Categories
Business/Finances Leadership & Practice Management Preparing for Grad School/Residency

#114 – Leadership: how to get stuff done

This podcast is for leaders, clinicians, residents & students who need to get wildly important things done. It’s about how to prioritize when so much of your work seems important. How to find balance when so much seems to be coming at you. How to get started at achieving your biggest goals.

This episode will walk you through the 4 Disciplines of Execution by Chris McChesney, Sean Covey & Jim Huling. 

I have no financial relationship with these folks, the book or their publishers. It’s just a great concept that will help you get organized, identify your wildly important goal and figure out the work you actually need to do and CAN do to accomplish your goals.

The 4 Disciplines of Execution (4DX) model will ask you to identify your wildly important goal. You’ll then create several lag measures (subgoals) and several lead measures (objectives) for each lag measure. These lead and lag measures are where the real work is. The wildly important goal may seem out of reach. Even the lag measures (which lag behind the work you’ll do in the lead measures) may seem a bit ambitious. That’s ok. The lead measures should be the specific actions you will take on a daily or weekly basis that will chip away at the lag measures. As you put the work in on the lead measures, your lag measures will come into sight and slowly be realized. As you stack up achieving the lag measures, your wildly important goal will become within reach.

The next components of the 4DX model is the scoreboard where you track your progress on each lead & lag measure. This can be any relevant metric on any kind of progress tracker: a list on a whiteboard, a data point in an Excel file, the pounds on the scale, dollars in the investment account or left on the loan. Whatever.

Lastly, is the cadence of accountability. You need to either personally set up a check in on your progress with yourself or you need to set this up with your team, mentor or coach. The authors of the 4DX model recommend this be a short weekly meeting where you review progress from the last week and plan actions for the coming week. Accountability is about follow through, taking steps (as small as they might be) and slowly, setting up the cadence of consistency.

I was on the Peloton last night and heard Matt Wilpers say that the order of priorities in exercise is developing consistency, then duration, then load. You can’t go out hard all of a sudden and expect big results. Develop consistency. Show up a little bit each day or each week. Then put the time in. Build the duration of your investment towards your goals. Then you’ll know when to put the extra effort in.

Check out the show and if you want to dig deeper, definitely check out the 4 Disciplines of Execution.

McChesney, C., Covey, S., & Huling, J. (2012). The 4 disciplines of execution: Achieving your wildly important goals. Simon and Schuster.

What’s your Wildly Important Goal?

Categories
Anesthesia Education Business/Finances Leadership & Practice Management

#112 – How to Transition from Clinician to Chief CRNA

What’s up y’all! This is Jon Lowrance and this is episode 112 – How to Transition from Clinician to Chief CRNA.

Y’all are going to love this conversation.

So… I almost don’t know where to begin cause there’s so much to talk about…

This is an episode about chief CRNAs but so much more. It’s like when you watch one of those food documentaries about the best pizza kitchens in the world and you’re like: oh, a documentary about pizza, but then it’s really about the experience of chefs, small business owners, friendship and passion. This episode is like that.

It’s about chief CRNAs. And we have a couple of guests that are going to talk with us about an article they published on the research they did into the professional experience of chief CRNAs. But this story is really about the transition that most healthcare providers take when they take the step from expert provider to clinician-leader, practice manager or owner. You’re going to see this through the lens of what these 2 researchers saw when they did a qualitative analysis of chief CRNAs across the state of North Carolina. But you might take something away from this about the physician who leads your team or the CMO or health system president that runs the show where you’re at.

If you work in healthcare, cause you probably do – again, unless you’re my mom, who listens to all these podcasts – hey Gail! But for the rest of you, if you’re in healthcare, this episode will likely help you understand your clinical leaders better.

I never set out to be a chief CRNA or practice manager. I wanted to be the best clinician I could. I wanted to stand in the gap between the chaos and the outcome. I wanted to master my craft as an anesthesia provider and take the best care of patients possible.

