June 2006

Grant Results

SUMMARY

The Health Research and Development Institute—which was concerned about the supply of qualified leadership for the country's most complex health systems as well industry performance—formed a coalition with the Association of University Programs in Health Administration and the Accrediting Commission on Education for Health Services Administration to catalyze fundamental, field-wide change in the way health care managers and leaders are trained and evaluated.

The work led to the establishment of the National Center for Healthcare Leadership and its development of projects for the field. A wide range of collaborating organizations and subcontractors participated in the planning and founding of the national center. (See Appendix 1 for a list.)

Key Results
Project staff from the National Center for Healthcare Leadership:

  • Created the Health Leadership Competency Model, which defines the competencies required for outstanding health care leadership for the future. The model guides the design and development of the National Center for Healthcare Leadership's educational interventions and assessment initiatives.
  • Created the Advanced Leadership Development Program, a six-month experiential program for senior executive teams. The program is run through the Global Business Partnership of the University of Michigan Business School, a collaborating partner of the center.
  • Established the Leadership Excellence Networks (LENS), a collaborative learning network made up of leading health care systems committed to fostering the skills and behaviors required for high-performing, effective health care leaders in various stages of their careers and across the disciplines of administration, medicine and nursing.
  • Created the Graduate Health Management Education Demonstration Project to improve university-based graduate health care management education programs by implementing competency-based education and outcome assessment. Four graduate health management education programs participate in the program:
    • University of Michigan (Ann Arbor, Mich.)
    • University of Minnesota (Minneapolis)
    • Simmons College (Boston)
    • University of Washington (Seattle)
  • Created the Health System Demonstration Project to work with management in selected provider organizations to accelerate improvement in clinical and organizational performance in their organizations. Five health systems participate in the project:
    • AtlantiCare (Egg Harbor, N.J.)
    • Henry Ford Health System (Detroit)
    • North Shore-Long Island Jewish Health System (Great Neck, N.Y.)
    • St. Luke's Episcopal Health System (Houston)
    • Regional Medical Center (Memphis)

Funding
The Robert Wood Johnson Foundation (RWJF) provided four grants totaling $1,028,583 from June 2000 through December 2004:

  • Two grants to the Association of University Programs in Health Administration for strategic planning.
  • Two grants to the National Center for Healthcare Leadership for its work.

 See Grant Detail & Contact Information
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THE PROBLEM

A growing number of CEOs of major health care organizations and leading academics in health care administration believe that managerial performance in the field of health care is no longer adequate, according to the report from the summit conference held in Orlando, Fla., on February 8–9, 2001 (Grant ID# 038844, reported on in detail in The Project).

Participants noted these specific symptoms of the problem:

  • Deficiencies in terms of cost, quality and patient satisfaction.
  • Difficulties in attracting the profession's fair share of young leaders.
  • Lack of a clear, documented advantage to getting a degree from a college accredited in health care administration.
  • Academic institutions were not providing the kind of programming needed by practitioners in the field and to advance practice.
  • Insufficient attention devoted to the value of a practical learning experience as an integral component of professional development-particularly residencies, postgraduate fellowships and mentorships.
  • Declining support for young managers, particularly in close mentoring relationships and planned career development.
  • Inconsistencies and uneven quality in mid-career education in health care administration compared to leading corporations in other industries.
  • Failures in the advancement of women and underrepresented minorities.
  • An acute shortage of individuals prepared for the senior ranks of the emerging multibillion-dollar health care systems and health insurance companies.

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RWJF STRATEGY

RWJF supports programs that involve a diverse group of promising scholars and leaders in leadership development, training and research. It makes investments to build specific fields within health and health care and help ensure that the United States has a sufficient, well-trained workforce. Programs include:

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THE PROJECT

RWJF awarded four grants to catalyze fundamental, field-wide change in the way health care managers and leaders are trained and evaluated:

  • Two grants to the Association of University Programs in Health Administration.
  • Two grants to plan and establish the National Center for Healthcare Leadership.

The Association of University Programs in Health Administration received additional funding of $125,000 for the planning phase and summit meeting including approximately $50,000 from the Health Resources and Services Administration of the U.S. Department of Health and Human Services and $75,000 from 11 other sources.

The National Center for Healthcare Leadership received additional funding of $412,595 from the W.K. Kellogg Foundation, along with $260,000 in corporate sponsorship, $14,000 from the University of Michigan Business School for license fees for the initial Advanced Leadership Development Program pilot program and $51,000 in in-kind contributions. (See Appendix 2 for details of the other funding.)

The First Two Grants

Grant ID# 038844 The Healthcare Research Development Institute partnered with staff at the Association of University Programs in Health Administration and at the Commission on Accreditation of Healthcare Management Education to plan, organize and convene a summit conference of national leaders in health care management and policy.

A 13-member senior steering group—with membership representing academic and private sector interests, along with representatives from the three collaborating organizations—provided guidance for the summit. (See Appendix 3 for a list of members of the committee.)

The chief goals of the summit were to:

  • Engage a broad range of stakeholders in assessing the adequacy of existing education, training and performance in health administration.
  • Produce a definitive statement of next steps.

