PMO for Success

By: Tina Machi, HCE Member

A large portion of an IT leader’s time is typically spent on driving, leading, managing, or supporting projects. It does not matter whether we are in Business Engagement, Application Development, Infrastructure, Security or Operations, etc., we have our hands on the clay. While we may have high success rates, some projects do fail.  According to Project Management Institute, projects fail due to lack of attention and/or efforts to several performance factors:

  1. Business Value
  2. Clear accountability
  3. Consistent process
  4. Consistent project methodologies
  5. Customer Engagement
  6. People
  7. Tools & techniques

I would like to share strategies to:

  1. Optimize a Project Management Office (PMO) to improve project success, increase speed-to-market, and help gain market share.
  2. Leverage a PMO to achieve operational excellence.

View Presentation

Thinking About What’s Next in Healthcare Security

By Ben Scaglione, CPP, CHPA, CHSP

With vaccine distribution ramping up, normal societal activities are in sight. When normal returns, what will hospital security look like? Will staff increases implemented back in March and April of 2020 stay or be eliminated? Will entrances that were locked reopen? Will temperature checks remain a standard in the industry? What will happen to visiting hours, will they go back to normal or continue to be restricted? What will the New Normal be for the security of our institutions?

These are just a few of the questions to be considered come May and June.  Although “Normal” may not truly transpire until October or November the discussion on future processes should be considered during this transitional period.  Turning on or off security practices implemented during Covid-19 should not be conducted at the last minute, it should be an organized, planned process.

I think one of the main considerations for many hospitals as we progress into the New Normal is visitor management. For many hospitals that had no restrictions prior to Covid, now have to assess the use of visitor management post-Covid. Will patient-centered care continue? Will hospitals continue to restrict visitors or go back to unlimited/unrestricted visitation.

Will hospitals close alternate entry points or continue to post security officers to screen persons entering the buildings.  Many hospitals, pre-Covid-19, allowed access into hospitals, clinics, doctor’s offices and outpatient services unrestricted. These services were closed at the onslaught of Covid-19 and have since reopened with a security or hospital staff screening patrons for access and temperature. Many hospitals are utilizing contract guard services to provide these functions. Will contracted security services for these services continue or will they revert to pre-Covid levels? Or will they be converted to in-house security services?

Will temperature screening continue? Will it disappear completely, or will it return only during Flu season. Will hospitals that have non-security staff taking temperatures still use the same staff after Covid or will this function be the New Normal for security services. How will lobbies and entry points physically change if this process becomes the New Normal. Will hospital lobby structures change to restrict access and funnel visitors, patients and staff differently?

Lastly, how will access control change going forward. The shift to using personal cell phones has started as an access credential. Will this process be accelerated along with the demise of push paddle for automatic door openers? Will fingerprint and other biometrics that require the touching of a surface disappear from the security environment?

All these questions should be considered in the evaluation of the New Normal and this process should start soon so that proper planning can occur.

This blog was posted on THE SECURE HOSPITAL: The Healthcare Security Site on March 4, 2021. You can access the site at: If you would like to contact the author, Ben Scaglione, he can be reached at


Leader Development: Supercharge your strengths or fix your flaws?


By: Kevin Nourse, PhD



I just kicked off a year-long leadership academy for a group of 20 physicians that are members of an international medical academy. As part of the program, I administered an emotional intelligence self-assessment that opened many participants’ eyes about their skills and development needs. A number of the participants asked me whether they should focus on developing their strengths or addressing weaknesses. I suggested they consider a balance of both approaches.

Foundational Approaches to Development

There two primary schools of thought on development – the strengths-oriented advocates and the fix-the-flaws gurus.

The strengths approach, popularized by writers Rath and Conchie (2008), is anchored in the positive psychology mindset. Their foundational ideas assume most people are not aware of their strengths. When people develop this awareness and invest time enhancing them, it enhances their abilities, confidence, and satisfaction. By extension, this school of thought suggests focusing on fixing weaknesses is frustrating and does not translate to sustainable performance improvement. A critical aspect of this approach is leveraging others’ strengths, recognizing that no leader can be good at everything.

Steve, a chief operations officer in a health system, is highly skilled as a project manager and ensuring no detail slips through the cracks. However, because he is very good at this competency and enjoys doing it, he rarely thinks strategically about his organization, including longer-term planning and visioning. Given his level in his organization, Steve needs strategic thinking capabilities to perform his role. In developing his project management strengths, Steve might want to consider how he might become more aware of when to tap this strength. For example, when identifying strategic opportunities and a new initiative vision, using a project management perspective might not be the best choice. He could also consider tapping the strategic thinking capabilities of his second in charge, Maria.

