Presented at 2017 American College of Healthcare Executive (ACHE), Congress, March 2017. The thirst for how to develop strategic minded leaders at all levels will be quenched in this workshop-style seminar. The seminar will help students reflect, think and communicate strategically, and provide methods on how to develop strategic minded leaders at all levels including themselves. Students will be introduced to the Strategic Health Leadership (SHELDR) competency model followed by a self- assessment. Research on the SHELDR competencies, overview of successful strategic leaders (i.e., competencies applied most or wish they had more of), and distillation of strategic leader development programs according to experts will be presented. Learning Objectives: a. Differentiate managerial versus strategic leadership competencies, learn from successful leaders and develop plans to develop strategic minded leaders including themselves b. Challenge students to develop a personal ethos statement and communicate strategically

1. ACHE Seminar 108:
Gimme SHELDR!
Prepping for
Strategic Health Leadership
(SHELDR) 30 March 2017
0900-1200PM

2. Administration and Workbook
2
Pg: 2-3

3. Disclosure Of Relevant Financial
Relationships
The following faculty of this continuing education activity has no
relevant financial relationships with commercial interests to disclose:
• Douglas E. Anderson
• David E. Womack
3

4. Faculty
• Douglas E. Anderson, DHA, CPHQ, FACHE
University Adjunct Faculty and Healthcare Consultant
MBO Partners
13454 Sunrise Valley Dr #300
Herndon, VA 2017
Douglas.E.Anderson57@gmail.com
• David E. Womack, MHA, FACHE
SVP, Area Manager - Kern County
Kaiser Permanente
5055 California Ave., #240
Bakersfield, CA 93309
David.E.Womack@kp.org
4

5. Learning Objectives – Fast and Interactive
• Understand why and how strategic health
leadership is imperative to your success
• Assess yourself using the Strategic Health
Leadership (SHELDR) competencies
– Refer to the Workbook for Competencies
• Apply ideas to “begin or refine”
development of a personalized:
– Leadership philosophy (PLP) &
– Leader development plan (LDP)
5
A Great Way to Gather and Organize Your Thoughts and Ideas From This Week!
Pg: 16

6. Agenda to Support the Learning Objectives
• Introduction – WHY – Apply What You’ve Learned
– Share insights on cohort of senior leaders
– Complete “Honest” Self-assessment
• Personalized Leadership Philosophy (PLP)
– Develop Leadership Philosophy outline
• Customized Leader Development Plan (LDP)
– Draft Your Leader Development plan
• Session Summary and Discussion
• Leadership Toolkit (Resources) to Sustain You!
Fast Paced, Interactive. Challenging
Reference the Workbook (i.e., Competencies)
Check In = Short Time Outs and Nudges
Take a Comfort or Stretch Break at Any Time
6
Pg: 6

7. Warning: Therapy Session .. Crucible of
Experience? Growth Moment? Thoughts?
• Think about a leader you know
– “Positive” traits, attributes, actions,
imperfections? OR
– Toxicity to create a “toxic”
experience? How? Why? Impact?
• Ask yourself about this crucible:
– Why did I choose a ”positive” or
“toxic” leader or situation?
– What are my assumptions?
– What influenced my assumptions?
– How will I perform in a more
dynamic environment?
How do I develop myself to be or not
to be “THAT LEADER”?
7
“I experienced poor leadership early on...my mentor helped me. I decided, if I stayed in the [Service]
I would be the leader everybody expects to have” ~Study Participant
Pg: 7

8. Session 1: Introduction to the Strategic
Health Enterprise Leadership
(SHELDR) Study
8

9. Session 1: Overview
• Strategic Health Leadership (SHELDR) Study
– Opportunity, Proposition, the Study
– Leadership Gaps
– SHELDR Model
• Self Assessment
– See Workbook
• SHELDR Study Insight
• Summary
9
Pg: 8

10. Opportunity, Proposition, the Study
• Opportunity: Leaders must be adept at mastering VUCA-driven
turbulence; gaining insight from successful strategic leaders is a start
– Volatility, Uncertainty, Complexity, and Ambiguity (VUCA) fueled by exponential change
(and opportunity) = new norm … “wickedness”
– 1000s of publications on leadership exist, few focus on the environment of healthcare and
their cohorts of , especially at the strategic level
• Proposition: Studying senior health leaders will result in better leader
development; leads to transforming the healthcare system at any level to
be most reliable health system with the healthiest population in the world!
• The Study: Study cohort of strategic leaders (former military Surgeon
Generals (SG)) on application of strategic leader competencies; compare
and contrast to panel of experts to identify leader development actions
“We go to the same medical schools and read the same leadership books, yet many think we are different” ~Study Participant

