The Pulse of Leadership in Healthcare

The Pulse of Leadership
in Healthcare

Developing the 21st Century
Healthcare Leader

Contributors:
Douglas G. Stark, BBA, MA, Director - Organizational Effectiveness,
Training, & Recognition, UTMB Health
Chris Blauth, Director of Product Strategy, AchieveGlobal
Craig Perrin, Director of Solution Development, AchieveGlobal
Rosalyn Laves, Strategic Account Manager, AchieveGlobal

Executive Summary

Much like leaders in other sectors, leaders in healthcare • Generally leadership today can be distilled into six
organizations are now being called on to re-envision the “zones,” or groups of best practices, which the re-
roles they play in cultivating organizations that are faced search identifies as Reflection, Society, Diversity, In-
with the need to develop new perspectives and new genuity, People, and Business.
skills. In the healthcare industry, though, the situational
• Overall, leaders in healthcare ranked the six zones
context is further complicated: Major legislative and
of leadership (with the exception of the Diversity
systemic changes are turning technology and privacy
zone) as being more important in meeting their or-
into significant forces shaping the evolution of the in-
ganizational challenges than did leaders in other in-
dustry. Today’s leaders in healthcare organizations are
dustries.
often expected to skillfully navigate these major
changes, even as economic turbulence emerges as an- • Survey participants representing the healthcare in-
other contextual factor. dustry generally had more concern about the effec-
tiveness of leaders in their organizations than did
AchieveGlobal’s multi-phased, multi-level study exam- participants from other industries.
ined how leadership within the healthcare industry must
change to keep up with today’s challenges. Our broader • Healthcare leaders were rated as being more effec-
research started out by identifying leadership issues out- tive in the “Diversity” zone.
lined in peer-reviewed academic journals over a two- • Among healthcare leaders, the largest gap be-
year period. At a later stage of the research, tween the importance of a specific zone and the ef-
focus-group sessions facilitated development of a quan- fectiveness of leaders in that zone was in the
titative survey completed by 971 corporate leaders and People zone.
employees in Europe, Asia, and North America. Survey
results further supported development of a comprehen- • In the healthcare sector, leaders who are most ef-
sive new model of leadership and a related individual as- fective recognize their own strengths and liabilities,
sessment instrument. adjust their approaches, adopt new strategies, and
maximize the strengths, while minimizing the liabili-
Part of our global study included a selection of respon- ties of others in their organizations.
dents who represented organizations in healthcare. The
responses from these participants from healthcare • Leadership training is particularly critical in the
helped shape our definition of what constitutes effective healthcare sector and, when implemented effec-
leadership in healthcare settings. They also provided in- tively, may provide a key to organizational growth
sights into similarities and differences between leader- at a critical time for the industry.
ship in healthcare and leadership across other industries.

The literature review, focus groups, and surveys provide
compelling insights into current challenges and best
practices for leaders across the healthcare industry.
Here are some of the key findings and conclusions:
• Leadership in the 21st century is more than ever a
complex matrix of practices, which varies from one
healthcare organization to another, along the lines of
organizational size, scope of operations, and revenues.

2 | THE PULSE OF LEADERSHIP IN HEALTHCARE

Introduction

At every turn in the healthcare industry, there are signs of AchieveGlobal’s research on leadership principles raised
reform. Fundamental ways of doing business are chang- important questions about leadership today:
ing, as organizations across the industry ramp-up to transi- • What major challenges confront 21st century leaders?
tion into the healthcare information superhighway.
• What changes are necessary for leaders to keep
A major goal for the U.S. healthcare industry is achieving pace?
the complete interoperability of electronic medical records
(EMRs), as stipulated in the American Recovery and Rein- • What leadership practices remain important and rele-
vestment Act of 2009 (ARRA). Major components of this vant?
are the new operating procedures for providers that re- • What new practices are emerging in response to shift-
ceive Medicare or Medicaid reimbursements. In order to ing priorities?
receive significant financial incentives from the U.S. federal
government, these organizations are now required to Healthcare industry leaders and other employees also par-
prove that they make “meaningful use” of electronic ticipated in this study, and their responses provided key in-
records, helping patients manage their health and con- sights into how these challenges affect healthcare leaders.
tributing to overall improvement of population health. We also gained understanding of what skills and practices
are important to successful leadership in the 21st century
At the same time, healthcare practitioners and their partner healthcare industry.
companies are also being called on to observe stricter stan-
dards of privacy and security in their handling of all patient
information based on HIPAA and the Privacy Require-
ments of the Healthcare Information T echnology and Clini-
cal Health (HITECH) Act.