The National Summit on the Future of Education and Practice in Health Management and Policy, held in Orlando, Fla., on February 8–9, 2001, drew approximately 200 participants. Proceedings appear in the December 2001 special issue of the Journal of Health Administration Education. (See the Bibliography for details.)

Grant ID# 042147
Project staff convened a post-summit work session March 16–17, 2001, in Chicago. The approximately 40 attendees (primarily the principal speakers and discussion leaders from the summit) finalized the action plan initiated at the summit.

A paper, "Agenda for the Future," (by Project Director Jeptha Dalston, published with the summit proceedings in the December 2001 special issue of the Journal of Health Administration Education) summarizes an action agenda in seven key areas (see Appendix 4 for details).

  • Momentum and communications.
  • Encouraging broad participation at the various career stages—early career, mid-career and advanced career.
  • Establishing appropriate baselines of data.
  • Identifying core competencies for superior performance.
  • Identifying the best means for career preparedness.
  • Identifying effective measures for determining quality career preparation.
  • Strengthening the values, level of diversity and talent pool.

The Second Two RWJF Grants

Initial Proposal The senior steering group for the project unanimously approved the establishment of the National Center for Healthcare Leadership as a formal structure to carry out the mission of encouraging stronger managerial leadership in the health care field. In November 2001, the National Center for Healthcare Leadership was founded with initial funding from the W.K. Kellogg Foundation and, in 2002, its staff submitted a new proposal to RWJF to pursue the action plan crafted at the post-summit meeting in March 2001.

The proposal envisioned a project for catalyzing change in the field of health care administration, spearheaded by the grantee organization in association with a broad range of councils made up of volunteers from the field.

RWJF weighed concerns from a range of professional societies (primarily the American College of Healthcare Executives, the Healthcare Financial Management Association and the Medical Group Management Association) about the need for the proposed center.

Grant ID#s 043084 and 049126
RWJF decided to support the creation of the Chicago-based center with two grants to carry out the action plan.

A 26-member Strategic Framework Group—an expansion of the senior steering group that had guided the planning effort (see Appendix 5 for a list of members)—oversaw the formation of the National Center for Healthcare Leadership. The group named a board and four advisory councils to lead the center (see Appendix 6 for the board members).

Marie E. Sinioris, M.P.H., at the time an independent contractor with the Strategic Framework Group, became vice president in charge of administration for the center, and later became the president and CEO.

Healthcare Leadership Project. The center's principal undertaking is the Healthcare Leadership Project, which aims to create a process to:

  • Identify and prioritize professional competencies for effective health care management and leadership.
  • Translate these competencies into educational outcomes that early-, mid- and advanced-career health managers must attain.

Activities. To achieve these goals, a project team including the project director, an administrative assistant and consultants conducted a variety of activities:

  • Subcontracted with American College Testing to conduct a comprehensive literature review on leadership competencies, as well as a survey of best practices in identifying and prioritizing competencies.
  • Subcontracted with the Hay Group to identify competencies needed by managers and leaders, along with developing evaluation protocols and methods.
  • Convened a Core Competency Council, a panel of 13 health care management practitioners and academic leaders, to guide the effort.
  • Appointed an Advisory Council on Research and Continuous Improvement to guide the development of future research initiatives in the area of evaluation and continuous improvement.
  • Subcontracted with the Tiber Group to assess the current state of executive development in health care management, findings from which were used to guide the design of the Advanced Leadership Development Program. (See Results for details on the program.)
  • Commissioned two research studies to understand the supply of qualified and demographically diverse individuals in health care management. (See Appendix 7 for a description.)
  • Formed a Blue Ribbon Task Force on Accreditation jointly with the Commission on Accreditation of Healthcare Management Education to create a strategy for integrating education outcomes into the accreditation process for schools of health care management. The center conducted two national studies to support the effort. (See details in Appendix 7.)
  • As part of the process of creating the Graduate Health Management Education Demonstration Project, project staff conducted literature reviews and other activities. (See details in Appendix 7.)
  • The center held a conference—entitled "Meeting the Challenge: NCHL's First Invitational Symposium"—in Princeton, N.J., on January 14, 2003. A total of 120 individuals representing 78 organizations attended.
  • The center sponsored two best practice conferences in 2004—on July 16 in Chicago and on December 12 in Orlando, Fla.—for participants in the Health System Demonstration Project.
  • Center staff published nine articles, 10 reports and five issues of a newsletter. Staff also made approximately 15 presentations at professional conferences. Media coverage of the project included six articles in trade journals such as The Week in Healthcare and Modern Healthcare.
  • The center's Web site contains information on its goals, activities and programs, along with the newsletters and some articles. (See the Bibliography for details.)

