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“It is a riddle, wrapped in a mystery, inside an enigma; but perhaps there is a key.” These words, spoken in 1939 by Winston Churchill, were focused on the changing global environment with its attendant looming change and crisis. However, this quote could be relevant to both the current condition of health care and the intent of this book to provide a key. As another quote—doing more with less—transforms into doing everything with nothing, health care is experiencing change, crisis, and challenge at an unprecedented level. A phalanx of puzzling new laws and regulations are making reimbursement and other pathways to profit for the majority of healthcare organizations—most of which are nonprofit—vexing and perilous, threatening the very existence and solvency of these selfless, community-driven organizations. The patient, heretofore considered a constituent who had unconditional abiding trust in his or her doctor and local healthcare organization, has now become jaded due to the media and political complexes making health care more complex in popular perception. As trust erodes, the patient has become a skeptical and wary customer attached to the mantra consumer beware!

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As these new and potentially nefarious external forces impel change on the healthcare organization, internal reactions lead to more strife and a need for rebounding clarity. While operating budgets shrink, healthcare leaders have to become more resourceful in their utilization of precious resources from allocated staff to allocated financial assets. As demand for new and improved services resonates from the media to the customer/patient and then land with a thud on the local healthcare organization, healthcare leaders must ensure that their sector of the organization is not only providing vanguard, cutting-edge services but is providing those services at a high-quality level, lest patient satisfaction scores and other demanding assessments fall into the negative column. And as steady staff members become unsteadied and unsure in undertaking their daily job responsibilities in the face of all of this change, which they firmly believe will get worse before it gets better, the healthcare and physician leaders in our profession must be beacons of hope, stewards of a purposeful course, and a source of positive impact and progressive growth and development—all in one day, every day. A tough charter indeed and one that we hope can be met with this book.

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The Manual of Healthcare Leadership: Essential Strategies for Healthcare and Physician Leaders is intended to be an immediately useful, ready-to-apply handbook as you undertake this tough charter. We are fortunate as authors to have garnered a practical perspective based on over 60 years of combined experience in healthcare, physician, and organizational leadership. We also have the opportunity to be both innovators and educators at several leading healthcare and medical institutions, and our work has included curriculum design and course content. We have been provided with a wealth of acumen gleaned from the most important source of effective healthcare and physician leadership strategy: the knowledge and practices of hundreds of successful healthcare and physician leaders at all decision-making levels in scores of healthcare organizations that have provided their communities with stellar health care based on the true power of people.

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Rather than providing another theoretic tome or a catchy collection of trendy psychobabble phrases and vacuous argot, this book seeks to provide relevant and resonant information by using a very accessible and viable two-part cadence. In each chapter, first an overall aegis of information and insight into critical leadership and management accountability is provided based on current practice and effective employ. Second, detailed but efficiently presented information is augmented by strategies and practical applications that can be employed by your organization immediately upon reading and understanding their import and employ. A reader can certainly start on page one of this book and continue apace to the last page, all the while acquiring useful and applicable knowledge, as we have organized the content in a sequence that not only charts the initial responsibilities of a healthcare leader, but also parallels the chronology of management and leadership development in a progressive manner. Additionally, each chapter contains specific leadership and management responsibility that can be accessed as needed due to the clarity of enumerated organization and the ready-to-use proven strategy resources provided.

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Our intention for this book—in fact, our sincerest aspiration for this effort—is that all our readers will find immediate use which will help them navigate the most potentially treacherous aspects of their job—maximizing the performance of each staff member in the interest of collectively providing peerless health care to their service community. In this regard, readers of this book can range from senior executives to board members to department heads to team leaders and supervisors to students, both in the classroom and on the job, who aspire to become leaders in the most demanding of all human services—healthcare and medical leadership. As patients are increasingly aware of costs and new dimensions of the medical services, they feel compelled to closely scrutinize every aspect of health care delivery. Accordingly, sharp assessments are conducted in every stage in the delivery of the health care that seems to be both more expensive and more complex. And while they might not be experts in medical services nor health care delivery economics, current patients do consider themselves very well qualified to make a critical assessment on the quality of compassion and communication extended to them in the care process. The human touch must be extended by each and every member of a healthcare organization and encouraged by the healthcare leader who is charged with the critical responsibility of selecting, training, guiding, and assessing members of their staff. While undertaking this responsibility, the healthcare leader must also negotiate, plan, resolve problems, manage change and crisis, and handle any other challenges that require a near Herculean effort on a daily basis.

