Archive by Author | Andrew Garman

NCHL expands its November conference

Throughout its history, NCHL’s annual conference has followed a brisk half-day format, followed by an award / recognition dinner. This year for the first time we are expanding the format to two half-days. Most fundamentally, the change reflects NCHL’s expanding role in supporting healthcare leadership development, as well as the pace of evolution currently taking place in the health sector.

Understanding and preparing for sector-level change

The November 20th afternoon sessions will focus in on sector-wide changes and adaptive responses to these changes. Tom Main from Oliver Wyman and Roy Smythe, MD, from AVIA and HX360 will provide the former, with Rick Brush from Collective Health and David Erickson from the Center for Community Development Investments introducing the latter. In between sessions attendees will be encouraged to participate in discussions about what these changes mean for their own organizations, as well as how we can best move forward collectively in support of improving health.

Best Organizations for Leadership Development

The November 21nd morning sessions feature presentation teams representing many of the organizations being recognized this year as Best Organizations for Leadership Development, including Penn Medicine, NorthShore-LIJ, Sutter, Duke Regional, University of Wisconsin Medical Foundation, Henry Ford Health System, Stanford Health, Cone Health. and Cleveland Clinic. Sessions will focus on high-priority topics including strategic alignment with organizational goals, physician leadership development, diversity & inclusions, and innovations in efficiently recruiting and developing leadership talent. We will also be discussing work NCHL and our partner organizations are doing to support more collaborative approaches to the national administrative fellowships process.

The Gail L. Warden Leadership Excellence Award

The evening of November 20th, we have the opportunity to recognize two outstanding healthcare leaders, Nancy Schlichting and Dr. Glenn Steele, Jr.  In addition to providing well-deserved recognition for these two pioneers in the field, this fundraising  event helps support NCHL’s work throughout the year in support of healthcare leadership development.

We hope you will join us in November for these terrific events, and help us spread the word.

On behalf of NCHL and its stakeholder groups, thank you for your support.


– Andrew N. Garman, PsyD

NCHL Chief Executive Officer



2014 resolutions for healthcare leaders

Dissatisfied with your “must do” resolution list this year? Here are a few “nice to do” suggestions from NCHL, to help round that list out with a to-do or two that are hopefully at least a bit more inspiring and fun. (Public commitment is optional, but worth considering.)

Goal #1.  Work on bending the sick curve.  Earlier this fall, the Robert Wood Johnson Foundation published the first health-related “good news” infographic I have seen in years. The graphics depict CDC data indicating that from 2008-2011, childhood obesity rates among young children dropped in 18 U.S. states.

How about setting a goal to be a part of that good news when the next report comes out? You can find suggestions on the Health Care Providers page of the Let’s Move website.

Goal #2. Work on bending the stress curve.  Getting the sense that healthcare management has become a lot more stressful these days? You’re not alone – and it’s not just healthcare management. Research by Harris Interactive has been tracking an upward trend in stress levels among working adults for over a decade.

Interested in getting stress management taken seriously in your organization?  The American Psychological Association’s “Stress in America” study provides a good overview of the current state, as well as the ways healthcare systems could take a more active role to the benefit of our patients. What about leading by example? The current issue of Frontiers in Health Services Management is all about strategies for personal and professional resilience in the age of healthcare reform.

Goal #3. Work on transcending “bending the cost curve.”  Recognized as problematic almost from its inception, the problems with the very well-traveled “bending the cost curve” metaphor are by now well documented in forums as diverse as the New York Times, Health Affairs, and IHI COO Jeffrey Selberg’s remarks at NCHL’s 2012 Annual Conference.

How might we best help the national dialog move past an obsession with near-term cost, and toward the aspirations represented by the triple aim?

Yes it’s a tough question, which is why I’m giving you a year.

Looking forward to seeing what you come up with.  And wishing you a healthy, prosperous 2014, from all of us at NCHL.




Assessing high-potentials and senior executives: Healthcare vs. Top Companies

Of all the areas known to contribute to the effectiveness leadership development systems, there is none for which the evidence base is stronger than the use of high-quality assessments. But it is also well-known that management practices, like clinical practices, often take quite a while to catch up to science.

