Great Leaders Are Thoughtful and Deliberate, Not Impulsive and Reactive

https://hbr.org/2019/04/great-leaders-are-thoughtful-and-deliberate-not-impulsive-and-reactive?utm_source=facebook&utm_medium=social&utm_campaign=hbr&fbclid=IwAR15xBzRuRJsKxkITe-z0wa1AwDMc_gwJmhM5r6ONnL7bw3s9zP8qRxYiEE

You set aside the first hour of your day to work on a strategy document that you’ve been putting off for a week. You haven’t been disciplined about getting to it, but you’ve had one crisis after another to deal with in the past week. Now, finally, you’ve carved out 90 early morning minutes to work on it.

First, however, you take a quick peek at the email that has piled up in your inbox overnight. Before you know it, you’ve used up the whole 90 minutes responding to emails, even though none of them were truly urgent.

By the time you walk into your next meeting, you’re feeling frustrated that you failed to stick by your plan. This meeting is a discussion with a direct report about the approach he’ll be taking in a negotiation with an important client. You have strong views about how best to deal with the situation, but you’ve promised yourself that you will be open and curious rather than directive and judgmental. You’re committed, after all, to becoming a more empowering manager.

Instead, you find yourself growing even more irritable as he describes an approach that doesn’t feel right to you. Impulsively, you jump in with a sharp comment. He reacts defensively. You worry for a moment — and rightly so — that you cut him off too quickly, but you tell yourself that you’ve worked with this client for years, the outcome is critical, and you don’t have time to hear your direct report’s whole explanation. He leaves your office looking hurt and defeated.

Welcome to the invisible drama that operates inside us all day long at work, mostly outside our consciousness. Most of us believe we have one self. In reality, we have two different selves, run by two separate operating systems, in different parts of our brain.

The self that we’re most aware of — the one that planned to work diligently on the strategy document and listen patiently to your direct report — is run by our pre-frontal cortex and mediated through our parasympathetic nervous system. This is the self we prefer to present to the world. It’s calm, measured, rational, and capable of making deliberate choices.

The second self is run by our amygdala, a small almond-shaped cluster of nuclei in our mid-brain and it is mediated by our sympathetic nervous system. Our second self seizes control any time we begin to perceive threat or danger. It’s reactive, impulsive, and operates largely outside our conscious control.

This second self serves us well if a lion is coming at us, but the threats we experience today are mostly to our sense of worth and value. They can feel nearly as terrifying as those to our survival, but the danger we experience isn’t truly life-threatening. Responding to them as if they are only make things worse.

It’s in these moments that we often use our highest cognitive capacities to justify our worst behaviors. When we feel we’ve fallen short, we instinctively summon up our “inner lawyer” — a term coined by author Jonathan Haidt — to defend us.

Our inner lawyer is expert at rationalizing, avoiding, deflecting, dissembling, denying, disparaging, attacking, and blaming others for our missteps and shortcomings. The inner lawyer works overtime to silence our own inner critic, and to counter criticism from others. All this inner turmoil narrows and consumes our attention and drains our energy.

The problem is that most organizations spend far more time focused on generating external value than they do attending to people’s internal sense of value. Doing so requires navigational skills that most leaders have never been taught, much less mastered. The irony is that ignoring people’s internal experience leads them to spend more energy defending their value, leaving them less energy to create value.

In our work with leaders, we’ve discovered that the antidote to reacting from the second self is to develop the capacity to observe our two selves in real time. You can’t change what you don’t notice, but noticing can be a powerful tool for shifting from defending our value to creating value.

A well-cultivated self-observer allows us to watch our dueling selves without reacting impulsively. It also makes it possible to ask our inner lawyer to stand down whenever it rises up to argue our case to our inner and outer critics. Finally, the self-observer can acknowledge, without judgment, that we are both our best and our worst selves, and then make deliberate rather than reactive choices about how to respond in challenging situations.

