June 20, 2024 Experienced managers have more meaningful interactions with their teams

What the data says
Clinical managers, inclusive of all inpatient and outpatient specialties, with five or more years of experience as a manager have 30% more meaningful interactions overall with their team members relative to less experienced managers. They do 42% more recognition activities – the actions that data indicates has the largest impact on RN retention – and have 10% fewer accountability conversations.

Experienced non-clinical managers have twice the number of meaningful interactions as less experienced managers. They do more than twice the amount of check-ins, recognitions, and celebrations (i.e., birthdays and work anniversaries). These non-clinical managers have 54% fewer accountability conversations than less experienced managers.

In terms of overall volumes, check-ins are the most common category of manager actions, followed by recognition, celebration, and accountability (as shown in the chart below).

What it means

Senior managers have learned from experience to prioritize recognizing and engaging more with their team members. Clinical managers, for a variety of potential reasons, close the gap with more experienced managers faster than non-clinical managers do. 

1. Greater experience provides the skills needed to both allocate time for meaningful interactions and to prioritize doing so.
   • Less experienced managers are often focused on learning the process elements of their roles; for example, they need to meet compliance targets and learn how to use a variety of systems to run their departments, such as scheduling and payroll.
   • A director of clinical practice at a midwest medical center shared recently, “As a new manager, you want to ‘check things off’ and so going to your time and attendance system to do a task feels good…but team time is not a ‘check the box’ item. It is an investment that builds slowly and sometimes invisibly over time. It is harder to recognize the impact but it is greater overall.” New managers need time to learn the effect of such an investment in their team on stronger culture, commitment, alignment, engagement, and retention.
     
     
2. More experienced managers have fewer critical conversations, possibly because they don’t need to do as much.
   • With more experience comes the ability to manage proactively. This includes setting clear expectations, communicating them, reviewing the data for variations from expectations, and intervening early as needed.
     
     
3. For a number of possible reasons, there is a greater gap in practice between experienced and less-tenured managers in non-clinical areas
   • Non-clinical managers are more likely to have become leaders through experience outside of frontline work (e.g., an advanced degree); while this provides a solid foundation for future growth potential, they are less likely to come into a leadership role with years of observing the value of relationship-based patient care and team leadership.  
   • Meaningful interactions between managers and their teams may be more ingrained in clinical areas than they are in non-clinical areas.
   • Managers may have more leadership and management education than managers in non-clinical areas.
   • Finally, clinical team members’ careers are based on relational interactions, which may often be transferable to leadership roles. The nature of frontline clinical work is relational by design, given the focus on patients, and this may translate to team-based relational skills as these team members are promoted. 

What the implications are for healthcare leaders 
Training and mentorship are important, but it’s particularly important to focus on developing relationship-based leadership skills. Managers should learn how to have effective critical conversations while also being proactive to lessen the need for them. A specific investment in leadership support for new non-clinical leaders is also needed.

1. Reduce the gap in actions and priorities that exists between more experienced and less-tenured managers through training, mentoring, and other approaches.
   • Executives could consider providing new managers with training focused on sharing the knowledge of senior managers to reduce this gap. Executives can consider implementing measurement systems to monitor the consistent level of meaningful interactions by new managers.
   • Service line leaders and directors could consider a program of pairing new managers with a senior manager mentor, providing them with an outline of items to discuss, including how and why to prioritize relationship-based actions.
   • Developing and deploying new leader orientation specifically focused on engagement with direct reports could accelerate the closing of the gap. Newer managers’ areas of focus are often overly-weighted towards running processes and having corrective conversations, at the cost of building relationships, culture, and a strong team foundation.
     
     
2. Support less-tenured managers to be proactive by setting expectations, building a positive culture, and thus needing to have fewer accountability conversations.
   • Experienced managers have 10% fewer accountability conversations than new managers. While this shows an ability of new managers to take on one of the most challenging parts of their role, it may be a symptom of having fewer upstream conversations about expectations with early interventions.
   • Training newer managers on how to set expectations with team members and to review progress early and often could reduce the need for accountability conversations overall.
   • In addition, as accountability conversations are 5% of managers’ overall activity, specific hands-on training for these discussions would benefit early-tenure managers. All managers would benefit from training that includes how to approach each of the five generations in the workforce in ways that meet their unique communication needs.
     
     
3. Build specific strategies to bridge the gap in practice for new managers in non-clinical areas.
   • New managers in non-clinical areas in particular need more support in their first few months and years. For example, mentorship with experienced non-clinical managers may be especially valuable.
   • New managers in clinical areas are likely to have had conversations with patients about the need to change behaviors to improve their overall wellness. Their experience in these conversations may be readily applied to the employee who needs to change behavior in order to improve their performance. Non-clinical managers will not have this experience.
   • Leadership practices in non-clinical areas often include different roles and responsibilities from those in clinical areas. The KPIs differ as well as the tools and platforms. Leadership training built for nursing leaders may not translate or be absorbed by leaders in other areas. Executives can consider looking for leadership training that is inclusive of all areas. Executives should be thoughtful about only investing in leadership courses designed for clinical leaders as this only perpetuates this gap in practice.