The Los Angeles Public Health Leadership Institute: An Intra-organizational Approach To Leadership Development

1. The Los Angeles Public Health Leadership Institute: An Intra-organizational Approach To Leadership Development APHA Session: 4143.0 The Challenge of Leadership in Public Health Tuesday, November 9, 2004

2. AUTHORS • Bridget Ward • Director, Office of Organizational Development and Training, Los Angeles County Department of Health Services – Public Health • Carol Woltring • Executive Director, Center for Health Leadership and Practice, Public Health Institute • Jonathan Fielding • Director of Public Health and Health Officer, Los Angeles Department of Health Services – Public Health

3. 4,084 square miles - 88 cities Population (January 2004) - 10,103,000 Population is larger than 41 states 44.6% Hispanic 31.1 % White Languages 224 languages spoken in LA County 92 languages spoken in LAUSD Education 80 school districts in LA County 12.6 % Asian/PI 9.7% Black LOS ANGELES COUNTY • 2% Other

4. LOS ANGELES COUNTY DEPARTMENT OF HEALTH SERVICES • 2nd largest Health Department in the U.S. • Total DHS workforce - 24,229 employees • Public Health • 4,140 employees (17%) • 38 different programs, including 8 geographically divided areas • 19% of total DHS budget

5. WHY LEADERSHIP DEVELOPMENT ? • Ten Essential PH Services • Assure a competent public and personal health care workforce • Enhanced performance through improved leadership • Improved collaboration across the Department • Leadership needed for: • Launching new PH initiatives and strategic plan • New challenges such as BT and emerging infections

6. CONSULTANTSELECTION PROCESS • OODT decided to use internal advisory/planning committee and outside consultant to conduct the Institute • Research for consultants with Public Health experience who would customize the curriculum to LA goals and objectives • Center for Health Leadership and Practice was selected

7. TARGET AUDIENCE • 104 Senior Managers (top 4 levels in LAPHS-PH) • 4 Cohorts of 25-30 Senior Managers trained in 3-4 month program from October 2003 – December 2004

8. LOS ANGELES COUNTY PUBLIC HEALTH LEADERSHIP INSTITUTE (LAPHLI)THEORY OF ACTION Long-term Outcomes • Enhance participants’ commitment to and strengthening their accountability for the Department’s mission, thereby strengthening the Department’s overall accountability to the residents of Los Angeles County • Foster the development of a shared vision and integrative approach to defining and achieving Departmental goals • Promote the practice of collaborative leadership skills within the Department and increase the success of internal and external collaborations • Increase evidence-based decision-making by participants in addressing public health challenges • Enhance the Department’s capacity for learning and change through improved leadership capabilities of participants • Contribute to the development of an organizational culture that promotes leadership (including the next generation of leaders) through role modeling and coaching by participants Leadership Institute Activities Skills Training Areas • Personal Leadership • Organizational Leadership • Community • Leadership Learning Activities • Workshops (Five Days) • Personal Leadership Assessments • Executive Leadership Development Plan • Personal Coaching • Collaborative Leadership Change Project Short-term Outcomes Enhanced Personal Leadership Skills (Within 6-12 months) Inputs Trainees LA County Department Of Health Services Public Health Senior Managers and Program Directors

9. LAPHLIKEY CONTENT AREAS • Current Leadership Challenges in Public Health and LADHS-PH • Leadership Skills for the 21st Century • Leading and Managing • Reflective Leadership: Knowing Your Personality Preferences (MBTI) • Systems Thinking • Designing and Leading Collaborative Organizational Change • Communications • Sustaining Collaborative Change Work • Developing Leadership in Others

10. EVALUATION • Consultant hired to assess: • Cohort I • Short term objectives • Recommendation if LAPHLI should continue • Ten in-depth interviews following completion • 6-month Follow up study • Cohorts I, II, and III • Comparison across Cohorts • Daily evaluation forms • Completed by each participant • Reviewed by trainers for immediate feedback

11. COHORT I EVALUATION RESULTS • 75% recommended Cohort II and III be approved • None recommended it should not continue • 25% stated it should continue if executive staff participated • 53% identified it as their single top experience for short term training • All identified as one of their top 4 experiences for short term training

12. RESULTS OF IN-DEPTH COHORT I INTERVIEWS • Medium to high scores for daily learning objectives • Collaborative Leadership Change Projects useful for participant and Department • LAPHLI should continue • High agreement for personal leadership ability improvement • Too soon to determine scope for entire department

13. RESULTS OF 6 MONTH FOLLOW-UP INTERVIEWS • LAPHLI adds value for individual and Department • Strong commitment to personal leadership development • Senior/Executive involvement needed for challenges with change projects • Most valuable benefit is interaction with staff across the Department

14. COMPARISON OF COHORTS I, II, AND III • Remarkably consistent results among cohorts and scores • Immediate use for new skills to add to existing skills • Individual abilities and organizational capabilities are improved • Collaboration across Department will continue to improve

15. COLLABORATIVE LEADERSHIP CHANGE PROJECTS • 24 projects designed by intradisciplinary/intraorganizational teams • Internal tracking being done • Results, lessons learned, challenges are showcased at on-going Leadership Forums • LAPHLI produced positive outcomes for participants and the Department

16. LEADERSHIP FORUM • Internal Leadership Group comprised of the 104 LAPHLI Graduates • Self-Governed • Meet Bi-Monthly for ½ day • Six Goal Teams • Commitment to ongoing leadership development and culture change

17. LAPHLI FUTURE DIRECTIONS • Leadership Forum – sustained development and action • Leadership skill-building workshops for alumni and their managers (next level) • Succession Planning – including future staff development strategies • Development of internal coaching and mentoring strategies

18. CONCLUSION • Organizations can and should put their own “legs” on leadership training investments.