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Advice & Insights for healthcare's Leaders & HR Profressionals

5 Virtues for Frontline Leaders

Posted on February 10, 2016 by James A. Rice, Ph.D., FACHE


How can Hospital and Ministry of Health Leaders from SE Asia master new approaches to leadership and management? To address this question, The US Embassy Singapore developed a two week program involving faculty from the Singapore public hospital system, SingHealth, and USAID supported health sector managers from the US. Bob Stevens, CEO of Ridgeview Medical Center and I conducted four workshops in this program. Twenty-three participants from the health sectors of Philippines, Thailand, Vietnam, Myanmar, Laos and Cambodia were encouraged to avoid common vices of ineffective leaders such as the inability to take risks, and the failure to engage and listen to diverse stakeholders. Effective frontline leaders should embrace the flip-side of such vices by striving to accomplish these five virtues:

Virtue 1: Engage Diverse Stakeholders

Stakeholders have a right and need to understand and guide the good work of clinicians and community health workers to deliver health services that are not only of good clinical quality, but that also satisfy patients, are cost effective and contribute to stronger communities and nations. Smart leaders provide sincere invitations for eclectic and diverse groups of people to engage in important decision-making processes.  

Virtue 2: Ask Smart Questions

Experienced leaders know how to ask smart questions that seek to probe the real meaning of the essential characteristics of a situation, challenge, problem or opportunity. These questions are asked not just of close confidants of the leader, but of diverse stakeholders and especially the most vulnerable and disenfranchised of the organization’s service population.

Virtue 3: Listen to Stakeholder Insights and Advice:

Effective leaders must also listen carefully to the answers and insights gained from the question asking process. Many leaders are not good at listening.

Virtue 4: Take Sensible Risks:

Effective leaders are willing to take sensible risks to overcome obstacles, to yield innovation and to create conditions for health workers and managers in which they can explore new methods and processes for accomplishing their goals and plans.

Virtue 5: Provide Recognition & Rewards:

Great leaders create “celebration cultures” in which health workers, staff and stakeholders believe their ideas, insights and initiatives are needed, welcomed and valued. Smart leaders provide recognition and rewards for participants in their organization’s pursuit of service improvements. These leaders also recognize that sustainable rewards are often more than just money.

To expand your effectiveness, we hope you will avoid the vices and embrace the virtues outlined in this blog.

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Governing in the Context of Health: a global perspective

Posted on January 26, 2016 by James A. Rice, Ph.D., FACHE


In the North America and Europe,  tax-exempt hospitals have benefited from boards composed of community leaders who generally volunteer their time and expertise to enhance the performance of one of their community’s largest employers and essential contributors to the health and well being of the community and its employers

That is not the case in many low and middle income countries in Asia, Latin America and Africa. To explore our prior work to develop good governance practices in Africa, we include a series of blogs here that provide insights into the challenges faced by these hospital governing boards. The first resource is a web based educational program being used by health systems managers and board members in Asia, Latin America and Africa

You can Learn “Governing in the Context of Health” in Eight Hours in a new USAID Unveiled Governance and Health eLearning Certificate Program. To register for the program click here.

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Can Health System Boards Learn from University Boards?

Posted on January 13, 2016 by James A. Rice, Ph.D., FACHE

In a recent landmark report from the National Commission of College and University Board Governance,[1]   we find seven important recommendations to enhance the effectiveness of good board work. As we explore these seven imperatives, consider how they can also stimulate health systems’ boards to raise the bar on their own performance in the changing situations for hospitals and health services delivery

  1. Boards must improve value in their institutions and lead a restoration of public trust in higher education (aka hospital care).
  2. Boards must add value to institutional leadership and decision making by focusing on their essential role as institutional fiduciaries.
  3. Boards must act to ensure the long-term sustainability of their institutions by addressing changes finances and the imperative to deliver a high-quality education (aka health care) at lower cost
  4. Boards must improve shared governance within their institutions through attention to board-president relationships and a reinvigoration of faculty (aka medical staff) shared governance.
  5. Boards must improve their own capacity and functionality through increased attention to the qualifications and recruitment of members, board orientation, committee composition, and removal of members for cause.
  6. Boards must focus their time on issues of greatest consequence to the institution by reducing time spent reviewing routine reports and redirecting attention to cross-cutting and strategic issues not addressed elsewhere.
  7. Boards must hold themselves accountable for their own performance by modeling the same behaviors and performance they expect from others in their institutions.

