Management Skills for

Clinicians, Volume I
Management Skills for
Clinicians, Volume I
Transitioning to Administration

Linda R. LaGanga

Editors
David Dilts
Larry Fredendall
Management Skills for Clinicians, Volume I: Transitioning to Administration
Copyright © Business Expert Press, LLC, 2019.

All rights reserved. No part of this publication may be reproduced, stored

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First published in 2019 by

Business Expert Press, LLC
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ISBN-13: 978-1-60649-816-3 (paperback)

ISBN-13: 978-1-60649-817-0 (e-book)

Business Expert Press Health Care Management Collection

Collection ISSN: 2333-8601 (print)

Collection ISSN: 2333-861X (electronic)

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 Abstract
This book introduces new managers working in health care to the basic
skills and competencies to support them in transitioning to their man-
agerial roles. Some topics and examples also can help more experienced
managers reassess and revitalize their skills. Targeted readers have been
promoted recently into managerial, supervisory positions. They have
clinical training and experience, and little or no business management
training and experience. More experienced managers can benefit, too,
from collected insights of other managers who were interviewed and
from examples in recent and revisited literature. The book covers both
“hard” business skills and “soft” people/organizational skills. We draw
from books, articles, examples and managerial experience of the author
and colleagues at different organizational levels and throughout health
care settings and professions.

Keywords
management; supervisory; leadership; meetings; time management;
­employee performance; employee coaching; healthcare administration
 Contents
Preface...................................................................................................ix
Acknowledgments.................................................................................. xxi

Chapter 1 Introduction to Health Care Management.........................1

Chapter 2 So, Now You Are in Charge! Leading Your Team
and Managing When Others Report to You.....................19
Chapter 3 Planning and Organizing.................................................65
Chapter 4 Managing Up, Down, and All Around!..........................107
Appendix A Interview Participants and Selected Highlights...............133
Appendix B Meeting Agenda Form...................................................145
Appendix C Example of an SBAR......................................................147

Notes..................................................................................................151
References............................................................................................163
About the Author.................................................................................167
Index..................................................................................................169
 Preface

Overview of Your Management Journey

Welcome to the world of health care management! Working in health care,
you have chosen a meaningful career that helps people live better, healthier
lives. You have developed extremely valuable clinical knowledge and skills
through your education and training, followed by your experience work-
ing directly with patients and in organizations that provide health care.
By stepping up into managerial and other leadership roles, you are
taking responsibility for greater impact and well-being through the con-
tributions of your team members and other colleagues you lead, both
within your organization and beyond in the communities you influence.
There are many new skills for you to learn that help you leverage your
valuable experience to maximize your effectiveness as a health care man-
ager and administrator. To focus on the management skills you are likely
to need at appropriate points in your professional journey, topics are or-
ganized into two volumes:

• Management Skills for Clinicians, Volume I: Making the Transition

from Patient Care to Health Care Administration
• Management Skills for Clinicians, Volume II: Advancing Your Skills
to Thrive in Administration

More information is provided in the following text to help you navigate

these books to provide timely help in your managerial journey. First, I would
like to offer a view of where and how the material for these books developed.

Background from the Author

As the author of these books and a health care manager myself, I have been
there with you, experiencing joy and enrichment with new opportunities
x Preface

to develop mastery of skills that stretch our capabilities, and struggling

with unexpected challenges revealed by new situations we had not yet
experienced.
Before writing these books, I worked for almost 30 years in progres-
sive levels of management. After completing an advanced degree in a
clinical field, I earned clinical credentials through testing and experi-
ence, made the transition from clinician to manager, and progressed
to executive levels of leadership leading large departments in two large
behavioral health centers. I am a Licensed Professional Counselor, Na-
tional Certified Counselor, and certified Mental Health First Aid In-
structor. Before becoming a therapist, I was in high-technology settings
and the computer software industry, where I worked my way from cus-
tomer service and technical consultant positions to become a supervisor,
then a manager, and continued to progress into senior and executive
management. I have led clinical, technological, quality, customer ser-
vice, and analytical operations. While experiencing the challenges of
operating effective health care delivery with limited resources, I decided
to update my skills to optimize the allocation of clinical resources. I
returned to school and earned my PhD in Operations Research. My
doctoral dissertation and research have concentrated on improving ac-
cess to health care services.
Many of the people I have worked with provided helpful leadership
by example that inspired descriptions in this book. This book reflects
valuable lessons from the Mental Health Center of Denver (MHCD),
where we built the foundation for a thriving culture that promotes the
well-being of its employees and clients. The mission of MHCD is, “En-
riching Lives and Minds by Focusing on Strengths and Well-Being,”
founded on the philosophy that “people can, and do, recover from mental
illness and that treatment works.”1
MHCD is focused on making a difference in the lives of tens of thou-
sands of people every year, on mental health literacy inspiring people to
become messengers to the larger community, and on expanding access
to effective and compassionate treatment. MHCD has been named as
a Top Workplace by the Denver Post for 6 years in a row, was honored
as the Top Company in 2017 in Health Care by ColoradoBiz Magazine,
has earned numerous awards for innovative projects that enhance the
 Preface xi

well-being of the community, and is recognized internationally for meas-

uring and improving treatment outcomes.
MHCD is where I experienced the initial transition in my career from
clinician to manager—first, from providing direct clinical care, then to
managing teams and staff, and later to higher levels of executive manage-
ment responsibility. Lessons from this exemplary workplace, and inter-
views with many of my colleagues there, are included in this book.
I gathered helpful input from many others, including my colleagues
at Mental Health Partners (MHP). As a member of MHP’s executive
management team, I participated in the development of its Mission,
­Visions, and Values: “In alignment with our mission—Healing is our pur-
pose. Help is our promise. Health is our passion.—Mental Health Partners
(MHP) provides immediate access to expert mental health and substance
use care so people can enjoy healthy and fulfilling lives. Our vision is for
Healthy minds. Healthy lives. Healthy communities. We accomplish this
through our core values.

Empathy: Putting ourselves in others’ shoes.

Hope: Believing in positive possibilities for every person.
Healing Environment: Providing a safe space where people feel
accepted.
Wellness: Supporting long-term health and well-being.
Teamwork: Realizing the power of working together with humility
and trust.
Partnership: Building relationships to strengthen our communities.
Excellence: Pursuing the best in everything we do.”

