Abstract
Healthcare organizations are reliant on cadres of managers to oversee operations, ensuring the delivery of excellent patient care and accomplishment of institutional missions. These managers obviously must be well versed in the principles of management, but they also must be proficient in leadership. As leadership can take many different forms, healthcare organizations must take care in their associated leadership development efforts to ensure that they have a firm grasp on the precise leadership qualities needed within their given organizations. Achieving this knowledge can be greatly facilitated by developing leadership expectations statements. This article profiles leadership expectations statements, presents a recent statement developed by Willis Knighton Health, and outlines the steps required for assembling and using them in any healthcare institution.
Keywords
Background
Healthcare organizations face daunting challenges to coordinate vast arrays of people, places, and things in a manner which ultimately results in exceptional patient experiences.1–4 Among a seemingly endless list of priorities, health and medical establishments must ensure that a capable managerial staff is ready, willing, and able to deliver their very best to ensure that designated missions are accomplished. These managers obviously must be highly proficient in the art and science of management, but they also must be highly proficient in the discipline of leadership. Indeed, for the best outcomes, healthcare managers must also be leaders.1,4–7
Although the terms management and leadership are often used interchangeably, the two actually are very different concepts. Management is defined as “a range of activities (i.e., planning, organizing, staffing, directing, coordinating, reporting, and budgeting) which are carried out by formally appointed individuals (e.g., chief executive officers, vice presidents, directors, managers, supervisors) for purposes of aiding organizations in realizing their missions.” 1 (p6) Leadership is defined as “a skill, composed of a series of appealing qualities, which permits a person to establish productive relationships with others, affording opportunities to influence them in a manner to achieve goals and objectives.” 1 (p32) The former relies on position power; the latter relies on personal power. Both are essential.8–10 When leadership skills fuse with management skills, managerial performance is amplified, compelling healthcare establishments to shore up this combination of talents in their managerial workforces.
The notion that healthcare organizations are interested in ensuring that their managers possess leadership skills is in no way surprising, as it is well known that leadership acumen advances managerial productivity.1,6–10 What is surprising, however, is that healthcare organizations sometimes do not explicitly identify the specific leadership qualities that they need and require of managers. And even when they do, they often do not actively circulate this information among the managerial ranks. Frequently cited leadership qualities include vision, competence, charisma, courage, empathy, honesty, and ambition, just to name a few.5,11–13 Since the qualities that define leadership are numerous and highly varied, efforts must be taken to investigate and identify those which are of particular importance to given healthcare organizations, thus necessitating associated managerial proficiencies. One healthcare institution might, for example, discover that it is best served by managers who possess the leadership qualities of empathy and compassion, while another might favor its managers to be charismatic and assertive. Knowledge of essential qualities, however, should not be held in close quarters. Instead, the designated qualities should be actively communicated to managers across given healthcare organizations, affording opportunities for focused leadership development efforts and related pursuits. A simple tool, known as the leadership expectations statement, can facilitate this vital identification and communication process.
Definition
Formally defined, a leadership expectations statement is a brief passage which references the leadership qualities (i.e., competencies, attributes, skills) that an establishment needs and requires of its managers, succinctly profiling associated expectations. Its assembly requires healthcare organizations to reflect on those leadership qualities which are viewed to be vital for managerial performance within their given establishments, selecting a practical array designated as most critical, with each being clearly defined to ensure proper understanding. The leadership qualities then are fashioned into a statement conveying their importance, thus serving as a helpful leadership reference that can facilitate everything from the recruitment of managers who possess requisite leadership skills to the development of managers as leaders across their careers within given healthcare organizations. The concept of the leadership expectations statement, in fact, emerged from the author’s quest to identify a practical tool that could be used to enhance leadership development efforts within organizations. By preparing leadership expectations statements, healthcare establishments ensure that they do not neglect to explicitly identify critical leadership qualities. Circulation of such actively conveys associated knowledge among managerial ranks, permitting its influence and use in daily practice.
A leadership expectations statement is structured in a fashion similar to that of a mission statement, but instead of concentrating on global organizational pursuits, it focuses on the essential leadership qualities which a given institution expects its managers to possess and use in their work lives. As with a mission statement, the brevity of a leadership expectations statement enhances memorability and utility, helping to ensure that the content remains at the forefront of thought and action. Leadership expectations statements, too, are similar to values statements, but are more narrowly defined, centering specifically on leadership qualities, rather than on broad institutional standards and principles.
