Staying Grounded and Minding the Gap


By Lee Ann Liska

I’ve read a number of articles on the Iceberg of Ignorance, originally published in 1989 by Sidney Yoshida, reporting that top leaders only understand about 4% of what is going on in their companies.  Does this sound right to you? 

If you are a CEO, you may not believe it, but do we really know?  If you are a manager or supervisor, you may believe this about your bosses, but not yourselves.  If you aren’t a manager or supervisor, but report to one, you may completely agree with this statistic!  

While no leader in a large organization can truly know everything that happens on the front line, what are the best practices we can employ to ensure that we stay in touch with our staff?  With our busy meeting schedules, how do we get in touch with what is really happening in our organizations?  

I have used a few tactics over the years.  Besides rounding on patients and staff, which I truly enjoy, I love to be present at as many recognition events as possible—quarterly leadership awards, patient experience milestones, annual tributes to Nurses, Doctors, Allied Health, etc.  “Lunch with Lee Ann” is a monthly event that I started years ago with both managers and staff.  Rather than a formal update, typically taking up more than half the meeting, we introduce ourselves and share something about ourselves.  This informal setting puts everyone at ease, and we can quickly get down to the business of answering questions, sharing challenges and managing rumors.  Each of these lunches takes a different direction, depending on the invitees, their positions, and personalities. Many come with a list of issues and questions from their teammates—the trick is to make sure that no one person takes over!  

I’ve also adapted this luncheon for patients’ families—selected by current inpatients at the time of the meeting.  Hearing from families of loved ones about the great ways we care for patients, along with the areas for improvement, is so humbling.  This is how we really know how well we are doing—the “voice of the customer.”  Having great relationships with physicians and being a resource for problem solving is certainly a way to understand doctors’ perspectives and frustrations.  The challenge is finding people in the organization who have the courage to tell you the truth, not just what they think you want to hear.

What techniques do you employ to tackle this gap of information?  How do you work to be visible, at a time when too many meetings and endless electronic communication keep you from your staff?  

Lee Ann Liska is a CEO with over 30 years of integrated health systems management experience in successful provider organizations.  With a background in hospital operations, physician practice management, and ambulatory services in academic and community health systems, she shares her expertise on leadership and patient experience at