Overview of Your Management Journey
Welcome to the world of health care management! Working in health care, you have chosen a meaningful career that helps people live better, healthier lives. You have developed extremely valuable clinical knowledge and skills through your education and training, followed by your experience working directly with patients and in organizations that provide health care.
By stepping up into managerial and other leadership roles, you are taking responsibility for greater impact and well-being through the contributions of your team members and other colleagues you lead, both within your organization and beyond in the communities you influence. There are many new skills for you to learn that help you leverage your valuable experience to maximize your effectiveness as a health care manager and administrator. To focus on the management skills you are likely to need at appropriate points in your professional journey, topics are organized into two volumes:
- Management Skills for Clinicians, Volume I: Making the Transition from Patient Care to Health Care Administration
- Management Skills for Clinicians, Volume II: Advancing Your Skills to Thrive in Administration
More information is provided in the following text to help you navigate these books to provide timely help in your managerial journey. First, I would like to offer a view of where and how the material for these books developed.
Background from the Author
As the author of these books and a health care manager myself, I have been there with you, experiencing joy and enrichment with new opportunities to develop mastery of skills that stretch our capabilities, and struggling with unexpected challenges revealed by new situations we had not yet experienced.
Before writing these books, I worked for almost 30 years in progressive levels of management. After completing an advanced degree in a clinical field, I earned clinical credentials through testing and experience, made the transition from clinician to manager, and progressed to executive levels of leadership leading large departments in two large behavioral health centers. I am a Licensed Professional Counselor, National Certified Counselor, and certified Mental Health First Aid Instructor. Before becoming a therapist, I was in high-technology settings and the computer software industry, where I worked my way from customer service and technical consultant positions to become a supervisor, then a manager, and continued to progress into senior and executive management. I have led clinical, technological, quality, customer service, and analytical operations. While experiencing the challenges of operating effective health care delivery with limited resources, I decided to update my skills to optimize the allocation of clinical resources. I returned to school and earned my PhD in Operations Research. My doctoral dissertation and research have concentrated on improving access to health care services.
Many of the people I have worked with provided helpful leadership by example that inspired descriptions in this book. This book reflects valuable lessons from the Mental Health Center of Denver (MHCD), where we built the foundation for a thriving culture that promotes the well-being of its employees and clients. The mission of MHCD is, “Enriching Lives and Minds by Focusing on Strengths and Well-Being,” founded on the philosophy that “people can, and do, recover from mental illness and that treatment works.”1
MHCD is focused on making a difference in the lives of tens of thousands of people every year, on mental health literacy inspiring people to become messengers to the larger community, and on expanding access to effective and compassionate treatment. MHCD has been named as a Top Workplace by the Denver Post for 6 years in a row, was honored as the Top Company in 2017 in Health Care by ColoradoBiz Magazine, has earned numerous awards for innovative projects that enhance the well-being of the community, and is recognized internationally for measuring and improving treatment outcomes.
MHCD is where I experienced the initial transition in my career from clinician to manager—first, from providing direct clinical care, then to managing teams and staff, and later to higher levels of executive management responsibility. Lessons from this exemplary workplace, and interviews with many of my colleagues there, are included in this book.
I gathered helpful input from many others, including my colleagues at Mental Health Partners (MHP). As a member of MHP’s executive management team, I participated in the development of its Mission, Visions, and Values: “In alignment with our mission—Healing is our purpose. Help is our promise. Health is our passion.—Mental Health Partners (MHP) provides immediate access to expert mental health and substance use care so people can enjoy healthy and fulfilling lives. Our vision is for Healthy minds. Healthy lives. Healthy communities. We accomplish this through our core values.
Empathy: Putting ourselves in others’ shoes.
Hope: Believing in positive possibilities for every person.
Healing Environment: Providing a safe space where people feel accepted.
Wellness: Supporting long-term health and well-being.
Teamwork: Realizing the power of working together with humility and trust.
Partnership: Building relationships to strengthen our communities.
