CHAPTER 7

Administrative Leadership: Performing

There can be economy only where there is efficiency.

Benjamin Disraeli | British Prime Minister

All the preparation in the world combined with every strategic tool and decision platform would still be insufficient for extraordinary organizational leadership. To round out the process “administrative leadership” is needed. The reason for the name has to do with the importance of leadership on the spot, in each and every situation. There is a kind of leadership that must be prevalent and yet distinct from the anticipatory and strategic processes, though integrated with them. This kind of situation-based, repetition-strong leadership is akin to management, but it bears a heavy emphasis on people orientation in accomplishing objectives. Essentially, where anticipatory leadership scans the horizon and calculates the odds of success, and strategic leadership sets the course and plans for the worst, administrative leadership sets all hands on deck to keep things running.

It needs to be noted that this kind of leadership is often argued as being management and therefore not leadership. This false dichotomy has long been held, as proponents argue that leaders and managers are supposedly separate classes of supervisors. In the May–June 1977 edition of the Harvard Business Review, Abraham Zaleznik took this question to task with the piece, “Managers and Leaders: Are They Different.” In a 1992 reprint of the piece, he suggested that,

A critical difference between managers and leaders lies in the conceptions they hold, deep in their psyches, of chaos and order. Leaders tolerate chaos and lack of structure and are thus prepared to keep answers in suspense, avoiding premature closure on important issues. Managers seek order and control and are almost compulsively addicted to disposing of problems even before they understand their potential significance.¹

John Kotter built upon that argument with another article, first published in 1990 and reprinted in 2001, which suggested the differences did not necessitate mutual exclusivity; rather, he argued for their complementarity. Kotter wrote that “Management is about coping with complexity … without good management, complex enterprises tend to become chaotic in ways that threaten their very existence …. Leadership, by contrast, is about coping with change.”² Management, in this sense, is a mindset and skillset, which leaders need to cultivate for the work transition that occurs between the peaks and troughs of strategic change. Moreover, it is this mindset and skillset, constrained by strategic choices, that is herein called “administrative leadership.” The reason for my emphasis on administration should be obvious, that it is this set of leadership practices that oversee and administrate the daily choices of an organization’s strategic path. It is leadership, because it is held within the paradigm that change is ongoing and being harnessed through the other leadership practices.

What It Is: The Mindset and Language

Along the lines of the management toolkit, Gary Yukl and Richard Lepsinger note that “operational planning, clarifying roles and objectives, monitoring operations, and solving operational problems” are the key impact behaviors of leaders intending to increase efficiency and reliability within organizations.³ These are highly indicative of administrative leadership, as its endgame is continuance, and such behaviors are clearly aligned with management activities. The key difference, therefore, between pure management and this kind of administrative leadership is the impetus of strategic leadership guiding and guarding the behaviors’ application. Thus, my argument is that administrative leadership would be simple management without strategic leadership’s initiative, meaning strategic leadership can exist without administrative leadership, but not the reverse. The latter takes the leadership process within an organization to a higher level, empowering a synergy of doing “the right thing” and doing that right thing excellently. To be more specific, consider the adaptive cycle and how a solution to the entrepreneurship problem leads to an engineering problem and then to its solution; and in turn, that leads to an administrative problem. Management is the consideration of that administrative problem without the adaptive cycle as context. Administrative leadership, however, is the application of shrewd management with the adaptive cycle in mind. It’s management-mindedness supportive of strategic change. The motivation value of administrative leadership, then, is the important role it plays in creating organizational slack by refining the engineering problem’s solution, thereby making room for new solutions to new entrepreneurship problems to be discovered.

