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The Rx VBHC Series: SESSION 7 | ENABLING PERFORMANCE THROUGH PEOPLE Part 1: Developing Effective Teams and Leaders for this New Healthcare Era - How? L.E.A.D.E.R.S.H.I.P. Intelligence (LQ)




 Today, we will focus on  ENABLING PERFORMANCE THROUGH PEOPLE - Part 1: Skills and behavioral elements all leaders and team members must internalize and operationalize to enable sustained performance – L.E.A.D.E.R.S.H.I.P. Intelligence (LQ).

Next week in Part 2, we will focus on additional skills, and tools people need to enable performance – Workplace Intelligence Behaviors, Effective Team Builder Competencies, and Tools to Transform Team Members into High-Performing Teams.




    Over the last two decades, I have witnessed teams and leaders putting all their energies into developing strategies and initiatives, acquiring new technology and tools, creating new healthcare models, and giving eloquent and inspiring speeches, as a means to transform their organizations into high performing entities.  And then at the end of the year when they do not get the expected results, they wonder, what happened?

     Effective healthcare leaders and high performing teams know that while strategies, technology, new models, buildings, and innovations are important, they are just tools in the healthcare system’s toolbox - similar to a hammer in a carpenter’s tool box.  Without the skill of the carpenter, a hammer is a dormant tool.  However, in the hands of a skilled carpenter, that same hammer can help create a throne for a king.  That hammer’s performance was enabled by the skill of the carpenter, and it is the same in healthcare.

     In this new era of value-based healthcare, the skills and abilities of our teams, team members, and leaders will determine whether our organizations will perform and achieve the following goals:

  • Become the solution for lowering the cost of care by eliminating waste, inefficiencies, non-value-added processes, and inconsistencies in all activities

  • Ensure optimal health outcomes for all patients in our care

  • Explore and act on new opportunities to improve your performance and achieve a competitive advantage

  • Meet or exceed the expectations of what matters most to individual patients

  • Move from silo thinking, actions, and processes to form interdependent alliances to solve challenging problems and create new opportunities

  • Through alliances with others, build the healthiest communities

  • Transform strategic theories into strategic actions to ensure organizational success

  • And in the midst of challenges, stay true to the mission, vision, and core purpose of the organization

What skills are needed in our team members and leaders to navigate this new healthcare environment? How will leaders and team members internalize and operationalize these skills? What competencies does an effective team builder need to have to coach their team members for success? We have researched hundreds of articles, journals, and books on leadership, learned from some of the best leaders in business, immersed ourselves in the complexity of various business and health care systems, and observed ecosystems where leadership occurs naturally in nature. What we have found is that while leaders must have high levels of professional and technical expertise, they must also have something even greater - L.E.A.D.E.R.S.H.I.P. Intelligence (LQ) skills.


What is Leadership Intelligence (LQ)?

     Leadership Intelligence is a compilation of behavioral elements and skills needed by leaders in business today, to effectively navigate the through uncertainty and leverage the tools in the healthcare toolbox for success in this new value-based healthcare environment.

     While there exist no guaranteed formulas for leadership success, at least none that we know of, we believe that these elements and skills will help leaders lead effectively in the new environment.  These behavioral elements are: lead with a purpose and by example, effective engagement, accountability, development of self and others, execution of priorities, recognition and acknowledgement, solidifying relationships, health of teams, interdependence, and personal life focus. These elements have been consolidated into the acronym L.E.A.D.E.R.S.H.I.P. to help you to remember them.

     These are timeless principles that have kept many of us grounded, consistent, and effective as leaders amid the challenges and uncertainty that exists in healthcare today.  We believe that using these elements and skills will do the same for you as it did for Dr. Sam and his team.  Dr. Sam worked with his Human Capital Department to develop experiential training that leveraged LQ and other skills to build and transform his team members into effective and high-performing leaders.


Highlights of the 10 Elements of L.E.A.D.E.R.S.H.I.P. Intelligence (LQ) 

(excerpts from the 10 Elements of L.E.A.D.E.R.S.H.I.P. Intelligence (LQ) Handbook )


1.  LEADING:  Lead with a purpose and by example.

The Marine Corps trains its leaders to use a principle called Ductus Exemplo, which is Latin for “lead by example”.  This principle is at the heart of the training process that turns cadets into officers.  If you think about it, that’s a major transformation. How do the trainers at Officer Candidate School make that transformation happen?  They lead by example. Here are ten principles that Dr. Sam’s team members focused on to start, continue, and remain on the journey of Ductus Exemplo: integrity, have a core purpose (aligned with organization and bigger than self), listen, have grit and guts (fortitude, perseverance, and resilience), be a role model to others, recognize success in others, engage in self-care, take responsibility, practice self-discipline, and have fun (details in chapter 10 of the LQ Handbook). 

As Mark Twain famously said, “The two most important days in your life are the day you are born, and the day you find out why.” Knowing and living your core purpose will not only give meaning to your life but also make you a purposeful leader in the good times and bad.


