By Rebecca Harmon, MPM, RHIA, CCA

When it comes to leadership, there is no shortage of advice. A quick search on Amazon returned over 100,000 books on the subject. Titles ranged from the vague (How to Lead) to the intriguing (Leaders Eat Last) and authors included business leaders, Navy SEALS, self-help gurus, presidential historians, and more.

With so many perspectives on leadership, where do we begin? Is leadership so complicated that we need 100,000 books to explain it?

I came into leadership after years in an elite training program: the trenches. I began this “elite training” as an enlisted sailor in the United States Navy, right out of high school. As a junior enlisted person, I had a front-row seat to many different leadership styles and practices. I quickly learned what I liked, what I dreaded, what I respected, and most important for my later roles, which tactics and practices simply do not work.

Throughout my time on active duty and later in a variety of roles with diverse organizations, I observed one consistent trait embodied by all successful leaders. That trait turned out to be something my mother and grandmothers taught me long ago—no matter who we are or what we are doing, being kind is always the best approach.

Another related trait I have consistently observed in successful leaders also came from my childhood: what goes around, comes around. It sounds ominous (it may have been intended as such on the playground!) but let’s look at it from the other side. When we are walking down the street and we smile at someone, nine times out of 10 that person will smile back at us.

The concepts of choosing kindness as our default response and understanding that what we put out comes back to us, are at the foundation of my leadership perspective, and both have helped me find success in my role as a health information management (HIM) leader.

Practicing the Pause

Sometimes people will ask how I maintain order or correct inappropriate behavior without abandoning the principles of kindness and reciprocity. The key lies in “practicing the pause.” Before I react I stop and ask myself how I would want to be treated if the roles were reversed.

I spent enough time early in my career on the other side of these scenarios to honestly evaluate that question. Those experiences—on active duty as an enlisted sailor and later as a junior faculty member at a university—help me remember that sometimes bad choices are grounded in the best of intentions.

We are all juggling multiple priorities—inside and outside of work—and sometimes make honest mistakes. I recall the many times I was the grateful recipient of kindness or benevolence from someone who had the power to be neither, but who chose to side with their better angels and grant me some grace.

My experience in the application of these simple leadership approaches have not been without challenges. In situations that demand a managerial response (employees not coming to work, repeatedly dropping the ball, or worse), I must act in the best interest of the facility, the workflow, the patients we serve, and the rest of the team.

I have had to implement performance counseling actions for underperforming individuals and issue oral and written warnings for unacceptable conduct. These circumstances are never welcome or easy, but I have learned that I can practice kindness even during difficult times.

For me, the hardest aspect of being a good leader is not figuring out which fad formula to follow or what processes to adopt from the latest bestseller. The greatest challenge lies in balancing the needs of the organization with my commitment to a leadership practice based on a principle of kindness during tough circumstances, and I routinely encounter situations where I must make hard decisions and enforce rules that weigh heavy on my heart.

Leadership is Human-Centered

As I think about this new year, and the many changes we saw in our profession prior to the COVID-19 pandemic, I know that my use and application of the principles of kindness in leadership will be even more important as we navigate the future.

Whether we are balancing the stressors of new technology or a global pandemic, we can strengthen our leadership foundation by committing to a few simple practices. I have committed to assuming good intentions (no matter how it looks) in people. I also remain open to being wrong and am willing to acknowledge my mistakes to others.

When we assume that everyone has good intentions, we avoid setting up an “us vs. them” scenario and almost-certain conflict. When we are willing to be wrong, we communicate our respect for others as well as our “humanness.” These practices (and others) support an atmosphere of kindness and give the people around us an opportunity, if not an incentive, to make positive choices, too.

Technology’s forward march comes with risk as well as reward for our profession, as once-reliable work options are subsumed by more efficient computer processes that are less prone to error and check the box on cost/benefit questions.

We continue to see other healthcare professionals move into spaces over which we once had sole purview: the electronic health record (nurse informaticists and IT professionals), clinical documentation improvement (nurses), and coding (medical assistants). We know that as artificial intelligence (AI) continues to evolve, tasks once managed in our departments will be decentralized to the clinical service lines and supported by dashboards and other automatic technology.

These changes loom on the horizon as many of us with long tenure in the HIM profession consider our place in this fast-changing world. If we choose (or need) to work another 10 or 15 years, do we have the knowledge, skills, and ability to do so? If the answer is “no” what should we be doing today to ensure we have this option?

Knowing the realities we face, I feel a responsibility as a leader beyond ensuring timely discharge summaries and accurate operative reports. I must position my department to not simply meet our metrics, but to thrive in a time of incredible change. I believe that kindness as a leadership practice can be more than a welcome change for our staff. It can become a strategic advantage.