While only a small handful of leadership qualities are featured in leadership expectations statements, such statements do not imply that the noted qualities are the only ones of importance. Many leadership qualities are called upon on a daily basis in healthcare organizations. Often, these leadership qualities are not formally identified, residing merely in the minds of top executives who transfer them to others informally in daily practice. Sometimes, though, they are formalized by establishments in what are known as leadership competency frameworks.14–16 These essentially are comprehensive arrays listing the leadership qualities viewed to be relevant to given organizations. While valuable as an institutional record and reference, such frameworks are somewhat unwieldy when used in practice as the arrays typically are quite lengthy, hampering easy recollection and application. The leadership expectations statement overcomes this limitation by featuring only those qualities which are deemed to be most important to organizational operations, hastening both practicality and memorability, fostering use in daily organizational life. Performance benefits also are afforded, as the selection of a prioritized, succinct list of qualities is in keeping with research which indicates that focused attention on several leadership competencies delivers greater results than widespread attention across many facets. 17
Willis Knighton Health’s leadership expectations statement
To further bolster an understanding of leadership expectations statements, it is helpful to view an example. Figure 1 presents a recent assembly which was completed for Shreveport, Louisiana-based Willis Knighton Health. Willis Knighton Health's Leadership Expectations Statement.
As this illustration conveys, Willis Knighton Health selected 10 leadership qualities to feature in its leadership expectations statement, occupying the top portion of the depiction. The statement’s language makes it very clear that Willis Knighton Health expects its managers to possess the associated competencies, as they have been deemed to be essential to operations. The bottom portion of the illustration presents the definitions of each leadership quality, ensuring that anyone exposed to the statement understands the meaning of the qualities featured. This is important as leadership qualities can be defined in many different ways. The presented definitions express the meaning as Willis Knighton Health defines the given terms, ensuring clarity.
Benefits
Even a cursory review of Willis Knighton Health’s leadership expectations statement reveals many benefits, influencing and advancing institutional and individual productivity on several fronts. These benefits are detailed as follows.
Clarification of leadership priorities
Leadership expectations statements force healthcare organizations to identify specific leadership qualities which are viewed to be mandatory for managerial success and vital to institutional performance. These statements are not generic communications; they are customized declarations. Preparation necessitates that healthcare establishments reflect deeply on their particular leadership needs, identify fitting leadership qualities of particular benefit to their given organizations, select a subset deemed to be most critical, and devise associated leadership expectations statements, accordingly. By clarifying leadership priorities via statement preparation, healthcare establishments gain valuable knowledge, positioning themselves to pursue leadership development opportunities, including leadership recruitment initiatives, which are focused precisely and correctly on identified needs.
Focused leadership recruitment
Now more than ever, competition between and among healthcare organizations for top managerial talent is at a fever pitch, with such scenarios warranting careful and concerted recruitment efforts. These recruitment efforts must be focused, driven by a comprehensive understanding of the leadership qualities that given healthcare institutions want to see in their managerial personnel. Such knowledge, in fact, is a crucial ingredient for a productive search.18–22 Leadership expectations statements can aid in this process, courtesy of their identification of essential, institution-specific leadership qualities, thus bolstering the abilities of healthcare organizations to recruit and select fitting managerial candidates.
Enhanced leadership development
Healthcare establishments rely heavily on leadership development initiatives, such as training workshops, guest speaker events, mentoring programs, and other educational opportunities designed to build skills in various areas of the discipline. These initiatives must be tailored to address critical areas of importance, featuring them in associated learning opportunities, permitting managers partaking in the opportunities to develop as leaders.1,11,22,23 Critical leadership qualities are identified by leadership expectations statements, providing a ready resource for designing institutional leadership development offerings and determining associated content. Related to this, leadership expectations statements notably serve as helpful educational aids. They, for example, can be a centerpiece of employee orientation sessions, clearly and conveniently conveying the qualities that managers must exhibit to be considered leaders and offering staff employees who aspire to become managers indications of requisite leadership competencies which must be developed. They, too, can be used in counseling sessions between senior and junior managers, serving as a useful reference when discussing assignments, evaluating performance, or, when warranted, demanding corrective actions.
Beyond institutional leadership development enhancements, leadership expectations statements boost the personal leadership development efforts of managers, informing them of key leadership qualities, permitting them to direct their own efforts toward enhancing associated acumen. Combining personal efforts with those provided institutionally affords productive synergies, yielding numerous mutual benefits. Full awareness of leadership expectations importantly can help managers remain focused and attentive, even during times of intense workplace stress, reminding them of competencies which must be exhibited without fail, further demonstrating the value and utility of leadership expectations statements.
Strengthened organizational memory
Organizational memory results from the efforts of organizations to institutionalize knowledge in a manner to ensure its availability on demand and prevent its departure whenever employee turnover is encountered.1,12,24–26 If knowledge of valued leadership qualities resides solely in the minds of executives, such knowledge is at risk of being lost over time, eroding organizational memory. This loss is of no concern for healthcare organizations which have developed leadership expectations statements. Preparation of such yields a formal, physical document, strengthening organizational memory and bolstering intellectual capital.
Developing a leadership expectations statement
Reflecting on the development of Willis Knighton Health’s leadership expectations statement reveals a formal process which can be used by any healthcare establishment to prepare its own leadership expectations statement. Constructing a leadership expectations statement requires five steps as follows.
