Evolving Knowledge: What is Effective Leadership Now?

Transcription

1 This presenter has nothing to disclose Evolving Knowledge: What is Effective Leadership Now? Stephen Swensen,, MD, MMM, FACR, Medical Director, Office of Leadership and Organization Development Mayo Clinic December 10, 2013 Thomas W. Lawson Swensen SJ, Dilling JA, Mc Carty PM, Bolton JW, Harper CM Jr. The Business Case for Healthcare Quality Improvement. J Patient Saf 2013; 9:44. Business Strategy vs. Expense 5:1 ROI

2 Interdependent Dimensions of High-Impact Leadership and Reduce Costs. Cambridge, MA: ; Available on Brookings Institute. Barrington L, Silvert H: CEO Challenge New York: The Conference Board, August Intangible assets. Social capital begets discretionary effort, diffusion, learning, agility. Leadership is a social process

3 Transitioning from Volume-based to Valuebased Systems Requires New Mental Models and Reduce Costs. Cambridge, MA: ; Available on Swensen. Cottage Industry-Post-industrial Era. New England Journal Med 2010 Feb 4;362(5) Two jobs Q Academy Fellows

4 High-Impact Leadership Behaviors What leaders do to make a difference and Reduce Costs. Cambridge, MA: ; Available on High-Impact Leadership Behaviors and Reduce Costs. Cambridge, MA: ; Available on

5 Flying in the plane you service: Patient-centered JACR Mar;7(3): SDM-Triple Aim High-Impact Leadership Behaviors and Reduce Costs. Cambridge, MA: ; Available on

6 Newcastle University. Anthrozoos, Berg Publishing. November 27, 2008 The currency of leadership is attention. Heifetz Keltner. Psychological Review. Goleman. Harvard Business Review. Dec Rise through the ranks and gain power, their ability maintain personal connections suffers psychic attrition. focus their gaze less on lower-ranking staff more likely to interrupt and to monopolize conversations. High-Impact Leadership Behaviors and Reduce Costs. Cambridge, MA: ; Available on

7 Ashish Jha. Health Affairs May : MFMER High-Impact Leadership Behaviors and Reduce Costs. Cambridge, MA: ; Available on

8 Swensen, Cortese. Transparency and the ''End Result Idea Chest 2008;133; Chassin New York 41%. FMEA RFO Huddles Unit-specific metrics % High-Impact Leadership Behaviors and Reduce Costs. Cambridge, MA: ; Available on

9 Every system is perfectly designed to get the results it gets Gittell, J.H., Weinberg, D.B., Pfefferle, S., Bishop, C. (2008). Impact of Relational Coordination on Job Satisfaction and Quality Outcomes: A Study of Nursing Homes, Human Resource Management Journal, 18(2). Jody Gittell, PhD Medical Care Volume 28, Number 8: Gittell JH Impact of relational coordination on quality of care,. Medical Care, 2000;38(8):

10 IHI High-Impact Leadership Framework and Reduce Costs. Cambridge, MA: ; Available on IHI High-Impact Leadership Framework and Reduce Costs. Cambridge, MA: ; Available on

11 Traditionally, women have been underrepresented in American and European orchestras. Renowned conductors have asserted that female musicians have "smaller techniques," are more temperamental and are simply unsuitable for orchestras, and some European orchestras do not hire women at all. Proving discrimination in hiring practices, however, has been difficult. The study by Cecilia Rouse, an associate professor in Princeton's Woodrow Wilson School of Public and International Affairs and the economics department, and Claudia Goldin, a professor of economics at Harvard University, seems to confirm the existence of sex-biased hiring by major symphony orchestras and illustrates the value of blind auditions, which have been adopted by most American symphonies. Their report was published in the September-November issue of the American Economic Review. "This country's top symphony orchestras have long been alleged to discriminate against women, and others, in hiring," Rouse said. "Our research suggests both that there has been differential treatment of women and that blind auditions go a long way toward resolving the problem." Florence Nelson, director of symphonic services at the American Federation of Musicians, described the research as a "very important statement, especially to those of us who have done auditions both ways -- behind a screen and without the screen." She has played flute and piccolo in major orchestras. Traditionally, new members of the great symphony orchestras were handpicked by the music director and principal player of each section. Most contenders were the male students of a select group of teachers. To overcome bias, most major U.S. orchestras began to broaden and democratize their hiring procedures in the 1970s and 1980s, advertising openings, allowing orchestra members to participate in hiring decisions and implementing blind auditions in which musicians audition behind a screen that conceals their identities but does not alter sound. Of the "Big Five" symphonies -- the Boston Symphony Orchestra, the Chicago Symphony Orchestra, the Cleveland Symphony Orchestra, the New York Philharmonic and the Philadelphia Orchestra -- only Cleveland still does not hold blind auditions. Use of the blind auditions varies among the other orchestras, with some holding them only in preliminary rounds. In their study, Rouse and Goldin examined lists of personnel from 11 major orchestras, including the Big Five, and actual accounts of the hiring process maintained by personnel managers in eight major orchestras. Among musicians who auditioned in both blind and non-blind auditions, about 28.6 percent of female musicians and 20.2 percent of male musicians advanced from the preliminary to the final round in blind auditions. When preliminary auditions were not blind, only 19.3 percent of the women advanced, along with 22.5 percent of the men. Using data from the audition records, the researchers found that blind auditions increased the probability that a woman would advance from preliminary rounds by 50 percent. The likelihood of a woman's ultimate selection is increased several fold, although the competition is extremely difficult and the chance of success still low. As a result, blind auditions have had a significant impact on the face of symphony orchestras. About 10 percent of orchestra members were female around 1970, compared to about 35 percent in the mid-1990s. Rouse and Goldin attribute about 30 percent of this gain to the advent of blind auditions. "Screens have been a very important part of the whole audition process," Nelson said. "My sense is that blind auditions have made a tremendous difference in the amount of hiring discrimination women face." Rouse. Blind Auditions. September-November issue of the American Economic Review. Nelson recalled how sensitive she was to the gender issue while auditioning. She remembers being told in the 1980s to remove her shoes while walking to center stage behind a screen, so the judges would not hear the "clickety-clack" 2013 of a MFMER woman's slide-21 high heels. 7x. Collective Intelligence. Market share. Devil s Advocate. IHI High-Impact Leadership Framework and Reduce Costs. Cambridge, MA: ; Available on

12 Seybert Harvard Business Review June 29, 2013 Medicus 2012: 78% of hiring executives desired team-oriented physicians; 58% vast majority unfit The Pipeline EOT s MCHS MT (41) President (1) Center/Office/IMP Chairs (28) Non-Shield Leaders (26) Site CEO s (3) BOG (12) SAC s Consultants (Care Team Leaders) Officers & Counselors (18) Mentor-Coaches Dept/Div Executive Committee Leaders (90) Dept/Div Chairs (233) Executive Deans (3) Residencies Medical School Shield /Institutional Committee Leaders (56) Cappelli P. HR for Neophytes. Harvard Business Review; October 2013: Matthew Bidwell. Wharton. Takes 3 years for outside hires to perform as well as inside hires + Direct cost of search + Indirect cost of search: time, morale, turnover + Higher risk of failure 2013 MFMER slide-24

13 Interdependent Dimensions of High-Impact Leadership and Reduce Costs. Cambridge, MA: ; Available on