Case Study

Strengthening clinical and operational leadership and partnerships in an academic Medical center

Joy W. Goldman RN, MS, PCC: CEO
Cliff Kayser, MS, PCC: CSO

Background

SixSEED Partners (SSP)  was invited to work with a 789-bed, academic medical center located in a major metropolitan area.  We were asked to design a program that would improve the partnering between operational leaders: the Security Department and a clinical department:  Shock Trauma leaders, in service to improving staff and patient care when dealing with high profile trauma patients.  These patients posed challenges to these departments due to the crowd control often necessary with police gunshot victims and the support of political leaders.  

The Strategy:

After interviewing both department Senior Vice-Presidents and hearing their shared vision, SSP proposed a six-month engagement where we would combine expanding thinking capacity to better lead through complex and volatile situations with action learning and forced pairing to strengthen trust through mutual accountability. We wanted to be able to measure impact on a qualitative and quantitative basis and we wanted to strengthen the system so that each leader was doing work at the level that matched their position in the organization. Applying our Leadership Ecosystem Capacitation (LEC) model, we wanted to impact individual, team and system-level change to ensure sustainable impact. Complicating this work was the fact that all of our work would be done within the context of the Covid-19 global pandemic; mass vaccination campaigns; and the nation’s crisis of systemic racism.

The Solution: 

Over the six-month period, we offered a combination of in-person and virtual sessions where we introduced polarity thinking and the SMALL process: seeing, mapping, assessing, learning and leveraging. The eight leaders were engaged in identifying their own pain points which were mapped to represent their reality. The two tensions measured were:

• Continuity & Transformation (what’s working now and what would we like to see differently in our partnership)
• Autonomous Outcomes & Integrated Outcomes: how well do we leverage the expertise of each department while integrating and combining our complementary strengths in service to the patient and our respective teams

In addition, we met with the Senior Vice Presidents on an every -other- week basis to provide support for them as they coached their leaders in doing this work. We wanted to help them identify their own tensions of Holding Responsible & Giving Freedom. As strong problem solvers, we wanted them to notice any tendency to want to rescue or persecute and help so they could best leverage this interdependent tension. We brought in to our work internal hospital resources like process improvement talent so they could map out a desired procedure (Standard Operating Procedure) for managing high profile patients which could then be codified and shared so the results were less dependent on certain staff and could be standardized across both operational and clinical areas.

The Impact:

Not previously mentioned but of significance for our work was the fact that the Security Department consisted of all Black leaders and the Shock Trauma leaders were all Caucasian. We found this important given the larger context of protests and beliefs around systemic racism. We acknowledged a theme of “being heard” and elevating voice within operations since clinical areas often received the spotlight as direct patient care providers.
Markers of success included:

• Seamless and coordinated management of a high -profile patient two months post the conclusion of our work
• One of the Security-Shock Trauma Leader dyads presented their work at the Leadership Forum for the flagship hospital and Mid-Town Campus with many accolades
• The Senior Vice-Presidents were able to offer numerous examples of mid-level director empowerment, including the presentation to them of a new Standard Operating Procedure created by the eight leaders
• Elimination of process delays and confusion as they created a “Tiger page” that now alerted all involved
• Improvement in all but two markers between the baseline and interim polarity assessment

Cliff Kayser, MS, PCC:  CSO

Background

SixSEED was invited to partner with a hospital seeking to support a new Director of Perioperative Services struggling to acclimate to the organization. The hospital sought an Executive Coach to support the leader’s difficult transition to the new role which was also occurring in the midst of the high-stress COVID-19 pandemic environment and severe nursing staff shortages. There was a need to accelerate the leader acclimating given the high revenue impact of her clinical areas.

The Strategy:

The Executive Coach partnered with the leader using a polarity framework:  a structured approach which matched well with the client’s military background.  In partnership with the client’s executive sponsor, they decided to focus on 7 key tensions.  Crucial to the client’s success would be to leverage the benefits of each of these “polarities” while at the same time being aware of her strong preferences for pole values that are shown in bold, below:

Confidence And Humility

Assertive And Cooperative

Candor And Diplomacy

Advocate And Inquire

Provide Direction And Invite Participation

Give Freedom/Trust And Hold Responsible/Verify

Mandatory Protocol And Discretionary Protocol

The strong preferences and combined impact for those pole preferences were creating barriers to her leadership effectiveness. As she became more aware of the dynamics between and among these competency pairs, she began exploring new approaches and creative ways to create “leverage” – to maximize the benefits of each, while minimizing the downsides of overdoing her strengths.

The Solution: 

In partnering with the coach, the client was able to prioritize a key tension for she and her team which was Give Freedom/Trust And Hold Responsible/Verify. She believed her team was framing the tension as an “Or” – and strongly over-relying on Giving Freedom/Trust to one another and falling short on holding one another responsible for follow-through on mandatory safety protocols.

The leader and coach co-designed and delivered a team development session for her 11-member leadership team. In the session, the team mapped and assessed their performance focused on Patient Safety And Staff Safety as it related to how individuals and the team navigated giving one another freedom while holding each other responsible for following safety protocols.

The Impact:

Near the end of the 6-month engagement the client completed a follow-up self-assessment for the original seven polarity tensions. The results are summarized below.  Most importantly, her leaders were able to depersonalize behaviors and recognize tensions as preferences and not as “good” or “bad.”  The client, by increasing visibility, developing relationships, and becoming a better “leader of leaders,” she was able to influence and “scale” systemic change.