Perhaps our health systems’ board members should meet periodically with their university board colleagues to share ideas about how best to leverage the time and talents of community leaders for stronger board work for stronger organizational performance?


[1] “Consequential Boards: Adding Value Where it Matters Most,” Association of Governing Boards , of Colleges and Universities, Washington DC 2014

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People Strategy: Board Oversight of C-Suite Development

Posted on October 30, 2015 by James A. Rice, Ph.D., FACHE

A new Board Chairperson asked the CEO of a mid-sized health system... "I see we have invested a lot to establish a new IT plan; a master facilities plan; and a record-setting capital plan.  Where is our 'People Plan'?  What are our strategies to invest to enhance the pride and performance of the human assets that represent almost 60% of our operating budget, and impact 100% of our success in quality and operational efficencies... our people?"

A good question.  A question not being asked enough, nor talked about enough in the boardrooms of our nation's leading hospital and health systems.  

Successful health care organizations can only improve and sustain their performance if they raise the bar on their talent management strategies.  Enhancing talent management will not flourish unless it receives more serious attention in the boardroom and C-suite offices.  Such attention is more likely if CEOs and senior HR executives are invited into the boardroom to engage Board leaders in broader and deeper "critical conversations"about these issues:

  • The current shortages of mission-critical health professionals in medicine, nursing, and many other technician jobs;
  • The large portion of our health professionals that will be retiring over the next 5-10 years;
  • The long lead-time needed to attract in new clinical and leadership talent;
  • The lack of clear investments to ensure our people (medical staff, employees, and managers) are able to practice in a culture that is patent centered, performance driven, and values based.
  • We too often lack "The Long View" about sensible and structured ten year strategies for:
  • Nursing and allied health professional recruitment and development;
  • Medical staff recruitment and development;
  • Physician leadership development;
  • Modern web-based employee support systems;
  • Executive and middle manager succession and career planning;
  • The link between HR capital and capital for facilities, medical technologies, and IT; and
  • The business case for more sophisticated talent management.
Boards need to be more effective, enthusiastic, and engaged in setting the strategic framework for the development and deployment of their organization's human capital.  This enhanced sophistication can only happen, and be sustained, if CEOs and senior HR executives step up now to move their "People Strategy" onto the Board's radar screen.

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Long-term Strategy and Leadership

Posted on October 30, 2015 by James A. Rice, Ph.D., FACHE

Board engagement and a committed senior leadership team are essential to fostering a health system's shared vision, aligning organizational components so that the health system can best pursue this vision, and building a commitment to the vision at all levels of the organization. 

To become a high-performance organization, a health system needs senior leaders who are drivers of continuous improvement and whose styles and substance are in accord with the way the health system sees its mission and its own character.

To create a workforce that shares this vision and is aware of the contribution that each employee and physician can, and must, make toward achieving it, the health system's senior leaders must work as a team to convey a clear and consistent portrayal of this vision throughout the organization by their words and deeds and the example they set.  

Board leaders and career managers may bring differing values to the team, but they must work at building mutual understanding and trust, and at committing themselves to a shared set of goals for their health system.  These coals can take years to achieve, so the health system must have a succession planning strategy that ensures a sustained commitment and continuity of leadership even as individual leaders arrive or depart.  When planning for a health system's future, Boards and leaders should consider the following three questions:

  1. Defining Leadership. Has the health system defined the kind of Board and executive leaders it wants (i.e., their roles, responsibilities, attributes, and competencies) and the broad performance expectations it has for them in light of the Health System's shared vision?
  2. Teamwork and Communications.  Do senior leaders pursue an explicit strategy to promote teamwork, communicate the Health System's shared vision in clear and consistent terms to all levels of the organization, and receive feedback from employees?
  3. Ensuring Continuity.  Does the Board take steps to ensure reasonable continuity of leadership through executive succession and continuity planning?

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