Financial Leadership

How healthcare finance leaders can coach operational leaders for better performance

February 18, 2020 11:46 pm
  • Finance leaders increasingly have responsibility for supervising operational leaders within their organizations.
  • Although time-consuming, one-on-one coaching can be highly effective.
  • When coaching operational leaders, finance leaders should address barriers to financial outcomes.

As an associate CFO, Averil Kane spends some portion of each workday coaching service line and department heads at Cambridge Health Alliance (CHA) in Cambridge, Mass. She’s seen an uptick in the time she spends coaching since CHA implemented new productivity and benchmarking tools to create more accountability on the front line.

“Today, operational leaders have to be a lot more accountable for their performance, which means that we need to provide more coaching to help get them there,” Kane said.

Kari Cornicelli, FHFMA, CPA, executive vice president and CFO at Phoenix Children’s Hospital, agrees that a sharper focus on performance has created more opportunities for finance teams to coach operational leaders. “Over the years, there’s definitely been a change in the type of education and interaction that we have with front-line leaders,” she said.

For example, more finance leaders are called on to coach department heads on the basics of managing their business, including budgeting, managing productivity and reducing supply costs. Through coaching, the goal is to help department heads build competencies that drive improved performance. In the process, the leader strengthens accountability without generating counterproductive fear, said Robert Porter, senior vice president and executive coach at MEDI Leadership in St. Louis.

Coaching is the opposite of issuing directives (or what Porter calls using “brute force”) to get operational leaders to act. If department heads perceive that finance leaders have forced them to make a change, they may feel frustrated, victimized and powerless, Porter said. In contrast, coaching can help operational leaders feel a greater sense of ownership for their outcomes.

Through effective coaching, finance leaders also avoid being labeled as “scorekeepers on the sidelines,” Porter said. Instead, they are more likely to be perceived as supportive partners.

Best practices for coaching

Experts offer the following suggestions to make coaching effective.

Provide one-on-one coaching when possible. Since moving to a new electronic health record, leaders at CHA have access to more real-time financial data and dashboards. Encouraging operational leaders to check their data daily is a priority, so finance leaders such as Kane provide individualized coaching and support to increase familiarity with the system.

In these coaching sessions, Kane uses a department’s own data, which helps make training more “real” for leaders. Although these sessions can be time-consuming, they are often worth the investment. “In the long term, we have found these sessions were more valuable for leaders because they really got what they needed,” Kane said.

Look for opportunities to educate during standing meetings. Cornicelli, a former Chair of HFMA, recommends providing some type of financial education during monthly meetings with operational leaders. In her previous role as vice president and CFO for the Sharp Metropolitan Medical Campus in San Diego, Cornicelli and her team of financial analysts worked with department leaders each month to help eliminate variances in productivity, supplies and other areas.

“Over time, you should develop a working relationship where the finance team becomes a business partner to the clinical team,” she said.

Embed finance leaders on process improvement initiatives. Finance leaders can find opportunities to educate clinicians while offering data analysis or other support to process improvement teams, Cornicelli said. Finance leaders who are certified on a process improvement methodology, such as Lean or Six Sigma, can provide even more value to clinical teams, she added.

Establish an open and honest dialogue with operational leaders. “With that dialogue, you can understand each other’s interests and concerns, and try to find a way forward that respects each other’s needs in pursuit of a common goal,” said Porter, who previously was president and chief strategy officer at SSM Health in St. Louis. An example of a common goal is financial sustainability to ensure the organization can continue to offer high-quality care.

When coaching, finance leaders also should try to uncover operational barriers that may prevent leaders from achieving peak productivity or reaching a financial target, Porter said. By having an open dialogue, finance leaders can learn about scheduling challenges, department vacancies and unpredictable volume shifts that may add to the problem — and then potentially offer solutions.

Understand the importance of respect. “It’s absolutely essential that you establish a respectful partnership,” Cornicelli said. Recognize operational leaders’ clinical expertise, and don’t judge their business skills — they often are juggling dozens of staff and patients each day.

Approaches to avoid when coaching

Finance leaders should avoid these coaching-related mistakes, experts say.

Don’t focus solely on the short term. During these discussions, finance leaders should emphasize achieving the type of sustainable improvement that is essential to the organization’s ongoing mission. Finance leaders should demonstrate that they “care about creating a solution that at once is responsive to the financial realities and allows clinical leadership to maintain or improve the quality of care,” Porter said.

Avoid lengthy coaching sessions. Beyond taking operational leaders away from their work, Kane said, marathon coaching sessions are overwhelming and counterproductive. By keeping coaching sessions short, finance leaders respect their colleagues’ time and priorities. “Show them you understand that their patients come first,” she said.

But that doesn’t mean having only one session, she added. “Some operational leaders might need a number of sessions over a few months to even a year.”


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