Lessons in leadership, part 1: Managing yourself

The best hospital and health system leaders are critical thinkers, creative problem solvers and natural prioritizers. But leaders in healthcare don't run the show alone — there is a wide range of employees whom CEOs and other executives count on to make their organization successful. In short, leaders must be more than smart — they have to be people-smart.

Part I of "Lessons in leadership" includes important leadership traits, insights for women leaders, tips for transitioning into new roles, pitfalls to avoid and the importance of keeping physical fitness a priority.

On leadership personality traits and characteristics

1. Self-awareness, as defined by the Harvard Business Review, is "understanding who we are and how we are similar to or different from others." A main component of self-awareness is accurate understanding of how consistent — or inconsistent — our self-view is compared to how others perceive us, or against objective data. While many companies have training and development programs with some sort of self-assessment designed to increase self-awareness, in practice, self-evaluations are typically far less accurate than objective assessments, according to HBR.

2. Without external data to confirm self-reported evaluations, self-awareness assessments may reinforce peoples' inaccurate perceptions of themselves, which can be harmful to development, performance and the effectiveness of team work, according to HBR. The results of an HBR study on the executive development program at a Fortune 10 company showed when individuals had low self-awareness, teams suffered significantly and were more likely to make worse decisions, engage less in coordination and show less conflict management. When team members overrated their self-awareness levels, chances of team success were cut in half.

3. In contrast, the study found individuals with high self-awareness are 36 percent more likely to make better quality decisions than those with low self-awareness, 46 percent more likely to successfully coordinate with teams and 30 percent more likely to successfully manage conflict.

4. Like self-awareness, emotional intelligence is a critical characteristic of successful leadership. However, climbing up the corporate ladder can lower people's EQ, according to Forbes contributor Travis Bradberry, co-author of Emotional Intelligence 2.0. Mr. Bradberry said EQ scores increase up the corporate ladder from individual contributor to manager, but steeply decline beyond middle management. CEOs, on average, have the lowest emotional intelligence.

"Once leaders get promoted they enter an environment that tends to erode their emotional intelligence. They spend less time in meaningful interactions with their staff and lose sight of how their emotional states impact those around them," Mr. Bradberry wrote. However, for every title, the top performers are those with the highest EQ scores. So, while CEOs typically have the lowest EQ scores, the best-performing CEOs are those with the highest EQs.

5. To boost your EQ, consider the following tips from Mr. Bradberry:

• Show you care about people. "Employees don't want to feel like a herd of cattle, but as people who are being appreciated for their hard work and effort," according to Mr. Bradberry. Emotionally intelligent leaders find a balance between imposing demands on their employees and showing compassion.
• Show employees they're significant. Leaders with high emotional intelligence focus on motivating their employees by showing how the job can benefit their own lives, not just the company. Leaders should introduce their employees to opportunities that will allow them to produce successful and significant work.
• Take good care of yourself. Leaders who relate to their employees and colleagues on an emotional level possess an understanding of their own emotions. According to Mr. Bradberry, it's important to pay attention to the way certain situations make you feel so you can understand how your emotions influence the way you act.

6. Despite the potentially negative connotations of an anxious person, anxious leaders are more dependable, agile and better planners than complacent leaders, the other type of leader, according to Cass Sunstein, a legal scholar at Harvard, author of numerous books and former administrator of the White House Office of Information and Regulatory Affairs.

7. "There is no question that the anxious leader is much better than the complacent leader," Mr. Sunstein told the Washington Post. "The anxious leader is able to redirect energies, listen to information from employees and won't continue the course of action if it's failing. The anxious leader also will be flexible and inventive, and will foresee things that could go wrong. There's a saying that goes, 'If you make a plan, God laughs. If you make two plans, God smiles.' The anxious leaders are making two plans." In contrast, complacent leaders — though demonstrative of positive personality traits, such as being optimistic, upbeat and confident — risks enacting a sense of infallibility.