The administrative leadership mindset aims to stabilize the execution of strategic efforts by reducing the uncertainty that naturally accompanies new activities. Such aligns well with Yukl and Lepsinger’s (2004) flexible leadership model, being tasked with ensuring efficiency and reliability. Because their model is built on behaviors that prove leadership’s presence, their model assesses this leadership need by a combination of (a) “employee productivity, direct cost of operations, cost of sales, and return on assets,” and (b) the, “number of product defects caused during production, errors or omissions in providing products or services, avoidable delays in production or delivery of products or services, customer complaints, and accidents or injuries to employees or customers,” where the former category deals with efficiency and the latter with reliability.⁴ To prove “leadership” in these categories, leaders will utilize a combination of goal setting programs, quality and process improvement programs, cost reduction programs, performance management systems, structural arrangements, and recognition and reward systems.

Some of those categories will be more easily adapted for your health care contexts than others, but the notion of observation for the sake of proving efficiency is nevertheless valuable. It is a form of leadership analytics at work. Every assessment will generate value to the degree that it fits your organization’s goal interest. Observation is for the sake of maintaining strategic alignment over the long run. As Yukl and Lepsinger wrote,

Although each of these approaches can potentially add value and help an organization enhance its performance, the success depends on whether an approach is appropriate for the situation, whether it is implemented effectively, and whether it is supported by leaders at all levels of the organization.⁵

Given the earlier discussion of generic strategies, it should be noted here that administrative leadership of this kind is especially important for their extensive execution. Programs and efforts to decrease waste and rework are akin to decreasing input costs for manufacturing. As the workplace complexity rises, organizations have an increasing need for resource efficiency. It can become tempting to not delineate the work procedures, expectations, and schedules, as one moves closer to the work itself (i.e., as the levels of hierarchy decrease), but that generally leads to disorganization and disunity. The reason for the breakdown in organization management by measures, and the apparent absence of free and flexible decision making, can be found in how hierarchies breed opposition by disconnecting individuals from one another’s goals. When we separate units according to their tasks without expressing their mutually reinforcing goal positions, we give each no reason to promote the other’s good. We give ourselves no reason to reallocate resources to our hurt and the help of another unit that would ultimately help us more down the road. We narrowly focus on the goal-building objective we have been assigned and not on the organization-unifying goal itself.

Administrative leadership responds by keeping the aims of strategic leadership in the forefront, but it breaks those goals into accomplishable chunks according to divisions. It also identifies manageable schedules and accountability for that work. Additionally, replicable processes are necessary for scalability. And since organizations need added flexibility to innovate on processes to increase their efficiency, administrative leadership makes room and plans in vulnerability expectations (taking into account negative effects from any proposed change beforehand). Programs that identify and reduce customer complaints and formerly unaddressed issues improve product development and quality assurance and lead to more motivated employees and better asset returns. Furthermore, reliability gains in procedures ultimately translate to safer work environments and forecasting. When forecasting reliability for the internal situation improves, a major task is completed toward more effective anticipatory leadership (energizing the adaptive cycle). Again, it should not be assumed that the three forms of leadership practices simply follow in step-by-step order. They are all active concurrently and integrate with one another. What has been described in delineating their purposes, however, should help in understanding the key approaches to leadership which initiates innovation, reacts against it, and builds upon it.

Before delving into a couple powerful and proven tools of administrative leadership, we first need to address its other purpose beyond building efficiency and reliability into the execution of strategic decisions. That other purpose becoming ever more important with time is: building additional support systems for entrepreneurial insight development. Remember, this was a point highlighted in Chapter 4 in reference to the administrative problem of the adaptive cycle. Added stability stemming from solutions to the administrative problem help fuel this work by reducing the input resource needs, whether for:

• Personnel because task completion time decreases;
• Material resources because of economies of scale and duplicated procedural processes; and
• Experienced perspective on true needs and waste, or  otherwise.

As those systems for efficiency and reliability emerge and improve the execution and reduce the resource demands of strategic decisions, the capacity of the organization should increase in reference to the initial resource allocations. Essentially, this means the system should develop slack. You have people who can check more rooms in less time, more experienced methods of cleaning, or of identifying needs. You might have better operational expertise with your telecommunications systems, proprietary software, or organizational decision making processes. These would allow you to make the same decisions as you have previously made in less time and expend fewer resources in the process. What, then could happen as a result? You may experience one of two happenings.

