Table 2 Barriers to Effective Healthcare Leadership: Categories, Subcategories, and Exemplars
BARRIERS | EXEMPLARS |
|---|---|
Supervisory structure | |
Silo-ed priorities | “The service line models are good. However, sometimes […] we kinda get stuck into our own way of doing things or own directives […] and it kinda does form pillars and work. Sometimes we’re not all on the same page” (P08). |
Lack of communication | “Nursing doesn’t report at the service line level to the service line director and so you’ve got the silo of Nursing doing kinda whatever it wants and then the medical staff doing whatever they want and there’s no interaction” (P05). |
Pace of change | “At the VA, we get things rolled down to us daily that need attention and action” (P10). |
Complexity of clinical data infrastructure | |
Locating data | “My biggest frustration is [that] I find a report I like and then for me to find that report again is impossible” (P05). |
Volume of data | “I think the other struggle is that we have too much data and it’s all over the place” (P04). |
Over-reliance on technology for communication | “I think a lot of work is done or sent through e-mail that really should be done with a face-to-face discussion or telephone meetings. A freer, easier exchange of ideas, really drilling down on processes and details, is what is really important in my job” (P15). |
Gaps in available leadership training | |
Conflict management skills Skills at building cohesive teams | “How do get people connected? I think that’s the biggest thing that we don’t train our leaders to do […] that storming and norming and conflict and all of that stuff” (P12). |
Motivating staff | “We don’t have good manager trainings on how to use your soft skills a little more and how to motivate employees […] the intangible things” (P08). |
Delivering bad news | “You don’t get a whole lotta training on how [to] be the bad guy. The crucial conversations training. I think that should be required for every leader” (P04). |
Formal mentorship program | “You should create a mentorship program where you pair up people that have done this for periods of time in their life, or are considered to be extremely effective in this area, and partner them up with people that are just starting out” (P10). |