November 2021
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TD Magazine

Filling the Leadership Gap in Healthcare

Monday, November 1, 2021

What does it take to build a competency-based leadership development program?

Congratulations, you're a leader. Now what? Too often leaders don't know what their next steps should be, mainly due to a lack of formal leadership development. In the healthcare industry specifically, there is a rather large gap when it comes to development that is not clinical in nature. However, leadership competencies are just as important as learning how to properly take a patient's vitals.


So, what can a healthcare organization do about that? One solution is to develop a competency-based leadership program to meet those needs and begin closing the gaps. In fact, that is exactly what I did as the first leadership development consultant—and as a department of one—at Baton Rouge General, a large healthcare organization in Louisiana.

Leadership development as a priority

Developing a competency-based leadership program begins with aligning leadership development with the organizational objectives and strategic initiatives to ensure that it is linked to the organization's overall business strategy. In addition, the company must be committed to leadership development and believe it is the employer's responsibility to invest, develop, and grow its leaders. That was apparent at Baton Rouge General by the sheer fact that it created a new leadership development consultant position.

Prior to developing that role and hiring me, the organization did not have the cohesive and integrated Leadership Development Institute that exists today. There had been some course offerings for leaders to attend, but they were not integrated and formally constructed like the Leadership Development Institute is currently. The responsibility for development that a company possesses is paramount to ensuring that organizational leaders are equipped to inspire, motivate, and engage the rest of the workforce.

General and specific leadership competencies

The next step in the program development process is to identify competencies of effective leadership through industry best practices and a thorough review of the literature. Look at not just books but also published journal entries and online articles from reputable sites, as well as your circle of professionals and like-minded individuals to discuss your findings and see what their thoughts are.

When creating Baton Rouge General's leadership competency model, some of the resources that I used included Advisory Board, the Association for Talent Development, Press Ganey, Gallup, Lominger, and the National Center for Healthcare Leadership. After identifying the competencies, I aligned them with Baton Rouge General's core values and then began to pinpoint the leadership team's attributes and capabilities. Being new to the organization and the healthcare industry, I took about three months of discovery to learn more about Baton Rouge General and its leaders. I asked questions, listened, and conducted focus groups with leaders from different levels.

I collected information using a variety of tools and techniques such as questionnaires and structured and unstructured interviews. For example, I sent a survey to all the leaders (about 200 people) asking them to rate each of the leadership competencies (for example, written and oral communication, building collaborative relationships, and conflict management) and their importance to achieving organizational outcomes as a leader. From those results, I held several other structured face-to-face interviews to dive further into the results.

After gathering that information, I clustered the data to identify themes that helped reveal numerous competencies and development areas specific to the workforce. For example, I grouped compassion and sensitivity, putting people at ease, fostering diversity, and customer service under a patient-focused competency cluster.

A competency model takes form

This point was where development of the competency model began, which would lead to program development. I knew doing so would require more than one person, so I assembled a group of subject matter experts to help me. I leveraged internal experts at all levels.

Determining who and how many people should be in your group depends on factors specific to your organization. However, having an executive presence is a must to illustrate that the organization is committed to leaders' development. Also include frontline leaders for whom you're designing the programming. Their involvement in the development process will help with buy-in and ensure you are identifying their needs. Those leaders also will later become program champions.

The way I came to identify who would be part of the group is through a stakeholder analysis. Baton Rouge General is a Lean Six Sigma organization, so it uses many lean tools, some of which I enlisted to help ensure that I included all the key players in this decision process.

My role falls under the HR and development team, and I report directly to the vice president of strategy and development. Thus, I invited several individuals from HR, including the director and senior director, as well as HR business partners to join me in developing the competency model. In addition to having HR representation, the group had executive support from the vice president of strategy and development, who formally served as our executive sponsor.

Also included in the 12-person group were some frontline leaders from the nursing areas. Having them participate ensured that we received stakeholder feedback regarding what we created and that the resulting solution would be value-added time for their development.

With the group assembled but before moving forward with our task, we established criteria for how the group would make decisions on what the development focus would be. Group members evaluated the needs-analysis results and chose where to focus based on the value different factors would bring to the development effort. We ultimately decided that we would only look at the top-ranked five to eight competencies that leaders identified as critically important. We next prioritized the identified needs.

Remember: The end result does not need to include every competency. Make sure to capture all of them during the analysis but keep your focus on understanding the difference between current and desired results. Compare those findings with the best practices and role-model behaviors, and the difference is the gap that the company needs to address.

In my case, after the needs assessment, we identified 30 competencies, 14 of which reached the minimum threshold we set. We then took those 14 competencies and sorted and grouped them. An example of one area that we consolidated was the coaching and mentoring competency, which is where we decided to cluster the competencies of developing others, feedback, and conflict management.

The activity took some time to discuss and come to a consensus on where items should fall or be grouped. The discussion that ensued was meaningful and assisted in placing competencies in the right areas to focus on for development.