First, your organization might become tighter and continuously more efficient and reliable. Hopefully, however, you realize that such a choice bears the added concern of locking you into a very inflexible competitive position. It could be a huge winner, but it would demand incredible faith amidst these rapidly changing health care circumstances and market assumptions and great uncertainty within our regulatory environment. Second, your organization could continue to operate more efficiently and reliably without changing its allocation of resources, meaning that while your resource demands go down, you continue to operate under the same needs assumptions. In that scenario, you end up having a lot of leftover materials or time, which functions as a very comfortable buffer in case your circumstances shift dramatically and your needs change on the fly. While such seems to be a wonderfully safe tactic, in fact, this kind of stocking up for emergencies is dangerous, because it does not consider the ramifications of reallocating resources and reevaluating risk. For example, by continuing to save time in certain tasks without reallocating any of it, your personnel are, at best, only improving their competence in their current roles and responsibilities. That improvement is only commensurate with their behaviors, and so their role and responsibility competence will not improve beyond that task list. Neither of these options displays a healthy approach to risk management or opportunity management. Moreover, unwillingness to engage in new solution-crafting (for the complicated rather than complex aspects of the environment) with some of the organization’s resource slack is a denial of the adaptive cycle premise that the environment, including the competitive environment, is regularly changing.

This is the often forgotten power and duty of management, which is not forgotten with administrative leadership, that of leveraging the slack resources for reinvestment on entrepreneurial and engineering problems. Your efforts at measuring across the organization for the sake of understanding opportunities for efficiency and then acting on them will also give you an indication of the quality and quantity of resources that are saved in time as you become more efficient. Moreover, discovering efficiency and reliability opportunities in one area will often lead to patterning processes in other areas for scope gains, for example, you institute a rule to cut down on paper waste in one department and see it works without creating obstacles for work and keeps the area cleaner and documents more manageable, then you test it in analogous areas throughout the organization to identify the validity of the rule. With the saved direct and indirect resources, which are known only if information is measured and progress tracked, you are able to duplicate efficiency gains and leverage savings in areas of uncertainty—on those innovation and entrepreneurial problems.

Reinvesting slack for anticipatory and strategic leadership practice gains is critical to why administrative leadership practices need to be thoroughly pursued. The better you are at what you do on a daily basis, the less anxiety those routine activities produce by their protocol and less chance those activities have of slowing your healthcare organization’s strategic path. Thus, you have the capacity to build new kinds of systems, not the kind which directly solve the entrepreneurship or engineering problems (if they did, then this would not be a practice of administrative leadership), but rather the kind which support the practices of anticipatory and strategic leadership. Examples of such solutions include monitoring systems for product output and performance evaluation, such as turnover rates, patient satisfaction, lengths of stay, product profitability, R & D expenses, and general budgeting. These investments are indirect supports. If you remember from our discussion on innovation in Chapter 2 how the spectrum of innovation with regard to technology can entail supporting technologies, then you have an idea of what a leadership practice that indirectly supports efforts to solve entrepreneurial and engineering problems looks like. For example, if your strategic planning efforts are fairly nascent or old and stodgy, then improving them would be an administrative leadership effort, since it would indirectly affect the efficiency and reliability of that anticipatory and strategic leadership behavior. You might install new planning software or streamline your booking process for leadership retreat venues, or your HR department could add new personnel to key areas that facilitate the anticipatory and strategic leadership functions. In particular, regarding personnel, areas that focus on customer preferences and the market conditions will prove especially important to increasing your external foresight and organizational communication competencies, the latter of which is at the core of administrative leadership. The dependability of information and the consistency of its flow may even be its essence.

