Ep: 020 -The Leadership Paradox in Healthcare: Why Your Experts Might Be Holding You Back

0:00Welcome back Bridge Builders to Bread to Lead the podcast transforming healthcare leadership. I'm your host, Dr. Jake Taylor Jacobs, and I'm thrilled that you're here. We're currently ranked as the 30th top business and leadership podcast nationwide, and it's all thanks to listeners like you. Bridge Builders, if you haven't already, grab a copy of my book, Bread to Lead on Amazon. It's packed with strategies to elevate your leadership game. If you got questions or ideas for the show, visit us at breadtolead.com. Now, what are you waiting for? Let's die.

0:34now the applause is for the fact that on this podcast we are stepping our game up and i'm extremely excited about it i'm excited about it because i know you all heard that introduction sounding all professional i'm excited about that this podcast was actually started as a speakerphone, a megaphone, if you will, from the book Bread to Lead, our book Bread to Lead that's in Amazon right now, really trying to help transform leadership all over the world, specifically in healthcare. And we're honored to be ranked number 34 today. Yesterday was number 30. For some reason, we cannot break the top 30, but I'm excited that we are consistently staying in the 35 and below range.

1:32And then for all categories, because of you listeners, we are ranked 100 between 150 and 156 in the entire country when it comes to business leadership. And I think that's very important because a lot of the lessons that we've learned in our healthcare journey as a company, what I've learned as a corporate fixer can absolutely help all people that are listening to this podcast. So again, another applause for you

2:07because you deserve it. I want to give a shout out to all of the bridge builders out there that's spreading the podcast in all of these hospitals all across the country. I'm super excited about how committed we are being as it pertains to changing healthcare all over the world. I'm going to tell you, I'm going to be honest with you. I'll do my intro in a second, but I think I found my calling in healthcare. I think I love being a corporate fixer specifically in a healthcare space because with turning around a hospital, we're bettering patients' lives, creating safer places for people to go and get worked on and to get made well so they can go out and protect their family.

2:54So welcome back, Bridge Builders, to another eye opening episode of Bread to Lead. I am your host, Dr. Jake Taylor Jacobs, COO of Sips Healthcare Solutions, principal managing partner of BizCo Capital. For those new to our community, I've spent my career as a small business and corporate fixer, diving into struggling businesses and corporations and now having the privilege to do the same thing in the health care space with Sips Consults. And I have another celebration. Sips Healthcare has been ranked number one in providing services and solutions for central sterile processing and perioperative services and solutions.

3:43We're number one in the country. I'm excited to not only talk about it, but I'm excited that what we're doing is being recognized by our peers. You can you cannot buy this ranking from Black Book. You cannot, you know, ask for an interview. They do an anonymous survey and collect data from people that are in the field and the people that are in the field have ranked us number one. I'm super excited about that. I just had to say that. And so, you know, as a corporate fixer, I've historically helped businesses and corporations transform their operations and now health care. My particular focus, as you can tell, I just gave, you know, the announcement of our number one ranking as SIPPS Healthcare Solutions.

4:32It lies in perioperative services and central sterile processing, two areas that are absolutely critical to hospitals, operations and patient safety all across the world. Now, for some of you that are listening to my podcast that are not in the health care space, that is dealing with anything that is before, during and after surgery. So anything around supporting a surgery, that is the primary space where my company, where we come in and ensure that the patient safety and infection rates are low to ensure a healthy return of the patients to their families. Today, we're tackling a topic that's been keeping me up at night, if I were to be honest.

5:20And I bet it's been gnawing at many of you, too, that are in the health care space. We're going to talk about a paradox that's plaguing periop and central sterile processing departments all across the country. A paradox that's costing millions in lost revenue, stifling innovation and leaving talented professionals burnt out and disillusioned. And here's a million dollar question that I want to bring to you that we're going to kind of mull over this entire podcast episode. And we're going to ensure that we answer this question as we continue to walk through it. My question is, are you placing technical experts in leadership roles in your periop and CSP departments and wondering why these crucial areas aren't thriving?

