Case History: Med-center Partnership

Case History: Med-center Partnership


This project focused on bridging institutions to advance clinical and community-engaged collaboration, education and research.  Joan acted as chief facilitator and liaison to build a new partnership between MeHarry College and Vanderbilt University, to also include Metropolitan General Hospital.

The main focus was on enabling the partners to work effectively together, to resolve issues and generate productive ideas.  The mission was to coordinate a major medical initiative, creating a collaborative partnership that would result in a highly profitable medical research program between a consortium of universities, hospitals and government agencies.  The target demographic were poor, under-served populations.


Provided ongoing consulting and facilitation to Vanderbilt on two initiatives.

  • The first was focused on setting up and tracking the implementation of a diversity initiative at the VU Medical College (VUMC). This involved benchmarking what other academic medical colleges of equal prominence have been doing, and leading the Cultural Diversity Steering Committee.


  • The second project centered around assisting in the implementation of a formal alliance that has developed between VUMC, Meharry College and Metropolitan General Hospital, focusing on the integration of the various cultures, both organizational and ethnic.


Facilitation: Joan oversaw communications between VUMC and MeHarry and VUMC and Metropolitan General Hospital in forming an extraordinary pioneering alliance. Discussions were focused on bridging racial and cultural gaps between organizations with little understanding of each other or of ways to communicate and build trust and collaboration. She acted as the facilitator at each location as well as for all cross-functional meetings, overseeing the implementation of the complete project.

One challenge was to integrate the diverse cultural, ethnic and organizational environments associated with a white university and a historically black medical university in order to achieve a viable and valuable partnership.

Coaching and Consulting: Joan provided ongoing consulting and facilitation to Vanderbilt on three initiatives:

1) She set up and tracked implementation of the diversity initiative and led the Cultural Diversity Steering Committee.

2) She assisted in the implementation of a formal alliance developed between VUMC, MeHarry College, and Metropolitan General Hospital, focusing on the integration of cultures, both organizational and ethnic.

3) Early on, the scope broadened revealing the need for additional best practices research and assessment in diversity alliances in universities, a project that Joan developed and oversaw. She also reported back the results so that the Alliance committee could make the best decisions possible on how to work together.



The Alliance has become highly successful in leading and advancing inter-institutional efforts and it garnered $340 million+ in grants to date.

All organizations involved have grown in size and reputation. Many sub-alliances have developed and research for minority cultures has increased.

The focus continues to be on medical issues for under-served populations and the initiatives continue to expand since Joan initially set up the structure. For example, the Diabetes Improvement Project at MeHarry-Vanderbilt has been running since 2010. It consists of a consortium of hospitals and universities (including all those in the M-V partnership) across middle Tennessee with 7 systems serving over 106,000 uninsured or poorly insured people.

Delegation: Why You Can’t Just Say “Go Do It”

Delegation:  Why You Can’t Just Say “Go Do It”

There is a common belief when it comes to managing people—especially at the senior VP and executive levels—that the higher you are in your position, the less you actually need to provide any sort of hands-on management to your direct reports. The thinking goes something like this: You had to be bright and smart to get to this executive level. Similarly, the people who report to you directly must also be very smart, or they wouldn’t have gotten to their positions. Therefore, they should know their jobs, and you should rarely or never need to tell them what to do in very specific terms.



That’s the myth. Here’s the reality.

The level of involvement you need to provide when you assign a task does not depend on your job title or your ranking in your company. Rather, it depends on these three factors:

  • To what degree does this person have the skills and expertise needed to do the task? 
  • To what degree are you confident that your perception of the person’s abilities is actually true? 
  • To what degree does the person you have in mind agree with your own assessment?

Each time you delegate a task, you need to weigh these three factors and determine how involved you need to be. There is no one-size-fits-all.


The Five Levels of Delegation

Now, let’s clarify what it means to delegate, and then talk about why most managers are doing it wrong.

