Chris Payne

LDRS 811

Activities Assessment

As the hospital grows, the reality is that the community that surrounds it is much slower to

grow, if at all, putting a hard limit on both leaders and providers. This makes the task of

intentionally developing leaders from within a vitally important focus for Kearney County

Hospital. To recap, here is a list of the learning objectives:

1. Establish a multi-method leadership pipeline.

2. Establish an in-house leadership development team.

3. Establish a leadership development position.

These three objectives encompass multiple methods of leader and leadership culture

development. Formal programs (clinical ladder, classes), feedback processes (360 survey,

employee surveys), developmental assignments (interdepartmental co-management) and

developmental relationships (mentors and coaches) are the primary methods recommended to

create and maintain a healthy leader and leadership culture.

Intervention Strategy #1: Establish a multi-method leadership pipeline

Creating understanding and processes around both vision for employees and the

hospital itself will start to shift the culture from simply working at the local hospital to

embodying the vision of Kearney County Hospital from the CEO to the most recent hire in the

dietary department.
 KCH should begin the process by creating an executive team which will compile job

descriptions, compare against existing leaders and directors and future plans for growth for the

hospital and start to develop standards for each layer of leadership and report their findings to

the board. These should include education requirements, methods and standards for national

accreditation and necessary compliance, and leadership attributes. Ideally, candidates should

already possess the requirements for the next level if they are being considered for promotion,

but a team should be in place to consider exceptions if a vacancy creates unsafe or negligent

conditions. The first step of legitimizing the pipeline will be to make sure that leaders who

currently occupy leadership position meet the criteria being proposed. Once that is

accomplished, then rolling it out to the rest of the organization can be done with greater

integrity.

In establishing a multi-method leadership pipeline, building mentoring into a layer in the

pipeline will offer two benefits. First, if mentoring is a requirement for a certain leadership

position, it requires that the leader to be relational. Can the leader adequately assess,

challenge and support another employee? If not, then they will need specialized training and

feedback so they can become proficient at it. If that leader is unable or unwilling to adapt, then

that inability or unwillingness will hold them back. Second, if that leader cannot mentor or

coach well, then the organization doesn’t have to worry about duplicating the culture of that

leader because they will not advance further into the organization. It is essential that a learning

environment be created and there be room for both success and failure. If a mentor creates a

culture where the mentee feels the freedom to fail, that person will likely be willing to dream
beyond their current capacity. Van Velsor, McCauley and Ruderman (2010) suggest that the

mentor have the ability to take a non-judgmental posture when it comes to providing feedback.

Formal programs should already exist for nurses and other skilled positions. Integrating

these programs in to the leadership pipeline will make integrating the pipeline into the

organization seem like less of a huge jump. Nurses have clinical ladder assignments that focus

on certain areas of healthcare and help increase the base pay that nurses earn. If a nurse is

applying for a leadership position, tying those clinical ladder assignments to not just pay but

leadership should increase the importance of those programs.

Creating a culture of feedback and training leaders on both how to give and receive it

will be a crucial step in creating the pipeline. Not only will this help direct leaders on how to

grow but will help them help other leaders learn to grow as well, creating a culture that

reproduces itself. Healthy feedback processes can have an exponential effect within an

organization if implemented well. Obviously, this will be a resource intensive process, but any

cultural change and paradigm shift is worth being intentional and investing heavily in. Van

Velsor, McCauley, and Ruderman (2010) recommend that more than one method be employed

in creating and processing feedback.

“Multiple methodologies and activities provide experiences that accommodate a variety of

learning styles. These might include assessments, videotaping exercises, outdoor problem-

solving experiences, coaching, peer feedback, senior executive interviews, journaling, small

group dialogue, large group discussion, and goal setting with online follow-through. These

combined methodologies provide multiple opportunities for participants to gain insight into

and make changes in their mental models, individual behaviors, and impacts on others”
Intervention Strategy #2: Establish an in-house leadership development team.

Creating a leadership team within Kearney County Hospital will be crucial to developing

an intentional leadership culture. By not having a leadership development team, the culture of

leadership is left to chance in hopes that good things are caught and bad habits are discarded.

