1. The Los Angeles Public Health Leadership Institute: An Intra-organizational Approach To Leadership Development APHA Session: 4143.0 The Challenge of Leadership in Public Health Tuesday, November 9, 2004

2. AUTHORS Bridget Ward Bridget Ward Director, Office of Organizational Development and Training, Los Angeles County Department of Health Services – Public Health Carol Woltring Executive Director, Center for Health Leadership and Practice, Public Health Institute Jonathan Fielding Director of Public Health and Health Officer, Los Angeles Department of Health Services – Public Health

3. LOS ANGELES COUNTY 4,084 square miles - 88 cities Population (January 2004) - 10,103,000 Population is larger than 41 states 44.6% Hispanic 31.1 % White Languages 224 languages spoken in LA County 92 languages spoken in LAUSD Education 80 school districts in LA County 12.6 % Asian/PI 9.7% Black 2% Other

4. LOS ANGELES COUNTY DEPARTMENT OF HEALTH SERVICES 2nd largest Health Department in the U.S. Total DHS workforce - 24,229 employees Public Health 4,140 employees (17%) 38 different programs, including 8 geographically divided areas 19% of total DHS budget

5. WHY LEADERSHIP DEVELOPMENT ? Ten Essential PH Services Assure a competent public and personal health care workforce Enhanced performance through improved leadership Improved collaboration across the Department Leadership needed for: Launching new PH initiatives and strategic plan Launching new PH initiatives and strategic plan New challenges such as BT and emerging infections New challenges such as BT and emerging infections

6. CONSULTANT SELECTION PROCESS OODT decided to use internal advisory/planning committee and outside consultant to conduct the Institute Research for consultants with Public Health experience who would customize the curriculum to LA goals and objectives Center for Health Leadership and Practice was selected

7. TARGET AUDIENCE 104 Senior Managers (top 4 levels in LAPHS-PH) 4 Cohorts of 25-30 Senior Managers trained in 3-4 month program from October 2003 – December 2004

8. LOS ANGELES COUNTY PUBLIC HEALTH LEADERSHIP INSTITUTE (LAPHLI) THEORY OF ACTION InputsTrainees LA County Department Of Health Services Public Health Senior Managers and Program Directors Short-termOutcomesEnhancedPersonalLeadershipSkills (Within 6-12 months) Leadership Institute Activities Skills Training Areas Personal Leadership Organizational Leadership CommunityLeadership Learning Activities Workshops (Five Days) (Five Days)PersonalLeadershipAssessmentsExecutiveLeadershipDevelopmentPlanPersonalCoachingCollaborativeLeadership Change Project Long-term Outcomes Enhance participants’ commitment to and strengthening their accountability for the Department’s mission, thereby strengthening the Department’s overall accountability to the residents of Los Angeles County Foster the development of a shared vision and integrative approach to defining and achieving Departmental goals Promote the practice of collaborative leadership skills within the Department and increase the success of internal and external collaborations Increase evidence-based decision-making by participants in addressing public health challenges Enhance the Department’s capacity for learning and change through improved leadership capabilities of participants Contribute to the development of an organizational culture that promotes leadership (including the next generation of leaders) through role modeling and coaching by participants

9. LAPHLI KEY CONTENT AREAS Current Leadership Challenges in Public Health and LADHS-PH Leadership Skills for the 21st Century Leading and Managing Reflective Leadership: Knowing Your Personality Preferences (MBTI) Systems Thinking Designing and Leading Collaborative Organizational Change Communications Sustaining Collaborative Change Work Developing Leadership in Others

10. EVALUATION Consultant hired to assess: Cohort I Short term objectives Recommendation if LAPHLI should continue Ten in-depth interviews following completion 6-month Follow up study Cohorts I, II, and III Comparison across Cohorts Daily evaluation forms Completed by each participant Reviewed by trainers for immediate feedback

11. COHORT I EVALUATION RESULTS 75% recommended Cohort II and III be approved None recommended it should not continue 25% stated it should continue if executive staff participated 53% identified it as their single top experience for short term training All identified as one of their top 4 experiences for short term training

12. RESULTS OF IN-DEPTH COHORT I INTERVIEWS Medium to high scores for daily learning objectives Collaborative Leadership Change Projects useful for participant and Department LAPHLI should continue High agreement for personal leadership ability improvement Too soon to determine scope for entire department

13. RESULTS OF 6 MONTH FOLLOW-UP INTERVIEWS LAPHLI adds value for individual and Department Strong commitment to personal leadership development Senior/Executive involvement needed for challenges with change projects Most valuable benefit is interaction with staff across the Department

14. COMPARISON OF COHORTS I, II, AND III Remarkably consistent results among cohorts and scores Immediate use for new skills to add to existing skills Individual abilities and organizational capabilities are improved Collaboration across Department will continue to improve

15. COLLABORATIVE LEADERSHIP CHANGE PROJECTS 24 projects designed by intradisciplinary/intraorganizational teams Internal tracking being done Results, lessons learned, challenges are showcased at on-going Leadership Forums LAPHLI produced positive outcomes forparticipants and the Department

16. LEADERSHIP FORUM Internal Leadership Group comprised of the 104 LAPHLI Graduates Self-Governed Meet Bi-Monthly for ½ day Six Goal Teams Commitment to ongoing leadership development and culture change

17. LAPHLI FUTURE DIRECTIONS Leadership Forum – sustained development and action Leadership skill-building workshops for alumni and their managers (next level) Succession Planning – including future staff development strategies Development of internal coaching and mentoring strategies

18. Organizations can and should put their own “legs” on leadership training investments. CONCLUSION