11. Call to Action: Health System Challenges, Strategic
Leadership, Leader Development Literature Synthesis
Transformational
Collaborative
Complexity
2016-2021
2015-2020
1. Your Future Is VUCA Driven
With Exponential Change
3. Must Leverage the Future
With Modern Leadership
Theories and Principles
2. Outdated
Leadership
Models
And
Gaps
In
Leader
Development

12. Senior Leaders Recognize Gaps in Leader
Development and Leadership
• 2008: ACHE Survey determined leader development programs were
variable from organization to organization; about ½ had or thinking of
developing a leader development program
• 2012: Harvard University Center for Public Leadership Poll: 70% of
Americans blame leadership as factor in economic decline
• 2014: Deloitte Business Confidence Survey: C-level executives did
not think their direct reports had the skills for greater leadership roles
• 2015: ACHE Professional Development Task Force: identified core
and emerging leadership competencies needed by healthcare
executives to succeed in a rapidly evolving healthcare environment
(read: transformational and complexity leadership)
According to the 2001 IOM report, 98,000 Americans die each year from preventable errors.
Yet by 2010, a NEJM study found no substantial progress citing invisibility of error, inertia,
and incentives as the culprits. This was confirmed by the IOM in a 2012 report and called for
Continuously Learning Leadership leading to the CEO’s High Value Checklist.

13. Federal Health Sector is Addressing the
Gaps and Solutions Too
• 2011: RAND Corporation: reviewed health care leadership competency
models—Joint Medical Executive Skills Program (JMESP). Identified
several leader development opportunities:
– Understand stewardship, context in which the organization operates
and global health environment (i.e., systems approach & thinking)
– Need federal health agencies to coordinate organizational leader
development, partnering, and learning across agency boundaries
• 2012: Federal Health Futures Group identified 12 skills required of
leaders at the enterprise or multi health system and interagency level.
• 2015: Department of Veterans Health Administration (VHA):
independent assessment noted the health systems faces a “crises in
leadership and culture” in addition to other systematic problems
“I experienced poor leadership early on...my mentor helped me. I decided, if I stayed
in the [Service] I would be the leader everybody expects to have” ~Study Participant

14. Strategic Health Enterprise Leadership (SHELDR)
Competency Framework Development
14
Component Description
A. Integrates
Needs of Others
and the
Organization
1. Actively Listens To Others
2. Develops Leaders and
Teams of Leaders
3. Celebrates
4. Stewardship of Resources
B. Encourages
Aspirational and
Innovative
Thinking.
1. Critical Thinker
2. Applies Systems Approach
3. Challenges Status Quo
4. Creates a Culture of
Innovation
C. Informs,
Inspires, and
Influences
1. Develops Vision
2. Communicates
3. Leads Change
4. Empowers Others
D. Promotes
Professionalism
and Builds
Character
1. Collaborates
2. Applies Ethics
3. Develops Trust
4. Life Long Learner
5. Resilient
Refer to Competencies in Workbook
• 1. Foundation for Study (Literature Review):
• Used strategic-level leadership references
• Bass Transformational Leadership Model
(BTLM) is most reliable, used, validated, and
criticized model … leaves off key elements
• 2. Method (Qualitative Research Software):
• Analyzed 76 documents; categorized
(coded) 2,045 words/phrases into common
competencies for strategic leadership
• BTLM enhanced with Complexity and
Collaborative leadership theories
• Result: 17 Strategic Health Enterprise
Leadership (SHELDR) competencies
• 3. Crosschecked With Similar Leaders:
• Analyzed 22 interviews of CEOs or CEO
equivalents published in the Journal of
Healthcare Mgmt., ACHE, 2010-2015
• Incorporated association and author’s
strategic level competencies into results
Pg: 16
4.

