of career advancement, it is important to understand that “skating,” which is when individuals transition between positions every 2 to 3 years, can be a win-win for both the organization and EHLs when the transitions are intraorganizational. In contrast, interorganizational skating has often been viewed as a sign of employee disloyalty; however, this may be more accurately reflecting the reality that internal advancement opportunities are not available, are unknown, or are not provided to EHLs. These leaders understand the importance of obtaining progressive career experience; organizations should be encouraged to provide such opportunities and to ensure that EHLs are aware of the possibilities for their future career growth either through the development of individualized career plans or through regular performance and goal reviews. Keeping EHLs apprised of advancement opportunities in their organization and those that are expected to be available in the future are an important development and retention tactic.
Engagement An important component to retaining and developing EHLs is providing them with opportunities to engage with senior leaders within their organizations. An adapted version of the ladder of engagement framework depicts eight levels of engagement that EHLs may experience (Table 2). The higher the “rung,” the greater the degree of responsibility, accountability, and visibility and, therefore, the higher the level of engagement. A multipronged approach that facilitates relationship building and provides increased visibility of senior leaders can foster a strong sense of engagement. It is important to note that organizations do not necessarily need to make significant financial investments in order to create engagement among EHLs. Formal mentorship programs are an excellent vehicle to engage these leaders and increase their feeling of connectedness to their organization. Another option is to offer EHL annual forums or retreats held by senior leaders. These forums provide opportunities for Table 2. Ladder of engagement
Continuing education EHLs actively seek out professional development opportunities. Providing support so that these leaders can attend workshops, seminars, or conferences is an excellent strategy to provide formal education while simultaneously expanding their professional networks. Senior leaders and their organizations may wish to examine their current level of professional development investments for EHLs. If there is room for improvement, consult with your EHLs to learn about their professional development priorities. To reach the next level, empower EHLs to put into practice the theory they have learned; this further enhances their skill set and demonstrates to them that their senior leaders want them to contribute their knowledge and abilities. Organizations who invest in continuing education are making an investment into their future and an investment in their employees, which will result in strengthened commitment and loyalty in an era of competition for scarce talent. Continuing education need not be formal. EHL survey respondents indicated that organizations may wish to consider establishing a corporate infrastructure for com6
mittees, working groups, and special projects, which offers EHLs the opportunity to participate and contribute as an equal player. Intraorganizational or external secondments, internships, or residencies are also effective strategies as are formal or informal mentorship programs. Such programs are seen as key tools with which to provide EHLs with invaluable opportunities to learn from senior leaders and to develop skills that are valued by their organizations.
Level
Positioning of EHL
Example
8
Engagement
7
Management
6
Collaborative
5
Consultative
4
Supportive
3
Tokenism
2 1
Decoration Manipulation
EHLs have ideas, set up project, and invite others to join in decision making. EHLs have initial idea and decide how project is carried out; EHLs take charge. Others have idea and EHLs are involved in each step of project planning and implementation. Project designed/managed by others but EHLs are consulted. Their views and input are valued. Others decide on project. EHLs volunteer their support and others respect their views. EHLs are asked for their opinions and have little to no control over how views are expressed. EHLs take part in a project/initiative. EHLs do or say what others instruct them to.
Healthcare Management Forum ● Forum Gestion des soins de sante´ – Spring/Printemps 2011
ENGAGING THE NEXT GENERATION OF HEALTH SYSTEM LEADERS: PERSPECTIVES OF EMERGING HEALTH LEADERS
Table 3. EHL survey results Survey question
Number of responses provided
Question #1
28
Question #2
48
Question #3
31
Question #4
18
Examples of responses Mentorship programs Residency/internship/placements Does the person have a “vision” Dedicate one or two open spots on working groups/committees/task forces for motivated employees Feedback from colleagues, word of mouth Offering a mentorship program with staff and senior leaders Find challenging assignments for these individuals Developing a culture of internal promotion Recognize their contributions to challenging assignments; personal “thank you” letter Allow for flexibility in work: hours, locations, times Make it a corporate priority Mentorship Support for continuing education Give people opportunities to work on projects Create ladders for leadership development so skills can be gained, implemented, and then built on That we are just here to breeze by and “climb the ladder” without doing the ground work Too academic and less practical Full of new ideas but not able to solve complex real life issues That health leaders primarily go into administration That we are not dedicated to the organization just because we do not work long hours
EHLs to raise concerns and questions, for groups to work together to identify new opportunities for continuous development, and for senior leaders to ask for input on key corporate issues or initiatives.
