What Traits Do Health Care Leaders Need Today?

Gary Kaplan, MD, FACP, FACMPE, FACPE; Chairman and CEO, Virginia Mason Health System

As I think about leadership at Virginia Mason, it’s very much within the context of our Virginia Mason production system. As you may know, we are one of the furthest along of anybody in the world in applying the Toyota Production System to health care and so-called lean management. And that requires a different way of thinking, and, for us, we think of it as a management system, and as part of that management system at all levels of the organization, leaders have to think in new and different ways.

In many ways, it’s aligned with several elements of the IHI Leadership Framework. It requires things like relentless focus. We have a very voracious appetite in our organization, and I think health care clinicians and leaders around the world are developing increasingly voracious appetites, but if we don’t have relentless focus on the priorities that we need to be working on, nothing really gets accomplished. So, one of the key attributes of today’s leadership is focus, and that’s certainly one of the keys in the IHI Leadership Framework.

Another attribute that I think is critically important is authenticity at the frontlines. We tell our leaders, the days where we sit in our offices, look at spreadsheets, think of ourselves as overseers or as the bosses in our hierarchical leadership context — those days are over. And really, what we are about is about coaching, facilitating, tearing down the barriers to, again, our frontline staff being able to do their very best work.

And so, we say that much of our time needs to be spent on the “gemba” — on the shop floor — at the frontlines. I often say to my direct reports, “Let’s go over your list for a few minutes, but then we are going to go somewhere. We are going to go the ICU or to the clinic or to the laboratory, where it’s really all happening.”

And so you have to present, you have to understand the work, and you have to think of yourself as a coach and facilitator, I think, in order to truly lead in today’s environment.

Another aspect of the IHI Leadership Framework that we believe is critically important in our work is transparency. As leaders, we have to be willing to tell the truth. In the old days, part of our job was to help people feel good. I was a master at obfuscation, which really was about people coming for constructive feedback, but leaving feeling so good they couldn’t remember what the constructive feedback was.

Today, it’s about clarity. It’s about transparency. It’s about being willing to shine a bright light on the current state, which when you do so, points out the current state; the status quo is really unacceptable in so much of health care today. I’m so proud of so many things that we’re doing, and, yet, we can be so much better. So, I think an element of transparency is critically important in order to help us understand where to focus and to help us understand how to do our very best work.