North Shore-Long Island Jewish trains its own leaders

Some years back, leaders of 12-hospital North Shore-Long Island Jewish Health System realized the system needed to do more to identify potential future leaders in the organization, develop their skills and ensure smooth transitions when top brass departed. The Great Neck, N.Y.-based system had just a few years earlier established a sweeping employee education and training program, but more aggressive leadership development was still needed, administrators said.

Hospitals that have a robust succession plan and leadership development strategy are the exception rather than the rule, said Andrew Garman, CEO of the National Center for Healthcare Leadership and professor of health systems management at Rush University in Chicago. “The reason it's so often overlooked is because of the tyranny of the immediate,” Garman said. “There are so many competing priorities. What brings it on the radar screen is someone passing away or leaving, and then the hospital is in a tight spot.”

North Shore-LIJ's leaders were determined to avoid that scenario. In 2008, the system established its High Potential Development Program to spot the most promising leadership candidates, retain them and give them the skills to move up within the organization. The High Potential program draws people from every area of the health system, from housekeeping to accounting to patient care. Participants are nominated by their managers. Last year, 50 people were chosen from a pool of more than 200.

The High Potential program is housed within North Shore-LIJ's Center for Learning and Innovation, which the system launched in 2002. It is modeled on corporate leadership universities founded by companies such as General Electric, and offers a wide array of experiential learning and mentoring opportunities.

Conceived by North Shore-LIJ CEO Michael Dowling, the center expanded quickly, offering simulation training, professional development and a variety of specialized courses and programs. Since its inception, more than 130,000 employees have received training at the center, which now occupies a 45,000-square-foot stand-alone facility in Lake Success. “Nothing like it existed in healthcare before,” said Joe Cabral, chief human resources officer for the system.

Succession planning is an area where many hospitals and health systems struggle, said Sanjay Saxena, a partner and managing director at the Boston Consulting Group. For some healthcare organizations, such planning doesn't even begin until a CEO or other top leader announces plans to leave. “It's a mixed bag right now,” Saxena said. “For-profits tend to think about succession planning with more foresight. For the rest of the industry, it's very hit or miss.”

Cultivating leaders and building a pipeline of top talent has to be done in a systematic way, especially now that hospitals are seeing far more C-suite turnover than in previous years, he argued. “It needs to be an institutional activity, not something that is done on an ad hoc, start-stop basis.”

North Shore-LIJ selects people for the High Potential program based not only on their strengths but also on the health system's anticipated leadership needs. “If we know we will need a few CFOs because a couple will retire in the next few years, I will give priority to those folks who could fill those roles,” Cabral said. “We do this very methodically.”

The yearlong program is highly customized. Those with little or no leadership experience, for instance, spend more time in the classroom learning the fundamentals of management and finance, while those with more leadership experience spend less time on formal instruction and more time on hands-on projects addressing areas such as sepsis, ICD-10 conversion, readmissions and advanced illness.

Carolyn Sweetapple was in the first class of the High Potential program and recalled taking part in a number of projects related to efficiency and operations, including one aimed at reducing noise on a unit plagued by poor patient experience scores. “They really encouraged us to be innovative and think of new ideas,” she said.

Since completing the program, Sweetapple has been promoted twice, first to vice president of North Shore- LIJ's Quality Institute and then to her current role as assistant vice president of system operations. “When you're done with the program, you're challenged to leverage the knowledge right away,” she said. “It builds a commitment to the organization. They've invested in me and I want to return that investment.”

That investment includes the opportunity to earn an MBA with tuition paid by the health system. It's a perk that many High Potential participants take advantage of, Cabral said. North Shore-LIJ has a partnership with nearby Hofstra University.

Of the 500 people who have participated in the High Potential program, 85% have been promoted or changed roles. The retention rate among those who go through the program is 95%.

Cabral and his colleagues also hold yearly succession planning meetings to identify where future openings might be, as well as quarterly meetings to recalibrate those annual projections and conduct executive talent review. “We talk about who is ready now, who will be ready in two years, who will be ready in three,” he said. “For those who aren't ready yet, we talk about what skills they will need to be ready to lead.”

Garman, of the National Center for Healthcare Leadership, said North Shore-LIJ has mastered a systematic approach to leadership development. “They have a fully integrated cycle of activities, “ he said. “They're doing it about as well as I've seen anyone do it.”

In 2011, the health system expanded the program with the addition of a two-year High Potential program created just for physicians. Dr. Kevin Bock was part of the 47-member inaugural class of that program, which ended in 2013. A critical-care physician with a deep interest in medical informatics, Bock said the program provided an opportunity to learn more about leadership and finance, skills missing from traditional medical education. He also earned a master's degree in healthcare delivery science at Dartmouth College, paid for by North Shore-LIJ.

Since completing the program, he was promoted from director of clinical information systems to his current post as associate chief medical information officer. “There's a tremendous sense of indebtedness,” he said, “that someone thought of you this way and invested this much in you.”

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