What It Does: The Tools

Quint Studer’s Health Care Flywheel

In his personal and powerful work Hardwiring Excellence, health care leader Quint Studer provides nine principles of service and operational excellence to help health care organizations achieve bottom-line results. These principles guide actions that Studer argues help create momentum for changing the organizational culture of healthcare environments. Since we have already looked into the general components of organizational cultures, here we are more focused on health care in particular and the kinds of principles and practices that facilitate the efficiency of our efforts and the opportunities they can create. This flywheel Studer promotes consists of three components: self-motivated passion (the initial driver), prescriptive to-do’s that the nine principles guide, and the results of the actions across each of five organizational pillars (people, service, finance, quality, growth). Studer argues that this model illustrates the capacity for change within a healthcare organization that can remind its people of their purpose for being in the industry, prove through actions how their work is worthwhile, and ultimately that they are making a difference (as is the organization on the whole).

The first action for turning the flywheel is passion, which Studer speaks about in regard to self-motivation and that organizations need to do more on the end of constraining themselves rather than aiming to add something to their employees. Basically, managers do more to limit the passion their people have, day in and day out, than their people do to lose motivation. Their personal reasons for being involved in health care were already self-motivating. It tends to be operational policy and failing systems that put the hurt on that motivation and passion. We must do what we can, therefore, to remove obstructions and enhance the corporate conversation about success. Perhaps one of Studer’s greatest and most obvious points is that in healthcare we are trained to highlight problems so that they can be assessed and executed against. That kind of mindset, however, rarely has a chance to celebrate—a necessary and healthy behavior of sustainably high-achieving organizations. In that light, and as reiterated through Principle Nine, recognizing and rewarding success undergirds the construction of systems administrating and communicating value and achievement. You see, Studer’s principles for facilitating outstanding healthcare outcomes function as fantastic guidance for administrative leadership practices.

The second action for turning the flywheel is the set of prescriptive to-do’s that he recommends for producing the organization’s desired results in the five pillar areas. Measuring those areas tends to revolve around evidence of: (1) lowering turnover, (2) raising satisfaction across stakeholders, (3) improving service and quality, (4) increasing service capacity, and (5) improving the financial status.⁶ Results accrue when we follow the prescriptive behaviors for handling organizational problems that inhibit our strategic path and help us adjust course. According to Studer, these prescriptions are guided by Nine Principles. They are:

1. “Commit to excellence.”
2. “Measure the important things.”
3. “Build a culture around service.”
4. “Create and develop leaders.”
5. “Focus on employee satisfaction.”
6. “Build individual accountability.”
7. “Align behaviors and goals with values.”
8. “Communicate at all levels.”
9. “Recognize and reward success.”⁷

Each principle underpins particular administrative leadership practices that lead to a high-performance culture. These practices, in turn, produce results that our people can be proud of, which motivates and can help the organization reinforce the sense of purpose intrinsic to our field. As you might imagine, and as intended, this growing sense of purpose contributes to a recycling of the flywheel—refueling employees’ passion, reminding them of the value generated through the prescribed activities, and making that value visible in results across the five pillar areas. Let’s briefly address the practices each principle promotes.

Principle One deals with the motivation at the heart of all integrative leadership practices. If you are not interested in excellence for the sake of your personnel, your patients, your stakeholders, or even yourself, then you are in the wrong business. The key practices of this principle deal with setting the strategy in a similar format for each unit or division within your organization. The process does not need to be uncreative to be streamlined, and in fact, a clear and bounded process will give people greater freedom to understand where creativity needs to be focused. Moreover, it allows for greater cross-department understanding and interaction, since it establishes mutually reaffirming experiences regarding each’s approach to the organization’s mission, vision, and values.

