Burnout among clinicians was an epidemic before COVID-19. Now, with the novel virus, the burden of being on the frontlines of healthcare is even heavier.
Although burnout looks like an individual problem, it is actually the individual manifestation of multiple system problems. One of those problems is leadership that does not protect the well-being and humanity of team members. If care team member stress and distress is allowed to progress to burnout, it can hurt patient care, safety and experience. It can also negatively impact care teams, their relationships, organizational culture, employee retention, and the overall well-being and resilience of clinicians and staff.
While healthcare workers as a group are very resilient, as made clear by what they have endured during this pandemic, they cannot endure persistently toxic environments – especially not when facing the uncertainties and insecurities brought forward by the novel coronavirus pandemic.
Overturning the epidemic of burnout and enabling clinicians and other care team members to thrive in an ever-changing environment requires a leadership model that fosters well-being and humanity. Organizations must adopt human-centered leadership by explicitly supporting their team members’ cognitive, emotional, physical, and spiritual well-being so they can, in turn, maximize their human and healing potential.
Human-centered leadership is based on two core principles:
1. The well-being of team members. Healthcare demands much from those who are called to serve.
Care team members give of themselves, manage complexity, and strive to deliver exceptional patient-centered care. They do so in an environment of imperfect information, communication, processes, and technology. It is incumbent on every healthcare leader – at every level – to lead in a way that maximizes well-being. Human-centered leadership is focused on maximizing the physical, mental, emotional, and spiritual well-being of those they lead.
2. Human and healing potential. The work of healthcare is healing, which extends not just to the clinical but to administrative factors. Healing cannot be reduced to procedures or codes. Clinicians deserve to build their own human potential and be recognized and cherished as full humans through work. In this way it is similar to concepts such as Servant Leadership and Lean Leadership, both of which set the leader’s goal on empowering team members. Borrowing from Lean principles, human-centered leadership trusts that team members have a tremendous capacity for driving improvement. Servant Leadership even sets the growth and health of team members as persons as a success metric. Human-centered leadership sets human potential on an equal footing with healing potential as an aim of work.
Identifying the Required Skills
After interviewing more than 50 healthcare leaders across the spectrum, my team and I, along with members of the Experience Innovation Network, identified the beliefs, behaviors, and skills that human-centered leaders strive to master. These centered around concepts such as authenticity, humility, courage, transparency, coaching, and stewardship of resources and well-being. We organized these masteries into a meaningful framework. At the core of this framework are two critical axes of mastery.
The first focuses on developing a leader’s heartset (how complex needs and unique perspectives are recognized and addressed), mindset (creating opportunities for growth while ensuring work feels meaningful and has a purpose), and skillset (building skills in a way that accomplishes the mission while gaining a personal sense of satisfaction).
The other involves developing person’s ability to lead themselves so they can interact mindfully with others, lead others through their ability to empathize with and coach them, and ultimately lead the organization to excellence by understanding, embracing and living the organizational mission in a way that empowers others to do the same.
Mastering the Model
Most healthcare leaders we interviewed believe that the masteries of human-centered leadership can be developed in nearly anyone. Many also feel that the skills and values traditionally taught in business and leadership training often focus on organizational results, sometimes at the expense of people.
As a result, those interested in human-centered leadership should first focus on the individual and relational aspects of their personal development. These aspects are not the norm in traditional leadership training, which tends to be more authoritarian.
Without good models in their own careers, leaders who choose to pursue human-centered leadership must intentionally work to overcome ingrained patterns and habits to create a new normal. Additionally, organizations must support their leaders so they can conduct difficult conversations in a caring and compassionate way.
Mastery starts with a commitment to the principles of human-centered leadership as the best way to lead. Human-centered leaders believe that leading in alignment with values will result in positive outcomes (quality, safety, finance, etc.). They also commit to creating a dialog about what cognitive, emotional, spiritual, and physical well-being look like and how to achieve them. Reciprocity (modeling desired traits) is central to human-centered leadership.
Breaking Down Barriers
Logic seems to dictate that human-centered leadership should be adopted automatically and immediately by healthcare organizations. Yet, it isn’t that simple. It is actually a radical change from the hierarchical and often paternalistic way healthcare organizations have been run traditionally. Therefore, there are several barriers to implementation.
One barrier is the effort required to move in this direction. Under stress it is often far easier to revert to a command-and-control model versus human-centered leadership. Then there are differences in the maturity and experience level of team members throughout the organization. Managing a group of seasoned, mature leaders is different than managing those who are new or have little workplace experience. It is important not to manage to the lowest common denominator. Avoid designing processes or rules that will prevent you from rewarding good people and the good work they do.
Then there is inherent human bias and inequity. Everyone has their biases, but leaders dedicated to human-centered leadership must actively guard against them. When systems display inequity, leaders must recognize and change the systems to create organizations that embrace, model, and advance true equity, diversity, and inclusion.
Mastering human-centered leadership requires continuous development and intentional practice. Many leaders assume they are self-aware, yet only 10-15% exhibit holistic self-awareness. Human-centered leaders also seek to advance their mastery through a learning and growth mindset and daily practice.
Determining the Impact
What does all of this effort yield? The answer is different for different organizations.
Many of the masteries of human-centered leadership are more about the how than the what of leadership, which makes them difficult to quantify. Human-centered leadership is a relational model, and so measuring its impact must include linking metrics of business success with conversations that support the team and assist with assessing whether leaders and team members are aligned with the organization’s core values.
It is also reflected in team members’ attitudes toward the workplace. Team members who are inspired and energetic – who find joy in their work – provide a strong indicator that human-centered leadership is present and working. Continued burnout, poor attitudes and general frustration show that work still needs to be done.
Handle with Care
Now more than ever we need leaders how can lead with humanity and courage who have a focus on elevating the well-being of healthcare team members. Embracing human-centered leadership takes effort, care and commitment, especially for leaders who have experienced or are leading in cultures that have historically embraced more traditional leadership models. Human-centered leaders have to dig deep to connect with team members on a personal and human level. They have to confront biases and inequities (their own and those of other people) with grace and equanimity. However, if they do so, their organization will reap the rewards of authentic human connection, integrity, and shared purpose and accomplishment. These will form the foundation for sustained excellence in quality, safety, and human experience for patients, families, and team members alike.