If these transitions weren’t complex enough to navigate,
healthcare organizations, like all companies, are facing
tough economic times, and must therefore successfully
evolve, while keeping an eye on shrinking budgets. With
all of these factors playing into today’s realities, individu-
als in leadership roles in healthcare are facing critical
challenges from within their organizations, as well as
from the entire industry.

THE PULSE OF LEADERSHIP IN HEALTHCARE | 3

Methodology: A Three-Phased Approach

Central to this research

study was the idea that

analysis of 21st-century

leadership concerns among

leaders and employees

would help develop a model

that highlights key

leadership practices for

21st Century leaders.

Central to AchieveGlobal’s research study was the idea In terms of size of operations, just over 40 percent of
that analysis of 21st-century leadership concerns among participants worked for organizations with fewer than
leaders and employees would help develop a model 500 employees globally, while 23 percent were from or-
that highlights key leadership practices for 21st century ganizations with between 1,000 and 9,999 employees.
leaders. This model would: Over 13 percent represented organizations of having
• Give leaders a useful tool to allow them to visually 10,000 and 25,000 employees, while just over 6 percent
identify what strengths they (or others in their work were from organizations having 25,000 employees or
environment) already possessed, and could there- more.
fore use, and which potential liabilities they had to Figure 1. Number of Employees in Respondent
work on or eliminate. Companies
• Allow leaders to track changes in their leadership
strengths over time by revisiting the model. 0%
3% 4%
• Provide leaders with a leadership profile, which re-
flected a detailed picture of effective leadership in 14%
the 21st century.
41%

The research involved both secondary and 23%

primary research, including: 16%

I. A literature review of peer-reviewed business and
leadership journal articles and the development of a
provisional leadership model
Fewer than 500 10,000-24,999
II. Testing of the provisional model with two focus
25,000-49,999
groups of leaders who responded to a preliminary 500-999
definition of leadership 50,000-100,000

II. Further development of the leadership model and ad- 1,000-9,999 50,000-100,000
ministration of a survey in the United States, Mexico,
India, China, Singapore, Germany, and the United
Kingdom Taking the geographic scope of the healthcare organi-
zations into consideration, almost 69 percent of partici-
pants represented organizations that have domestic-
Survey Demographics only operations (in only one country) and had 2008
Among the 971 survey participants, there were 74 revenues of less than $50 million, while 14.9 percent
healthcare leaders internationally. One ostensible limita- were regional, 10.8 percent multiregional, and 5.4 per-
tion to this report is that the sub-sample of healthcare cent of participants came from global organizations.
providers comprised only 8.2 percent of the total sam-
ple. However, our statistical analyses uncovered signifi- The healthcare leaders also described themselves in
cant differences between healthcare providers and terms of the number of direct reports, their current
leaders in other industries, suggesting that the industry leadership role, and the length of time they had been
differences we found are likely valid. Additionally, the working at their current level. The largest group of par-
sub-sample of healthcare providers was extremely di- ticipants had no direct reports, with the second largest
verse, spanning four global regions, so the findings likely having between six and ten direct reports. The largest
incorporate some degree of global generalizability. percentage of participants also had between two and
ten years of experience at their current level.
Healthcare participants were asked to identify the or-
ganization in which they worked in terms of numbers of See Appendix 1.1 for further details on the demographic
employees globally, the geographic scope of their or- summary of healthcare participants.
ganization, and their organization’s 2008 revenue.