CONCLUSION Identifying and developing EHLs can involve informal and formal tactics. By creating opportunities that engage EHLs as per the Ladder of Engagement and implementing strategies that align with the ACE Model of EHL development, organizations can establish a strong foundation for talent management. Research from the private sector has concluded that “leading organizations view talent management as a strategic priority and an important long term investment that needs reviewing, refining and reinvention (in some cases) as needs and priorities change.”8 Given the ever-changing healthcare landscape, organizations that establish EHL identification and development as an ongoing strategic priority will ensure that they are cultivating their talent, will be better positioned to overcome potential gaps in succession planning, and ultimately will assist in improving our healthcare system.
APPENDIX: EHLS SURVEY ON IDENTIFYING AND DEVELOPING EMERGING LEADERS EHL is a grassroots initiative that began in with a small, core group of members in Ottawa with a vision to develop emerging health system leaders across Canada. Presently,
there are five pan-Canadian EHL nodes with over 400 members representing various healthcare sectors. The on-line survey was e-mailed to all members by their respective node cochairs. Participants were asked (but not required) to provide up to five answers for each of the four questions. Fourteen EHL members completed the survey and provided a total of 125 qualitative responses out of a possible 280 responses. Please see Table 3 for a breakdown of the number of responses per question and specific examples. The authors reviewed the survey responses to identify emergent concepts that served as the content for the ACE Model of EHL development. Question #1: In your opinion, what are the most effective ways for organizations to identify “high potential” employees for leadership positions (now or in the future)? Please provide up to five responses. Question #2: What specific initiatives can senior leaders and their organizations take to retain “high potential” employees? Please provide up to five responses. Question #3: Let’s assume your organization is interested in developing its “high potentials” for future leadership positions. What specific steps should they take? Please provide up to five responses. Question #4: What are some popular myths about emerging health leaders or “high potentials” you’d like to debunk? Please provide up to five responses.
REFERENCES 1. Ogden G. Talent management drives success. Healthcare Registration. 2010;19:11.
Healthcare Management Forum ● Forum Gestion des soins de sante´ – Spring/Printemps 2011
7
Hunt, Gruenwoldt, and Lyster
2. Collins J. Good to great: Why some companies make the leap and others don’t. New York: HarperCollins; 2001:44. 3. Sacolick I. Other companies should have to read this Netflix presentation. Available at: www.businessweek.com. Accessed August 5, 2009. 4. Berger LA, Berger DR. The Talent Management Handbook: Creating Organizational Excellence by Identifying, Developing & Promoting Your Best People. McGraw-Hill. 5. Retrieved on October 25, 2010 from www.businessdictionary.com.
8
6. Deloitte Development LLC. Talent management in health care. 2006. Available at: view.fdu.edu/files/brkprsgill.ppt. Accessed October 1, 2010. 7. Canadian Health Leadership Network. LEADS in a Caring Environment Framework. 2010. Available at: http://www.chlnet.ca/ leads-caring-environment-framework. Accessed October 25, 2010. 8. Lubitsh G, Smith I. Talent management: A strategic imperative. Ashridge J. 2007;Spring:1-6.
Healthcare Management Forum ● Forum Gestion des soins de sante´ – Spring/Printemps 2011
Engaging the next generation of health leaders: Perspectives of emerging health leaders Jennifer C. Hunt, MA, MHA, CHE; Emily Gruenwoldt, BAH, MHA; Adrienne Hagen Lyster, BComm, MPA
Abstract—Identifying and engaging the next generation of Emerging Health Leaders (EHLs) is a foremost challenge for the Canadian healthcare system. If intellectual capital is the currency of the 21st century, identifying and developing EHLs must be a strategic objective of innovative and progressive health organizations. We have integrated our experiential knowledge with some relevant findings from the literature and data collected from a cohort of EHLs to assist senior leaders and organizations with this challenge.