Principle Two is where we address measurement as a means to manage the best and most important behaviors we want reproduced across the organization. In essence, this is the principle that motivates us to always think in terms of behaviors, practices, and actions that solve problems, enhance situations with added value, and limit our willingness to let issues fester unaddressed. In their studies, the Studer Group found four common drivers for patient satisfaction, something health care providing organizations need to be intensely concerned with (not mainly for reputation, but for the love of their patients!). These were communication, pain management, personal needs, and response to call lights. Thus, the practice of administrative leadership would include the measurement of how well and often and where we communicate with our patients and their receptivity and appreciation or concerns about that communication. It seeks to understand that data with follow-up communication with the patients and put that information gained to use as soon as possible— certainly with the responding patient but also in new circumstances to test for positive feedback. Additionally, the results from measuring all these areas should become open information among the organization. You cannot expect employees to get animated about issues going well or be motivated to higher levels of performance without also giving them the “highlight reels.”

Principle Three is about developing a service-oriented culture. The advice given here pertains to two practices. The first has to do with the establishment of teams that gain authority and responsibility for handling matters of process improvement across various issue areas. These are people with personal investment and concern for the area, and they do not simply function as a committee that has ideas; rather, they are vested with the power to implement changes themselves. The second practice deals with keeping people connected to the organization’s mission, vision, and values through scripted sayings. These are not pat answers. They are memorized reasons for why you do a certain action a particular way. It keeps patients/clients/stakeholders aware, and it is also a reinforcing mechanism for driving particular behavior. In this way, it affirms the administrative leadership practice of creating systems and promoting behavior that increases reliability. Studer remarks that, “Doctors are the best at Key Words at Key Times….they save a lot of time…they know this will make their patient feel a lot better. So they do it out of both efficiency and concern.”⁸ There are other practices that also help promote a service-oriented culture, but I will leave you to read the book or contact their Group for advisement on your own.

Principle Four is about creating and developing leaders. And, differently from the book you are now reading, the behaviors Studer highlights are far more administratively oriented. They are streamlining prescriptions (like arrive on time) rather than “ontological prescriptions” (like being generous). For instance, and this is great practical advice in my opinion, he notes, “taking leaders off-site to train them on employee selection, new employee orientation, and retention is crucial.”⁹ The rule of thumb here is two days off-site for 90 days on-site. Within the vein of developing leaders, he notes that three issues take the lead: ensuring they understand organizational change, how performance moves with personal performance conversations, and the how and why to establish organizational institutes for codifying leadership competencies. Organizational change is the framework in which the latter two issues find their places. It starts with onboarding individuals and moves toward understanding those individuals and ensuring they have proper training and development as gaps are identified. This is followed by leaders emerging (according to their performance behaviors). Simultaneously, those who underperform also emerge. Next, the organization strengthens alignment as low performers exist or are asked to leave because they choose to remain unaligned to the organization’s mission, vision, and values through the expected behaviors and the results they generate. In regard to performance conversations, the High-Middle-Low Conversations content offered in this tool is invaluable administrative leadership wisdom.

Principle Five relates to employee satisfaction, and there is one primary activity promoted: rounding for outcomes (health care terminology). This practice entails visiting your different personnel to identify needs, concerns, testimonies of success, and relaying back to them motivating results. The idea here is that people want to see how their work makes a difference, and leaders have a prime opportunity as the face and ears of the organizations they lead to do the most about the bad situations that arise, while hearing the most about the good results accrued. Thus, rounding for outcomes is a practice of keeping your ear to specifics like what equipment is slowing people down, which personnel have done exceptional work that their peers appreciate, with what policies people are disappointed or discouraged, etc., The purpose behind it, of course, is continual improvement across the organization, across units, across personnel, and across activities. And, rounding for outcomes should be measured! The only way to prove development in all areas is taking place is by measuring all areas. If rounding produces desirable behavior that increases efficiency and reliability of the organization’s product/service, then keep a tab on its pulse.