Excellence: Pursuing the best in everything we do.”
MHP collaborates with many organizations throughout the community to deliver integrated and coordinated care, with work in shared locations with primary care physicians. An innovative comprehensive health home brings together treatment providers in one location for mental health, physical health, and dental services. “The health team works together to meet all of a patient’s needs and improve their overall health.”2
Mental Health Partners was one of four community mental health centers accepted into the Colorado State Innovation Model (SIM), a federally funded, governor’s office initiative that helps health care providers deliver whole-person care. According to Colorado Lieutenant Governor Donna Lynne, “SIM providers must focus on the entire patient, which means addressing mind, body and mental wellness. That complete approach to health is what makes the SIM initiative so valuable. Patients get the care they need when they need it, and providers learn how to succeed with new payment models. It’s a great example of meaningful reform in our state.”3
To broaden my perspective outside the settings where I have worked, I also spoke with nurses, MDs, and many professionals with experience in other health care systems and hospitals throughout the United States. Some of them I met through professional associations and applied research activities on improving health care systems. Together, many of us have collaborated in bringing effective management and leadership practices from prior work settings, then adapting them to fit new settings to enhance our work cultures and help our people develop. This is reflected in many of the examples you will see in this book.
To help you in your development as a health care manager, chapters are developed around the skill areas identified by this book’s editors and author, from our experience in health care, as crucial to the success of health care managers.
Successful health care leaders need a variety of skills to manage effectively in the complex and challenging arena of health care, where risks and rewards can have major impacts on the well-being and safety of our patients and care recipients. Such skills are described and illustrated with the actual experiences shared by many health care management professionals, along with recommendations from many management books and articles.
Learning activities and discussion questions are offered in each chapter to help you assess your proficiency, apply new knowledge, and increase your mastery of the material. Personal skills and abilities are included to focus on how you relate to and communicate with other people, sometimes referred to as “soft” and “people skills” or with the ability to recognize and manage our emotions, as “emotional intelligence.”4 While some of the chapters focus on more “technical” or “nuts-and-bolts” skills such as hiring and budgeting, integrated throughout the book are the softer leadership skills that you need to successfully manage in these other areas.
Contents and Organization of Management Skills for Clinicians, Volumes I and II
This two-volume set of books consists of:
- Management Skills for Clinicians, Volume I: Making the Transition from Patient Care to Health Care Administration
- Management Skills for Clinicians, Volume II: Advancing Your Skills to Thrive in Administration
Volume I guides readers through the essential knowledge and understanding they need to develop as soon as they transition to new managerial roles. The emphasis is on shifting focus from caring for individual patients to taking broader responsibility for leading other professionals and administering the necessary activities that keep health care organizations running smoothly. The chapters focus on understanding the special features of managing in health care settings, taking charge to lead your team, managing performance of those who report to you, essential skills for planning and organizing, and building relationships with the people you manage, your boss, and others around you.
Volume II helps readers advance their skills to thrive in administration. The focus is on enhancing relationships, your workplace culture, and your comfort with business practices for effective budgeting, financial management, hiring activities, and human resource management while building your momentum and growth. Advancing your communication skills will help you grow and improve as you foster the growth of those you manage and lead. You will learn to embrace conflict and handle it constructively. Developing your business skills in hiring, human resource management, and financial management will help you garner and administer the resources that support your team’s important work. Recognizing and developing the strengths of you and your team members enhances performance and motivation to sustain your success as a health care manager.
Objective
We introduce new managers working in health care to the basic skills and competencies to support them in transitioning to their managerial roles. We guide readers in the activities they will handle initially and later as they arise in organizational cycles, such as budgeting and hiring. We also offer topics and examples that can help more experienced managers reassess and revitalize their skills.
Target Audience
We target clinical staff who have been promoted recently into managerial, supervisory positions. The targeted reader has clinical training and experience and little or no business management training and experience. More experienced managers can benefit, too, from collected insights of other managers who were interviewed and from examples in recent and revisited literature.