The more traditional approach to development emphasizes identifying a gap between your current (deficient) and desired behavior. The development plan then focuses on filling the gap by increasing your skill and confidence. In many cases, these deficits are created by overusing ones’ strengths. The overuse or misuse of strengths can create derailing behavior or what leadership researchers Robert Kaiser and Darren Overfield (2011) refer to as “lopsided leaders.”

Although Steve may never be an expert in strategic thinking, he could develop some necessary capabilities in this area to mitigate his weaknesses, enabling him to be able to speak strategy to his boss, the CEO. To achieve this, he could allow his second in charge, Maria, to mentor him, read a good book on the topic, or engage trusted colleagues about practicing this skill.

Hybrid Approach: Striking a Balance

I subscribe to a hybrid approach of development that embraces both methods. This approach assumes the importance of focusing on using your strengths and developing substantial weaknesses that could derail your career and limit your success. Further, it entails leveraging the talents of your leadership team to augment your weaker skills. In constructing their development plans, I often recommend that leaders identify one strength and one weakness.

Here are seven useful strategies for your development to consider that integrate the strength-based and deficit perspectives:

  1. Ask five trusted colleagues to identify your top 3 strengths and their impact, along with specific situations when they are most helpful.
  2. Reflect on conditions where your interactions with others did not succeed and assess the extent to which you may have overused your strengths.
  3. Reflect on peak experiences or achievements and determine how your strengths contributed to the successful outcomes.
  4. Consider mentoring others who are interested in developing skills you would consider to be your key strengths.
  5. Reflect on your job role and determine the extent to which you can enlist your strengths; consider negotiating a change in your job role with your boss to find ways to align better with your strengths.
  6. Identify role models; interview them to find out how they think and behave.
  7. Consider how you can leverage the strengths of others on your team to mitigate your weaknesses.

Successful leaders are intentional about their development and take consistent action over time to optimize their potential. Well-crafted development plans include a balance of developing both strengths and weaknesses. By taking a balanced approach, leaders can ensure they are well-prepared for future roles.


Kaiser, R.B. & D.V. Overfield. (2011). Strengths, strengths overused, and lopsided leadership. Consulting Psychology Journal: Practice and Research, 63, 89-109.


Rath, T. & Conchie, B. (2008). Strengths Based Leadership. New York: Gallup Press.


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Dr. Kevin Nourse has more than 25 years of experience developing transformational change leaders in healthcare and other sectors. He is the founder of Nourse Leadership Strategies, a coaching and leadership development firm based in Southern California. For more information, contact Kevin at 310.715.8315 or


Message from ACHE Regent – Winter 2021

Fear and Loathing in Health Care

In this new year, it is easy to become overwhelmed by multiple events that seem beyond our control and perhaps feel a sense of doom. On reflection, much of this is fear. Fear is a powerful emotion that drives behaviors.

As healthcare leaders, we must acknowledge that fear is pervasive in Medicine. Our patients fear whether their illness will be cured and that they could be financially bankrupted due to inadequate coverage. Our front-line providers have feared for their lives over the last year, a fear that is thankfully being mitigated by vaccination and falling COVID-19 numbers. Our practitioners feel concerned about whether they can fully care for their patients and always have the lurking threat of litigation hanging over them.

If we are honest with ourselves, many of us fear that we cannot provide all that is necessary to help our constituents or that we are inadequate to the task of servant leadership.

Before I started my surgery internship in 1982, I was both excited and scared. Confiding in a resident, he told me to read three books: House of God, by Sam Shem, a semi-fictional account of his first year as a medicine resident at a Boston teaching hospital; The Right Stuff, Tom Wolfe’s portrayal of the test pilots who would subsequently become the Mercury 7 astronauts; and Hunter Thompson’s drug-fueled, gonzo journalism missive from 1971 – Fear and Loathing in Las Vegas. My resident wanted me to understand the culture that I was about to immerse myself in – one of high energy, hard work, the need for confidence, living a bit on the edge, and the recognition that all this would be scary.

In House of God, the protagonist learns how to keep his patients alive and avoid being chastised, deals with his fear that he’ll hurt someone, loses his idealism, has a few memorable adventures in the call room, and subsequently changes specialties to psychiatry. The test pilots in the ’50s and ’60s had tremendous skill and bravado and recognized that they could well be killed doing their job. But they were the best of the best. Their fear was covered by the attitude that if someone augured in – it was because they didn’t have enough of “The Right Stuff.” But when you got inside their heads, there was a drive to succeed and fear and doubt. Alan Shepard was heard muttering, “God, please don’t let me screw this one up,” before the first Mercury launch. Such studied confidence is vital in any high-risk profession, and for those that combine that skill with realistic insight, the results are spectacular. The late Hunter Thompson was the National Affairs editor for Rolling Stone. His books involve completely immersing oneself in an experience, in his case, while under the influence of numerous drugs. He traveled to Las Vegas to cover a convention of District Attorneys dealing with the “The fear and loathing caused by the drug problem in America.” In the backdrop of Las Vegas, the combination of polarized attitudes leads to an interesting study of pushing limits and seeing two alternatives, yet concurrent, realities.

