A Call for Evidence-based Leadership

Transcript of April 30, 2010 Presentation by Marie Sinioris to National Association for Healthcare Quality (NAHQ)

Evidence-based leadership will drive U.S. healthcare organizations’ performance in coming years, said Marie Sinioris, president and CEO of the National Center for Healthcare Leadership (NCHL), in her recent address to NAHQ state leaders at the State Leadership Summit in Chicago.

“Ten years ago, the Institute of Medicine (IOM) made a challenge to have 80 percent of all healthcare evidence-based. We need to do the same in management,” she said. “Is our approach to changing leadership behaviors grounded in science? Does it actually change organizational climates and individual behaviors?”

NCHL is a not-for-profit organization whose mission is to be a catalyst for high-quality healthcare management leadership for the 21st century. The organization conducts research in areas such as defining what competencies are necessary to transform the healthcare industry.

Health Reform and Leadership
Sinioris, who is also a professor of health systems management at Rush University in Chicago, says that with health reform, success will go to leaders who develop cultures that span boundaries.

“The electronic health record is absolutely essential. It goes beyond just implementing it,” she said. “Interconnectivity is essential.” To achieve community-based care and wellness, interconnectivity among healthcare records, school health records, and pharmacy networks is imperative, she said.

Sinioris called for new levels of transparency and accountability in reporting. ‘High-leveraged changes’ to our healthcare system, including nursing indicators and outpatient metrics, will lead to more informed decisions.

“This is going to be at levels that are unprecedented in our problem solving. It’s not just a fishbone analysis; it is really thinking outside the box,” Sinioris said. “We’re talking about systemic, sustainable quality at the highest levels of our organizations. [We need to] reduce disparity gaps and advance innovation to create new care models and relationships.”

Competency-based Learning
Sinioris points to a 2009 IOM report, Redesigning Continuing Education in Health Professions, which calls for a close link between professional education and quality and patient safety. “It moves away from CME and CNE credits. It’s not about getting credit, but demonstrating competence,” she said. “We’re moving from knowledge-based classroom learning to experiential learning … If leaders aren’t attending to their own professional development, how are they going to do the job and create high-performing environments for change?”

Healthcare quality leaders must possess good collaboration and communication skills, as well as an ability to partner with and be accountable for each other. Moreover, with the retirement rate of healthcare executives expected to soar in coming years, more attention must be paid to succession planning—an area far more developed in business than in healthcare.

In addition to possessing technical knowledge, quality leaders must become well versed in change management, transformation, and innovation. They must focus on and learn techniques to improve their innovative leadership capabilities to create new concepts, Sinioris said.

“[Cultivate] an ability to energize stakeholders and sustain their commitment to change focus, processes, and strategies. The role that I envision for [healthcare] quality leaders is that of ‘change coaches’. You need to understand the science of improvement and be armed with change-management skills. How do you get people to change behavior and embrace change?”

Sinioris called for quality leaders to:
• Improve their peer-coaching skills in order to provide effective feedback immediately.
• Develop human capital dashboards. “This is about educating the board and trying to get them to be mindful that it’s about capital—human capital, not just financial indicators. We’re a service industry—and a high-risk one. Why would you not be monitoring your human capital with the same metrics you use for anything else that’s critical?”
• Rethink your job description and understand what competencies you’ll need to do your job effectively.

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