Kindness as a Strategy

Multiple articles have been written on strategies to keep HIM “at the table” with any organizational initiative, and it is important to continue to advocate for the HIM skill sets to be a part of larger conversations, but let’s not miss the great power that resides in having a reputation for being skilled and knowledgeable as well as helpful and kind.

A now-vintage commercial popularized the concept of the easy button. Perhaps adopting kindness as our default response can position the HIM profession as an easy button in a world where it is becoming increasingly popular to make other choices.

Kindness as a leadership practice is less about the what and much more about the how. How do we respond to individuals who are not performing? How do we treat employees whom we simply dislike (I have been on both sides of that)? How do we respond to external inquiries that irritate or inconvenience us?

In my AHIMA20 presentation “Finding our Superpower at Work,” I suggested that anyone can transform their workplace by shifting to a kinder perspective. This is true, but as a leader, I feel a deep responsibility to model this behavior in all that I do.

Can a shift to kindness as a default response substantively change the future for HIM? This remains unknown. What I do know is that as individuals and as a profession, we will have many more options open and available to us if we have left a trail of kindness in our wake.

 

Rebecca Harmon (Rebecca.Harmon@va.gov) leads the health information management department at the VA Pittsburgh Healthcare System. Harmon returned to traditional HIM practice in a leadership role after many years as an HIM educator. She is presently the past-president of the Western Pennsylvania Health Information Management Association (WPHIMA) and a popular presenter at local and state HIM association meetings.

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13 Comments

  1. Great article Rebecca. I feel very fortunate that I have actually seen you and your kindness up close and personal during my HIT education. Yes, being kind is essential, but I like that you tapped another issue, admitting when you’re wrong. Good job!! Being kind makes everyone happy

  2. This is a very inspiring article. A great reminder of a simple character trail that works 100% of the time, at all levels, in every decision.

    The key takeaway for me is “…assume everyone has good intentions.”

    Thank you.
    Karleen Thomas

    1. Thank you Karleen. It is truly “warrior work” to assume everyone has good intentions, but the investment in the ability to take this persepctive is worth the time and effort!

      All the best –

      Rebecca

  3. Thank you for sharing your experience and way forward. It certainly plants a seed in all who read and has definitely given me the opportunity to reflect on my actions.

    1. Thanks Barb !
      I’ve had wonderful teachers who planted seeds for me, and feel it’s a “duty” for me to pass these and more on as well.
      Appreciate you reading my article

  4. I echo and practice your kindness leadership principle. Over 40 years in HIM. So simple yet applying in your Department with staff at all levels supervisors managers makes your work life much better. I am sorry to say that C suite So called leaders did not subscribe to this trait. Especially during these pressured times they show their True Colors their actions speak much louder then the so called transparency words did not match.

    1. This is always disappointing, but the best strategy to combat this is to plant the seeds of kindness at other levels in the organization. Effectively applied, the groundswell of kindness that sweeps the organization will either transform the C-suite or they will leave.

      It seems simple, and maybe even simplistic – but the great power of creating pockets of kindness and good in any corner of the organization is unmatchable.

      Focus not on the negative behaviors of others – that only steals your peace. Instead, look around for the good seeds you can plant – and then watch your garden bloom!

      Knowing the best for you moving forward!!

      Rebecca

      1. Thank you for sharing these inspiring words of knowledge. I concur that one of the key strategies is to plants seeds, but it should not exclude the executives. It is true that it might develop from the base, that is from the bottom layer to the upper layers of the organizational structure. However, in order to achieve a healthier environments with implementation of cultural values and practices, it must start with the executive levels who then are able to lead by example and have a broader reach.

        Having experienced different practices in my roles across organizations in Puerto Rico and New York City, I can attest that some companies might not have grasped the full notion of cultural competencies in our present time. However there are many examples of C-suite executives who are committed to delivering these practices and are already in the business of health, one of which include my present company. I strive to become a healthcare executive myself, for which I am to start an educational path next fall, and I learn much from reading content like this one.

        1. Thank you for reading my article and taking the time to comment!
          Wishing you all the best in your career journey!!

          Rebecca

  5. I enjoyed this thoughtful article and appreciate it being brought to my attention. The leadership principle of kindness is one I strive to uphold and one I appreciate from those who lead me. This article reminds me of the importance to continue to do so as well as using kindness as a leadership strategy. Thank you Rebecca!

  6. Very true and well done Rebecca! You practice what you preach and are respected throughout the entire professional community. Your style works!

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