The Healthcare Manager's Playbook

This is the seventh post in a twelve part series exploring key lessons I wish I had known before becoming a director for the first time. This series is inspired by a common question I hear from new directors during onboarding: “What do you wish you had known before you became a director?”

In this post, I want to discuss an often unspoken responsibility of leadership. If there is a problem in your department, it is up to you to fix it. As the leader, the responsibility is on you. There is no one else to pass the problem along to and expect it to be resolved. As clinicians, we were accustomed to pointing out issues and passing them along to our bosses to solve. As a director, that option no longer exists. You are now the one who must step up, take on the problem, and lead the effort to solve it.

If supplies are out of stock, it is not enough to simply reorder them. It is your responsibility to develop a system that prevents shortages from happening again. If storerooms are disorganized and cluttered, the solution is not only to clean them out but to establish clear locations for items so they can be easily found and properly restocked. If weekend staffing is lacking and patients are not receiving the care they need, it is your responsibility to adjust resources, hire additional staff, and find better ways forward.

It can be tempting to wait for someone else to step in, but the reality is that no one is better positioned than you to fix the problems in your department. You have the visibility, the influence, and the authority to drive improvement. You understand your team’s needs and your department’s priorities. If you do not take the lead, no one else will, and frustration will continue to grow.

In the book Extreme Ownership, Jocko Willink explains that effective leaders take responsibility for everything that happens under their watch. When mistakes occur, the leader owns them. When systems fail, the leader addresses them. This perspective is not meant to create pressure but to offer clarity and empowerment. You are now in the best position possible to make a meaningful difference.

Under the principles of extreme ownership, a director is responsible for the department’s performance in its entirety. This includes the team, the outcomes, the processes, the people, and the culture. Whether an issue stems from something you created or something you allowed to persist, it falls within your responsibility to address it.

While it may feel intimidating to lead a problem-fixing effort for the first time, it is important to act anyway. Leadership often begins with small, imperfect steps. It is better to take action and feel uncomfortable than to remain passive out of fear. With each step forward, the discomfort lessens and confidence grows.

Recurring problems and chronic frustrations should not be accepted as part of the job. They are signals that something needs to change. When irritation becomes routine, mistakes continue to repeat, or inefficiencies drain energy from the team, it is time to intervene. Resist the temptation to say, “That is just how we have always done it.” You are in this role to improve systems and outcomes, not to preserve the status quo.

You have both the opportunity and the responsibility to break cycles of frustration and create systems that truly work. Just because it has always been a certain way doesn’t mean it has to always be that way. The actions you take today will become the improvements your team appreciates tomorrow. Now go fix what needs fixing.

About the Author: Shane Haas serves as the National Director of Outpatient Services at Ernest Health, a leading provider of inpatient and outpatient rehabilitation. He enjoys the consistent practice of learning and sharing leadership and management skills. His backgrounds in Physical Therapy (UF ’96) and Industrial Engineering (TTU ’02) provide a balanced heart and head perspective that shapes the Healthcare Managers’ Playbook.

References:

• Willink, J., & Babin, L. (2015). Extreme ownership: How U.S. Navy SEALs lead and win. St. Martin’s Press.