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Challenges facing Healthcare Leaders: Management Competencies Organizational Complexity

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Challenges facing Healthcare Leaders: Management Competencies Organizational Complexity

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    1. Challenges facing Healthcare Leaders: Management Competencies Organizational Complexity Wallace Lockhart, University of Regina Allen Backman, University of Saskatchewan

    2. Five core disciplines of Public Health Epidemiology Health Promotion Biostatistics Environmental Health Health Policy and Management

    3. Need to re-think curriculum for Health Management Program Is current program providing the right competencies? targeted at the right levels, The right people? Where should future program be focused?

    4. Need to re-think curriculum for Health Management Program Do we emphasize Leadership? Core areas (Hard skills)? Accounting and Finance Organizational Behaviour Marketing Human Resources Management Strategic Planning Personal skills Emotional intelligence and relationship management, Personal attributes Commitment, values and motivation. Broader concepts Life-long-learning & responsiveness.

    5. Why study management competencies? We have a variety of competency maps; We have lots of management programs; But our organizations have changed … Are we keeping up with those changes? What you do is valuable! … despite popular political rhetoric (if you aren’t a care-giver, what label is given to you?) … and it is important to discuss this

    6. Project Parameters: Management is broad field: personal attributes, leadership, EI, life-long learning Our focus: Management competencies in 4 categories (care giving, strategy, core management, and financial / analytical). 3 levels: Front line, middle & senior

    7. Past Studies: MacKinnon (2003) Competencies, Gaps Hewitt (2006) – Human Resource Dilemma CCHSE (2006) – Discussion Paper So what have we learned? That we don’t know enough!

    8. The Research Quantitative & Qualitative – Triangulation Questionnaire Survey 266 CCHSE members – CEO, VP, HRM Mix of CEO, VP, Manager / Director Depth Interviews – Survey respondents Focus Group – at 2008 NHLC

    9. PART 1 - COMPETENCIES How important are each of (list of 18 items), for managers at each level? Current average competency level in your organization, for each item. From these two, we extrapolate “THE GAP”

    10. Competency Areas for Research Caregiving General Knowledge New Developments Professional Practice Managing Quality Knowledge of other HC Professions Strategic Thinking Decision-Making/Judgment Process Redesign Partnership, Collaboration & Advocacy Leadership Communications Organization/Human Resource Mgmt Managing in a Team Environment Financial – Read & Interpret Reports Financial – Budgeting Financial – Responsibility for Budget Analytical Skills (Qual/Quantitative) Use of I.T./Technology Tools

    11. RESULTS – PART 1 We will scan Front Line & Senior levels Importance The GAP

    12. FRONT LINE: Important? Most Important Communications Managing – team env. Care Giving skills Managing quality Least Important Process Redesign * Financial & Analytical Strategic Thinking *: take note!

    13. FRONT LINE: THE GAP Greatest GAPS Communications Managing quality Leadership Managing teams Process redesign! * *: What? It’s not that important! Least GAPS Partnership & collab Strategic thinking Care giving

    14. Part 1 Discussion – Front Line We promote strong clinicians to managers OR – we promote passion / leadership But they lack management skills; AND … we don’t train them very well or give them time for school. Larger organizations: less emphasis on financial, analytical & strategic. Who provides training? CHA, not grad pgms

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    16. SENIOR MANAGERS: Important? Most Important Leadership Strategic Thinking Communications Decision Making Financial - Budget Least Important I.T. / tech tools Care giving

    17. SENIOR MANAGERS: THE GAP Greatest GAPS Process Redesign Communications Managing Quality Strategic Thinking Analytical Skills Least GAPS Financial – Budget Care Giving

    18. Part 1 Discussion – Middle Mgrs Competency ratings low across the range. Large gaps in the most important areas Position challenge: between the top and the front (communications are key – and weak) Process redesign is key – and very weak!

    19. Part 1 Discussion – Senior Mgrs (We are just the messengers, don’t shoot us .. these are views of senior managers, many of you!) Gaps are smaller than other levels, but still some important concerns. Many have graduate management degrees, yet major GAPS in strategy, analytical skills, communications … why? (Hmmm … ummm, come to think of it, we’re the teachers. Never mind; ignore this; let’s move on …)

    20. Part 1 – Other discussion Looking up / looking down Financial: Either important – or not! Leadership: Definable? Learnable? Accreditation: Competencies vs Attributes Universities: Core competencies, part-time, flexible, perhaps certificate programs?

    22. PART 2: ORGANIZATION FACTORS This is where the fun part starts! Just a few insights – for now!

    23. The Questionnaire – Part 2 Organizational factors that may influence a manager’s ability to do their job. Sufficient skills? Sufficient authority? Analytical support? Time! Training / Succession ORG: do P&P help? Org structure – help? Span of control Org complexity

    24. Small organizations are inefficient. Bureaucratic. Big is better. Right? Re-Regionalization

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    29. You and your management team see things in the same way, right? Hey, Boss …

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    33. A few more …

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    37. Conclusions – Part 1 We have a better sense of strengths & GAPs Process redesign; managing quality; analytical skills; strategy … doesn’t that come from engineering and business schools? Front line managers – the greatest GAPs What can we do about it? Healthcare organizations CHA – provides / supports core mgt programs Universities – opportunities, non-trad’l programs

    38. Observations – Part II Organizational factors are at least as important as management competencies. Regional healthcare organizations continue to evolve … We have to make sure we have people with the competencies needed to manage them! Integration of complex, diverse services is a complex organizational and operational challenge. Big, complex organizations aren’t working!

    39. So … What do we do about this? Universities: What can/should we teach? How much conceptual vs experiential? Should we train the front-line managers? Healthcare organizations: Do org systems let managers manage? Why would strong clinicians take mgt job? Do you provide needed training opportunities?

    40. THANK YOU! Questions, Please! wallace.lockhart@uregina.ca a.backman@usask.ca

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