6:12Again, the question is, are you placing technical experts in leadership roles in periop and CSP departments and wondering why these crucial areas aren't thriving? If you're nodding your head right now, don't worry, you're not alone. In fact, you're in the majority. But by the end of this episode, you're going to have a whole new perspective of leadership in periop and CSP. And more importantly, you're going to have actionable strategies to transform these departments yourself. And I just want to start something. OK, we want to start with a scenario. I see all too often in hospitals across the country.

6:53And listen, in order for us to put our pictures on, you know, there used to be a show called Barney. I don't know if it's still around. And what he wanted to do when he got the children to imagine something different. And he sing a song, said, just imagine, just imagine all the things that we could be. Imagine all the places we can go and see. Imagination's fun for you and me. And the reason why I love that song is because being a practitioner in leading organizations, simulations you have to kind of create these imaginary simulations in your mind to see what the result of a decision that you're making and how it affects not just your department but other departments that depend on the effectiveness and the efficiency of your department and all too often we have an idea in our head we say ah that's a great idea we put it to paper we put it out there on the floor in our departments and we wonder why they are not taking it it's because we haven't thought about it.

7:57We haven't imagined the scenario playing all the way out in all of the areas that could in fact be an issue. We're not dealing with that before we bring it to the department. So listen, let's imagine that you're the CEO of a midsize hospital. Your perioperative services department is struggling. Turnover times between surgeries are too long. First case on time starts are abysmal and surgeons are complaining about instrument availability and quality. Your central sterile processing department isn't faring much better either. They're plagued by high error rates, long processing times and staff turnover.

8:40So what do you do? You look for your best surgeon and the one with the most impressive track record, the one who knows the OR like the back of their hand, surgeon or nurse, because in perioperative services, you typically would have a CNO, a nurse, kind of oversee perioperative services. Okay. And you promote them head of perioperative services. For CSP, you take your most experienced technician, the one who can assemble even the most complex instrument sets in their sleep, and you put them in charge of central sterile processing. Fast forward six months and things are worse than ever. OR efficiency is down.

9:21Costs have continued to climb. And that star surgeon, they're talking about quitting medicine altogether. In CSP, error rates haven't improved. Staff morale is at an all-time low. And your new manager is drowning in administrative costs and tasks, excuse me, administrative tasks that they never were trained to handle. What went wrong? You put your best experts in charge. And the question I know you're probably asking right now is, isn't that what you're supposed to do? Well, bridge builders, that's the leadership paradox. We're going to unpack it today because here's the hard truth. Being an expert in surgery or an expert in nursing or an expert in sterile processing doesn't automatically make you a great leader of the periop or CSP department.

10:17In fact, sometimes it can make you a terrible one. Now. Before you start thinking, I'm anti expert. Let me be clear. Technical experts are crucial to any peri-op and CSP department. We need them. They're the ones who ensure surgeries run smoothly, who guarantee the sterility of instruments, who push the boundaries of what's possible in these specialized domains. But and this is a big but. That can't not lie. You other brothers can't deny. I'm sorry. I had to. They're not always the ones who should be leading transformation in your periop and CSP departments. Let's break this down. In the world of periop and CSP leadership, we've got two distinct types of leaders, subject matter thought leaders and transformational leaders.

11:15Both are important. Both bring value to the department, but they are not interchangeable. And when we try to use them interchangeably, this is when things go awry. Let's start with the subject matter thought leader in Periop and CSP. These are your experts in Periop. These might be your top surgeons, your top nurses, OR nurses, your ACE anesthesiologists. In CSP, these are your technicians who know every instrument, sterilization protocol inside out. They excel at driving technical results and they're the go to experts in their niche. But here's the thing about subject matter thought leaders in periop and CSP.

