Rule 4: Blend personal and organizational development

Rule 4: Blend personal and organizational development

The six rules of good healthcare management and leadership development.


A great irony of leadership development initiatives is that when times are tough they are among the first programs to be cut, when this is actually the best possible time for them to happen. What better context to develop people than when they have ‘live ammunition’ to develop their skills with?

The most sophisticated leadership and management schemes are seen as indistinguishable from organizational development, rather than a branch of human resources. Training programs are integrated with existing corporate priorities and strategic improvement projects.

Jonathan Gosling, Emeritus Professor of Leadership at Exeter University, calls this “use work, don’t make work”. In other words, practical improvement projects – a vital part of any successful management and leadership development program – are not directed at made-up or marginal problems but pressing challenges that the organization has already identified as needing to overcome.

One of the key trends in this regard is the movement towards training team members together. The link between team functioning and high quality care is becoming ever clearer.1 As a result, the traditional model for management and leadership development programs, where individuals are the focus and training is separated from their normal work context and colleagues, is changing. Courses aimed at just one profession or one cadre of workers are becoming less common, replaced by interventions designed to boost collective leadership – often by training doctors, nurses and managers together.

Symptoms of failure:

  • Leadership development is absent from the organization’s major strategic plans.
  • Most training is done in professional silos.
  • The board is not being kept aware of the content of improvement projects underway as part of development programs.

Key action for boards:

Integrate training efforts to develop staff teams together. Ensure that action learning projects are focused on the pressing problems of the organization.

Case study

Forging system leadership through peer exchanges: Halton’s leadership exchange (Canada)

Collaboration across health and social service agencies is a core part of any modern, sustainable system. However, in the Health Department of Halton (a district of around half a million people across four municipalities west of Toronto) it sometimes seemed easier to collaborate with external organizations than other internal departments and services in the local system.

In an attempt to improve intra-organizational collaboration, a ‘leadership exchange program’ trained pairs of management staff from different areas of health and social services to act as action-researchers in each other’s workplaces. The program focused on how leadership and collaboration are accomplished (or hindered) in real-time and in context; and as a by-product enabled participants to appreciate each other’s leadership strengths and challenges. Outcomes included ideas to reduce barriers and normalize a culture of collaboration.

The aim of the program was twofold: to assist middle managers in developing their leadership in a meaningful way and to tackle low intra-organizational collaboration to improve the local healthcare system’s ability to be flexible and innovative. The resulting exchange involved managers from emergency care, public health, mental health, housing and child services.

There were three phases to the exchange process: a two-day pre-exchange workshop for all of the managers involved, two-day exchanges in each direction, and a post-exchange phase consisting of individual interviews and a half-day group debrief/workshop.

Participants all felt the exchange helped them gain a new perspective on their own leadership style and a chance to improve their listening skills and ‘systems-awareness’. It also allowed them to develop relationships with other managers, who they otherwise would not have worked with, which have persisted long after the exchange.

Lynne Hanna, manager of the School Years Program, said “I have over 20 years of experience as a manager, but the exchange allowed for a view into another part of the sector which I’d not previously had a lot of insight into – in particular seeing areas like labor relations, organizational design and role diversity within management”.


1 Faculty of Medical Leadership and Management & The King’s Fund; Leadership and leadership development in healthcare: The evidence base (2015).

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