Guest Post! "Measuring Leadership Accountability"

Today's fantastic guest post comes from William Gould, a #HealthcareHR executive who lives the No Excuses philosophy!


Leadership accountability seems to be a favorite, or not-so-favorite debate occupying the senior leadership meetings in healthcare organizations across the country - from the towers of the federal government, to the board rooms of community hospitals.  Here's the impetus:  the American healthcare system is a wreck, and it is going to get worse.  The point to disruptive change is disruption, and we are living it.

We must rely on adaptive leadership to get us to the next iteration of who we need to become to provide quality, low cost care for our nation and our communities.  Leaders must lead differently, and organizations must develop and hold those leaders accountable to the work that they do.  Many organizations turn to HR and OD professionals to help drive change leadership, and to measure leadership accountability.  How?  We develop programs, competencies, evaluation methodologies, and metrics.  Why?  Because we are HR and that's what we do.  Does it work? 

HR Programs 

Many leadership accountability programs look like this: supercharged job descriptions; standardized leadership competencies; 360-degree evaluations; standardized performance appraisals; and, carefully integrated incentive compensation schemes, to name a few.   

We re-brand, repackage and redeploy the same tired systems with the hope of changing leadership behaviors that will achieve break through results: higher quality outcomes, increased patient satisfaction, lower costs, and a highly engaged workforce.

Blah, blah, blah.

Same old HR programs.  But does it work?  Does it really drive different leadership behaviors, and get at the right accountability our healthcare leaders must demonstrate to transform a broken healthcare system?

We can organize, codify, and subjectively measure standard behaviors and outcomes until we are blue in the face.  The problem is that we are continuing to measure the same old behaviors, by the same tired leadership thinking that contributed to our healthcare mess.  How do we pull the right levers? 

Leadership Is Personal 

Leadership isn't a process or a program, it is a personal journey and a values-based experience.  Transformational leaders become accountable at the point where their behaviors align with their personal values and their organization's mission.  Transformational leaders are those who demonstrate the courage to take actions outside of the scope of their poorly written job descriptions.  But how are we supposed to design and measure that? 

My Own Epiphany 

I have been a healthcare HR leader for the past 15 years.  I currently work for a faith-based, mission-driven organization with a long history of providing care to the under served and poor in our community.  I drank the healthcare Kool-Aid long ago and work hard to align my professional leadership behaviors to support my organization's mission.  I too have developed a number of HR and OD programs aimed at developing leaders and measuring leadership accountability.

 
Three years ago I was diagnosed with diabetes.  A few weeks ago I attended the American Diabetes Association's Expo at the Colorado Convention Center (iRunDiabetes.)

My emerging personal efforts as a diabetes advocate neatly intersect with my professional work as a healthcare executive.  The Expo was marketed heavily to an under insured and under served population to provide them with healthcare and diabetes resources that can't typically access.  I am not one of them.  I am fortunate to have health insurance, and access to care.

For those who do not have diabetes, or other serious chronic conditions, it can be overwhelming even when you have access to care and the resources to pay for it.  I wandered the Expo hall with a profound sense of guilt and remorse; not just because I felt fortunate to have resources to manage my disease, but because I realized the gap that existed between my personal values, and my professional work.

I thought for days about how hard it must be for the diabetics at that Expo who do not have regular access to care. These are many of the same people who my hospital serves when their untreated condition becomes critical. 

Leadership Accountability 

I may be hitting the leadership requirements on my performance evaluation and business objectives in my paid work (although there is plenty of room to improve), but it feels like I am failing when it comes to leadership accountability - the type of leadership accountability that is going to help change the healthcare game.

Maybe my leadership accountability lies in closing the gap between my diabetes advocacy and my work as a healthcare executive?  None of this is measured in my performance evaluation.  I don't have an incentive built around improving access to an under served population - I'm a HR guy.  But if I really want to be one of the transformational leaders who contributes to changing a broken healthcare system, maybe I need to find a way to succeed.

Urgency doesn't come from a program in the workplace, or a fancy measurement scheme in the OD department.  Leadership comes from an urgency of purpose, and is based in personal values.  Maybe the best measure of leadership accountability lies in hiring the right leaders, and giving them the tools, freedom, support, and resources to really make a difference?   But, how do we measure that? 

William Gould is the VP of Human Resources and Support Services for a faith-based, nonprofit hospital in Denver, Colorado.  He is also a recovering HR and leadership blogger who is now trying his hand at writing about diabetes and his running obsession at iRunDiabetes.  His professional objective involves taking the friction out business and people processes that are most commonly caused by stupid HR practices.  He is fond of organizational development work, and passionate about wellness.  Connect with him on LinkedIn. 

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