Key Findings – All Participants

The Leadership Zone Model

The Leadership Zones Leaders strong in the Society Zone:
The core finding of the overall research study was vali- • Act ethically to serve the larger good, not just to
dation that 42 practices—some behavioral, some cogni- obey the law.
tive—are required to meet the challenges of
• Encourage others to take socially responsible ac-
21st-century leadership. The researchers sorted these 42
tion.
practices into six categories, or “zones,” represented
here in a hexagonal model, in which each zone repre- • Openly challenge what they consider unethical de-
sents seven unique practices, identified below. cisions and actions.

Figure 2. The Leadership Zone Model • Take action to benefit others, not just themselves.
• Recognize and reward others based on merit, not
on politics.
• Make fair decisions, even if they have a negative
Business Reﬂection impact on the team.
• Take steps to reduce environmental harm.

Leaders strong in the Diversity Zone:
People Society • Strive to meet the needs of customers representing
other cultures.
• Encourage collaboration among people from dif-
ferent groups.
Ingenuity Diversity
• Display sensitivity in managing across cultural
boundaries.
• Collaborate well with people very different from
themselves.
• Effectively lead groups made up of very diverse
people.
Leadership Zone Attributes
• Learn about the business practices of other cul-
Leaders strong in the Reflection Zone: tures.
• Take responsibility for their own mistakes.
• Manage virtual teams with explicit customer-centric
• Seek knowledge required to make sense of the big goals and practices.
picture.
Leaders strong in the Ingenuity Zone:
• Examine what role they play in the challenges that
their team faces. • Help other people to adapt quickly to changes.

• Treat failure as a chance to learn and grow. • Help groups to develop a shared picture of a posi-
tive future.
• Reflect often on their performance as a leader.
• Develop their associates with the goal of improving
• Give serious consideration to opinions that differ overall group capabilities.
from their own.
• Solve real-world problems by thinking clearly and
• Speak frankly with others to learn from them and engaging others.
build trust.
• Tell stories to motivate others toward strategic
goals.


• Create a work environment in which innovation can Reflection helps leaders avoid pitfalls in other zones,
thrive. make the most of honest feedback, recognize the limits
of their knowledge, and avoid repeating their mistakes.
• Find ways to promote speed, flexibility, and innova-
When leaders see their mistakes as a chance to learn
tion.
and grow, they gain the ability—and credibility—to help
others adopt the same behaviors.
Leaders strong in the People Zone:
• Read a range of emotions in others and respond Society
appropriately.
In this zone, leaders apply principles—such as fairness,
• Adapt to the leadership needs of different groups. respect, and “the greater good”—to balance individual
and group welfare. Here, leaders attend to economic,
• Help others resolve issues of work-life balance.
environmental, and ethical matters that affect the larger
• Make a daily effort to inspire the trust of customers society.
and colleagues.
Recent unethical business practices with worldwide con-
• Minimize the negative human impact of decisions sequences highlight the need for leaders to serve and
and actions. encourage others to serve a larger good. While every
• Build and maintain a cross-functional task network. leader must achieve short-term goals, socially aware
leaders know that some short-term goals sabotage
• Communicate well with customers and colleagues long-term health—of the organization, the society, and
at all levels. the planet.

Leaders strong in the Business Zone: Diversity
• Adapt quickly to changing business conditions. In this zone, leaders value and leverage human differ-
• Manage the costs of operation. ences, including gender, ethnicity, age, culture, beliefs,
and work styles. Here, leaders prove their ability to work
• Learn new ways to make the business competitive. with diverse people and appreciate cultural perspec-
• Develop and implement effective business plans. tives.

• Analyze and use hard data to promote business re- This ability to derive value from human differences is a
sults. core skill for 21st-century leaders. A global workforce re-
quires a leader’s awareness of cultural nuances; a dis-
• Manage customer acquisition, retention, and life-
persed workforce requires structured yet flexible
time value.
leadership; a diverse workforce requires tailored collabo-
• Add clarity to the organization’s vision and values. ration and coaching. All these tasks require leaders who
balance their own strong identity with their daily effort
A description of the six zones follows here: to understand people very different from themselves.

