Leading from the Back

A shepherd is a person who tends, herds, feeds, or guards herds of sheep. Because sheep eat grass, clover, and other pasture plants, they can't stay stagnate in one pasture for too long. The environment changes, and to maintain their health and productivity, the sheep must move from pasture to pasture; thus the importance of the shepherd--keep the flock intact, protect it from predators, and guide it to new horizons so that it can continue to grow. But does the shepherd lead the flock from the front or the back?

Obviously, shepherds have been "leading from the back" for more than 5,000 years (talk about opportunities for cycles of improvement), in one of the oldest professions known to man. Shepherds guide the flock, allowing individuals or small groups to go here and there, testing new ground or new spots to feed, but all moving in the same direction.

So, why am I writing about it here? Because in an upcoming Quest for Excellence^® presentation, Kevin Unger, PhD, FACHE, president and CEO, Poudre Valley Hospital and Medical Center of the Rockies of University of Colorado Health (formerly Poudre Valley Health System), will be discussing senior leaders’ roles in decreasing costs and improving outcomes while leading from the back.

According to Unger, there is great value for senior leaders to take a shepherding role--guiding their workforce, actively participating in improvement, and involving all senior leaders (including physicians) but giving the workforce opportunities to take initiative. For example, "Senior leaders create a focus on action through their active involvement in improvement team initiatives, but the involvement does not mean solving the problems for the teams," said Unger. He adds, no improvement methodology can be successful if it is not consistently applied--or supported by senior leadership, and front-line staff can problem-solve.

"The visibility of senior leaders is necessary for engaging the workforce in performance improvements," he said. Senior leadership, including physician leadership, need to be engaged for successful improvements to take place.

His presentation goal is to give audience members (and especially senior leaders) practical ideas on how to become more involved with improvement initiatives without undermining the work of improvement teams. Specifically, he will focus on what senior leaders can do to be actively engaged in both decreasing costs and improving clinical outcomes.

Unger says that Poudre Valley Hospital and Medical Center of the Rockies learned from its Baldrige journey (it received the Malcolm Baldrige National Quality Award in 2008) the importance of continuous improvement. According to Unger, using the Baldrige Excellence Framework (1) assists in identifying areas where your organization can focus improvement initiatives, (2) provides a structured framework for making system improvements and creating focus, and (3) is a disciplined approach for identifying areas of strengths to build upon.

To learn from this and other sessions featuring role-model Baldrige Award recipients sharing best practices, register for the Quest for Excellence, April 12–15, in Baltimore, MD.