To improve your capacity to self-observe, begin with negative emotions such as impatience, frustration, and anger. When you feel them arising, it’s a strong signal that you’re sliding into the second self. Simply naming these emotions as they arise is a way to gain some distance from them.

Also, watch out for times when you feel you’re digging in your heels. The absolute conviction that you’re right and the compulsion to take action are both strong indicators that you‘re feeling a sense of threat and danger.

In our work, we provide leaders with small daily doses of support — reminders to pay attention to what they’re feeling and thinking.  We’ve also found it helpful to build small groups that meet at regular intervals so leaders can share their experiences. A blend of support, community, connection and accountability helps offset our shared impulse to stop noticing, push away discomfort, and revert to survival behaviors in the face of perceived threats to our value. A good starting place is to find a colleague you trust to be your accountability partner, and to seek regular feedback from one another.

Finally, it’s important to ask yourself two key questions in challenging moments: “What else could be true here?” and “What is my responsibility in this?” By regularly questioning your conclusions, you’re offsetting your confirmation bias — the instinct to look for evidence that supports what you already believe. By always looking for your own responsibility, you’re resisting the instinct to blame others and play victim and focusing instead on what you have the greatest ability to influence — your own behavior.

A deceptively simple premise lies at the heart of this deliberate set of practices: see more to be more. Rather than simply getting better at what they already do, transformational leaders balance courage and humility in order to grow and develop every day.

 

 

 

EVERY HOSPITAL BOARD NEEDS A CEO SUCCESSION PLAN. HALF ARE FAILING.

https://www.healthleadersmedia.com/strategy/every-hospital-board-needs-ceo-succession-plan-half-are-failing

The organization needs to have a strong sense for who will lead next. That’s ultimately the responsibility of the board, not the incumbent. This article appears in the July/August 2019 edition of HealthLeaders magazine.

The departure of a CEO can severely disrupt an organization’s progress, especially when the leader leaves suddenly without a clear successor. Despite the well-known need for succession planning, an alarming number of healthcare provider organizations are chugging along without a plan in place, just hoping that their top executives stick around for the foreseeable future.

Forty-nine percent of hospital and health system boards lack a formal CEO succession plan, according to the American Hospital Association Trustee Services 2019 national healthcare governance survey report. That leaves them vulnerable to the disruptive gusts of a CEO’s sudden departure, and it can inhibit their ability to pursue longer-term strategies by leaving them overly dependent on one leader’s vision.

The failure of these boards to formalize CEO succession plans is outrageous and unacceptable, says Jamie Orlikoff, president of the Chicago-based healthcare governance and leadership consulting firm Orlikoff & Associates Inc. and board member of St. Charles Health System in Bend, Oregon. “Whatever the reasons are, it’s just a fundamental and inexcusable abrogation of a basic governance responsibility, so I am nothing less than shocked that the figure is almost 50%,” Orlikoff says.

Why Plans Aren’t Made There are typically a few basic reasons why an organization may be slow to finalize a CEO succession plan. Perhaps the current CEO just doesn’t want to talk about it, Orlikoff says. Some executives are more comfortable talking to their families about their own life insurance plans than they are talking to the board about what to do in the event of their sudden departure, he says. Or perhaps it’s the board members who don’t want to talk about it. Orlikoff says at least four board chairpersons for various organizations have told him in the past seven years that they don’t want their current CEOs to leave and that they don’t want to think about succession planning because the recruitment process is too burdensome. Or there could be an unhealthy power dynamic between the CEO and the board, with the CEO asserting control over tasks that should be handled by the board members, Orlikoff says.

What makes the relationship between the CEO and the board so tricky is how it ties together two distinct relationships. On the one hand, the CEO and the board are strategic partners defining and executing a shared vision. On the other, they are an employee and an employer. “Those are two very, very different and very important functions,” Orlikoff says.

