Clinical Leaders as Change Agents: 3 Keys

For a number of years, there has been a widespread and persistent gap between the value-based delivery models many hospitals/health systems aspire to provide and the current volume-based reality. 

Clinical leaders at the executive level, such as chief medical officers, chief nursing officers, department heads, and others, have often been viewed as the key agents of innovation needed to bridge this gap. But in today’s evolving healthcare system, nurse managers, medical directors, department heads, and other front-line leaders are also being tasked with initiating and innovating performance improvements and supporting numerous enterprise-wide initiatives. We believe this positions these individuals at the critical juncture between driving clinical excellence and operationalizing enterprise strategy.

These clinical leaders uniquely combine the knowledge of a hospital’s culture and operations with in-depth clinical training and experience. They can be effective in persuading fellow clinicians to embrace new strategies and initiatives, such as evidence-based treatment protocols, population health management, cost-saving measures, and the related principles of value-based delivery systems. 

They can also effectively persuade administrative leaders such as CEOs to empower physicians with the highest level of clinical autonomy possible and allow them to play their dual role. The result can be a hospital or health system with a united staff, common goals, and a clear path to achieving them.

The role of clinical leaders is likely to become even more critical as a result of COVID-19. The pandemic is imposing a level of challenge and stress that either unites a hospital and its staff or deepens existing divisions. According to The Physicians Foundation’s 2018 Survey of America’s Physicians, 78 percent of physicians “sometimes,” “often,” or “always” experience feelings of burnout (Note: the survey was conducted for The Physicians Foundation by Merritt Hawkins, a company of AMN Healthcare). COVID-19 only adds to the level of stress and burnout many physicians feel, which hospitals will have to address to avoid turnover and regain momentum in a post-pandemic world.

Unfortunately, we have not properly equipped Front-Line Clinical Leaders to fulfill this side of their role in an organization. The key to enabling and engaging Front-Line Clinical Leaders is actually activating them to be true Innovation & Change Agents. There are three keys to this process:  

• Activation and enablement – To be innovating change agents, clinical leaders must have the highest degree of organizational support from the CEO level.
• Organizational influence – They must be authorized with real power and not be seen as figureheads. When they make a decision or enact a change, it has to stick.
• Continuous and ongoing role – Their role should not be limited to a particular project or point of implementation. They should be a permanent leadership fixture, not a one-time problem solver. 

Given real support, power, and an ongoing role, clinical leaders are in a position to effect meaningful and innovative change, but they must have both the “will” and the “skill” to do so. Both of these qualities can be developed in various ways. 

“Will” is developed by:

• Creating a shared mission through collaborative events
• Investing formal and informal time to discuss the hospital’s culture, mission, challenges, and goals.
• Providing clinical leaders with the opportunity to elicit feedback and present their perspectives.

“Skill” is developed through:

• Training on communication and management skills
• Providing the tools and techniques used to drive operational effectiveness and performance
• Educating leaders on critical thinking and non-clinical problem solving 

Most potential clinical leaders have, at best, divided their time between clinical duties and obligations and whatever management or leadership duties they may have been assigned or taken on. Some have spent little or no time on leadership activities. 

For most, becoming true Innovation & Change Agents is a journey with a number of sequential steps. Given the rapidly evolving and highly complex nature of healthcare, it is a journey that never ends. 

AMN Healthcare Advisory Services
AdvisoryServices@amnhealthcare.com