I
dentifying and engaging the next generation of Emerging Health Leaders (EHLs) is a foremost challenge within the context of the current Canadian healthcare system. The majority of senior leaders today are of the baby boom generation, many of whom are approaching retirement. Replacing their knowledge, experience, and expertise will require strategic conversations on talent management to ensure the next generation of leaders has been identified and is prepared to assume the healthcare leadership helm and the challenges they will face. This will involve investments of both time and money. Given our own professional experiences as EHLs and having engaged in informal qualitative research regarding career barriers and enablers, we have our finger on the pulse of EHLs’ preferred talent management strategies. We have incorporated our experiential knowledge with some of the relevant findings from the literature as well as data collected from a cohort of EHLs to ensure that current and future leaders are prepared to provide the best healthcare system to the Canadian public.
PERSPECTIVES OF THE NEXT GENERATION OF EHLS A brief survey was distributed to members of EHLs across the country to learn what they felt were effective organizational strategies to identify and develop leaders. (For additional information on EHLs, please visit www.emerging healthleaders.ca.) The survey was comprised of four From The Ottawa Hospital, Ottawa, Ontario, Canada (Ms Hunt); Emerging Health Leaders, Ottawa, Ontario, Canada (Ms Gruenwoldt); and Primary Health Services Branch, Saskatchewan Health, Regina, Saskatchewan, Canada (Ms Lyster). Correspondence: Jennifer Hunt, MA, MHA, CHE, The Ottawa Hospital, Department of Mental Health, 1053 Carling Avenue, Ottawa, ON K1Y 4E9, Canada (e-mail: [email protected]). Healthcare Management Forum 2011 24:4 – 8 0840-4704/$ - see front matter © 2011 Canadian College of Health Leaders. Published by Elsevier Inc. All rights reserved. doi:10.1016/j.hcmf.2010.12.001
questions (please see the Appendix for survey questions); we performed a thematic content analysis of their responses.
THE CHALLENGE OF IDENTIFYING EHLS Despite a steadily increasing demand for health system leaders, a leadership gap has emerged. As a result, health organizations are scrambling to establish complex talent management systems to help fill this void and to retain their EHLs. Far from being a “soft” initiative, talent management is the engine that drives success in today’s healthcare environment.1 Jim Collins, author of “Good to Great,” suggests that people are not your most important asset, the right people are.2 Post-secondary institutions and private industry have rightly identified the demand for executive leadership training as a multisector priority. If intellectual capital is the currency of the 21st century, identifying clinical and nonclinical EHLs must be a strategic objective of innovative and progressive health organizations. But who are these EHLs, and how are they most effectively prepared for senior leadership positions? When members were asked to identify the most effective ways for organizations to identify EHLs, they reflected on the importance of considering both the intrinsic qualities and extrinsic behaviours that young leaders may possess. Key characteristics that identify emerging leaders according to our survey data include valuing lifelong learning, having strategic vision and innovative ideas, and possessing strong communication skills. Extrinsic behaviours of emerging leaders include pursuing graduate education, involvement in professional development activities and associations, and a willingness to take on increased responsibility and risk. In the past, EHLs were identified largely based on qualitative measures. Literature from as recent as 10 years ago would identify a “keeper” as “an employee an organization would fight to keep.”3 Identifying EHLs, and talent management more broadly, is now a rigorous and quantitative science that begins with organizations
ENGAGING THE NEXT GENERATION OF HEALTH SYSTEM LEADERS: PERSPECTIVES OF EMERGING HEALTH LEADERS
