Center Managers Leading the Change: Using Frontline Mangers to Achieve Organizational Success Through the Holographic Brain Mode

OBJECTIVE
The purpose of this study was to examine the leadership traits that front line leaders in healthcare centers must exhibit to be successful.

METHODOLOGY
Approximately 400 Lincare centers were chosen for study based on center performance in growing one particular profit center and Earnings Before Interest, Taxes, Depreciation and Amortization (EBITDA). Approximately 3700 center managers and employees at Lincare centers all over the United States completed the Leadership Practices Inventory. No demographic distinctions were made or tracked. Lincare is the nation’s largest home respiratory services provider with about 1,000 locations in the continental United States. Two hundred surveys were returned (6% response rate).

KEY FINDINGS
The author notes:

Employees in the High Oxygen Customer Growth group observed the corresponding managers engaging in the Five Practices 10 to 20 percentile points more often than employees in the Bottom 100 Centers in Oxygen Customer growth group observed managers engaging in the Five Practices. The result adds to the existing evidence suggesting managers’ engagement in the Five Practices is directly linked to higher performing teams. More specifically, the result provides evidence showing engaging in the Five Practices positively affects business growth and the accomplishment of organizational goals (Kouzes & Posner, 2002). Additionally, managers in Top 100 Oxygen Customer growth group self-reported engaging in the Five Practices at about the same rate and relative frequency as employee observations. The similarity suggests managers in the group are highly aware of how words and actions are perceived by employees. Conversely, managers in the Bottom 100 Oxygen Customer growth group self-reported engaging in the Five Practices at a much higher rate (up to 50 percentile points higher) than employee observations. Also, managers and employees in the Bottom 100 Oxygen Customer growth group have very different impressions of the relatively frequency with which managers engage in each of the Five Practices; the graph curves move in opposite directions at three-out of four successive data points. Indeed, managers in the Bottom 100 Oxygen Customer growth self-reported engaging in the behaviors much more often than did managers in the Top 100 Centers in Oxygen Customer growth group. The disparities, particularly the difference between employee observations and managers’ self-observations (supported by Table 2.2 and starkly illustrated by Graph 2) suggest managers in the Bottom 100 Centers in Oxygen Customer growth group have little or no awareness of how words and actions are perceived by employees. The result provides evidence that self-awareness and considered introspection are also important components in leading high-performance teams and achieving organizational goals (p. 32).

Results between the Top 100 Centers in EBITDA (A2) and Bottom 100 Centers in EBITDA (B2) are less conclusive and, to some degree, counter-intuitive. Employees in the Bottom 100 Centers in EBITDA group observed managers engaging in the Five Practices 10 to 15 percentile points more often than did employees in the Top 100 Centers in EBITDA group. One might have predicted the reverse. Additionally, managers in the Top 100 Centers in EBITDA group self-reported engaging in the Five Practices up to 55 percentile points more often than employees in the group observed, showing a lack of introspection and awareness on the part of managers. Conversely, employees and managers in the Bottom 100 Centers in EBITDA group were in more agreement about the degree to which managers engaged in the Five Practices. Further, Table 3.2 (Top 100 EBITDA group) shows many more areas of significant difference between employee observations and manager self-reporting than does Table 4.2 (Bottom 100 EBITDA group). Results between the Top 100 and Bottom 100 EBITDA groups appear to contradict the preponderance of evidence showing engaging in the Five Practices results in higher-performing teams (p. 33).

Some of the unexpected results may be explained in the nature of the performance measure used. Oxygen customer growth is a relatively straight-forward yard stick and is highly within the local center’s control. Oxygen growth is currently the most important measure of performance for Lincare management and sometimes is achieved at the expense of other less-important goals (p. 33).

EBITDA, however, may be less well-defined and less within a center’s control. Expenses (equipment costs, for example) are based on national contracts. Employee compensation packages are generally set by corporate guidelines. Even vehicle purchase and maintenance plans are outside of the center managers’ control (p. 34).