Employees are smart, they are observant, and they possess a keen sensitivity to what their leaders say and do.  They can spot inconsistency a mile away.

Inconsistency — in communications and in actions — is the great enemy of leadership credibility.  In healthcare, the three areas where leaders suffer the most credibility damage are: 

  1. Quality of care and patient safety
  2. Employee relations
  3. Customer service

In an effort to improve quality of care and patient safety — huge problems that have yet to resonate with most politicians and opponents of healthcare reform — the industry has spent billions of dollars on analysis, training, program design and ongoing assessment.  Hospitals have spent more than several million dollars printing signs and buttons with catchy slogans extolling the importance of quality care.  While some progress has been made, the improvements do not match the financial investment.  Every year thousands of patients die from preventable mistakes, or their hospital care is prolonged, due to serious hospital acquired infections.  


Some leadership coaches that have looked at this issue argue that main problem is that the “campaign” to improve quality of care and patient safety has not been inculcated into an organization’s cultural DNA. People are assigned to lead quality improvement but there is no C-suite passion. That is a common leadership failing.

Signs and buttons that proclaim “Quality Is The Most Important Thing” are translated by skeptical employees as “Quality Is The Most Important Slogan,” according to Dr. Aubrey Daniels in his book “Bringing Out the Best in People.”  In other words, if leaders do not consistently eat, sleep, and preach the importance of quality every day, in every possible communication, the industry will see marginal improvements but not to the extent that patients will be truly safe. The employees will see the inconsistency.  

The issues are similar for employee relations and customer service.  Opportunities are lost, money wasted, and bad will produced, because the performance of leaders does not match the performance they expect from their employees.  In far too many hospitals, leaders create campaigns with slogans.  New management initiatives are launched with great fanfare, but then employees pick up inconsistencies.  A Vice President trying to improve productivity or lower costs, can undercut the efforts by word or deed.  Harried nurses, with sicker patients, take short-cuts.  Pesky new priorities emerge as financial or market strategies change. Slowly but surely the focus is lost. The organization moves on. Years later boxes of buttons and signs are found in a remote storage room, and no one can remember the point. 

Employees have great radars.  They see the wheels coming off before anyone else. In far too many organizations, where the leaders develop tunnel vision for the latest crisis, the employees have perfected the shrug of resignation — here we go again.  

© 2010 John Gregory Self