Healthcare’s Leadership Gap with Ronnie Kinsey | E. 72

The Healthcare Leadership Experience

As healthcare continues to move through a challenging transition, Ronnie Kinsey explains to Jim Cagliostro how he works with healthcare leaders to surpass their greatest goals and resolve leadership gaps.

Episode Introduction

Ronnie highlights the importance of exposing clinicians to the business side of healthcare, how ‘’one to one to one up’’ leadership can lead to multiple gaps of ‘’abyss potential’’, and why people must prioritize behavior and check things at the door. He also explains why all leaders should consider an outside resource for support, why coaching is not therapy, and how attitude is key to successfully nurturing leaders.

Show Topics

• Healthcare has to incorporate the business side

• The challenge of one to one to one up leadership

• Promotion can result in leadership gaps

• Behavioral procedures take priority in healthcare

• The impact of culture in filling gaps

• Developing leaders comes down to personality and attitude

• Frontline employees can resolve hospital painpoints

04:19 Healthcare has to incorporate the business side

Ronnie said that clinicians must be prepared for the business side of healthcare at an earlier stage.

‘’There are so many people who got into healthcare with the idea of delivering care. They wanted care. But then you and I have had conversations. You're doing the business side of healthcare now as well. There is the whole business side of healthcare, which cannot be ignored. I think that clinicians schools could probably potentially do a better job of preparing clinicians for the business side of healthcare. Because …..if the bills aren't paid and if there's not access to plan for growing for the future, we've got a problem. So that's got to be there, but I think that it has to be really ingrained into the clinician earlier on. That would be one of my big asks for the new educational shift is that clinicians just be much more attuned to the business side of healthcare. Definitely don't lose the caring side, but be aware of the business side.’’

07:30 The challenge of one to one to one up leadership

Ronnie explained gaps happen when people leave as most hospitals only have one leader on the frontlines.

‘’You on average have one leader per category of management. So the front lines, whatever, until you get up to the C-suite and it's divided other ways. So say you have one leader that you report to, then that's at one level and that leader reports up to another leader at another level. So it's generally a one to one to one up. Well, what if that chain breaks and one of those ones goes out? There's a break. There's no extra time to fill in for that missing person per se. And again, remember we just said it takes about four months to replace them. Well, how to bring the next person up to speed, how to even try to get them close to knowing the personalities that play on that particular whatever we want to call it, the ward, the unit, the floor, the department, service line, you can name that. So look already where the gap comes in. So then from the front line, some people are wondering, "Well, who do I go to?" Okay. We can give them names, we can give them a title and that's fine. That person doesn't have extra time for you. They already have their financial responsibilities because they're in leadership…. So now are they short of resource? Where do they go? There tends to not be just so many extra hands sitting around waiting to help out because systems are really under constraints overall, especially after COVID, right? We're under a whole new redefinition of the healthcare system. It's been coming, I'll say it's for sure been coming since EHR. Well, it became no exception after COVID. … I can make that example at every level, all the way up.’’

10:12 Promotion can lead to healthcare leadership gaps

Ronnie explained why promotion can result in a cycle of resentment and resistance if clinicians aren’t prepared.

‘’And again, leaders aren't necessarily born, but leaders can be developed. So then their lies the gap. There lies the gap. So often it happens in healthcare, somebody did so well in the clinical side, they're going to get promoted. Well, guess what? They like the idea, sounds good. They want to grow. They'd like to do something new and at another level. But boom, what if they're not prepared for the business side? What if now they're not prepared to hold somebody accountable. A, they didn't show up on time. B, didn't say the right thing. C, didn't have the right thing and you know where that goes? Then there's the accountability and the disciplining that takes place. Well, then you have resentment. Then you have resistance. Are you following me on the gap yet? Do you see where this turns into a huge cycle? And then at the same time, you need to be delivering care and healthcare efficiently, appropriately, timely and properly all the rights. Right person, right time, right thing, right place, right outcome, right? Applying all of those things, but your time factor doesn't increase. People don't have extra time to work on these things.’’

14:28 Behavioral procedures take priority in healthcare

Ronnie said people have to check certain things at the door, set expectations and hold others accountable in the working environment.

‘’I'm going to share with you part of why I'm a coach now. I hired my first executive coach when I was working with a large pharmaceutical company to give a presentation overseas to our sales team and it had to do with behavior. And the executive coach says, "You can have your thoughts. You're entitled to your thoughts. You should have your thoughts, you're a human being. On the job, in this role, these are the behaviors that we'd like to pay you to perform." Boom. Cleared the sky like I'd never seen before. When I heard him say it the way he said it, he said, "You're entitled to your thoughts. You should have your thoughts. You're very welcome to have your thoughts, but on the job, please follow these behavioral procedures that we're asking you to follow."… The new phraseology seems to be like, "Bring your whole self to work." Well, you are anyway. And we are human, we have needs, we have issues. There's a time and there's a place for certain things you may or may not agree. And as adults, as professionals, as mature people, we do learn to check certain things at the door while we perform other things. It's just kind of understood. You'll be able to do that if you are a well trained, good intending, well hired professional. ….We have to set expectations and we have to hold people accountable. We know this is not ideal. We know that it'd be easier to be at the beach with ice cream right now or something like that. But we're now at work and we're doing this and we plan to do this throughout the next eight hours or the next 10 hours, 12 hours for the next three months, for the next three years, whatever it is, are you the right one to carry this behavior out with us during this time?’’