Step 1: Identify a comprehensive range of leadership qualities considered to be important to operations
To formulate a leadership expectations statement, a healthcare organization first must identify a comprehensive range of leadership qualities which are considered to be important to operations. As a healthcare establishment draws on many leadership qualities, this initial list likely will be extensive. Populating the array can be assisted by reflecting on classic leadership theories. Trait theories of leadership, for example, postulate that one’s leadership ability is based on his or her personal characteristics or traits; behavioral theories of leadership postulate that one’s leadership ability is based on his or her behaviors or actions; and contingency theories of leadership postulate that situational influences dictate the traits and behaviors that are necessary for demonstrating effective leadership.27–30 Reflecting on these theories, one might ask the following questions: What traits should our leaders possess? What behaviors do we desire our leaders to demonstrate? What situations are our leaders likely to encounter and what qualities will help them address those situations? Modern leadership theories, such as charismatic leadership21,31,32 and servant leadership,33–35 also can be explored for purposes of generating leadership qualities for inclusion. By thoughtfully addressing these and related inquiries, healthcare establishments will be afforded with a list of important leadership qualities relevant to their particular institutions, with these efforts ultimately yielding a leadership competencies framework.
Step 2: Select a manageable assortment of the identified range of leadership qualities viewed to be most critical for success
Next, the healthcare organization must examine the leadership qualities identified in the prior step and select a manageable assortment—perhaps no more than 10—which are viewed to be most critical for the establishment’s success. By focusing on the most essential leadership qualities, healthcare organizations can concentrate on priorities, improve memorability that is not possible through lengthy “laundry list” depictions, and foster use in practice, with these characteristics generating high utility. As noted earlier, directing concentrated attention toward a small number of critical leadership skills has been shown to improve leadership development efforts. 17 Intensive knowledge of operations arguably is the best resource for determining the leadership qualities for inclusion in this exclusive list. As such, C-suite executives are ideally situated for making such determinations.
Step 3: Define the selected leadership qualities, conveying their specific institutional value
In the third step of assembly, the healthcare organization must define the selected leadership qualities, taking care to incorporate in associated characterizations the specific institutional value afforded by the given qualities. This is a very important step as leadership qualities, when unaccompanied by firm depictions of meaning, are subject to misinterpretation as they can be defined in different ways by different people. The meaning, specifically from the perspective of the healthcare organization, must be conveyed well for each leadership quality selected.
Step 4: Craft the selected leadership qualities into a leadership expectations statement
In the fourth step of assembly, the healthcare organization must craft the selected leadership qualities into a leadership expectations statement. This requires examining the selected qualities, seeking to arrange them in a manner to convey a meaningful narrative which expresses their importance in the daily work lives of managers. This narrative can take many forms, with the only requirement being that it accurately conveys expected leadership qualities. A good starting point for this involves completing the following general statement: “At my healthcare organization, leaders are expected to be _________.” By inserting the list of selected leadership qualities in a logical arrangement and customizing the passage as desired, the healthcare organization will be afforded with a meaningful and memorable leadership expectations statement tailored specifically for the institution. To increase application opportunities, a short form, presenting only the leadership expectations statement, and a long form, presenting the leadership expectations statement and associated leadership quality definitions, should be created.
Step 5: Publicize and deploy the leadership expectations statement, updating it as needed to ensure continued relevance
The final step of the developmental process requires the healthcare organization to publicize the leadership expectations statement, determining conveyance methods and applications, deploying it, accordingly, bringing the statement to life. The concise portrayal permits useful presentations in, for example, training manuals, workplace posters, brochures, and even on business cards, permitting frequent exposure opportunities for personnel. Special conveyances by top leaders are particularly useful, prominently illustrating the importance of leadership expectations statements and robustly motivating associated compliance across managerial ranks. With the assembly complete, the healthcare organization can enjoy the benefits afforded by its leadership expectations statement, as detailed earlier, positively influencing and impacting the institution’s leadership development efforts. Importantly, as leadership needs change over time as environments and missions evolve, periodic reviews should be conducted to ensure continued relevance. In stable environments, an annual review should suffice. In rapidly-changing contexts, however, reviews should be conducted more frequently.
Conclusions
Healthcare organizations are reliant on cadres of managers to oversee operations, ensuring the delivery of excellent patient care and accomplishment of institutional missions. These managers obviously must be well versed in the principles of management, but they also must be proficient in leadership. As leadership can take many different forms, healthcare organizations must take care in their associated leadership development efforts to ensure that they have a firm grasp on the precise leadership qualities needed within their given organizations. Achieving this knowledge can be greatly facilitated by developing leadership expectations statements. Given the ability of these statements to clarify a healthcare organization’s leadership priorities and positively impact leadership development, creation and use of these simple tools should not be overlooked. Their use in the halls of medicine has the potential to amplify and enhance operations, aiding healthcare organizations in the vital task of bolstering leadership acumen within managerial ranks.
Footnotes
Acknowledgments
A special note of thanks is extended to Jaf Fielder, Bonnie Dubin, and the greater Willis Knighton Health family for their helpful assistance throughout the development and publication of this article.
Declaration of conflicting interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This article is part of a supplement supported by the James K. Elrod Super Professorship in Health Administration at LSU Shreveport.