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RESULTS

Staff at the National Center for Healthcare Leadership:

  • Developed a protocol for evaluating organizational culture that embraces the six aims identified by the Institute of Medicine as key to improving the national health system—that care should be safe, effective, patient-centered, timely, efficient and equitable. The protocol also measures key indicators using a series of assessment instruments.
  • Developed a protocol for aligning human resource systems with the center's competency model. The center commissioned a white paper on succession planning and talent management. It served as the basis for a December 2004 conference for participants in the Graduate Health Management Education Demonstration Project on best practices. See bullet four below for more details on the project.
  • Created the Health Leadership Competency Model to guide the design and development of the center's initial educational interventions and assessment initiatives. The model consists of 26 competencies in three main areas:
    • Transformation: Envisioning, energizing and stimulating a change process that coalesces communities, patients and professionals around new models of health care and wellness.
    • Execution: Translating vision and strategy into optimal organizational performance.
    • People: Creating an organizational climate that values employees from all backgrounds and provides an energizing environment for them. This area also addressed leaders' responsibility to understand their impact on others and to improve their capabilities—as well as the capabilities of others. Details on the competency model are online.
  • Created the Graduate Health Management Education Demonstration Project to improve university-based graduate health management education programs by implementing competency-based learning and outcome assessment. See Appendix 7 for activities that led to the project's creation and products it created. In May 2004, a selection committee convened by the center chose four graduate health management education programs to participate in the program:
    • University of Michigan (Ann Arbor, Mich.)
    • University of Minnesota (Minneapolis)
    • Simmons College (Boston)
    • University of Washington (Seattle)
  • Participating sites use the center's Healthcare Leadership Competency Model. They:
    • Conduct a comprehensive review of their curriculum and teaching methods.
    • Develop and implement a programwide competency-based learning and assessment curriculum.
    • Participate in the evaluation of competency-based learning and assessment outcomes using measures and methods specified by the center.

    Center staff collected baseline data as part of an evaluation that will help identify, catalogue and disseminate best practices in curriculum design, teaching and assessment that the pilot sites have developed. Staff expects the demonstration to run at least five years.
  • Established the Leadership Excellence Networks (LENS). LENS is a collaborative learning network made up of health care provider organizations committed to fostering the skills and behaviors required for high-performing, effective health care leaders in various stages of their careers and across the disciplines of administration, medicine and nursing.
  • Created a portfolio of leadership programs, including a Coaches Academy and a series of fellowships. The Coaches Academy consists of several components:
    • A cadre of center-certified executive and middle management coaches who are available to work with participants of LENS and the Graduate Health Management Education Demonstration Project to conduct leadership and organizational development planning.
    • A two-day on-site workshop for health care organizations to develop managers' skills to create "coaching cultures" within the organizations.
    • The Coaches Certification Workshop, which trains and evaluates potential coaches.
    • A Diversity Awareness Program as a one-day workshop.
  • Created a plan for evaluating individual, team and organizational performance in participating organizations. Project staff also initiated development of a national health leadership database that will serve as a central depository for all data related to both the demonstration project and the Leadership Excellence Networks (LENS).
  • Created the Advanced Leadership Development Program as a six-month applied workshop for senior executives in health care. Run through the Global Business Partnership of the University of Michigan Business School, a collaborating partner of the center, the program includes:
    • Three off-site workshops (one five days long, the others three days long).
    • Internet communications to aid collaborative work with peers.
    • Visits to selected facilities.
    • On-site support to each participant's health care organization.

    A PowerPoint description of the program is available online.

    Pre- and post-test questionnaires of the first workshop in 2002 indicated that participants' scores on a set of educational outcomes had significantly improved at post-test.

    Questionnaires that examined the effect of the coaching that workshop participants received from their CEOs on professional development and specific strategic projects indicated that the level of coaching from CEOs correlated positively to workshop participants' comfort with the organization and their perceptions of the use of evidence in strategic decision-making.
  • Created the Health System Demonstration Project to accelerate improvement in clinical and organizational performance in selected provider organizations. Participating sites, which are also members of the center's Leadership Excellence Network (LENS), include the following health systems:
    • AtlantiCare (Egg Harbor, N.J.)
    • Henry Ford Health System (Detroit)
    • North Shore-Long Island Jewish Health System (Great Neck, N.Y.)
    • St. Luke's Episcopal Health System (Houston)
    • Regional Medical Center (Memphis)

    Committing to the implementation of the center's Leadership Development System—a comprehensive and systematic approach for improving and sustaining leadership performance at all levels within an organization—the sites work with the center to:
    • Assess individuals and organizations to identify gaps in competencies.
    • Conduct leadership and management development programs to improve individual, team and organizational performance.
    • Design and implement a competency-based human resource development system to support and sustain organizational improvement. It has an emphasis on:
      • Recruitment
      • Selection
      • Succession planning
      • Performance management
      • Job design
      • Reward and recognition
      • Efforts that align governance with leadership development objectives

    Throughout the demonstration, expected to run for about five years, the center provides the sites with:
    • Access to the center's array of individual, team and organizational assessments and feedback.
    • Coaching on individual and organizational levels from the center's Coaches Academy.
    • Customized individual leadership development plans for senior management.
    • Strategic organizational leadership development plans.
    • An ongoing community of interest and action, developed through:
      • Best practice conferences
      • Monthly teleconferencing
      • Internet-based resources
      • Access to National Center for Healthcare Leadership research and findings
      • Access to best practice database and tools

    Center staff collected baseline data as part of an evaluation that will glean outcomes and best practices from the demonstration. It will disseminate findings to other Leadership Excellence Networks (LENS) participants and the field. Staff will also use them to further inform its Leadership Development System.

