How do you embed good leadership in your practice? How do you as a practice manager ensure that you possess the traits of a leader and guide your practice team to success and your practice to operational efficiency – and excellence? Tina Bachini and Ian Jones of the Practice Managers Association offer some sage advice
The General Practice Forward View (GPFV) recognises that support and training for practice managers is as important as improving the numbers of doctors in primary care. One of the areas highlighted for PMs was that of leadership development.
So, what makes a practice manager a good leader?
1. Is there a clear vision and strategy to deliver high-quality care outcomes?
PMs should establish clear goals and objectives for all staff across the practice – driven by the patient demands and the business needs. To achieve this PMs need to be both inspiring and persuasive with good listening skills and above all, they need to communicate the vision with clarity and conviction.
2. Do the risk and governance arrangements ensure that responsibilities are clear, and that quality, performance and risks are identified, understood and managed?
Success in business often comes down to recognising and managing possible risks associated with potential opportunities and the anticipated returns. The types of risks faced in most practices – and remember practices are businesses – are quite varied and far ranging. Risks should typically include both financial and physical risk categories.
Risk management does not equate to risk aversion; however, decisions driven by risk/reward assessments usually have a higher probability of successful outcomes.
Education plays a vital role in the awareness across the practice. This should cover the practical aspects of risk management and should include everybody, including the PMs, GPs, directors and GP partners. Risk management responsibilities should be clear. Whether it is intuitive actions based on experience and expertise in risk management or whether it is a result of risk policies and procedures, effective risk management is key to any successful business. Training and building awareness can lead to a risk management culture that will drive business success.
It’s important to create a register of the risks for the practice – and in so doing begin to create a risk aware culture… after all it is the responsibility of everybody to understand and manage the risks.
How does the leadership and culture reflect the vision and values, encourage openness and promote good quality care?
Honesty and integrity are the fundamental cornerstones of good leadership. PMs who are effective leaders are trustworthy and always have the best interests of the patients and practice staff in mind. They hold themselves accountable for their actions and decisions, and encourage their staff to do likewise. Transparency is also important, even when there is bad news to share. Strong leaders find reasons to get the practice team together and celebrate success, retirements, birthdays, and business success – reaching a target for new patients, costs savings through more efficient practices, workflow efficiencies – everything that creates a feeling of collaborative working and team support. Strong leaders are quick to accept responsibilities for failures, even when they may have not been directly responsible. They are also quick to give others credit for successes.
3. How are people who use the service, the public and staff engaged and involved?
It’s important to foster trust and collaboration, thereby making it possible for others to do great work. Successful leaders put staff in leadership positions whether it is a new project, an ongoing programme or simply an idea. They create ways for them to lead. To build the right team they must let them run, being supportive and nurturing and picking them up when they fall.
4. How are services continuously improved and sustainability ensured?
Challenge the process – encourage continuous improvement and learn from mistakes. The ability to be flexible as conditions change is always a function of great leadership. The best leaders make tough decisions and take managed risks. They are also able to recognise when they need the expertise or knowledge of others.
There are a number of formal approaches to continual improvement. The PDCA iterative four-step management method is widely used for the control and continual improvement of processes, services and products.
PLAN – Establish the objectives and processes necessary to deliver results in accordance with the practice services. By establishing service expectations, the completeness and accuracy of the assessment will lead to targeted improvement. Star small and build from there.
DO – Implement the plan, execute the process. Collect the data – this will support the analysis in the following “CHECK” and “ACT” steps.
CHECK – Study the actual results (measured and collected in “DO”) and compare against the expected results (targets or goals from the “PLAN”) to establish any differences. Look for deviation in implementation from the Plan i.e. Charting data can make this much easier to see trends over several PDCA cycles and to convert data into real information. Information is what you need for the next step “ACT”.
ACT – If the CHECK shows that the PLAN that was implemented is an improvement to the previous standard (baseline), then that becomes the new standard for how the practice should ACT going forward (new standards are enACTed). If there’s no improvement, then the existing standard (baseline) will remain in place. In either case, if the CHECK showed something different – good or bad – then there is more learning to be done.