How to Use These Books
We cover both “hard” business skills and “soft” people/organizational skills. These books draw from books, articles, examples, and managerial experience of the author and colleagues at different organizational levels and throughout health care settings and professions.
As you see examples from health care managers who were interviewed for these books, consider how you could apply their approaches effectively to align with your strengths and the characteristics of the organization where you work. Tables developed in these books provide a foundation for you to develop tools tailored to what would work effectively in your environment. Review the frameworks described from other literature and practice applying them in your managerial and administrative activities. As you gain experience as a manager, experiment with what’s offered and build your own tool sets to boost your effectiveness and to contribute to your organization.
Health care management is complex with a wide range of interrelated activities that a manager will likely encounter, often in the same day or workweek. Volume I covers the things most needed from your first day as a new manager. You also may encounter other topics—such as hiring and budgeting, which are examined in Volume II—early in your new role. As your needs unfold in your management role, you may find it helpful to shift from reading sequentially the chapters in each volume to delving more deeply into specific chapters and sections that address the issues you are encountering.
Chapter Descriptions
Volume I: Making the Transition from Patient Care to Health Care Administration
Chapter 1. Introduction to Health Care Management
This chapter introduces the unique challenges of new health care managers, explains their importance, and provides practical guidance to help you succeed in these new situations. Insights and themes from interviews and conversations with 64 health care managers and administrators are summarized. We identify some special features of managing in health care and the particular challenges in refocusing your clinical training to succeed as a health care manager as we apply some of the lessons gleaned from interviews. Initial activities are proposed to help you get started in comprehending the scope and skills that health care managers need to learn and master.
Topics in this chapter:
- Motivation for developing management skills
- What’s so special about health care management?
- Interviews from a variety of perspectives
- Interview questions
- Themes from interviews
- Who can help? Get a mentor!
- Chapter summary and key points
- Introductory activities to get you started
Chapter 2. So, Now You Are in Charge! Leading Your Team and Managing When Others Report to You
You are in a new role now with supervisory responsibilities. This requires you to transition from being a team member to the team’s leader. You need to establish credibility and earn the respect of others for new capabilities you are developing. You will need to treat others fairly and avoid granting special treatment to those who have been your friends. Mentors and peers can help you in your development so you do not have to figure things out all by yourself.
We will show you how to communicate your expectations for behavior and performance to help your people perform well. We also look at what you need to do when things do not work out and improvement is needed, or you need to fire people who report to you.
- What is different about being a manager
- Delegating responsibility to others
- Power and trust in your new managerial role
- Setting expectations and communicating them
- Accountability without fear and blame
- Performance expectations
- Coaching for performance and development
- Performance tracking and planning
- Performance problems
- Chapter summary and key points
- Learning activities for this chapter
This chapter in Volume I focuses on how you get started in your new role with responsibility for managing others. Soon, you will develop more skills for creating a positive working culture, building a strengths-based team, selecting and hiring new people. For further information on these and other topics related to work culture, employee strengths, and hiring, please see Chapter 2 in Volume II.
Chapter 3. Planning and Organizing
You will face new challenges and be expected to make decisions in your role as a health care manager. Learning to lead with structure and applying some management tools can help you to take charge confidently as you plan, organize, and get things done.
Topics in this chapter:
- Planning and being proactive
- Organizing and leading meetings
- SBAR: a tool for effective meetings and other decision making
- How decisions are made
- Honoring your commitments for getting things done
- Managing your time and yourself
- Managing my time and myself: what I have learned and recommend
- Chapter summary and key points
- Learning activities for this chapter
Chapter 4. Managing Up, Down, and All Around!
Being a manager involves supervising and leading the team of people who report to you, and communicating clearly what you expect them to do. In Chapter 2, we looked at how you take charge and get started in that part of your role, and continued in Chapter 3 with structured techniques to help you plan and organize. Now, let us consider other important people in your new world of management.
