When budgets shrink, CLOs are understandably fearful for their learning dollars. Positioning learning as a cultural asset, one that many influential champions support, can help solidify learning’s position as a key contributor to employee performance, competence and skill.
Quite often, senior management and employee buy in are critical to learning programs’ successful implementation and adoption. The CLO has numerous avenues by which to achieve this, but few are more simple or effective than using a learning champion to help sway the workforce.
If Kathryn Kaplan, Ph.D., had not known she was valued and appreciated as CLO, after sitting down with Chief Learning Officer magazine to share her story, she would have quickly learned how much esteem she has garnered from her colleagues at Maimonides Medical Center, a health system in Brooklyn, N.Y.
Sondra Olendorf, senior vice president of nursing and hospital operations, and David L. Feldman, M.D., vice president of perioperative services, stumbled over each other’s sentences to express their pleasure with Kaplan’s work since she joined Maimonides three years ago.
“We made the conscious decision, unlike a lot of the great hospitals in New York, that we wanted the professional and nonprofessional staff at this institution to own their own need for learning,” Olendorf said. “So, when we discussed a chief learning officer role, we looked for someone not only with Kathryn’s credentials and experience but with her style.”
Before joining Maimonides, Kaplan worked as an organizational development specialist at The Mount Sinai Medical Center and the NYU Hospitals Center. Before that, she was an occupational therapist with a specialization in psychiatry. Now that she has discovered the world of organizational behavior, she said she is eager to study and make the subject matter part of her lifelong learning path.
“I’ve written four books, many articles and know health care in my bones,” Kaplan said. “What was hard for me was not patient care — I felt very well-trained for that. It’s the context in which health care occurs that is difficult. Having a bad boss, understanding why the outpatient and inpatient departments feud or why, when one person leaves who everyone agrees was awful, nothing changes.”
With certifications in emotional intelligence and Myers-Briggs, as well as a doctorate in management and organization from the School of Business at The George Washington University, Kaplan has been able to leverage her education and expertise to develop several leadership programs at Maimonides, but her team-oriented work style doesn’t always coincide with a hierarchical hospital environment.
“I would say one of the greatest challenges I have is my style — I’m a very collaborative, creative partner,” Kaplan explained. “Those are my strengths, but it’s difficult to do that in a hospital setting that’s very much about silos and chain of command.”
Kaplan’s ability to bring out people’s strengths and a sense of accountability is one of the reasons she was hired, Olendorf said.
“If people don’t own their own learning, particularly people who are already smart and who are highly credentialed, it doesn’t necessarily translate into continual learning and application,” she said. “Our culture is designed in silos, with very tenured, credentialed, trained people that we regard highly and who regard themselves highly, at the top of these silos. Kathryn has been masterful at working with people at all levels and helping us create this culture where people understand that leadership is at all levels and all positions, even if you’re not a manager — the housekeeper has the same ability to lead in the context of an initiative, as does a clinical chairman or a director of nursing.”
When she first joined Maimonides, Kaplan conducted a needs assessment and interviewed about 100 people, including chairmen, executive nursing directors and top administrators. She identified 10 organizational learning needs, and with the help of the organization’s leadership development steering committee, she prioritized and began several initiatives. The first was a physician leadership development program.
Many physicians were already in leadership positions, but Kaplan said some didn’t have the background or training necessary to develop a team or foster collegial relationships and partnerships, or they lacked knowledge of key management functions such as finance and negotiation.
Simultaneously, she began work on another high-priority initiative called the Culture of Mutual Respect, which centers on how people should treat one another in the hospital environment. The pilot program has been rolled out to more than 600 people, including physicians, nurses and other staff in three departments: perioperative services, pediatrics, and obstetrics and gynecology.
“That initiative was endorsed in 2004. Kathryn came in 2005, and for a year, I floundered around, not knowing what to do,” Feldman said. “Kathryn came in like a knight in shining armor, more or less, and really showed us the way. She developed the program, and the two of us together pushed it out. It’s only because she was able to understand how to make this happen from an educational perspective that it has actually gone anywhere.”
Kaplan said the initiative’s power does not come from its guidelines, which play a key part and are clearly posted for all hospital staff. Rather, the Culture of Mutual Respect draws strength from its link to cultural change, the strategic vision behind the code and its alignment with organizational goals.
The program has six components: role identification, measurement, learning skills in the form of VitalSmarts’ “Crucial Conversations,” mediated conversations to help people focus on themselves and what they can do to be more respectful, system issues, and nurse and physician leadership.
