Blip-Zip Executive Summary
This article addresses the pressing need for strategic leadership in the healthcare industry and introduces the 17 SHELDR competencies as a solution. By mastering these competencies, healthcare leaders can drive transformation and contribute to a healthier future. These crucial competencies will enable leaders to navigate complexity, shape a culture of innovation, and ensure the future success of the health system. Take advantage of this opportunity to excel in today’s demanding healthcare landscape!
Blip-Zip Takeaways
- Become a strategic thinker: Develop critical thinking skills to address complex healthcare challenges.
- Embrace innovation: Foster a culture that encourages novel ideas and solutions.
- Inspire and empower others: Communicate a clear vision and motivate teams to achieve shared goals.
Keywords/Themes
#SHELDRcompetencies, #strategichealthleadership, #leadershipdevelopment, #healthcaretransformation, #complexhealthchallenges, #cultureofinnovation, #futureofhealthcare, #strategicthinking
Table of Contents
The Problem and Solution: Strategic Health Leadership (SHELDR) Competency Development
As a follow-on to my GIMME MORE SHELDRS: DEVELOP MORE STRATEGIC HEALTH LEADERS–NOW! This exciting article reveals a summary review of the literature on strategic leadership and ends with the development and proposed application of the SHELDR Model and set of 17 competencies. You can find my DISSERTATION HERE.
Today’s health system is volatile, uncertain, complex, and ambiguous (VUCA), which is too “wicked” to transform. According to several healthcare leadership authors and futurists, transformational leadership is required to transition the “wicked” nature—complex, unsafe, unreliable, costly, wasteful, unsustainable, and frustrating—of the US healthcare system into the most reliable health system with the healthiest population in the world. Many believe the future of health system change is here; it is just not evenly distributed.
The current 100-year-old delivery of the “sick” care paradigm is failing. The current health system’s foundation is a patchwork of the 1900s industrial era of public health, sanitation, and safety crisis, health insurance as a wage ceiling workaround during World War II, and the creation of Medicare and Medicaid. After numerous policy patches, the implementation of the Patient Protection and Affordability Care Act (PPACA) promises to transform the health systems to tame the “wicked” nature of the current health system.
To tame the “wicked” nature of today’s health system, leadership must be adept at applying foresight or agile and adaptive thinking, willing to challenge the status quo, able to navigate exponential change, and able to create a culture of innovation and psychological safety, allowing others to develop into better leaders at all levels.
Hence, a new brand of Strategic Health Leadership (SHELDR) is needed to tame the wickedness in the health system to create the most reliable health system with the healthiest population (e.g., better health, wellness, and resilience) in the world.
The Root Cause of Failing Health System
However, there is a bottleneck: leader development practices. Senior health leaders readily admit that struggling with the sheer complexity and need for sustainable change is daunting.1-3 Studies by researchers, associations, organizations, and advisors cite chronic health leader development gaps associated with individual performance at higher levels of progression and complexity. 4-6 The cause of this mismatch in leadership competencies is that the literature consistently suggests that 20th-century production mindsets and leadership theories and competencies (e.g., knowledge, skills, behaviors, and attributes) still pervade and must be revised. 7-12
Today, strategically minded leaders are needed more than ever to navigate their organizations through a volatile, uncertain, complex, and ambiguous (VUCA) dynamic, interdependent environment. 13-16 This new breed of strategic leaders must positively aspire to the challenges associated with the Patient Protection Affordable Care Act (PPACA), create the most reliable health system, and create the healthiest population in the world. Otherwise, the system will continue to fail and undermine national security.
A Deep Dive Reveals Leader Development Gaps and Pressing Needs
Senior health and non-health leaders readily admit that struggling with the sheer complexity and need for sustainable change is daunting. Studies from all sectors by researchers, associations, organizations, and advisors cite chronic health leader development gaps associated with individual performance at higher levels of progression and complexity. For example, the Advisory board interviewed 50 Healthcare CEOs. Here are their findings on the development of competencies and skills.
Many think that healthcare education and leadership development communities need to meet expectations. According to a survey sponsored by the American College of Healthcare Executives (ACHE), healthcare leadership development has faltered, given the rise of complexity over the past 15 years. The leadership development challenge in healthcare is considered to be in a state of crisis today. 10,11 Compared to other business sectors, the healthcare industry has responded slowly to changing trends. 17
Recent surveys of 355 healthcare executives in July 2007 collected 104 responses, 29% of the sample. Survey results indicated that only 50 percent of the respondent health systems reported having a formal leadership development program in place, and most of those programs had been established after 2003; another 12% reported having a program under development. 10,11 The driving force behind the creation of these programs was healthcare organizations’ dissatisfaction with how prepared healthcare executives were when promoted to positions of senior leadership. 11,18
Many associations and experts report that leader development programs need to develop leaders capable of transforming a complex health system at the enterprise level. For example, the Center for Creative Leadership (CCL) reviewed literature and studied leadership development practices. The results indicated that the environment has changed—it is more complex, volatile, unpredictable, and ambiguous. The skills needed for leadership have changed—complexity and adaptive thinking abilities are required 19.
