Five Key Attributes of Leadership

June 20, 2017 2:03 pm

Engaging and motivating employees are critical obligations of healthcare leaders.

Strong, effective, high-performing executive leadership is essential in healthcare organizations today given the dynamic healthcare environment and the evolving role of consumerism. Expectations of all stakeholders for improved operating performance and outcomes in all areas continue to increase.

Five attributes for fostering high-performing leadership—accountability, engagement, communication, vision, and embodiment of the critical intangibles of being a leader—can help executive leaders drive organizational performance (including financial performance, customer-service and quality outcomes, volume or business growth, internal and external reputation, employee engagement, and other measures) to higher levels.


At the executive level, accountability means being transparent, sharing organizational goals and priorities, and reporting the progress toward those goals. Accountable leaders open themselves up to public evaluation and scrutiny. A leader who models these behaviors will contribute to a culture of accountability across the organization.

A culture of accountability starts with the CEO but also includes department managers and supervisors who hold themselves as well as their employees accountable for both effort and performance. Employees are continually comparing their treatment by leadership with the treatment their colleagues receive, and they are motivated when they perceive they are being treated fairly (and discouraged when they perceive their treatment to be unfair or unequitable). When a manager or supervisor doesn’t hold an employee accountable in a fair or consistent manner, other employees see the discrepancy and can become disenchanted and demotivated.


Good leaders at every level make fostering employee engagement a primary goal. Although management is about getting work accomplished through others, leadership (one of the four basic functions of management) is about motivating and inspiring others to work hard to achieve organizational goals. Disengaged employees typically give effort commensurate with only the minimum standards and expectations. Countless factors can contribute to employees’ level of engagement and satisfaction in their work environment and employment relationship, including the three discussed below.

Recognition and appreciation. Leadership’s ability to foster employee feelings of being wanted and appreciated clearly plays into engagement. Leaders can enhance employee engagement and spur productivity just by making rounds, attending regularly scheduled departmental staff meetings, or conducting open employee meetings. Engaging in these activities lets employees know their leaders are paying attention. Conversely, when employees don’t feel wanted or appreciated, they are much more apt to “quit on the job” and meet only the minimum standards required to maintain their employment. Moreover, when employees become disengaged, they detract from the organization’s mission, vision, values, goals, and priorities. This attitude of disengagement can spread throughout the organization, affecting the effort and performance of other employees, the organization’s image and reputation, and the ability to attract and retain high-performing employees.

Inquisitive environment. An effective leader invites employees to be innovative and creative and discusses and implements their ideas for improving the organization’s operations and working environment. Collaboration and teamwork should be valued, and new and different ideas welcomed and appreciated. A leader should consistently convey an openness to consider new ideas and suggestions; otherwise, new ideas and suggestions will not be forthcoming. Unfortunately, executive leaders often create an environment that, instead of fostering new or different ideas, stops them from being presented, discussed, or evaluated and thus prevents them from gaining any traction. If a leader responds to a suggestion with the comment, “That will never work,” he or she will promptly shut down dialogue about the matter. The result is a real reluctance of employees to bring new ideas or creative solutions forward.

Participatory leadership. Just as important as listening to employee suggestions is actively seeking them. As a rule, employees want to be involved in problem solving and decision making in matters that affect their job, their work, and their working environment. Effective leaders work collaboratively and openly with employees, utilizing their skills, experience, and critical thinking. To engage employees, leaders should take the following steps:

  • Seek input and create dialogue around employee suggestions for improvement, solutions to problems, and new ideas.
  • Consider that input within the decision-making process.
  • Strive to implement employee ideas into the workplace to the extent possible.

Participatory leadership is a way to recognize that there is no monopoly on good ideas and that people doing the work often have the best ideas about how to make their work more efficient and effective. A leader whose leadership is not participatory creates an environment where employees can become aloof, disinterested, and disengaged because they don’t believe the leader cares about them or values their input or opinions.


Action at every level of an organization must begin with communication. Effective communication is a powerful force that includes active listening along with clearly spoken and written communication.

The most powerful component of leadership communication is listening to employees. How are things going? What other help, support, or resources do you need to get the job done efficiently and effectively? What do we need to change or improve? When leaders ask these and similar questions while paying attention to employees in a positive, constructive manner, employees feel valued and appreciated. When leaders listen to their employees, they build trust, leading to a stronger level of engagement and a stronger employment relationship. Conversely, failing to pay attention or listen to employees is detrimental to the supervisor-subordinate relationship, to the employment relationship overall, and to employee engagement. Research shows one of the top reasons why an employee leaves an organization is the relationship with their immediate supervisor, which is directly affected by leadership communication. a

One of the most effective ways leaders can engage with employees is to engage with them in their work space. Making rounds and interacting with employees in their work area is a visual display that the leader cares about employees and their work and an opportunity for leaders and employees to communicate directly. Furthermore, this action can help a leader see with his or her own eyes problems and opportunities for improvement the leader may otherwise not see.