What is the current state of assessment in practice? Recently two industrial psychologists, Allan Church and Christopher Rotolo, conducted a study to find out. Both work for Pepsico, a company well-known for its sophisticated leadership development practices, and are well-connected to other companies that emphasizing leadership development as a core competency. (Most had received national recognition for their leadership development programs.)  From the 84 companies responding to their survey, insights included:

  • The most frequently cited populations the organizations used assessments with were senior executives (90%), followed by middle managers (81%) and high-potentials (75%).
  • The most frequently used assessments were 360-degree feedback (60% for senior executives; 66% for high-potentials), followed by personality inventories (57% for senior executives, 66% for high-potentials).
  • The most frequently cited purposes of assessments were to identify development needs (74% for senior executives; 82% for high-potentials) followed by identification of potential (30% for senior executives, 50% for high-potentials).  The least frequently cited purpose was external recruitment / selection (25% for senior executives, 14% for high-potentials).

At NCHL’s annual conference on November 19th in Chicago, we will be taking a look at how Allan and Christopher’s results compare to the 104 leading U.S. health systems who participated in NCHL’s 2013 survey of leadership development practices.  (A quick preview: although the use of high-quality assessments in healthcare leadership development is growing, we still clearly lag behind the best-in-class companies from other industries.)

Several organizations presenting at the annual conference have particularly strong assessment programs as part of their work. We look forward to hearing more about them very soon, and hope many of you will be able to join us.  For those who can’t, we will be providing a white-paper on our findings.  Look for it this winter.


Want to understand and improve the U.S. healthcare system? There’s a MOOC for that.

Today’s Detroit News features a story about a new MOOC (Massive Open Online Course) being launched tommorrow by University of Michigan professor Matthew Davis.  Dr. Davis identified the need the course while teaching medical students, noting a pervasive lack of clarity about health policy, government health care, and insurance.

Davis has unusually strong credentials to teach such a course. In addition to roles teaching in both the medical and public policy schools, Dr. Davis is also a practicing pediatrician, and was recently appointed Michigan’s Chief Medical Executive in June of 2013.

Although the course breaks important new ground in applying MOOCs to healthcare, it is not the first MOOC to pursue this critical area of education. Dr. Ezekiel Emanuel of the University of Pennsylvania previously offered a popular Coursera MOOC on Health Policy and the Affordable Care Act. Today, Coursera now lists 59 current open-enrollment courses on health-related topics; EdX lists an additional 9.

As a non-profit that spans the worlds of healthcare and higher education, NCHL is watching the unfolding MOOC story with great interest.  (If you are unfamiliar with MOOCs, there are two excellent TED Talks – Peter Norvig’s about Courseraand Daphne Koller’s about ‘big data‘ – that will give you an efficient introduction.)  As U.S. health systems continue to evolve toward population-based approaches, the need for efficient access to high-quality leadership development is growing as well. Several of the presenters at this November’s Human Capital Investment Conference in Chicago will be describing their approaches to overcoming geographic and cultural boundaries; MOOCs seem like a highly promising tool to efficiently expand their reach.

You can read more about Dr. Davis’s course, and join 10,000+ others who have signed up to take it for free, on the Coursera website.  Classes start Monday, October 7.

Part 1: Hiring Practices – The Science Behind NCHL’s 2013 National Health Leadership Survey

This series of posts relates to NCHL’s 2013 leadership development survey, which we will be closing out this week. If your hospital or health system did not receive an invitation to participate (or if you’re not sure but would like to participate), please contact Joyce Anne Wainio at

Accelerating development

In my last post I described research on the role of experience (vs. talent) in developing leadership and other competencies.  But  it’s just as important to understand that not all experiences are equally valuable.

In judging the value an experience may have, relevance is a particularly important criterion.  Sitting in a classroom or reading a book has little relevance by itself; it becomes relevant through its application to real-world challenges, or high-fidelity simulations.

Next is the nature of the challenges experiences provide.  A review by Cindy McCauley and Stephane Brutus (see p. 7) identified four characteristics of experiences with greater developmental value: Unfamiliar Responsibilities, Need for Substantial Change, Greater Responsibility or Latitude, and Dealing with Failure or Adversity.