8. Some individuals possess an aptitude for leadership, but truly remarkable leaders are made over time, according to Jeff Haden, ghostwriter, speaker and Inc. magazine contributing editor. After learning how to work with different personality types through training, experience and introspection, these leaders learn to nurture, motivate and inspire employees, setting their organizations on the track to success. Remarkable leaders demonstrate more than just an aptitude for delegation and giving occasional praise — they are also uniquely charismatic.

9. Charismatic leaders possess the following traits:

• They really listen. According to Mr. Haden, charismatic leaders listen more than they talk, and give whoever is speaking their full attention. This means they maintain eye contact, nod or give other nonverbal listening responses while the other person is speaking. They restrain themselves from interrupting the speaker to comment, ask questions or offer advice until the speaker prompts them to or it is an appropriate time. Along the same lines, they put any possible distractions away. You can't connect with someone if you keep glancing at your phone or computer screen, Mr. Haden says.
• They give genuine praise often. Not only do remarkable leaders give praise to their employees regularly, they make it their job to find out what their employees are doing well ahead of time, according to Mr. Haden. Not only will people appreciate the kind words, they will recognize the fact their leader pays attention to their efforts and successes.
• They discuss their own failings, but not other's. While everyone likes hearing a little gossip now and then, most people don't respect the person who is doing the telling. Remarkable leaders never discuss the failings of others, unless in confidential or other special circumstances. On the other hand, a sign of a truly charismatic leader is a willingness to discuss his or her own failings. According to Mr. Haden, remarkable leaders instinctively admit mistakes and are quick to take responsibility. This is essential for a culture in which mistakes represent challenges to overcome, not chances to blame others.

10. Successful leaders don't underestimate the competencies and value of their staff, and understand the power of delegation. However, there are several important duties leaders should always take responsibility for themselves, including:

• Delivering praise and discipline.  While disciplining employees is unpleasant, handing the job off to a subordinate shows a lack of respect to the person receiving the discipline and also prevents the opportunity of having a conversation with the employee on what to do or change moving forward. Similarly, praise and incentives that come from a high-ranking leader is very meaningful and inspiring. Leaders should take advantage of the opportunity to show recognition of good work.
• Culture and team building. "Perhaps a manager's most important job is building, training and nurturing his or her team, which is why it's vital not to completely outsource these tasks," according to Bernard Marr, an expert in strategy and performance management. Employees think of their managers — especially top executives — as the figureheads of an organization's culture, so it's imperative for leaders to take a proactive stance when it comes to setting the mission and goals, as well cultivating the culture of an organization.
• Crisis management. It's crucial for the leader to have a presence in a crisis, and to show all parties he or she is monitoring the situation and actively seeking a solution. No matter how big or small, a crisis will inevitably have an impact on employees, their emotional lives and productivity. "It doesn't matter whether your organization is negotiating a hostage situation or trying to salvage your biggest account; a wise leader will be present and involved," according to Mr. Marr.

On transitioning into a new leadership role

11. For those eager to lead, stepping into a new leadership role is a an exciting time. However transitioning is a challenge — for both new leaders and their teams. Here are three common mistakes to avoid when inheriting a team, according to the Harvard Business Review.

• Trying to be a friend instead of a leader.  Although it's important for new leaders to be empathetic to the challenges their team faces as they adjust to a new leader's preferences and expectations, it is important to not spend too much energy trying to be their friend. This will confuse the power dynamic and can lead to backlash when you start to exert control.
• Showing frustration with the quality of the team. The team you inherit is the product of your predecessor — team members' habits and strengths reflect the previous leader's expectations of them. If your expectations are different, it is important to offer constructive, encouraging advice to guide change. 
• Attempting to force trust and candor too soon. While many new leaders want to create a transparent and trusting culture from the beginning, exposing the team to contentious issues too soon can be destabilizing, according to HBR. Teams need time to build confidence working and handling uncomfortable topics with a new leader.