20:53 The impact of culture in filling gaps

Ronnie explained why bringing in people short-term can create more gaps down the line.

‘’It's going to take six months to a year before trust develops really, really developed. Because every place of work has the stuff that people do not want to publish and talk about immediately. Every place, anytime you put two people together you have a culture. And we know that culture is important in every place and cultures are unique. Not to say that one is so one off like none in every other place, but every place will never have exactly the same personalities, exactly the same dynamic, exactly the same location, et cetera. So if you're bringing someone, say, who's temporary. Okay, you're here for three months. They have already checked your due date at the door. Okay, welcome. You're here in June, so see you later in September. You're three months. So they've kind of like got that circle around you we're just going to be nice for three months, sometimes. People can work well together. But also for the people who are staying, that's not their long-term solution. There lies another gap. Who's going to be here in October for them? Whether it's an option that that person could get hired on long-term or not, you're still in test phase. People may be withholding what are the real issues? Because what's going to get done about them anyway? And then some people worry, did I say too much? Did I reveal too much about what's really going on? Is it going to look bad on me? Because remember, it's easy to shoot the messenger.’’

25:20 Developing leaders comes down to personality and attitude

Ronnie said that the right attitude is essential in leadership, but not everyone can be coached.

‘’So if we took two terms to work with, let's talk about, okay, there's personality. That's one thing. And then there's attitude. I want to go with attitude. I want to put weight on attitude. The right attitude can take you very far. So then there's kind of the innate attitude. Some people just have that bright shining sun in the sky attitude and they can weather the storm, what have you. Some just truly have that. Some can be shown to look at the sun rather than the mud. Okay. I like that. I heard a quote recently. "Two prisoners looked out from the prison bars, one saw this mud, the other saw the stars." What's your takeaway from that? Exactly. Yeah. You get to choose what you see. One saw a dirty, dismal, hopeless situation and the other one saw hope and aspiration. So attitude can be nurtured and developed, but it helped a whole bunch. If you already bring it, if you already bring it, the nurture curve is shorter. And by the way, as coaching goes, not everyone can be coached. Not everyone is willing to be coached. It's a possibility. It's not a guarantee.’’

32:18 Frontline employees can resolve hospital painpoints

Ronnie said that frontline employees can offer viable solutions for the C-suite.

‘’How can you be the solution? What solution can you bring or suggest? Okay, let's go back to the pay grade conversation. This is one thing I want to take down to the lowest level. I think that companies who could ingrain into their people, I don't know if it could be an incentivized thing, can you look for the solution? Can you bring... So you've got a pain point, you've got a block, you've got a cog in the wheel. What in your view, what is the solution to bring that out? Because no one's going to know the pain better than you if you're in it. If you ask me if I'm up in the C-suite, there's no way,I would have to go and do some research. I would have to bring a meeting together to really understand what it is they're going through down there. Were you at the front line, pass the pain points up, but not looking like a complaint. What are one to two viable solutions that you see for your pain point? Bring that. Try to think of a solution-based approach. I hear your pain. Thank you for bringing that up. What do you think the solution is?’’

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You’ll also hear:

The impact of EHR on burnout in healthcare. ‘ I was involved in transitioning from pen and paper to the computer and I saw huge resistance from the clinicians involved and the leaders involved….The idea of burnout has been around for quite some time, but I began to see it really unravel when we started launching EHR.’’

How multiple gaps can lead to ‘’abyss potential.’’ ‘’… maybe you need to take off. Now, I'll circle back, there lies the gap again. I'm not saying wrong. I'm just saying this goes back to the gap. You need to be out. We got that. If you have the flu, please be out. Now our schedule will be a bit disrupted. So there goes back to a gap. A potential gap. And if not noticed and managed effectively and timely, you're going to have a mess.’’

Why it’s vital to consider an outside resource for support – and why coaching is not therapy. ‘’I want everyone who might be listening to know that you should never have second doubts about getting any help that you might think you need or want for your mental fitness. Coaching is not mental therapy. … You can get mental toughness from a coach, but it's not therapy. There may be therapists who do some coaching per se, but generally coaching is not therapy. I wanted to put that out there.’’

Hospitals need to get a new wheel, not recreate one (and two inspirational quotes from Walt Disney and Elon Musk).

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