The Strategic Leader - Northern Manhattan Perinatal

Report
National Healthy Start Association Leadership Institute
August 4th and 5th 2007
Lecture Theme:
Where Do We Go From Here?
Defining the Healthy Start Project Director’s Leadership Challenge:
Transforming Vision & Hope into Reality!
Mario Drummonds, MS, LCSW, MBA
Executive Director/CEO
Northern Manhattan Perinatal Partnership
Principle Investigator, Central Harlem Healthy Start Program
1
LEADER LEARNING OBJECTIVES:
1. Provide a Working Definition of Leadership & Leadership
Types
2. Determining Forces of Change in External Environment
3. Positioning Your Healthy Start Program in the Environment
4. Learning about the Visioning Thing!
5. Connecting the Dots between Assumptions about External Environment, Vision/Strategy
and Organization Core Competencies: Dr. Peter Drucker’s Theory of the Business
Concept
6. The Importance of Organizational Strategy
7. Leadership & Management: What is the Difference?
8. Cultivating & Nurturing a Performance-base Culture & Values
9. The Art & Science of Execution
10. MCH Leadership Challenge Assignments
11. Leadership Tidbits & Lessons for the Future
2
WHAT IS LEADERSHIP?
Leadership is the self-defined capacity to communicate
vision and values while providing programs, structures
and core services that satisfy human needs and
aspirations while transforming people, your organization
and society in the process!
3
Leaders are Dealers in Hope!
Leaders Help Organize a People’s Hopes & Dreams!
Leaders Take the Assets they are given Today (People,
Structure and Programs) and Make Them More
Valuable Tomorrow.
Leaders stretch their organizations beyond their current
capabilities and structure by challenging everyone to do
what they think is impossible to do.
4
THERE ARE THREE TYPES OF LEADERS:
• Transactional Leader
• Transformational Leader
• The Strategic Leader
Which Leader Type Are You?
5
Transactional Leaders:
Transactional Leadership generally appeals to extrinsic
motivation, depends on the exchange of performance for
rewards, tends to foster compliance and/or self-interests on the
part of followers, and relies heavily on the exercise of:
• AUTHORITY
• POWER
• INFLUENCE
6
Transformational Leaders:
Transformational leadership generally appeals to intrinsic motivation, fosters
the internalization and ownership of the vision, mission, values and
goals…and encourages followers to work for the good of the organization!
-Articulates a vision of the future
-Develops vehicles for getting there
-Communicates and gets people aligned to the
vision
-Motivates, inspires, and empowers staff
-Is focused and centered
-Leads and manages transformational change
7
The Strategic Leader:
Strategic leadership is generally provided by the top-level manager(s) of an
organization whose primary responsibility and concerns involve the survival,
growth, and long-term economic viability of the enterprise…and with
creating value for its customers, employees, and key stakeholders. The
Strategic Leader:
-Is proactive and strives to create a desired future
-Thinks and acts strategically
-Establishes and maintains strategic direction
-Is concerned with both the present and the future
-Has strong positive expectations of performance
-Is imbued with the entrepreneurial spirit
8
UNDERSTANDING THE FORCES OF CHANGE EXTERNAL
TO YOUR PROGRAM
Leaders must possess the skills to act in advance of the
critical changes going on in the environment if they are
to succeed. We must anticipate the big opportunities
of the future and commit your agency to doing what it
takes to take advantage of them!
9
Cont’d.
Leaders must have bifocal vision with the ability to perceive
accurately things happening further out toward the horizon that
will inevitably impact the agency, as well as possess the ability to
focus the agency on the immediate, pressing events in the
environment.
10
Cont’d.
No single aspect of managerial skill is more important than a
leader’s assessment of the external landscape of how patterns of
converging and diverging trends fit together. If this work is
completed incorrectly, the agency’s strategic positioning will
likely be wrong. Leaders will be tempted to develop the wrong
capabilities, hire the wrong people, or enter the wrong markets.
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INTRAORGANIZATIONAL ASSESSMENT• Power, influence & position of Healthy Start Program
inside your agency or health department
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CUSTOMER ANALYSIS:
Preparing for the 2009 Competitive Application
• Growth of women over 35 Pregnant
• Ethnic & class changes of WOCB age
• Birth rate declines or spurts
• Immigrant women influx into project area
• Teen pregnancy rates
• Status of African American, Latino and
White men in your project area
• Aging of the U.S. Population
13
Cont’d.