An intentional leadership development team can identify and multiply good habits while at the

same time identifying unhealthy habits through feedback and mentoring and correct them in a

healthy way.

The first step should be to identify how many hours should be devoted to leadership

development early in the process and then apply those hours to both the administrative staff

and leadership job descriptions. This may require either an activity-based job description for

many employees or at least a time study to see what can actually be expected of them.

Intentionally applying personnel hours to leadership development shows a serious

organization-wide commitment to creating an intentional leadership culture.

A large portion of these hours, at least initially, will go towards training in feedback

programs. Kansas Center for Leadership should be consulted as Kearney County Hospital

already has a working relationship with KCL. Time should be allocated for developing a 360

feedback process that is relevant to current leaders while at the same time works towards

growing leaders in multiple capacities to meet the standards of the leadership pipeline.

This will require multiple employee surveys, the first of which should include things like

what have and have not worked them. Once compiled, this will help assess the success of

existing and historical processes. This will also provide clues about what language to use so

that future surveys and processes won’t mimic failed or abandoned prior attempts.
 The leadership team can then start to develop an ongoing feedback process that

evaluates training sessions, place emphasis on future sessions and develop specialized training

for specific areas of leadership.

Intervention Strategy #3: Establish a Leadership Development position

This strategy should be implemented alongside strategy #2. The leadership

development position should formalize existing leadership programs and system and

coordinate with the leadership development team to apply the leadership pipeline, mentorship

program and current formal programs to a cohesive process. A large portion of this job will be

initially devoted to developing and applying a feedback process.

This should begin with the employee surveys, and then compiling the data and applying

it and adapting it to already existing processes in collaboration with the Kansas Center for

Leadership. Once the 360 process is decided with the leadership development team, then the

person in this position will begin to work with each department head on how to roll it out

within their respective departments. This will also help develop the feedback process for the

individual leaders as the partnership between this new position and department head will

reveal observed strengths and weaknesses in the leader.

This leadership development-focused employee will create systems that will create

accountability for achieving goals and will drive conversations with leaders. This position will

also document evidence of progress and provide support for challenges.

Return on Investment

Simply making changes for the sake of making changes is often the perspective of those

whose work flow and time management are deeply affected by those upon whom change is

inflicted. Many valuable resources will be required to make the changes submitted in this

report, including money and employee hours. Words like “culture” and “environment” are

difficult to put numbers to and are often rejected by those who are responsible for the budget.

Improvements in leadership development are obviously beneficial to organizations that desire

or need to grow, however, these values can seem subjective and difficult to measure.

One measure that could be used to quantify the monetary value of leadership

development would be employee retention. A leadership pipeline gives visionary leaders,

learners and future-thinkers a place to go. Many leaders are gifted at launching, whiles still

others are gifted in managing and growing. Providing a place for leaders who gifted at all of

those things creates a future in which employees can see themselves growing and learning. A

recent conversation with the CNO (chief nursing officer) at Kearney County Hospital revealed

that the average cost to replace a skilled worker equates to about $50,000 to $60,000 of

combined employee hours, training and money spent. What if KCH, with a developed pipeline

and established leadership development team and personnel, could reduce their turnover rate?

That would certainly be a measurable, tangible statistic to prove the value of the culture

change.
Jack Phillips and Patti Phillips (2006) suggest five levels (p. 143) at which return on investment

can be measured.

Table 1

Levels of evaluating return on investment

Evaluation Measurement focus

1. Reaction and Planned Action  Measures participant satisfaction with leadership
development and measured planned actions

2. Learning  Measures Changes in knowledge

3. Application and  Measures changes in on-the-job training

Implementation

4. Business Impact  evaluates changes in business impact measures

5. Return on Investment  compares program monetary benefits to program

costs.

Obviously, some of these results will come back in the form of 360-degree feedback, employee

surveys and leadership data collection, which is built into the activities required for learning

objectives.

References

Phillips, J.J. & Phillips, P. (2006). The Handbook of Leadership Development Evaluation.
Retrieved from https://ebookcentral-proquest-com.ezproxy.fhsu.edu

Van Velsor, E.C., McCauley, C.D., & Ruderman, M.N. (2010). The Center for Creative Leadership
handbook of leadership development. San Francisco, CA: Jossey-Bass.