Hospital workforces have undergone significant changes since the pandemic hit and organizations need strong talent pipelines for future growth. Los Angeles-based Keck Medical Center of USC, under the guidance of CEO Marty Sargeant, designed an innovative middle manager program to fulfill this need.
The initiative empowers mid-level leaders to problem-solve in real time and build successful departments in an increasingly complex healthcare environment. Mr. Sargeant recognized the clinical workforce changed during the pandemic, and their philosophies around work shifted as well. With the rapidly evolving headwinds, the hospital needed to revise their approach for more agile and accountable middle managers.
Mr. Sargeant and his team conducted listening sessions and surveys with middle management leaders to understand their big challenges and perceived opportunities to improve the team and instill a sense of purpose within their work. He knew the team would enjoy their jobs more and provide better outcomes if they led purposeful lives at work and had an opportunity to make a difference.
Mr. Sargeant has 20-30 books on his shelf about engaging employees at a higher level and instilling customer service, clinical excellence and growth. But the executive team decided to forge their own path.
"It became obvious that we needed to give tools, resources, and expectations for our mid-level leaders to help us accommodate the needs of the future," said Mr. Sargeant during an episode of the "Becker's Healthcare Podcast." "We wanted to give the tools and capabilities to build the strength of our middle management, not necessarily mimic other programs or examples, such as 'if Disney ran your hospital.' We wanted to give the leadership the keys to the car, and unlock their potential to be the true leaders we needed."
The leadership team considered several options to support the "leading purpose" for middle managers for professional development. But Mr. Sargeant's chief of staff persistently recommended of Dr. Brene Brown's Dare to Lead framework won the day.
"When I really looked at the content that Dr. Brene Brown has in her Dare to Lead research, it started to resonate with us that the tactics she used are research-based tactics that really show how you build a courageous leadership body and approach to engaging local leadership and understanding both the concept as well as why the concept works in a challenging and aggressive environment such as healthcare," said Mr. Sargeant. "Dr. Brown's work also speaks from the heart, and when you see it, people can relate to it and feel part of it in their DNA."
The leadership team designed a program with readings and trainings for Dare to Lead, as a book club. Around 240 managers took six to seven sessions where they discussed concepts and talked about the relationship of Dare to Lead's teachings to their work. Everyone benefitted.
"This environment is co-learning, so you're building a vocabulary and you're building shared expectations and shared consensus between leaders and leadership teams on what these tactics mean to them and our environment here," said Mr. Sargeant. "It flourished into a culture-building exercise, into a culture tenor for the entire organization. Now, it's become sustained. Instead of just initial training and initial book club participation, we have our leaders every two months break out into their leadership teams and have actual dialogue on their lead concepts, how it aligns with the headwinds we're experiencing as an organization."
The book has aligned all leaders around a common language to approach conflict and problem-solving between their teams. When someone says, "I think we need to have a rumble" or "I need to lean in with curiosity, generosity and grace," all team members understand they're trying to bring a different perspective to the conversation or solicit meaningful feedback.
The middle-manager pipeline program inspired a stronger culture and the entire organization felt the results. The system now reports less than 7% turnover for nurses and the first year manager turnover has been zero for most of the last year.
Keck Medical Center of USC has also surveyed participants and front-line team members about teamwork and communication since the program began, and Mr. Sargeant reported "dramatic improvement" in those year over year scores.
The middle managers have also become more nimble, Mr. Sargeant says, and they take ownership of problem-solving as new issues and headwinds arise.
"We're able to have more frank discussions about solutioning," said Mr. Sargeant. "It doesn't have to be driven from the top. I look and listen from that leadership perspective, and they feel free to have opinions and to help us achieve the results we need. I couldn't be more pleased with that level of leadership uprising."
The health system is now engaging with faculty physician leaders, including medical directors, to offer a modified version of the program on solving for tomorrow and deepening the current cohort's relationships. The team takes semi-annual retreats and has bimonthly teams focused on the tactics of Dare to Lead, and the evolution of Dr. Brown's teachings. They discuss how to deploy the tactics to keep them fresh, and identify skills to practice as leadership principles become part of the DNA for new leaders.
Now, leaders no longer blame others when an issue arises. Instead, they attempt to understand the nuances of the situation and deploy empathetic skills, understanding and curiosity to align around common initiative objectives and understand resource requirements.
"Our approach has changed so it's less polarizing and more engaging," said Mr. Sargeant. "I've seen issues where people in the past would have walked away thinking they would never get any timely support from an individual; there isn't going to be anything different from where we are today to where people are more engaged in the active and transparent conversion. It's conversation that comes from the heart."