MHP collaborates with many organizations throughout the com-

munity to deliver integrated and coordinated care, with work in shared
locations with primary care physicians. An innovative comprehensive
health home brings together treatment providers in one location for
mental health, physical health, and dental services. “The health team
works together to meet all of a patient’s needs and improve their overall
health.”2
Mental Health Partners was one of four community mental health cen-
ters accepted into the Colorado State Innovation Model (SIM), a federally
xii Preface

funded, governor’s office initiative that helps health care providers deliver
whole-person care. According to Colorado Lieutenant Governor Donna
Lynne, “SIM providers must focus on the entire patient, which means
addressing mind, body and mental wellness. That complete approach to
health is what makes the SIM initiative so valuable. Patients get the care
they need when they need it, and providers learn how to succeed with new
payment models. It’s a great example of meaningful reform in our state.”3
To broaden my perspective outside the settings where I have worked,
I also spoke with nurses, MDs, and many professionals with experi-
ence in other health care systems and hospitals throughout the United
States. Some of them I met through professional associations and ap-
plied research activities on improving health care systems. Together,
many of us have collaborated in bringing effective management and
leadership practices from prior work settings, then adapting them to fit
new settings to enhance our work cultures and help our people develop.
This is reflected in many of the examples you will see in this book.
To help you in your development as a health care manager, chapters
are developed around the skill areas identified by this book’s editors and
author, from our experience in health care, as crucial to the success of
health care managers.
Successful health care leaders need a variety of skills to manage effect-
ively in the complex and challenging arena of health care, where risks and
rewards can have major impacts on the well-being and safety of our pa-
tients and care recipients. Such skills are described and illustrated with the
actual experiences shared by many health care management professionals,
along with recommendations from many management books and articles.
Learning activities and discussion questions are offered in each
chapter to help you assess your proficiency, apply new knowledge, and
increase your mastery of the material. Personal skills and abilities are
included to focus on how you relate to and communicate with other
people, sometimes referred to as “soft” and “people skills” or with the
ability to recognize and manage our emotions, as “emotional intelli-
gence.”4 While some of the chapters focus on more “technical” or “nuts-
and-bolts” skills such as hiring and budgeting, integrated throughout the
book are the softer leadership skills that you need to successfully manage
in these other areas.
 Preface xiii

Contents and Organization of Management Skills

for Clinicians, Volumes I and II
This two-volume set of books consists of:

• Management Skills for Clinicians, Volume I: Making the Transition

from Patient Care to Health Care Administration
• Management Skills for Clinicians, Volume II: Advancing Your Skills
to Thrive in Administration

Volume I guides readers through the essential knowledge and under-

standing they need to develop as soon as they transition to new manag-
erial roles. The emphasis is on shifting focus from caring for individual
patients to taking broader responsibility for leading other professionals
and administering the necessary activities that keep health care organiza-
tions running smoothly. The chapters focus on understanding the special
features of managing in health care settings, taking charge to lead your
team, managing performance of those who report to you, essential skills
for planning and organizing, and building relationships with the people
you manage, your boss, and others around you.
Volume II helps readers advance their skills to thrive in administration.
The focus is on enhancing relationships, your workplace culture, and your
comfort with business practices for effective budgeting, financial manage-
ment, hiring activities, and human resource management while building
your momentum and growth. Advancing your communication skills will
help you grow and improve as you foster the growth of those you manage
and lead. You will learn to embrace conflict and handle it constructively.
Developing your business skills in hiring, human resource manage-
ment, and financial management will help you garner and administer
the resources that support your team’s important work. Recognizing and
developing the strengths of you and your team members enhances per-
formance and motivation to sustain your success as a health care manager.

Objective

We introduce new managers working in health care to the basic skills and
competencies to support them in transitioning to their managerial roles.
xiv Preface

We guide readers in the activities they will handle initially and later as
they arise in organizational cycles, such as budgeting and hiring. We also
offer topics and examples that can help more experienced managers reas-
sess and revitalize their skills.

Target Audience

We target clinical staff who have been promoted recently into manager-
ial, supervisory positions. The targeted reader has clinical training and
experience and little or no business management training and experience.
More experienced managers can benefit, too, from collected insights of
other managers who were interviewed and from examples in recent and
revisited literature.

How to Use These Books

We cover both “hard” business skills and “soft” people/organizational

skills. These books draw from books, articles, examples, and managerial
experience of the author and colleagues at different organizational levels
and throughout health care settings and professions.
As you see examples from health care managers who were interviewed
for these books, consider how you could apply their approaches effectively
to align with your strengths and the characteristics of the organization
where you work. Tables developed in these books provide a foundation
for you to develop tools tailored to what would work effectively in your
environment. Review the frameworks described from other literature and
practice applying them in your managerial and administrative activities.
As you gain experience as a manager, experiment with what’s offered and
build your own tool sets to boost your effectiveness and to contribute to
your organization.
Health care management is complex with a wide range of interrelated
activities that a manager will likely encounter, often in the same day or
workweek. Volume I covers the things most needed from your first day as
a new manager. You also may encounter other topics—such as hiring and
budgeting, which are examined in Volume II—early in your new role.
As your needs unfold in your management role, you may find it helpful
 Preface xv

to shift from reading sequentially the chapters in each volume to delving

more deeply into specific chapters and sections that address the issues you
are encountering.

Chapter Descriptions
Volume I: Making the Transition from Patient Care to Health
Care Administration

Chapter 1. Introduction to Health Care Management

This chapter introduces the unique challenges of new health care managers,
explains their importance, and provides practical guidance to help you
succeed in these new situations. Insights and themes from interviews and
conversations with 64 health care managers and administrators are sum-
marized. We identify some special features of managing in health care and
the particular challenges in refocusing your clinical training to succeed as
a health care manager as we apply some of the lessons gleaned from inter-
views. Initial activities are proposed to help you get started in comprehend-
ing the scope and skills that health care managers need to learn and master.

Topics in this chapter:

• Motivation for developing management skills
• What’s so special about health care management?
• Interviews from a variety of perspectives
• Interview questions
• Themes from interviews
• Who can help? Get a mentor!
• Chapter summary and key points
• Introductory activities to get you started

Chapter 2. So, Now You Are in Charge! Leading Your Team

and Managing When Others Report to You

You are in a new role now with supervisory responsibilities. This requires
you to transition from being a team member to the team’s leader. You need
to establish credibility and earn the respect of others for new capabilities
xvi Preface

you are developing. You will need to treat others fairly and avoid granting
special treatment to those who have been your friends. Mentors and peers
can help you in your development so you do not have to figure things out
all by yourself.
We will show you how to communicate your expectations for behav-
ior and performance to help your people perform well. We also look at
what you need to do when things do not work out and improvement is
needed, or you need to fire people who report to you.

Topics in this chapter:

• What is different about being a manager
• Delegating responsibility to others
• Power and trust in your new managerial role
• Setting expectations and communicating them
• Accountability without fear and blame
• Performance expectations
• Coaching for performance and development
• Performance tracking and planning
• Performance problems
• Chapter summary and key points
• Learning activities for this chapter

This chapter in Volume I focuses on how you get started in your new
role with responsibility for managing others. Soon, you will develop more
skills for creating a positive working culture, building a strengths-based
team, selecting and hiring new people. For further information on these
and other topics related to work culture, employee strengths, and hiring,
please see Chapter 2 in Volume II.