“Some boards have great difficulty envisioning the distinction between those two roles.” A board should lean on the CEO as a strategic partner because the CEO is likely to know more about the industry and more about the local market than the board members do, Orlikoff says. But when the board neglects to assert its proper place in the employer-employee relationship, the CEO may be given free rein over a broader scope of issues than is appropriate, and that can impede the CEO succession planning process, he adds.

In other words, while it’s perfectly appropriate for a CEO to groom a potential successor, the board should not defer to the CEO’s selection, and the CEO should not insist that the board do so. How to Fix This The existence or nonexistence of a formal CEO succession plan is often a symptom of whether the relationship between a CEO and the board is healthy, Orlikoff says.

Notably, the task of devising a succession plan is one exercise that can improve that relationship, he adds. While the detailed steps each organization should take will vary from one situation to another, there are two specific items that Orlikoff recommends: 1. Ask about the mundane threat of a bus.

Whether you’re a CEO or board member for an organization without a formal succession plan in place, there’s one straightforward question you can ask to kickstart productive dialogue on the topic: What do we do if our CEO gets hit by a bus tonight? The question is nonthreatening. It doesn’t signal a CEO’s possible intent to resign or retire. It doesn’t suggest the board members are thinking about giving him or her the boot.

It simply asks, as a matter of fact, how the organization will maintain continuity in the event of an unplanned CEO departure, just as parents would speak with their families about life insurance, Orlikoff says. The CEO should tell the board, without any other senior leaders present, whom the CEO would pick to step into the interim CEO role, Orlikoff says. That will inevitably prompt follow-up questions: Would the interim CEO be a good permanent replacement? Which of the requisite skills do they lack? How well do they align with our long-term needs and vision?

The conversations about an unplanned CEO departure will flow naturally into questions about a planned departure. Where are we in the current CEO’s contract cycle? When does the CEO want to retire? What skills and traits will our next CEO need to lead the organization into the future of healthcare?

Conversations about an unplanned departure should begin on the very first day of a new CEO’s contract, Orlikoff says. Conversations about a planned departure should begin at the end of the CEO’s first year, he says. For a CEO with a five-year contract, the board should start asking halfway through contract whether the CEO wishes to renew a contract or leave the organization, and the board should know three years into the five-year contract whether the CEO wants to stay, he says.

Hold executive sessions without the CEO present. An increasing number of hospital and health system boards are routinely listing executive sessions on their meeting agendas, and that’s a good thing, according to the AHA Trustee Services survey. A slight majority, 52%, of all respondents routinely included an executive session in the agenda of every board meeting, according to the survey report. But 26% of system boards, 59% of subsidiary boards, and 48% of freestanding boards still don’t.

Even if a board has an executive session, though, that doesn’t mean members are able to fully discuss the topics in their purview. The survey found that CEOs participate in the entire executive session for a majority, 54%, of all boards. That includes 41% of system boards and 57% for both subsidiary and freestanding boards. That deprives trustees of an opportunity to discuss the CEO in his or her absence and might impede the CEO succession planning process, Orlikoff says.

Related: 4 Steps for Planning CEO Succession Boards should think of their meetings in three stages, Orlikoff says. The first stage includes everyone in the room, including board members, the CEO, senior executives, and invited guests. The second stage is a modified executive session that includes the board members and CEO only, which is where the majority of the meeting should take place. The third stage should be an executive session with the board members only. “Confident, secure CEOs know that their boards need to go into executive session without them present occasionally in order to perform certain governance functions. They encourage it,” Orlikoff says. “Insecure CEOs or those who are attempting to control and manipulate the board are very uncomfortable with executive sessions and don’t want the board going into an executive session.”

It’s Mutually Beneficial While it may be difficult to prompt board members to think about a future under different leadership, CEOs who do so are not only investing in the organization’s long-term success but also signaling that they are the sort of leader willing to make investments in the organization’s long-term success. “When a CEO goes to the board and says, ‘You guys need to do this,’ … it demonstrates an incredibly high degree of confidence.

