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Working with Leaders

Working with leaders in QI means building purposeful relationships with people who have the authority and influence to sponsor your work, clear barriers, and sustain change. It involves aligning your project with organizational goals, engaging leaders as true partners, and giving them the right level of information to act— whether as sponsors, champions, influencers, or (initially) resistors. Effective leader engagement clarifies the project’s purpose, stakeholders, barriers, and targeted outcomes so everyone moves in the same direction and adapts together as conditions change.

Key Steps

  • Identify the right leaders and roles. Map the “who’s who” (sponsor, champion, influencer, resistor) and how their engagement aligns with your project’s scope and success.
  • Align early on aims and impact. Clearly communicate the problem, desired outcomes, and connection to organizational priorities.
  • Set the working cadence and decision path. Agree on how to communicate (email, virtual, in-person), how often (e.g., weekly during active cycles), and who decides what (use RACI or similar) to streamline escalation and approvals.
  • Engage for action and remove barriers. Provide concise, regular updates; ask explicitly for what you need; leverage leaders to unblock issues; and adapt your approach based on their feedback to maintain momentum and sustainment. 

Resources to Get Started

Read
  • A Tool Kit for Improving Communication in Your Healthcare Organization: Effective leadership starts with communication This article from the American College of Healthcare Executives (ACHE) presents an array of evidence-based tools to strengthen leadership skills and drive better, sustainable results for healthcare organizations through improved communication techniques. 
  • Senior Leadership Engagement – These modules from the Agency for Healthcare Research and Quality (AHRC) describe how to engage the senior leadership in the facility’s initiatives and develop shared accountability for the work needed to achieve the facility’s safety goals.

Use
  • Situation-Background-Assessment-Recommendation (SBAR) – This article from the Institute for Healthcare Improvement (IHI) provides an overview an SBAR, a concrete communication tool for framing any conversation, especially critical ones, requiring immediate attention and action. This technique could be a way to communicate with senior leaders more effectively. 
  • RACI Chart – This tool helps clarify who does what by mapping responsibilities, tasks, or deliverables to specific roles and can be especially useful for cross-functional teams and projects that involve multiple departments. RACI stands for Responsible, Accountable, Consulted, Informed and are the categories used to classify each stakeholder. 

 

Related QI Concepts

  • Communication Plan – This tool helps define audiences, messages, channels, and cadence which is crucial when communicating with leaders. 
  • Process Map – The process helps visualize stakeholders, handoffs, and decision points you may need leaders to help influence.
  • Project Charter – The project charter clarifies important information about your project including your aim, scope, measures, and roles for you and your leaders.
  • Stakeholder Analysis & Engagement – Although leaders are not a part of your frontline team, they should be considered as a part of your stakeholders that communicate with on a consistent basic.