12. For some, a promotion to a new leadership role can be an incredibly stressful adjustment, especially when the person being promoted did not want the new role, according to Richard Wellins, PhD, and Tacy Byham, PhD, who co-authored Your First Leadership Job: How Catalyst Leaders Bring Out the Best in Others. According to a survey the Drs. conducted, only 29 percent of newly appointed leaders said being a manager was part of their-long term career goal.

13. Twenty percent of people promoted to a leadership role were moved up to reward technical skills, while 11 percent were chosen because there weren't any other competent individuals to fill the position, according to the survey. Almost half of the survey respondents did not want to be a manager, and two-thirds of new managers were not hoping for a management role when they were promoted. Additionally, 78 percent of people in a management role indicated they would give up their title if they could keep the money and privileges that come with it.

14. Sometimes, when people become the head of a new team, they find their new roles include responsibilities outside of their expertise. This is particularly relevant in healthcare, where executives lead extremely bright minds and individuals who are knowledgeable and passionate about their work. Here are three tips for managing people who know more than you from the Harvard Business Review.

• Resist the inclination to dive in and master the situation. Leaders who are experts in one area often believe their high intelligence and strong work ethic will allow them to master the information they need to know in their new role. They may be tempted to learn all of the details. However, this can be a road to disaster, for it will be nearly impossible to become in expert in something they have only just started. Instead of "specialist management," which depends on expertise, adopt a "generalist style," which involves using basic leadership principles to handle most cases. Do your best to learn as you go.
• Shift your attention to relationships, not facts. Instead of focusing on facts, try building relationships with your colleagues and subordinates by spending a lot of time face-to-face getting to know them. Relationships are an important element of the generalist leadership style because you are constantly adapting your approach to fit the individual in the situation, and knowing how to do this is key.
• Be valuable by enabling things to happen, not by doing the work yourself. When you are the expert in something, you make contributions by making decisions based on your knowledge. As a generalist, you can't make the same kind of contribution, but you can enable things to happen. You can do this by problem solving, mediating conflicts among employees and continually asking for feedback.

15. Whether a rookie or seasoned leader, reflection is key to a successful future. Here are four questions all CEOs should ask themselves each year about strategy, according to Scott Becker, JD, publisher of Becker's Healthcare.

• Key leadership. Identify your top leaders. Do you have a clear line of communication with those leaders? Are you in regular communication with them? Are they developing and managing their teams? Are you and they actively develop the next set of leaders?
• Clear goals. Does your organization have clear objectives and goals? How well have you communicated these objectives and priorities for the next three months and the next year?
• Building around strengths. Reexamine the market and your organization's position. Do you look at what is working well in terms of profits and revenues, as well as other efforts? Should you redouble efforts around those things that are working well? Are there additional opportunities that are adjacent to these efforts?
• Key threats. Pinpoint the top three or four threats to your organization. How significant are they? What can you do to reduce exposure to these threats? 

On women leaders

16. Although corporate executive roles are primarily held by men, women executives bring strong, valuable leadership qualities to the table that are less prominent among men, such as vision and the ability to convey it convincingly to others, according to The Guardian.

17. Companies with a larger female presence on their boards tend to give more attention to environmental and social issues, according to Kellie McElhaney, PhD, a professor at University of California Berkeley's Haas School of Business' Center for Responsible Business. According to her study of more than 1,500 global corporations, companies whose executive teams have an even balance of men and women are more likely to invest in renewable power, low-carbon products and energy efficiency. 

18. According to a study by Credit Suisse, there is a positive correlation between female leadership and financial performance. Between 2005 and 2013, companies with at least two women on their boards returned a compound of 3.7 percent each year over those companies with no women on the board. However, female participation in top management roles (CEO or directors reporting to the CEO) in the end of 2013 was just 12.9 percent.