15. Learning Activity #1: Complete SHELDR
Competency Self Assessment Survey (~20 min)
15
• Step 1: Do the Assessment
– Reference competencies
• 4 SHELDR Categories (A-D)
• 17 Total Competencies
– Refer to scoring items
• Novice | Improve| Aspire| Sustain
• 1 2 3 4
– Score each statement
– Total score by Category (A-D)
– Catch your AhHas, Ideas, Insights
• Step 2: Transpose Scores
• Step 3: Circle Category
• Step 4: Prepare to share
your assessment
Refer To Self Assessment
Stretch Yourself! Time permitting, answer 8 Participant Interview Questions
Step 1 (4x)
Step 3
Step 2
Pg: 17-22

16. Check In: Honest? Have A’ha Moment? Actionable
Insight? See a Pattern? Connect a Dot?
16
MBTI = Personality Type
How Will You Apply SHELDR?
Did your last 360 results measure
your potential as a SHELDR?

17. Competencies Applied by Participants and
What Experts Observe Most Often (~Top 5)
“ I selected TRUST as #1; it is an outcome of developing an alternative future, influencing others to
be part of the solution, and helping them succeed as leaders” ~Study Participant
Participant14
Participant12
Participant1
Leaders Differed

18. Summary and Tool Kit “Preview”
• Transformation requires strategic
and systems minded leaders
• Significant gaps in leader
development exist
• Participants provided insight on
application of the SHELDR model
– Consistent with Expert Panel
Member (EPM) inputs
• Results of your self assessment
provides a baseline for action
18
“I was always looking for gaps and seams in the process or between functions . ” ~Study Participant

19. Session 2: Importance of a Personal
Leadership Philosophy (PLP)
19
“Between stimulus and response, there
is a space. In that space is our power to
choose our response. In our response
lies our growth, freedom, and character.”
~Victor Frankl
Pg: 28

20. Session 2: Overview
• SHELDR Study Insight
– Crucibles
• Why A Philosophy
• Components
• Learning Activity #2
– Brainstorm
– Write
– Share
• SHELDR Study Insight
• Benefits
• Summary
20
Pg: 28

21. Crucibles: Events Or Persons That Shaped
Study Participant’s ’s Leadership Styles
• 24% of the participant’s
crucibles happened in early-mid
career; 28% had help of
influential individuals
• Most participants were
developing their SHELDR
competencies early on
informally and formerly
• System approach, critical
thinking, life long learner,
challenge the status quo, and
strategy execution accounted
for 42% of the SHELDR
competencies applied
throughout formative years
“As I reflect back, I really hadn’t realized how much my leadership skills were being developed
… I was just doing my job to the best of my ability … ” ~Study Participant

22. What is, and, Why Develop a Personal
Leadership Philosophy (PLP)?
• Answers these critical questions:
– WHO AM I AS A LEADER?
– WHAT I BELIEVE?
– WHAT DO I STAND FOR?
• Challenges you to explore and reflect on
your personal values, assumptions,
experiences and beliefs about leadership
• Introspective investigation of your
principles, knowledge or conduct
• Outcome: Written foundation to guide
actions, behaviors, thoughts, aspirations
– Provides centeredness and character
– Enhances authenticity and resilience
22

23. The Foundation and Starting Point For An
“Authentic” Personal Leadership Philosophy
• Values
• Principles
• Beliefs
• Behavior
• Attitude
• Theory
• Leader Development
• Aspirations
23

24. Learning Activity #2A: Brainstorm (~12 min)
• Values: Which values do you refuse to
compromise? Consider grounds for quitting?
• Principles: How comfortable are you with who
you are? What are your principles of leading?
• Beliefs: What is my reason for being beyond
my paycheck and bonus?
• Behaviors: What is the single most important
competency to you? Why this competency?
• Attitude: Am I opportunistic, a healthy skeptic,
or risk adverse? Early adopter? Fence sitter?
• Theory: What is your theory of business?
• Leader Development: What’s your plan to
coach, guide, and mentor your team?
• Aspirations: What is your vision? Purpose?
24
Choose 1-3 Areas Below To Define YOU in the Context of the SHELDR model!Pg: 32

25. Check In: Out of Your Comfort Zone Yet?
Stuck? Need a Jolt?
25
See Appendix C: Example Leadership Philosophies: Reflect The Authentic You?
See Appendix D: Additional Tips On Developing Your Leadership Philosophy
Pg: 33
A: 62-73

