Developing Middle-Level Leaders

The pandemic’s lingering impact on midlevel healthcare leaders is still evident, with many experiencing long-term symptoms of trauma, such as exhaustion, anxiety, and anger. These leaders bear the weight of ongoing challenges, struggling to support their often under-resourced staff while also being pressured to achieve organizational goals. In this post-pandemic landscape, even seasoned leaders are struggling to implement and reinforce familiar initiatives as mental exhaustion has set in. To many healthcare leaders, doing the right thing can feel overwhelming.

Despite their suffering, these dedicated leaders continue to show up each day to make a difference in the lives of their patients, families, and colleagues. If doing the right thing feels difficult for these mid-level leaders, what can executive leaders do to simplify the work and break down barriers so each individual has the opportunity to achieve and sustain success?

•EMBRACE SERVANT LEADERSHIP

1. Evaluate the leadership style of the executive team to ensure their approach meets the challenges of midlevel leaders. As midlevel leaders continue to face significant obstacles, they need a psychologically safe environment where it is okay to ask for help and where they are coached and supported through difficulties and mistakes.

2. Focus on improvement rather than aggressive goals. Recognize even incremental success.

3. Meet leaders where they are now. Most healthcare systems have an abundance of new leaders and staff. Healthcare providers may need to ‘start over,’ with a focus on basic processes, behaviors, and foundational, evidence-based practices to rebuild a highly reliable environment.

•USE DATA STRATEGICALLY

1. Use data (e.g., patient experience, employee engagement, clinical outcomes) to identify departments that are above or below goals and are improving or declining.

2. Group midlevel leaders into cohorts based on department performance. For example, group together leaders of departments who are below goal but improving. Leaders in underperforming areas will feel connected and supported in their journey rather than isolated.

3. Provide monthly data updates to track department-level performance.

4. Analyze data at the department level to allow mid-level leaders to understand the needs of their particular patient or internal customer population. For example, patient needs, expectations and outcomes may differ dramatically depending upon variables such as medical condition, environment, care team, gender identity, and race.

•NARROW THE FOCUS

1. Provide each midlevel leader with one or two high-impact metrics relevant to their particular department (e.g., patient engagement, the inpatient Nurse Communication domain, Emergency Department throughput).

2. Create customized, evidence-based action plans to affect change specific to the needs of each department and focus on the education and reinforcement of only one or two tactics at a time.

•IMPLEMENT A COMPREHENSIVE SUPPORT STRUCTURE

1. Create supportive forums (e.g., monthly Zoom meetings or lunch and learns) where leaders from each cohort collaborate and learn from others at the same place in their improvement journey.

2. Understand that a training class alone will not result in sustainable change. Consistency comes from ongoing observations and coaching of processes and behaviors. As new initiatives are implemented, observations and coaching of those new expectations should be added to existing audits.

3.Utilize executive leader rounds to offer visible operational and leadership support.

•CELEBRATE IMPROVEMENT, NOT JUST GOAL ACHIEVEMENT

1. Acknowledge any improvement, no matter how incremental, to reinforce a supportive learning environment.

2. Celebrate high-performing departments with small tokens of appreciation presented by executive leaders.

3. Partner leaders from high-performing departments with leaders from lower-performing departments for collaboration and mentoring.

4. Recognize team improvement at huddles and staff meetings, sharing specific feedback on what is going well.

5. Immediately recognize individuals in real-time as you observe them meeting/exceeding expectations.

Midlevel leaders face immense challenges, and it falls to executive team members to guide them through a complex environment. Simplifying focus, breaking down barriers, and creating a supportive learning organization is imperative. The investment in developing these midlevel leaders now will educate them on strategic prioritization, enhance interdepartmental engagement, and ultimately accelerate performance improvement, driving sustainable transformation.