Quality improvement within a healthcare facility depends on the leadership of its senior executives. However, leaders will not be able to achieve substantial performance changes by merely applying their skills; the whole system must be amended. To facilitate improvement efficiently, both individual and organizational levels should be considered in the process. Therefore, notable leaders should not only transform themselves and build their will but know how to establish a firm foundation for optimization and execute needed changes.
A broad definition of leadership implies working with employees and systems to develop and implement necessary changes. At an individual level, a successful leader must be an embodiment of core values. That person should be trustworthy, consistent, communicative, focused on results rather than popularity, and also humble and confident at the same time (Joshi, Ransom, Nash, & Ransom, 2014). He or she should be capable of stimulating and inspiring team members with their energy, motivating them to facilitate change.
Personal characteristics appear to be just one part of an efficient leadership style. There is a set of areas in which an executive should possess practical knowledge, such as a deep understanding of the whole system processes and the role of each staff member in achieving the required aims in complex projects (Joshi et al., 2014). A good leader should be able to explain such information to medical workers and teach the usage of improvement methods. There’s also a strong necessity to develop new leaders in the organization, providing nurses and physicians with needed help.
However, efficient CEOs will never try to foster change by themselves solely. At an organizational level, intelligent management includes creating a supportive environment in which many individual leaders can thrive. The primary goal of a senior manager is to foresee and set the direction toward improvement for the entire facility (Joshi et al., 2014). Furthermore, any system optimization demands a firm foundation, which must be prepared based on the current situation in the healthcare industry and the chosen direction. At this stage, the ability to generate and rapidly test ideas from the best performers comes forward. Furthermore, such interventions often involve troubling procedures of reframing values and enforcing new goals and rules among medical staff members.
People are often inclined to view any organization in a hierarchal way, believing that leadership only regards the responsibility of senior positions. Such a view is natural because CEOs indeed have a larger scope and greater opportunities. However, top managers do not have the information on quality issues that frontline staff faces every day (Joshi et al., 2014). Therefore, the process of optimization strongly depends on the participation of clinicians and nurses on every level, supported by a well-aligned leadership system. For this reason, true leaders must understand the importance of every single employee for successful transformation toward improvement.
As an example of an excellent leader, I chose William Rupp, MD, former CEO of Luther Midelfort-Mayo Health System (LM). He is a certified physician with 32 years of experience in the fields of hematology and medical oncology (“William Chancy Rupp”, 2019). He became chairman of the LM board in 1992 and CEO of LM in 1994 (Joshi et al., 2014). He managed the organization until 2001 and was the leading force behind innovations in quality and safety. I consider Dr. Rupp an inspiring and notable leader because of the following reasons.
Firstly, under his supervision, LM gained a certain reputation for its outstanding quality of healthcare services. In his interview, Dr. Rupp speaks about some of the innovations implemented in hospitals (Joshi et al., 2014). For example, his team put “a simple paper-and-pencil reconciliation system in place for in/outpatient medications, and adverse drug events decreased fivefold” (Joshi et al., 2014, p. 368). Furthermore, a red/green/yellow light system for managing hospital flow and nurse staffing was also implemented, which appeared to be an extraordinary tool for empowering nurses and communicating across nursing units; it also led to the reduction of unsafe staffing situations.
Secondly, Dr. Rupp regularly generated useful ideas in his management, such as creating a team of change agents or trying open-access scheduling. In particular, the main function of change agents was to search for effective innovations in the healthcare industry and promote their realization (Joshi et al., 2014). Dr. Rupp had the difficult task of supporting these agents amidst medical workers’ complaints and perceiving the incoming information so that any operational detail would not be missed. He had to withstand the resistance and the unwillingness to change and at the same time, pay attention to the possibility of safety risks.
Thirdly, during financial losses in 1998-1999, Dr. Rupp had to exercise his ability to see a larger picture and act against the pressure from many parts of the organization to reduce investment in innovation and quality. According to his interview, he “felt that during rough times we needed more ideas, not fewer” (Joshi et al., 2014, p. 370). He demonstrated that for every dollar invested in change agents’ salaries, LM had generated ten dollars in return. In the end, his insightfulness and decisiveness brought satisfactory financial results.
William Rupp also talks about the way they used to enforce changes in medical practice. When the innovation was designed, the process of implementation was supported by a special protocol that was obligatory to use for every physician. Such a method stimulated medical professionals either to adapt to the change or to give valuable feedback if some procedure could not be utilized safely. One way or another, the evidence-based practice of medicine remained the top priority. In my opinion, this example provides good evidence of a strong will exercised by an effective leader.
Dr. Rupp defines the primal rule as “Success is defined by quality.” He also shares the main lessons learned about the CEO’s role in leadership for quality and safety. They include constant searching for useful ideas and pushing the quality agenda throughout the organization (Joshi et al., 2014). Besides, he claims that the CEO doesn’t make change happen single-handedly. Those are the core beliefs that help him to be a remarkable leader. Such a characterization had been proven by time, respect within the industry, and impressive achievements.
To summarize, the qualities of a leader play a crucial role in successful improvement within the entire organization. Good leaders can develop ideas based on an overall view of a system; they create a favorable climate in which improvement teams can be effective; they establish a steady foundation for improvement processes; finally, they promote and enforce the necessary change. Efficient executives are responsible for the function of the whole system and the culture within it; however, their efforts would be insufficient without medical professionals’ participation at every organizational level. Therefore, the essential characteristics of a good leader include not only personal skills but certain operational knowledge and the ability to foster change throughout the organization.
Joshi, M., Ransom, E. R., Nash, D. B., & Ransom, S. B. (2014). The healthcare quality book: Vision, strategy, and tools (3rd ed.). Chicago, IL: Health Administration Press.
William Chancy Rupp. (2019) Web.