engaging in a reflective exercise to identify the values, skills, and competencies that will enable them to realize their strategic priorities. Once these criteria are established, best practice would suggest that organizations engage in a cyclical (ie, annual) nomination or volunteer process to identify EHLs, facilitated by a rigorous performance review process. In larger organizations, securing broad engagement in the selection of candidates results in a stronger talent pool overall. A talent management committee comprised of the CEO (or senior management representatives), midlevel managers, human resources representatives, and patient group or frontline representatives (if appropriate) is ideally situated to review applications/nominations against objective organizational criteria. EHLs are recognized as a small group of individuals who embody the core competencies and values of the organization, have shown superior accomplishments, and have inspired others to attain superior accomplishments in line with organizational priorities (Berger and Berger).4 This best practice approach for the identification of EHLs closely aligns with survey data of members of EHLs. Respondents to the EHL survey suggested using the following formal and informal identification mechanisms: 1. Establish a framework for regular performance reviews involving goal setting and feedback. This allows management to monitor performance and to identify individuals with high leadership potential; 2. Create a database to document the breadth and depth of EHLs skills as they relate to organizational priorities; and 3. Use informal tactics such as recommendations and feedback from colleagues. The literature and survey data show that it is crucially important that EHLs are engaged in discussions regarding their identification as high potentials as well as in determining the appropriate next steps in their development, which will be further discussed. There should be no stigma attached to an emerging leader who, for any reason, declines to enter the accelerated development track for high potentials.
DEVELOPING EMERGING HEALTH LEADERS: THE ACE MODEL Two of the four survey questions asked respondents to indicate how senior leaders and their organizations can retain EHLs and, more specifically, what steps their own organizations could take to develop these individuals for current or future leadership opportunities. The responses revealed that organizational strategies should address three key areas, which we have termed the ACE Model: Achievement, Continuing education, and Engagement. A
third question was posed to learn about “current myths” (Table 1 outlines the details below).
Achievement A common characteristic among EHLs is their strong orientation toward achievement. EHLs take pride in their work and appreciate the opportunity to disseminate the results to others. The chance to translate knowledge or theory into practice appeals to them, particularly when strategic analysis or consideration for environmental context is required. Stretch goals, those “that cannot be achieved by incremental or small improvements but require extending oneself to the limit to be actualized,”5 are therefore an important strategy to use with this group.6 Equally significant, EHLs need and want to be held responsible and accountable for their work. If organizations regularly delegate authority or accountability to others, EHLs may feel undervalued and/or frustrated, leading them to seek out external opportunities. Providing recognition is another strategy that will assist in contributing to a sense of achievement. EHLs, typical of Generations X, Y, and the Millenials, value informal and formal acknowledgment of their accomplishments. Withholding recognition until such time as an annual performance appraisal is a critical mistake; Table 1. Five myths about EHLs 1. EHLs are not loyal to their organization. EHLs are incredibly loyal, provided employers find ways to recognize them for their achievements and, furthermore, offer opportunities for continuing education. EHLs want to engage and be engaged to make a difference. 2. EHLs do not put in the hours. EHLs work just as hard as baby boomers; they may just work differently. Rather than working rigid 9 to 5 hours, EHLs value the opportunity to work in a flexible environment. Loosen the reins on traditional policy and watch your EHLs thrive working at home or working non-traditional hours. 3. EHLs think they know it all. Quite the opposite! EHLs are looking for opportunities to be mentored and coached by senior leaders, within their organization or beyond. EHLs value hearing about the experience you have had, even though they may find alternate paths to achieve the same success. 4. EHLs want more money. EHLs value recognition for their accomplishments. Financial incentives are motivating for some EHLs but not all. Many would place value in flexible work hours, opportunities for continuing education, or verbal recognition privately or before their peers. 5. EHLs are not interested in leadership positions because they are too focused on work-life balance. Work-life balance is important to EHLs but so too is career satisfaction. Finding creative solutions for EHLs to have both career achievement and family opportunities will increase their organizational loyalty.