Reflection Ingenuity
In this zone, leaders assess their own motives, beliefs, at- In this zone, leaders offer and execute practical ideas.
titudes, and actions. Reflective leaders look within and What’s more, they help others do the same by creating
ask, “How can I make sure my own blind spots and bi- a climate in which innovation thrives.
ases don’t cause me to make poor decisions?” and “How
can I leverage my strengths to become a better leader?” Ingenuity is the currency of success in a capricious
global economy. Closely allied is the ability to manage
the changes—on both business and human levels—im-
plied in every innovation. Ingenuity is vital as well to
helping groups develop a motivating vision of future
success.


People
In this zone, a leader’s ability to connect with others on a
human level realizes enormous benefits, including im-
proved communication of every kind.

In part, leadership is getting work done through others –
a real challenge without the skill and zeal to engage
people in a team effort. Leaders effective in this zone
inspire trust and loyalty, weather difficulties through a
wide support network, soften the human impact of hard
decisions, and encourage shared commitment to busi-
ness goals.

Business
In this zone, leaders develop strategies, make and exe-
cute plans and decisions, organize the work of others,
and guide effort toward predicted results.

Yet 21st-century challenges demand more than text-
book formulas. Beyond the hard skills of analyzing data
and managing costs, leaders must respond quickly to
threats and opportunities—a skill that requires close at-
tention to key trends and events. Still vital is a leader’s
ability to shape the customer’s experience, but also to
cultivate that customer’s lifetime value.

Balancing these six zones can be daunting because it’s
nearly impossible to give equal attention to every zone
all the time. Even so, increased awareness of the zones
and activities can help leaders make conscious trade-
offs in response to shifting conditions.


Healthcare Specific Findings

Healthcare leaders are being

called on to make major and

fundamental changes to how

their organizations operate,

especially as budgets shrink.

Pressing Challenges for Healthcare Leaders within healthcare leadership, but also indicate opportu-
nities for making changes (such as leadership training
Leaders within the healthcare industry who participated
and development and succession planning) that would
in the study were asked to identify the five most press-
have significant impact on leadership effectiveness and,
ing challenges that their organizations will face over the
ultimately, organizational success. It's also worth noting
next one to three years. Not surprisingly, the challenge
that deficiencies in the healthcare workforce further en-
that received the highest ranking among leaders was
hance deficiencies in healthcare leadership.
“Cost pressures.” This is reflective of the current envi-
ronment in which healthcare leaders are being called on See Appendix 2.1 for further detail on how participants
to make major and fundamental changes to how their ranked organizational challenges over the next one to
organizations operate, even as budgets shrink. three years.
The second highest ranked challenge was “Controlling
Figure 3. Challenges Among Healthcare Leaders
healthcare costs.” Since healthcare leaders are at the
frontlines, facing the challenge of controlling healthcare
costs, it comes as no surprise that this particular chal- Most Pressing Organizational Percent of
lenge ranked so high among survey participants. In- Challenges over the Next 1–3 Years Leaders
deed, for healthcare leaders, this challenge is two-fold:
Cost (e.g., margin) pressures 37.8
The industry struggles to come to terms with address-
ing the issue of controlling healthcare costs, while Controlling healthcare costs 35.1
healthcare organizations (like other organizations) also Improving customer satisfaction 35.1
try to find ways to control the cost of healthcare cover-
age for their own employees. Quality of leaders 32.4
Growing the business 32.4
Tied for the second-highest ranked challenge among
healthcare leaders was “Improving customer satisfac-
tion.” Since the goals of HITECH, HIPAA, ARRA, The
Joint Commission and the Magnet Program are cumu- Figure 4. Challenges Among Other Industry Leaders
latively to improve quality, efficiency and security of
healthcare, it stands to reason that a focus on improving Most Pressing Organizational Percent of
customer satisfaction would rank high among health- Challenges over the Next 1-3 Years Leaders
care leaders.
As identified by the participants, the third most pressing
organizational challenge for healthcare leaders was Growing the business 31.0
“Quality of leaders,” suggesting that there are likely is- Competitors 27.8
sues relating to recruitment, learning and development,
Employee productivity 27.2
and succession planning within healthcare organizations.
As a likely result of these first four issues, healthcare Improving customer satisfaction 25.6
leaders also noted that growing the business was a major
challenge. This stands to reason, since cost pressures
and an expressed concern about a dearth of leadership
quality would logically affect the ability to grow business.

