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SAEM Chief Resident Leadership Forum Leadership vs Management Roles Carey Chisholm Indiana University 3 June 2011.

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Presentation on theme: "SAEM Chief Resident Leadership Forum Leadership vs Management Roles Carey Chisholm Indiana University 3 June 2011."— Presentation transcript:

1 SAEM Chief Resident Leadership Forum Leadership vs Management Roles Carey Chisholm Indiana University 3 June 2011

2 Congratulations!!!! “Crème de la crème” Demonstrated some unique skills in order to be here So pat yourself on the back… And then realize that our expectations of this collective group are even higher

3 So, What’s This About? Leadership vs Management Roles Pragmatic advice (hopefully!) Ideas for personal/professional growth Springboard for future thought and development

4 "Leaders are made, they are not born. They are made by hard effort, which is the price which all of us must pay to achieve any goal that is worthwhile." Vince Lombardi (1913 – 1970)

5 Which is MORE important? Be a good leader?Be a good leader? Be a good manager?Be a good manager?

6 How many of you are satisfied with your leadership skills? How many of you are satisfied with your management skills? What’s the difference?

7 “Lead as though those who will follow are volunteers…” Wildspitze, Austria 12,382 ft

8 Defining your CR “niche” “Elected” versus “selected”“Elected” versus “selected” –Who are your constituents? “Academic CR”“Academic CR” “Administrative CR”“Administrative CR” Hybrid?Hybrid? Scheduler?Scheduler? –Shifts –Didactics Interviewer?Interviewer?

9 Your “legacy” will be defined by your accomplishments during the upcoming year … and how well you groom those who will follow you in this role!

10 Your impact as CR is limited only by your vision, dedication and work ethic!

11 Your “role” is defined by your program structure and the leadership – management style of your PD… But there still should be ample opportunity to both lead and manage.

12 Exercise…. Name the 5 top leaders in American historyName the 5 top leaders in American history

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14 Exercise Now name the top 5 managers in American history…..Now name the top 5 managers in American history…..

15 Bill Gates, co-founder of Microsoft Steve Jobs, co-founder of Apple Larry Page, co-founder of Google Andrew Carnegie, steel industry Conrad Hilton, hotel industry Henry Ford, automobile industry

16 “Nearly all men can stand adversity, but if you want to test a man's character, give him power.” Abraham Lincoln

17 Are you a “leader”… or are you a “manager” ??? What’s the difference? Who cares????

18 Leadership vs Management Management is “working within the system”Management is “working within the system” Leadership is “working on the system”Leadership is “working on the system” Management is “doing things right”Management is “doing things right” Leadership is “doing the right thing”Leadership is “doing the right thing” You CANNOT be successful as a CR unless you do both well, and know when to lead and when to manage.You CANNOT be successful as a CR unless you do both well, and know when to lead and when to manage.

19 Leadership vs Management “A leader is someone who knows where to go.”“A leader is someone who knows where to go.” “Management skills are how they actually get there”“Management skills are how they actually get there” – Mark Shead, 2007 Designing vs implementing a planDesigning vs implementing a plan Managers have subordinatesManagers have subordinates Leaders have followersLeaders have followers

20 When do you “manage”? Maintenance of the status quoMaintenance of the status quo Stewardship of resourcesStewardship of resources Accountability is desiredAccountability is desired Consistency is importantConsistency is important Adherence to regulations/protocols or accreditation standards is impt.Adherence to regulations/protocols or accreditation standards is impt. Task focusedTask focused

21 When do you “lead”? Change is necessary or desiredChange is necessary or desired –Crisis or Opportunity Moral authority: doing the right thingMoral authority: doing the right thing –Lead by example Unique opportunitiesUnique opportunities Onerous taskOnerous task

22 A US President is enjoying 85% approval ratings Are they leading or managing?Are they leading or managing?

23 What’s the difference between being a “resident” advocate, and a “residency” advocate?

24 Resident advocate = immediate needs Residency advocate = longitudinal view

25 Empowerment Share with constituents Tap into creativity Problem solving Scheduling –12 & 2 example Promotes ownership May decrease complaints Some risks – not for the unconfident