Healthcare Management Forum ● Forum Gestion des soins de sante´ – Spring/Printemps 2011
5
Hunt, Gruenwoldt, and Lyster
instead, provide them with timely and specific recognition for their accomplishments. Career advancement is perhaps the ultimate achievement for EHLs. Survey respondents indicated that they would like their organizations to clearly identify the skills and abilities that are required and valued in order to advance. A tool such as the Canadian Health Leadership Network’s “LEADS in a Caring Environment” framework provides individuals and organizations with a shared understanding of the key competencies and skills to lead in today’s healthcare sector.7 Within the context of career advancement, it is important to understand that “skating,” which is when individuals transition between positions every 2 to 3 years, can be a win-win for both the organization and EHLs when the transitions are intraorganizational. In contrast, interorganizational skating has often been viewed as a sign of employee disloyalty; however, this may be more accurately reflecting the reality that internal advancement opportunities are not available, are unknown, or are not provided to EHLs. These leaders understand the importance of obtaining progressive career experience; organizations should be encouraged to provide such opportunities and to ensure that EHLs are aware of the possibilities for their future career growth either through the development of individualized career plans or through regular performance and goal reviews. Keeping EHLs apprised of advancement opportunities in their organization and those that are expected to be available in the future are an important development and retention tactic.
Engagement An important component to retaining and developing EHLs is providing them with opportunities to engage with senior leaders within their organizations. An adapted version of the ladder of engagement framework depicts eight levels of engagement that EHLs may experience (Table 2). The higher the “rung,” the greater the degree of responsibility, accountability, and visibility and, therefore, the higher the level of engagement. A multipronged approach that facilitates relationship building and provides increased visibility of senior leaders can foster a strong sense of engagement. It is important to note that organizations do not necessarily need to make significant financial investments in order to create engagement among EHLs. Formal mentorship programs are an excellent vehicle to engage these leaders and increase their feeling of connectedness to their organization. Another option is to offer EHL annual forums or retreats held by senior leaders. These forums provide opportunities for Table 2. Ladder of engagement
Continuing education EHLs actively seek out professional development opportunities. Providing support so that these leaders can attend workshops, seminars, or conferences is an excellent strategy to provide formal education while simultaneously expanding their professional networks. Senior leaders and their organizations may wish to examine their current level of professional development investments for EHLs. If there is room for improvement, consult with your EHLs to learn about their professional development priorities. To reach the next level, empower EHLs to put into practice the theory they have learned; this further enhances their skill set and demonstrates to them that their senior leaders want them to contribute their knowledge and abilities. Organizations who invest in continuing education are making an investment into their future and an investment in their employees, which will result in strengthened commitment and loyalty in an era of competition for scarce talent. Continuing education need not be formal. EHL survey respondents indicated that organizations may wish to consider establishing a corporate infrastructure for com6
mittees, working groups, and special projects, which offers EHLs the opportunity to participate and contribute as an equal player. Intraorganizational or external secondments, internships, or residencies are also effective strategies as are formal or informal mentorship programs. Such programs are seen as key tools with which to provide EHLs with invaluable opportunities to learn from senior leaders and to develop skills that are valued by their organizations.
Level
Positioning of EHL
Example
8
Engagement
7
Management
6
Collaborative
5
Consultative
4
Supportive
3
Tokenism
2 1
Decoration Manipulation
EHLs have ideas, set up project, and invite others to join in decision making. EHLs have initial idea and decide how project is carried out; EHLs take charge. Others have idea and EHLs are involved in each step of project planning and implementation. Project designed/managed by others but EHLs are consulted. Their views and input are valued. Others decide on project. EHLs volunteer their support and others respect their views. EHLs are asked for their opinions and have little to no control over how views are expressed. EHLs take part in a project/initiative. EHLs do or say what others instruct them to.