Also, the methods used to develop leaders have remained the same (much). 2,4 CCL also found an identical need in its 2011 White Paper Boundary Spanning Leadership—in interviewing over 128 senior executives, they identified a mission-critical gap between the 86% who believed it was “critical” to work effectively across boundaries and the 7% who felt they were currently “very effective” at doing it. 20
Organizations have come to understand that developing leaders is achievable. Developing leaders can be improved by strengthening the connection and alignment of efforts between leaders and systems through which they influence organizational operations. 21 Strategies tend to fail when executives need to recognize that their organization’s environment is changing. 9,22 The ideal health system and leadership development program will challenge all healthcare professionals to work together to improve the health of a community.
The root cause of this mismatch in leadership competencies is that the literature consistently suggests educators and mentors must revise the 20th-century production mindset and leadership theories. Question: Why do health leaders continue to tolerate production-minded leadership?
Approach to Development of the SHELDR Competencies
The SHELDR study literature review was designed to answer these questions: Can we do better? Is there an opportunity to improve? A thematic analysis was accomplished in two phases using the qualitative research software package NVIVO 11. Specifically, an analysis of 300 references on strategic leader development gaps and best practices, development of an evaluation framework, and synthesis of strategic health leadership competencies resulted in several observations and the foundation for the study’s methods and results. Question: What differentiates strategic leadership from operational-level leadership?
Strategic Leadership Evaluation Framework
The Bass Transformational Leadership Model (BTLM) served as the initial foundation. For example, the American College of Healthcare Executive Professional Development Task Force report recommended incorporating transformational and visionary leadership competencies into their current competencies. However, given the VUCA-driven environment and disadvantages of the BTLM, a more robust evaluation framework was developed. Collaborative and complexity leadership theories were integrated to characterize today’s strategic health leaders and serve as the evaluation framework.
Question: Have you heard of similar strategic leadership theories, especially in the healthcare sector? Models? Frameworks?
Voila! 17 Strategic Health Leadership Competencies
This is a provisional thematic analysis of 76 articles on transformational, collaborative, and complexity leadership, with strategic leadership as the primary subject and 2,045 words and phrases related to producing the Strategic Heath Leadership (SHELDR)competency model (4 components, 17 competencies) and an enhanced version of the BTLM with competencies from collaborative and complexity leadership theories.
Strategic Health Leadership (SHELDR) Competencies, 2024
| Component | Competency Description |
| A. Integrates Needs of Others and the Organization: Attends to followers and organization (inter and intra) needs; actively listens to understand rather than be understood. Builds inter- and intra-personal relations. Develops current and future leaders. Helps others succeed | Actively Listens To Others: Engages in and understands the concerns, needs, and aspirations of individuals and teams; conveys empathy to uncover possibilities; provides support by removing barriers and obstacles. Develops Leaders and Teams of Leaders: Coaches, guides, and mentors leaders and teams. Encourages self-development and intrinsic motivation. Gives constructive feedback. Assures education and training opportunities.Celebrates: Recognizes individual and team contributions, innovations, and progress. Encourages acknowledgment of success and setbacks to continuously improve, learn, and innovate. Expresses sincere gratitude. Practices Stewardship: Judiciously allocates and aligns resources (i.e., money, personnel, information, equipment, information, and infrastructure) with strategy efficiently and effectively; insists on accountability. |
| B. Encourages Aspirational and Critical Thinking: Challenges assumptions (others, self, organization); takes calculated risks; integrates ideas from inside or outside the organization. Applies critical thinking: agile, adaptive, and systems thinking for a sustainable positive effect. | Critical Thinker. Applies foresight and agile thinking to anticipate or find opportunities in dynamic, uncertain, complex, and ambiguous situations. Uses complexity and adaptive thinking to solve problems or shift momentum to find and apply sustainable solutions. Applies Systemic Approaches: Assesses situations systematically; understands interconnections and interdependencies between humans, systems, and processes to develop strategy, solve problems, and make complex decisions. Includes working across boundaries and organizations.Challenges the Status Quo: Challenges assumptions of others, self, and organization. Asks probing questions from multiple perspectives. Embraces diversity to generate new ideas, concepts, solutions, and better processes.Creates a Culture of Innovation and Health: Creates an inclusive, safe, and amiable culture designed to encourage novelty and new ideas. Manages risks with experimentation, alternative perspectives, test and evaluation, and prototyping. |
