Leadership is particularly critical in complex and high-need domains, such as oncology. Research hospitals guided by a general manager with close support respectively from the healthcare and administrative directors tipically feature also a vision promoted by their scientific directors. Strategy and execution in comprehensive centers with focus cancer are designed to foster their translational activity in a continuum where oncology services and research are aimed at excellence.
Leadership is built around three pillars. Mandate, values, and example are what makes the difference for an established organization delivering high-quality services at the core of a wider mission as socio-economic community driver.
Criticities for multi-disciplinary activity framed into health systems of regional scope and beyond stream from the necessary alignment of shared goals within institutional as well as in thematic networks. Cancer centers are key nodes whose top-level compliance is usually set by international standards. At the same time, their bench-to-bedside performance is framed into multi-annual acts that entail resources and conditions often sub-optimal to the extent. In complex work environments, technical skills and strategy are no longer enough to reduce for example waiting lists as the regional health directorate expects from comprehensive centers operating under its authority. In parallel, a fierce competition limits the thrive of new scientific challenges parting from institutional research lines as defined in accordance to relevant ministerial funding bodies.
Admissions plan, investments plan, scientific plan, or training plan are just evidences of how endeavours will be targeted. That is exactly where a governmental mandate comes into play. Even if the aforementioned top leaders have not taken part into previous negotiations, they rely on tailored regional or ministerial support granting them individual decision-making to properly execute the plans. Leaders will thus trust the process to secure fair chances to team success or, at least, for deep understanding of the underachievement factors.
Furthermore, institutional values provide the keys to the ultimate goal of societal benefit for payers and patients while enhancing the hospital’s reputation in peer-review scientific circuits. An oncological referral center may explicit in its chart of values the centrality of the person, professionalism, synergy, honesty, and innovation as guidelines for its employees. The daily routine of general managers, healthcare directors, administrative directors, and scientific directors encompasses multiple trade-offs, often interdependant. Institutional identity is marked by values leveraging on fortright attitude and courageous choices while minimizing imbalance. The higher leaders stand in the organization, the wider will be the impact of their decisions from within and on the surrounding ecosystems. Qualifying medical technologies for diagnosis and treatment worth many dozens milions such as protontherapy require a shared vision, an open dialogue among stakeholders to identify critical issues, and long-term combined efforts to secure its sustainability. A call to leadership is also represented by almost-for-free Artificial Intelligence enabling technologies whose adoption boosts the potential to translate scientific results into new products or services for oncological patients and for healthcare professionals. Small innovation engines such as the Technology Transfer Offices characterized by a constant entrepreneurial development stage are called to action as well. Underlying point is that creating value around new opportunities should be always anchored to solid institutional values.
Lastly, high-performing workplaces need footprinting examples. Lessons learned from oncology-related initiatives proved to be trailblazer for treating other diseases. As an example, in Italy the national oncology network was the first one gathering the elite of national specialists at the service of translational research in patient education and networking.
But how should the ‘Leading by Example’ concept really work?
As a matter of fact, leaders definitely help the organization contribute to face higher challenges and their own commitment is pivotal to inspire team members.
Leadership should also rely on the willingness, backed by proven ability, to make external examples at reach for the cancer center and for its innovation engines. Examples can be related to the systemic and architectural side, or to the human resources side and key mentoring figures. A combination of both leverages is highly desirable as well. Otherwise, fundamental processes aimed at global benchmarking of successful models or at recruiting young professionals won’t be rewarding for relevant stakeholders along the process.
To elaborate on examples, let’s imagine a medical research center that without losing focus on core bench-to-bedside activity is conscious of its potential to drive the growth of bio-industry networks. It should likely look for leading examples. Health systems from territories that re-shaped their socio-economy from manufacturing sector collapse towards a knowledge-based economy featuring bio-medical innovation will definitely offer a plan to support gaps in talent, technology and capital. The latter concept, just an example of how a regional vision is necessary to create operational support and assemble leadership that includes oncology services.