I've worked in healthcare a long time and have met hundreds if not thousands of senior leaders. Every day I see that this group is passionate about serving staff, patients, and the community to the best of their ability.
Yet, research indicates that frontline workers' trust in senior leadership has decreased over the past few years. In fact, there is a significant gap between what C-suite leaders are doing and what the front line thinks they are doing. In a moment I'll share some reasons for this gap and explain why middle managers hold the key to closing it — but first, let's talk about why focusing on this issue is so urgent.
Research points to a big correlation between trust in senior leadership and organizational support and retention. People need to feel that whoever is "up there" in the organization is looking out for them and has their best interests at heart. It's the key to creating that critical feeling that this is the place for me. When they don't feel this way, they tend to disengage…and there's a good chance they'll leave.
Various environmental factors have gone into creating these trust issues. Uncertainty, rapid change, and stress all work together to breed free-floating mistrust. Plus, much of it goes back to the COVID-19 pandemic. In fact, COVID's impact decreased frontline workers' trust in senior leaders and increased their trust in their supervisors.
During the pandemic, senior leaders became less visible, through no fault of their own. They were making the big decisions but doing so behind the scenes. COVID distanced them out of the need to keep everyone safe. Their intentions were pure. Yet the front line's perception was: Where are the senior leaders in these times of crisis? Meanwhile, the mid-level managers — who fought side-by-side with people on the front lines every day — became the trusted anchor.
Due to high levels of turnover during COVID, many of those in the middle were new. They didn't have time to develop great communication skills, and training was not a priority during those challenging days. The result, in many cases, was a we/they dialogue. As supervisors conveyed senior leaders' messages to the front line, at times they subconsciously positioned those leaders in a less than favorable, or at best neutral, way.
Despite such (unintentional) missteps, the trust bond that was built between mid-level leaders and frontline workers is a wonderful thing. In fact, precisely because that bond exists today, middle managers are the key to reversing the senior leader trust gap. It is their job to align messages and share them in a way that builds trust and unity rather than eroding it.
This will require skill development. Even today, middle managers continue to create a we/they dynamic and perpetuate the trust gap. Again, it's not on purpose. Usually, it happens because they haven't had the opportunity to build leadership skills on the right way to share information and changes with staff.
The first step toward changing how mid-level managers communicate is making them aware that they're doing it. When we work with organizations on trust-building conversations, we ask their mid-level leaders three questions:
- What are some good things about your senior team?
- What are some good things about working for this organization?
- What are you doing to help create this positive perception of senior leaders and the organization with your direct reports?
When we ask these questions, it's an aha moment. You can hear a pin drop. These mid-level managers suddenly see the vital role they play in trust building. And they also see that when they don't actively build trust in senior leaders and the organization, they may be contributing to turnover (which is a huge stressor for them).
It has never been more important to invest in your mid-level leaders. Making sure they have the skills to be successful in their role is a game changer. It will create a more aligned and unified culture — one where people trust their leaders and each other, feel a sense of belonging, and feel confident they can flourish and thrive.
Quint Studer is the coauthor (with Katherine A. Meese, PhD) of The Human Margin: Building the Foundations of Trust (ACHE, March 2024). He is the cofounder (with Dan Collard) of Healthcare Plus Solutions Group® (HPSG) and the best-selling author of 15 books. For more information, please visit www.healthcareplussg.com.