Researchers have delineated what I have come to call the five levels of delegation. Here they are:

The common perception is that as a top-level executive, you are supposed to primarily operate at levels 4 and 5. In fact, you may feel that it’s actually insulting to simply tell your people what to do—especially with detailed instructions—and expect them to do it.  Well-intentioned consultants would say you are “micromanaging” and that is bad.

Furthermore, you may believe that the people who report to you want to take charge and be at level 5 as much as possible, even in the absence of sufficient information. (And often, this is true; some team members will be looking to make a good impression on you, while others will sincerely want to take a load off your shoulders.)

Unfortunately, delegating directly to level 4 or 5 often leads to breakdowns. This is especially true in today’s organizational culture, in which change and disruption are the norm. In an environment like this, it’s illogical to expect direct reports—no matter how competent they are—to become knights who go forth on their own, find the holy grail (without a map and maybe without even understanding what a grail is), and report back when they’re done.   It never worked like that in the past, and it definitely does not work like that today.

Very often, people who get knighted go forth and do their best based on what they think the boss expected. Then, when they bring the results back to their boss, the boss says, “No—that’s not what I wanted.” They look bad, the boss is frustrated, and the blame game begins.


To avoid this scenario, you need to ask yourself: How badly do I really need this task that I’m delegating to be carried out perfectly? The more important the task is, the more you need to ensure that your direct reports truly have the skills, experience, and information they need to carry it out.

If the task is crucial, this means having a conversation with each person involved, asking lots of questions, and making sure that the person is capable of doing the job. Do NOT simply accept “Don’t worry, boss, I can do this.” This is what people think you want to hear, but it’s not what you need to hear.

Frequently, people won’t admit up front that they’re unprepared for a task because they’re afraid that they’ll get fired or they want to save face. Other times, people aren’t even aware that they’re lacking key skills or data (which is a dangerous—and these days, common—situation). This is why you can’t accept “I can do this” at face value.


It’s important for you to understand that every human being has blind spots, and the most dangerous ones are:

  1. They think they know and they don’t
  2. They don’t know what they don’t know.

Part of your job is to help the people under you identify and address their blind spots, without making them feel stupid.  And part of their job is to be open to your masterfully helping them gain awareness of their own blind spots. Your ability to do this, and their ability to accept and learn, will increase tenfold the expertise that each of you have to offer.


Remember: Most people in the job market who get promoted fast have a narrow band of expertise in one area, but may have little or no knowledge outside of that area. Others are great generalists but have never actually gotten their hands dirty doing things that are relevant to today—not three years ago. When skills and experience are lacking, or your direct reports don’t know how to make good decisions (another skill that needs to be taught), you can delegate at level 5 until the cows come home, and it will keep coming back to bite you in you-know-where.

What’s more, your team, who only want to succeed and to help you succeed (assuming that you hired well, treat people with respect, and demonstrate your own competence) will become very demotivated when you keep saying “Jump,” they keep saying, “How high? We can and will do this!”, and then you’re disappointed in their results.

So don’t just say, “Do it.” If necessary, be ready to roll up your sleeves, get dirty, and really find out the details of what’s needed. How do you know when to delegate and levels 4 and 5?  The answer is powerful: you and the team or other individual both agree with candor, and the results that you and the other(s) want show up.

Also, make it clear to your team that it’s their responsibility to be open with you—for instance, to say, “I’m not exactly sure what you want me to do,” or “This is what I plan to do step by step—is that what you want?” or “I have expertise in this and this, but THAT will be new to me—can we meet weekly and update?” Then reward their openness by giving them the support they need.


Delegating wisely + communicating well = success

Now, let’s circle back to my model of management, and look at it in relationship to another model by Michael Hyatt. Hyatt outlines these five levels of delegation on his blog:


  • Do exactly what I have asked you to do: Don’t deviate from my instructions, since I have researched the options and determined my preference.
  • Research the topic and report back: After we discuss it, I’ll tell you what I want you to do.
  • Research the topic: Outline the options with the pros and cons for each, and make a recommendation. If I agree, you can move forward with that approach.
  • Make a decision and then tell me what you did. I trust you to do the research, make the best decision you can, and then keep me in the loop.
  • Make whatever decision you think is best. No need to report back. I trust you.