As a provider, before I volunteered in Haiti after the earthquake, I was asked if I was afraid of the violence or if I could deal with the extent of the disaster. Perhaps because I was older and my children were grown, I didn’t fear as much for my safety. But there was intense doubt about how I would handle what I would see. I learned that by depending on those around you, fear was shared and diluted.

The adversarial nature of our tort system creates anxiety and fear and impacts on the patient /physician relationship. Politically, as the health care reform debate continues to play out, both sides use fear to influence their base. Medicare “Death panels” vied with “Losing my insurance because I have cancer.” Based on a long history of racial disparities and distrust, those that would benefit most from the COVID-19 vaccination are also more likely to refuse it.

Because fear is a basic human emotion, just like joy and passion, it can powerfully influence behavior. How we chose to handle fear can define how we live our lives.

We all deal with fear differently. Some become overly arrogant, never admitting to a second thought and subsequently forging forward to a disaster. Others are paralyzed by fear and do not take any chances, achieving and experiencing little. Perhaps the best tactic is to recognize that the fear you feel is a sign to be a bit more aware, a bit more prepared, a bit more willing to reach out for advice, a different perspective, and support. When you can integrate fear, both your own and others, into the overall experience and balance it with planning, confidence, and a little bit of faith, your abilities as a leader are enhanced.

Harry C. Sax, MD, FACHE
Regent for California – Southern

President’s Message – Fall 2020

As 2020 comes to a close, I want to take a moment to share the many things to be thankful for this year.

I have been inspired by the gratitude I see so many of you practice every day, despite the many challenges with COVID.  Whether it’s a sincere thank you to a teammate who helped you with a task, or a thoughtful recognition of a colleague’s contribution to a team’s success or supporting a colleague who has lost their job in 2020, your actions help us create a culture of our American College of Healthcare Executives (ACHE) values of integrity, lifelong learning, leadership, and diversity and inclusion.

As we enter the holiday season and I complete my Presidency of Healthcare Executives of Southern California (HCE So Cal), I want to share how grateful I am for the open and transparent conversations and educational webinars around safety, cybersecurity, resiliency, emergency management, authentic leadership and commitment to diversity, inclusion and equity.  I am surrounded by HCE So Cal members who want to make a difference.  I see you striving to continually improve our healthcare systems and contribute to a positive and inspirational culture.

I am thankful for the partnerships we have with the American College of Healthcare Executives (ACHE), San Diego Chapter of Healthcare Leaders (SOHL), California Association of Healthcare Leaders (CAHL), Hospital Association of Southern California (HASC), other state chapters associated with ACHE as well as higher learning network universities.  I am so grateful for our wonderful sponsors who year after year contribute to HCE SoCal financially as well as by presenting on educational topics.

I see excellence every day in our strong and talented colleagues who work tirelessly to protect our patients.  I am humbled by the teamwork and compassion I see and hear.  Stories evoke powerful emotions, and the stories told this past year about resiliency, fostering connections, caring for others and transformational leadership have been heartwarming.

Finally, I am grateful and thankful for your leadership and active participation in HCE SoCal.  Your servant leadership regardless of your role or title makes lives better for our patients and each other.  Together we are united and stronger than ever.   Thank you for allowing me to serve as your President of HCE So Cal this past year.

Your Humble Servant,

Dr. Tricia Kassab, EdD., RN, FACHE

Leadership Retreats in the Era of COVID

By: Kevin Nourse, PhD

Leadership retreats have traditionally provided valuable opportunities to build relationships and trust, share insights, advance organizational change priorities, and reinforce corporate culture. When conducted at the end of a fiscal or calendar year, they provide an excellent opportunity to reflect on achievements and lessons learned and set clear intentions for a new year. With the magnitude of changes many leaders currently face in the new normal triggered by COVID, there has never been a more critical time to bring leaders together to align on a vision for the future and share insights from the past six months.

These realities beg the question: How can organizations conduct leadership retreats that create value using a virtual platform?

In this blog post, I share my observations on five key challenges organizations face in conducting virtual retreats and mitigation strategies to ensure success.