Leaders also ranked the challenges of “retaining talent,”
and “employee productivity” as being of significant con-
cern. The challenge of retaining talent suggests that
there is room for healthcare organizations to re-examine
the motivation of their leadership, and also how leaders
are affecting employee morale and, therefore, produc-
tivity. These facts in particular point to existing liabilities


Comparing Healthcare Leadership to The Zones of Leadership: Importance and
Leadership in Other Industries Effectiveness of Leadership Practices
Our survey also revealed compelling differences be- Generally, both healthcare and general-industry leaders
tween leadership in the healthcare industry and leader- highly endorsed all six zones of leadership (Reflection,
ship in other industries across a few distinct areas. Society, Diversity, Ingenuity, People, and Business) as
being important in meeting their organizational chal-
While healthcare leaders identify “cost pressures,” “con- lenges over the next one to three years. Of the six
trolling healthcare costs,” and “improving customer sat- zones, both healthcare leaders and other leaders ranked
isfaction” as the top three challenges confronting their the Diversity zone lowest, with healthcare leaders indi-
organization, other industry leaders ranked “cost pres- cating that they saw that particular zone as being of
sures,” “growing the business” and “competitors” as even less importance than other industry leaders.
being the most pressing challenges that their organiza-
tions would face over the next one to three years. It’s ev- Figure 5. Leadership Zone and Importance
ident that healthcare leaders are less focused on
competitive positioning of their organizations, and more Importance of the Six Zones for Healthcare
focused on the operational realities of doing business, and General-Industry Leaders
General Healthcare
as well as on meeting employee and customer needs. 40
Not surprisingly, for all organizations, “cost pressures”
ranked highest of all pressing challenges, as the econ- 39
omy continued to govern deep and dramatic shifts. Is- 38
sues related to competition would also likely differ from
37
market to market, depending on whether a healthcare
organization operates in a competitive, urban setting 36
versus a non-competitive, rural environment.
35

One surprise came in the area of “technology chal- 34
lenges,” which other industry leaders ranked as more
pressing than did healthcare leaders. In light of the Reﬂection Society People Ingenuity Diversity Business
changes under ARRA and the HITECH Act, it seems
that technology challenges would rank higher for health-
care leaders, who might be confronted with decisions
about, for example, which electronic medical records Figure 6. Leadership Zones and Effectiveness
(EMR) vendor is best equipped to meet their organiza-
tional needs, and how to get employees to adopt new Effectiveness in the Six Zones of Healthcare and
workflow and systems using new technology. It would be General-Industry Leaders
General Healthcare
telling to repeat this part of the study at a later date, 40
since some of the definitions tied to ARRA and
38
HITECH continue to take effect at the time of publica-
tion of this report. 36