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LESSONS LEARNED

  1. Establish inclusive, intensive and continuous communications with organizations and people in the field. The planning phase of the project sought to establish consensus among stakeholders—many of whom had conflicting interests—that the field was in need of broad and fundamental change, as well as agreement as to what that transformation should entail. The project director for the first two grants credited a comprehensive communications effort with establishing the rapport necessary to accomplish this. He also noted the importance of setting a tone of urgency in eliciting participation from the field. (Project Director/Dalston)
  2. Stressing shared values can help bring greater clarity and structure to a field that is inherently ambiguous. Health care management resides in the juncture between medicine—which is characterized by its intensive structure and rigor—and corporate America—which stresses profit and lacks credentialing. The key to achieving progress in this field is to get disparate participants to rally around the underlying values of health care. (Project Director/Dalston)
  3. When working with groups representing diverse interests, focus on those committed to change—do not become distracted by the stakeholders that have not endorsed the project. In this project, several professional societies strenuously objected to the creation of the National Center for Healthcare Leadership. The center also had to struggle for recognition in the field as a startup organization. According to the project director of the last two grants, rapid change causes disruption and discomfort and cannot be achieved with total consensus. (Project Director/ Sinioris)
  4. Conduct evaluations to provide compelling data and create the case for change. At the onset of the Advanced Leadership Development Program, project staff not only established the scope and specific parameters for an evaluation, but also incorporated it into the structure of the program. Tracking a program from the beginning can make the evaluation data even more valuable. (Project Director/Sinioris)
  5. When seeking to create change across an entire field, cultivate role models who can lead the way. According to Sinoris, the project director of the last two grants, the National Center for Healthcare Leadership Board of Directors (Appendix 6) served that purpose. It was composed of industry thought leaders and representatives of the four graduate health management programs and four health care systems that agreed to participate as demonstration projects to implement and evaluate innovations in leadership development and assessment. (Project Director/Sinioris)

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AFTER THE GRANT

The National Center for Healthcare Leadership continues to carry out its mission as a self-sustaining organization with a diversified revenue mix of fee-based activities, corporate sponsorships and foundation grants.

In 2005, RWJF awarded a $380,000 grant (ID# 052748) to the center to strengthen the focus on nursing within senior leadership teams. As of April 2006, investigators were working with health systems participating in the center's Leadership Excellence Networks to:

  • Assess and analyze the role of nursing in the teams.
  • Identify and implement individual and institution-specific interventions in at least three health care organizations to heighten the importance of nursing among interdisciplinary leaders.
  • Measure improvements in individual competencies, team effectiveness and the climate for nurses, physician and administrative leaders.

In 2005, the national center inaugurated the National Healthcare Leadership Award, which is an annual prize recognizing the health care leader whose commitment, values and vision embody the primary mission of the national center to identify and mentor future generations toward the goal of transforming organizational performance and improving health care in the United States. It is awarded at a ceremony.

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GRANT DETAILS & CONTACT INFORMATION

Project

Improving Leadership Development Programs for Health Care Organizations and Universities

Grantee

Association of University Programs in Health Administration (Arlington,  VA)

  • Planning for Health Care Executives in the 21st Century
    Amount: $ 200,000
    Dates: June 2000 to May 2001
    ID#:  038844

  • Strategic Planning for Health Care Executives in the 21st Century
    Amount: $ 49,983
    Dates: March 2001 to October 2001
    ID#:  042147

Contact

Jeptha W. Dalston, Ph.D., F.A.C.H.E.
(713) 523-4500
jdalston@flash.net

Grantee

National Center for Healthcare Leadership (Chicago,  IL)

  • Improving the Education and Training of Health Care Executives
    Amount: $ 479,600
    Dates: March 2002 to March 2003
    ID#:  043084

  • Improving Leadership Development Programs for Health Care Organizations and Universities
    Amount: $ 299,000
    Dates: January 2004 to December 2004
    ID#:  049126

Contact

Marie E. Sinioris, M.P.H.
(312) 755-5018
msinioris@nchl.org

Web Site

http://www.nchl.org

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APPENDICES


Appendix 1

Participating Institutions

American College of Healthcare Executives, based in Chicago, is a professional society of 30,000 health care executives who lead the nation's hospitals, health care systems and other health care organizations.

American College Testing (ACT), based in Iowa City, Iowa, is an independent, not-for-profit organization that provides assessment, research, information and program management services in the broad areas of education and workforce development.

Association of University Programs in Health Administration, based in Arlington, Va., is a not-for-profit association of university-based educational programs, faculty, practitioners and provider organizations working to improving the field of health care management and practice.

Commission on Accreditation of Healthcare Management Education, originally called the Accrediting Commission on Graduate Education for Hospital Administration, is recognized by the U.S. Department of Education as the only the accrediting agency in the field of graduate education in hospital administration. It is based in Arlington, Va.

Hay Group, headquartered in Philadelphia, is a global organizational and human resources consulting firm.

