What is public health leaders' greatest knowledge or skills deficit? It seems most everyone has an opinion about the knowledge or skills that leaders need to acquire. Barney Turnock explained in Public Health: What It Is and How It Works that, “Senior public health officials must have the preparation not only to manage a government agency, but also to provide guidance to the workforce with regard to health goals or priorities, interact with stakeholders and constituency groups, provide policy direction to a governing board and interact with other agencies at all levels of government whose actions and decisions affect the population whose health they are trying to assure.” Louis Rowitz outlined in Public Health Leadership the innumerable talents, traits, skills, and perspectives required to be the consummate public health leader. And the Institute of Medicine identified in The Future of the Public's Health that leaders must have “expertise in their specific subject area; substantive expertise in the content and values of public health and competencies in the core skills of leadership…skills for vision, communication and implementation…”
So, the skills and knowledge and competencies required are known but the question remains, how are current public health leaders performing in terms of the core skills? One way to answer this is to look at the 360-degree performance data collected for the 155 public health leaders (“PHLI Scholars”) who have completed the National Public Health Leadership Institute during the last three years. Those PHLI Scholars from across the United States had 1,158 peers, superiors, subordinates, and clients complete the Center for Creative Leadership's (CCL) Benchmarks® assessment to evaluate their skills in: meeting job challenges, leading people, and respecting self and others. The results over the three cohorts were remarkably consistent. For all three, the number one leadership deficit was in “confronting problem employees.” You might say: but, this is not a leadership skill, this is a basic management skill. And, you would be right. Being able to effectively address the members of your team who are not performing is a basic managerial skill that is needed just as much for entry-level managers as for health directors.
Now, leaders in public health will say they are rated poorly at confronting problem employees because they work within civil service systems, with unions and government bureaucracies that limit their flexibility. However, the 88,731 private-sector respondents who have evaluated their leaders with the CCL's Benchmarks® instrument, also have identified “failure to confront problem employees” as the number one deficit for over 10,000 leaders who work in Fortune 500 companies, associations, not-for-profits, the military, and the government. Clearly, we in public health are not unique in not having the skills—or the incentives or support systems—to address problem employees.
Does this matter, you might ask? The largest Gallup pool survey ever conducted—over one million employees—tried to answer if there was a relationship between the work environment and organization performance. In other words, does what employees think really matter in terms of an organization doing well? Gallup's results were extremely surprising—not because the answer was “yes,” but because what really matters to employees in terms of staying in jobs and performing well was unexpected. Gallup determined that the strength of a workplace can be measured by employees' responses to questions such as, “Do I have a best friend at work?,” “Is there someone at work who encourages my development?” or “Are my co-workers committed to doing quality work?” Human resource departments have traditionally focused on schedules and benefits and pay structure and grievance procedures, and, yet, satisfaction or dissatisfaction with those job dimensions does not impact organizational performance as much as employees liking their boss, their co-workers, and their team. As the saying goes, employees don't leave their job, they leave their boss. The Gallup research is an incredible validation of the importance of middle- and senior-managers in determining organizational effectiveness.
Because managers were determined to be so critical to organizational performance, Gallup interviewed over 80,000 managers across 400 organizations to try to understand what the world's greatest managers do differently. And, they then summarized their findings in one word: fit. Yes, fit. Great managers have the innate ability to fit employees with the position or work that needs to be done. And, perhaps more importantly, to address those who are not a fit.
Who fits people to roles—positions—expertly? Coaches do. The job of a coach is to prepare others to dunk the basket, land the puck, and cross the goal line. The coach sits on the sidelines hoping they have selected the right players, put them in the right position, prepared them for their respective positions, taught them how to play together—hoping they will score the most points and win the game. But the coach isn't the one who plays the game.
Herb Brooks, the most recent in a long line of coaching legends who has been brought to the silver screen, was featured this year in the movie Miracle. Highlighting the relatively inexperienced US Olympic Hockey team's 1980 win over the dominant Soviet Union team, Miracle credits Brooks with being able to select the right kids for the right positions and then to optimize their performance in those positions. In one of the movie's most powerful scenes, Brooks is being admonished because he is not selecting the best players and he responds, “I'm not looking for the best players, I'm looking for the right players!”
So what does coaching have to do with confronting problem employees? The first question to ask yourself is how you would define your role. Several years ago, a senior leader who had just lost his job commented, “How can they do this to me? In the 15 years I have been here, there has never been a major mistake!” This leader defined his role as leadership = control. He saw the leader's job as controlling people, projects, and schedules. And, yes, it was true that there were no major mistakes during his tenure, but neither was there innovation or partnering with other community organizations or development of staff. What he most valued, what he brought to the organization, was risk-free management, which was not what the organization valued.
