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Brooks Rehabilitation: Evidence-based Leadership for Evidence-based Healthcare

Brooks Rehabilitation teams up with Pfeiffer to implement a leadership development program that leads to a revolutionary—and much-needed—culture shift.

Serving patients from southeast Georgia and northeast and central Florida for more than 35 years, Jacksonville, Florida–based Brooks Rehabilitation operates one of the largest inpatient rehabilitation hospitals in the United States and one of the region’s largest home healthcare agencies. This not-for-profit also includes 26 outpatient rehabilitation clinics, a skilled nursing unit dedicated to orthopedic rehabilitation, a rehabilitation medicine physician practice, and an award-winning skilled nursing facility. In addition, the Brooks Rehabilitation Clinical Research Center specializes in research trials for stroke, brain injury, and spinal cord injury, among other conditions, to advance the science and practice of rehabilitation.

Having built a legacy of unmatched expertise and a dedication to results, Brooks—like many other healthcare organizations—came face-to-face with major challenges in early 2000. Dramatic changes in research and the practice of rehabilitation medicine were under way, and economic and regulatory pressures required that Brooks expand its business and broaden its reach to remain competitive and relevant. Streamlining operations and building expertise among all staff became the first order of business. But in reality, these goals could only be achieved with a major shift in the cultural mindset.

Building a team for growth

The question of who would lead the organization through this era of change became evident when Doug Baer was promoted to CEO in 2002. While sustainability and financial performance are measures of success for any CEO, Baer’s leadership philosophy was what truly provided meaning and inspiration to his team and created the momentum for change.

“To be successful in our dynamic environment,” he says, “it was imperative we develop leaders throughout the organization who would challenge the process and strive to develop new and innovative programs.”

From the beginning of Baer’s tenure, Brooks started to have a different look and feel. Baer brought in Michael Spigel, now executive vice president and chief operating officer, who continued to push a new cultural standard with his passion for leadership development.

“I’ve always had a strong belief that if you influence people, you are in a leadership role,” adds Spigel. “At Brooks, I wanted to be sure that we developed rich programming for both clinical and nonclinical staff that was open to every- one—regardless of title or position.”

Once more talent was on board— including Karen Gallagher, vice president of human resources and learning; Edith Katz, employee development manager; and Monica Chandler,learning manager—Brooks finally had a solid team experienced in leadership development to complement the clinical expertise of the medical staff and move the organization forward.

To ensure Brooks’s success, it became clear that nothing short of a revolutionary culture shift would shake people out of their comfort zone. Building leadership capacity in every- one, at every level, was essential. With no personal development programs available to build on, Brooks turned to The Leadership Challenge leader- ship development program by James M. Kouzes and Barry Z. Posner. Several staff members already had seen first- hand the power of this research- and evidence-based model to transcend organizational hierarchy—making leadership everyone’s business. Brooks’s leaders were confident it would be both sustainable and flexible because the program’s core practices were grounded in everyday behaviors and actions.

While many at Brooks understood that developing leadership talent was inherently the right thing to do, pro- gram advocates set out to do more. By implementing The Leadership Challenge program, they proposed to demonstrate that it also was good for business by delivering a positive return-on-investment.

Brooks’s focus on a continuum of learning In structuring its 12-week program, Brooks incorporated a variety of tools required as prework, including a goal- setting assignment, various exercises, and the Leadership Practices Inventory (LPI) 360-degree assessment instrument. In addition, the program design integrated an action learning frame- work to create a unique continuum of learning built around a model that includes conceptual learning, home- work, lab classes, and ultimately, application.

In the first few conceptual classes, participants share their Personal Best Leadership stories, review important concepts related to the Five Practices model, and begin defining their guiding values and beliefs—an essential step to mastering the first of the five practices, Model the Way. With coaching and guidance from the program facilitator, learners review their LPI data and, based on both self-measurements and insight from others, draft a personal leadership development plan that remains the focus of their work throughout the workshop.

“Change projects” have become a key program component. Participants are tasked with identifying a process or function they feel passionate about changing, and engaging their manager or a member of the senior leadership team in helping to refine and sponsor the initiative. Incorporating what Kouzes and Posner call “outsight,” learners develop an action plan that includes research into best practices other high-performing organizations have used to successfully execute similar opportunities.

Practice is the focus of the lab classes. In a safe learning environment, participants share their homework assignments, including their visions and change project ideas, before presenting to constituents. For example, learners describe the current and desired future state of their change project, present their action plan, and learn how to provide balanced feedback as they give and receive input on the message and delivery.

Most important, learners take their learning back to their work, setting dates in their development plan to apply what they’ve practiced in class. “At the end of the program, these leaders are ready to be the effective change agents we need to continue Brooks’s success,” says Katz.

The full executive team participates in a special celebration, sending a positive message to everyone about the importance of this program. Also, each participant’s next level manager provides a personal story that acknowledges the positive contributions being made to the individual’s team, department, and the overall organization.

A leadership development strategy that delivers Collaboration within teams and throughout the organization is critical to success. Within Brooks, stories abound of how The Leadership Challenge experience continues to serve as a training ground for individuals to collaborate across functions and departments, turning ideas and visions into reality.

For example, when an orthopedic clinic manager wanted to make evidenced-based research easily accessible to staff therapists across the system as they developed care options for patients, the Scholarly Resource Center was born. Through a connection made during The Leadership Challenge program with an IT colleague, all Brooks therapists now access the latest peer-reviewed research—with a click of a mouse through the eBrooks intranet.

After finishing the Brooks leadership challenge program together, Joanne Hoertz, vice president of nursing, and research director Holly Morris saw how the new Nursing Research Council could benefit, too. “This program was an innovative and creative way to build cohesiveness among the members, focus on group goals and objectives, and develop as both leaders and role models within the nursing department,” says Morris.

For the HR and employee development team that designed and implemented this powerful culture- shifting program, the “hard” bottom-line results are undeniable. According to Spigel, “We set out to make sure that The Leadership Challenge program solved real business problems. And we are not disappointed. For example, our new electronic online payroll communication system, eStubView, was a direct result of the out-of-the-box thinking the program generated. It has already delivered $50,000 in cost savings.”

Brooks continues to move full steam ahead, capitalizing on the goals it has already reached. While the ROI is, of course, important to Brooks, Baer also notes, “Now that we’ve had more than 200 people complete the course, we are seeing how The Leadership Challenge program has helped us achieve many of our other goals in addition to improved financial performance, including higher staff retention, and improved quality and patient satisfaction.”

And Gallagher agrees: “Employees are now asking, ‘How can I make a difference?’ And to me that speaks volumes to what we see as the real success of The Leadership Challenge program. The increase in employee engagement has been phenomenal.” Recent survey results published by The Advisory Board Company ranked Brooks’s employee engagement scores in the 91st percentile—outperforming 112 of the 125 healthcare organizations that participated in the survey. “Fundamentally, we’ve changed the lexicon.”

Terri Armstrong Welch is president of Armstrong Welch Ltd. and an independent writer and editor;



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