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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



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.


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 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.

Part 4: Accelerating Development – The Science Behind NCHL’s 2013 National Health Leadership Survey

Several weeks ago, NCHL launched the most recent round of its triennial national survey of leadership development practices in healthcare.  An announcement was sent out to a national sample of CHROs and COOs, with an open invitation to other hospitals and health systems who may be interested in participating to benchmark their own practices.  While we work on collecting results, I will be sharing a few posts about the science behind the survey.

Hiring Practices

The current survey asks many more questions than previous ones about hiring practices for healthcare leaders.  The simple reason for this is that personnel selection practices can be unusually potent tools for ensuring leadership bench strength.  For the interested reader, a 1998 review article by Frank Schmidt and John Hunter, summarizing 85+ years of personnel selection research, shows clearly just how much the more systematic approaches outperform the more informal approaches managers tend to naturally gravitate toward.  Much of this research points to the fundamental rule that the best predictor of future performance is past performance under similar circumstances.  In a subsequent review article in 2005, I demonstrated that the same is true for leadership positions .

Many health systems have adopted pre-screens and other structured assessment protocols for their staff positions; remarkably, however, many of these organizations do not exercise the same care when it comes to hiring new leaders.

Why is this the case?  I suspect it has to do with the reality that healthcare has been slower than other industries to recognize what the profession of human resource management has to offer by way of evidence-based approaches to process improvement. Because HR grew up in an era of compliance, this remains the lens that many healthcare systems still look through.

That noted, I am optimistic that our newest survey will reveal expanded use of effective selection tools across the health system.  Given the challenges our sector is facing, I certainly hope this will be the case.

About the survey

If your hospital or health system did not receive an invitation to participate in NCHL’s survey (or if you’re not sure but would like to participate), please contact Joyce Anne Wainio at

‘Big data’ and the Learning Healthcare System: Implications for leadership development

Last week, the Health Organization Research Association held their annual meeting at Rush University Medical Center in Chicago, IL. Friday’s program was dedicated to an exploration of healthcare organizational excellence using publicly available datasets.The morning began with the National Center for Healthcare Leadership introducing their collaborative Organizational Excellence (‘OrgX’) initiative, whose goal is to reduce entry barriers for academics and practitioners to collaboratively access healthcare organization datasets and expertise. Next on the program  Image

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On Boarding Executives from Other Industries with Bob Riney

When considering an industry as vast and complex as the healthcare industry, the meticulously methodical assembly lines of a major car factory do not readily come to mind; however, for Bob Riney, president and COO of Henry Ford Health System, watching truck after truck being made at a tour of the Ford Rouge Factory in Dearborn, Michigan, was a profound moment. To him, the 10,000 workers creating a nearly fool-proof product in a safe working environment was in stark contrast to healthcare, which is often chaotic and lacking strong, centralized, accountable leadership. With over 96,000 deaths each year due to avoidable mistakes and over $750 billion in waste throughout the industry, it is hard to disagree (Best Care at Lower Cost, IOM). From Bob’s perspective, looking at ways to incorporate leaders from industries outside of healthcare can, in some cases, steer the industry toward greater performance.

This was no more apparent than in our recent webinar entitled “On Boarding Execs from Other Industries.” Bob spoke eloquently about the perceived barriers that executives from other industries face and the massive amount of “organ rejection,” where new executives from outside healthcare prove ineffective in their new position—largely through no fault of their own—and are rejected by the healthcare system.

Bob provided several examples of executive leadership from outside healthcare who were hired at Henry Ford and explained how their competencies as managers and leaders were applicable to their new positions in healthcare. One example was the choice of a former IRS manager to become the new chief information officer. In this case, the executive had experience merging complex information and datasets from both government and private sources. Bob explained that HFHS has found much success in its outside hires to drive the system to someplace completely new and ultimately reducing waste.

Bob rightly noted that the success of these leaders is due to HFHS’s on-boarding process, which includes cultural assimilation, an in-depth orientation, frequent one-on-one meetings, and coaching. Too often a new executive might approach the healthcare industry from the perspective of private enterprise and free, open markets or decision making by edict when in reality healthcare’s business is mostly dictated by government’s fixed pricing and decision making by consensus. An executive on-boarding process that is both culturally and strategically immersive has proved helpful to HFHS. A methodical introduction with orientation to every aspect of the system provides prospective leaders with the interactions and, eventually, understanding of the multiple intertwining relationships that define health care, giving them the ability to integrate their knowledge outside of healthcare effectively into healthcare. This helps create competent and successful leaders.

Which brings us back to the assembly line. No, patients are not precisely analogous to cars but leaders in healthcare must start to ask how best they can achieve that same level of efficiency. In an industry struggling to readily adopt best practices from other industries, perhaps the outside hire may well be worth the investment.

Do you have experience hiring outside of healthcare? Tell us about your successes and how to best avoid failure in the comments. LENS members may access the webinar here.

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