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The New Sheriff in Town: The Unique Role of an Interim Manager: Part 2

Charles K. Van Sluyter, for HealthLeaders Media, February 12, 2010

For many years I have belonged to a national network of healthcare executives. In recent years, after serving in 15 hospitals in nine states as an interim healthcare executive, I have become a "go-to" person within the network for people who are considering interim management work. In Part 2 of this column, I'll deal with what happens once you're in the interim manager's seat and help you avoid common mistakes that might potentially sink the engagement.

Listening to the client . . . carefully
Of course the client will provide you with the core of your assessment including expected deliverables supported by their own facts and opinions. Clearly a client's thoughts should weigh heavily in your planning. However, a client's most pressing needs may not be aligned with what they may want you to do. The following story illustrates the point.

The night before I began an interim CEO assignment in a community hospital, I had dinner with the board chairman and two other board members, all of whom had been appointed by the county board of supervisors. The hospital had steadily lost market share in previous years and was experiencing severe financial difficulties. What the hospital needed was some basic financial discipline and physician recruitment.

Nevertheless, the purpose of the dinner was not to discuss financial problems, but to give me a list of the names of hospital employees the Board members wanted me to terminate on my first day on the job. The list included the chief financial officer, the chief nursing officer, the VP of human resources, the director of medical staff services and the CEO's administrative assistant. I was told that these key staff members had signed a petition to the County Board of Supervisors to have these three board members removed. The county supervisors had ignored the petition.

I was able to buy some time by convincing the Board members of the legal jeopardy to the hospital of hasty terminations plus the severe disruption to the hospital's operations if all these staff left without capable replacements. Within a few months I was able to conduct my own assessment of the hospital's executive leadership and plan smooth transitions in some of the key positions. Ironically, midway through my nine-month tenure as interim CEO, the County Board of Supervisors terminated the three hospital Board members who had given me the list of names.

My point in telling this story is that as the "stranger from out of town" you may be expected in short order to solve political problems your predecessor was unable or wisely unwilling to solve. You will be most vulnerable to making ill-advised decisions early in your tenure. Initially you will feel driven by a self-imposed sense of urgency to prove your value and a tendency to make decisions with incomplete information and little else to offer but your own confusion.

Some of the best advice I received when I was too inexperienced to appreciate it was "go slow." Ask a lot of questions. Learn the history of the issues. Reserve judgment. Make very few statements and fewer decisions. Patient listening should precede bold leadership.

Planning the work, working the plan
How do you go slowly when you are eager to make a sure-footed start and good impression? A simple technique I have used successfully for several years when taking a new assignment is to work with my staff to develop a "Management Action Plan" with a short-term focus, generally about 90 days. Interim managers are seldom hired to formulate a new vision, update the strategic plan or change the culture. If you enjoy working at that level, interim management might not be a good fit. Interim managers typically need to focus on correcting the dysfunctional operations of their area of responsibility. The MAP is an easy tool to develop and to use to communicate the priorities.

The MAP should be a living document. It comes to life as you assess your client's needs and the resources available to address those needs. The MAP needs only to be a few pages long. It must contain measurable objectives with realistic deadlines. Each objective is assigned to one person for completion. Scheduled updates to revise the plan and reinforce the focus are essential.

As important as the content of the MAP is the process used to develop and update it. No matter how experienced you may be, as an interim manager you are likely to confront problems you have never seen before. My experience has been that the seeds of the solutions to such problems are within the staff most affected by them.

Participative management still works and is essential to obtaining trust and voluntary cooperation from an educated and skilled workforce.

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