Why Managers Need to Shift Focus from Putting Out Fires to Empowering Their Teams

In my reading stack this weekend (ok, virtual stack), I came across a number of articles on leadership and management. Some were good, some were not, and lots were focused on “old” issues and problems. One in particular, caught my attention – “Management as We Know it Is Broken: How can Leaders Fix It?” What really caught my attention is something I have written about and worked on for most of my career. From the article (available here https://www.corporatecomplianceinsights.com/management-broken-leaders-fix/?utm_campaign=Weekly%20Newsletters&utm_medium=email&_hsmi=294175633&_hsenc=p2ANqtz–BSRDzgqL_0jbqZF0_26WQALOZYafbLKmkuEAchMZuT1gSGiyzk0ivJdim0wQvzLxlVNHEXyF2M1o3RTA9ZyBNlT-3bw&utm_content=294177115&utm_source=hs_email )…

Recent studies highlight a concerning reality: Only a fraction of managers receive the necessary training to excel in their roles. According to the Chartered Management Institute’s recent Better Management Report, 82% of managers have not had any formal management and leadership training, and only half of the 18% who do receive any training go on to accomplish an associated qualification. 

This underscores a critical gap in preparing leaders for the complexities of their people-related responsibilities, which is having a knock-on effect on organizational retention — 50% of employees who find their managers ineffective are planning to leave in the next 12 months. People are voting with their feet, with staff more likely to jump ship and find new employment in cultures where they feel supported and valued by their managers. 

This is healthcare in the U.S. – spot on! Below the C-suite (and sometimes, within the C-suite), most managers from director level positions through manager and supervisor roles have ZERO formal management or leadership training. They have been promoted based on task competence or professional qualifications, not based on leadership or management aptitude. Some have demonstrated a core level of competency in day-to-day supervision but not for the most critical constructs that make effective managers and leaders. The report referenced above from the Chartered Management Institute – Better Management Report is available here: CMI_BMB_GoodManagment_Report

The primary failing of most managers in healthcare is their inability or lack of awareness on how their role is not to fix things for employees but to coach employees to find solutions and/or, to create environments where solution-finding is a common practice and systems exist to support such endeavors.  A simple example is when I was a young boy, I would ask my father how to spell a word. Dad would point to the bookshelf, to a dictionary, and say, “look it up”. When I told him I couldn’t spell it, that’s why I needed his help, he would say “start with what you know” and “bring the dictionary here”. Dad and I would sound it out, work on it, sometimes with a piece of paper. I always found the answer myself, maybe with a bit of coaching.  That’s good management.

When I have worked with C leaders on employment related issues or done webinars/seminars on staffing topics, I always remind them that their almost singular focus on recruitment is a bit of a “fool’s errand”. It has a bit of a dog chasing its tail characteristic.  Retention is the best recruitment tool as it makes recruiting less necessary and retained employees beget new employees in many cases. In nearly all regards, it is “cheaper to keep them”, and known that consistent staff produce better patient outcomes. A webinar that I did not too long ago on this subject is available here: https://rhislop3.com/wp-content/uploads/2023/03/new-concepts-in-healthcare-staffing.pptx

The primary cause of nursing and other staff turnover is culture and culture comes from management and leadership. I have watched organizations tank by having such a negative culture and ineffective leadership, to the point where sustainability is nearly impossible.  When 60% of an organization’s expense budget is typically labor related, bad leadership and bad management can make the difference between success or failure.  

Nurses surveyed give the following reasons for leaving their current positions: moving, personal matters, promotion, salary, retirement, and burnout. They also leave because they’re dissatisfied with their jobs, they’re given little independence or respect, staffing and scheduling don’t meet their needs, physician/nurse relationships aren’t collegial.  Today, burnout, an outcome of a poor, ineffective culture is a prime contributor to quitting, particularly direct care positions.

From a book titled, Corporate Culture and Performance (Kotter and Heskett),

Organizations with a performance-enhancing culture experienced:

• 682% revenue growth
• 282% employment growth
• 901% stock price growth
• 756% net income growth.

Organizations without a performance-enhancing culture experienced:

• 166% revenue growth
• 36% employment growth
• 74% stock price growth
• 1% net income growth.

Note, these are not necessarily health care organizations, but parallels exist. Companies with leaders that manage the corporate culture and develop managers and directors down the line to maintain the performance culture, outperform companies that don’t focus on culture.

By experience, the components that drive retention are as follows. 

• Good pay. This is not a top of the market qualifier, but it is a key component. Pay must be comparable to the market and personally, I like pay to be competitive internally as well. By this I mean, performance creates more pay, organizationally and personally. 
• Flexibility. This is all about being an employer that to the max possible, allows staff to craft their schedule and their benefits.  Some staff work for pay – make it happen.  Some staff work for benefits – make it happen. Develop self- scheduling and team scheduling.
• Respect. Employees want to know that what they think matters. They want to be treated as valuable members of the team with something meaningful to contribute. At the very least, employees don’t want to be yelled at, demeaned, or humiliated by abusive managers or coworkers.  Edicts don’t work. Mandates don’t work. 
• Autonomy. Employees appreciate being able to fulfill their work duties in a manner that suits their standards of practice and their personality and experience. Often, more than one way exists to achieve a goal, and staff value the freedom and flexibility to choose in ways that align with their standards of practice and the needs of their patients. Managers who insist that low costs are superior to excellent care frustrate staff and pushes them to other employment options.

My tips for improving retention and developing a positive work environment are as follows.

• Improve communication between administration, management, and staff. Any demeaning conduct from bullying to gossiping, to demeaning or defaming, to belittling or manipulation (let alone any harassment) cannot be tolerated and the same, will cause people to leave.
• Hold employees accountable for fulfilling their job and their work. Managers must learn how to give feedback, but accountability also must include coaching and reward.  Great organizations focus on reward more than on discipline.
• Hire slowly and fire quickly. Managers need to learn how to interview and hire. Poor performance cannot be tolerated and staff that violate key conduct rules or jeopardize patient care or safety, must be terminated immediately.  Tolerance of their presence creates a cancer and pushes away good staff. 
• Deal quickly with conflict. Good, competent people want to work with other competent people in places that value and support their talents. See above with regard to fire quickly.
• Focus on fairness. Make sure that all comparable staff are subject to the same standards and requirements. Employees who come to work on time and perform as expected don’t like it when coworkers aren’t disciplined for poor performance, etc.