| C. Informs, Inspires, and Influences: Develops and articulates a futures-based aspirational vision and strategy despite a dynamic, uncertain, complex, and ambiguous (DUCA) environment. Inspires followers to achieve the vision or strategy and take independent initiative at all levels. | Develops Vision: Senses signals; anticipates the future. Develop aspirational vision, strategy, plans, and capabilities to meet the needs of customers, suppliers, and stakeholders via supply chains. Communicates Proactively: Engages followers, teams, partners, and stakeholders to aspire to a greater vision through interpersonal communication or outreach. Makes vision clear, meaningful, and understandable. Strategy Execution and Leads Change: Sets the tone, pace, and example to lead change. Aligns and integrates concepts, strategies, capabilities, organizations, and processes into common practice and culture. Empowers Others: Shares leadership collectively. Builds, aligns, and sustains diverse teams of leaders to achieve the vision, outcomes, and effectiveness—measures progress and results. |
| D. Promotes Professionalism and Builds Character: Serves as a role model for high ethics and morals; instills pride; gains respect and trust with proactive communication and collaboration. Leads by example, constantly developing themselves. | Collaborates: Builds mutually beneficial relationships and common goals within and across organizations. Partners with networks and communities of practice and stakeholders.Applies Ethics: Serves as a role model for unwavering ethical decision-making and respect for autonomy.Develops Trust: Builds and sustains trust through example, integrity, accountability, and transparency with individuals across organizational boundaries and stakeholders.Lifelong Learner: Seeks, leverages, uses, generates, and shares knowledge.Resilient: Returning from adversity through optimism and improving personal health, wellness, and stress management. |
Question: What do you think the top 5 SHELDR competencies consist of?
As a crosscheck, an analysis of 22 interviews of CEOs or CEOs published between 2010 and 2015 in the Journal of Healthcare Management equivalent questions centered on future research topics and leader development. Many of the issues and responses were similar to the SHELDR model competencies. The synthesis provided a solid foundation for evaluation and the study’s research design.
Question: What other studies of strategic health leadership are available?
Summary and Conclusion
The health system faces a critical challenge: a lack of strategic leadership. This article illuminates the SHELDR model, which equips health leaders with 17 crucial competencies. Mastering these competencies empowers leaders to navigate complexity, foster innovation, and propel the healthcare system toward a brighter future.
Critical Question: What competencies are missing? How do they compare to those in your organization?
Ready to propel your career and contribute to a thriving healthcare system? Explore the deep-dive questions, professional development activities, and resources provided to hone your leadership skills and become a transformative leader in healthcare.
Learn More!
8 Gutwrenching Questions Every Strategic Health Leaders Must Answer to Catapult Upward As A Coach
Deep Dive Discussion Questions
Understanding your leadership strengths and weaknesses is crucial. By reflecting on these questions and actively engaging in the development process, you can solidify your leadership foundation and prepare yourself to tackle the complexities of the healthcare landscape.
These questions are designed to spark self-reflection and encourage you to assess your leadership journey critically:
- Think back to a challenging situation you faced in your leadership role. How did you apply the SHELDR competencies to navigate the situation? What were the outcomes?
- Identify your top 3 strengths from the SHELDR competency list. How can you leverage these strengths to further your impact as a leader?
- Considering the areas for improvement within the SHELDR framework, describe one specific action you can take to develop a particular competency. What resources can support you in this endeavor?
Professional Development and Learning Activities
Equipping yourself with the necessary tools and knowledge is vital for continuous improvement as a leader. By engaging in these activities, you can continuously refine your leadership skills and position yourself for success in the ever-evolving healthcare environment. Here are a few practical activities to consider:
- Conduct a self-assessment using a leadership competency framework. This action will provide valuable insights into your strengths and weaknesses.
- Develop a personal development plan outlining specific goals aligned with the SHELDR competencies.
- Seek out mentorship opportunities from experienced leaders in the healthcare field.
- Enroll in leadership development programs or workshops designed to enhance your leadership skills.
- Participate in industry associations and attend relevant conferences to stay abreast of trends and best practices.
References and Resources
- Out of the Crucible: How the US Military Transformed Combat Casualty Care in Iraq and Afghanistan, Dr. Arthur Kellerman
- The Commonwealth Fund: High-Performance Health System National Scorecard (https://www.commonwealthfund.org/publications/scorecards) – This resource offers a national benchmark for the US healthcare system, allowing for the identification of areas for improvement.