It also demonstrates an incredibly high degree of commitment to the organization,” Orlikoff says. “It shows that you’re thinking beyond yourself,” he adds. “You’re thinking about the best interests of the organization, that you’re willing to have difficult conversations for the good of the organization.”

“INSECURE CEOS OR THOSE WHO ARE ATTEMPTING TO CONTROL AND MANIPULATE THE BOARD ARE VERY UNCOMFORTABLE WITH EXECUTIVE SESSIONS AND DON’T WANT THE BOARD GOING INTO AN EXECUTIVE SESSION.”

KEY TAKEAWAYS

Not having a formal succession plan may be a symptom of an unhealthy relationship between the CEO and the board.

When CEOs prompt the board to think about who will lead next, it demonstrates self-confidence and commitment to the organization.

 

 

 

Seattle Children’s sues to block release of health records; top official resigns

https://www.beckershospitalreview.com/infection-control/seattle-children-s-sues-to-block-release-of-health-records-top-official-resigns.html?utm_medium=email

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Seattle Children’s Hospital has filed a lawsuit to block the release of health department records regarding mold at its facility, according to court documents cited by King 5. 

The hospital’s legal team filed an amended complaint in an attempt to block the release of state and county health records.

Documents previously released to the media through a public records request revealed a nearly 20-year history of Aspergillus mold in the air handling system of the hospital’s operating rooms.

Most recently, an infant at Seattle Children’s Hospital died Feb. 12 after she developed a mold-related infection acquired at the facility, the seventh mold-related death since 2001.

The health records sought by the media are “confidential and sensitive,” Adrian Urquhart Winder, attorney for Seattle Children’s, said, according to King 5. The attorney cited a state law that says records produced for quality improvement purposes cannot be publicly disclosed.

On Jan. 10, Mark Del Beccaro, MD, former CMO and senior vice president of Seattle Children’s Hospital, resigned, according to a hospital spokesperson. King 5 could not reach Dr. Del Beccaro for comment.

 

 

 

The role of the modern Hospital & Health System CFO: 3 things to know

https://www.beckershospitalreview.com/finance/the-role-of-the-modern-cfo-3-things-to-know.html?utm_medium=email

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The role of hospital and health system CFO has changed in recent years. CFOs are now change agents within their organizations and are deeply embedded in the day-to-day operations of the business.

Speaking on a panel called “The Evolving Role of the CFO” at the Becker’s Hospital Review 8th Annual CEO + CFO Roundtable in November, a panel of health system CFOs and finance leaders from across the country discussed how the finance chief role has changed and expanded.

The five panelists were:

  • Jeanette Wojtalewicz, senior vice president of Omaha, Neb.-based CHI Health
  • Nicholas Mendyka, vice president of system finance operations at Minneapolis-based Allina Health
  • Doug Welday, CFO of Evanston, Ill.-based NorthShore University HealthSystem
  • Kris Zimmer, CFO of St. Louis-based SSM Health
  • Mike Browning, CFO of Columbus-based OhioHealth

Here are three takeaways from the discussion:

1. CFOs are strategic leaders. The panelists noted that younger CFOs — those in their early 30s — come to the role with a fresh viewpoint. They are strategic and drive performance across the organization. Though CFOs who have been in the role for a decade or two may have a more traditional viewpoint, they’re adapting to the role of the modern CFO and embracing their more strategic position.

2. CFOs need different skills than in the past. The CFO role has expanded beyond traditional finance and accounting, and the skills CFOs need have changed too. When recruiting new members to their teams, the CFOs on the panel said they look for candidates with natural curiosity, data visualization skills and natural leadership abilities.

3. Clinician-finance partnerships are important. New payment models link quality of care to reimbursement, making it vital for CFOs and their teams to develop an understanding of the clinical side of the business. This has caused some health system CFOs to change their approach to training. The panelists said they try to help their teams develop an understanding of each department and learn how clinical and finance are connected.