Principle Six is about wholesale ownership of the change process and improving performance at every level. If we do not own the mission, then in Studer’s terms, we’re “renters.”¹⁰ One thing to note here is that the administrative leadership practices that these principles encourage are part of the systemic operations of the organization. They are not linearly advanced from one principle to the next. They are altogether promoting high quality habits that lead to outstanding healthcare outcomes. For example, with the effort to instill personal accountability, practices include methods to motivate loyalty and attachment to the organization by giving personnel reasons to own the organization’s mission and performance. Much of this is accomplished through giving individuals opportunities to make significant decisions, to voice their guidance and opinions in appropriate settings, and to be rewarded for their attentiveness and contributions to improvements. One additional administrative leadership practice noted has to do with peer interviews, as this helps teams congeal and select people with the competencies the team knows it can benefit from.

Principle Seven is about bringing behaviors into alignment with your organization’s goals and values. Studer exclaims, “If there are only a few things you do as a result of reading this book, let one be the adoption of an objective, measurable leader evaluation tool. Then hold leaders accountable for those results.”¹¹ As mentioned previously about the principles’ systemic effect, you will notice how this practice highlights accountability as well. In summary of this practice, let me say that it involves the evaluation of how well a leader performs across key pillar areas according to his or her preset goals and results. To ensure this practice takes root, additionally supportive practices like progress reports and implementation plans are recommended. Moreover, other evaluations are also encouraged, specifically for support services. Support services as a whole function analogously to how administrative leadership integrates with anticipatory and strategic leadership. If the latter were the doctors diagnosing and treating patients with the nurse team’s support, then support services would be the effort to keep everything else running smoothly so that patients, like organizational goals, can be addressed properly and with the utmost attention and effectiveness.

Principle Eight relates to communication reaching all levels of the organization. It entails putting those you lead in a good position to understand your mission and objectives, and gives them a reason to be loyal and supportive. As an administrative leadership practice, managing up is a fantastic tool for disseminating important information, such as when things are going well and people are not interpreting your sharing as passing the buck or judgment. Writing thank you notes is a key practice of such leadership, as it expresses gratitude for organizationally aligned behaviors and helps generate synergy. Furthermore, you can also put clients/patients/stakeholders in a good position to appreciate your organization by communicating to them in the fashion they most understand: that of feeling informed and in-the-loop about your skillset and experience. In this way, communication is an administrative leadership practice that keeps you and the rest of the organization aware of how success is accruing across units and organizational goals. Studer recommends holding quarterly employee forums and constructing unit communication boards for such communication.

Principle Nine, as previously mentioned, is about recognizing and rewarding success. Practicing this behavior through thank you notes and awards and celebratory events, alongside monetary gain, is a key method of encouraging excellence in performance. Perhaps the most important lesson here for practicing administrative leadership in support of other leadership actions is that you recognize and reward until the particular high-performance behavior is ingrained. With new people entering your organization regularly, you will need to reward them commensurate with their experience and performance history. At the same time, the pursuit of high-performance and outstanding health care outcomes must not stagnate. As times change and your organization is adapting, you will need to creatively construct new ways to reward the innovative behaviors that will keep your organization improving and sustainably competitive. You will want to measure it to manage it, and celebratory motivation will encourage it, not simply for tangible rewards, but also because it recognizes peers who are exhibiting the kind of behavior that displays the purpose of their work and how it makes a difference.

That all being said, I barely scratched the surface of Studer’s fantastic approach to an excellent performance culture among health care organizations. His flywheel, pillars, and principles are fantastic aids for the administrative leadership focus that drives the daily behaviors leading to organizational success through ongoing improvement efforts. There are other good consulting formulas and models for health care leadership of this kind, but I have rarely come across one so powerful, personal, and practical as this. Do yourself a favor a pick it up, digest it, and start implementing it in support of your integrative leadership model.