34
See Appendix 2.2 for further details about the challenges
confronting other industry leaders. 32

30
Reﬂection Society People Ingenuity Diversity Business


This discovery might be attributed to the sample demo- With major changes taking place in and around the
graphics, since all of the participants represented healthcare industry, this gap is cause for concern. It’s
healthcare organizations that had a domestic focus and worth pointing out that it takes strength within the Peo-
were operating in only one country. However, this find- ple zone for a leader to be able to communicate the sig-
ing also highlights what might also be a missed oppor- nificance of such issues as controlling costs and
tunity for healthcare organizations: Leaders that are adopting new technologies into overhauled workflows.
ill-equipped to take into consideration and leverage dif- Without key strengths in the People zone, leaders will
ferences of age, gender, ethnicity, cultural origin, or val- be ill-prepared to help other employees balance the
ues and beliefs are more likely to miss vital opportunities stresses of work with the stresses of life, or even earn the
to draw on the opportunities that such diversity can respect and trust of their colleagues. Since the health-
bring. On the other hand, leaders who are well care industry is focused on patient care more than ever
equipped to navigate and leverage diversity within the before, lacking leadership strength in the People zone
workplace are better able to communicate across cul- also points to a lack of commitment to meet the needs
tural barriers, and put to work the real value of having of patients. Obviously, this draws further focus on the
such diversity. point that leaders in the healthcare industry need lead-
ership development that specifically builds strength
It's also worth noting that within the healthcare environ- within the People zone.
ment, diversity is considered less important than for
other industry leaders because of the already existing Our leadership research confirms that leaders whose
trends of diverse workforces within healthcare. For ex- strengths lie in the “Reflection” zone are better
ample, a recent study in the journal Health Affairs indi- equipped to adjust to blind spots and to leverage other
cates that 25 percent of all doctors in the United States zone strengths. Further, the better a leader is able to
are graduates of foreign medical schools. recognize his or her own assets and liabilities, the better
that person will be able to adapt new strategies, and
One discovery is that leaders in the healthcare industry recognize assets and liabilities in others. In the present
feel that other leaders in their organizations were not as context, with increasing demands being placed on
effective as they should be, to a far greater degree than healthcare organizations, it would serve leaders within
their other-industry counterparts. This suggests that these organizations well to develop their ability to re-
while healthcare leaders are ranked as being generally flect on strengths and liabilities, and those of others.
effective, there is room for improvement. Leaders would then be better equipped to build on
strengths and minimize or eliminate liabilities within the
Our research looked at the gaps between how partici- context of the overall strategic direction of the organi-
pants rated importance of a zone versus how they rated zation.
the effectiveness demonstrated by their organizational
leaders in that zone. Among healthcare participants, the With this in mind, leadership training is more relevant
largest discrepancy, or gap, showed up in the “People” than ever in the healthcare sector, as organizations learn
zone, showing that while participants thought that it was how to navigate this time of critical change.
very important that leaders should possess strengths in
the People zone, they rated their organizational leaders See Appendices 2.3 and 2.4 for more details on how
as ineffective in this zone. healthcare leaders and other industry leaders ranked im-
portance and effectiveness of the six leadership zones.


Implications and Conclusion Numerous recent scholarly studies and books that focus
on healthcare organization and management empha-
Without question, the healthcare industry continues to
size the significance of effective leadership within
experience some of the most significant challenges it
healthcare1. From navigating a global recession to gear-
has faced in recent times. With federal regulations and
ing up for major legislative change, healthcare organi-
associated definitions still being finalized, leaders within
zations face radical change and must position
healthcare and healthcare-linked organizations will con-
themselves to respond. Leaders within the healthcare
tinue to redefine what constitutes effective leadership.
industry play an integral role in how their organization
We may also see changes in how they rate their own
meets the needs of multiple stakeholders: from patients
leadership, in terms of the importance they place on
to technology suppliers, the federal government and, of
specific practices, and how effectively they achieve the
course, their own employees. Even more fundamentally,
criteria of successful leadership.
they play a role in helping to improve overall population
Through all of this, leaders—and specifically healthcare health, a broader goal of recent changes in regulation.
leaders—are most effective when they are actively aware Ultimately, healthcare leaders must remain sensitive to
of the complexity of multiple challenges they face, and all of these factors, even as they guide their organiza-
the spectrum of practices that are important to success tions toward success.
at the individual, organizational, and industrial levels. As
with leaders in other industries, healthcare leaders must
be fully cognizant of their own strengths and liabilities.
They also need to possess the skills and determine the
combination of leadership practices required to build on
the strengths while minimizing the liabilities of others, so
that they can ultimately build organizations that can
weather the shifts and navigate the changes unfolding
around them.

There is also the issue of succession in healthcare and
the fact that in healthcare organizations there may be a
tendency to promote within organizations. Added to
this, there are issues related to licensing requirements
that further add complexity of hiring, succession, and
leadership training.

1 See for example the book, Leadership in Healthcare by Richard Gunderman, and the arti-
cle, “Managing in a Downturn: How do you manage in a global financial recession?” in
Journal of Healthcare Management. May, 2010.

