Leverage the Present to Build the Future

Executives at a Wisconsin health care network figured out how to fill its leadership pipeline.

By Nancy Noelke Mar 1, 2009

March 2009 CoverIn 2003, Deb Rislow was information systems director. Now, as chief information officer and interim vice president of an operating team, she oversees 900 workers and a budget of $154 million. She credits much of her progress to the leadership program developed by her employer, Gundersen Lutheran Health System in La Crosse, Wis.

Our integrated health care delivery system includes a 325-bed medical center, a multi-specialty medical practice, 41 clinic locations and affiliated organiztions. In 2008, we hosted more than 1.29 million outpatient visits.

Our 6,834 employees include 434 physicians, 268 associate medical staff members, 225 managers and supervisors, and 70 senior leaders.

In 2001, we began studying nationwide projections on the coming shortage of health care leaders. By 2010, experts estimate that more than 40 percent of all health care managers will be 55 or older and considering retirement shortly. Meanwhile, increasing complexity in health care and in the economy requires highly skilled talent. We asked, "Do we have a ready supply of leaders prepared to step into increasingly complex and demanding roles?" We developed a systematic approach to talent development that allows us seven years later to more confidently answer "yes."

Why Grow Leaders?

Growing your own leaders makes sense from recruitment and retention standpoints. "It ensures continuity, sends a positive message throughout the organization and provides better odds of a good cultural fit," says Kathy Klock, senior vice president of operations and human resources.

"As we develop talent, we seek to find the right blend of maximizing an individual’s strengths while meeting the organization’s strategic needs," says Mary Ellen McCartney, chief learning officer. Finding the right person, right position and right work serves as a compass. In his compelling book Good to Great (HarperBusiness Publications, 2001), Jim Collins discovered that leaders of great companies first focus on getting the right people "on the bus" and then decide where to take it.

In 2001,Gundersen Lutheran’s Chief Executive Officer Dr. Jeff Thompson charged HR officials with researching best practices in talent development. We devoted staff time to researching best practices and began to build a program using senior leaders as the pilot group to test assessments and tools.

Leadership at the Top

By 2003, the program was conceived and led by senior leaders. A Talent Development Review Group was championed by Dr. Thompson and sponsored by Klock, and it consisted of the chief medical officer, the senior vice president of business services, the chief learning officer and me, an internal consultant for talent development. We are accountable for developing a strong leadership bench, making development moves happen and actively overseeing the growth of high-potential talent.

We developed five core processes: defining leadership competencies, identifying high-potential talent, assessing leadership capabilities, creating development plans and tracking ongoing progress. This gives us an accurate picture of leadership bench strength, capability and readiness.

Diverse Offerings

Here’s how Rislow, the former information systems director, began developing as a leader:

Throughout her progression from systems analyst programmer to information systems manager to the director of information services, Rislow demonstrated strong analytical skills, a drive for operational excellence, and the ability to translate and implement vision into action.

Her aspiration, when she was invited into the talent pool in 2003, was to bring all business and patient-care systems to an electronic paperless environment.The Review Group identified that she needed closer access to senior leaders and could benefit from playing a key role in the organization’s strategic planning process. Through a stretch assignment in corporate strategic planning, the organization benefited from Rislow’s analytical skills while allowing her to demonstrate her ability to engage senior leaders in advancing the corporate mission, vision and strategy.

Five core processes help executives gain an accurate picture of leadership bench strength, capability and readiness.

- Nancy Noelke

She has gone on to lead systemwide change projects, including implementation of a new electronic medical record that went live in November 2008. Rislow reports, "I have learned new skills that have allowed me to assist in bringing about large sustainable change." In addition to her new duties, she continues to lead the organization’s strategic planning.

Five Core Processes

Here are details about each step in our leadership development process.

Define leadership competency. If you aren’t sure of the most critical knowledge, skills, experiences and traits required of your leaders, you will likely not find them. We spent two years building a tiered leadership competency model that includes criteria for executives, directors and managers to ensure well-defined profiles with the right mix of skills, knowledge and attributes to address the challenges facing the organization. Today, Gundersen Lutheran’s competency model reflects nine areas: operations, finance, vision, strategic thinking, building partnerships and teams, staff development, change management, performance management, and leadership character. The tiered model defines behaviors and competencies demonstrating excellence in each role. The competencies are integrated into HR processes including behavioral interview questions, position descriptions and development offerings. They form the bases for 360-degree feedback and talent assessments.