The Memory JoggerTM II: Health Care Edition

When it comes to continuous improvement and effective planning, there are few better reference tools than The Memory JoggerTM guides. Since there happens to be a “Healthcare Edition,” I would be remiss to skip its endorsement here.¹² While like with the other tools, there is far too much quality content to cover it fully, we can briefly consider the primary benefits of the Memory JoggerTM II for administrative leadership. Essentially, it offers you several different tools in one spiral-bound book for evidence-based improvement when working with ideas, with numbers, and in teams. These tools are measurement and data-based, looking at actual behavior within the organization, and so they would certainly fit into the administrative leadership paradigm of pursuing efficiency and effectiveness together. Moreover, these tools are based on principles similar to Studer’s, that sustainable quality improvement focuses on customers/ patients/stakeholders, analyzes the improvements of the entire organization rather than only select areas, involves all personnel in the processes, and combines the data with team knowledge to improve decision making. This edition offers health care organizations over twenty tools for improvement activities, from structured and unstructured brainstorming sessions and cause and effect fishbone diagram drawing to prioritization matrix making and radar chart construction. Though I refer you to the pocket guides, you can also contact the nonprofit organization behind the tool, GOAL/QPC, and request training in the tools’ use for your leaders and staff.

Consider the Pareto Chart tool, which is highlighted for its ability to help organizations focus on their key problems.¹³ Administrative leadership keeps focused on what the strategy development and execution work has set forth and builds in systems that empower efficient and reliable deployment of organizational activities. The tool is based on the Pareto Principle that 20 percent of sources (inputs) cause 80 percent of any problem (outputs), and it calls for the use of a brainstorming session with existing organizational data to identify possible causes of a problem, with the goal of isolating the “20 percent issue(s).” In the guide, the example issue is, “Why are there delays in processing patients through the Emergency Department; what problems are people having,” and so brainstorming looks at previously measured reports from the Emergency Department. After brainstorming, the next step is choosing a measurement unit for comparing data, like frequency. Then, a time period for the study is chosen, during which the frequency of issues can be compared across the brainstormed issues list. After the comparison and documenting the results with tables and graphs (visually plotting the numbers and percentages), the team jointly interprets the findings to answer which issue has the greatest negative impact on your organization. Importantly, the issues that are brought to light may not be equally important, and so the unit you measure across may veil this a bit, which is another reason to use multiple tools to get an accurate grasp of the impact of different issues on your organization’s most important goals. Administrative leadership practices like these can definitely help in that respect.

Another tool the reference guide looks at is the Interrelationship Digraph (ID), which helps you search and discover drivers and outcomes, the causes and effects related to solutions you need to implement in particular areas of the organization.¹⁴ For instance, suppose you set your strategic direction, but then in the administration of that aim you are unsure of what kind of localized application will give you the best results. The ID will help you with that by encouraging lateral rather than linear thinking. The steps in ID start with generating a unifying agreement about the primary issue being looked at. Essentially, it starts with defining the problem in order to have a unifying goal: solving that problem. Notice, solutions to problems are a vital component to administrative leadership. In contrast, because anticipatory and strategic leadership focus on complex environments where solution-finding can be a dangerous approach, intentionally or unintentionally circumscribing your alertness to a single path, it has not been unrestrictedly encouraged. With administrative leadership, however, you need focus to gain efficiency, and these tools from Memory JoggerTM will help you achieve it.

After defining the problem, you ensure you have issue experts on your team to give the necessary, credible input for arranging the issues and determining plausible correlations between them and the problem under review. Through team discussion, you seek to determine the priority of relationships and influence and determine which issues are greater influences within a relationship. For instance, does one area (A) exert influence through multiple channels on another area (B), whereas (B) only exerts a single, less significant influence on (A)? The team will go through these kinds of discussions until they have a clear first-round review of the influences among the issues, and then they will rank them according to the influence they exert on the others. After a review and another round of influence strength evaluation, the team will diagram out their final ID, in which the reason/issues are drawn in relation to one another with arrows indicating their dominant influence. The outcome of this tool is a visualization (along with the data that helped the team create it) of what factors are driving influences on others within the organization. As I have asserted multiple times throughout the book, strategic thinking is in many ways systemic thinking. This kind of tool helps you understand the systemic influences on behaviors present in your organization. If you can understand which issues and behaviors are dominant among the fold, then you will have a better grasp on what behavioral changes will actually make a difference in the organization’s operations.