Appendix

Appendix 1: Demographic Figure 3. Organizational revenue in 2008
Information—Healthcare Participants 2008 Revenue Percent
The following tables provide summaries of how partici-
pants described their organizations and themselves. Less than $50 million 56.8

Figure 1. Number of Employees Globally $50 million–$250 million 20.3

# of Employees Globally Percent $250 million–$500 million 10.8
Fewer than 500 40.5
$500 million–$1 billion 4.1
500–999 16.2
More than $1 billion 8.1
1,000–9,999 23.0

10,000–24,999 13.5 Figure 4. Number of Direct Reports

# of Direct Reports Percent
25,000–49,999 2.7
None 27.0
50,000–100,000 0.0
1–5 20.3
More than 100,000 4.1
6–10 18.9
Figure 2. Geographic Scope of Operations
11–20 10.8
Geographic Scope Percent
21–30 1.4
Domestic (operates in only one country) 68.9
31–40 5.4
Regional (operates in one global region) 14.9
More than 40 16.2
Multi-regional (operates in several
global regions) 10.8

Global (operates in all major global regions) 5.4


Figure 5. Current Leadership Role in Organization Appendix 2: Comparisons Between
Current Leadership Role Percent
Healthcare Leaders and All Other
Leaders
No direct reports 32.4
2.1 Challenges Among Healthcare Leaders
Manage first-line associates 28.4 Figure 1. Most Pressing Organizational Challenges
Over the Next 1-3 Years, as Percent of Leaders in
Manage first-line managers or supervisors 12.2 Healthcare Organizations

Most Pressing Organizational Percent of
Manage the managers of first-line managers
Challenges over the Next 1–3 Years Leaders
or supervisors 6.8
Manage one or more major areas of the
Controlling healthcare costs 35.1
organization 10.8
Improving customer satisfaction 35.1
Manage the entire organizational unit 9.5 Quality of leaders 32.4
Retaining talent 28.4
Figure 6. Time at Current Level in Organization
Time at Current Level Percent Driving sales growth 24.3
Technology challenges 21.6
Fewer than 2 years 21.6
Expanding into new markets 20.3
2–10 years 35.1 Attracting talent 20.3
Competitors 17.6
10–20 years 18.9
Achieving operational excellence 16.2
More than 20 years 24.3 Product/service innovation 14.9
Gaining access to capital 12.2
Regulatory environment 12.2
Ethical leadership practices 10.8
Responding to changing customer
buying patterns 10.8
Lack of trust among leaders and employees 9.5
Insufficient talent overall 9.5
Being perceived as “green” (environmentally
responsible) 9.5
Changing methods of distribution 9.5
Creating virtual workplace structures 8.1
Demonstrating corporate social responsibility 6.8
Insufficient number of leaders 6.8
Diversity in the workforce 5.4
Succeeding with mergers and acquisitions 2.7


2.2 Most Pressing Challenges among Leaders Appendix 2.3 Leadership Zone and Importance
in Other Industry Organizations
Importance of the Six Zones for Healthcare
Figure 2. Most Pressing Organizational Challenges and General-Industry Leaders
General Healthcare
Over the Next 1-3 Years, as Percent of Leaders in Other
40
Industry Organizations
39
Most Pressing Organizational Percent of 38
Challenges over the Next 1-3 Years Leaders
37
36
35
Competitors 27.8
34
Improving customer satisfaction 25.6 Reﬂection Society People Ingenuity Diversity Business

Technology challenges 25.1
Driving sales growth 24.8
Appendix 2.4 Leadership Zones and
Expanding into new markets 23.9
Effectiveness
Product/service innovation 21.9
Retaining talent 19.6 Effectiveness in the Six Zones of Healthcare and
General-Industry Leaders
General Healthcare
Quality of leaders 18.8 40
Achieving operational excellence 16.6 38
Responding to changing customer buying patterns15.3 36
Attracting talent 14.7 34
Controlling healthcare costs 12.6 32
Gaining access to capital 12.1 30
Reﬂection Society People Ingenuity Diversity Business
Lack of trust among leaders and employees 11.2
Regulatory environment 9.9
Being perceived as “green” (environmentally
responsible) 9.8
Changing methods of distribution 9.3
Diversity in the workforce 9.1
Succeeding with mergers and acquisitions 8.0
Ethical leadership practices 8.0
Insufficient talent overall 7.2
Demonstrating corporate social responsibility 6.9
Insufficient number of leaders 6.5
Creating virtual workplace structures 6.4


