The Good, the Bad and the in Between…

The Good, the Bad and the in Between…

The Good, the Bad and the in Between…


Managing a Diverse Staff During Times of Change

ADVANCE Assistant Editor

With the health care industry undergoing an unprecedented period of change, just working in the health information management (HIM) profession can be challenging and stressful. Managing and leading others through this difficult time is an even more daunting task.

“Change is something people fear,” stated Donald Lombardi, PhD, in a seminar at last year’s national convention of the American Health Information Management Association (AHIMA). Dr. Lombardi is principal partner of CHR/InterVista, a NJ-based health care consulting company and the author of eight books, including Thriving in an Age of Change: Practical Strategies for Healthcare Leaders, upon which his presentation at AHIMA was based. “When people are afraid, they want to stick with the comfortable and the familiar, which in health care is often not an option.”

Dr. Lombardi noted that many times, HIM professionals are thrust into leadership positions when they have plenty of technical and clinical experience, but very little training in managerial tactics. This alone can make the first few months in a supervisory role very challenging and stressful.

Factor in an environment of constant change, and the situation for new managers can resemble a pressure cooker. “Even the most skilled leaders can find themselves at a loss when dealt the wild cards of mergers, acquisitions, downsizing and re-engineering,” said Dr. Lombardi.

Fortunately, Dr. Lombardi offered several concrete tips on how to effectively handle a team of disparate people. “On the road of life, there are three kinds of people: those who make it happen; those who help it happen; and those who wonder what in the devil is happening,” Dr. Lombardi told ADVANCE. “It’s the same in the workplace.”

In each work environment, he continued, there are three types of employees: “superstars,” “steadies” and “non-players.” Each tends to deal with change differently, so diverse management tactics are required to elicit the best results from every staff member.

Read the scenario below and see if you can guess which staff members are superstars, steadies and non-players.


Place: Bleeding Hearts Hospital, Anytown, USA

Scene: Manager Courtney has called a meeting of the HIM department to discuss a new departmental re-engineering effort that will be taking place. Her staff consists of four other people: Katie, a medical transcriptionist; Kathy and Janet, the department’s coders; and Laurie, a coder who specializes in utilization review.

Courtney: Unfortunately, we cannot hire another staff member to resolve departmental absences; the budget won’t allow it. Instead, we are all going to cross-train to learn the basics of each other’s jobs. During unexpected absences we will all need to pitch in to fill the void.

Janet (mumbling): …too cheap to hire some real help. I don’t have time to learn everyone else’s job. I have enough to do already!

Laurie: I don’t know—new skills will make us all a lot more marketable within the profession. Think of how these added job responsibilities will enhance your resume! I think we should all prepare memos explaining the step-by-step details of our positions.

Janet (louder): That would eat up a whole day right there!

Courtney (trying to ignore Janet’s negative comments): Kathy and Janet, I’m hoping you two can mentor Katie and teach her the basics of coding.

Kathy: No problem, Courtney. I’ll put aside some of the easier cases and begin training her on those.

(There is no response from Janet).

Courtney: Katie, the transition will be difficult on you—not only do you have a lot to learn, you’ll have to train all of us in your area as well. I hope you can put together a list of all the doctors you transcribe for, the format they use and their particular style preferences.

Katie: I’m sure I’ll get used to it. I will start writing a memo about my job duties this week.

Laurie: Maybe to ease the transition, the hospital would sponsor some in-house workshops on some of these specialties, or pay for classes at the local college. I’ll call administration and look into it.

Janet: I certainly will not spend any of my free time taking classes to learn other people’s jobs! I have a life outside of work, you know.


Can you guess which employee is the superstar in this group? If you think it’s Laurie, you’re correct.

“Approximately 10 percent to 20 percent of a typical staff will be superstar employees—a ‘golden minority,'” Dr. Lombardi commented. “These individuals are a manager’s dream.”

Superstars, Dr. Lombardi elaborated, always exceed a manager’s expectations. “They approach managers not with problems, but with solutions to problems,” he stated. “They have high expectations for their own performance. Superstars can be trusted because they do a thorough, careful job no matter what the task.”

These above-average employees view times of change as a challenge, not a hardship to be suffered through. “Superstars are not afraid to learn. They thrive when tackling new projects and mastering new skills,” noted Dr. Lombardi. “What they fear instead is the mundane and the routine. They discover ways on their own to exceed the boundaries of their job description.”