While my model looks at the five different ways to delegate a task, Hyatt’s model looks at the issue from a different angle: It tells you how to communicate your expectations at each level so that your direct reports are absolutely clear on what you want.


When we put the two models together, here is what we get:

All stages of this model are empowering.  When people don’t know what to do and you tell them, they’ll be grateful—and they’ll also be more likely to give you the results you want. When people know exactly how much and what type of input you need from them, they’ll be more efficient. When collaboration is indicated, a good dialogue will enable your team to make the best decisions possible. And when you conclude that a person or team truly is capable of handling a task without your input, you’ll avoid over-managing.

Delegating—and communicating your expectations clearly and smartly when you delegate—takes work. However, the payoff is huge. It will make your team respect you more, and vice versa. It will maximize your performance and minimize your costs. And it will ensure that despite change, disruption, and sometimes utter chaos, you will get the job done as efficiently and effectively as possible.

Does Your Coach Pass the Test

Coaching Traits

Does Your COACH Pass The Test

Assessments are a powerful tool in the business coach’s arsenal. Done correctly, they provide objective data and feedback that coaches can use to help clients identify opportunities for positive change. They can reveal both the big picture and personal idiosyncrasies that clients may need to either tone down or use to greater advantage. In the right hands, assessments can transform an individual or an entire corporation for the better.

However, done incorrectly—as they too often are—assessments can actually do more harm than good. That’s why prior to selecting a coach, you need to know some facts about the assessment process.


Start Here

First, let’s talk about what a test battery is. It means that your coach will conduct multiple assessments (more on this shortly). In selecting the most effective battery, a good coach will ensure that:

• Each assessment makes a clear contribution.
• Each assessment relates to the reasons why you desire coaching.
• Each assessment coordinates with the others, providing an in-depth understanding of your needs, strengths, and perceived weaknesses.

It’s very important to understand that not all assessments are alike. In fact, some have very little validation. One of the most popular assessments that organizations use today was vetoed for use in research and dissertations for this reason at the graduate school where I received my degree in industrial organizational psychology.

In addition, when it comes to conducting assessments, not all coaches are alike. I strongly believe that anyone using assessments needs to receive very thorough training—years of it, not just weeks or months. Coaches who lack this training will misuse even the best tests. In addition, they will be at the mercy of venders who promote worthless or even harmful assessments. Again, it isn’t enough for coaches to choose the most popular assessments, because some of the weakest and least statistically valid assessments are the most popular today.

Smart Assessments

Finally, even if an assessment is robust—meaning that its results are truly valid—coaches need to use it effectively. This includes:

• Clearly explaining the purpose and process of each assessment to clients beforehand.
• Describing the results of each assessment in language that clients can understand.
• Showing clients how to translate the findings into concrete, positive steps.
• Describing the strengths and limitations of each assessment so clients can give the results the proper weight.

Choosing A Coach

With these points in mind, how do you select a coach whose assessments will do good rather than harm? Here are two questions to ask up front:

1. Ask if the coach plans to use a customized test battery or merely administer one or two tests.

If a coach claims that a couple of assessments and an hour of information-gathering will be sufficient to develop an action plan, look for another coach. It takes at least four to five assessments for a coach to develop a well-rounded picture of a client.

In addition to asking how many tests the coach will administer, ask the purpose of each one. Also, ask how each assessment relates directly to your needs or your corporation’s needs.

2. Ask the coach what will happen after the assessments.

Too often, coaches provide the results of an assessment but offer little or no interpretation of these results. (One reason is that assessment reports can be very sophisticated, and many coaches themselves don’t fully understand them.) This is dangerous, because it means that the assessments won’t translate into insight and increased self-awareness. Instead, they have the potential to do serious damage.

