Use job descriptions to ensure effective leadership

It has become a "best practice" for medical staff organizations to formulate in a written position description the essential functions and accountabilities of medical staff leaders, such as president (or chief) of the medical staff, department chair, and others.  This is often the case in medical staff organizations where these positions receive some type of payment or stipend.

The position descriptions to which I'm referring include significantly more than what is included in the medical staff bylaws regarding the specific position. The question is, do these position descriptions help ensure effective leadership?

The short answer is, not necessarily.  Let's take a look at how position descriptions can maximize effective leadership.

The Power of the Pyramid applies when we think about leadership positions:
1. appoint excellent physicians
2. set and communicate expectations
3. measure performance against expectations
4. provide periodic feedback
5. manage poor performance
6. take corrective action

1. Appoint excellent leaders. Position descriptions should include qualifications for the specific position.  This may include years of service on the medical staff organization, participation in other leadership positions (i.e., the president of the medical staff may be required to have served as the president-elect for two years, or the chair of the credentials committee might be required to have served on the committee for two years prior to becoming chair).  It is also best practice to require that those in leadership positions participate in education programs related to their position, and to continue to participate during their tenure.

Provide an orientation process for new leaders. This orientation session can be a group effort, or can be done position by position.  Logical individuals to participate in this orientation process would include the previous person in the leadership role, the chief medical officer or vice president for medical affairs (if such a position exists), the director, medical staff services and the director, quality support services.

2. Set and communicate expectations. Position descriptions should clearly and specifically define the functions and accountabilities of the leadership position.  It is helpful to include in position descriptions the amount of time (per week or month) anticipated.  For example, the chair of the credentials committee may be expected to chair the monthly credentials committee meeting, to make phone calls to references on new applicants, to interview new applicants, and to be available to the medical staff office to deal with problematic applications.  All of these tasks may take 10 to 20 hours per month (depending upon the size of the medical staff and volume of applications). 

Candidates for these leadership positions should review the applicable position description and agree to carry out its responsibilities prior to being nominated or selected.  This is critical to effective leadership and to communicating the message that the position descriptions are not just extraneous documents, but really define the expectations of the position.

3. Provide periodic feedback.  In my experience, this step is the one that is most often missing.  Feedback, or an evaluation of the leader's performance, is something that should occur prior to the end of the leader's term in the position so that the leader can make adjustments in his or her performance.  This evaluation should not be perceived as a negative experience, but rather as an opportunity to learn what is effective, what isn't effective, and how to be a better leader.  Again, this feedback may be conducted by the CMO or VPMA if that position exists.  If not, the MEC may assist in the evaluation.

The message here is that the mere presence of position descriptions does not ensure effective leaders. Position descriptions have to be used to their maximum advantage.  Almost all medical staff leaders with whom I've met and discussed leadership issues want to be effective.  They also see acting in a leadership capacity as an opportunity to learn new skills.  Make sure your medical staff organization is helping its leaders to be successful.

Until next week,

Vicki L. Searcy, CPMSM
Practice Director, Credentialing & Privileging
The Greeley Company
vsearcy@greeley.com
www.greeley.com