Leading a Public Health Workforce Through a Time of Change, Crisis or Uncertainty

1
Leading a Public Health Workforce Through a Time
of Change, Crisis or Uncertainty

• LCDR Kelly Brown, MHSA, MHRDV, USPHS
• CDR Elizabeth Osborne, USPHSLTJG Monique Bailey,
  USPHS

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Guarantees and Sources of Change

• No one can argue
• that change is constant
• Can be regulatory, policy, organizational,
  personnel, personal, etc.
• that difficult times are inevitable
• Every organization has a history of high and low
  morale, success and failure
• that uncertainty can be stressful

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Methodology

• Personal experience
• Change Management Theory
• Interviews and Data

4
DIHS Case Study

• A-76 Study
• Rapid Expansion
• Re-organization and Realignment

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Tough Times Never Last, but Tough People Do! By
Robert H. Schuller12 Principles for Managing
Problems Positively

• Dont underestimate
• Dont exaggerate
• Dont wait
• Dont aggravate
• Illuminate
• Motivate

• Bait
• Date
• Sublimate
• Dedicate
• Communicate
• Insulate

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I love leadershipDr. Eugene Migliaccio, CAPT,
USPHS, Ret.

• Leadership born out of respect for my elders
  (parents and family)
• Watched family engaged in business
• Have to be a good follower to be a good leader
• No matter where I sit, I feel like I can do
  better
• Have always sought out positions where I could
  lead and contribute

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A great leaderDr. Eugene Migliaccio, CAPT,
USPHS, Ret.

• Spends time with you
• Picks you up when you fall, and lets you run
  again
• Gives you counsel and coaching
• Makes you say, What would the CAPT/ ADM/CDR do?
• Learns to hone leadership skills while watching
  other good leaders
• Keeps abreast of change
• Technology
• Workforce (harness and lead the drive of the
  younger workforce)
• Stays engaged academically (in terms of the
  applicable profession)

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A-76 History

• Government should be market-based
• OMB Memoranda
• A-76 Study for Medical And Support Services for
  DIHS
• Solicitation Notice was published in August 2005
  with a Response Date of October 2005
• Keys for a Successful A-76Study

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A-76 History, Continued

• A-76 is not contracting out or outsourcing
• A-76 is a competition resulting in increased
  efficiency and lower costs The taxpayer wins.
• Competition provides opportunity for managers to
• Streamline organization, Implement best business
  practices, Increase productivity, Enhance
  quality, Increase efficiency of operations, Lower
  operational costs
• The Process focuses on
• Government/customer requirements, Organizational
  structure, Work processes, Defined outcomes,
  Competition

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Typical A-76 18-Month Timeline
1.
2.
3.
4.
10.
11.
12.
13.
15.
14.
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A-76 Challenges

• A-76 studies have numerous challenges
• Managerial Balancing study and mission
  priorities, Allocating and managing resources,
  Meeting study milestones, Minimizing adverse
  impact on employees, Adverse personnel actions
• Cultural Managing employee fear and resistance,
  Maintaining union partnership, Managing
  organizational overload, Educating other
  stakeholders

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Tough Times Never Last, but Tough People Do! By
Robert H. Schuller12 Principles for Managing
Problems Positively

• Dont underestimate
• Dont exaggerate
• Dont wait
• Dont aggravate
• Illuminate
• Motivate

• Bait
• Date
• Sublimate
• Dedicate
• Communicate
• Insulate

13

• 50

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Crisis of Opportunity Dr. Eugene Migliaccio,
CAPT, USPHS, Ret.

• Leadership is about change
• How you lead it, and communicate with your staff
  is most important
• You lead from where you sit we can all see
  ourselves as leaders
• Come up with a plan/strategy to engage your staff
• In some ways, in the wake of crisis, it is easier
  to garner buy-in
• In the aftermath of a congressional action or an
  issue with quality of care, the ideal situation
  arises,
• People can see that change is necessary
• Difficult change Continuous improvements or
  organizational shifts

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Rapid Expansion Number of Geographically
Separated DIHS Sites Over Time
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Rapid Expansion Number of DIHS Authorized Staff
Over Time
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Tough Times Never Last, but Tough People Do! By
Robert H. Schuller12 Principles for Managing
Problems Positively

• Dont underestimate
• Dont exaggerate
• Dont wait
• Dont aggravate
• Illuminate
• Motivate

• Bait
• Date
• Sublimate
• Dedicate
• Communicate
• Insulate

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The Public Health WorkforceDr. Eugene
Migliaccio, CAPT, USPHS, Ret.

• In the private sector, individuals are drawn and
  committed to their areas of interest, to what
  excites them
• In public service and public health, they are
  committed to the mission
• If you can rally your workforce around the
  mission, things will begin to align

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Message to the TroopsDr. Eugene Migliaccio,
CAPT, USPHS, Ret.

• Managers
• Leadership is about stretching yourself
• You must take risks to grow
• If youre not taking risks, youre not giving
  yourself your just due
• Always encourage risk-taking, innovation, and
  creativity

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Tough Times Never Last, but Tough People Do! By
Robert H. Schuller12 Principles for Managing
Problems Positively

• Dont underestimate
• Dont exaggerate
• Dont wait
• Dont aggravate
• Illuminate
• Motivate

• Bait
• Date
• Sublimate
• Dedicate
• Communicate
• Insulate

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Re-Organization and RealignmentDr. Eugene
Migliaccio, CAPT, USPHS, Ret.

• Has been Director of FOH 2 years
• 1800 staff, geographically separated with offices
  in many regions
• Provides services to Federal Employees
• (1) Clinical (2) Employee Health (3) EAP
• Came into FOH with a mandate for change
• Build a team
• Grow the business
• Had lost 2 major contracts and lost 40 of
  revenue lost
• No leader for 1.5 years

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Re-Organization and Realignment Strategies Dr.
Eugene Migliaccio, CAPT, USPHS, Ret.

• Brought in a consultant
• Leadership expert Taught Leadership _at_ Federal
  Executive Institute
• Refined Mission, Vision and Values
• Introspection
• Where are we, where do we want to go?
• Identified 11 major initiatives to move the
  organization forward (7 to tackle this year)

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I thought I was communicatingDr. Eugene
Migliaccio, CAPT, USPHS, Ret.

• You can never communicate too much
• You can more easily get buy in from your senior
  level management
• Do you have buy in 2, 3, 4, 5, 6, 7 levels or
  layers down
• Permeating it is the difficult thing
• Lesson learned on change People will always
  frame things differently, in their own way
• Communication is still the key to everything you
  do

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Message to Those in CrisisDr. Eugene Migliaccio,
CAPT, USPHS, Ret.

• Troops
• You lead from where you sit
• You dont have to be in charge to lead
• Have a positive attitude
• Find ways to contribute to the mission
• Build your skills so you can teach and give back