2.  ENGAGEMENT:  Engage team members through communication and collaboration.

Jack Welch, the former CEO of GE once said, “There are only three measurements that tell you nearly everything you need to know about your organization’s overall performance: employee engagement, customer satisfaction, and cash flow…It goes without saying that no company, small or large, can win over the long run without engaged employees who believe in the mission and understand how to achieve it.” Eight principles that helped Dr. Sam and his leaders become more engaging: Connecting with team members to understand what inspires them to perform, connecting daily tasks to the bigger picture and mission of the organization, creating clarity, communicating effectively especially in challenging times, remain curious, congratulate efforts and successes, support effective collaboration, and be credible at all times. Remember engagement is hard to build and easy to lose, so this will be an ongoing process.


3.  ACCOUNTABILITY and ownership: Always remember that the buck stops with you.

In the book ‘The Oz Principle’, accountability is defined as “a personal choice to rise above one’s circumstances and demonstrate the ownership necessary for achieving desired results—to See It, Own It, Solve It, and Do It.”

Six Accountability Principles for everyone to own:

  • Responsibility: Accept responsibility for your work and the results, whether the outcome is good or bad

  • Victimhood vs. Ownership: Until you take full responsibility, you will be a victim;

  • Clarity: For each project, clearly define team members’ roles and points of accountability; understand the difference between what you’re responsible for and what you’re accountable for; Communicate goals effectively and engage others in joining you in pursuit of success;

  • Looking Outward and Looking Inward – the mirror, learning from past mistakes, and understanding the customer’s voice.

  • Your Competition:  Study your closest competitors and look for what they do better than you

Developing an Accountable Work Environment: Accountability isn’t just about individual leaders or team members, accountability extends to the whole workplace.  In order to be an organization with great accountability, the following components need to be in place and sustained over time: clarity of purpose, clarity of expectations, ongoing cadence of review, feedback, recognition, and leverage learnings that can be applied to future projects.


4.  DEVELOPMENT: Develop yourself by becoming an ever-learning leader, and develop your team members to ensure long-term success.

According to Malcolm Gladwell, “Practice isn't the thing you do once you're good.  It's the thing you do that makes you good.  Achievement is talent plus preparation.”

  • To grow and prepare yourself to become an effective leader, you must do the following: define your purpose and calling to be a leader in your organization and industry, learn to see yourself clearly (and discern both your strengths and weaknesses), seek out opportunities to gain new experiences and lead new projects (no matter how small), focus on continuous learning and increasing your awareness of the changes in the world around you, identify mentors to help you grow and help make your blind spots visible to you, learn to question your motives to ensure authenticity and a genuine belief in what you are supporting, leverage your strengths and mitigate your weaknesses (don’t ignore them), and always give back to society and your local community through volunteer efforts and mentoring others.

  • Shortcomings that can inhibit leadership include: Resisting change or having a hard time developing and learning from mistakes, repeated failure meet business objectives, problems with developing or maintaining good working relationships with others, and too-narrow functional orientation—lacking the sufficient depth to manage outside of one’s current function can make it difficult to lead teams across departments or business units.

  • Developing Leaders around You begins with hiring the right people, then helping them develop their management and leadership skills (staff and leaders), provide growth experiences especially for the high potentials, ensure accountability and ongoing feedback, and when new opportunities open up, you will have an increased chance of hiring from within to preserve the core and stimulate progress at the same time.


5.  EXECUTION:  Systematically execute your priorities to ensure both success and sustainability.

Studies have shown that execution is business' biggest challenge and that 70% of strategic failures occur due to poor execution. Why is this?  Larry Bossidy, one of the authors of Execution:  The Discipline of Getting Things Done, said, “Many people regard execution as detail work that is beneath the dignity of a business leader.  That’s wrong—it is one of a leader’s most important jobs.” In addition, many people struggle with execution simply because it requires concrete work that’s not always exciting.  Many leaders are great at developing strategies, ideas, and plans, but not so good at the day-to-day tasks required to actually make those ideas and plans a reality.  Both sets of skills are important for success, and not everyone has both.

Also, according to Chris McChesney, coauthor of the 4 Disciplines of Execution: Achieving Your Wildly Important Goals, the fundamental reason why execution is so difficult is that it requires people to change their behavior and to implement these changes in a new healthcare environment that are already swirling with other urgent priorities.

To execute effectively, teams must have clarity of purpose, establish key priorities aligned with the bigger picture, develop mutually accountable measures of success, and create a plan and process to execute. Execution also involves the development of a cadence of accountability, displaying and communicating early wins, celebrating successes, learning from failures, and conducting post-project reviews without blame.


6.  RECOGNITION:  Recognize and acknowledge incremental steps, aligned behaviors, calculated risks, successful outcomes, and learn from unsuccessful attempts.

