Excerpt from “Stewardship:The Noblest Form of Leadership – Part II,” Compass Clinical Consulting Profile in Healthcare Leadership Interview with University of Virginia Medical Center Chief Executive Officer, R. Edward Howell, by Cary Gutbezahl, MD.
Dr Cary Gutbezahl: When we first met, one of the things you presented that really impressed me was the concept of legacy goals. They seem closely linked to your concept of stewardship. What are legacy goals and how did they originate?
R. Edward Howell: Legacy goals are the direct link to stewardship. They result from going to the end and asking the question, “What do we need to be, and what is the end game?” They are different from annual performance plans and strategic plans.
Strategic plans are a way to achieve legacy goals. They are a means to an end. But I find that a lot of places never talk openly about the end. You have to think about the end game with some caution. Make sure your goals are big enough, achievable and understandable. Don’t put them in the way of annual performance plans and strategic plans. They serve as a backdrop to remind us all as we embark on this journey, where do we want to end up?
Sailboats are driven by the wind. Sailors understand that to get from where you are to where you want to be will often not be a straight line. And so the concept of “tacking,” where you sail in a direction that makes it look like it’s not in line at all with your goal; but it allows you to “come about” and get to where you’re going.
I view legacy goals as that reference point where an organization tacks— recognizing the changes within and on the outside to help us get to that end point. I, as the leader of the organization, should be able to identify this.
That was the reference point that brought me to say, “We’re doing well, but in our tacking back and forth, I think we’re off course.” The issues that initiated the changes weren’t really earth-shaking. As I said, one of them was to be a source of pride within our university. I felt that if we were the best part of the best public university in America, what others did would be interesting, but we would be fine.
A second point goes back to what one of our real missions is, and that’s creating new generations of healthcare practitioners. If we can attract the very best residents to get their training here, we will have the best training program in the country.
So, the second legacy goal is to be the most attractive site for residents to do their training. If you’re going to train good residents, you have to have faculty.
The third legacy goal is to be a place that’s attractive to a clinical faculty—a person who devotes their career and their life to caring for patients and teaching others how to care for patients.
If we became the most attractive place in the country for those people to work, we would have a high-quality and highly efficient organization. I talked earlier about being the University of Virginia and serving the country to be recognized as a top organization.
Our goal is that if you walk down any street in the region and ask who you think of as top quality and highly sophisticated in healthcare, the unaided response would say “UVA.”
The final legacy goal is the end game and stewardship. When it comes time for me to hand over the keys and turn out the lights, that what we created would be the most desirable job of its kind in America.
Legacy goals for future generations to follow—let’s think about each independently.
PRIDE
If we are seen as a general source of pride as America’s best public university, we’re likely to have a capacity to do what we need to do and the resources we can call upon from the rest of the university—from engineering to business.
The collective strength of the organization that results from being a source of pride leaves the next generation of leadership with the ability to deal with all of the uncertainty they are likely to find.
PEOPLE
If we have great individuals in training and great faculty, whatever happens in the future, we will be well-positioned.
If we’re top of mind and earn that reputation every day, there will be a reason for people to come here.
That’s called clinical differentiation.
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