Briefing Notes: Ambivalence About Leadership in Academic Medicine.

 CFAR Inc.

Description: In academic medicine, there is considerable ambivalence about formal leadership. Various leaders in academic medicine were asked to reflect on what close friends said to them when they first took a significant leadership role. This briefing note looks at some of their responses and reflects on these comments.

Amb_acmd.pdf   [153.98 Kb]

Briefing Notes: An Active and Collaborative Approach to Strategy in Academic Medicine

 CFAR Inc.

Description: CFAR has developed an approach to strategic planning that embraces action and collaboration. Leaders in academic medicine want a strategy that will support practical, collaborative, action-oriented steps to address their most challenging issues. The principles described here are useful for informing a structure that best meets the unique needs of any institution.

Stra_med.pdf   [218.05 Kb]

Briefing Notes: Board Orientation

 CFAR Inc.

Description: Orientation should be a two-way process of the new to the history, strategic challenges and mores of the board, and of the current board members to the fresh views and capabilities of the new members before they become too influenced by the status quo.

BN_Board Orient.pdf   [127.82 Kb]

Briefing Notes: Board-Staff Dynamics and Natural Entry Points for Connection

 CFAR Inc.

Description: Board and staff live in different micro-cultures, even as they share the mission and work of a particular organization. This briefing note looks at the typical pattern surrounding board meetings and gives suggestions for staff to capitalize on opportunities for deepening the board-staff connection.

Boa_stff.pdf   [187.15 Kb]

Briefing Notes: Developing One’s Delegation Capacities

 CFAR Inc.

Description: In this briefing note we outline key frameworks and ideas from the literature on delegation and conclude with advice, to both delegatees and delegators on ways that they can improve the effectiveness of their working alliances.

dev_delg.pdf   [337.52 Kb]

Briefing Notes: Dynamics of Triangles

 CFAR Inc.

Description: Top teams sit on the boundary between a fast-changing wider world and a complex internal organization. We know that any two-person relationship under stress will often "triangle" in a third party. This briefing note looks at some approaches to dealing with triangles.

Dy_trian.pdf   [332.79 Kb]

Briefing Notes: Effective Strategies to Increase Engagement in Meetings

 CFAR Inc.

Description: This briefing note outlines some strategies, to be used selectively and in moderation, for vitalizing meetings and increasing the presentness and mindfulness of all who are attending.

BNeffmtgs.pdf   [154.06 Kb]

Briefing Notes: Enactments in Crafting Change Strategies

 CFAR Inc.

Description: This describes the process used to try out an influence encounter with an important stakeholder. This process is valuable as preparation for being more effective in influencing a key stakeholder. It also can surface concretely strategic choices.

EnactChgStrat.pdf   [166.39 Kb]

Briefing Notes: Lessons Learned from a Board Development Intervention

 CFAR Inc.

Description: This briefing note highlights lessons learned over a four-year period as CFAR collaborated with the executive director and successive Board presidents of a professional association in increasing the effectiveness of the board.

Less_brd.pdf   [147.43 Kb]

Briefing Notes: Managing the Crush Upon Becoming a College or University President

 CFAR Inc.

Description: This paper offers some advice for the early stages of one’s presidency, especially on ways to leverage scarce time. This note does not address directly the critical issues of developing and communicating key values, vision and priorities, but rather ways of connecting to the institution to give you the intelligence to do so.

crush.pdf   [384.37 Kb]

Briefing Notes: Managing the Entry to a High Pressure Leadership Role

 CFAR Inc.

Description: Upon your appointment, everyone needs to see you yesterday and often they and observers will over interpret the meaning of the order in which you attend to various constituencies. This note offers some advice for the early stages of one’s leadership especially on ways to leverage one’s scarce time.

HiPress.pdf   [462.37 Kb]

Briefing Notes: Productive Pairs

 CFAR Inc.