Challenge #1: Death by passivity

Whether conducted in-person or via Zoom, many leadership retreats fail because participants are overwhelmed by the amount of content introduced without any interactivity. In many instances, organizers fear drives them to pack retreat agendas with too much material. When they begin to run out of time, presenters begin to speak even faster and eliminate opportunities to interact with the audience. To address this:

  • Review the presentations proposed by each speaker to make sure they have built interactivity into their talks; aim for every 6-8 minutes using such features as a chat, poll, whiteboard, or breakout groups.
  • Be ruthlessly honest when reviewing the program design in terms of realistic time allocations of each segment.
  • Provide opportunities for regular breaks after 90-minute parts of the content and informal breaks as needed, such as inviting everyone to stand up and stretch.
  • Avoid using a monotone voice that can lull people to sleep; consider standing when you facilitate or present and use your hands naturally to inject more energy and vocal variety.
  • For a multi-day retreat, poll participants at the end of the first day to determine if there is enough interactivity.
  • Invite participants to turn off their video cameras – not only does this reduce the bandwidth needed for the session, but it also reduces the exhaustion participants might experience.

Challenge #2: Frustrations of Zoom-newbies

Many new Zoom users get frustrated when a leadership retreat begins, and they are unsure how to use the software features. This frustration can spill over and lead them to disengage from the retreat content. Consider:

  • Orienting new Zoom users on how to use software features before the start of the retreat
  • Explaining to participants how to maximize their participation such as using a workstation (versus a PDA or cell phone), printing the materials in advance, and joining the session in a location that is quiet and has a powerful WIFI signal.
  • Inviting participants to sign-on 15-20 minutes early to work through any technical issues, especially audio.
  • Polling your group in advance to find out who has experience or skill in using Zoom.

Challenge #3: Technical snafus, poor sound, and lighting

Producing a polished, well-facilitated virtual retreat with sufficient lighting and audio can significantly impact whether you achieve your envisioned outcomes. Early in the pandemic this spring, Zoom session participants were much more forgiving of technical snafus since many were still learning how to use it. However, as Zoom has become more commonplace, expectations of a well-produced session have become higher. To prevent technical snafus:

  • If you are the facilitator starting the Zoom session, consider hardwiring your system to a network instead of using a WIFI.
  • Each session should have a producer running the meeting and managing the technology, enabling a subject-matter expert to focus on content delivery.
  • Be sure to do dry runs if you’ve never used specific Zoom features, such as breakout groups or whiteboards.
  • Ensure you have adequate security, including passcodes.
  • Test both the audio and lighting for presenters to ensure higher quality communication.

Challenge #4: Lack of relevance, organization, and flow

With in-person retreats, it is much easier to spontaneously adapt the program in the moment. On the other hand, successful online retreats typically need much more preparation. The lack of significance for participants can result in disengagement, frustration, and wasted resources. To build relevance:

  • Conduct focus groups to gather input from selected participants about their challenges, envisioned outcomes for the retreat, and logistical issues or concerns.
  • Poll front-line staff to gather their feedback on issues that limit their ability to perform their roles or perspectives on how well the leadership team collaborates; use this information in the retreat to improve overall organizational functioning.
  • Clarify both the retreat objectives or outcomes and the detailed design for each segment, including the start and end time, the speaker, and interactive activities.
  • Consider using a time-bound approach that addresses and explores past accomplishments, present realities, and plans or goals for the future.
  • Poll the group periodically to assess how well the session are meeting their needs and addressing the stated objectives.

Challenge #5: Lack of real-time human connection

One of the most significant benefits of an in-person retreat is the ease of access to colleagues for spontaneous relationship building. However, there are strategies you can use to inject human connection in a Zoom retreat, such as:

  • Conduct icebreakers throughout the retreat in breakout groups of 4-5 people to give everyone a chance to engage; provide some powerful open-ended questions to guide the conversations.
  • Poll the group at various intervals to learn more about participants and their backgrounds (e.g., tenure, title, college degrees, etc.)
  • Invite participants to share a personal artifact near their workstation on video, such as a photograph, paperweight, or diploma.
  • Schedule an informal, unstructured happy hour as the final session and invite participants to breakout groups for networking and relationship building.
  • Enable participants to customize their Zoom name to reflect their role, location, pet name or other descriptive information (e.g., “Kevin – Palm Springs”).

Virtual leadership retreats that focus on building alignment, clarity, and trust are more critical than ever given the uncertainties many organizations face in the COVID pandemic. Through preparation and purposeful design of the agenda, interactivity, organizations can achieve a substantial return on the investment of time and resources.

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Dr. Kevin Nourse has more than 25 years of experience developing transformational change leaders in healthcare and other sectors. He is the founder of Nourse Leadership Strategies, a coaching and leadership development firm based in Southern California. For more information, contact Kevin at 310.715.8315 or