Literally, like 6 months before our chief CRNA announced that he was going to step down after 8 years in his role, I had the opportunity to become a daily shift supervisor – like a board runner in the OR. I was like: I’m never going to do that. It seems way too hard. Then our chief stepped down and his role opened up and I was like… wellllllllll…

This episode hopefully will be relevant to any clinician who, like me, has stepped into a role or is thinking about taking on a clinical practice leadership role that maybe they’re not totally ready for. You’re not alone.

So we’re going to talk with Austin Cole and Robert Whitehurst, co-authors of an article about the competencies & professional development needs of chief CRNAs that was published in April 2024 in the AANA Journal.

Austin framed his doctoral project at Duke University around this study. Austin Cole, DNP, CRNA began his career after graduating from the school of nursing at UNC-Chapel Hill. Following graduation, he spent two years as a Registered Nurse in a cardiothoracic critical care unit. He received his DNP and nurse anesthesiology training at Duke University and currently practices as a CRNA at Duke Regional Hospital in Durham, NC.

Robert Whitehurst is the President of Advanced Anesthesia Solutions, a CRNA practice providing anesthesia services to a variety of outpatient practices. He graduated in 1997 from East Carolina University School of Nursing with his Bachelor of Science in Nursing and in 2004 from Duke University School of Nursing with his Master of Science in Nursing. Bob Whitehurst is also the Chairperson for the North Carolina Association of Nurse Anesthetist’s Political Action Committee and he’s passionate about patient access to high quality anesthesia care. He’s happily married to Amy Whitehurst; they have 4 children and in his spare time he enjoys hanging out with his family and playing tennis with friends.

Austin & Bob’s paper is titled “A mixed-methods exploration of competencies and professional development needs among chief Certified Registered Nurse Anesthetists.” For the study, the authors contacted 85 chief CRNAs across North Carolina and conducted structured interviews and qualitative analysis with 10 of them. They set out to understand the competencies and professional development needs of chief CRNAs.

I gotta say, when I read their article, so much of it resonated with me as a chief CRNA. The path for so many practice managers – including physician anesthesiologists and other Advanced Practice Providers, like PAs & NPs, is that a senior clinician with several years of clinical experience often steps into a practice management & leadership role that’s been vacated and their learning curve in leadership happens through on the job training.

That’s kinda suboptimal.

Yet it’s pretty rare for groups or hospitals to have dedicated mentorship and professional development programs established and to encourage clinicians to develop as practice leaders. It’s even more rare for clinicians to have formal leadership & management training prior to stepping into leadership roles. In the show, we hit on 2 important concepts – the double loss phenomenon and the halo effect. The double loss phenomenon is where the group looses a senior clinician when they step into a leadership role since they’re not doing clinical work as much and they gain an inexperienced leader & manager… someone with little to no experience in that kind of role.

No bueno.

The halo effect is the cognitive bias where people believe that because they’re really good at doing one thing – like being an expert anesthesia provider – they’ll automatically be really good at another – like being a practice leader. Competency in your clinical practice does NOT translate to competency in leadership & management. They’re two wildly different skill sets and you need to train, study and work hard at leadership & management just like you trained, studied and worked hard to become an expert clinician.

So I think you’re going to enjoy this show. Regardless of your clinical background – whether you’re a CRNA, a med student or resident, physician anesthesiologist or some other Advanced Practice Provider. Even though we’re talking about chief CRNAs here, we’re really talking about the phenomenon of clinicians transitioning into leadership & practice management roles. I’m a big believer that if healthcare is going to change for the better… become more effective, efficient, safer and just better for both patients and the people providing the care, we will need expert clinician-leaders. We need these clinician-leaders to learn the art & science of practice management. We need clinicians to develop the key competencies to become expert leaders. That transition and development is not a given. It doesn’t just happen with on the job experience. You can be a very experienced practice leader and be terrible at your job.

This episode is a great place to start for new and future clinician-leaders. I hope you enjoy it as much as I did! I’ve got links in the show notes to the article that Austin & Bob published.

And with that, let’s get to the show!

Cole, A. L., Simmons, V. C., Turner, B. S., Whitehurst, R., & Tola, D. H. (2024). A Mixed-Methods Exploration of Competencies and Professional Development Needs Among Chief Certified Registered Nurse Anesthetists. AANA journal, 92(2), 105–113.