Description: As organizations face increasingly complex and fast-changing environments, they typically specialize and differentiate units in order to focus on a particular function. The challenge in organizations is to link the knowledge and worldview in different units in the service of a product or service, creating a productive pair. This note looks at the different characteristics of productive pairs and how they can be fostered.

prodpairs.pdf   [197.91 Kb]

Briefing Notes: Small "L" Leadership Transition Skills

 CFAR Inc.

Description: Below are some small “L” leadership skills that can help with transitions at many levels: a new colleague joining a work group, a new unit leader, or even the CEO of the enterprise.

smallTrans.pdf   [221.11 Kb]

Briefing Notes: Strategies for Piloting Improvements in Board-Staff Relationships

 CFAR Inc.

Description: This briefing note lists specific strategies that boards have used to increase the harvesting of the intellectual capital in their members.

Brd-staf.pdf   [152.56 Kb]

Briefing Notes: Summary of Key Factors for Successful and Unsuccessful Change

 CFAR Inc.

Description: Implementing change in an organization is a lengthy and often difficult process. It requires collaboration between departments within the organization and persistence to drive the change initiative forward. This document outlines a number of factors that, taken together, impact the dynamics of change and ultimately help determine whether change efforts are sustained over time.

KeyFactorsChange.pdf   [185.22 Kb]

Briefing Notes: Thoughts on Organizational Transformations

 CFAR Inc.

Description: This briefing note looks at some common issues encountered in reflecting on many organizational-change experiences where the intent was to achieve a significant transformation.

Org_trans.pdf   [475.16 Kb]

Briefing Notes: Transition Advice for Medical School Deans

 CFAR Inc.

Description: The lessons learned in this briefing note come from a group of new deans sharing their insights about how to use the time between one's appointment and one's early months in office

Trans_ad.pdf   [155.74 Kb]

Briefing Notes: Typical Patterns in Top Teams: How This Group 'Gets Stuck'

 CFAR Inc.

Description: This briefing note looks at some commonly found patterns of interaction that tend to prevent groups from doing their work. Included are suggestions on how to break through each pattern by taking a learning role.

Top_team.pdf   [123.92 Kb]

Briefing Notes: Use of Idealized Design in Administrative Redesign and Downsizing

 CFAR Inc.

Description: This briefing note examines the case of a medical school facing the implementation of a cap on the amount of allowable overhead for central administration that translated into a challenge to take out ten percent of the budget on an annualized basis. and how idealized design was used in this situation.

ideal_dwn.pdf   [157.05 Kb]

Campaign for Strategy Implementation: Learnings from the Development of University of Pennsylvania Health System’s Geriatric Clinical Service Group

 Thomas Gilmore, Florina Gogarnoiu, Risa Lavizzo-Mourey and Nancy H. Smith

Description: This article illustrates the use of a “campaigning approach” through telling the story of the development and implementation of the Geriatric Clinical Service Group within the University of Pennsylvania Health System and summarizing the lessons learned from this experience.

UPHS-IOACmpStrat.pdf   [188.95 Kb]

Campaigning for Change

 Larry Hirschhorn

Description: Information on how to obtain this article which was published in Harvard Business Review, July 2002

hbrcamp.pdf   [327.88 Kb]

Challenges of Leading and Planning in Academic Medical Centers

 Larry Hirschhorn, Thomas Gilmore, Michael Kelly

Description: This article describes our understanding of the academic medical center contrasted sharply with a for-profit corporation. We emphasize its "loosely coupled" structure, its "church-state" character and the sub-units that amplify this structure and character in ways that pose unique challenges to leadership. We also briefly review some significant pressures that academic medical centers face and describe a number of leadership strategies.

Lead_AMC.pdf   [198.43 Kb]

Clinical Leadership on the Unit and at the Top—a “Swiss Army Knife” for Sustained Performance

 Linda May, Victoria Rich, PJ Brennan, Elizabeth Riley-Wasserman

Description: presented at the University HealthSystem Consortium 2008 Quality and Safety Fall Forum

UHC2008.pdf   [535.14 Kb]

Consider All of the Players in Healthcare Negotiation

 Jennifer Tomasik, Mario Moussa

Description: Published in Healthcare Executive, Volume 19, Number 6, Nov/Dec 2004, p. 29. (Professional Pointers column).