A leader without vision typically defaults to a transactional style of leadership—one that is predominantly about directing the daily tasks and functions to be accomplished. Transactional leadership is effective and even necessary in health care: Leaders should understand the operational business functions and processes, be familiar with the skills of employees, and be able to effectively assign tasks and teams to accomplish the work. However, leaders also should be able to establish strategies, goals, and objectives based on internal and external changes, trends, and opportunities for improvement, and be able to connect the work of their organization or department to the larger internal and external environment. In other words, a good leader can see the big picture and communicate that vision in a way that enables others to clearly see it, too.

At the corporate level, the vision of leaders involves strategic planning and positioning the organization to optimally serve its consumers. At the department manager or supervisor level, leaders should be able to interpret how the organization’s strategic plan relates to the department, service, or function and should be able to develop action plans that are supportive of and in alignment with the organization’s strategic initiatives and priorities. This alignment is paramount to ensure the organization and its employees are working in synch with one another.

In the management by objectives approach, the supervisor and subordinate work together on the following steps to ensure alignment:

  • Meet to discuss the employee’s work objectives
  • Collaboratively identify objectives the employee will adopt
  • Set action steps for the employee to accomplish the objectives
  • Meet at a designated regular interval to discuss employee progress

The basis for this approach helps create alignment with corporate and department goals at the employee level, fosters maximum employee engagement and support, and encourages collaboration, facilitating dialogue with leadership that includes an employee’s personal objectives and interests. The joint development of objectives and plans helps put an employee’s objectives and interests in alignment with the organization’s. When leaders do not take this approach, employees may feel that leadership isn’t interested in their ideas, growth, or development; the result can be discord and a feeling that the leader and the employee aren’t really in alignment or even on the same team.

Critical Intangibles

Health care may well be the ultimate people business. The most effective healthcare leaders tend to be those who connect with others in ways that make the leader seem human. Critical intangibles of leadership include trusting in others and being trustworthy, having integrity and credibility, and understanding people.

Integrity. Closely linked to trust, the integrity of a leader is always being assessed by employees, and any void here will result in less employee engagement and the giving of employee discretionary effort: that is, the cognitive and emotional desire to go above and beyond the minimum required standards of the job or work being performed. One example is how a leader reacts to mistakes—both his or her own and those made by others. A leader who outwardly demonstrates a desire for strong effort and performance, but also admits when he or she makes a mistake, helps to create a culture where excellence is personified. Employees are much more apt to give higher levels of effort and performance when they believe in the integrity of leadership, and that an occasional mistake made in good faith is acceptable.

Trust. It can be argued that trust of a healthcare leader is everything. When there is a lack of trust in a leader, followers do not believe the leader is genuine or sincere. Followers become hesitant, reluctant, and sometimes even scared to do more than what is specifically asked or expected of them. Furthermore, a lack of trust in leadership can become contagious, and collaboration and teamwork are negatively affected as well, creating a dysfunctional environment.

Emotional intelligence. There is a growing recognition of the importance of emotional intelligence in effective leadership. Understanding people and how they might react to certain situations or events, including new policies, procedures, and priorities, is a vital leadership competency. In addition, emotional intelligence involves a leader’s ability to recognize and understand his or her own emotions and typical reactions to certain people, situations, and environments, and to adapt when necessary—for example, by staying calm when highly frustrated or when confronted in a hostile environment. When a leader misinterprets the emotions of others, or his or her own emotional responses—particularly in difficult or crucial situations—negative reactions or outcomes can result and can have a cascading negative effect throughout the organization.

High-performing leadership requires skills and competencies in the critical intangibles of leadership—aspects that can’t be quantified or measured. In a people business such as health care, the critical intangibles of leadership play an important role in organizational performance.

Mastery of these key attributes—accountability, engagement, communication, vision, and the critical intangibles—can be difficult, but it is possible for any healthcare leader who takes them to heart. When a leader adopts these practices, the resulting style of leadership will effectively drive organizational performance to a higher level.

Steven B. Reed, FACHE, 
is president, Magellan Management Group, Indianapolis.


a. Efron, L., “Six Reasons Your Best Employees Quit You,” Forbes, June 24, 2013.


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