Appendix 3. Accuracy of the Six Zones of
Leadership Model
In order to test how internally reliable and accurate the
leadership instrument was in measuring leadership inter-
nationally in the healthcare and general-industry sec-
tors, a Cronbach’s alpha was calculated for each sample
on both the “Importance” scores and the “Effectiveness”
scores. The alphas for the healthcare “Importance” and
“Effectiveness” scores were .982 and .986 respectively,
and the alphas for the general-industry “Importance”
and “Effectiveness” scores were .975 and .980 respec-
tively. All of these alphas are truly outstanding (1.0 is
perfect), suggesting that the instrument is very reliable
in its ability to measure leadership in both the health-
care and general-industry sectors. Additionally, all six
subscales of the leadership instrument correlated very
highly with each other in the “Importance” and “Effec-
tiveness” components for both the healthcare and gen-
eral-industry samples. All correlations except one were
above .50 and are considered large-sized effects. These
high correlations suggest that the six domains of leader-
ship tapped by the instrument all triangulate on a larger
leadership construct. In other words, the six-zone ap-
proach in which leadership was conceptualized in this
instrument is likely very accurate for both healthcare
and general-industry leaders internationally.


About The Contributors
Douglas G. Stark Chris Blauth
Director Organizational and Workforce Development - Director of Product Strategy, AchieveGlobal
University of Texas Medical Branch
Chris, Director of Product Strategy, spearheads
Doug and his team support over 12,000 faculty and AchieveGlobal’s efforts to develop and maintain prod-
staff in academic medicine. Since 2000, he has played a ucts that will prepare leaders at all levels of an organiza-
critical role in developing a leadership academy ad- tion. Chris holds a B.S. in Accounting and Finance from
dressing the development needs of leaders at all levels the University at Buffalo, and an MBA in Marketing
and launched an on-line training system that houses from Canisius College.
over 80 courses. Doug holds a BBA in Marketing and a
M.A. in Organizational Communications from Western Rosalyn Laves
Michigan University. Strategic Account Manager, AchieveGlobal

Craig Perrin Rosalyn works with companies around the world to build
Director of Solution Development, AchieveGlobal customer loyalty, improve sales performance, and build
leadership skills. Her clients tend to be focused in the
As AchieveGlobal’s Director of Solution Development, healthcare industry, and she serves as the strategic or-
Craig is a thought leader who works cross-functionally chestrator for all of BlueCrossBlueShield relationships
and with clients to guide creation of a range of responses with AchieveGlobal. Prior to joining AchieveGlobal,
to market needs. Since 1986 he has played a central role Roz worked as an Assistant Director for Outpatient
in developing the company’s flagship programs in lead- Care at UT M. D. Anderson Cancer Center. She holds
ership, sales, and customer service. Craig holds a B.A. B. A. and M. Ed. degrees.
and M.A. from San Francisco State University.


About AchieveGlobal
In the 21st century, the level of human skills will determine
organization success. AchieveGlobal provides exceptional
development in interpersonal business skills, giving com-
panies the workforce they need for business results. Lo-
cated in over 40 countries, we offer multi-language,
learning-based solutions—globally, regionally, and locally.

We understand the competition you face. Your success
depends on people who have the skills to handle the
challenges beyond the reach of technology. We’re experts
in developing these skills, and it’s these skills that turn your
strategies into business success in the 21st century.

These are things technology can’t do. Think. Learn.
Solve problems. Listen. Motivate. Explain. People with
these skills have a bright future in the 21st century.
AchieveGlobal prepares you for that world.

World Headquarters
8875 Hidden River Parkway, Suite 400
Tampa, Florida 33637 USA
Toll Free: 800.456.9390

www.achieveglobal.com

© 2010 AchieveGlobal, Inc No. M01346 v. 1.0 (10/2010)

The Pulse of Leadership in Healthcare

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