In one case involving a Fortune 100 company, a coach gave a female senior executive a very powerful assessment. This woman, while definitely needing improvement in some areas, had worked extremely hard to pull herself up by her bootstraps and to succeed in a challenging job. However, her coach at the time interpreted the assessment results in a very superficial and negative way that left her feeling discouraged. The report itself was very murky, and a negative tone came through in it as well.

When I arrived later to gather information and conduct my own assessments, the woman was very nervous, and it took a great deal of effort on my part to persuade her to agree to go through the assessment process again. She was so pleased this time that she brought me the original assessment that caused her so much pain. I went through it carefully with her, tying it in with the feedback from my own battery of assessments. When she understood the whole picture—both her strengths and the beliefs and behaviors that might be getting in her way—she took ownership of the information. She’s now positive and confident, is clear on what she wants to achieve in her career, and is effectively grooming herself for those next steps.

In another case, a corporation brought in a psychologist and “expert” to assist a department troubled by infighting. The person’s solution was simply to give an assessment to everyone and then tell each participant, in front of the rest of the team, what they were doing right and wrong. There was no discussion on how to change their behavior to resolve differences positively; instead, the coach just got up and left.

The group was shell-shocked, and some members were devastated. Somehow, their top boss was referred to me, and after much debate about inviting a psychologist into their presence, they decided they were willing to try. Following my testing and feedback, the group went from hostile to eager to totally onboard, and the infighting ended. To this day, their now C-Suite-level boss and others from the same original team turn to me when they need to communicate delicate feedback or information, require team coaching, or are preparing for a restructuring.

What to Look For

Good coaches give feedback that is not just accurate and constructive, but also empathetic and insightful—especially when it involves perceived weaknesses. People are excited about learning more about themselves, but many are also nervous about exposing what they deem to be their weaknesses. When coaches give feedback properly, it allows clients to step outside themselves and view themselves as a whole entity. Good coaches discuss weaknesses as openly as strengths, because those very “weaknesses” often have contributed as much to a person’s success as what we call their strengths.

For instance, I have another client who is in a powerful position in a Fortune 500 company, making decisions that impact many other people at the global company. One assessment I gave this client was an emotional intelligence assessment called the MSCEIT. This test reveals how well clients perceive, use, understand, and manage their own emotions as well as the emotions of others. The assessment revealed that he was very weak in accessing and integrating emotion accurately. However, another sophisticated assessment I gave him allowed me to determine that he was highly ethical.

Earlier in his life, this man saw the damage that emotion can cause, and decided to stay focused on reasoning and analysis. This emotional detachment gave him the ability to steadfastly do what he and the corporation agreed was best for the organization as a whole, despite the emotional reactions of others. Combined with his high level of ethics, it allowed him to become very successful. However, it also led to problems. For instance, because he kept his emotions at arm’s length, other people frequently perceived him as doing the same thing to them. In addition, many perceived him as manipulative.


In our work now, we focus on how he can best show his ethical self and learn to experience and show compassion, while allowing others to see that he has no other agenda than doing what is best for the company. He is also learning how to be transparent in appropriate ways, which is encouraging others to do the same in return. It’s been fun and personally heartwarming to watch him unfold within himself and at the same time begin to read people and respond to them more accurately. He still meets with resistance, as his job is to institute major change, but people—including his boss—now better understand where he is coming from, and are joining forces to support him. In the process, they’re learning how to better embrace the disruptions that are necessary for everyone to grow.


Clearly, assessments can be a powerful tool for good—but only when the right person conducts them.

So don’t automatically assume that any coach and any assessment will do the job. Instead, seek out a coach who has years of training in using assessments, will custom-tailor a battery of well-validated assessments to your specific needs, and will translate the results into practical information you can understand and positive steps you can take. Your coaches won’t be shy about testing you… so don’t be hesitant about testing them!