It is vitally important that you build a positive relationship with your boss and ensure you are meeting your boss’s needs and expectations of you. Those you work with as colleagues and peers also are important in your work world. We explore ways for you to build and sustain important relationships in multiple directions. You will gain wider perspective and effectiveness as you practice managing up, down, and all around! These are essential skills as you make the transition from providing direct patient care to managing the people and other resources involved in health care administration.
Topics in this chapter:
- Your new world and who is in it
- Managing up: your important relationship with your boss
- The importance of influence
- Building positive relationships
- Up, down, and all around your successful transition to administration
- Chapter summary and key points
- Learning activities for this chapter
Volume II: Advancing Your Skills to Thrive in Administration
Chapter 1. Enhancing Your Relationships at Work: Managing Communication, Feedback, and Conflict
Now it is time to enhance your relationships and work through some more advanced skills. It is natural that the various people you work with have different perspectives, so you can expect disagreements to arise. In this chapter, we extend your skills and effectiveness in communicating, giving and receiving feedback, and handling conflict. You will gain wider perspective and more experience as you practice building relationships and strengthening them all around you at work!
Topics in this chapter:
- Reflecting on related topics in Volume I
- Communication guidelines
- Giving and getting feedback
- Conflict in work relationships
- Chapter summary and key points
- Learning activities for this chapter
Chapter 2. Hiring and Engaging People in a Culture of Well-Being
Health care is all about people, who deliver treatment and keep the organization running effectively to meet the needs of the people we serve, our patients. In this chapter we focus on these crucial human resources, the people who do the work on the team you manage. We will look at the value of creating a great place to work and the profile of a health care organization that built a work culture where people can thrive.
Then, we examine the specific things you need to do to hire people and get them started in their work on your team. We will look at how you hire, engage, and retain these people to do their best work. We show you the value of your Human Resources team and identify the things they can help you with, and when you must consult with them to hire new people and bring them onboard.
Topics in this chapter:
- The importance of people!
- What makes an organization a great place to work?
- Using strengths in your team
- Your roadmap to hiring and human resources
- Hiring: getting started
- Organizing your selection process
- Interviewing and selecting:
What are you looking for and what should you ask?
- Compensation, terms, and job offers
- Welcome aboard and setting the tone
- Chapter summary and key points
- Learning activities for this chapter
Chapter 3. Business Basics: Finance and Budgeting Are Not Just for Accountants!
Why do you need to know budgeting and finance? This chapter will answer this question by explaining some basic financial and budgeting concepts, why they are important for every manager to know, and how an effective manager uses these ideas. We will look at financial aspects of your organization that you need to know about to manage effectively. We start by reviewing why money is important to keep your organization and team running. We will explain budgeting and examine an example of a team budget to help you see what you need to track and manage. We will look at some financial measures for your organization and help you interpret them to understand the financial health of your organization.
Topics in this chapter:
- Why money matters
- Profit: what it means and why it’s important, even in nonprofit organizations
- Budgeting for what you’re managing
- Your budget: what it looks like and what does it tell you?
- Big picture financial health of your organization
- Recommendations for successful financial management
- Applying financial principles in clinical practices
- Chapter summary and key points
- Learning activities for this chapter
Chapter 4. Where Do You Go from Here? Keeping the Motivational Fire Burning
In this final chapter, we wrap up your journey toward being an effective health care manager.
We shift from the skills you have been learning in earlier chapters to do your job now, consider how you sustain your momentum, and look ahead to your future. We will look at how you balance areas of your life and renew yourself, sustain your success, address challenges that signal the need for changes, foster your growth and development, benefit from others helping you to improve, move from success to significance, and continue to fuel your passion for the work you do.
Topics in this chapter:
- Highlights of your journey to here
- Leaders who are burning bright
- Balance and renewal
- Sustaining your success at work
- Your growth and improvement
- Outward and onward!
- Chapter summary and key points
- Learning activities for this chapter