“One of the things that’s really unique about it is that it gives equal emphasis to the system issues that are catalysts for frustration,” Kaplan said. “You can imagine, in an operating room, if you get the same broken instrument three times in a row, you get a little irritated. We track all of the issues that need fixing and then try to close the loop and get back to people to say, ‘OK, we worked on this and that. It still doesn’t excuse you from being respectful.’”
In an effort to get staff members to own their development, Maimonides decided not to centralize learning. Instead, the different departments such as IT or nursing have dominion over the types of learning they provide, as well as how to deliver them.
Kaplan acts as a facilitator, touching learning across the organization and helping shape the culture and set priorities on things that can be influenced. This strategy allows people engaged in leadership development to enact strategic direction in the organization, and the resulting benefits can be measured.
“We try to use more of a pull than a push method so that people are attracted to this because we’re meeting their needs, and they want to learn,” Kaplan said. “I use a training evaluation model called ROI, and it’s built on Kirkpatrick’s four levels of measurement. We have been careful to look at those four measures in every initiative, assessing level of satisfaction, content follow-up, indications of application in their real jobs and the impact on the organization.”
Kaplan said it can be tough to come up with numerical calculations to validate leadership development and other learning efforts, but some strong anecdotal success indicators have emerged inside and outside the organization.
“I meet with nursing orientees every time there’s a new group, and I ask them a few things,” Olendorf said. “One, how long have you been a nurse? Why did you choose nursing as a profession? Why did you choose to practice at Maimonides? They’ll say, ‘We heard that Maimonides is a nurse-friendly organization.’ I ask them what that means. It could mean we pay better or a lot of things, but the two things they mention most frequently are the work that we’re doing around good nurse and physician relationships.
“They’re hearing from the outside that we have not shortchanged continual learning and good, upfront orientation for nurses. That can be translated as the institutional commitment to learning and competency of professional staff. I didn’t used to hear that, and it’s a very competitive nurse-recruitment environment in New York.”
In the spirit of continuous learning, two years ago, Kaplan, Olendorf and Feldman participated in a nurse-physician collegial relations group that arose from the physician leadership program. During the last session on vision, Olendorf suggested the group bring together nurses and physicians once a month to examine Maimonides’ vision. This meeting became known as the Leadership Operations Workgroup.
In its first year, the group successfully tackled a throughput problem on how to get people through the hospital quicker. After conducting a pilot program on one hospital unit, participants were able to free up time for residents to see patients, and by limiting visitation, they also were able to conduct patient discharges more efficiently.
Kaplan took the initiative further and designed a session in which nurses and physicians could set aside specific time to examine their common issues.
“They addressed ‘What is it that I wish you knew about us,’ ‘What we think about you,’ and ‘Here’s what I wish you would do differently,’” Kaplan said. “Each group prepared that, shared, and over time, this was the most powerful, honest conversation they had ever had. They continue to affect collegial relations — and not just collaboration — by talking about what it really means to have mutual respect at the highest professional level. Now, they’re doing work throughout the institution on joint projects like orienting new staff or putting names up so everyone knows everybody. Doctors and nurses together are doing projects with the people in their area. It’s real leadership.”
Olendorf said Kaplan has made an impact on the overall organization, as well as individuals therein.
“Kathryn’s figured out a way for us to get the work done that is really artful — people seek her out,” Olendorf said. “She’s made my job easier, and she’s enriched my thinking about myself and life-work balance. As a colleague and someone who’s so trustworthy, you can have any kind of conversation with her. I find that to be really helpful. She’s a good person first and then a great chief learning officer.”
Feldman echoed the sentiment.
“Kathryn and I have spent a lot of time together working on leadership development, and we’ve done a lot of traveling too, looking at other programs and the like,” he said. “Our skills are so well-matched, it’s like we know what each other is thinking. It’s a unique working relationship, and she makes me look good all the time.”
NAME: Kathryn Kaplan, Ph.D.
TITLE: Chief Learning Officer
COMPANY: Maimonides Medical Center
- Designed and implemented a multifaceted program to make the Culture of Mutual Respect a way of practice, not just something on paper.
- Developed a physician leadership program to create an evolving cadre of physicians to play a bigger management and leadership role.
- Established an ongoing forum for nurse and physician leaders to enhance collegial relationships and engage in joint leadership projects.
- Created a leadership development program for managers to encourage interdepartmental collaboration on priority issues.
- Contributed to the development and measurement of labor management initiatives to strengthen the strategic alliance between the hospital and unions.
“The CEO’s vision, which informs and inspires our work, is that leadership development is not the exclusive purview of managers. Rather, it is the capacity for engagement in all employees and at all levels to enhance patient care and support organizational growth.”
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