Chapter 3. Planning and Organizing

You will face new challenges and be expected to make decisions in your
role as a health care manager. Learning to lead with structure and apply-
ing some management tools can help you to take charge confidently as
you plan, organize, and get things done.
 Preface xvii

Topics in this chapter:

• Planning and being proactive
• Organizing and leading meetings
• SBAR: a tool for effective meetings and other decision making
• How decisions are made
• Honoring your commitments for getting things done
• Managing your time and yourself
• Managing my time and myself: what I have learned and recommend
• Chapter summary and key points
• Learning activities for this chapter

Chapter 4. Managing Up, Down, and All Around!

Being a manager involves supervising and leading the team of people who
report to you, and communicating clearly what you expect them to do. In
Chapter 2, we looked at how you take charge and get started in that part
of your role, and continued in Chapter 3 with structured techniques to
help you plan and organize. Now, let us consider other important people
in your new world of management.
It is vitally important that you build a positive relationship with your
boss and ensure you are meeting your boss’s needs and expectations of you.
Those you work with as colleagues and peers also are important in your work
world. We explore ways for you to build and sustain important relationships
in multiple directions. You will gain wider perspective and effectiveness as
you practice managing up, down, and all around! These are essential skills as
you make the transition from providing direct patient care to managing the
people and other resources involved in health care administration.

Topics in this chapter:

• Your new world and who is in it
• Managing up: your important relationship with your boss
• The importance of influence
• Building positive relationships
• Up, down, and all around your successful transition to
administration
xviii Preface

• Chapter summary and key points

• Learning activities for this chapter

Volume II: Advancing Your Skills to Thrive in Administration

Chapter 1. Enhancing Your Relationships at Work: Managing

Communication, Feedback, and Conflict

Now it is time to enhance your relationships and work through some

more advanced skills. It is natural that the various people you work with
have different perspectives, so you can expect disagreements to arise. In
this chapter, we extend your skills and effectiveness in communicating,
giving and receiving feedback, and handling conflict. You will gain wider
perspective and more experience as you practice building relationships
and strengthening them all around you at work!

Topics in this chapter:

• Reflecting on related topics in Volume I
• Communication guidelines
• Giving and getting feedback
• Conflict in work relationships
• Chapter summary and key points
• Learning activities for this chapter

Chapter 2. Hiring and Engaging People in a Culture of Well-Being

Health care is all about people, who deliver treatment and keep the
organization running effectively to meet the needs of the people we
serve, our patients. In this chapter we focus on these crucial human
resources, the people who do the work on the team you manage. We
will look at the value of creating a great place to work and the profile
of a health care organization that built a work culture where people
can thrive.
Then, we examine the specific things you need to do to hire people
and get them started in their work on your team. We will look at how you
hire, engage, and retain these people to do their best work. We show you
the value of your Human Resources team and identify the things they can
 Preface xix

help you with, and when you must consult with them to hire new people
and bring them onboard.

Topics in this chapter:

• The importance of people!
• What makes an organization a great place to work?
• Using strengths in your team
• Your roadmap to hiring and human resources
• Hiring: getting started
• Organizing your selection process
• Interviewing and selecting:
What are you looking for and what should you ask?
• Compensation, terms, and job offers
• Welcome aboard and setting the tone
• Chapter summary and key points
• Learning activities for this chapter

Chapter 3. Business Basics: Finance and Budgeting Are Not Just for
Accountants!

Why do you need to know budgeting and finance? This chapter will
answer this question by explaining some basic financial and budgeting
concepts, why they are important for every manager to know, and how
an effective manager uses these ideas. We will look at financial aspects
of your organization that you need to know about to manage effectively.
We start by reviewing why money is important to keep your organi-
zation and team running. We will explain budgeting and examine an
example of a team budget to help you see what you need to track and
manage. We will look at some financial measures for your organization
and help you interpret them to understand the financial health of your
organization.

Topics in this chapter:

• Why money matters
• Profit: what it means and why it’s important, even in nonprofit
organizations
xx Preface

• Budgeting for what you’re managing

• Your budget: what it looks like and what does it tell you?
• Big picture financial health of your organization
• Recommendations for successful financial management
• Applying financial principles in clinical practices
• Chapter summary and key points
• Learning activities for this chapter

Chapter 4. Where Do You Go from Here? Keeping the Motivational

Fire Burning

In this final chapter, we wrap up your journey toward being an effective

health care manager.
We shift from the skills you have been learning in earlier chapters to
do your job now, consider how you sustain your momentum, and look
ahead to your future. We will look at how you balance areas of your life
and renew yourself, sustain your success, address challenges that signal
the need for changes, foster your growth and development, benefit from
others helping you to improve, move from success to significance, and
continue to fuel your passion for the work you do.

Topics in this chapter:

• Highlights of your journey to here
• Leaders who are burning bright
• Balance and renewal
• Sustaining your success at work
• Your growth and improvement
• Outward and onward!
• Chapter summary and key points
• Learning activities for this chapter
 Acknowledgments
I am grateful to my family, friends, and many colleagues for your enthu-
siastic support, encouragement, and helpful suggestions along the way. I
appreciate your patience and understanding as I dedicated my time and
attention to writing this book.
I am grateful to the editors of this Health Care series, David Dilts
and Larry Fredendall, for approaching me with the idea of developing
this book to fill a need you noticed in your work with health care orga-
nizations. Many thanks to you and publisher Scott Isenberg at Business
Expert Press for your guidance, encouragement, feedback, and great sug-
gestions that strengthened the usefulness of this book to the clinicians
and managers we intend to reach. Thank you to Charlene Kronstedt for
guidance on technical publication requirements.
I appreciate many helpful conversations with Ginny Trierweiler, PhD,
a licensed psychologist and professional coach who has helped many or-
ganizations and leaders to build their managerial effectiveness. In helping
me conceptualize important areas to address in this book, she pointed out
how power differences between managers and those they supervise can af-
fect the transition for clinicians who are promoted to manage teams they
worked in with former peers. I appreciate her wisdom about the clarity
needed to transition from the role of individual clinician to manager and
her suggestions for doing that successfully.5
Special thanks to Curtis V. Smith for volunteering to proofread and
offering helpful writing suggestions.
Thank you to the many professionals and organizations who gener-
ously shared their experiences with me in interviews and other conver-
sations that helped to develop this book. They are all people whom I
noticed and admire, or were referred by trusted colleagues, for their ap-
proaches, skills, experience, and contributions to the arena of health care
management. Their insights and comments are included throughout the
book. Everyone is listed in Appendix A of Volume I, along with selected
highlights of interviews and conversations.
 CHAPTER 1

Introduction to Health Care

Management

Chapter Overview
This chapter introduces the unique challenges of new health care man-
agers, explains their importance, and provides practical guidance to help
you succeed in these new situations. Insights and themes from interviews
and conversations with 64 health care managers and administrators are
summarized. We identify some special features of managing in health care
and the particular challenges in refocusing your clinical training to suc-
ceed as a health care manager as we apply some of the lessons gleaned
from interviews. Initial activities are proposed to help you get started in
comprehending the scope and skills that health care managers need to
learn and master.

