Hospital Leaders Take On Emotional Intelligence

This article was originally published in the the January/ February 2019 edition of Texas Hospitals Magazine. See more at the magazine's website.

By Lance Lunsford, MBA

President/ CEO, THA HealthShare; SVP Strategic Communications, Texas Hospital Association

Gordon Gecko, featured as the bad-boy antagonist in the classic movie “Wall Street” and played by Michael Douglas, infamously represents the bare-knuckle 1980s businessman whose “greed is good” business mantra inspires his own class of leaders of a certain type. The slicked back hair. The expensive suits. And of course, the calls made from the roaring surf of a Long Island beach with an impressively massive cellphone. Gecko embodied what some consider a type of business leader whose aggressive tactics and fearless attack are what drives a successful organization.

That was more than 30 years ago.

What Gecko would seek to achieve today with the same style and tactics might make the grade for a private equity or venture capital firm, but it is hardly the approach for most executives in 2019. The Gecko approach is tangential to what many hospital leaders today prioritize. For them, staffing turnover is a threat. Reimbursements are weighted with a consideration for patient satisfaction. Quality outcomes are examined with white gloves daily. Focusing on these tall orders can be daunting.

As a result, leaders are adjusting styles to develop ways to inspire large teams en masse. Their tone and style is being adjusted to ensure that their rallying cry does not take on the shape it had in a smoke-filled room when Gecko inspired a generation of cuff-linked aspiring CEOs by saying, “Greed, in all its forms; greed for life, for money, for love (and) knowledge, has marked the upward surge of mankind.”

A New Leadership Paradigm Emerges

In many ways, gone is the ‘greed is good’ speech. Taking its place is a new priority on a style embodied by the practices around emotional intelligence. Considered the father of the movement, psychologist Daniel Goleman reported on behavioral sciences for The New York Times and published the book Emotional Intelligence in 1995, which earned a spot on The New York Times best-seller list for 18 months. Today, Harvard Business Review includes his work on its list of top “must read” articles, catapulting the practices of EI into the mainstream as core measures of high-quality leadership – for some, in equity to the intelligence quotient.

Several studies have focused on EI’s use becoming a priority, because results are emerging on its effectiveness.

“Leaders who get the best results tend to show more strengths in key competencies in emotional intelligence,” Goleman writes. Further justification of EI by Goleman references a 1996 study by David McClelland, which found senior managers with high emotional intelligence outperformed other divisions within their own companies by 20 percent. Managers without those emotional intelligence scores meanwhile underperformed by almost the same amount, the study reported.

Still, the skills associated with EI might seem a little soft. For others, they round out what it takes to develop a strategic operation.

Applying Emotional Intelligence to the Demands of Hospitals

Managing operations in hospitals today means being able to maintain a company culture whose mission is centered on doing more than managing a patient from admission to discharge. It means being able to inspire employees to do so while also minding the holistic details that decrease a patient’s stay, reduce mistakes, increase patient happiness and satisfaction beyond issues related to their health needs, and yet still address the care needs that brought on the patient’s issues in the first place.

The growth of hospital organizations into large, complex systems that deal with the comprehensive health care needs of the entire continuum puts enormous responsibility into the hands of managers who have to meet the broad needs of the communities that depend on their hospitals. Being able to keep teams dedicated to seeing these difficult goals through to long-game success puts leaders in a position where the management of culture is as important as managing efficient throughput of patients or physician recruitment and business development.

As hospitals have become more complex with bigger and bigger systems, hospital managers are left managing more than ever. These management responsibilities in any organization can be daunting. Challenges can bring out the worst of an otherwise good manager. As responsibility grows, stress builds, and suddenly successes aren’t as frequent or apparent; the self-awareness around underperformance and management grow. As a result, the stress can vanquish any good leader. When it does, a lack of conscious management of emotions can result in a leader losing his or her temper or lashing out when challenged a certain way, thereby undermining key aspects of an ideal company culture.

“People who have a high degree of self-awareness recognize how their feelings affect them, other people and their job performance. Thus, a self-aware person who knows that tight deadlines bring out the worst in him plans his time carefully and gets his work done well in advance,” writes Goleman for the Harvard Business Review.

Goleman says these leaders can identify when working with others conjures a specific frustration, noting an example of a leader having to respond to the myopic needs or views of a self-interested colleague.

“And she will go one step further and turn her anger into something constructive.”

Lessons in Leadership From Texas Hospitals

Several Texas hospital leaders recognize the recent emergence of EI as a new trend but noted the core tenets of the practices have always been important and evident in the best leaders. For Robert Haynes, CEO of Guadalupe Regional Medical Center in Seguin, much of EI deals with a leader’s empathy and operationalizing the perspectives of the team as a whole.

“It’s about when you’re in a room full of people and having the ability to remove yourself personally and truly look at all of their perspectives,” Haynes said. As a result, a leader can quicken the process of navigating complex problems quickly while also ensuring all voices are heard. “We’re all in this journey together to address problems, and there’s many ways to cross an ocean,” Haynes explains. “Screaming along the way uses a lot of resources and takes a longer route.”