AllPlyrs.pdf   [121.24 Kb]

Dilemmas of Physicians in Administrative Roles: Dealing with the Managerial Other Within

 Thomas Gilmore

Description: Presented at the International Society for the Psychoanalytic Study of Organizations Symposium, June 20--22, 2002 Melbourne, Australia

physadmin.pdf   [153.92 Kb]

Effective Leadership During Organizational Transitions

 Thomas Gilmore

Description: This article is based on a presentation made at the 6th Annual Nursing Economic$ Conference, October 28,, 1989 and appeared in Nursing Economic$, Volume 8, Number 3, May--June 1990. More information on the journal can be found at www.nursingeconomics.net

nrsecon.pdf   [804.48 Kb]

Handling the Inevitable Reorganization Effectively

 Thomas Gilmore

Description: Chapter 12 in Making a Leadership Change: How Organizations and Leaders Can Handle Leadership Transitions Successfully. New York: Authors Choice Press, 2003, pp. 185 -- 209.

TGBkCh12.pdf   [2.19 Mb]

Impediments and their Countermeasures in Strategic Planning

 Jennifer Tomasik, Thomas Gilmore, Andrew Schafer

Description: This is a draft table that looks at some of the typical problems and countermeasures in strategic planning. The final article can be found in The American Journal of Medicine, Vol 118, No 3, March 2005, pp 315-320.

ACFx3zO4Z.pdf   [129.43 Kb]

Increasing Investigator Productivity through Organizational Practices and Group Processes

 Larry Hirschhorn

Description: A Presentation to AAMC Basic Science Chairs Meeting, Salt Lake City, October 7, 2005

LHaamc.pdf   [810.43 Kb]

Leaders as Middles

 Thomas Gilmore

Description: Leaders are increasingly experiencing themselves as middles and the behavioral implications are different for those in that position. This paper looks at middles in three dimensions: organizationally, historically in time, and in the value chain.

leadmid.pdf   [121.88 Kb]

Matching Donor Interests with Problem-Centered Academic Programs

 Larry Hirschhorn, Susan Frost

Description: Published in " Academic Leader", Volume 21, Number 9, September 2005, pp. 1, 8.

donor.pdf   [112.03 Kb]

Mindfulness and Executive Education

 Thomas Gilmore, Kenwyn Smith, Gregory Shea

Description: This article overviews the ways in which all of the stakeholders in executive development courses can get significantly greater value from their investments. It starts before the program begins, discusses ways of learning while at the program, and attends to the transition from the program back to work.

mindful.pdf   [94.07 Kb]

Negotiating a Change in Medical Center Governance: A Case Study of Institutional Alliances

 Debbie Bing, Jessica Geiben Lynn, Mario Moussa

Description: The authors relate a process in which faculty confronted their preconceptions and arrived at a shared vision regarding the center’s mission. Ultimately, this unified vision paved the way for developing a new governance structure.

instAllian.pdf   [266.13 Kb]

Organizational Learning and the Leadership Skill of Time Travel

 Thomas Gilmore, Greg Shea

Description: This article describes how leaders can travel into the past to identify and pull forward essential aspects to the organization's continued identity. Published in the Journal of Management Development, 16 (4) Summer 1997, pp. 302 -- 311.

timeTravel.pdf   [40.47 Kb]

Resources: Medical Schools and Academic Medical Centers

 CFAR Inc.

Description: CFAR has worked extensively in the area of academic medicine. Listed are selected citations for briefing notes and staff papers we have developed on this topic.

med_reso.pdf   [127.30 Kb]

Unit Clinical Leadership Model: A Successful Partnership between Front-Line Clinicians, Quality, and Senior Leaders

 Larry Hirschhorn, Linda May, Victoria Rich, PJ Brennan, Elizabeth Riley-Wasserman

Description: A joint presentation with The University of Pennsylvania Health System presented at the 2009 IHI National Forum on Quality Improvement in Health Care

IHI2009.pdf   [692.66 Kb]