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This book will be a capable resource in assisting you in undertaking these somewhat daunting responsibilities. Each segment of the book presents the why, what, and how of each critical management and leadership responsibility. That is, the book provides exposition of the rationale and need for a specific management and leadership responsibility, explains the context for the aspect of management, and then provides specific strategies and proven systems in such critical areas as selecting the right staff member, conducting a criterion-based performance evaluation, and preparing change action plan for your team. Instruction is provided in this book not only with text, but each diagram and resource section has been innovated purposefully to specifically provide sequential thinking and progressive application for a critical dimension of management and leadership. Honoring the Druckerian Philosophy that management involves doing things right, and leadership is all about doing the right things, a plethora of strategies throughout the text are presented with the triad of why, what, and how that should be easily resonant and evidently applicable to your specific responsibilities as a healthcare manager and leader.

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The book begins with strategies on how to make the vexing transition from staff member or professional to manager and leader. Chapter 1 “Making the Transition to Physician Leader” uses the platform of the Peter Principle of Healthcare to help you to avoid common pitfalls in making a smooth transition and ensuring that your initial foray into management is one teeming with positive impact and a strong foundation for success. Chapter 2 “The PACT System for Strategic Leadership Communication” continues the discourse by presenting the PACT Formula, a very intuitive application that will assist you in setting goals and plans, establishing policy, and enhancing your foundation of management and leadership. Chapter 3 “A Healthcare Leader's Guide to People Management” provides a comprehensive perspective on people management and includes specific instruction on how to manage all of your human capital. The chapter's resource section is supplemented by a validated interviewing and selection system that is in use at many leading healthcare organizations to help you select the absolute best candidate from both internal and external application pools. Chapter 4 “Dealing with Politics, Problems, and Process” deals in a forthright, direct, and thoughtful manner with the potentially perilous combination of change, crisis, and conflict. In addition to providing tutelage on the catalytic factors of this omnipresent and often treacherous confluence, a change management guide is detailed in the resource section that will assist you in being proactive in not only avoiding problems but truly turning challenges into opportunities past the clichés and bromides. Chapter 5 “Practical Strategy for Planning” delves into the essential leadership accountability of planning by examining various aspects of planning and delineating a practicum on the major steps inherent to the planning process. The chapter concludes with a very powerful tool, the Change Readiness Index (CRI), that has been maximized by a number of healthcare and medical organizations as a comparative organizational survey and scorecard that can then act as the foundation for truly meaningful and efficacious strategic planning.

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In Chapter 6 “Motivation, Communication, and Negotiation,” the book pivots toward the trifecta of communication, motivation, and negotiation– the individual accountabilities of a healthcare leader that can have profound positive impact on all members of the organization. The chapter's resource section contains a criterion-based performance evaluation system used by leading healthcare medical organizations which can also be implemented as it has been at many progressive organizations as a pay for performance system that truly enhances positive motivation for the strong members of the organization while eliminating those who lack motivation, ability, or knowledge to contribute at a level commiserate with their paycheck. Chapter 7 “Maximizing Team Action and Individual Performance” fuses the individual responsibilities of the leader with the selfless action vital to inspiring a team with the dynamics of strong team building that ensures your staff is well positioned for both present and future demands. A maxim in health care is that what we did today is likely not going to be good enough for tomorrow. Chapter 8 “Encouraging Creativity and Innovation” moves to the important responsibilities of inspiring innovation and creativity by pragmatically and logically illustrating several strategies and tactical actions that can be used to tap creative contribution from both the staff members who you believe are capable of being thought leaders, as well as those who might be hidden gems among your charges. In a similar vein, Chapter 9 “Education and Development Strategies” helps you to prepare for tomorrow by exploring practical strategies in the areas of education and development. A very useful job resource is provided at the end of this chapter to help your leadership and management development by exploring critical questions attendant to many situations you may face on a daily basis and arriving through the use of those questions at the best possible solutions. Finally, Chapter 10 “Applying the C-Formula: Strategies for Staff Engagement” brings the book to a strong functional conclusion by detailing the critical C-Formula that provides both a comprehensive review of the critical lessons contained in this book and puts forth some more new and viable strategies for your use.

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We would like to acknowledge and thank all of the great folks at McGraw-Hill Education, all of our friends and colleagues in the wonderful world of healthcare and medical management and leadership, and, most of all, our families who have been the prime teachers of our leadership acumen. We hope that the knowledge, support, inspiration, and care provided by all of these great people have helped to shape this book and that it will be useful as you continue to do good work.

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Donald N. Lombardi
Anthony D. Slonim

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