Healthcare Financial Management Association, based in Westchester, Ill., is a professional society of health care financial management professionals. It works to advance the financial management of health care by helping members and others improve the business performance of organizations operating in or serving the health care field.

Healthcare Research Development Institute, located in Pensacola, Fla., is a group of leading hospital and health care system chief executive officers and corporate executives serving the health care field who come together to enhance quality and productivity in the health care industry.

Institute of Medicine, a part of the National Academy of Sciences, is an organization chartered by the Congress to provide national advice on issues relating to biomedical science, medicine and health. It is located in Washington.

Medical Group Management Association, based in Englewood, Colo., is a professional society working to provide information, networking and professional development for the individuals who manage and lead medical group practices.

Tiber Group, based in Chicago, is a management consulting firm exclusively serving the health care industry.


Appendix 2

(Current as of the time of the grant; provided by the grantee organization; not verified by RWJF.)

Additional Funders

During RWJF grant ID#s 033884, 042147 to the Association of University Programs in Health Administration

Aggregate amount: approximately $125,000; amounts by funder given where known.

Abbott Laboratories
Abbott Park, Ill.

American College of Healthcare Executives
Chicago, Ill.

American Hospital Association
Chicago, Ill.

Healthcare Research and Development Institute
Pensacola, Fla.

Health Resources and Services Administration, U.S. Department of Health and Human Services
Washington, D.C.
$50,000

Heidrick and Struggles
Chicago, Ill.

Johnson and Johnson
New Brunswick, N.J.

MDB Information Network
Dallas, Texas

Modern Healthcare Magazine
Chicago, Ill.

Tyler & Company
New York, N.Y.

University of Alabama at Birmingham Health System
Birmingham, Ala.

Witt-Kiefer Executive Search Firm
Dallas, Texas

During RWJF grant ID#s 043084, 049126 to the National Center for Healthcare Leadership

W.K. Kellogg Foundation
Battle Creek, Mich.
$412,595


Appendix 3

(Current as of the time of the grant; provided by the grantee organization; not verified by RWJF.)

Senior Steering Group

Gail Warden, M.H.A., F.A.C.H.E., Chair
President and CEO
Henry Ford Health System
Detroit, Mich.

Diane Appleyard, M.A.
President and CEO
Healthcare Research Development Institute
Pensacola, Fla.

James W. Begun, Ph.D.
Professor and Chair
Department of Healthcare Management
University of Minnesota
Minneapolis, Minn.

James C. Crews, F.A.C.H.E.
Special Advisor
Banner Health System
Phoenix, Ariz.

Jeptha W. Daltson, Ph.D., F.A.C.H.E.
President and CEO
Association of University Programs in Health Administration/Commission on Accreditation of Healthcare Management Education
Washington, D.C.

Ray Davis, Ph.D.
Associate Professor
Department of Public Administration
University of Kansas
Lawrence, Kan.

Jack C. Ebeler, M.P.A.
President & CEO
Alliance of Community Health Plans
McLean, Va.

David J. Fine, M.H.A., F.A.C.H.E.
CEO
UAB Health System
Professor of Healthcare Administration
University of Alabama at Birmingham
Birmingham, Ala.

John Griffith, M.B.A., F.A.C.H.E.
Professor
School of Public Health
University of Michigan
Ann Arbor, Mich.

Richard P. Gustafson, M.B.A.
Managing Partner Healthcare Practice
Heidrick and Struggles
Chicago, Ill.

William F. Jesse, M.D., C.M.P.E.
President and CEO
Medical Group Management Association
Denver, Colo.

Stephen F. Loebs, Ph.D.
Professor and Chair
Graduate Program in Health Service Management
Ohio State University
Columbus, Ohio

Mary Stefl, Ph.D.
Dean
Division of Behavioral and Administrative Studies
Trinity University
San Antonio, Texas


Appendix 4

Action Agenda from the Summit

"Agenda for the Future," (by Project Director Jeptha Dalston, published with the summit proceedings in December 2001 special issue of the Journal of Health Administration Education) summarizes an action agenda in seven key areas:

  • Momentum and communications. The communications process should be continuous and increasingly broad. Study groups and other working parties should be convened to gather data, conduct analyses and perform other functions to highlight the issues and factors involved in realizing the potential for change.
  • Encouraging broad participation at the various career stages—early career, mid-career and advanced career.
    • In strengthening early-career preparation, faculties of the undergraduate and graduate programs constitute the major resource, along with alumni and preceptors.
    • In mid-career, the involvement of professional societies is key.
    • At the advanced stage, the most relevant groups are practitioner leaders in the largest and most complex health care delivery organizations and organizations involved in health care financing, supply, distribution and consulting, along with the professional societies.
  • Establishing appropriate baselines of data. To measure comprehensively and accurately the nature and extent of the problems that the field faces, and to help identify the opportunities to address them that exist, efforts should be applied to establish appropriate baselines of data. Examples of the type of data needed are:
    • Comprehensive measurement of the decline in the number and quality of residencies and fellowships.
    • Verification and measurement of the perceived gap between the field of practice and academia.
    • Measurement of the perceived decline in adherence to the values of the field.
  • Identifying core competencies for superior performance. The field needs a broad-based examination of the competencies that most determine superior performance at each career stage.
  • Identifying the best means for career preparedness. Identification of the best means for achieving competency in all career stages involves the whole of pedagogy: content, curricula, learning methods, structure, faculty, mentors and coaches. It is probable that:
    • Academic core preparation applies primarily to early-career practitioners.
    • Continuing education and its structures for certification apply primarily to mid-career and some advanced-career practitioners.
    • An institute for advanced learning applies to the most advanced-career practitioners.
  • Identifying effective measures for determining quality career preparation. The field will benefit by reexamining the existing, conventional means of measuring and setting standards—i.e., undergraduate academic certification, graduate academic accreditation and continuing education certification—with the intent to update and refine as may be indicated.
  • Strengthening the values, level of diversity and talent pool.
    • Definitive action must be taken to assess adherence to the field's values and to identify ways of strengthening both the content of those values and commitment to them.
    • In regards to diversity, a divergence exists between the health care field's rhetoric of intent and its performance. This discrepancy should be assessed and measured, and steps taken to align intent and outcomes.
    • Finally, to compete effectively with other fields for available human talent and potential, efforts should be made in the areas of marketing, promotion and recruitment.


Appendix 5

(Current as of the time of the grant; provided by the grantee organization; not verified by RWJF.)

Strategic Framework Group

Diane Appleyard, M.A.
President and CEO
Healthcare Research Development Institute
Pensacola, Fla.

G. Ross Baker, Ph.D.
Associate Professor
Department of Health Administration
University of Toronto
Toronto, Ontario
Canada

Jo Ivey Boufford, M.D.
Dean
Robert F. Wagner School of Public Service
New York University
New York, N.Y.

Ramon Castellblanch, Ph.D.
Director, Health Care Administration
Quinnipiac College
Hamden, Conn.

James C. Crews, F.A.C.H.E.
Healthcare Advisor
Phoenix, Ariz.

Jeptha W. Daltson, Ph.D., F.A.C.H.E.
President and CEO
Association of University Programs in Health Administration/Commission on Accreditation of Healthcare Management Education
Washington, D.C.

Pamela Davidson, Ph.D.
Senior Researcher
UCLA Center for Health Policy Research
Los Angeles, Calif.

Ray Davis, Ph.D.
Associate Professor
Department of Public Administration
University of Kansas
Lawrence, Kan.

William Dwyer, M.B.A.
Vice President, Strategic Marketing
Abbott HealthSystems Division
Abbot Park, Ill.

Jack Ebeler, M.P.A.
President and CEO
Alliance of Community Health Plans
Washington, D.C.

David J. Fine, M.H.A., F.A.C.H.E.
CEO
UAB Health System
Professor of Healthcare Administration
University of Alabama at Birmingham
Birmingham, Ala.

Raymond Grady, M.H.A., F.A.C.H.E.
President and CEO
Evanston Hospital
Evanston, Ill.

John Griffith, M.B.A., F.A.C.H.E.
Professor
School of Public Health
University of Michigan
Ann Arbor, Mich.

Richard P. Gustafson, M.B.A.
Managing Partner Healthcare Practice
Heidrick and Struggles
Chicago, Ill.

Charles N. Kahn III, M.P.H.
President
Federation of American Hospitals
Washington, D.C.

William F. Jessee, M.D.
President and CEO
Medical Group Management Association
Denver, Colo.

David C. Leach, M.D.
Executive Director
Accreditation Council for Graduate Medical Education
Chicago, Ill.

Peggy Leatt, Ph.D.
Professor
University of Toronto
Toronto, Ontario
Canada

Stephen F. Loebs, Ph.D.
Professor and Chair
Graduate Program in Health Service Management
Ohio State University
Columbus, Ohio

Gary A. Mecklenburg, M.B.A.
President and CEO
Northwestern Memorial HealthCare
Chicago, Ill.

Judith Overall, M.S.H.A., J.D.
Associate Professor and Chair
Department of Health Systems Management
Tulane University
New Orleans, La.

Lawrence D. Prybil, Ph.D.
Associate Dean
College of Public Health
University of Iowa
Iowa city, Iowa

Mary Richardson, Ph.D.
Professor
Graduate Program Health Services
University of Washington-Seattle
Seattle, Wash.

Catherine Robbins, M.B.A., F.H.F.M.A.
Institute of Health Policy
Heller Graduate School
Brandeis University
Waltham, Mass.

Mary Schmidt, M.B.A.
President, Customer Partnerships
Baxter Healthcare Corporation
Deerfield, Ill.

Gail Warden, M.H.A., F.A.C.H.E.
President and CEO
Henry Ford Health System
Detroit, Mich.


Appendix 6

(Current as of the time of the grant; provided by the grantee organization; not verified by RWJF.)

National Center for Healthcare Leadership Board of Directors 2001-2004

Officers*

Gail L. Warden, M.H.A.
Chair

David J. Fine, M.H.A.
Vice Chair and Secretary

William E. Moeller
Treasurer

Marie E. Sinioris, M.P.H.
President and CEO

Board of Directors
Diane P. Appleyard, M.A.