Topics in this chapter:

• Motivation for developing management skills
• What’s so special about health care management?
• Interviews for a variety of perspectives
• Interview questions
• Themes from interviews
• Who can help? Get a mentor!
• Chapter summary and key points
• Introductory activities to get you started
2 MANAGEMENT SKILLS FOR CLINICIANS, VOLUME I

Motivation for Developing Management Skills

Interviews with many health care leaders provided real-world examples
and recommendations that confirmed the importance of the topics in
this book. These address skills that may be particularly challenging to
new managers in health care because they were not part of their profes-
sional education and may be considered at odds with traditional values
associated with caring for patients. In this chapter, we introduce some of
the themes and lessons gleaned from interviews, identify some particular
challenges in refocusing your clinical training to succeed as a health care
manager, and offer some activities to help you focus as you get started.
For example, holding staff accountable for performance metrics may
feel uncomfortable and in conflict with clinical training that taught us to
be nonjudgmental and emphasized support, comfort, and understanding
toward patients when they were going through difficult times. Getting
teams focused and moving forward on higher-level organizational goals
requires teamwork and collaboration that might have been absent from
highly competitive and demanding clinical programs that required mas-
tery of complex scientific material.
On the other hand, our clinical training and experience provide valu-
able assets for us to build on in our journey toward being successful in
management. What we learned and practiced in goal-setting with patients
can teach us about setting realistic and relevant goals, which is helpful in
managing teams and projects.

What’s So Special about Health Care Management?

Health care is a complex business. It is not just the patients and clients,
being the direct recipients of our care and treatment services, who are
considered our customers. In addition, the organizations we work for
are accountable to the payers of those services, typically insurance plans,
grant funding administrators, and other government entities, who also
require data and reports to monitor organizational performance. Perspec-
tives from a variety of clinicians, managers, and administrators help us
understand and manage successfully in the challenging and rewarding
arena of health care.
 Introduction to Health Care Management 3

Deep Caring about the People and the Work

People who work in health care really care about the people they help and
the work they do. Everyone I interviewed cares deeply about the people
and communities they serve and the teams of people they lead. Paul Bretz,
LCSW, DDiv, Executive Director of Centus Counseling, has a wide col-
lection of educational degrees, has earned professional certifications in
clinical practice, quality, and compliance, and has in-depth experience
in clinical, spiritual, administrative, and leadership roles. He expressed
this commitment vividly when he said, “In a meeting, every person who
talked about a client teared up. It doesn’t get much better than that!”1
When I asked Preston Simmons, MHA, DSc, FACHE, “What is spe-
cial about working in health care?” from his perspective as the administra-
tor of one of the largest health care organizations in the United States, he
explained that people working in health care want to make a difference;
clinicians have a passion for patient care and pay attention to good out-
comes. High integrity is particularly important.2

Rapid Change for Efficiency

Ken Bellian, MD, MBA, has a range of valuable experiences as a physi-

cian, chief medical officer, university instructor on health care innovation,
entrepreneur, and advisor for organizations developing technological
solutions to difficult health care problems. He describes the world of
health care as changing rapidly with continuing need for efficiency to
drive down costs as expectations rise for patients’ needs to be met quickly
with good outcomes. This requires focus, persistence, and insistence,
enveloped in the driving context of meeting patient needs. He believes an
effective health care leader must communicate to the staff the process and
strategy for meeting these needs.
He described change as unsettling to most people; as a leader, your
ability to make your staff feel valued, heard, understood, and respected
is essential to manage the change successfully. Managers can help people
move forward by identifying the early adopters who figure out how to
improve their patient flow to see more patients while completing their
administrative requirements promptly, and supporting others in adopting
4 MANAGEMENT SKILLS FOR CLINICIANS, VOLUME I

effective practices, utilizing helpful technology, to improve their working

lives and the experience of their patients.3

Complicated Drivers of Delivery

Indeed, the complicated operational levers that drive health care deliv-
ery can be very difficult to understand. Vonderembse and Dobrzykowski
(2016) explain managerial challenges that are specific to health care. For
example, supply and demand for health care services can be difficult to
balance because of insurance payment systems that insulate patients from
true costs of care and may lead to overutilization of services. Rapidly shift-
ing reimbursement models can be difficult to comprehend and imple-
ment, especially when technological infrastructure for information sharing
is still evolving. And, the total cost of health care is driven not only by
the number of units of care delivered, but also by the price of each claim
or unit of care, thereby causing increasing pressure to enhance efficiency,
reduce waste, and improve collaboration and resource management.4

Ensuring Standards Are Met

In health care settings, you may find that as you rise to higher levels of
management, you spend more time dealing with people and organizations
outside of your own. Patients, clients, and their family members may seek
a manager, someone in charge—you! —when they are dissatisfied with
the care and treatment they received from a clinician. You are also likely
to deal with external administrative functions involved in the payment
for health care services, assurance of compliance with health and safety
rules and regulations, and patient privacy laws. You will be responsible for
ensuring that the work of your team or department conforms to standards
of clinical care, documentation, and billing, along with internal perform-
ance targets that are needed to keep the organization running well.

Interviews for a Variety of Perspectives

More than 60 accomplished health care professionals across a wide range of
health care professions and settings graciously participated in interviews and
 Introduction to Health Care Management 5

conversations with me to share their insights and recommendations about

becoming an effective health care manager. All of them are listed in Appen-
dix A along with some selected highlights of interview themes. You will meet
some of these people in this chapter, and you will see others later in chapters
where their advice and examples are particularly relevant. They bring valu-
able experience from many roles and levels, including clinicians, early-career
initial supervisors and managers, through directors, vice presidents, exec-
utive directors, chief executive officers, and governing boards of directors.
You will see experiences and insights from physicians, nurses, psychol-
ogists, social workers, psychotherapists, and other providers and adminis-
trators. Their experience comes from a variety of settings from outpatient,
hospital, academic medical centers, and universities, with health care
focus in physical and behavioral health, home health care, physical and
voice therapy, dental practice, pharmacy operations and other specialty
areas. They represent different sectors such as not-for-profit, for-profit,
and governmental.
I selected effective managers and leaders to interview to explore spe-
cific aspects of their experience as new and developing managers. As I have
worked with many of them, I have admired their effectiveness and know
the value they have contributed to their organizations and professions. I
wanted to find out and share with you more about their backgrounds,
perspectives, and the history and application of tools and approaches they
contributed to our work practices and cultures.
Other participants were recommended by people I had selected to
interview, who envisioned particular value that could be added by some
of their trusted colleagues. And I sought out additional participants
through my network of contacts and their contacts to broaden the field
of multiple clinical perspectives and deepen the perspective constructed
from multiple contributors. I chose them specifically to broaden the base
of experience and perspectives from a wider variety of health care profes-
sions and settings.
And in the course of my ongoing activities, I encountered others whom
I already knew or was just meeting; when I told them about this book and
its purpose, they strongly agreed with the need and offered insights and
examples from their experiences that can help address important issues
that new health care managers face.
6 MANAGEMENT SKILLS FOR CLINICIANS, VOLUME I

