Colleges of Oriental medicine are multifaceted complex institutions that present significant challenges in leadership and management. Organizational structure and mission, when combined with the issues of a specialized professional and service workforce, can create discord to create considerable issues for leadership to resolve.
OM colleges sometimes have overlapping organizational structure. Our colleges include a minimum of one academic program, a community clinic and various externships, along with academic, business and professional services. The relationships among each are prone to change, and new leadership in any area can alter influence and authority throughout the organization.
Each facet of our institutions carries out an array of varied endeavors including didactic education, clinic education, patient care, community service and, in some cases, research. The struggle for resources and assignment of allocation priority are often difficult to determine among program areas and needs, as well as across missions. Leadership faces the challenge of weighing costs with benefits, which can be daunting when benefits are reliant on academic value judgments of effect and recognition rather than just the business financial return and market position. Academic versus clinic values, and business versus clinical practices illustrate program conflicts that can lead to organizational conflicts.
An additional issue that adds to the complexity is the "free agent" nature of the highly specialized and independent faculty who provide education, clinical supervision and patient care services in college community clinics and externships centers. Overseeing the management of staff who provide professional, technical and administrative services adds to the challenge. This requires significant infrastructure and organizational skill to support the functional components of the OM college.
According to the service-profit chain from How Leading Companies Link Profit and Growth To Loyalty, leadership behavior influences employee engagement/satisfaction, which affects customer satisfaction and overall organizational performance. In an effort to improve engagement and satisfaction of the institution's administrative team, faculty and students the institution should employ the following steps:
Step One: Selecting a Leadership Team. Select a small executive leadership team to provide input and oversee the strategic planning and tactical decision-making across all aspects of the center. One key is to align mission with administration. Appoint members from both functional (academic and clinical) units and support (administrative and financial) units. Each team member is responsible for oversight of an aspect of the institution's mission and the performance of a sector of the organization. Leadership team members are chosen based on criteria such as expertise in an area of the institution, confirmed leadership ability and status in the institution. A key benefit of the leadership team is having members chosen from the culture who can help a new leader connect more successfully with students, faculty and staff.
Step Two: Objectively evaluate organizational culture. Leadership must assess the existing state of affairs in order to measure the possibilities for improvement and directions for improvement. This is a critical step for creating positive changes in institutional culture and performance. The most noticeable issues of concern are commonly in academic, clinical and fiscal performance. Weaknesses in organizational culture and structure are often determined to be the two underlying core cause of a deteriorating college.
Issues are bound to arise in environments where there is a prevailing passive-avoidance culture which promotes avoidance of risk, controversy, timely decision-making and accountability. In particular, when the institutional culture emphasizes process rather than outcome and authority becomes diffused throughout the organization, it becomes difficult to get any decision at all. A culture of passive-avoidance and weak leadership makes it difficult for any individual to make a decision and be held accountable.
Gather information from academic, clinical and administrative leaders. Include external advisors from academic medicine, management and leadership. Offer input to asses the institutional structure and function. The information resulting from this research is useful toward developing a strategic plan by which the leadership team can create a successful course of action to develop structural alignment.
Step Three: Establish and clearly communicate a shared vision. The fundamentals of organizational performance are established at three levels. The top level is Mission and the Vision. The middle level is Alignment of Organizational Structure, Resources and Recognition. At the bottom is Values/Culture as the base upon which the institutions builds.
The Mission and Vision of the institution reminds and reinforces the founding goals of the institution and holds leadership to the task of defining and facilitating the work needed to realize the goals of the entire organization and how each component plays its part. From this, the leadership team can develop a plan that illustrates how each segment can serve the whole; e.g., how the excellence of the clinic can serve the academics and research of the institution. Successfully focusing on the Mission and Vision improves overall performance.
The Alignment of Organizational Structure expects a high degree of cooperation and collaboration among and within each institutional segment to the achievement of the mission. Each segment is expected to exhibit considerable commitment and engagement with other areas of the institution. Alignment of the institutional goals requires prioritizing activities that benefits the entire organization and the mission. Resource allocation is based on achieving the Mission and Vision.
Expectations are assigned for the whole institution and for each department. These expectations can begin a shift in the department level through encouraging teamwork, innovation and excellence. Leaders are required to be proactive through active engagement rather than passive avoidance. The goal is to improve culture and services, and increase financials by growing revenue. It is critical to invest in high-performing people and programs.
Culture is often at the root of institutional discourse, and leadership carries the responsibility for the state of the institution's culture. A good strategy for improving the culture of an institution is for leadership to focus on excellence and engagement to increase satisfaction levels across the community, including faculty, staff, students and patients. Leadership behavior influences employee engagement and satisfaction, which in turn affects customer satisfaction and organizational performance. Investment in leadership is never wasted.
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