by Neil F. Horton, MS, RN
Consulting Director
As the new value analysis hire in an urban academic medical center, I spontaneously approached my boss, the director of supply chain, blurting out “I need to buy some paper towels—how do I expense that?” “For what?” he asked. I told him they were for the kitchen—that there was nothing to clean up spills. “I’ve never seen paper towels expensed in this office,” he said. “What have we been using? And what would it cost annually? And where are you able to cut back to offset that?” I was dumbfounded. “I’ll have to get back with you,” I said. I walked back to my office wondering what had just happened. He seemed a little heated and I had to figure this out. I had just gotten a lesson in how not to approach my new boss—and there is a concept that could have prevented it.
“Managing up” means being deliberate in the way you approach your relationship with your boss. This concept is particularly useful in healthcare supply chain, where the dynamic landscape serves up frequent challenges and changes. Here I was, day one in a new job, and I had not thought for a moment about how my question was going to land—I just blurted it out.
There are several variations regarding how to act on the concept of managing up. I have boiled them down to three:
- What is your boss’s preferred style of interaction? Formal vs. casual? In a group setting or one-on-one? Should you begin with a high-level perspective or start with data?
I learned that my boss did not like surprises. He liked to have regularly scheduled meetings with his team, he wanted to see an agenda before any meeting and he needed a business case before you asked for his support. And most importantly, he valued good data. He regularly quoted W. Edwards Deming: “Without data you’re just another person with an opinion”.
- What matters most to your boss? Do you know how your boss’ success is measured? Your ideas and problems will be viewed through this lens. Significant resources will not likely be allocated to your project if your objective does not align with the metrics that matter most to your boss. Similarly, framing an idea within the context of your boss’s goals may help your project gain traction.
I learned that my boss greatly valued the respect of the clinicians he served and understood that the single most important metric to him was progress toward the annual savings goal. In his five years on the job, it was met consistently.
- What keeps your boss up at night? I know it is cliché, but there are always active threats to the smooth functioning of a healthcare supply chain: product outages, recalls, a pandemic, contaminated supplies or a missing shipment. Looming problems must be taken into consideration during decision making and being sensitive to this will help you articulate your ideas successfully.
As the director of supply chain, my boss regularly faced clinicians concerned about new product requests or a standardization initiative, or unplanned expenses that threatened the budget. I soon understood that clinical quality and financial performance would be the backdrop for nearly every discussion we would ever have.
A few months later, after thinking through these considerations, I introduced an alternative tactic to my boss during one of our regularly scheduled meetings, “I have an idea for how to pick our strategy for that spinal implant project.” He looked thoughtful. “Shoot,” he said. “We don’t. We give the surgeons three options, each acceptable to us. They make the decision based on clinical acceptability and cost.” As he was thinking it over, I added: “Only with their ownership will we be successful.” He thought for a moment… “Okay, you build the slide deck, and I’ll go to the meeting with you.”
Two weeks later, we went to that meeting and presented a story. The surgeons ultimately chose the strategy and the project exceeded goal.
Whether you are a new employee or a seasoned professional with a new boss, taking time to consider the three elements above can help you establish trust and create an optimal working relationship with your boss. Oh, and I never did have to buy paper towels. It turns out there were napkins two drawers down!
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