Contract Management:
Midlevel Management Development
Betty J. Noyes, RN, MA
Management Development, 26 JONA, Vol. 32, No. 1, January 2002,
JONA Volume 32, Number 1, pp 25–26
In the midst of healthcare reengineering, midlevel managers were asked to do more with less. They were given fewer staff to perform a greater variety of tasks. Their managerial
responsibilities increased but managerial preparation did not. This lack of educational preparation among middle managers became an issue of significant
importance. Executive leaders recognized that achieving clinical excellence and desired financial
return were not possible without properly educated middle managers.
The managers at the unit level were well intentioned but lacked the skills to handle the responsibilities expected of them. During the 1990s, healthcare’s managerial talent
burned out quickly because they were forced to perform tasks for which they had neither preparation nor experience. Their directors and nurse executives had little time themselves to coach and mentor. Novice managers were expected to interview,
hire, counsel, and budget as well as care and case manage. These
managers needed skill-building education and inspiration.
It is essential that a management development program be available to address the needs of novice and intermediate managers as well as those of directors, who have more sophisticated learning needs. Participants should include managers from both
clinical and support departments. The program should also be designed to include aspiring front-line managers, so that there is an organization approach to succession planning.
Program Goals
The goals of a management development program should be to:
- Provide practical knowledge and skills that facilitate the development
of leadership attributes and competencies
- Support the personal career development of participants and facilitate
recruitment and retention of leaders for the organization
- Enhance the collective functioning of the patient care management
leadership team
- Facilitate the development of core competencies required of a successful
front-line manager
- Enable leaders to build effective work teams and implement supportive
management strategies
- Provide access to a career path for the learner that promises the highest
level of personal/professional satisfaction and career achievement
possible.
Each organization’s culture, communication style, and strategic efforts are unique and will guide the specific content of a management development program. The program should be built upon the competency and job requirements for midlevel managers
that is tailored to meet specific organizational and managerial needs. From this starting point, skills are identified that are necessary to competently fulfill the responsibilities
found in most job descriptions. Administratively experienced healthcare leaders then develop the appropriate curriculum.
Organizational Assessment
The management development program must support and supplement the organization’s existing strategic initiatives, critical educational needs, and enhances the performance of the frontline managers. Strengths, weakness, and perceived opportunities for enhancing
participants’ skill bases must be identified. Support of the senior team to reinforce
learning is critical.
Participant Assessment and Evaluation
Before implementation of any management development program, a plan for participant assessment and evaluation must be developed. Some assessment and evaluation areas include.
- Participant self-assessments
- Immediate supervisor’s assessment of the participant
- Confidential knowledge test
- Specific educational needs as identified by senior executives
- Participant evaluation of each module
- Total program evaluation
The first 3 items should be administered before and after program implementation.
Assessment of Participants' Needs
Participants should complete a confidential application/self-assessment survey. Questions might ask them to describe their most recent successful accomplishments and a failure, along with additional questions requiring narrative responses, for example, “What aspects of your job keep you up at night?” Participants should also be asked how they feel about the organization and what they would like to change and/or enhance. The assessment
should also ask the participants to indicate their self-confidence in each of the areas the program will address: finance, human resources, case management, critical process improvement, and communication/ conflict management. Finally, the survey should ask questions about job satisfaction. In addition, each participant’s immediate supervisor should identify the participant’s strengths and areas that need skill development. The survey results should be shared only with the faculty teaching the management development program. The organization’s executive team can be given a cumulative/aggregate report.
Program Description
The management development program should stress problem solving and implementation of the basic skills for the adult learner. Only about 30% of content should be lecture. Each session should engage the student in group activities to discuss and practice the skill
set being presented. The participants are asked to involve themselves
in cooperative efforts in class discussion and exercises. Gaining
teamwork skills are essential for the participant’s achievement in
management.
Content
Content modules might be up to 2 days in length, depending on the organizational
priorities and decision of the executive team. Sessions should be spaced approximately 1 month apart and taught by experienced healthcare personnel. One faculty member should attend all sessions to assure continuity.
Examples of module content might be:
- Personal Effectiveness
- Financial Management Skills
- Communication Skills
- Human Resources Management
- Care and Case Management Strategies
- Coaching Skills
- Critical Process Improvement Skills
- Technology
- Managing Teams
Each module should involve a small amount of preliminary work, for example advance readings or requiring that samples of work be brought to the class.
Learning Project
To encourage application of skills, a learning project should be part of the program. Each participant should choose an organizationally approved project, to complete during the
course of the program. Learning projects ideally integrate with internal initiative and quality assurance programs. The quality assurance director typically provides oversight. The outcome of the learning project is to illustrate the achievements of the participants’
leadership on a departmental and organizational level. The learning projects provide
opportunity for the participant to gain experience in financial, human resource, stakeholder identification, and involvement. Learning projects provide practice in the use of process improvement tools. The participants should present their projects in both
written and oral formats to their peers and the senior executive team upon completing the program.
Post Program
Continuation programs should be encouraged. Such continuation programs may take several forms, advanced classes in selected topic areas, internal sponsored conventions, Web based continuing education programs, and scheduling periodic conferences for graduates to enhance learning and foster the continuation of team building.
Conclusion
It is not hard work, long hours, or performance pressure that cause managers the greatest amount of stress; they see these as part of the job. What triggers harrowing days and sleepless nights is a syndrome called “impossible expectations.”1 Managers are asked to solve problems and perform management tasks for which they do not have the knowledge, experience, or resources to succeed. Our managers want to be successful and help their organizations but they are set up to fail. Critical to addressing this problem
is a comprehensive and ongoing management education and development program.
References:
- Hymowitz C. In the lead: impossible
expectations and unfulfilling work
stress managers, too. The Wall Street,
January 16, 2001, p. B1.
- Betty J. Noyes, MA, RN,
Author affiliation: Noyes & Associates,
Ltd., Bainbridge Island, Wash.
- Corresponding author: Betty J. Noyes,MA, RN, President, Noyes & Associates,Ltd., 5179 NE Sullivan Road, Bainbridge Island,
WA 98110 (Noyes@noyesconsult.com).
- Management Development, 26 JONA • Vol. 32, No. 1, January 2002,
JONA Volume 32, Number 1, pp 25–26,
©2002, Lippincott Williams & Wilkins, Inc.,
http://www.nursingcenter.com
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