26. Learning Activity #2B: Write It Out (~15 Min)
26
• Write from the lip-heart-soul!
– Get it on paper!
• Go beyond the proverbial
“Mission 1st, People Always”
– Don’t sound hollow!
• You decide the format:
– 2-3 paragraphs or
– 10-12 short statements
How I Think, Act, and Decide
• Leadership is a life long developmental journey.
• We balance work, success, and recharge time.
• I help people capitalize on their strengths and talents.
• Leader development is example, enthusiasm, passion.
• Integrity is a make or break proposition responsibility.
• I respect diversity of talent and different perspectives
• I strive to actively listen with respect and gratitude.
• I’m a staunch advocate for community health
integration, innovative thinking, and action
Feedback Always Welcome!
CEO-X: What I Believe
I believe universal coverage will improve health the
most and ultimately be more cost effective than
leaving millions without care. I also believe it is a
legitimate role of government to shape competitive
markets for the good of society - especially the
healthcare market. And where there are no private
competitors in a market I believe it is a legitimate
role for government to provide coverage.
Imagine ...
1. Selected for highly visible project
2. An interviewer asks you to describe
your leadership style
3. Address your C-Suite staff on Day 1
4. New CEO to provide guidance during
new staff orientations (30 min)
5. You meet a brand new department
chief on the elevator for 1 minute ride
6. The media places a microphone in
front of you unexpectedly on a merger
Pg:34
A: 62-73

27. Learning Activity #2C: Share Your
Leadership Philosophy (~10 Min)
27
Facilitative Questions
• What is your vision and purpose?
• What values need to be added?
• Clarify your theory of business?
• Does it describe you or someone else?
• Do you have purpose beyond your
paycheck or bonus?
• Can you practice your principles?
• What is the single most important
leadership competency or strength?
• What’s your plan to coach, guide, and
mentor your team? Yourself?
Is This Really Me (You)?
See Appendix C: Example Leadership Philosophies: Reflect The Authentic You?
See Appendix D: Additional Tips On Developing Your Leadership Philosophy
Pg:35
A: 62-73

28. Resilience Feeds Your Character, Reinforces Who
You Are, Creates the Authentic Stronger You!
• Responses varied on the set back types; very emotional and personal
• What was clear was how many reached for their faith, clung to their ethics
and standards, engaged in self “positive” talk and became more resilient

29. Summary: Benefits of a Personallized
Leadership Philosophy – Do You Agree?
• Causes self-reflection, signals seriousness
– Provides personal clarity and objectivity
– Provides courage, confidence, conviction
• Makes followership and collaboration easier
– Provides predictability of direction,
accountability, expectations
– Causes you to mean what you say
• Builds your character to be centered,
grounded, authentic, and resilient
• Assures you (and others) won’t get lost in a
dynamic and VUCA driven world
29
.

30. Session 3: Leader Development
Plan (LDP) (Focus on SHELDR)
30
Pg:38
A: 73-77

31. Session 3: Overview
• Challenge of Leader
Development
• Educational Gaps
• SHELDR Study Insight
• Learning Activity 3
• SHELDR Insight
• Benefits
• Summary
31
Pg:38
A: 73-77

32. Leadership
Development
Programs
“Equip”
Healthcare
Leaders To Be
Successful
Throughout
Their Careers Front-Line Health
Leaders
Senior
Leaders
Managers of
Managers
Operating
Cycle
Strategic
Alignment
Performance
Management
Talent Review
& Succession
Values &
Competencies
Recruitment
& Selection
Learning &
Development
Nursing Medicine Allied Health Administration
Source: National Center for Healthcare Leadership (NHCL)
Abundance of Leader Development Models,
Theories, Programs (Secret Sauces?) Exist
Many Organizations
Have Great Models,
Frameworks And
Competencies … The
Hard Part Is Actually
Developing A
Personalized
Leadership
Development Plan …
And Developing
Leaders
SEE APPENDIX E: EXAMPLES OF SHELDR DEVELOPMENT METHODS FOR DEVELOPMENT
IDEAS BY SHELDR CATEGORY AND COMMENTARY ON LEADER DEVELPOPENTA: 73-77