In many organizations, the pace of change and focus on multiple priorities often prevents teams from remembering and celebrating accomplishments. When people are recognized, it is generally for big innovations or improvements. While this is very important, it is also crucial to acknowledge failures that resulted from calculated risks. Therefore, it is important for team leaders to create a balanced environment where people can take calculated risks, fail fast, and learn from their failures to eventually achieve excellence. When the MAB Prescription Strategy initiative was implemented, Dr. Sam, the medical group, and health plan leaders recognized the teams quarterly for the outcomes achieved. They listened and understood the challenges that the teams faced, and acted as barrier “busters” for the teams and programs so the teams could focus on progress.


7.  SOLIDIFYING RELATIONSHIPS:  Solidify and build relationships to create trust and a lasting network.

What are the fundamental relationships that need to be developed, fostered, and solidified to build a positive work environment for teams to flourish and promote excellence? While it is important to develop good relationships with everyone, there are four types of professional relationships we must focus on, build, manage, strengthen, and solidify. These include relationships with team members and subordinates, peers across departments and silos, manager(s), and customers. Solidifying these core relationships will make the work more rewarding and effective.


8.  HEALTH PROMOTION: Promote functional, mental, physical, and ethical health in the workplace.

One of the best examples of promoting health in the workplace came from William C. Weldon, the former Chairman, and CEO, Johnson & Johnson.  He said “We dedicate resources to health and prevention because, like any successful investment we’ve made, it yields steady returns.  Those returns take two forms: a healthier, more productive, more committed workforce and significantly lower healthcare costs.  For every dollar we invest in our workers’ health, we see a return of more than four dollars in reduced health care costs, lower absenteeism, and improved productivity.  Our healthcare spending averages 4% below benchmarks for our industry.  From 2001 through 2009, we avoided more than $21 million in health care expenditures.”

One strategy that Dr. Sam’s teams adopted was the T.E.A.C.H. strategy, comprised of: Techniques to reduce stress and gain perspective, Education on the importance of health, Activities and increasing each person’s activity level as they are physically able, Capacity-building skills, and Healthy habit development.


9.  INTERDEPENDENCE: Create interdependence to encourage new thinking and foster innovation.

This saying by Charles Palus codifies the need for interdependence - “Just as we can no longer fix today’s sophisticated car with a single tool, we cannot solve today’s complex organizational problems with a single blue-chip leader.”

In many organizations today, a significant number of functional units and departments still function fairly independently as they develop expertise in their units or silos.  While it is essential to develop functional unit expertise, this methodology is no longer sufficient for addressing the complexities of the new healthcare landscape and ensuring organizational success.  Organizations with primarily independent leadership may not adjust well when more fully integrated services across the various disciplines and areas of expert knowledge are needed.  As the environment grows in complexity, beyond the scope of any given functional unit, independent leadership must be coupled with interdependent leadership for success. 

Interdependent leadership requires mutual inquiry and learning.  It is a highly-developed stage of a leadership culture that has the capacity to create C.L.A.D.— Commitment, Leverage, Alignment, and Direction—in a variety of challenging contexts.  It is highly valuable in contexts that demand collaboration across boundaries, silos, and functional units in which outcomes are more emergent and less linear.  This includes environments in which the understanding of connections and working with people across disciplines is critical for growth.


10: PERSONAL LIFE:  Focus on your personal life and work integration; do not forget yourself.

According to George Krueger & Mary-Lynn Foster, “We think that we need to achieve balance every day.  In reality, sometimes work demands more of us; at other times, our personal life needs the most attention.  Give yourself permission to focus on what’s most important.  Don’t worry about whether everything is balanced every day.”

In the new business and healthcare world, we are experiencing changing realities such as the remote worker, globalization, technology, generational diversity, women in the workplace, the changing expectations of men, and the changing 8–5 workday.  These new realities have made the distinction between work and personal time more blurred.

So, what are people doing to strike a balance between meeting value-based goals and their personal family needs?  Part of the solution is the adoption of the concept of work/life integration (see chapter 10).


These 10 elements of LQ leadership and the additional skills in part 2 (next week) were leveraged by Dr. Sam’s leaders and team members to enable the MAB Rx Strategy and contributed to delivering excellent performance across the continuum of care—from better patient outcomes, fewer healthcare errors, better healthcare costs, and increased coordination of care to creating effective innovations that helped improve the health and wellbeing of patients and team members and gave the organization a competitive advantage.


The Rx VBHC Series: SESSION 7 | ENABLING PERFORMANCE THROUGH PEOPLE Part 2: Developing Effective Teams and Leaders for this New Healthcare Era

Additional skills and tools needed by teams and team members to enable performance:

  • The six forms of workplace intelligence

  • Important Competencies for the Effective Team Builder and Leader

  • Tools to Help Transform Team Members into High-Performing Teams

More information about the MAB Rx Strategy can be found at:

My hope and goal is to provide you with a prescription strategy that will make a difference in the lives of patients with multiple chronic conditions – the most frequent and expensive users of healthcare, contribute to making healthcare value a reality for all, and give you a competitive advantage in this new era of value-based healthcare!











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