26 CR Toolbox Time ManagementTime Management CommunicationCommunication –Written, e-mails –Verbal –Unspoken Conflict resolutionConflict resolution Empowerment & DelegationEmpowerment & Delegation Role ModelingRole Modeling

27 Who works BEST under pressure? Who is a tremendous multi-tasker?

28 ANSWER NO ONE!!!!!!NO ONE!!!!!!

29 Time Management #1 predictor of what you will (won’t) accomplish#1 predictor of what you will (won’t) accomplish “By failing to plan, you’re planning to fail”“By failing to plan, you’re planning to fail” Ultimate stress management toolUltimate stress management tool Control, flexibility, productivityControl, flexibility, productivity Ask those in leadership roles…Ask those in leadership roles…

30 Time Management Tools CalendarCalendar Task listTask list –Prioritized ContactsContacts AvailableAvailable Capture “passing items” that require action or F/UCapture “passing items” that require action or F/U

31 Planning Longitudinal projects: “retrograde planning”Longitudinal projects: “retrograde planning” Anticipate specific components for task completionAnticipate specific components for task completion Establish specific time intervals for eachEstablish specific time intervals for each Build in a 20% bufferBuild in a 20% buffer Longitudinal tracking systemLongitudinal tracking system

32 Planning Every task should have a deadlineEvery task should have a deadline “A goal without a deadline is a dream”“A goal without a deadline is a dream” Look ahead:Look ahead: –6 mos (once a month) –1 month (once a week) –1 week (daily) Build in buffers!!!!! Expect the unexpected!Build in buffers!!!!! Expect the unexpected!

33 Scheduling Fair & TimelyFair & Timely Tracked over timeTracked over time –WE, Holidays, Nights Contingency plansContingency plans –Tardiness –Short term absence –Long term absence A well done schedule displeases everyone equally…..A well done schedule displeases everyone equally…..

34 Scheduling Issues Handling requests (equitable)Handling requests (equitable) Reward good behaviorsReward good behaviors Play to individual’s strengthsPlay to individual’s strengths Watch ACGME mandates (switches)Watch ACGME mandates (switches) Triple the time you think it will takeTriple the time you think it will take Kevin Rodgers’ hand-out postedKevin Rodgers’ hand-out posted

35 Communication Front page rule for e-mailFront page rule for e-mail Sit on e-mails written in angerSit on e-mails written in anger Listen, take notesListen, take notes Summarize and paraphraseSummarize and paraphrase Behaviors, not peopleBehaviors, not people Social Media Policy?Social Media Policy?

36 “Never Wrestle with a Pig… You both get muddyYou both get muddy And the pig likes it!”And the pig likes it!”

37 Conflict resolution Seek “win – win” resolutionsSeek “win – win” resolutions Keep track of favors (asked and given)Keep track of favors (asked and given) If a “non-negotiable” is created by an outside entity (e.g. ACGME), all parties aware?If a “non-negotiable” is created by an outside entity (e.g. ACGME), all parties aware? Example IM clinics = EM conferencesExample IM clinics = EM conferences Jim Adams handshake and introJim Adams handshake and intro

38 “Sent-Boxed” (Nick Mohr) Track your correspondenceTrack your correspondence Organize in retrievable mannerOrganize in retrievable manner Helps establish “problem ownership”Helps establish “problem ownership” Complaints that schedule requests weren’t honored (multiple requests never answered)

39 When confidentiality isn’t an option ImpairmentImpairment –Substance abuse –Depression/suicidal –Specific threats Sexual harassmentSexual harassment “Would you like for me to go with you to discuss with the PD?”“Would you like for me to go with you to discuss with the PD?”