12:00They typically focus on what and how. How do we perform the surgery more efficiently? What's what new sterilization techniques can we implement to improve turnaround times? These are crucial questions. and we need people who can answer them. However, subject matter thought leaders often keep their gaze too narrowly within their domain. A surgeon might be focused on optimizing their specific procedures without considering how changes might impact the overall flow of the OR. A CSP technician might be laser focused on perfecting a particular sterilization process without seeing how it fits into the broader context of the entire hospital operations.

12:50That's where transformational leaders come in. These leaders operate at a higher level. They're not just concerned with how to do things better within the existing frameworks. They're questioning the frameworks themselves. They're connecting the dots across the departments. They're fostering innovation and inspiring teams to adapt to change. Transformational leaders in Periop and CSP are masters of the why and the who. Why are we structuring our OR schedule this way? Who needs to be involved to improve communication between Periop and CSP? How can we inspire our teams to embrace new technologies or processes?

13:35Now, here's where things get interesting, Bridge Builders. The reality is that only about one in 10 professionals have the rare combination of technical mastery and transformational leadership ability. Let that sink in. Only about 10 % of the peri-op and CSP workflows likely has the capacity to be both a subject matter expert and a transformational leader. This isn't just my opinion. This is backed by solid research. Studies on leadership from organizations like Gallup and Harvard Business Review consistently show that a small percentage of individuals possess high levels of competency in multiple leadership domains.

14:23It's rare to find someone who has both deep technical expertise in periop and CSP and the ability to inspire and lead large-scale organizational change. But the question should be, why is this combination so rare? So rare? Well, it comes down to the fact that the skill sets required for being a subject matter expert in peri-op or CSP often contrast sharply with the needed skills for transformational leadership. Think about it. What makes someone great? What makes someone a great surgeon or CSP technician? They're often highly detailed oriented, focused on perfecting specific techniques or processes.

15:11They excel at working within established protocols and systems. Now, what makes someone a great transformational leader in periop or CSP? They tend to be big picture thinkers, able to see how changes in one area might impact the entire surgical workflow. They're skilled at building bridges between departments, at inspiring diverse teams to work towards a come and go, at navigating the complex dynamics of hospital politics. These are different cognitive and behavioral strengths. It's like asking someone to be both a sprinter and a marathon runner. Can it happen? Sure. But it's rare. And it requires a unique individual who's invested significant time and effort in developing both skill sets.

16:03Equally. This rarity is sometimes something I've observed time and time again in periop and CSP departments across the country. There's often a clear gap between people who are technically astute as an expert in their field and those who can inspire and lead large scale change. Now, why does all of this matter? Why should you care about the difference between subject matter thought leaders and transformational leaders in these departments? And it's simple because when we confuse these roles, when we ask technical experts to lead transformation, we create the gap. In that gap, that's where departmental misalignment happens.

16:52That's where we see stagnation, burnout and yes, millions in lost revenue and profit. When you have two subject matter experts, one may be an OR subject matter expert, maybe a nurse, maybe a surgeon. One may be a SPD, census thorough processing department expert. And now you have two subject matter experts who believe in what they do so much. And they believe that their department is the sole reason the hospital runs. This subject matter expert believes that their department is the sole glue of the entire hospital and both are right and wrong at the same time. Both need each other. One may be more beneficial or more important in one aspect, while the other is more beneficial and important in another aspect.

17:44But when you're so focused on being a thought leader and defending your domain or your department, this is the issue that happens. And this leads to a lack of connectivity from one department to the next. Let me give you a real world example. I recently came across a case study of a large urban hospital that was struggling with efficiency and quality issues in their perioperative services and central sterile processing departments. They've been grappling with long turnover times between surgeries, frequent delays due to instrument issues in rising costs in both departments. The hospital had tried various approaches, implementing new scheduling software, bringing in lean consultants and even purchasing new equipment for CSP.

