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By Josh Hayman, Legitimate Leadership associate; Jenni Trow, The Eye Centre hospital manager; and Joanne Hulley, The Eye Centre operations manager.

The Eye Centre is an ophthalmology practice and hospital in East London, South Africa. It is a current client of Legitimate Leadership, having started working with the Legitimate Leadership Model in August 2017. In January 2018, two of its operations managers presented a paper (summarised below) at the Annual Congress of the Ophthalmological Society of South Africa (OSSA), in which they shared the history of the practice, their reasons for embarking on a Legitimate Leadership intervention, and their experiences so far in applying the model.

Legitimate Leadership interventions always start with a diagnostic, in which participating leaders are given feedback on their leadership gathered from direct reports through confidential surveys. When leaders accept this feedback openly, and act to address the key issues, significant positive gains, or “quick wins”, in employee willingness are very often made.

The Eye Centre has been in operating as an ophthalmology practice for more than 50 years, and until five years ago was a specialist consultancy service. In 2012 the owners of the practice embarked on an ambitious project – to establish a small eye hospital to enable access for all people to a world-class eye facility.

The addition of the hospital resulted in an increase in the staff complement from 13 to 38, including the addition of a general practitioner and two optometrists.

Until then, the small staff complement was largely self-managed and the owners of the business – themselves practising ophthalmologists – took responsibility for managing operations in their spare time. Looking after patients was their primary concern.

Because of the higher staff complement, the owners saw both the need and opportunity to develop a strong leadership group that would be more hands-on in terms of looking after the staff. This in turn would enable the specialists to concentrate on their core functions as well as continue to grow the business.

Jenni Trow, operations manager for the hospital, gave the reasons for embarking on this journey: “As leaders at The Eye Centre we had to collectively make a commitment to the Legitimate Leadership Model, as our objective was to change the culture from employees just doing the job to employees making a choice every day to make a contribution! We set out to empower our people to clearly understand how their contribution each day impacts on the group’s performance and instil in them a willingness to go the extra mile in pursuit of the benevolent purpose of our organisation.”

When the Eye Centre started with a Legitimate Leadership intervention in August 2017 a group of seven managers, which included the two owners of the business, Dr Stephen Cook and Dr Andrew Boliter, was selected to take part.

After an introduction to the model, Legitimate Leadership assessments were conducted for each group member. This is done to create impetus for change in each leader, by giving them feedback on how they are viewed by their people.

Joanne Hulley, operations manager for The Eye Centre, said about this process: “In order for us to be able to go ahead, we needed to understand where we stood individually as leaders. Each of us was assessed by our direct reports and a leadership profile was drawn up through an anonymous survey. What a leveller!! This gave us an in-depth view of our own strengths and weaknesses. We were mind-blown by some of the results, and it certainly illustrated for each of us the areas that posed a challenge, and where we needed to focus. Key themes were evident, and implementation of the modules was begun. This is a 14-month journey and we are just on four months into it.”

After giving the OSSA audience a brief introduction to the Legitimate Leadership Model, Joanne and Jenni went on to share their experiences of working with the model.

Joanne Hulley: “After running a large trading store on the Wild Coast (of South Africa) for 25 years, I joined the Eye Centre in 2013 as the receptionist and PA in the hospital. In 2017, I took on the job of running the practice’s operations with a staff of over 30 people. This group was, from a gender and culture perspective, completely different to the staff I led in the trading store. Becoming a better equipped leader was key to my new role and after an introduction to Legitimate Leadership and its concepts, we as a team signed up to embrace the model – while being fully aware of the vulnerable position this would place us in at times.

“Because I took on a role that was not part of the Eye Centre’s portfolio, I had barriers to cross as the long-serving staff were previously largely self-managed, and not used to having a manager looking after them! With the increase in the staff complement, greater structure was needed in terms of key accountabilities and expected contribution. There were grey areas as to the standards of behaviour expected in some areas. In addition, through time spent one-on-one with people and watching the game, I became aware of issues among the staff – ‘dandelions among the concrete’ – that, if not addressed, would affect the smooth running of the practice and the well-being of the staff. My view was this would lead to disengagement, in turn impacting the potential of our people to be excellent. Working with the Legitimate Leadership Model helped me to understand that courage was the antidote needed for these issues.

“It took some rather courageous behaviour on my part to address the things I would rather have allowed to escape. I created deliberate platforms with the staff for tough conversations, and at the same time ensured I spent time having authentic care and ‘whole person growth’ conversations with them. Giving deliberate time and attention to the well-being of my people, while at the same time being prepared to confront and resolve issues affecting the staff, has allowed a transparent and more efficient environment to emerge.

“For me this has been a personal achievement of growth in leadership. The journey is not yet over!”

Jenni Trow: After spending 15 years managing rural fixed and mobile primary health care clinics, I joined the practice in 2012 and was involved in all aspects of setting up the East London Eye Hospital. Once operational, I took on the position of the hospital manager, building the hospital into a successful business.

“After being introduced to the Legitimate Leadership Model and also having gone through a leadership assessment process involving feedback from my people, I came to the realisation that my focus needed to be on building a sense of contribution and increased accountability within my team. Historically, I had been used to getting things done, and would often find myself doing a lot of tasks that my team should really have been doing, and this was undermining them. I needed to step back and allow them to get on with the work.

“I divided the hospital staff into three teams – a Scrub Team, a Ward Team and an Anaesthetic Team. I appointed registered nurses as the leaders of each of these three teams, and worked to increase accountability in each of these leaders for three things:

  1. Problem solving – I wanted to teach them to try to reach solutions by asking open-ended questions first instead of just giving answers or them asking me for the solutions. This helped them to work towards finding solutions themselves.
  2. Individual goal development – listening to their people because not everyone has the same ideals and goals
  3. Performance improvement – one-on-one sessions were held by each leader comprising both hard and soft conversations.

“To enable this, I kept my leaders accountable for spending more time with their people through regular one-on-one time and team sessions, and asked them to report back to me on these so I could help them through the process.

“I am finding I have a lot more time to focus on growing and developing my people; and the team leaders are more engaged and accountable, as are their teams. As a leader of a team, you want your team to succeed in accomplishing its mission. We have put a lot of effort into finding and recruiting a wonderful staff that work for us. It is worth continuing to invest in them to help them to be as great as they can be – both for the sake of The Eye Centre and for the sake of their natural desire to become proficient at what they do.

“Our story is not finished. We are very excited for our staff as we aim to create an organisation with its own identity and set of values. This will have great significance in the lives of our employees, which goes well beyond simply carrying out their work and getting paid for it.

“The implementation of Legitimate Leadership has been insightful for us and we are confident that as we continue our development as leaders we will create a solid culture and foundation, keep dandelions at bay, and together with our most valuable resource – our staff – optimise our vision, goals and productivity.”

JOSH HAYMAN COMMENTS: The experiences shared by Joanne and Jenni show that when leaders accept this feedback openly and begin to change the things that require improvement, they often see immediate positive changes in employee willingness. In other words, their people respond to their giving behaviour by immediately giving back. This is powerful reinforcement for the leader, as it provides her with evidence that shifting intent from taking to giving really works.