From the various groupings, we established seven overall competencies that became the basis of our leadership competency model: patient focus, drive for results, building effective teams, coaching and mentoring, problem solver/decision maker, innovation and entrepreneurship, and work excellence values. Around the edge of the model are the leader development and talent management practices that contribute to the development of those competencies. They are best practices and items that we found throughout the other seven competencies and are essential in development. Finally, the model sits over the organization's four core areas: quality/safety, workforce engagement, patient experience, and financial stewardship.

Throughout the process, we took those four areas into consideration with each competency to again ensure alignment. For example, the building effective teams competency includes leaders learning how to successfully interview candidates using behavioral interviewing techniques. That directly affects financial stewardship if positions aren't filled and therefore affects productivity because a nurse may have to work overtime to fill scheduling needs.

Baton Rouge General’s Leadership Competency Model

Let the training begin

Now that we created our competency model, we could start work on filling the skills gaps. I began by developing the new-leader orientation because when I was first hired, Baton Rouge General did not have a formal method to orient me to the organization or the industry—a field with which I was not familiar. I didn't want that to be the case for our leaders moving forward, so I made sure to create programming to address that.


Another initiative, the core leadership development program, focuses on initial development of gap areas for all new leaders. It begins with participants attending new-leader orientation and then completing additional courses regarding behavioral interviewing, talent management, evidence-based leadership, change management, and basic labor law. All the Leadership Development Institute's courses are face-to-face and last approximately three to four hours. Internal experts at the director level serve as faculty members.

Prior to my hiring, a version of some of those classes or the material already existed—for example, basic labor law. However, there wasn't a formal program, and it wasn't clear which competency the content focused on developing. Given that, it was apparent that I needed to standardize and align the courses to the competency model.

The advanced leadership program is yet another development initiative that I established based on the model. After leaders complete the core program, usually within their first 18 months of becoming a leader in the organization, they begin the advanced program. It builds on some of the core courses such as behavioral interviewing, talent management, situational leadership, and conducting crucial conversations, each of which aligns to one or more of the leadership competencies. For instance, the behavioral interviewing course aligns with the building effective teams competency, and the curriculum on conducting crucial conversations aligns with the coaching and mentoring competency.

Cautions and recommendations

When companies establish competency-based development initiatives, a common pitfall is neglecting to identify their leaders' talents, attributes, and capabilities. Recognizing those factors helps provide a solid framework for leadership development and is the much-needed answer to achieving organizational success.

Another challenge when embarking on a project this large is to ensure the talent development team remains focused on the task at hand. It is easy to lose sight of the goal, but it's important to align and weave the competencies throughout the entire organization.

To combat the natural tendency of going back to the status quo and how things were before, make sure to integrate leadership development and the overall approaches with the company's other HR and talent development strategies—such as performance management, employee engagement, and career development.

Finally, just because you complete the process once does not mean you are finished and can operate under the identified competencies forever. Re-evaluate the established competencies on an annual basis. And every five years or so, conduct the entire process again to ensure the competencies are still relevant in the company. I will be embarking on this activity next year and fully expect for the competencies to change based on how healthcare is changing and specifically because of the impact the past year has had on it.

As for recommendations, first and foremost, build trust with your stakeholders and employees—they already know the organization's needs, and you will need them to champion your program after launch.

Also make sure to ask a lot of questions to different types of people when you are developing the programming. That way you can pull from all their knowledge and not just one voice that could be biased. You will not administer the program in a vacuum; therefore, you should not develop it in one either.

Overall, take your time—but not too much. Do your due diligence but be cautious of getting stuck or going down too many rabbit holes. Likewise, don't skip steps. If you don't conduct a thorough and proper needs assessment, you will end up with just a wish list for development.

Get the leadership development right

Leadership development should be a strategic focus in all organizations. Those without a formal program will have challenges achieving success. Leadership is essential to guiding innovation for improved outcomes and collaboration to share best practices. If you can get your leadership experience (and development) right, it will transform and grow every other dimension of your organization—from culture to performance management to customers (patients in this instance) to, finally, profit.

About the Author

Regina Leingang is a Leadership Development Consultant at the Baton Rouge General Health System. She is a graduate of LSU (B.S. 2005, MPA 2009, and Ph.D. 2013). Regina began her career with the Baton Rouge General in 2015 as their first Leadership Development Consultant. Regina has over 10 years of experience with the State of Louisiana in various roles and organizations before advancing to the Health Care arena. Regina is a Lean Six Sigma Green Belt, certified Senior Professional in Human Resources (SPHR), and a Senior Certified Professional within the Society for Human Resources (SHRM-SCP). Regina is also a DiSC® facilitator and has conducted several workshops as well as a Master TeamSTEPPS trainer teaching people and teams’ strategies and tools to enhance their performance.

Regina is actively involved as the current member of the Leadership Advisory Council, Past-President, President-Elect, Vice President of Membership, and Programming for the Association for Talent Development (ATD), formerly American Society of Training and Development (ASTD) – Baton Rouge Chapter. She is also a national member of the Society of Human Resource Management (SHRM), and a local member of Greater Baton Rouge SHRM. In her spare time Regina enjoys spending time with her husband and new baby boy, family, friends, and cheering on the LSU tigers and the New Orleans Saints.

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This is a very comprehensive model. I love that it springs from the values and sits atop the pillars.
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Great model.
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