33. Gaps: Initial Education Programs Are the
Foundation to Becoming a Life Long Learner
Interviews by Dr Regina Herzlinger, Harvard University, Author of Who
Killed Healthcare and Consumer Driven Healthcare
Analysis of Curricula
Vs.Analysis of CEO “Concerns”
“25% of the CEOs noted they were dissatisfied with traditional health care administration education they developed
their own training programs and would rather hire and train good candidates with little health-related education than
accept the “ready-made” graduates of most academic programs.” ~from the Survey

34. Expert Panel Member (EPM) Recommendations
on How to Develop Strategic Health Leaders
• Strategic leadership development requires more focus on critical thinking, removing
individual blinders, creating the future with simulation, exposure to complex projects.
• Self development & coaching should be supplemented with introspection and reflection
“We take promising executives, expose them to real-world situation or futuristic plans. We provide oversight and a
lifeline to let them to thrive with increasing levels of complexity by pairing them with professional mentors” ~EPMx
A: 73-88

35. Learning Activity #3: Create DRAFT
SHELDR Leader Development Plan (LDP)
35
• Step 1: What are your SHELDR Competency
Development Goals?
• Step 2: What Actions Will Help You Become a Better
SHELDR?
• Step 3: How Will You Sustain Momentum And Move
Forward as an Aspiring SHELDR?
“Training reinforces the need to search for a specific answer. Development
helps individuals recognize the opportunity, take responsibility, and be
creative in their approach to situations opportunities” ~EPMx
SEE APPENDIX E: EXAMPLES OF SHELDR DEVELOPMENT METHODS FOR
DEVELOPMENT IDEAS BY SHELDR CATEGORY
Refer to the SHELDR Competencies and Your Self Assessment & Philosophy
A: 73-77
Pg:42-46

36. STEP 1: What are your SHELDR
Competency Development Goals?
36
What: My Personal Strategic Health Leadership (SHELDR) Development Goals
Start with:
1. Strategic Health Enterprise Leadership (SHELDR) competencies
2. Your self-assessment results
3. Your leadership philosophy
4. Notes you’ve taken on feedback you have received
5. Action items and ideas from recent educational or mentoring sessions
Goal 1 (Within 6 Months):
Goal 2 (6 months to a year):
Goal 3 (You decide the time horizon):
Suggestions:
1. Based on feedback from all directions, select at least two SHELDR competencies
areas you would like to develop. Concentrate on these initially.
2. Focus only on your current, anticipated, or aspiration role or position.
3. Write specific goals describing how/what you want to change or improve.
Ask yourself: What can I do differently/better that would make the greatest
positive impact in my work? What development priorities will give me the
greatest leverage in improving my individual SHELDR competencies or my
organization’s performance?
What Do You Need To
FOCUS On?
Suggestions
Only

37. Check In #1: Are You Challenging The
Status Quo? Your Own Status Quo?
37
“My passion to provide better ‘Care-in-the Air’ started with my experience
during the 1983 Marine Corps Barracks bombing” ~Study Participant
Particiapent 7
SEE APPENDIX E: EXAMPLES OF SHELDR DEVELOPMENT
METHODS FOR DEVELOPMENT IDEAS BY SHELDR CATEGORYA: 73-77

38. STEP 2: What Action Steps Will You Take to
be a Better SHELDR? Immersive Learning?
38
What Are Some CREATIVE Actions
and Options You Can Seize?
Suggestions
Only

39. Check In #2: Competencies Participants Applied
During Their Formative (Crucible) Years, Then
Accomplishments Later in Their Career
“I love turbulence. Turbulence brings opportunity. I’m convinced the skills I learned as a safety and acquisition
officer helped me with the MHS (Quality of Care, Reliability, and Patient Safety) review” ~Study Participant
A: 78-88

40. STEP 3: How Will You Move Forward to Sustain
Momentum as an Aspiring SHELDR?
40
Who: Resources and Support for Achieving My Goals
How will I draw on my coach, peers and others to track my progress, gather advice
and feedback and support my learning?
Who will I ask to support me? Who do I know who already possesses the
competencies I want to build?
With whom should I share my development plan?
How: Accountability
When will I begin taking action to meet my goals?
When do I expect to see significant progress? (Milestone commitments)
How will I evaluate my progress?
How will I update my development strategy and learning plan? When will I review my
plan with those who helped me create it?
How will I leverage what I learn?
Acknowledgement
What will be the impact of meeting my development goals on me and my career?
How will my organization benefit from the changes/improvements I have identified?
How will I celebrate when I meet my goals?
To