Summary

In summary, administrative leadership is about greasing the wheels. Its practices are the kind keeping the organization running in the right direction by supporting the effective decisions strategic leadership practices produced. Since we recognize the environments around us are changing, we have to be agile enough to change with them, which is always a matter of degree when practiced in the momentary actions of day-to-day work. Administrative leadership practices, therefore, are those which execute and support organizational change on the particular level. They are the practices that find the shortest path to goal completion and help set the agenda for executing the solutions to engineering problems on a large scale. The tools identified in the chapter point to the need for organizing principles that can help establish mission-oriented activities. Such principles can help us make quicker decisions as to what is good and what could be harmful for our organization. For instance, a principle of setting excellent quality or innovation as the most important aim for personnel and then coupling that with a goal to serve patients’ needs all the time would help personnel know how to act or not act in particular situations. They would know their actions should support the delivery of excellent care and that being innovative to do so is looked upon favorably. Different principles may inform personnel otherwise.

Being consistent helps improve the administrative leadership aim of efficient and reliable operations throughout the organization, which leads to improved delivery of outstanding outcomes to all stakeholders. At the same time, the smaller moves helped along by creative measurement and team-based decision making tools support anticipatory leadership practices, offering up the means to introduce evidence-based findings and analysis into the entrepreneurial problem-solving cycle. That all being said, administrative leadership is the most often utilized practice of the integrative leadership model, because it is routinely given opportunity to function. This reality makes it all the more necessary for administrative leadership practices to support the other two components of integrative leadership, since they are no less important. Moreover, through their integration, anticipatory and strategic leadership gains a powerful support when administrative leadership functions streamline the path to outstanding health care outcomes. Of course, there will always be the tension to focus on solutions within administrative leadership practices that must be held at bay when the other two components need to be utilized. Organization’s assumptions need to be held loosely in anticipatory leadership, and only through study and analysis and group decision making become more readily accepted in strategic leadership. Ultimately, after refinement, they will become usable in administrative leadership in such a way that they further rather than falter your organization’s mission.

¹ Zaleznik, A. 1992. “Managers and Leaders: Are They Different?” Harvard Business Review 70, no. 2, p. 131.

² Kotter, J.P. 2001. “What Leaders Really Do.” Harvard Business Review 79, no. 11, p. 86.

³ Yukl, G., and R. Lepsinger. 2004. Flexible Leadership: Creating Value by Balancing Multiple Challenges and Choices, 62. San Francisco: Jossey-Bass.

⁴ Yukl, G., and R. Lepsinger. 2004. Flexible Leadership: Creating Value by Balancing Multiple Challenges and Choices, 12. San Francisco: Jossey-Bass.

⁵ Ibid, 77.

⁶ Studer, Q. 2003. Hardwiring Excellence, 50. Gulf Breeze, FL: Fire Starter Publishing.

⁷ Ibid., 45–231.

⁸ Studer, Q. 2003. Hardwiring Excellence, 90. Gulf Breeze, FL: Fire Starter Publishing.

⁹ Studer, Q. 2003. Hardwiring Excellence, 109. Gulf Breeze, FL: Fire Starter Publishing.

¹⁰ Studer, Q. 2003. Hardwiring Excellence, 167. Gulf Breeze, FL: Fire Starter Publishing.

¹¹ Studer, Q. 2003. Hardwiring Excellence, 189. Gulf Breeze, FL: Fire Starter Publishing.

¹² 2008. The Memory Jogger II: Healthcare Edition. Salem, NH: GOAL/QPC.

¹³ 2008. The Memory Jogger II: Healthcare Edition, 95. Salem, NH: GOAL/QPC.

¹⁴ 2008. The Memory Jogger II: Healthcare Edition, 76. Salem, NH: GOAL/QPC.