Many shared experiences and recommendations are collected and sum-

marized throughout this book. To bring to life key points and illustrate
how you can apply them in practical situations, some composite scenarios
are drawn from interviews, conversations, and my prior experience and
observations. Some details are combined and altered to highlight import-
ant principles while preserving confidentiality and privacy of interview
participants and others who were involved in sensitive situations.

Interview Questions
I started with a structured form to elicit specific information from those I
interviewed about their backgrounds and experience as new and evolving
health care managers, along with their recommendations and advice for
others starting out as new health care managers. I asked:

1. When and where (in what organization) did you have your first ex-
perience as a manager?
2. What were you doing before this transition to manager?
3. Why did you want to be a manager?
4. Why do you think you were selected to become a manager?
5. How much were your initial expectations met about your new role?
6. What pleasant surprises and unexpected challenges did you find?
7. What do you think contributes to the success of a new manager?
8. What worked well for you in getting started in your new role?
9. What would you have done differently?
10. What helped you get started in your new position as a manager?
11. Was there particular training, support, mentoring, materials, or
other resources that you found helpful?
12. What else would have been helpful to you in getting started as a new
manager?
13. How did you fill the gaps or get these other things?
14. What advice do you have for other clinicians moving into manager
roles?
15. What other things would you like to share about your experience?

Ad-hoc questions were used as needed to clarify and explore interest-

ing things that came up.
 Introduction to Health Care Management 7

The interviews were designed to start by eliciting some specific infor-

mation about how people got started as new managers, what did and did
not work for them, for the purpose of guiding other new managers. Later
questions broadened to allow participants to expand on relevant parts of
their experience and to contribute interesting insights and recommenda-
tions. Several of the later conversations and interviews were less structured
to allow deeper exploration of some specific perspectives and insights that
were particularly relevant to those participants’ experiences or disciplines.

Themes from Interviews

A number of experiences and suggestions emerged as commonly men-
tioned themes throughout the interviews. This chapter includes a small
sample of the comments from some of the interviewees. For more
examples, please see Appendix A. You’ll meet more of the interviewees
and hear from them as you progress through later chapters.

Expectations

A number of meaningful themes emerged in discussions with these man-

agers and leaders across roles and settings. Many emphasized the import-
ance of understanding performance expectations; managers should know
clearly what is expected of them from the manager and leaders above
themselves and must be clear in communicating expectations to the
people they supervise.

Stepping Up to Earn Credentials and Responsibility

Most of the clinically trained people mentioned the value and importance
of earning credentials, experience, and in many cases licensure that estab-
lished their credibility and responsibility. This willingness and ability to
step forward helped prepare these clinicians for greater responsibility and
facilitated their selection for promotion and expanded roles that became
available within their current workplaces or to transition to higher levels
of responsibility and leadership in new settings.
Several nurses talked about the value and importance of being cre-
dentialed as registered nurses and how it helped establish their leadership
8 MANAGEMENT SKILLS FOR CLINICIANS, VOLUME I

with hospital teams. As charge nurses, they began to assume responsibility

for coordinating activities on their shifts and making sure the patients in
their charge received high-quality care. Part of this responsibility included
advocating for their patients and other staff, which required being in tune
with the needs of others and being willing to negotiate with higher-level
administrators to meet those needs.5,6,7
Managers working in behavioral health care, in outpatient clinics, or
in residential treatment settings, began as therapists, case managers, or
counselors, and earned their licensure as licensed clinical social workers,
licensed professional counselors, or licensed addictions counselors while
working directly with patients (whom they also refer to as clients and
consumers). Yet, not every licensed or certified clinician makes the move
into a manager position, and so what differentiated these people? What
emerged was not only a willingness to accept responsibility when it was
offered but the initiative to seek greater challenges, to risk trying new
things, and to embrace uncertainty and change.8,9,10

Seek and Be Sought for Leadership

The MDs who spoke with me exemplify impressive careers of increas-

ing responsibility and leadership.11,12 As Kenneth T. Bellian, MD, MBA,
observed, medical education is devoid of management training and does
not prepare you for the increasing responsibilities of management. Some
of the common ways to gain more management responsibilities are to
either actively seek out leadership positions or to be identified as a poten-
tial leader. Commonly, providers are recognized as great clinicians, excel-
lent teachers, or successful researchers. They are subsequently promoted
as future leaders into management. Without formal management training
in the medical educational system, it is incumbent upon the individual
and the organization to actively support the provider’s leadership develop-
ment.13 For most of the MDs, in their initial transition to managerial
responsibilities, they stepped up to fill the need for leadership.
Kristi Mock, LCSW, Chief Operating Officer of the Mental Health
Center of Denver, started 34 years ago as a therapist. Her continual
progression to higher levels and broader scopes of responsibility began
with volunteering to cover interim management responsibilities when
 Introduction to Health Care Management 9

there was a gap. “Be that person leadership can count on,” she advises,
and “volunteer to do lots of different things to expand viewpoints and
perspectives, while continuing to be a high performer in your primary
responsibilities.”14

Constructive Engagement

Several said that although they did not see the transition to administra-
tion coming, they embraced it. Donald Penning, MD, of Denver Health,
sought education and training in management, and continues to pro-
actively handle culture change. It means getting truly involved with the
work and people, continuing to build clinical competence, and not focus-
ing on job titles. When Dr. Penning was at Denver Health as director of
anesthesia, he broadened his reach by assuming responsibility for all oper-
ating room functions, while conducting research and applying operations
research methodology to increase efficiency. He later moved to Henry
Ford Health System as vice chair of research, head of neuroanesthesia,
and professor of anesthesiology and neurosurgery.
When Dr. Penning invited me to visit and observe him and his ­Denver
Health team in action, I found it inspiring to see him actively leading his
staff in a daily check-in. His team members were busily engaged in work-
ing collaboratively on their team when they were recognized by their lead-
ers and their peers for the successful events of the previous day, followed
by constructive conversation with the team on what could be improved.
Dr. Penning attributes his success to a collaborative attitude and willing-
ness to “not just have the job but do the job,” which he learned in a man-
agement course he completed.15