18:32But the problem still persisted. When the case was analyzed, it was found that they had put their top surgeon in charge of perioperative services and their most experienced CSP technician in charge of centristural processing. These were highly skilled professionals to experts in their field, but they were approaching the problems from a purely technical perspective. They were so focused on optimizing individual processes within their departments without seeing the big picture of how these departments interacted and impacted the overall patient flow. The surgeon in charge of Periot was excellent at streamlining specific surgical procedures.

19:22But struggle to address broader issues like staff scheduling, interdepartmental communication and strategic planning. The CSP technician turned manager knew every instrument and sterilization protocol by heart, but was overwhelmed by the administrative and leadership aspects of running the department. This is a classic example of misalignment that happens when we ask subject matter experts to take on transformational leadership roles in periop and CSP. And the cost of this misalignment, they're staggering. costing hospitals millions of dollars. First, there's the financial cost. In this case, the hospital was losing millions annually due to inefficiencies delayed in council surgeries and the need to purchase duplicate instrument sets to compensate for slow processing times.

20:20Then there was the human cost. The surgeon and the CSP technician, who were brilliant in their domains were stressed and burnt out trying to manage departments in ways they were not trained for. Staff across both departments were frustrated and resistant to changes that didn't seem to address the root problems. And perhaps most critically, there's the cost to the patient care. Inefficiencies in peri-op and CSP don't just impact the hospital's bottom line. They can lead to delayed surgeries, increased risk of surgical site infections and overall lower quality of care. We'll take a break and we'll be back.

21:10Bridge builders, are you struggling with implementing transformational change in your health care organization? At SIPPS Healthcare Solutions, we understand the unique challenges of health care leadership. Our executive coaching and leadership development programs are designed to help you build a balanced leadership team that leverages both subject matter expertise and transformational leadership skills. Visit SipsHealthcare.com to learn how we can help you bridge the leadership gap and drive meaningful change in your organization. Welcome back, Bridge Builders. Before the break, we were talking about the costly misalignment that can happen when we confuse subject matter expertise with transformational leadership ability.

21:55Now, let's dig deeper into why this misalignment happens and how we can address it. One of the main reasons we fall into this trap. Is that it seems logical on the surface. If someone is an expert surgeon or nurse practitioner or CSP technician, surely, right, they're the best person to lead change. Right. But this thinking ignores a crucial truth. Leading change in peri-op and CSP requires a fundamental different skill set than being a technical expert in surgery or sterile process. Let's break down the key differences. Let's start with focus. Subject matter thought leaders focus on depth. A surgeon might be focused on perfecting a particular surgical technique.

22:54A nurse may be focused on ensuring patient safety in the OR. CSP technician might be dedicated to optimizing a specific sterilization process.

23:10sounds good, right? But their focus is on depth of their industry or depth of their domain, not the interconnected domains that all affect one decision. But transformational leaders, on the other hand, they focus on the breadth, the width. They need to understand enough about the multiple areas from surgery to anesthesiology to sterile processing to hospital administration to see how they all fit together in the big picture of patient care. Let's talk about the difference in communication style. Thought leaders in periop and CSP often communicate in the language of their expertise. They're comfortable with medical jargon and technical specifications.

23:56But transformational leaders need to be able to communicate complex ideas about surgical workflows or sterilization processes in simple terms that resonate with diverse audiences that are not from that domain. From frontline staff to hospital executives, even to patients. Let's talk about the difference in how thought leaders versus transformational leaders problem solve. Thought leaders excel at solving technical problems within their domain. Give them a specific issue with a surgical procedure or a sterilization protocol, and they'll likely come up with an excellent solution. Transformational leaders, however, are adept at solving systemic problems that cut across multiple domains.

24:46They're looking at how to change the system itself, not just fix the issues within the existing domain that they're residing in. Relationship to change, there's a difference. Thought leaders often drive incremental change within their domain. They might focus on small improvements to surgical techniques or minor adjustments to sterilization processes. Transformational leaders, on the other hand, drive radical change. They're about reimagining how the entire periop or CSP department could function differently, better, innovatively. And lastly, let's look at how each thought leader versus transformational leader how they deal with team dynamics.

