An Integrated Approach to Leadership Development

An Integrated Approach to Leadership Development

An Integrated Approach to Leadership Development

By  Eija Faulkner, Kathleen Lynch Cartine, Jay B. Morris –

A comprehensive program combined various learning applications for the best results.

The new norm for business and healthcare in particular has been coined by the U.S. Army War College as VUCA (volatility, uncertainty, complexity, and ambiguity). This new norm describes the environment that is driving the constant changes affecting healthcare today. To stay ahead of the curve, Yale New Haven Health System’s (YNHHS) senior leadership team sought to develop leaders who were strategic and able to lead in an environment that is constantly becoming more unpredictable.

The result was a six-month leadership development program for directors, which was initiated by the YNHHS’s leadership development department and Institute for Excellence, in collaboration with the Yale School of Management. “This program helped me transition from a task-oriented manager to a strategic leader,” says Patrick Schmincke, a Bridgeport Hospital vice president. Schmincke’s 14 other class members all agreed that the program was a learning experience that significantly improved their leadership development. Since graduating in 2010, Schmincke received a substantial promotion, as did more than half his class.


Transformational learning happens with a combination of learning applications, including quality classroom instruction, coaching, mentoring, workplace application, and senior leadership involvement. The 70/20/10 learning model has had an impact on the 15 high-potential directors (six nurses, three physicians, and six administrators) in a powerful and lasting way.

Within this framework, 70 percent of the learning came from workplace application and working in teams on systemwide projects that gave participants the opportunity to build skills by using and applying the knowledge gained in the classroom; 20 percent was from coaching and mentoring; and 10 percent of the learning emanated from the classroom experience.

The program objectives were to:

  • build the critical leadership competencies of directors across the healthcare system
  • enhance the health system’s capacity to handle strategic, complex, and critical issues in the future
  • identify successors for key executive and leadership roles who will carry on the mission and values of YNHHS and link to succession planning
  • build stronger relational networks across the system.


The curriculum was developed based on information collected from a focus group comprised of directors and from meetings with senior leadership led by the Institute for Excellence Council. During the focus groups, directors were asked to sort 67 leadership competencies as defined by the Lominger Voices 360 Assessment. The exercise helped to identify competency gaps and define the program objectives.

The leadership competencies considered essential were strategic agility, developing direct reports, managing vision and purpose, and integrity and trust. The Institute for Excellence collaborated with the Yale School of Management to customize course content. The institute’s consultants met with each professor to review the competencies.

Program launch

When the program began in September 2009, YNHHS CEO Marna Borgstrom welcomed participants and explained why they were selected for the program. She also discussed program expectations and the involvement and interest of the senior executive committee.
The committee’s seven members answered participants’ questions in a panel format and shared their own professional journeys, including the challenges and what they learned along the way. The committee members, advisor leaders, and program participants then interacted in a candid, open, and real fashion during a group lunch.

The faculty created an engaging and safe learning environment that stretched the participants out of their comfort zones. Problem-solving and decision-making concepts were presented through small-group discussions and exercises.

Time spent in the classroom helped to create strong, trusting relationships among the participants, and chipped away at the silos that had developed within the health system.
Rather than focus the majority of the time in the classroom, each faculty member integrated the objectives into the coursework so participants could link the content to their workplace situation and the projects.

Mentoring and coaching

To supplement the classroom training and provide individual feedback, members of the senior executive committee individually mentor the participants. Each senior leader, including the CEOs and COOs of each hospital, was assigned two directors outside of his hospital.

These sessions enabled the senior executives to get to know the participants as individuals, assess their ability to lead, provide input to the assigned learning projects, and offer executive-level career advice that linked directly to the talent succession process.
Members of the Institute for Excellence Council staff were assigned as coaches and used two assessments, the Hartman Value Profile (HVP) and the Lominger Voices 360, to provide feedback and identify areas of personal and professional development.

The HVP is a highly scientific, mathematical, and logically based assessment instrument for leadership development. The fundamental question it addresses is “Does this person (or group) possess good judgment?” According to the HVP, without good judgment, all the other aspects of successful work are vulnerable.

The Lominger Voices 360 Assessment combined the feedback from self, boss, direct reports, peers, and customers. Thirty-six leadership competencies were selected to assess both strengths and opportunities. General feedback was provided to participants in a classroom setting. However, the coaches followed up with each participant to provide perspective and encouragement.

Most of the directors found the mentoring and coaching to be useful components in their self-development for providing thoughtful reflection and insights. The HVP scores at the end of the program demonstrated increased strategic and decision-making abilities, improved self-confidence, and better self-care.

Action-learning projects

The senior executive committee selected three strategic projects that focused on building leadership capabilities related to complex, strategic organizational challenges and directed the classroom learning into action. The projects enabled the participants to better understand the culture and challenges at the different hospitals.

Initially, the projects were seen as extra work but proved to be beneficial at many levels, including exposure to senior leaders across the systems. The action learning projects enabled participants to apply the content from the classroom, reinforce feedback from mentors and coaches, and build relationships.


Recent interviews conducted with all of the participants confirm that the program—three years after graduation—has had lasting impact on their thinking and leadership. As a visible result of the program, nine of the 15 directors (60 percent) were promoted and all of the participants experienced an increase in their scope of responsibilities. In addition, the program whetted the participants’ appetites for ongoing learning and self-development.

Three key organizational levels were affected through this program: interpersonal relationships, interdepartmental relationships, and system relationships.

Interpersonal relationships. This group of peers has built a strong bond and they serve as resources for one another. A better integration of work-life balance exists since they were given permission from the organization to take better care of themselves.

Interdepartmental relationships. Pay-it-forward learning took place with all the directors using the skills back in their departments and imparting the learning to their direct reports.

Intersystem relationships. The program increased collaboration across the system with deeper understanding of complex issues. Many of the recommendations from the projects were implemented, and the establishment of trusting relationships has helped to get things done.

Woven throughout the six months was an increased level of trust that translated into faster and more efficient decisions among the people who went through this course together. In addition, the overall systemic score in the HVP increased by five points, which confirms that their leadership style had become more strategic.

To quote a senior system leader, “A risk was taken implementing this program. There was an investment of time and cost and the question was: Would it be worth it? It is clear that the program met its objectives. The participants believe they have changed and grown. More importantly, their managers and direct reports give examples of these changes in action.”

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