41. Competencies Participants Wish they Had More Of
and What Experts Say SHELDRs Need More Of
• Participant and EPMs generally
agree on 9 of 17 competencies
• Critical thinking was common
in the competencies most
applied and throughout the
interviews
• Trust and develops leaders
cited by EPMs as most needed
• Participants may value trust
and development of leaders as
a strength thus creating an
opportunity to learn from them
“I could’ve been a better active listener, however I caveat that with the need to be able to sort through the signal-to-noise
and chaff such competing agendas and tribesman-ship. I had to make the right decisions” ~Study Participant
“Building and sustaining trust allows for movement forward of the entire team. This action helps the leader to
overcome resistance to change and meld the diversity of individual talent throughout the organization.” ~EPMx

42. Session #3 Summary – Re-Review
Your Plan Frequently
• Refer to your self assessment
– Determine how to utilize or sustain your strengths
– Identify opportunities to IMPROVE | ASPIRE | SUSTAIN
• Think about admirable leaders you want model or talk to
• Define your plan with SMART-E “actionable” terms (Specific,
Measurable, Action oriented, Realistic, Time bound, Elastic)
– Competency: Knowledge, Behavior, Skill, or Attribute
• Jot down action steps to help you reach your goal and assign a
completion date to each one
• Assess obstacles and how to overcome them
• Identify resources available to you or you need to obtain
• Set a date to evaluate your progress towards your goal
42
“A culture of innovation constitutes the reservoir foreseeing the future, challenging the status quo, and generating
meaningful change. If it does not exist, they must create it. If they don’t, they will fail, and do” ~EPMx
A: 78-88

43. GIMME SHELDR Session Summary
• Learning from cohorts of
strategic leaders and
experts provides insight
• Development of a PLP is a
beginning of a journey
• Drafting a LDP is a must
do and it requires updates
persistence and updating
• Toolkit will sustain you
between events
43
Don’t Be THAT Leader!
Thrive with Purpose, Passion, Professionalism, Performance!Pg:52-53

44. Closing Thoughts To Sustain Your Journey
44
Health As A National
Strategic Imperative and
Dialogue!
Help Others Develop The
Most Innovative and
Reliable Health System And
Create the Healthiest
Population In The World
Better Equipped Strategic
Minded Health Leaders
(SHELDR) are Needed

45. Discussion and Toolkit
45

46. Douglas E. Anderson, DHA, CPHQ, FACHE
Douglas E. Anderson is a consultant and adjunct professor. He earned his Doctorate in
Health Administration (DHA) and International Health certificate from Central Michigan
University (CMU). While earning his DHA, he was involved in leader development
training, federal health facility evaluation, strategic communication, and business
development projects. Doug is a retired Colonel of the Air Force (AF) Medical Service
Corps. Prior to retirement, he served as the Director of Strategic Communication and
Strategy for the AF Surgeon General (SG) and spent one-year in Afghanistan helping the
Afghanistan National Police SG build their health system. He has been a CEO, COO and
Corp. Staff officer working a variety of transformational initiatives. He also holds a
Master's Degree in Strategy & Leadership from the Air War College, MBA from Central
Missouri University, and an MA from CMU. He is a Fellow in the American College of
Healthcare Executives. Phone: 703-282-7669. Email:
Douglas.E.Anderson57@gmail.com .
46

47. David E. Womack, MHA, FACHE
David Womack is the Senior Vice President, Area Manager for Kaiser
Permanente in Kern County. Prior to joining KP in 2011, he served as the CEO
of Whitman Hospital in Colfax WA and COO of Greenville Regional Hospital in
Greenville IL. David is a retired Colonel of the USAF Medical Service Corps.
He holds a Master's Degree in Strategy & Leadership from the Air Force War
College, a Master's of Health Administration from Baylor University and a BS
with double majors in Communications and Business from Oral Roberts
University. He is a Fellow in the American College of Healthcare Executives.
David is active in the community and currently serves as the Vice Chairman of
the Kern Economic Development Corporation and is on the Board of the Kegley
Institute of Ethics. Phone: 661-864-3392 / Email: david.e.womack@kp.org
47