25:35Thought leaders often work best with teams of other experts in their field. A top surgeon might prefer working with other experienced surgeons and surgical nurses. A skilled CSP technician might be most comfortable collaborating with other technicians. Transformational leaders, however, need to be able to work with and inspire diverse teams across the organization. They need to be able to bring together surgeons, nurses, anesthesiologists, CSP technicians, administrators, and more, aligning them toward one common goal, patient care. Now, here's where it gets tricky. In peri-op and CSP, we often promote people based on their technical expertise.

26:27And don't worry, I've seen this across many different industry sectors. This is typically what would happen. The best surgeon becomes the chief of surgery. The best nurse becomes the chief of nursing. Chief nursing officer. The best knowledgeable CSP technician becomes the departmental manager. And in many ways, this makes sense. We want leaders who understand the intricacies of work being done in the OR and in CSP. But if we're not careful, we can end up with a leadership team full of subject matter thought leaders and no transformational leaders. And it happens all the time. And when this happens, we see peri-op and CSP departments that are technically proficient, but strategically stagnant.

27:20They might be performing surgeries or processing instruments correctly according to best practices, but they're not innovating. They're not adapting to changes in the health care landscape. They're not inspiring their staff to reach new heights of efficiency and quality. So how do we address this issue? How do we ensure that we have the right balance of thought leaders and transformational leaders in our periop and CSP departments? The first step is recognition. We need to acknowledge that these are different skill sets and that they're both are valuable. We need to stop assuming that being an expert surgeon or CSP technician automatically qualifies someone for a leadership role in these departments.

28:07Next, we need to start intentionally developing transformational leadership skills in our Periop and CSP departments. This means investing in leadership development programs that go beyond technical skills. We need to be teaching things like strategic thinking, the ability to see the big picture of how Periop and CSP fit into the larger hospital ecosystem. We need to be teaching change management, understanding how guide how to guide these complex departments through significant changes in processes and technology. We need to be teaching emotional intelligence, the capacity to understand and manage one's own emotions in others and those of others.

28:50Crucial in high stress environments of the OR and CSP. We need to be teaching communication skills, the ability to articulate a vision for departmental improvement and inspire others to follow. We need to be teaching system thinking, understanding how changes in one area periop or one area in CSP might affect other departments throughout the entire hospital ecosystem. And we also need to rethink our organizational structures in these departments. Instead of always putting the top surgeon or the most experienced CSP technician in charge, we should be looking at creating leadership teams that balance subject matter expertise with transformational leadership skills.

29:39For an example, instead of making your top surgeon the head of perioperative services or your top nurse, the head of perioperative services or your top surgeon over the OR, You might pair them with a transformational leader who has a track record of driving organizational change in health care settings. The surgeon can provide a deep subject matter expertise that's needed, while the transformational leader can focus on the bigger picture of how to innovate and improve the entire perioperative process. In CSP, instead of promoting your most skilled technician to department manager, consider bringing in a leader with experience in process improvement and change management.

30:21This leader can work closely with the technical experts to drive departmental change while ensuring the high standards of instrument sterilization are maintained. Now, you may say, Dr. J, how does that affect? How does that affect our department, our technicians, our specialists? They have to be able to grow. They have to be able to promote up. We have to rethink or innovate what we consider leadership positions. You may have somebody that's an operational manager that's a transformational leader. And in the same breath, you may create an equal, a peer who's the clinical technician of the department.

31:09Their job is quality. Their job is teaching standards. Their job is to make sure everyone is skilled technically while the person running the organization is engineering efficiency within the department. And they work as a unit, not as one, especially when it's hard to find a transformational leader that has the ability to be both. Now, I can already hear some of you thinking, but Dr. J, where am I supposed to find these transformational leaders for periop and CSP? You said that they're rare. And you're right. They are rare. But here's the good news. While the natural ability to be both a subject matter expert and a transformational leader might be rare.