•
•
•
•
•
•
Life Expectancy Rate
Community Infant IMR & LBW Rates
% of Women with Gestational Diabetes
Local C-Section Rates in your Community
Local Mother-Child HIV Transmission Rates
Local Maternal Mortality
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POLICY ANALYSIS:
Local, State & Federal Search for Opportunities
•
•
•
•
•
•
•
Children’s Health Insurance Battle on Hill
CDC recent policy on interconceptional care
Recent Medicaid Documentation Policy
Dr. Michael Lu’s MCH Racial Disparities Theory
CDC’s RFP on Steps to a Healthier U.S.
National Focus on Childhood & Adult Obesity
Spread of Electronic Medical Records
15
LEGISLATIVE DEVELOPMENTS:
• Reauthorization of National Healthy Start Program
• Senator Bond (R-MO) Home Visiting Legislation
• Impact of Prematurity Research Expansion and Education of Mothers Who
Deliver Infants Early Act-Passed Congress in December 2006
• Postpartum Depression Screening Bill in Florida & New Jersey
• Senator Frist’s Minority Health Bill
16
Cont’d.
• National & State Cuts Proposed in Medicaid Spending
• Florida & New Jersey Passed Post-Partum Depression
Screening Laws
• Local and State Changes in Mayor or Governor’s
Offices
17
PHYSICAL ENVIRONMENT SCAN:
• Status of the housing crisis in your town
• Update on shrinking of poor, working and middle classes in
your town
• Pollution Dumps & Bus Depots Near Pregnant Women
• Recent floods and rain storms on neighborhoods
• Where our women live-“Katrinaization” of MCH care and public
health response systems : PLACE MATTERS!
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Cont’d.
• Stage of Gentrification of Local Community
• Status of Pregnant Women in other Systems-PrisonFoster Care-Juvenile Justice
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ECONOMIC ANALYSIS:
•
•
•
•
•
•
National Debate in Congress about Minimum Wage
Impact of Welfare Reform on your MCH population
The rising cost of healthcare in US and your city
Rising number of people who are uninsured
Health Workforce Shortage Data
The Impact of Managed Cared on local MCH industry and your
Healthy Start project
• Earned Income Tax Credit
20
MCH HEALTH ANALYSIS:
• Obesity Epidemic Impact on MCH Population
• Review latest studies concerning racism/stress on the
number of Black women who deliver low birth weight
infants
21
COMPETITIVE SCAN:
• Nurse Family Partnership
• Healthy Families America Home Visiting Programs
• Community Health Worker Programs
• Plans for Model Integration into MCH System of Care in the Region?
• Hospital Consolidation Activity in Region
22
Based on the Analysis of Your Local Climate, How will
you Reposition Your Program to take Advantage of
Possibilities that are lodged in the Future?
23
“The Best Way to Predict the Future is to Create It”
Dr. Peter Drucker
24
“The Only Way to Discover the Limits of the Possible is to
go Beyond Them into the Impossible.”
Arthur C. Clarke
25
While politics is the art of the possible, leadership is the
art of making the impossible come true! Leaders play a
role in constructing an agency’s strategic intent that
represents an ambition that stretches far beyond the
current resources and capabilities of the agency or
program.
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Vision Statement
STATEMENT ON WHAT THE AGENCY OR PROGRAM CAN
BECOME IN FIVE TO TEN YEARS. IT IS ALSO A STATEMENT
ABOUT HOW AND WHEN THE AGENCY WILL CREATE A NEW
SITUATION FOR THE CUSTOMER BASE IT SERVES.
IT COMMUNICATES HOW THE AGENCY WILL CHANGE. IT
COMMUNICATES HOW THE FOCUSED PROBLEM WILL
TRANSFORM AND WHAT NEW POSITIVE CONDITIONS WILL BE
CREATED AS A RESULT OF THE ORGANIZATION IMPLEMENTING
ITS MISSION!
Strategic Intent-Strategy as Stretch
Strategic Intent is a clear concept of the future for the agency. It implies a significant
stretch for the program. Current capabilities and resources are insufficient to the task.
Whereas the traditional view of strategy focuses on the “fit” between existing resources
and emerging opportunities, strategic intent creates by design, a substantial “misfit”
between resources and aspirations.
An organization’s strategic intent shows the leadership what new core competencies it
must begin to build right now, what new customer groups it must begin to
understand right now what new structures it must build right now to intercept the
future!
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cont’d.
Perhaps one of the most compelling strategic intents ever articulated was Christ’s command to his tiny
and impoverished band of followers to “Go into the world and preach the gospel.” Strategic Intent is as
much about the creation of meaning for your employees as it is about establishing direction.