40 How many of you have good delegation skills????

41 “No man will make a great leader who wants to do it all himself or get all the credit for doing it.” “The secret of success lies not in doing your own work, but in recognizing the right man to do it” – Andrew CarnegieAndrew Carnegie

42 Delegation Skills AuthorityAuthority Not responsibility or accountabilityNot responsibility or accountability Clear parameters of taskClear parameters of task ResourcesResources Time line & check pointsTime line & check points Right person for the right jobRight person for the right job Accept blame - Bestow creditAccept blame - Bestow credit

43 Leading by example Visibility & AccessibilityVisibility & Accessibility The “slow walk-through”The “slow walk-through” Volunteers, not subservientsVolunteers, not subservients Schedule is always examinedSchedule is always examined TransparencyTransparency

44 Problems Not understanding your role (constituents)Not understanding your role (constituents) Not understanding the “chain of command”Not understanding the “chain of command” Personal agenda supersedes residency’sPersonal agenda supersedes residency’s DisorganizationDisorganization Poor communication-negotiation skillsPoor communication-negotiation skills Gossip – Privacy – ConfidentialityGossip – Privacy – Confidentiality FavoritismFavoritism

45 What’s in a name? (establishing “moral imperatives”) “Conflict” versus “war”“Conflict” versus “war” –“War” implies a change in culture –Results in a fundamentally different way of viewing our place in the world –WW2 versus subsequent “conflicts” –“War on Terror” –“War on Poverty” (redistribution of wealth) “Medical Error” vs. “Patient Safety”“Medical Error” vs. “Patient Safety”

46 Caveat: Use “renaming” judiciously and purposefully. Can be an effective method to motivate others to follow.

47 Academic CRs Don’t be a “know – it – all”Don’t be a “know – it – all” Teach problem solving skills (not just facts)Teach problem solving skills (not just facts) Hone public speaking skillsHone public speaking skills –Elicit feedback Engage and dialogueEngage and dialogue Use mentor(s)Use mentor(s) Trial creative educational modalitiesTrial creative educational modalities

48 Academic CRs Always have a “plan B” for cancellations and no-showsAlways have a “plan B” for cancellations and no-shows Review content ahead of timeReview content ahead of time –Even when explicitly requesting topics Digital cameraDigital camera Capture casesCapture cases CQI, Risk ManagementCQI, Risk Management

49 Academic CRs Cases uncommon to academic centersCases uncommon to academic centers –Transfers, 3 rd trimester OB –Specialty referrals –Lack of technology –“When is it impt to come in at 0200 hrs?” Teach about ‘plan c’ and ‘plan d’Teach about ‘plan c’ and ‘plan d’

50 Administrative CR Know your role and resourcesKnow your role and resources Develop time management skillsDevelop time management skills Admin list serve for problem solving and mentorshipAdmin list serve for problem solving and mentorship Practice ‘committee skills’Practice ‘committee skills’ Develop relationships with other CRsDevelop relationships with other CRs

51 Administrative CRs Committee skillsCommittee skills –Agenda (highlight prep needs) –Assure key people attend –Timeliness (do NOT reward tardy) –Problem solving, NOT info exchange –Agenda item status: closed, pending, deferred, tabled –Render your opinion last –Clarify and summarize other’s thoughts

52 Administrative CRs Dealing with disruptersDealing with disrupters Assign recorder for minutesAssign recorder for minutes Timely distribution of minutesTimely distribution of minutes Strategic placement of controversial itemsStrategic placement of controversial items Showcase other’s effortsShowcase other’s efforts Praise in publicPraise in public

53 Relationships Meet face to faceMeet face to face Ask the hypotheticalAsk the hypothetical –“How would you like for me to address..?” Bad & GOOD!! Invite feedback, collaborationInvite feedback, collaboration Look for opportunities to commend the residentsLook for opportunities to commend the residents “Thank-you” cards, etc.“Thank-you” cards, etc.

54 Summary YOU define your success or failure Develop – learn skills for success Give back more than you take… …and you’ll take away far more than you ever dreamed. “Give ‘em hell”!!

55 Final Advice – Serenity Prayer Give me the serenity to accept the things I cannot changeGive me the serenity to accept the things I cannot change Give me the strength to change the things to change the things that I canGive me the strength to change the things to change the things that I can And the WISDOM to know the differenceAnd the WISDOM to know the difference

56 Best Wishes!!!


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