19. Kip Tindell, CEO of the Container Store, said in a recent CNBC article that he believes "women make better business leaders than men." He credit's the Container Store's 16-year run on Fortune's "100 Best Companies to Work For" list to the 70 percent of women who work for the company. Mr. Tindell cites two traits women are more likely to possess that enable them for leadership roles.

• Communication skills. Mr. Tindell believes women have innate skills — such as empathy and emotional intelligence — that make them better communicators than men. Although less than 5 percent of CEOs at S&P 500 companies are women, Mr. Tindell believes women's communication skills are the key pillars of conscious capitalism.
• A tendency to work in teams. According to Mr. Tindell, women are more mutually supportive and communicative than men, which make them better suited to work in a team.

20. In an analysis of Fortune 500 CEOs, Harvard Business Review found commitment is the key to the C-suite. This is especially true for women, who spent a median of 23 years at one company before landing the job as CEO. That's 50 percent longer than the median 15 years it takes men to get to the top. Of the 24 female Fortune 500 CEOs analyzed, 70 percent spent 10 years or more at their current company. Seventy-one percent of the female CEOs were promoted from within, compared to 48 percent of males. The average age of a female CEO is 56.

On pitfalls

21. Communication is an important determinant of an executive's success — just as much as more business-specific skills, according to the Harvard Business Review. The vast majority of polled employees — 91 percent — say communication issues can lower an executive's standing.

22. An Interact/Harris Poll of roughly 1,000 U.S. workers identified the following seven communication sins leaders commit most:

• Not recognizing employee achievements — reported by 63 percent of respondents
• Not giving clear directions — 57 percent
• Not having time to meet with employees — 52 percent
• Refusing to talk to subordinates — 51 percent
• Taking credit for others' ideas — 47 percent
• Not offering constructive criticism — 39 percent
• Not knowing employees' names — 36 percent
• Refusing to talk to people on the phone/in person — 34 percent
• Not asking about employees' lives outside of work — 23 percent

23. Executives can remedy these issues by focusing on improving their communication with employees. HBR suggests these strategies:

• Give specific praise.
• Give both personal and public thank yous.
• Ask employees for their opinions and ideas.
• Be transparent, especially during periods of change.
• Give feedback on an ongoing basis, not once a year.
• Admit your mistakes and share what you've learned from them.
• Address your employees by name.

24. Body language is a facet of communication that is often overlooked. However, your body language could be sending people the wrong signals, impeding your ability to influence and lead. According to Forbes, TalentSmart, a top provider of emotional intelligence tests, training and consulting, found the highest performing employees and leaders are high in emotional intelligence. Individuals with high emotional intelligence actively monitor their body language, preventing them from sending negative unspoken signals.

25. Consider the following body language blunders to avoid, according to Forbes.

• Slouching. Sitting slouched over conveys disrespect because it signals to whomever you are speaking to that you are bored and have no desire to be there. On the other hand, standing or sitting up straight maximizes the amount of space you fill and projects power. Having good posture commands respect and stimulates engagement from both people in the encounter.
• Being positioned away from someone who is speaking. When your body isn't directly facing the person who is speaking or you are not leaning into your conversation, it tells the person you are unengaged, uninterested or uncomfortable. Leaning in toward the speaker shows you are paying attention and interested in what they are saying.
• Crossing your arms and legs. Crossing your arms and legs creates physical barriers that communicate to the person speaking that you are closed off from what he or she is saying. Even if you are also smiling and participating in the conversation, the other person may still get a sense you are not fully receptive to his or her remarks.
• Too much nodding. Nodding along the whole time somebody is speaking shows you are anxious about getting his or her approval. Additionally, exaggerated nodding may come across as an attempt to show you understand or agree with something you really don't.
• Intruding on others' personal space. Standing too close to someone — nearer than one and half feet — communicates you don't understand or respect his or her desire for personal space. This may make people uncomfortable around you.