Assumptions About Your Environment, Vision, Programmatic Thrust, Core Competencies and
Structure Helps an Agency Select Strategies to Arrive at the Future.
All of these Assumptions Must Fit! Dr. Peter Drucker defines this reality as “The Theory of the
Business”
Examples of NMPP’s Efforts to Build Corporate Core Competencies & Strategies:
•
•
•
•
Social Health Marketing Group Development
Early Childhood Strategy
Hospital Strategy
MCH Advocacy Strategy
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So What Are Some of the Strategic Choices
You as Program Directors Can Implement
Today?
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•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Hospital Strategy
Local, State, Federal Advocacy Strategy
Early Childhood/MCH Collaboration Strategy
Outcome-based Case Management Strategy
MCH Chronic Disease Strategy
Perinatal Economic Development Strategy
Child Welfare/MCH Collaborative Strategy
Women’s Health Strategy
Perinatal Regionalization of Care Strategy
Women over 35 Strategy
Healthy Start Sustainability Strategy
State Title V Strategy
MCH Home Visiting Integration Strategy
Social Determinant of Health Strategy
Neighborhood Base Building Strategy
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Strategies should be subversive. They should challenge an industry’s way of doing
business thus creating more value for the Healthy Start program’s customers.
A strategy is basically a choice about performing activities differently or performing
different activities. A strategy should also tell the planning entity what it should
not be doing!
Strategies should define what makes the planning entity unique and what niche in
the market (or what new markets) the planning entity will position itself in to
achieve its mission and vision.
32
Managers & Leaders: What’s the Difference?
• The manager administers; the leader innovates.
• The manager is a copy; the leader is an original.
• The manager focuses on systems and structure; the leader focuses
on people.
• The manager relies on control; the leader inspires trust.
• The manager has a short-range view; the leader has a long-range
perspective.
• The manager asks how & when; the leader asks what & why.
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• The manager has her eye on the bottom-line; the leader has her
eye on the horizon.
• The manager imitates; the leader originates.
• The manager accepts the status quo; the leader challenges it.
• The manager is the classic good soldier; the leader is his/her
own person.
• The manager does things right; the leader does the right thing.
• The manager manages inventories, supplies and data; the leader
catalyzes, stretch, and enhance people.
• Managers push and direct; leaders pull and expect.
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The Role of the Healthy Start Director in Cultivating a
Performance-based Culture!
An Agency’s Culture Consists of the Deeply Shared Values and Beliefs of its Staff, which are
Displayed in how the Agency and its People Behave toward each other and their Customers!
An Agency’s Values are the Link between Emotion and Behavior. They are the link between what
Staff Think and What we Do.
You will have to determine what values the agency will live by and what kind of culture will be
established at your agency.
Does the culture in your agency support disagreement among staff or squashes disagreements? Is the
client viewed as a customer that needs to be satisfied in your agency or is the client treated as a
secondary person in the service plan?
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Did Janice receive a promotion based on merit or based on who she knows at the agency?
Is mistrust rampant in your agency or is trust used as a management tool to spur greater
performance?
The answers to the above questions will determine if your agency’s culture can support the
attainment of the vision, mission and strategy of your agency.
As the health care environment changes rapidly and funding uncertainty reins, your staff
needs something that is constant in their work lives as social change occurs all around
them.
An agency cultural values are touchstones, moral navigational devices that steady ones
nerves and provides a sense of stability and direction. My staff relied on our agency
culture on September 11, 2001 after the World Trade Center Crisis.
36
Leaders build performance-based cultures by teaching, doing and living the values agreed
on by the staff. Staff examines the behaviors of their leader to see if she/he really believes
in the values they communicate.
Your challenge is working and living together after the consultants are gone! Your job as
a leader is to help your staff find meaning and satisfaction in what they do day-to-day.
I suggest that you either call in a consultant or have your human resources director
convene a meeting with staff to discuss what the core values are that establishes meaning
within the agency.
Have the consultant obtain feedback from all staff- managers and line. Then publish your
findings and reward staff with concrete and intrinsic rewards for living the values.
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HERE IS ONE EXAMPLE!
1.
2.
3.
4.
5.
6.
“THE NMPP WAY”
Vision, Respect, Commitment, Teamwork, Results!
To perform up to the highest measure of competence, always.
To take initiatives, asks questions, absorb risks.
To adapt to change.
To make decisions.
To work cooperatively as a team.
