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Why Healthcare Leaders Should Build a Culture of Development

Why Healthcare Leaders Should Build a Culture of Development

Chart: data points are described in article

Story Highlights

  • Better employee performance means better patient outcomes
  • Leaders should create a culture of ongoing development
  • Managers can improve engagement by becoming performance coaches

With change permeating healthcare organizations, optimizing employee performance is more important than ever -- for both patient outcomes and organizational effectiveness.

It's alarming, then, that just one in five U.S. employees strongly agree their performance is managed in a way that motivates them to do outstanding work.

This is a costly problem, to say the least: Gallup estimates the cost of poor management and lost productivity from employees in the U.S. who are not engaged or who are actively disengaged to be between $960 billion and $1.2 trillion per year.

Broken performance management stems from the changing nature of work and modern employees' evolving needs. Millennial employees, for example, are looking for a coach, not just a boss. They want ongoing feedback, a rich sense of purpose, and continuous personal and professional development -- starting now.

The fix? Healthcare leaders must align their performance management tactics with changing workplace demands to ensure their people show up to work every day with the guidance, incentives and support they need to perform at their best.

Gallup's studies of high-performing teams prove that optimizing employee performance requires shifting from traditional, failing performance management practices to creating a culture of performance development.


In such a culture, managers learn to develop employees through frequent, meaningful performance conversations -- that is, future-oriented discussions that clarify expectations, celebrate successes, identify barriers and maintain accountability. The best coaches individualize these conversations based on employees' innate talents and 12 essential workplace needs.

However, for healthcare managers who oversee large or highly matrixed teams, serving as a performance coach for each employee can seem like a herculean task.

The following strategies can help healthcare organizations integrate frequent coaching conversations in clinical settings.

1. Embed conversations where they naturally occur.

Healthcare leaders can architect a culture of ongoing performance development by intentionally infusing coaching conversations in existing touchpoints, rather than reserving developmental discussions for one-on-one office meetings.

For example, managers can use morning huddles or impromptu hallway discussions to briefly "round" with employees -- asking about barriers, clarifying expectations and answering questions. Even brief conversations can promote an ongoing dialogue and communicate to employees that their manager cares about their development.

By seizing every opportunity for meaningful conversation, healthcare managers can build work environments in which developmental conversations are continuous, relevant and motivating.

2. Reduce spans of control with clinical coordinators.

For managers with very large spans of control, facilitating monthly or quarterly conversations with individual contributors is often logistically impossible.

In such instances, appointing and equipping nurses to facilitate ongoing coaching conversations can provide essential individualized development. Clinical coordinators continue front-line nursing duties, but are formally responsible for facilitating ongoing developmental discussions with an assigned group of nurses.

Relying on clinical coordinators provides essential individualized development, including quarterly goal-setting, accountability and strengths coaching. It can also prepare a succession line of future nurse managers and preceptors.

Clinical coordinators serve as a rich source of ever-present support. They are day-to-day, trusted counselors who hear opinions, remove obstacles and provide immediate feedback.

In Gallup's experience, because clinical coordinators maintain front-line responsibilities, they can readily foster credibility among their teammates, who tend to consider them relatable and knowledgeable about job demands.

To position clinical coordinators to thrive, healthcare leaders should select nurses with the right innate talents and provide ongoing education to further develop their capabilities.

3. Foster employee ownership and an atmosphere of development.

Healthcare leaders and managers should encourage employees to actively participate in their personal and professional development. This means creating an atmosphere in which employees feel comfortable asking for guidance about anything from prioritizing tasks to learning a new skill.

To set the tone for an environment of development, managers should challenge team members to share best practices, recognize one another's accomplishments and foster a sense of shared accountability.

This involves identifying behavioral competencies that define excellence in a role -- that is, successful actions that separate the best from the rest -- and teaching team members to apply their innate strengths to achieve these performance standards. When team members understand and celebrate one another's innate strengths, they perform at higher levels and deepen team employee engagement.

Managers should also advocate continuing education and on-the-job training opportunities. To help healthcare employees connect periodic learning opportunities to their future development, managers should clearly communicate how learning can advance employees' careers and help employees access learning opportunities that align with their long-term goals.

Changing Culture Requires Changing How We Work

Cultural transformation doesn't happen overnight. Still, employees today demand more from their companies, and proactively meeting those needs is essential for fostering exceptional performance. The payoffs for doing so -- in quality of care and business outcomes -- are well worth the effort.

Gallup can help you create a culture of high performance at your healthcare organization:

Bailey Nelson contributed to the writing of this article.


Ben Wigert is Director of Research and Strategy, Workplace Management, at Gallup.

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