Healthcare Research Development Institute

G. Ross Baker, Ph.D.
University of Toronto

Brenita Crawford, M.H.A.
Regional Medical Center

Jeptha W. Dalston, Ph.D.
Association of University Programs in Health Administration/Accrediting Commission on Education for Health Services Administration

Lloyd H. Dean, M.A.
Catholic Healthcare West

Michael J. Dowling, M.S.
North Shore Long Island Jewish Health System

William M. Dwyer, M.B.A.
Cerner Corporation

Leo F. Greenawalt, J.D.
Washington State Hospital Association

Richard P. Gustafson, M.B.A.
Heidrick and Struggles

David C. Leach, M.D.
Accreditation Council for Graduate Medical Education
Stephen F. Loebs, Ph.D.
Ohio State University

Gary A. Mecklenburg, M.B.A.
Northwestern Memorial HealthCare

Lee H. Perlman, M.B.A.
GNYHA Ventures

Janet E. Porter, Ph.D.
University of North Carolina at Chapel Hill

Catherine J. Robbins, M.B.A.
Brandeis University

Marla E. Salmon, Sc.D.
Emory University

Mary E. Schmidt
Baxter Healthcare Corporation

Steve Shortell, Ph.D.
University of California, Berkeley

Liaison Board Members
Howard Berman, M.H.A.

Lifetime Health Care Companies

Maureen A. Bisognano, M.S.
Institute for Healthcare Improvement

Janet M. Corrigan, Ph.D.
National Committee on Quality Health Care

Nancy-Ann DeParle, J.D.
University of Pennsylvania

Jack C. Ebeler, M.P.A.
Alliance Community of Health Plans

Scott P. Serota
Blue Cross & Blue Shield Association

Senior Advisor to the Board
John R. Griffith

University of Michigan

*Current Officers


Appendix 7

Details on Project Activities

Two research studies undertook to understand the supply of qualified and demographically diverse individuals in health care management:

  • Stephen Loebs, Ph.D., conducted a national survey to determine factors affecting entry to the health management field. (Loebs S. "A Study of the Decision Factors for Careers in Health Administration," Journal of Health Administration Education, 21(4): 485–528, 2004).
  • Janet Dreaschlin, Ph.D., conducted a literature review of barriers to the advancement of women and minorities and an evaluation of best practices. (Dreachslin JL and Curtis EF. "Study of Factors Affecting the Career Advancement of Women and Racially/Ethnically Diverse Individuals in Healthcare Management," Journal of Health Administration Education, 21(4): 441–484, 2004.)

Two national studies supported the work of a Blue Ribbon Task Force on Accreditation, which worked jointly with the Commission on Accreditation of Healthcare Management Education.

  • Eugene Schneller, Ph.D., conducted a study to examine various accreditation models and identify progressive accreditation practices. (Andersen R, Howard CC and Schneller E. "Contemporary Models for Accreditation: Lessons for Health Administration Accreditation." Journal of Health Administration Education, 21(2): 185–226, 2004.)
  • Sherril Gelmon, Dr.P.H., M.H.S., conducted a study to assess stakeholder satisfaction and their expectations regarding accreditation. (Gelmon SB. "Stakeholder Satisfaction with the Accreditation Process," Journal of Health Administration Education, 21(2): 241–268, 2004.)

Activities as part of the process of creating the Graduate Health Management Education Demonstration Project included:

  • Conducted a comprehensive review of literature regarding best practices in graduate or executive competency-based education and evaluation. Staff identified approximately 100 peer-reviewed journal articles addressing the topic. A review committee selected 43 of these which were abstracted in detail for a resource guide for potential faculty.
  • Conducted a second literature review, which they used as the basis of a 40-page Faculty Reference Manual for each site. Curriculum Mapping: Specification of Learning Objectives, Learning Methods Inventory, and Assessment Methods Inventory: Faculty Reference Manual is available in hard copy. Guidebook 1: Curriculum Mapping, Analysis, and Planning, which builds on the initial faculty reference manual, is available in hard copy.
  • Worked with the Association of University Programs in Health Administration's to develop a University Competency Development Guide to serve as a comprehensive guide for faculty. The first phase of the guide includes resources and enhancements for the career-entry baseline competencies. NCHL plans a second phase for 2006.
  • Developed a portfolio of career-entry learning outcome assessment tools, to be piloted in the demonstration sites in 2006:
    • Lifelong Leadership Inventory and Feedback Report
    • Pre-and Post-Course Competency Survey (faculty and student)
    • Team Assessment
  • Developed a questionnaire to assess the impact of the demonstration project on faculty skill development. Project staff also held two workshops—in Ann Arbor, Mich., August 2004, and in Chicago, March 2005—to introduce site directors to best practices in teaching and evaluation.
  • Initiated work on creating a longitudinal database on faculty development and teaching improvement.
  • Created a master plan for implementing competency-based learning and assessment.


