How Leaders Thrive in Times of Change

By Ellen Bettenhausen

To adapt and survive in times of great change, organizations must take advantage of every bit of organizational talent. This is particularly relevant in healthcare. As the healthcare industry continues to evolve, leaders face many challenges: aggressive growth, competition, changing payment models, advanced technology, multi-generational workforce, and so on. Leaders must build an organization capable of adaptive growth while emphasizing the importance of a team approach through engagement to improve quality and efficiency.

Engaging physicians requires restructuring the way various departments in healthcare organizations communicate and interact. But this can happen only if leaders first embrace the need to model the desired thought processes and behaviors. To forge agile organizations (and teams), leaders must be role models for collaboration, interprofessional care, continued education, skill building, self-reflection, and dedication.

Success as a leader depends on the ability to influence and work through others. Physician leaders can make an impact at all levels across the organization. For many, this requires a shift from the traditional clinical mindset. Behaviors considered acceptable in a clinical (intellectual) setting are not effective in leading sustainable change. Successful change leaders recognize and emotionally accept the values, self-image, professional perspective, and demeanor that a leadership role demands. Physicians are enormously influential people, and their attitudes and actions carry weight. Their behavior shapes the culture of the workplace environment, and that culture either engages or disengages others.

Driving sustainable change is challenging without a strong partnership between physicians and administration. In 2017, the leadership development team at a large healthcare system in California designed a year-long program offering learning opportunities to help facilitate the partnership and cooperation needed to achieve common organizational goals. It was intended to ensure that both administrative and physician leadership throughout the system were aligned and working together toward collective results. The foundation of the program focused on the Leadership Challenge Model and how these behaviors can help leaders recognize and overcome team dysfunction, create engaging work environments, and effectively manage their daily interactions.

A total of 26 physician and administrative leaders participated in the program. Pairings of physician and administrator were created to form six cohort groups. Each quarter throughout the year, these groups participated in learning experiences to strengthen and support the individual leaders as well as the relationships within the team. Additionally, each cohort was asked to identify a relevant organizational project to work on during the year, giving them the opportunity to experiment and practice the skills learned in the program.

The assumption of the program was that leaders who engage more frequently in behaviors associated with exemplary leadership will have higher levels of engaged staff and physicians. A study conducted to evaluate the program was designed to identify correlations between the behavior of a leader and how people respond to their workplace environment (engagement). To measure leadership behavior, all 26 participants were evaluated using the Leadership Practices Inventory (LPI) both pre- and post-program. To assess engagement in the workplace, the Positive Workplace Attitudes (PWA) survey was administered to all staff and physicians reporting into the participants’ areas of responsibility, both pre- and post-program.

The results of the study show that leadership behaviors have a clear statistical correlation and relationship with workplace engagement. Even more evident was that the relative impact to workplace engagement varies by the leadership practice. For example, the impact of “Enable Others to Act” was far greater than “Encourage the Heart.” The LPI practice behaviors could be ranked in order of impact on engagement (see table below).


Additionally, a clear relationship was demonstrated between each individual PWA question and its correlating top three LPI behaviors. For example, specific behaviors had a significant impact on whether employees felt their organization valued their work (see table below).


What are the implications of this data for leaders? In navigating healthcare’s changing environment, the findings suggest that leadership behavior matters. Effective leaders are aware of their ability to influence others with words and actions, thus impacting how people react to their environment. Building awareness around one’s natural tendencies and recognizing opportunities to intentionally demonstrate behaviors that create a more engaging workplace make a difference. Leaders who challenge their assumptions and recognize how they need to change to gain credibility become trusted role models for their organization.

Jim Kouzes and Barry Posner, authors of The Leadership Challenge, claim that according to their research, people who perceive leadership as having high credibility are more likely to be promoters of the organization, have strong sense of team spirit, be attached and committed to the organization, have a sense of ownership, and see the alignment between their own personal values and those of the organization. With this level of engagement, people are more willing to go above and beyond what is expected of them.

Ellen Bettenhausen will be presenting a session at the ATD TDI conference. For more information, click here .
How Leaders Thrive in Times of Change