Volume 1 2022
New Manager? Have gaps in management expertise? Develop your path, create your plan, and don’t be afraid to dig in and ask questions.
It’s tough stepping into a management role. No matter who you are or where you come from, the first days on the job can be challenging. This is more so if you are a brand new manager, and have just been promoted over your peers into the role. Maybe you are a stellar clinician, and decided to throw your hat into the ring for an open clinical manager role. People who used to be your co-workers now report to you.
This is a difficult and important transition, and one you need to have some self-awareness in order to successfully maneuver. One of the most important things to remember is that you are now the one who is being assessed for your performance and your overall adaptation to the new role. And not by your new boss, but by the people that are on your team. As McCormick refers to in The First Time Manager, “the people who now work for you are the most important people in your business life.”
Your success or failure as a clinical manager depends on the work of the people on your team. How you interact, coach and inspire them matters greatly. While you may feel like you can now set many things in motion and make a lot of changes to mold the operations and team to your liking, it’s not the time to make sweeping changes. It’s a time to assess and adjust to the new role and assimilate into the job. It’s a prime time to use common sense and restraint.
So many times I have seen a new manager start barking orders to previous peers, and completely change their persona with their newfound authority as a new manager. This kind of behavior is not well-received by staff or by upper management and is not an effective way to garner support from your team. Such behavior can erode the trust that needs to exist between the team and the manager. Such behavior and displays of self-importance degrade the relationships. With these people being the key to your success as a manager, it’s a good idea to assimilate into the position. It’s hard to win back the respect of the team once you have lost it. So try to avoid acting like a crazed drunk with power new manager your first days on the job. Restraint is key.
I can attest there are days that you may feel the need to just make people do what you want them to, exerting your authority in matters of frustration. Largely, it’s not the best choice. People know you are the boss, that you have the authority in a situation. Honestly, I can count on one hand the times I’ve had to use it to influence action. Working with people where they are at, coaching and capitalizing on the strengths of your team is a great way to work with people. Gain their support and trust by being yourself, being clear on expectations and rationale for those expectations, and providing clarity of focus and purpose. You are working with professionals, treat them that way, it will take you further in your career than being an authoritarian.
Assessing what you need to know & developing a growth plan
As a new or newish or established clinical manager, you need to assess what gaps you have in your knowledge of operations, and develop a plan to address those things. We all have things we need to work on, but as a new clinical manager you may not know what you don’t know…. This is one of the reasons I developed the five pillars – Regulatory, Financial, Clinical, People and Technology – to give a foundation to build on.
If you are coming into the role from the field, there are likely several areas that you need help with growing. The first step is to figure out where you need to grow, where you need to learn more. One of the more common areas is in finance. This is not a natural place for a clinician and something we don’t get in nursing school.
This was not a comfortable topic for me when I first started and I really needed to build on what I knew, which was nothing at the time! To fill this gap, reach out to your finance team. See if someone can meet with you to go over the financial statements or benchmarks that you are seeing in reports at your agency. Maybe meeting for lunch and providing the lunch can help ease the way. Formulate your questions and define your plan. This is an important step. No one else needs to see it, but having a clearly written out list/work plan for your growth can help to define what that means for you. You can outline the steps that you need to take to achieve a level of comfort and competency for yourself.
A great starting place is to review the financial reports that you have responsibility for and gain an understanding the measures, the budget and the measures that appear in the statements. Some agencies are able to drill down in the financial reports to the team level – which is the best way to have oversight as you get the financial performance for your team. But if not, usually they will be provided at a branch or department level. Get to understand how they are reported for your agency. Look at and learn about of staffing, how many FTEs are budgeted for your team, and open positions. If your agency pays overtime, understanding how that is calculated and reported. Understanding how the agency reports and calculates productivity and how they are performing to budgeted/expected numbers.
Staffing is the largest expense in a home health or hospice agency, making up for 70 to 80% of all expenses. Monitoring caseload, productivity and any overtime is a huge part of managing expense for a clinical manager. It’s a balance to be sure, so getting to know the team, the patient census and service area play a huge part in how well expenses are managed. Make sure that this area appears on your work plan. You will accomplish a lot when you learn how to manage this area well. Make it a priority!
Treat your career like a business
In our podcast interview with Patricia O’Brien, she advised that you need to ‘treat your career like a business’. It is like a business, it’s your income, your retirement, your savings and your life for many years. Paying close attention to it matters, and by doing so you can help to guide yourself to where you want to be. Patricia advised to look at your career goals, determine where you want to grow, where you want to be, the steps you need to take to get there. Look at that list, look at it every few months and tweak it. Ask yourself if you are on track to your goals, re-evaluate, re-align and keep moving it forward.