Third, high-quality performance feedback is critical. In this realm, research is beginning to favor the highly methodical debriefing approaches pioneered by the military, such as the After-Action Review (AAR).  One recent and unusually well-controlled study by Scott DeRue and colleagues examined the impact of AARs in the context of an MBA program.  The use of a graduate education context allowed the researchers much greater control over the leadership development interventions they were testing; participants thus differed primarily on whether they received AAR-style feedback (experimental group), or  less-structured feedback delivered with comparable frequency (comparison group).  Results indicated that the leaders receiving AARs saw significantly greater improvement in their leadership capabilities vs. the comparison group.

Lastly, there are important individual differences in leaders’ abilities to receive and effectively use feedback, and to benefit from developmental experiences.  This underscores the importance of using effective approaches to identify high-potential candidates for whom leadership investments will yield the greatest potential for future success.

As always, I welcome additional feedback or questions about how the evidence base can help improve our leadership development practices.   Feel free to drop me a note or reply to this post – or see me live at NCHL’s annual conference on November 19th, 2013 in Chicago.

Part 2: Strategic Alignment – The Science Behind NCHL’s 2013 National Health Leadership Survey

Every 2-3 years, NCHL conducts a national leadership development survey as part of ongoing efforts to strengthen the evidence base supporting these practices. If your hospital or health system did not receive an invitation to participate (or if you’re not sure but would like to participate), please contact Joyce Anne Wainio at

Deliberate practice

Research on virtuoso performance suggests that innate talent plays a limited role in determining who becomes a top performer. Instead, the top performers are those who clock the most hours of meaningful practice.

For readers interested in a highly accessible review of this work, I encourage you to pick up a copy of Malcolm Gladwell’s Outliers: The story of successin which he cites many colorful examples as diverse as hockey leagues, software engineering, flight safety, and the turn-of-the-century garment industry.

But what about leadership?  Biographies of prominent CEOs provide some interesting clues.  Descriptions of the careers of Warren Buffett, Michael Dell, and Bill Gates all point to early experiences honing what eventually became their trademark approaches to building highly successful companies.  The same seems to be true for healthcare leadership, as revealed by a study published in 2010 of the backgrounds of top executives of U.S. News Honor Roll hospitals.

Several questions on the 2013 survey about programs designed to provide early careerists with formative experience in leadership roles.  A well-crafted administrative fellowship is a classic example of such a program; others, such as job rotations, action learning projects, and simulations, all can provide these critical opportunities for practice, both early on and throughout a leader’s career.

Although practice is critical, not all practice opportunities hold the same power to transform good leaders into great ones, and great leaders in to exceptional ones.  In our next post, we will focus on the types of experience with the greatest potential to accelerate the development process.

Part 3: Deliberate Practice – The Science Behind NCHL’s 2013 National Health Leadership Survey

Every 2-3 years, NCHL conducts a national survey of leadership development practices as part of ongoing efforts to strengthen the evidence base supporting these practices. If your hospital or health system did not receive an invitation to participate (or if you’re not sure but would like to participate), please contact Joyce Anne Wainio at 

Strategic alignment

In 2011, we published a literature review summarizing the research linking management practices to organizational outcomes.  Among other conclusions, research suggested that leadership training and development programs have greater impact on organizational performance if they are tied to the strategic objectives of the organization.

Most of the research reported in that article came from other industries, so later that year we conducted several additional analyses to see if the findings would hold up in healthcare.  The first of these was a re-analysis of our 2010 leadership practices survey data, to investigate relationships bewteen individual practices and the results hospitals were finding on the new value-based purchasing measures.  Although many relationships were found between leadership practices and either clinical or experience of care outcomes, only one item correlated with both: “Leadership learning and development is aligned with organization’s strategic goals and priorities.”

In a separate study, published earlier this month, we surveyed 50 health systems to examine the extent to which strategically aligned HR practices enhanced health systems’ capacity to respond to health reform. Here too, we found that alignment was associated with expanded capacity to pursue cost reduction, access, and quality improvement efforts.

Several questions on the 2013 survey relate to senior leadership involvement with leadership development programs. While this is not as comprehensive a measure of alignment as the survey work mentioned above, it provides a reasonable proxy. If senior leadership has an active hand in these programs, participants are far more likely to be exposed to the strategic relevance of what they are learning.

Involving senior leaders as teachers pays other dividends as well, including opportunities to practice critical communication and reflection skills, and do so in an environment that is more feedback-rich than their operational roles.

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