Helping People Get the Work Done

A leader who has led in many different settings is licensed clinical psych-
ologist Jesús Sanchez, PhD, who has worked in medical rehabilitation,
community mental health, a state psychiatric hospital, private practice,
student health center, group consulting practice, and as a member of gov-
erning boards of directors. He has mastered a range of skills as a manager
and administrator. Like others I spoke with, his strong performance as
10 MANAGEMENT SKILLS FOR CLINICIANS, VOLUME I

a clinician and his abilities to organize and take responsibility for stra-
tegically important preparation for managed care implementation were
noticed by top management, and soon he was promoted into a program
manager role. “I didn’t know anything about management, but I knew
my job was to help my team do their job. Managers need to facilitate
the team doing its work more efficiently,” he explained, and added that
facilitating is not just telling people to do things; it involves building
relationships with other teams and organizations that foster productive
collaboration that helps people get the work done.16

Applying Varying Experiences and Perspectives

Many people demonstrated talents such as seeing opportunities to make

things work better,17 understanding potential challenges and strategizing
how to navigate successfully in their work settings, along with focusing on
the important details that are needed to implement projects while growing
and empowering their staff members to develop their abilities as clinicians
and leaders. Many interviewees applied transferable skills they developed in
earlier settings, including general business settings18 and military service19
to help their new organizations operate more effectively. “Military service
was one of the most valuable experiences of my life,” said Bill M
­ ilnor, MA,
VP of Business Processes at the Mental Health Center of Denver. There he
learned discipline and to work as a team toward the mission.20

Apply Your Strength and the Strengths of Others

Many people had assessed their strengths and those of their teams. Many
used formal assessment tools, and others learned to recognize what they
and their team members naturally gravitated toward doing. Mary Ellen
Benson, VP of Healthcare Transformation and Development at Aspen
Pointe, started as a physical therapist and advanced to leadership roles and
high levels of executive management through her abilities to work well with
people and get things done effectively. She shared good advice she received
from a CEO she reported to, “Be who you are and lead from within.”21

Relationships Foster Learning and Growth

These leaders all demonstrate deep self-awareness with openness to learn

and explore new approaches and share them with others. Clinical and
 Introduction to Health Care Management 11

medical training taught them to focus on patients and listen to others.

They recognize the importance of building relationships within and out-
side their organizations to foster their growth and help get things done.
Most of our interviewees started in their new manager roles with no
prior training in how to be a manager, and many have been fortunate in
gaining such development opportunities from training offered later by
their organizations or through actively reading articles and books, enroll-
ing in courses, and through continued self-directed learning.22 We heard
from many of the leaders that they knew they did not know everything
and found it helpful to admit what they did not know, and so they asked
questions and consulted with others with more experience.

Mentoring

Almost everyone mentioned mentoring and its value in helping people

grow. Many mentioned their appreciation for mentors whom they
encountered and developed helpful relationships with along the way.
Some joined external mentoring groups with peers in other organizations,
or even other industries, to give them nonbiased feedback and guidance.23
Others sought mentors in their own organizations to offer advice and
guidance that fostered their development. Several actively and intention-
ally mentored others.
For example, Darcy Jaffe, MN, FACHE, Chief Nursing Officer at
Harborview Medical Center, invites new hires out for coffee to connect
with them and offers to have them shadow her to see what an administra-
tor does. This gives these new nurses access to an experienced senior leader
and helps shape their vision for possible paths for their own growth.24

Learning to Run the Business of Health Care

Be honest about what you do and do not know, and be open to learning
from other sources and people to get better at what you do. Do not be
afraid to ask questions and admit what you do not know. Build relation-
ships with people in other departments to support you in handling new
business areas where you do not have training or experience.
For most of us, our clinical education did not include topics on run-
ning the business side of a clinical practice with the need to understand
12 MANAGEMENT SKILLS FOR CLINICIANS, VOLUME I

different insurance reimbursement rates, office overhead expenses, and

comply with billing and regulatory requirements. Some figure it out later
when they are running their own practices such as dentistry,25 speech
therapy,26 or psychotherapy.27 When some went on to work in larger
community health systems, they were faced with increasing complexity
of multiple public funding streams28 and new organizational dynamics
to understand.29 These leaders continue to learn, grow, and contribute,
working closely with the teams they manage to continually earn the cred-
ibility and respect of followers, peers, and the administrators to whom
they report.

Accountability for Productivity

As Dixie Casford, LPC, MBA, Vice President of Acute Care at ­Mental

Health Partners explains, there can be challenges to hold people account-
able for doing such required parts of the job while running the business of
providing help. She recommends separating therapy from supervision—
or, as others have expressed, supervision is not therapy and you are not
your employee’s therapist! As a supervisor, acknowledge the difficulty of
meeting performance expectations (e.g., meeting a specified number or
percentage of work hours providing direct service to clients) and ask,
“How can we put the right things in place?” to encourage engagement in
accomplishing what is needed to provide help to clients in a productive
way.30

Collaboration Enhanced with Nonclinical Disciplines

As their career successes illustrate, becoming a manager in health care is

not a one-time event but a continual unfolding of growth, responsiveness,
and anticipation of change driven by health care needs and requirements
in a rapidly changing, tightly regulated environment with uncertain
financial resources and extremely thin profit margins. The management
perspectives in this book are enriched by several nonclinical people who
shared their observations and experience working closely with clinically
trained people.31,32,33,34 Such people contribute valuable partnership to
the success of health care organizations, especially in hospital systems
 Introduction to Health Care Management 13

where it is common for top leadership responsibility to be shared in dyads

or triads such as a physician in the chief executive officer role working
closely with a nurse leader, such as a chief nursing officer with advanced
nursing credentials, along with an administrative leader with advanced
experience and education such as a master’s degree in health administra-
tion or master’s in business administration.

Shifting Your Perspective to Systems and Teams

In health care, there is particular emphasis on patient safety, access to

appropriate treatment, and continuity of care. This may require you as the
manager to get involved in designing schedules and protocols that deliver
needed, high-quality care to patients while providing the systems, tools,
and supports needed by your team members who report to you.
As Kenneth T. Bellian, MD, MBA, explained, as a provider you are
focused on the needs and expectations of each individual patient. Now,
in a leadership position, it requires you to think at a system level and to
bridge across many silos or departments to achieve success. This can be
especially hard for some people in medicine and health care, particularly
if their training was delivered in hierarchical or authoritative cultures.35
Preston Simmons agrees that people need to think differently. Key
skills include the ability to bring people together to make success happen.
It is a matrixed environment where people need to work with and through
others. New models emphasize team leadership, and people need to think
differently. Health care delivery operates in teams, which is not taught
to physicians in medical school. Older physicians were taught more of a
command-and-control approach. The work is extremely challenging due
to very complex regulations and razor-thin profit margins.36

Who Can Help? Get a Mentor!