Identify high-potential talent. In 2003, the Review Group began selecting high-potential candidates for consideration in one of four leadership levels. Theselevels consisted of a physician-executive pool, a pool for physician administrative leadership, an administrative executive pool, and a pool for high-potential administrative leaders at the director level.

Selection was based on performance in the key organizational strategies and demonstration of the competencies. Pool members also need to demonstrate an interest and willingness:

  • For upward advancement.
  • To participate in a leadership assessment process to determine individual skills gaps and development needs.
  • To receive development feedback and coaching to get a realistic view of current performance and develop skills and competencies for future work.
  • To assume assignments or roles that provide development opportunities.
  • To invest the time and effort required to learn new skills, grow professionally and report progress with members of the Review Group and their respective vice president or manager.

In the five years since we began the talent pools, 60 high-potential employees in all levels of leadership have been identified and assessed and their career paths discussed. As a result, new leaders have effectively stepped into expanded or new roles as they became available. In these five years, Gundersen Lutheran has promoted four high-potential directors into chief roles and six high-potential managers into director roles, expanded roles for nine high-potential managers and directors, and created a solid bench for all senior leadership positions.

Assess talent. Once high-potential candidates have been identified and invited into pools, their individual development needs are discovered through use of many robust assessment tools, shown at right.

Gundersen Lutheran Health System
La Crosse, Wis.

Services: An integrated health care delivery system including a 325-bed medical center, a multi-specialty medical practice, 41 clinic locations and affiliated organizations.

Patients: 1.4 million outpatient visits in 2007.

2007 gross revenue: $1.1 billion, net revenue: $638 million.

Top managers: Dr. Jeff Thompson, chief executive officer.

Employees: 6,834.

Locations: Western Wisconsin, southeast Minnesota, northeast Iowa.

Connections: www.gundluth.org(800) 362-9567.

McCartney and I serve as internal coaches trained to interpret the data and provide a summary of leadership strengths and development needs for each candidate. Together with the Review Group, we determine an initial strategy for closing the gap between where the candidates are and where they would like to be from a leadership standpoint.

Develop individual plans. We learned the importance of offering a diverse array of development opportunities while focusing on real-life experiences. We find that opportunities such as stretch assignments, role expansion and job rotations broaden the candidates’ views of the organization and stretch their skills and comfort levels.

Individual development plans are discussed and determined by the Review Group with contributions from candidates’ next-level leaders. Plans are based on organizational need and the candidates’ growth needs. They can include individual coaching, onboarding, continuing education, national learning networks, mentoring, project assignments, committee appointments, cross-functional stretch assignments, role expansion or job rotations.

An example of stretch assignments include those of an administrative director in the rehabilitation area who moved into the human resource operations manager role for three years before stepping into a broader role overseeing all hospital operations. Another example: Agrad student on a fellowship in an administrative position moved into a manager role in learning and development, then stepped into leading recruitment for three years and is now a senior consultant for HR information systems.

With such opportunities, candidates learn and potentially expand their functional capabilities, and the leadership team sees how the candidates perform when given greater responsibilities.

For instance, we created an experience-rich learning environment within the community for high-potential medical administrative leaders. Fifteen early- to mid-career physicians meet monthly with the CEO and members of the Executive Committee to discuss and engage in problem-solving around selected strategic business issues. Some examples of their projects include communication and integration of a medical staff compact, assistance in the development of an electronic medical record and organizational strategic planning.

Track progress. Setting milestones and success measures ensures that candidates actually build skills and experiences that apply to the leadership competencies and to future roles. We measure the impact of developmental activities through performance as well as feedback from peers and colleagues. The Review Group studies progress annually.

While numbers tell part of the story, we have also seen a cultural change among top leaders who now see talent development as a strategic imperative. The investment of time and resources has created an executive team that views its role as one of cultivating leaders and sustaining a long-term leadership pipeline for the future.

The author is a consultant for talent development at Gundersen Lutheran Health System in La Crosse, Wis.

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