Healthcare Management Forum ● Forum Gestion des soins de sante´ – Spring/Printemps 2011
ENGAGING THE NEXT GENERATION OF HEALTH SYSTEM LEADERS: PERSPECTIVES OF EMERGING HEALTH LEADERS
Table 3. EHL survey results Survey question
Number of responses provided
Question #1
28
Question #2
48
Question #3
31
Question #4
18
Examples of responses Mentorship programs Residency/internship/placements Does the person have a “vision” Dedicate one or two open spots on working groups/committees/task forces for motivated employees Feedback from colleagues, word of mouth Offering a mentorship program with staff and senior leaders Find challenging assignments for these individuals Developing a culture of internal promotion Recognize their contributions to challenging assignments; personal “thank you” letter Allow for flexibility in work: hours, locations, times Make it a corporate priority Mentorship Support for continuing education Give people opportunities to work on projects Create ladders for leadership development so skills can be gained, implemented, and then built on That we are just here to breeze by and “climb the ladder” without doing the ground work Too academic and less practical Full of new ideas but not able to solve complex real life issues That health leaders primarily go into administration That we are not dedicated to the organization just because we do not work long hours
EHLs to raise concerns and questions, for groups to work together to identify new opportunities for continuous development, and for senior leaders to ask for input on key corporate issues or initiatives.
CONCLUSION Identifying and developing EHLs can involve informal and formal tactics. By creating opportunities that engage EHLs as per the Ladder of Engagement and implementing strategies that align with the ACE Model of EHL development, organizations can establish a strong foundation for talent management. Research from the private sector has concluded that “leading organizations view talent management as a strategic priority and an important long term investment that needs reviewing, refining and reinvention (in some cases) as needs and priorities change.”8 Given the ever-changing healthcare landscape, organizations that establish EHL identification and development as an ongoing strategic priority will ensure that they are cultivating their talent, will be better positioned to overcome potential gaps in succession planning, and ultimately will assist in improving our healthcare system.
APPENDIX: EHLS SURVEY ON IDENTIFYING AND DEVELOPING EMERGING LEADERS EHL is a grassroots initiative that began in with a small, core group of members in Ottawa with a vision to develop emerging health system leaders across Canada. Presently,
there are five pan-Canadian EHL nodes with over 400 members representing various healthcare sectors. The on-line survey was e-mailed to all members by their respective node cochairs. Participants were asked (but not required) to provide up to five answers for each of the four questions. Fourteen EHL members completed the survey and provided a total of 125 qualitative responses out of a possible 280 responses. Please see Table 3 for a breakdown of the number of responses per question and specific examples. The authors reviewed the survey responses to identify emergent concepts that served as the content for the ACE Model of EHL development. Question #1: In your opinion, what are the most effective ways for organizations to identify “high potential” employees for leadership positions (now or in the future)? Please provide up to five responses. Question #2: What specific initiatives can senior leaders and their organizations take to retain “high potential” employees? Please provide up to five responses. Question #3: Let’s assume your organization is interested in developing its “high potentials” for future leadership positions. What specific steps should they take? Please provide up to five responses. Question #4: What are some popular myths about emerging health leaders or “high potentials” you’d like to debunk? Please provide up to five responses.
REFERENCES 1. Ogden G. Talent management drives success. Healthcare Registration. 2010;19:11.
Healthcare Management Forum ● Forum Gestion des soins de sante´ – Spring/Printemps 2011
7
Hunt, Gruenwoldt, and Lyster
2. Collins J. Good to great: Why some companies make the leap and others don’t. New York: HarperCollins; 2001:44. 3. Sacolick I. Other companies should have to read this Netflix presentation. Available at: www.businessweek.com. Accessed August 5, 2009. 4. Berger LA, Berger DR. The Talent Management Handbook: Creating Organizational Excellence by Identifying, Developing & Promoting Your Best People. McGraw-Hill. 5. Retrieved on October 25, 2010 from www.businessdictionary.com.
8
6. Deloitte Development LLC. Talent management in health care. 2006. Available at: view.fdu.edu/files/brkprsgill.ppt. Accessed October 1, 2010. 7. Canadian Health Leadership Network. LEADS in a Caring Environment Framework. 2010. Available at: http://www.chlnet.ca/ leads-caring-environment-framework. Accessed October 25, 2010. 8. Lubitsh G, Smith I. Talent management: A strategic imperative. Ashridge J. 2007;Spring:1-6.
Healthcare Management Forum ● Forum Gestion des soins de sante´ – Spring/Printemps 2011