There is so much complexity and subtle nuances that you now must mas-
ter although they were not included in your clinical training. So, it is
not surprising that the vast majority of interviewees mentioned the need
for others with wisdom to help guide them. When asked what advice
they would give other new managers, many replied without hesitation,
14 MANAGEMENT SKILLS FOR CLINICIANS, VOLUME I

“Get  a  mentor!” Mentors are typically wise people with more experi-
ence than you who are willing to help guide you in your development.
Sohnen-Moe (2016) explains that they often serve as trusted confidantes
to help you assess yourself honestly and figure out what you need to work
on to achieve your goals.37

Look for Others

Ideally, the person you report to (your boss) provides some of this mentor-
ing support and guidance to help you grow and develop in your role and
career. However, there are benefits of finding other mentors and people
who can help. One is for candid conversations in which you might want
to be more open to admit your shortcomings and weaknesses to someone
other than your boss, who is in a position to evaluate you to strongly influ-
ence your advancement and rewards. And, as Jeff Zayach, MS, pointed
out, it is helpful when you are new to have other people available to help
you so you do not have to take every question to your boss.38

Peer-Level Help on Typical Activities

Your peers in the organization are a valuable resource to help you learn
how things are done in your new role. This can cover your questions
about routine forms and typical activities. For example, you might need
to ask someone how to handle specific activities such as, “How do I
approve time sheets for the people who report to me?” “How do I enroll
in seminars offered by other departments?” as well as questions about
organizational norms and how things get done, such as, “If you have a
technical emergency and can’t reach anyone on the help desk, who do you
work with to get it fixed fast?” or, “Is it okay to approach the controller
to ask for approval of an unexpected large expenditure if I can’t find the
chief financial officer? In your experience, does our director want to be
involved in things like that?”
Craig Iverson, MA, offered a practical suggestion for working with
mentors or other guides, which might include a peer-level “buddy,”
another manager with whom you can talk things over and get feedback.
He recommends as a first step for new managers to sit down with someone
 Introduction to Health Care Management 15

more experienced and to develop a list of typical things to anticipate hap-

pening so you can be prepared when they do. Having someone to help
you work through unfamiliar situations can help you develop your man-
agerial skills as you learn about your options and available solutions to
challenges. From his experience as a clinical program manager he offered
an example of having several team members asking for the same holidays
off when coverage was needed for the clinic. His suggestion was to be
prepared with a way of responding, such as prioritizing requests for time
off according to seniority.39

Help with Your Professional Development

Mentors can enhance your overall professional development by help-

ing you explore options and develop your overall capabilities. You may
find mentors in your own organization, or outside in other organiza-
tions. Peer-level “buddies” can help you answer specific questions in
your work environment, help you anticipate and prepare for expected
issues, and guide you to respond confidently and effectively to unfamil-
iar situations.
In your new role, unfamiliar issues will come up for you about your
new level of power and influence that will affect your working relation-
ships with your team members and others in your organization. Remem-
ber, your clinical skills helped you recognize and respond to others’ needs.
These are still important approaches for you to use and build on, and you
will need to expand your perspective and learn to adapt in new ways. Take
heart, mentors can help so you don’t need to do this alone!

Chapter Summary and Key Points

In this chapter, we considered some of the special aspects of working in
health care that require you to develop new management skills that prob-
ably were not part of your clinical training. You have seen a summary
of important themes that emerged from interviews with many different
people working in a variety of health care roles and organizations, with
their suggestions and recommendations, which we will explore further in
later chapters.
16 MANAGEMENT SKILLS FOR CLINICIANS, VOLUME I

Key Points:
1. Managing in health care is complicated by funding and accountabil-
ity from multiple sources aside from patients themselves.
2. Health care managers are under increasing pressure to increase ef-
ficiency, reduce waste, and improve collaboration and resource
management.
3. Shift your perspective from individual patients to developing effec-
tive systems of care.
4. Step up and seek new challenges.
5. Get needed training and experience to earn credentials.
6. Be the person others can count on to get things done.
7. Get a mentor to help guide you.
8. Help your people do their jobs better.
9. Apply your skills and prior experience to help things work better.
10. Build relationships, internally and externally.
11. Know what is expected of you, and let others know what is expected
of them.
12. Collaboration between clinical and nonclinical staff is enhanced with
learning among people who have different training and disciplines.

With this introduction, we welcome you to this exciting and fulfilling

journey as you too become the most effective health care manager you can be!

Introductory Activities to Get You Started

You may use these as group discussion questions or write down your indi-
vidual responses. These questions can help you identify where you may
need to concentrate on skills and chapters in this book. We recommend
you develop a file or notebook to keep track of your progress. Do not
worry if you do not have all the answers now. You may use this as a base-
line assessment of your preparation for management and revisit questions
to help you measure your progress as you continue in your management
role and your progress through the book.

1. Review the Contents and Organization of the book, above.

a. Which chapter with its topics feels most familiar to you and
why? What are your top three existing areas of knowledge or
 Introduction to Health Care Management 17

competency in this area? How do you know how strong you are
in these areas—what feedback have you received or other evi-
dence do you have? What other sources of feedback will you get
as you advance as a manager in your current organization?
b. Which chapter do you have the least knowledge and experience
in? How does this topic relate to your current managerial job and
how do you anticipate that might change?
2. Consider examples of experience or recommendations from the in-
terviews described in this chapter.
a. What ideas would you consider adopting for your own manage-
ment development?
b. What resources could you use for more information (e.g., tar-
geted chapters of this book, people in your workplace or other
mentors, books, articles)?
3. What skills or experiences that you developed before your health
care management role will be valuable to you now? What oppor-
tunities do you see to apply them that will benefit your team and
organization?
4. From your experience working in other kinds of organizations and
your perspective as a customer of different kinds of businesses, what
have you found that is different in your health care organization and
the way it runs?
a. Consider things such as the reason the organization exists, how it
earns money to pay for its expenses, the skills and training of peo-
ple who work there, special risks and benefits of working there.
b. What do these different characteristics suggest that you need to learn
in order to succeed as a manager in your health care organization?
5. What relationships would you like to develop to support your team
and you in your role? How will you cultivate your contact and col-
laboration with these people and their teams or organizations?
6. Many of our interviewees mentioned the importance of having a
supportive and experienced mentor to give you advice and guidance
in your early journey into management.