Appendix 8

GLOSSARY

Competency-based education: Competency-based education differs significantly from traditional education, which is based primarily on a "syllabus" of course material – a list of items students must know to pass a course. In contrast, a competency-based approach specifies expectations in terms of what a student can do or accomplish, rather than in terms of knowledge acquired.

Underrepresented minorities: Racial and ethnic groups that are underrepresented in health care administration compared to their percentage in the United States population.

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BIBLIOGRAPHY

(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)

Articles

Andersen R, Howard CC and Schneller E. "Contemporary Models for Accreditation: Lessons for Health Administration Accreditation." Journal of Health Administration Education, 21(2): 185–225, 2004.

"Best Practices in Health Leadership Succession Planning." Educational and Advertorial Supplement to Modern Healthcare, December 2005.

Calhoun JG, Davidson PL, Sinioris ME, Vincent ET and Griffith JR "Toward an Understanding of Competency Identification and Assessment in Health Care Management." Quality Management in Health Care, 11(1): 14–38, 2002. Abstract available online.

Calhoun JG, Vincent ET, Baker GR, Butler PW, Sinioris ME and Chen SL. "Competency Identification and Modeling in Healthcare Leadership." Journal of Health Administration Education, 21(4): 419–440, 2004. Also available online.

Calhoun JG, Dollett L, Sinioris ME, Wainio JA, Butler PW, Griffith JR, and Warden GL. "Core Competencies for Health Care Leadership in the 21st Century: National Center for Healthcare Leadership Competency Model (2.0)." Unpublished.

Davidson PL, Calhoun JG, Sinioris ME and Griffith JR. "A Framework for Evaluating and Continuously Improving the NCHL Transformational Leadership Initiative." Quality Management in Health Care, 11(1): 3–13, 2002. Abstract available online.

Davidson PL, Griffith JR, Sinioris M and Carreon, DC. "Evidence-Based Leadership Development for Improving Organizational Performance." Evaluation Report to the National Center for Healthcare Leadership (NCHL), August 2005.

Dreachslin JL and Curtis EF. "Study of Factors Affecting the Career Advancement of Women and Racially/Ethnically Diverse Individuals in Healthcare Management." Journal of Health Administration Education, 21(4): 441–484, 2004. A PowerPoint presentation available online.

Gelmon SB. "Stakeholder Satisfaction with the Accreditation Process." Journal of Health Administration Education, 21(2): 241–268, 2004.

"The Final Report of the Blue Ribbon Task Force on Accreditation." Journal of Health Administration Education, 21(2): 121–166, 2004. The Final Report (2003) is available online.

Loebs SF. "A Study of the Decision Factors for Careers in Health Administration." Journal of Health Administration Education, 21(4): 485–528, 2004. A PowerPoint presentation is available online.

Proceedings of the "National Summit on the Future of Education and Practice in Health Management and Policy." Journal of Health Administration Education, 19(4): 2001.

Reports

Davidson P, Calhoun J, Holt K and Carreon D. NCHL Advanced Leadership Development Program. Chicago: National Center for Healthcare Leadership, 2003.

Davidson P, Calhoun J, Holt K and Carreon D. "NCHL Advanced Leadership Development Program 2002 Evaluation Report." Unpublished.

Griffith JR, Davidson PL et al. Research Opportunities in Healthcare Leadership. Distributed upon request.

Learning and Assessment Practices in Graduate or Executive Education. Literature Search, January 1993 to April 2004. Chicago: National Center for Healthcare Leadership, 2005.

National Center for Healthcare Leadership: Business Plan. Chicago: National Center for Healthcare Leadership, 2002.

NCHL Advanced Leadership Development Business Plan. Chicago: National Center for Healthcare Leadership, 2002.

National Center for Healthcare Leadership: Corporate Bylaws. Chicago: National Center for Healthcare Leadership, 2002.

National Center for Healthcare Leadership: Advisory Council Charges, Deliverables and Membership. Chicago: National Center for Healthcare Leadership, 2003.

National Center for Healthcare Leadership: Program Initiatives. Chicago: National Center for Healthcare Leadership, 2003.

National Center for Healthcare Leadership: Strategic Plan. Chicago: National Center for Healthcare Leadership, 2003.

Vincent E and Calhoun J. Plan for Competency-Based Learning and Assessment in Healthcare Management Leadership. Chicago: National Center for Healthcare Leadership, 2003.

Vincent E. Summary of the Review of Competencies and Best Practices in Healthcare Management. Chicago: National Center for Healthcare Leadership, 2002.

Resource Guides

Decker M, Calhoun JG, Sinioris ME, and Wainio JA. Guidebook 1: Curriculum Mapping, Analysis, and Planning. Chicago: National Center for Healthcare Leadership, 2006.

Survey Instruments

"Core Competencies in healthcare Leadership Delphi survey. ACT, Inc., fielded nationally August and November 2002.

World Wide Web Sites

www.nchl.org provides information about the various councils and programs provided by the National Center for Healthcare Leadership. Chicago: National Center for Healthcare Leadership, 2002.

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Report prepared by: Robert Crum
Reviewed by: Kelsey Menehan
Reviewed by: Molly McKaughan
Program Officer: Rosemary Gibson

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