- National Center for Healthcare Leadership: Health Leadership Competency Model (https://www.nchl.org/) – This website provides a framework for self-assessment and development planning for healthcare leaders.
- Robert Wood Johnson Foundation: Culture of Health (https://www.rwjf.org/en/building-a-culture-of-health.html)—The Robert Wood Johnson Foundation’s Culture of Health initiative aims to foster a national movement to prioritize health, well-being, and equity. Understanding this concept aligns with developing a cadre of strategic health leaders.
- Leaders Make the Future: Ten New Leadership Skills for an Uncertain World, May 7, 2012, by Bob Johansen
Citations
1. CCL M, Andre The Changing Nature of Leadership. Greensboro, NC: Center for Creative Leadership (CCL);2007.
2. CCL. Center For Creative Leadership (CCL). Center For Creative Leadership (CCL). http://www.ccl.org/Leadership/index.aspx. Published 2015. Accessed.
3. CCL. Strategic Leadership: An Organizational Imperative. Greensboro, North Carolina: Center for Creative Leadership (CCL);2004.
4. CCL. Addressing the Leadership Gap in Healthcare: What’s needed regarding leader talent? Greensboro, North Carolina: Center for Creative Leadership (CCL);2011.
5. Belasen AT, Eisenberg, Barry, Huppertz, John W. Mastering Leadership: a Vital Resource for Healthcare Organizations. Burlington, Massachusetts: Jones and Bartlett; 2015.
6. Rubino L, Esparza, Salvador, Chassiakos, Yolanda. New leadership for today’s healthcare professionals: concepts and cases. Burlington, Massachusetts, Jones and Bartlett Learning; 2014.
7. Maccoby M, Norman, Clifford L., Norman, C. Jean, Margolies, Richard. Transforming healthcare leadership: A systems guide to improve patient care, decrease costs, and improve population health. Hoboken: New Jersey: Jossey-Bass; 2013.
8. Kouzes JM, Posner, Barry Z. The Leadership Challenge. San Francisco, California, USA: Jossey-Bass; 2007.
9. Bass B. Executive in Strategic Leadership. International Journal of Business. 2007;12(1):33 – 52.
10. McAlearney A. Executive Leadership Development. Chicago, Illinois: American College of Healthcare Executives (ACHE);2008.
11. McAlearney AS. Executive leadership development in US healthcare systems. Journal of Healthcare Management. 2010;55(3):206 – 222.
12. Herzlinger R, Kumar, Vasant, Schulman, Kevin , Staman, Karen. Innovation In Health Care Education: A Call To Action. In. Bethesda, MD: Health Affairs; 2015.
13. Nickerson J, Sanders, Ronald. Tackling Wicked Government Problems: A Practical Guide for Developing Enterprise Leaders. Washington DC: Brookings Institute Press; 2013.
14. Sanders R, Nickerson, Jackson Help Wanted: A New Kind of Enterprise Leader In Online FTM, ed2013.
15. Johansen B. Leaders Make the Future: Ten New Leadership Skills for an Uncertain World. San Francisco, CA: Berrett_Koehler Publishers, Inc.; 2012.
16. Masterson B, Calvo, Ahmed, Jonas, Wayne Creating the Future of Health: The Journey. In: Masterson B, ed. Health Futures Group (HFG). Washington DC: National Defense University (NDU); 2013a.
17. Beinecke R, Daniels A., Peters J., Silvestri F. Guest editor’s introduction: the international initiative for mental health leadership: a model for global knowledge exchange. International Journal of Mental Health. 2009;38(1):3 – 13.
18. Charan R, Drotter, S., Noel, J. The Leadership Pipeline: How to Build the Leadership Powered Company. San Francisco, California: John Wiley & Sons, Jossey-Bass; 2011.
19. Schoemaker PJH, Krupp, Steve, Howland, Samantha. Strategic Leadership: The Essential Skills. In. Harvard Business Review (HBR). Cambridge, MA: Harvard Business Review Publishing; 2013.
20. Yip J. Boundary Spanning Leadership: Mission Critical Perspectives from the Executive Suite. Center for Creative Leadership;2011.
21. Robbins S, Millet, Bruce Millet, Waters-March, Terry. The Leadership Development Handbook, 4th ed. Center for Creative Leadership (CCL) and Organizational Behavior, Greensboro, NC: Prentice Hall; 2012.
22. Conger JA. The Dark Side of Leadership. Organizational dynamics. 1999;27:56 – 67.