If you see define yourself as a coach, then you see your number one job is to maximize the performance of those on your team. This is more important than program development or budgeting or strategic planning. As the other famous coach, Knute Rockne, said, “You win with the people!” If you see yourself first and foremost as a coach, it will have a powerful impact on how you spend your time. Coaches spend their time understanding what the team needs to get the job done, selecting the right person for every position and then giving them instructions and feedback. And, when the coaching process fails, they recognize that it is not working and do something about it.
So, back to this notion of fit. What is required for a coach to effectively fit the right person in the right position? First, the coach has to have a clear idea of what competencies are required for every position. Years ago, a group of managers were interviewing candidates for a director of nursing position. It became apparent that the interviewers—none of whom were nurses—could not begin to evaluate the candidates' nursing philosophy, conceptual framework, and skills currency. So often, candidates are hired based strictly upon whether people like them in the interview. This is because the manager and the hiring staff have not invested sufficient time to really think about the expectations of the role and what skills the ideal candidate will bring. Coaches invest their time really thinking about what is required in a position for the team to be successful.
Then coaches prepare players for their positions. They do this by teaching them their role and introducing them to others players' roles and then helping them practice their roles and then debriefing on how they did in the practice and then helping them practice again. So, how much time do you invest in teaching your employees' their roles and introducing them to others' roles? This can be time consuming. But the manager doesn't have to see him/herself as the only coach on the team. Recognizing this, many organizations have a system of appointing “on-board” coaches to serve as peer coaches for new employees. This system has been employed by many organizations to support workforce diversity by providing a support system for underrepresented minorities.
During practice the coach observes team performance, provides encouragement and feedback, and then takes notes. But what happens after practice is equally important because this is when the team is debriefed on how they did and the coach commits what they have learned to writing and develops a game plan to improve. Peter Senge, in The Fifth Discipline: The Art and Practice of the Learning Organization, identifies that learning organizations invest in reflecting on their performance and how to improve performance constantly. When was the last time you led your team through a debriefing of a major event or incident or even facilitating their reflection of their current performance? Just asking, “How do you think we are doing? What could we do better?” at your next staff meeting can unleash a torrent of creative ideas about how the team might function effectively.
But even with fit and practicing and debriefing, what do you do when the coaching fails? Well, in public health, rather than getting the person off the team, we often move them to another position. And, as Gallup identified, great managers are skillful at moving employees to the right position because they see the hidden talent in the individual—not because the employee needs to be moved off the team. So, the first step is to ask if this individual's talents can be better suited to another position.
Jim Collins has extensively studied the characteristics of companies which have outstanding performance. As Collins asked, “What if you don't want them in another seat, you want them off the bus?” The coaching process with a problem employee begins with getting the employee to see that a problem exists (see Figure 1).
Oftentimes, this is not easy because the employee sees the performance gap (Gap #1) as all the tasks they are performing that are beyond minimal job expectations, whereas the manager sees the performance gap as the difference between a consistent standard of performance and the failure of the employee to meet even minimal standards (Gap #2). The first step in the process is for the manager to hear the employee describe his or her perception of his or her performance. It is quite possible that the employee will enlighten the manager about unheralded contributions he or she is making. But the manager needs to be prepared to provide specific examples that illustrate Gap #2. The manager needs to understand why the employee is failing to perform and to work with the employee to develop alternative solutions. Then, an action plan for correcting the performance with clean expectations about performance needs to be developed. For example, the manager needs to reach agreement with the perpetually tardy employee that 8:00 AM is the starting time and that the frequency of the employee being ready to do their job by 8:00 AM will be observed for the next month. And the manager and employee need to agree to meet again to evaluate performance relative to the agreed-upon standard.
For the past three years, coaching sessions have been held with the 155 PHLI Scholars on “Confronting the Problem Employee” because the message of the need to strengthen this skill has been so powerful from their colleagues. And what has happened in every one of the coaching sessions is that public health leaders have come forward to describe the arduous process they have recently gone through to address a problem employee—oftentimes with the result being termination. And, over and over, these leaders have reported, “It was so difficult. It was the most difficult thing I ever did in my career. But it has transformed my team.” Almost everyone has made a hiring mistake in their time. What distinguishes great public health leaders is that they coach their staff to get the best from their team—and they address it when someone needs to get off the team.
Take a moment to think about how you're coaching your team. Do you define your role as coaching? How can you more effectively coach people so they fit with their positions? And, finally, what are you doing when the coaching fails?
For more information about the North Carolina Institute for Public Health, go to www.sph.unc.edu/nciph.