Health Care - From Good to Great?

I started writing this particular blog entry while waiting in the Denver International Airport for my flight home to Edmonton.  I had just completed class work for my LEAN certification with BMGI.  The time away from home allowed me to gain valuable training to complement my experience with LEAN implementation.  It also afforded me the opportunity to attend to other matters and interests - like re-reading books and synthesizing the learning into something relevant for myself and my consulting practice.

One author, researcher and speaker that I have thoroughly enjoyed and whose work has really resonated with me over the years is Jim Collins. It's amazing to think that Built to Last was first published in 1994 - almost 20 years ago.  Since then Collins has gone on to release well-researched and thoughtful studies on organizations and published those findings in Good to Great, Good to Great and the Social Sectors, How the Mighty Fall, and Great by Choice.  There are many results and lessons worthy of comment, but given the nature of my blog I want to focus on Collins' concept of Level 5 Leadership.  Collins started to build the base for this concept in Built to Last but articulated it more coherently and forcefully in Good to Great.

As Collins attests to in Good to Great he was initially highly resistant to recognizing and identifying leadership as a distinguishing factor between good and great companies.  He believed that the perspective put forth by his research team in the initial phases of their research leading to a conclusion that leadership distinguished good from great companies was too easy an answer.  He was concerned that he and his team not fall into a trap of just crediting the leader or blaming the leader with company success or failure.  He wanted his team to dig deeper to achieve a better understanding of key differences between the comparison companies.  Eventually, however, he was persuaded by the data his research team collected.  There was a difference in the style of leadership between the good-to-great and the comparison companies. 

Ultimately Collins and his team established a hierarchy of leadership which is represented here in simplified graphical form.  As you view this hierarchy, consider where you as a leader fit in and/or where those around you fit in.  In addition, start to consider what we hope for in leadership for our health care system today and what style of leadership we believe will truly transform our system to better meet the challenges we face.

Collins and his team were surprised to discover that the leaders of the good-to-great companies were not anything at all like what one would have expected from popular portrayal.  These leaders were not larger-than-life, bombastic, or constantly in search of the spotlight.  Rather, Collins and his team found the good-to-great leaders to be "...self-effacing individuals who displayed the fierce resolve to do whatever needed to be done to make the company great." (italics represent my emphasis).  The research team observed that the Level 5 Leaders possessed a blend of extreme personal humility and intense professional will.  Collins was at pains to assure us that it wasn't that Level 5 Leaders didn't have egos or self-interest.  They were incredibly ambitious leaders but channeled that ambition towards the creation of a great - and sustained - company, and not towards personal gain.

Collins and his team identified some extraordinary examples of Level 5 Leaders in action - one CEO giving up $5 million of a $20 million retirement package that he was contractually entitled to (and not due to any organizational or public pressure to do so); CEO's unwilling to take credit for organizational success and deferring to team accomplishment instead; CEO's determined and focused on developing the next generation of leaders and their personal successor(s) so that they could step aside and ensure the success of the company beyond their tenure.  In contrast, comparison company CEO's were identified as being very much larger than life, possessed of tremendous drive tied to personal success or gain, able to achieve great success for the company in the short-term, but not able to sustain those gains or successes past their particular tenure. Nor were such leaders particularly interested in developing their successors - they needed to be the unquestioned "big dog". 

Equally interesting, Collins' team found no support for the idea that a company had to recruit from the outside in order to move it from good to great status.  In fact, the evidence collected pointed in the opposite direction - there was a negative correlation in any sustained transformation from good to great.  Those leaders who were "raised" from inside the organization were more committed to the long-term values of the organization and were ultimately the most passionate about the long-term success of the organization even at the expense of their own personal gain or recognition.  In both Built to Last and Good to Great there was strong empirical support for growing leaders from within the company and ensuring continuity of quality leadership. Contrast that recommendation with the reality of constant turnover in too many of our organizations.

Finally, Collins identified Level 5 Leaders as having a markedly different perspective on success and failure - personally and organizationally.  He described this as the window and the mirror.  Collins and his team consistently saw Level 5 Leaders attribute success of the organization to factors other than themselves and in particular often credited their teams with achievements of the company.  By contrast, they were quick to take responsibility for the lack of success and identify learning opportunities to guide future efforts.  They did not blame others or circumstances for that failure.  Comparison company leaders displayed mirror opposite behaviours - quick to take personal credit and apportion blame away as required to maintain personal standing. 

As readers of my blog will likely already know from my entries, I am quite biased in favour of the conclusions reached by Collins and his research team.  I aspire to be a Level 5 Leader and most certainly hope to work with Level 5 Leaders as part of any team.  One of the conundrums that Collins leaves his readers with is why we see so few Level 5 Leaders at the head of companies.  Collins' take on this reality in the business world is that personal ambition often drives people to positions of power but it is this same ambition that stands at odds with the humility required for Level 5 Leadership and long-term success (and transformation) of an organization.  He further suggests that boards of directors compound this situation by looking for, recruiting and rewarding larger-than-life leaders to move their organizations from good to great.  Long-term success and a movement from good to great requires a change in the processes by which leaders are recruited, selected and sustained - and there has to be a commitment to a long-term agenda with stability for the leadership group.

I am interested in hearing your thoughts on Level 5 Leadership and its application to health care or in general.  I want to learn from you and I hope a conversation will help all of us advance our organizations to greater success and each of us to greater personal satisfaction.  Thanks again for reading.
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Greg Hadubiak, MHSA, FACHE, CEC, PCC
TEC Canada Chair/Executive Coach/Senior Consultant
hadubiak@wmc.ca

Helping leaders realize their strengths and enabling organizations to achieve their potential through the application of my leadership experience and coaching skills. I act as a point of leverage for my clients. I AM their Force Multiplier.