26. In healthcare, hospitals and health systems are always looking for innovative ways to expand their marketability to consumers and engage technology to gain a competitive edge. In the age of consumer-run healthcare, failure to successfully implement innovative ideas can prevent organizations from reaching their full potential. Leaders will have a better shot at developing and executing innovative ideas if they are aware of these four pitfalls to avoid, according to Entrepreneur magazine.

• Believing innovation is too costly. Many organizations retreat from efforts to develop innovative ideas because they perceive the process as too time-consuming, complicated and expensive. However, organizations that invest time and money into a structured and thorough process for vetting and implementing these ideas can create profound returns in various forms. Additionally, once an organization understands and becomes acclimated with this process, the generation of creative ideas will become a daily occurrence.
• Leaving team members out. Failure to involve the entire team in innovation efforts is a big mistake, as everyone in an organization has difference perspectives and experiences they can lend to the development of new ideas. Many business leaders have a tendency to involve just a select number of people — such as developers or founders — during innovation development efforts. However, employees outside of this core team can offer fresh insights and are not tied down by fixed thinking on how things were done in the past.
• Not having a system in place for identifying innovative ideas. The most successful businesses have systems for identifying creative ideas. These systems usually start by finding ways to develop solutions to problems or fill market gaps. Although they are innovative, many of these ideas are "incremental changes, not revolutionary new products," according to the report. To establish a system, identify problems, unsatisfied needs and market gaps and delegate these issues to team members who are best equipped to devise appropriate solutions. This problem solving should lead to the generation of innovative ideas.
• Failing to celebrate. Creativity is a fun, exciting way to engage people from across the organization. Additionally, rewarding and celebrating innovation will encourage more innovation and creativity and will help the business grow. Innovation contests, brainstorming sessions and other activities are a great way to encourage innovative thinking and collaboration among employees, according to the report.

On the importance of physical fitness

27. When it comes to priorities, exercise often comes second to work. professionals justify their lack of exercise by saying they don't have enough time with all of the work that has to be done, but physical activity can be a very important component of success. According to Michael Hyatt of Your Virtual Mentor, regular physical activity "is a Godsend" for entrepreneurs for several reasons.

28. First, exercise refines competitiveness. "Not only does completing a tough workout instill confidence and a positive sense of accomplishment, but to maintain my exercise regimen, I've had to sharpen my self-discipline and increase my capacity for self-sacrifice. These traits are directly applicable in a business environment," said Mr. Hyatt. Exercise also helps people establish a healthy work-life balance. Even though people who don't exercise say it is because they don't have enough time, research shows that incorporating exercise into your daily activities actually enhances a work-life balance. It also lowers stress and anxiety levels.

29. There is a direct link between exercise and problem-solving capabilities, creativity and planning, according to the Washington Post. Just one workout can boost higher-order thinking skills, which in turn makes you more productive and efficient.

30. For leaders in particular, exercise can be a valuable means of strengthening important leadership skills. According to Carmine Gallo, Forbes contributor and author of Presentation Secrets of Steve Jobs, one executive's personal trainer told him, "A proper training program will help you have better posture, exude more energy and prepare you to handle the demands of a busy professional life. Without energy you'll look and sound like a dud. The executive who exercises regularly looks and feels energized. They radiate passion, vitality and energy."

31. Many executives even believe physical fitness is necessary for success. According to a survey conducted by online job resources TheLadders.com, 75 percent of executives said good physical fitness is "critical for success at the executive level," while just 4 percent said their physical condition was irrelevant to their careers. Additionally, 75 percent of executives said being overweight is a "serious career impediment."

32. Interestingly, researchers found firms with top executives who had completed a marathon to be valued 5 percent higher on average than those that had executives who had not, according to measures by Tobin's Q, which gauges company value, according to Inc. magazine. Tobin's Q drew their findings after identifying CEOs of S&P 1500 companies who had completed a marathon in each year between 2001 and 2011. Researchers found the association between firm value and CEO fitness was even more pronounced for CEOs over the age of 55, those who had longer-than-average tenure, or those who were exceptionally busy, with two or more external director roles.