Understanding Relational Leadership™
Why a focus on leadership development? Because the biggest obstacle we have to revitalizing primary care is not the myriad challenges we face, but rather the lack of leadership capacity in our community for taking on those challenges. Our programs are founded on Relational Leadership™, an approach to leadership development that starts with cultivating authentic relationships as the first step to creating change. Whether you’re trying to develop more efficient workflows, improve the patient experience, or drive better health outcomes, Relational Leadership™ complements an understanding of clinical innovation with an appreciation for the full breadth of interactions that achieve authentic connection, common vision, and interdependent action.
Relational Leadership™ is comprised of four key competencies, around which each of our programs and trainings are built.
- Managing Self: The ability to effectively deal with the concerns of the organization, the people in it, and the person or patient.
- Fostering Teamwork: The ability to model, influence, and teach others to work cooperatively and interdependently to provide the best care and service possible.
- Coaching and Mentoring: The art and practice of facilitating the performance, learning, ability, growth, and development of another.
- Advocacy: The ability to energize and mobilize stakeholders, and sustain their commitment to changes in approaches, processes, and strategies.
A Deeper Dive into Healthcare Leadership Development
There are two major trends playing out in healthcare, and primary care in particular. On the one hand, we have massive levels of burnout and a growing exodus of clinicians from the workforce. On the other hand, we have a “renaissance” that is taking root in pockets around the country, where care delivery is being reborn through the application of new strategies like interprofessional teams and the engagement of other health professionals like pharmacists and social workers.
What will it take to slow, if not stop, the burnout and exodus, and concurrently ignite and spread the renaissance?
At Primary Care Progress, we believe that enhancing leadership capacity – specifically more leaders, operating at all levels and professions within the system, deploying a comprehensive set of leadership practices to manage change – will be essential for this change to occur. Those leaders will need traditional executive functioning skills, as well as expertise in quality improvement and change management, but they’ll also need to possess a new type of leadership: Relational Leadership™, which places just as much emphasis on the who and why of change, as the what and how. Doing so not only enables leaders to fix problems, but to do so in a way that fosters overall wellbeing and resilience of participants.
We know clinicians are often taught technical skills for systems improvement, and some even receive support in developing executive function skills. But what is frequently lacking in their education and clinical practice is an approach that fully considers the breadth of their human interactions. This dearth of relational optimization can manifest in a variety of ways: quality improvement activities that are technically sound but ultimately fail when implemented; low morale and high levels of burnout on teams involved in transformation efforts; and multidisciplinary teams that are regularly stuck, unable to work in an effective and collaborative manner.
In contrast, when leaders successfully complement their pre-existing technical leadership practices with relational strategies, their efforts frequently result in both success of the endeavor and satisfaction on the part of participants.
Examples of the value of engaging Relational Leadership™ in practice include:
- The clinical leader who increases her interprofessional process improvement team’s chances of success by eliciting team members’ values to develop a common vision for change.
- The ambulatory care team caring for a biopsychosocially complex patient that is most able to prevent repeated hospitalizations by understanding and addressing non-medical factors (e.g., transportation, housing, social support) underlying the hospitalizations.
- The underfunded primary care practice that has the best chance to remedy marginal payments from local third-party payers by understanding the politics and interests among the powerful local payers (e.g., large employers, the university system), as well as how to most effectively leverage those interests.
- An interprofessional care team that achieves improved care outcomes and enhanced morale of team members by taking the time to establish clearly-defined goals, norms, and roles that are regularly revisited and refined in a collaborative, inclusive team process.
This relational style of engagement runs counter to the prevailing model of leadership in healthcare. It replaces a traditionally hierarchical, authoritative, individualistic, prescriptive, and physician-centric approach with an approach that is collaborative, engaging, and nurturing. Given that the correct solution for a local challenge is discovered through a process of exploration and experimentation, Relational Leadership™ repositions the team from being merely a vehicle of execution of a pre-determined plan, to becoming a dynamic space of mutual learning, collaboration, and professional growth.