Today, many health care leaders are ensuring EI is part of their leadership structure as a way to serve a broader strategy. Some organizations are hard-wiring emotional intelligence practices into operations in managers. Others are making sure it is used as part of a management style that speaks to a broader strategy for hospital management. Getting EI priorities to stick requires broad adoption and understanding by senior leaders.

As chief operations officer for UMC Health System in Lubbock, Mark Funderburk, now its CEO, began analyzing an idea to develop a culture strategy around building employee satisfaction to improve employee retention. The effort came at a key time for the 500-bed public hospital system with more than 4,600 employees – years in advance of the patient satisfaction scoring that would eventually be a major determinant around reimbursement.

“It sounded ‘soft’ at first. Or somehow separate from the core business of a hospital,” Funderburk said, detailing how the principles of EI are embedded in UMC’s cultural strategy with staff identifying ways to work daily in what he describes as ‘servant leadership.’ “It was hard sell at first. It’s now a business strategy as much as anything else.”

The principles, Funderburk said, certainly took time. Staff who were slow to adopt the approaches would eventually exit, making paths to get the right people in place.

“We started to more selectively, based on peer interviews and, to be honest, to fire appropriately. You make appropriate calls and get the right people on the bus. That takes years. That can’t happen in a minute or a couple of days.”

The results helped drive employee satisfaction to higher levels right as patient satisfaction measures become a priority industrywide.

Updating Strategies for a New Generation in the Workforce

“Now, patient experience is based on the employee experience … particularly with millennials coming into the workforce, it has gotten tougher to sustain,” Funderburk said, requiring his leadership to revisit some strategies devised more than a decade ago.

At UMC, his team made tweaks to address the needs of a changing workforce. Those revisions did not mean what some might expect: the demands of the newer millennials did not center around longer breaks, more time off, or ping pong tables and kombucha tea on tap in the breakroom. Rather, it meant driving more recognition of teams and the efforts made toward achieving goals — more awareness of the short-term gains toward the longer-term goals.

Glenn Robinson, CEO of Baylor Scott & White Hillcrest in Waco, said considering the voices of the newer workforce is imperative as hospital leaders drive goals and make adjustments to listen to all staff.

“Sometimes millennials are painted in some unfair ways. There is a little millennial in all of us,” Robinson said. “I know when I started out, I wanted a leader who would teach me, invest in me. It’s so important to grow up our next generation of health are leaders, and they want to work differently. They’re not just looking for a career. They’re looking to achieve something. To make a difference. To make an impact.”

Emotionally Intelligent Leadership: A Learnable Skill

Leading across age groups with various needs means the purposeful and mindful practice of EI’s principles can be a new advantage, but Robinson said the importance of the underlying aspects of EI have been important no matter what recent management trends or outside business forces have emerged.

“Daniel Goleman was able to put a name together and some structure to what EI is all about, but it has always been important,” Robinson said. Determining one’s personal strengths and weaknesses with EI can be found with a simple online test, but introspection can help a leader identify whether they are calibrated correctly in consideration of their team’s needs and experiences. Robinson said leaders should ask, “Would you work for yourself? Do you truly try to understand what the members of your team are going through?”

Soft skill or not, like leadership, aspects of EI can be developed. While some might be born with the traits that make them naturally emotionally intelligent, the stress and demands of daily life highlight the need to develop practices to manage emotion.

“Some were born with it, but it’s truly learning and honing to make yourself better,” Robinson said, highlighting the need to have a default sense of the company mission, which can lead a team to identify and align their own personal missions.

Tim Lancaster, the retired CEO of Hendrick Health System in Abilene, said honing EI is as important as developing any other leadership characteristic.

“I do think there are some people who are natural born leaders. That’s a very small group of people. Even those people hone their own skills. The people that do well at (emotional intelligence management) are the ones who are intentional about it. Pick a leader. Watch that person. Watch how they behave in difficult and easy situations.”

Monitoring those who execute EI well, Lancaster said, can result in a huge benefit. And it might come at a perfect time – when you otherwise wouldn’t have the reference point to call on to deal with a difficult moment where a fuse is already lit.

“Everybody has that in them. They can have a short fuse. You have to learn to control that,” said Lancaster, who had coached a manager recently following a blow up in the office. “How in the world could you expect people to work at their very best when you’ve blow up at them? You lose that ability to get your point across.”

Finding those trigger points, Lancaster said, happens to everyone at some point. It is the aftermath and how a leader responds that determines what’s next for him or her. The freedom of management is not a freedom to unabashedly dole out whatever emotional response is desired as a reaction to a given challenge. If anything, the perception of management having the luxury to unleash expressions freely is a myth.

“Every time I’ve done that, I’ve learned in my career that’s not a luxury I should have let myself go to. It’s a sign that I let someone else take control of my emotions other than me taking control of my emotions. I regretted it every time, because it also didn’t get me the outcome I wanted,” Lancaster said.

More often, the utility of silence resulted in not only defusing a tense situation, Lancaster said, but also gave him an opportunity to develop a reputation. As a result the next time a disagreement or issue emerged with a staff member or physician, the outcome was very different.

“They come in next time much more calmly,” Lancaster said.

This article was originally published in the the January/ February 2019 edition of Texas Hospitals Magazine. See more at the magazine's website.