Andrea Sinclair
December 22, 2018

Changing Operations and Informal Leaders

Andrea Sinclair has written an article on her interpretation of the Global State of Operational Excellence Survey Report - Critical Challenges & Future Trends - 2018/2019.  Click here to download the full Survey Report 2018/19.  

The Most Comprehensive Study of Critical Challenges and Future Trends within Operational Excellence

With nearly 1000 respondents, 37 insightful questions, detailed analysis & insights from 40 industry thought leaders, and the BTOES Insights executive team, this 130 page report is recognised as the most comprehensive study of critical challenges and future trends within Operational Excellence, and is considered a key resource for the industry. Areas covered include:

  • The Critical Operational Excellence Challenges faced by executives.

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  • Analysis of key themes, including Cultural Transformation, Customer Delight, Sustaining an Operational Excellence program, Need for end-to-end Business Transformation, Keeping up with new technologies/impact of digitalization and Leadership Buy-in & Understanding.


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Changing Operations and Informal Leaders

The themes of this report clearly articulate the baseline problem: “(r)esearch shows that amongst the many factors that contribute to poor results are change fatigue, too many priorities to focus on, and poor employee engagement.” There are so many reasons that change feels urgent, from external market pressures to internal excitement from process improvement professionals themselves. Yet too often the pressures driving operational excellence initiatives fail to persuade those in operations. The best change efforts recruit those who understand and will do the work being changed in order to develop buy-in throughout the process of problem solving.  Click here to read the full Survey Report 2018/19. 




But what happens when even that expert-informed problem solving still happens far away from you?

I work in graduate medical education, which happens under the watchful eye of the Accreditation Council for Graduate Medical Education (ACGME). The people involved in the accreditation process put significant thought and effort into working with specialty experts to develop requirements and guidelines that are then distributed to schools across the country (and expanding to more schools globally each year). Sensibly, each program is left to determine how the actual operationalization of the requirements will happen, since there are nearly infinite variables impacting that piece of the implementation. Click here to read more Articles on The Global State of Operational Excellence: Critical Challenges & Future Trends - Research Report 2018/19.

 Changing Operations and Informal Leaders

But schools are complex organizations, and so are hospitals, and the intersection of the two makes for a mind-boggling level of complexity that needs to be navigated, often with little organization or thought put into the implementation process. Even the most carefully thought out plans often fail in the face of the actual circumstances. I am beginning to think a piece of that failure is because we too often overlook a critical step in the implementation of process improvement - translation into operations.




How can we increase the chances of successful change in the face of this complexity?

Within graduate medical education programs there is a management team (usually a Director and a Coordinator) who are responsible for meeting the ACGME requirements. This management team buffers the demands of the regulatory body to help mitigate some of the impact of change fatigue on other members of the team. Since the program director is also usually a full time clinician, reframing the program coordinator as the project manager responsible for localizing the requirements into operations allows us to see the faculty and students as subject matter experts - the team members who hold the key knowledge.

Lasting change requires solutions that address systemic, environmental, and procedural obstacles as well as workforce development but translation has to happen between the key organizational priorities, the solutions developed by data-driven problem solving, and the day-to-day operations.




How do we accomplish that translation?

By using (or developing) an asset which many organizations overlook - their informal leaders. To me, the most interesting thing about informal leaders is that they are rarely appointed by those with legitimate power. Instead, they are almost always self-created as people either accumulate the expertise or step up to take on responsibilities that are rarely a starting piece of their job description.


I also find it fascinating how informal leaders can accomplish a lot of change, even in organizations with resistant upper leadership. I think this is because an informal leader is positioned to connect the strategic goals with the daily processes in a way that can successfully persuade the people doing the work. The combination of trust-filled relationships, expert authority, and ability to connect people to a vision is what makes any leader successful, so it should not be too surprising that informal leaders have the same combination of skills. And while the transformations accomplished by informal leaders may not be as dramatic as what can be done when senior leadership is engaged, the changes can still be significant enough to build a persuasive case for the benefits of the endeavor.




A smart change agent identifies the people who have built cultural capital without authority and recruits them into sustaining the changes being made in their area. But what if an informal leader does not yet exist in the operations area where you need one?

In that case, this is an excellent opportunity to mentor someone who is intrigued by process improvement but is not (yet) directly involved in how they can connect the work they do with the key priorities in a really powerful way.

In the case of graduate medical education, the program coordinators are often those informal leaders. They are well positioned with intimate knowledge of the processes involved, deeply connected relationships to everyone within and around their programs, and the sort of informal authority that comes from doing a job that is responsible for nearly every outcome while being the boss of none of those who do the work. By looking for analogous positions in your company you might be able to find the missing piece in your organizational excellence puzzle. Find the people who are interested in taking on the work of smoothing the fit between key priorities and day to day operations, connect them with the organizational excellence vision, empower them to be the bridge between larger initiatives and their functional area and you will have greatly increased your chances of successful change.

Want to learn more? Download the full Report.
Changing Operations and Informal Leaders


About the Author 

Andrea Sinclair: Changing Operations and Informal LeadersAndrea Sinclair

Sr. Program Coordinator, University Of Louisville

Problem solver with progressive supervisory/management experience. I am continuously learning, currently adding clinical mental health skills to my resume. Check out her LinkedIn account.

Previously I was especially interested in fields directly related to process improvement in health care but oddly enough, the longer I work at a University the more I realize it's complex systems with high human interaction that interest me.

That being said, I really am looking to make a difference in processes that directly impact human lives, and that sounds a whole lot like counseling. So I'm taking advantage of my tuition benefit to study Psychology, with a goal of eventually completing a M.Ed and PhD in mental health counseling.

Specialties: process improvement, problem solving, team leading, medical ethics, bioethics, complicated situation visualization or philosophy in general, scarce resource management.



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