To be open, especially with information, knowledge, and news of forthcoming or actual
problems.
7. To trust, and be trustworthy.
8. To respect others (customers, vendors and colleagues) and oneself.
9. To answer for our actions, to accept responsibility.
10. To judge and be judged, reward and be rewarded, on the basis of our performance!
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Bringing it All Home: Transforming Vision into
Reality!
LEADERSHIP IS THE SELF-DEFINED CAPACITY TO
COMMUNICATE VISION AND VALUES WHILE
PROVIDING PROGRAMS, STRUCTURES AND
SERVICES THAT SATISFIES HUMAN NEEDS AND
ASPIRATIONS WHILE TRANSFORMING PEOPLE,
YOUR ORGANIZATION AND SOCIETY IN THE
PROCESS!
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Guiding Vision:
The leader has a clear idea of what he or she wants to do and
the strength to persist in the face of set-backs, even failure to
achieve the vision.
Leaders develop a radar system (information database) that helps
them connect the dots between their agency and the external
world. Leaders’ internal and external systems should help you
anticipate futures that are different from the past or present.
40
Leaders Communicate Passion:
Leaders have an underlying passion for the promise of
life, combined with a particular passion for a vocation, a
profession, a course of action. The leader who
communicates passion gives hope, meaning and
inspiration to other people that they work with.
41
Leaders Possess Integrity:
Leaders possess integrity. This ingredient is made up of
three flavors: self-knowledge, candor, and maturity.
42
A leader has to be in tune with her inner most strengths
and weaknesses. The leader must feel comfortable being
true to oneself. The leader must possess a fundamental
soundness or wholeness. A leader cannot cut his or her
consciousness to fit this year’s fashion.
43
Finally, a leader becomes a leader through years of
growing, learning and experiencing through being a
follower. Trust & Integrity are by-products of
leadership because they are qualities that cannot be
acquired, but must be earned. It is given by co-workers
and followers, and without it, the leader cannot function.
44
Leaders are Curious & Daring:
The leader wonders about everything, wants to learn as
much as she/he can, is willing to take risks, experiment
and try new things. The leader does not worry about
failure, but embraces errors, knowing she/he will learn
from them.
45
To become a leader then, you must become yourself;
become the maker of your own life. Leaders are not
born with the traits mentioned above, they are selfmade. Leaders, invent themselves, change their
organizations and then invent the future!
46
Execution: What Separates Your Organization from
the Competition:
The main difference between your Healthy Start program and your
competitor is the ability to execute your plans and measure results!
Execution is the missing link between Aspirations and Results!
Without execution, the breakthrough thinking we engaged in today
breaks down, learning adds no value and your staff fails to their
stretch goals.
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Execution has to be a part of your agency’s strategy and goals. Execution
is a systematic process of rigorously discussing how’s and what’s,
questioning, tenaciously following through, and ensuring accountability.
It includes making assumptions about the business environment, assessing
the organization’s capabilities, linking strategy to operations and the people
who are going to implement strategy. SYNCHRONIZING those people
and their various disciplines, and linking rewards to outcomes. These
actions are the substance of execution, and leaders cannot delegate them
regardless of the size of the organization!
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Summary: The Audacity to Lead!
The day you all were hired by your agencies is the day you stepped into the
cauldron of action, power and pressure where you had to practice rather than
merely preach.
Leaders are their own raw materials. You possess the ability to follow your
inner voice which taps native energies and desires. The success or failure of
your Healthy Start program depends on your ability to motivate people, nurture
a results-orientated culture, build unified teams and deliver quality maternal and
child health services.
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If you carry out the tasks outlined above colleagues, you
will face and honor your leadership challenge which is
to unlock the vast potential in your organization and
build lasting capabilities. Your job is to fix problems,
keep your agency’s vision and mission on the minds of
your staff.
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I am challenging you as executive directors and program
directors to manage & lead as though you held no rank,
as though you have to depend on the quality of your
ideas and the examples you set as leaders to have people
follow you! If you held no title, would your staff still
follow you? What you are speaks more loudly than
what you say!
Anticipate…Analyze….Act!
LEAD FROM THE FRONT! DRIVE CHANGE! CREATE
THE FUTURE! DON’T LOOK BACK!
Healthy Start Directors…
IT IS TIME TO TAKE THE LEAD!
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For More Information Contact:
Mario Drummonds, MS, LCSW, MBA
Executive Director/CEO
Northern Manhattan Perinatal Partnership
127 W. 127th Street
New York, NY 10027
(347)489-4769
[email protected]
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