Holland, Dan and Williams, James. "Sharpening Your Executive Competencies," Healthcare Executive, July/August 1994, 13-17.

How do you effectively lead your organization during a time when everything, from its structure and culture to its strategies and values, is dramatically changing? When do you "empower", "coach", "direct", "demand"? Healthcare leadership today requires a highly developed, carefully thought-out process that focuses on executive competencies -- those skills, traits, characteristics, and personal attributes that predict superior performance.

Knowledge or technical skills are no longer enough. They merely represent the "tip of the iceberg" of today's needed competencies such as insight into attitudes, motives, style, and personal characteristics relied on to carry out job responsibilities. Some competencies are relatively easy to train and develop, while others are deeply embedded traits of an individual, which are much more difficult to change. Keeping with the iceberg analogy, whereas "skills" and "knowledge" are "above the water line", deeper competencies such as "core motivation" and "self-concept" are usually hidden beneath the surface, yet exert considerable influence over daily behavior. It is these deeper, enduring competencies for which it is more important to identify and select.

The authors studied superior executives in organizations undergoing significant change and selected and modified the competencies to reflect the unique challenges inherent in healthcare. Five "clusters", each with its own unique set of skills, emerge. Each skill is also designated at above the water line (a), in "shallow" water (s), or in "deep" water (d).

1) Thinking cluster (Strategic orientation (a), conceptual thinking (s), analytical thinking (s)),

2) Leadership cluster (Leadership drive (d), change leadership (a), team leadership (a)),

3) Organizational Management cluster (Organizational understanding (a), talent development (a), ownership building (a)),

4) Results-orientation cluster (Achievement orientation (d), bias for action (s), holding people accountable (a)),

5) Self-management cluster (Self-confidence (d), commitment to mission (s), and insight into self and others (s)).

It is more important to select for the "deep" and, to some extent, the "shallow" competencies while the "above" competencies can be developed. A 360-degree assessment of the organization's high-impact, key positions needs to be compared against competencies to identify significant "gaps". Collective and individual developmental needs can then be determined.

If the majority of developmental needs are below the waterline, serious consideration regarding job-person fit must be given. Above the waterline developmental needs result in relatively easy to devise, focused, and target experiences that will yield tangible results within a reasonable time frame.

Times have changed and "traditional" management, typically by "objectives" and "results", will no longer ensure organizational success. With current structural paradigms crumbling, it's going to take a new type of executive to lead an organization into the future. A necessary, but painful part of the transition, is going to have to be the assessment of the current level of managerial skills versus the skills needed. The authors put it in a good perspective, "You can teach a turkey to climb a tree, but it's easier to hire a squirrel."

It is crucial to keep providing accurate and focused feedback. The chart below is very useful in observing behaviors and for obtaining feedback. Scaled Levels of Team Leadership Leads

12 Has genuine "charisma"

11 Positions self as the leader. Ensures that everyone buys into the leader's mission. Ensures group tasks are completed.

10 Acts to protect the group vis-à-vis the larger organization. Obtains needed personnel, resources, information for the group.

9 Uses complex strategies to promote teamwork and cooperation-hiring and disciplining decisions, team assignments, cross-training

8 Uses power and authority in a fair and equitable manner

7 Publicly gives credit to others. Encourages and empowers others

OR acts to promote a friendly climate, good morale, and cooperation,

OR acts to protect/promote group reputation with outsiders.

Facilitates

6 Genuinely values others' input and expertise. Ensures that all members of a group contribute to a process. Encourages initiative.

5 Expresses positive expectations of others. Speaks of team members or subordinates in positive terms. Shows respect for others' intelligence by appealing to reason.

4 Keeps people informed, clear, and up to date.

Manages

3 Manages meetings. States agendas and objectives, controls time, and makes assignments.

2 Cooperates, participates willingly.

Participates

1 Participates reluctantly, a "foot-dragger."

0 Neutral: passive, does not participate.

-1 Disruptive: uncooperative, causes trouble