a. What mentors or advisors have you had before? Consider work,

school, family, and other activities. How did their guidance help
you develop?
18 MANAGEMENT SKILLS FOR CLINICIANS, VOLUME I

b. What people do you know who might be helpful mentors for

you? Think about people with valuable experience who seem will-
ing to help you. What advice would you like from them and how
will you approach them?
c. What new traits or knowledge in a mentor would be most helpful
for you as you transition or develop now into a management role?
d. Identify at least two candidates you are already acquainted with
who could be a helpful mentor for you as a new or evolving man-
ager. How will you approach them and establish a relationship
and dialogue that is mutually beneficial?
e. Where could you find mentors or peers outside your organiz-
ation? Do you belong to or have access to existing groups that
could be helpful, such as a professional society for your clinical
discipline, former classmates, other groups; or how could you
start your own group? What are the benefits of external resources,
possibly from other industries (not health care)?
 Index
Accomplishments, tracking of, 53
Accountability
interviews and, 12
managers and, 36–42
fair and just culture, 37
psychological safety in work
environment, 38
quality improvement, reporting
and tracking for, 38–39
Administrators. See Managers
Administrative meetings, 72
Behaviors
coaching and, 48
expectation for, 19, 39
for managers, critical, 22
Business relationships, 122–125
Coaching, 48–53
description of, 48
for employee development, 51–53
ideal approaches, 49
importance of, 48–49
with motivational factors, 50
role in, 50
timing of, 50–51
Constructive engagement, interviews
and, 9
Credibility and responsibility,
interviews and, 7–8
Decision making, 81–89
command, 85–86
consensus, 88–89
consulting and, 86–87
dialogue and, 81–82
effectiveness of, 82
expectations and, 82–85
importance of other people
decisions, 89
time and, 85
voting and, 88
Delegating responsibility, manager
and, 22–25
Disciplines
nonclinical, 12–13
progressive, 57–58
time management and, 100
Expectations
decision making and, 82–85
importance of, 90
interviews and, 7
negotiations and, 90–91
performance, 39, 42–47. See also
Performance expectations
Expectations management model,
40–42
Health care management. See also
Management skills
caring of people and work, 3
delivery, complicated drivers of, 4
description of, 2
efficiency, change for, 3–4
manager and. See Manager
standards and, 4
Honesty, 89–90
Influence, importance of, 118–121
command-and-control
approaches, 120
communication and, 120–121
enlisting support, 121
leadership and, 118–120
matrixed environment, 120
Interviews
questions, 6–7
themes for, 7–13
accountability, 12
constructive engagement, 9
credibility and responsibility,
7–8
expectations, 7
170 INDEX
Interviews (Continued )
experiences and perspectives,
applications of, 10
helping others, 9–10
leadership, 8–9
mentoring, 11
nonclinical disciplines, 12–13
other resources, learning from,
10–12
relationships, 10–11
systems and teams, 13
for variety of perspectives, 4–6
Leadership, interviews and, 8–9
Management skills, motivation for, 2
Managers, 1–6, 8–15, 20–32, 48, 93,
137–138
accountability and, 36–42
fair and just culture, 37
psychological safety in work
environment, 38
quality improvement, reporting
and tracking for, 38–39
boss, relationships with, 109–118
activities, organization of,
115–116
chain of command, 111
checklist for alignment,
114–115
goals and needs, 113–114
loyalty problems, 111–113
negotiation, 117–118
reporting, 109–110
support and value, 110
coaching and. See Coaching
decision making and. See Decision
making
delegating responsibility, 22–25
guidelines, 23–24
helping others, 24–25
time management, 25
expectations, 32–36
behavior, steps in managing, 39
communications, 34–36
decision-making latitude, 35
description of, 32–33
management model, 40–42
performance, 39, 42–47
understanding, 34
importance of, 20–22
meetings and. See Meetings
planning and
description, 65–66
guidelines, 66–68
proactiveness and, 68–69
power and trust, 25–32
acknowledging others, 30
commitment, 28
effectiveness of power, 26
escalating disrespect and, 30–32
foundation, building of, 25–26
gaining trust, 32
professional relationship, 28–29
resistance management, 29
values and, 26–28
relationships
with boss, 109–118
value of, 108–109
responsibilities of, 21–22
time management and, 92–101
consolidated tracking, 99–100
description of, 92
discipline and consistency, 100
goals, importance of, 93–94
SMART approach, 93–94
techniques, 94–101
Meetings, 69–79
administrative, 72
agenda, example of, 78–79, 145
purpose of, 72
SBAR tool for, 79–81
strategic, 72
structure of, 73–77
agenda items and updates, 77
brief check-in or question, 75–76
follow-up, 76
introduction and focal point,
74–75
roles and responsibilities, 73–74
wrap-up, 77
types of, 71
Mentor, 13–15
looking for others, 14
peer-level help, 14–15
professional development and, 15
Nonclinical disciplines, 12–13
 INDEX
171
Performance expectations, 39, 42–47
feedback and, 46–47
performance scale and, 44–45
standards and, 44–46
word pictures and, 43–44
Performance problems, 54–59
challenges, 59
conversation and, 55
follow-up in writing, 55–56
planning for improvements and
measurements, 57
progress evaluation, 57
progressive discipline, 57–58
suspension and termination, 58
Performance tracking and planning,
53–54
Planning
description, 65–66
guidelines, 66–68
proactiveness and, 68–69
Positive discipline program, 58
Positive relationships, building of,
122–127
Power and trust, managerial role and,
25–32
Progressive discipline, 57–58
Psychological safety in work
environment, 38
Quality improvement, manager and,
38–39
Relationships
benefits of, 125–127
business, 122–125
give-and-take support for, 91
interviews and, 10–11
positive, building of, 122–127
SBAR tool, 79–81, 147–149
SMART approach, 93–94
Strategic meetings, 72
Time management, 92–101
consolidated tracking, 99–100
description of, 92
discipline and consistency, 100
goals, importance of, 93–94
SMART approach, 93–94
techniques, 94–101
 OTHER TITLES IN OUR HEALTHCARE
MANAGEMENT COLLECTION
David Dilts, Oregon Health & Science University (OHSU)
and Lawrence Fredendall, Clemson University, Editors
• Quality Management in a Lean Health Care Environment by Daniel Collins
and Melissa Mannon
• Improving Healthcare Management at the Top: How Balanced Boardrooms Can Lead to
Organizational Success by Milan Frankl and Sharon Roberts
• The Patient Paradigm Shifts: Profiling the New Healthcare Consumer by Judy L. Chan
• Leading Adaptive Teams in Healthcare Organizations
by Kurt C. O’Brien and Christopher E. Johnson

Announcing the Business Expert Press Digital Library

Concise e-books business students need for classroom and research

This book can also be purchased in an e-book collection by your library as

• a one-time purchase,
• that is owned forever,
• allows for simultaneous readers,
• has no restrictions on printing, and
• can be downloaded as PDFs from within the library community.

Our digital library collections are a great solution to beat the rising cost of textbooks. E-books
can be loaded into their course management systems or onto students’ e-book readers.

The Business Expert Press digital libraries are very affordable, with no obligation to buy in
future years. For more information, please visit www.businessexpertpress.com/librarians.
To set up a trial in the United States, please email sales@businessexpertpress.com.