Tested leadership lessons from the front lines

September 5, 2014
William Balfour

How the military’s management performance can guide healthcare organizations.

By Boe Young, Senior Vice President, iVantage, Major General, former Chief of Staff, Army Reserve; currently Commanding General, 75th Training Command.


As part of the advisory services team here at iVantage, I am reminded on a daily basis that the management and leadership challenges hospital CEOs face aren’t too dissimilar than those I dealt with during my time as a Major General in the United States Army.

In any given year, the military experiences a personnel turnover rate that can approach 40% — something that would bring many businesses to their knees. Yet, day after day and year after year, the military finds a way to seamlessly operate an aircraft carrier or harmonize the performance of a tank battalion with a constant level of performance.

The answer “I believe” can be found in seven key tenets, many of which find application in a hospital

  1. Cross train your staff. Everyone benefits from increased technical expertise and greater flexibility.
  2. Document standards.
  3. Ground everyone in understanding what the standards are, what they mean, how to achieve or exceed them.
  4. Use data to drive performance and create a culture of achievement. Leverage outside “inspectors” or internal consultants to focus on measuring and monitoring performance.
  5. Use data to drive adherence to a common set of standards and the ability to harness the power of competitive teamwork in an industrious way, facilitates this performance.
  6. Get engaged. Standards are only meaningful if leaders subscribe to the standards-based model and enforce those standards in a disciplined and consistent manner.
  7. Empower mid-managers through a construct called “command intent” understanding the desired end state and their left and right limits. This empowers this important group to quickly improvise as needed to unexpected circumstances, without unnecessary delays.

There are various styles and theories of leadership “most correct to a large degree” but the real question is how do we achieve sustained performance? To that extent, leadership becomes an enabler with the focus on standards at the core.

Consider key leader extenders to help coach your senior team; ensure your functional and clinical measurement systems help drive performance, identify the key mid-level managers that make your organization work” and invest in them; ensure your work is designed around flexible teams; and most important, put standards and a standards based mindset at the center of what you do.





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