Because of their attitude and nature, superstars usually become role models within a work environment. “They tend to mentor their peers and teach them new skills,” Dr. Lombardi stated.

The hardest aspect of managing a superstar is keeping them challenged. “Managers don’t really have to worry about motivating this kind of employee because they find their own motivation. Nor do superstars really need much supervision,” Dr. Lombardi asserted. “But you do have to worry about them becoming bored on the job.”

Another important element when managing superstars is to celebrate their “wins.” Said Dr. Lombardi, “Always give credit where credit is due it means a lot to any employee. Express your appreciation and thanks to the people who exceed their job description; let them know how valuable they are to the team.”

Alas, superstar staffers do reside in the minority. The next important type of employee—the steady—comprises 70 percent to 80 percent of any given workforce. In the scenario above, Kathy and Katie fall into this domain.

Steadies, Dr. Lombardi explained, are similar to superstar employees, with one difference: they only go beyond the boundaries of their job descriptions when asked.

“Don’t get me wrong; steadies are great employees,” Dr. Lombardi hastened to explain. “They are generally positive individuals who like their job and do it well. They don’t give managers any problems at all.”

And while it’s true that steadies do not constantly seek out new challenges, they accept and handle these “workplace wild cards” like professionals. “The steady does what needs to be done. If it is something new, they will learn it,” Dr. Lombardi affirmed. “They happily work with the resources given to them, rather than carp about what they would prefer.”

However, Dr. Lombardi warned, steadies are not interested in becoming superstars. “They do not aspire to management or leadership positions,” he related. “Nor are they the source of creative solutions or innovative ideas—this simply is not where the steady’s strengths lie.”

According to Dr. Lombardi, the key to managing steady employees is to realize they are motivated by three things: satisfaction, recognition and affiliation. “Keep the lines of communication open with your steady employees,” he recommended. “Although most steadies are satisfied with their job duties, it doesn’t hurt to monitor their situation. Do they want to learn anything new? Are they performing enough of the tasks that make them happiest? As manager, make sure the steadies remain pleased with their positions.”

In addition, it is equally important to recognize the hard work, good attitude and team spirit that characterize most steady employees.

The third type of employee, both the hardest to work with and to manage, is exemplified by Janet in the scenario above. “If the superstar is a manager’s dream, then the non-player is a manager’s nightmare,” Dr. Lombardi declared. “Non-players are constantly negative. They are only happy when they are complaining.”

And although non-players make up only 10 percent of a typical staff, they can often seem like a majority. “They are master manipulators who devote a lot of time to garnering negative attention,” cautioned Dr. Lombardi. “They want to play the victim in life, and they want their co-workers to either join in or sympathize.”

Furthermore, “This type of employee wants to do as little as possible to keep their job—the bare minimum,” Dr. Lombardi attested. “They know their job description chapter and verse; and they are determined to stick to it.”

Not surprisingly, non-players fear and resent having to learn anything new on the job. Dr. Lombardi noted that these employees have four favorite sayings they cling to like a mantra in their attempt to thwart change:

  • If it isn’t broken, don’t fix it.
  • We’ve always done it this way.
  • We’ve tried that before, but it didn’t work.
  • That’s not part of my job description.

“This attitude does nothing to further departmental goals,” Dr. Lombardi stated. “And a manager has to be careful: one bad apple can spoil the bunch.”

Of course, the big question is, how on earth do you manage an attitude like this? And how can you prevent it from infecting the rest of your staff?

First, Dr. Lombardi warned, supervisors must realize they are not going to change the non-player. “These peoples’ personalities are pretty well-formed,” he noted. “Don’t bother trying to convince a non-player that a change really is going to be for the best—you’re wasting your breath.”

Nor should a manager get caught in a trap of feeling sorry for and trying to help the non-player. “Five years ago, there might have been time to coddle them,” said Dr. Lombardi. “But in today’s cost-cutting, maximum efficiency environment, there is no room for this. You must manage the non-player with a ‘zero tolerance’ attitude.”

An effective supervisor will devote 70 percent to 80 percent of their time developing and supporting their superstar and steady employees. “If non-players are only 10 percent of your staff, only give them 10 percent of your energy,” Dr. Lombardi recommended. “Don’t let the non-players steal the show and waste everyone’s precious time.”

Dr. Lombardi also stressed the importance of constant communication with the entire team and recommended conducting a staff meeting once a month. “Discussing five crucial things will help ensure a smooth operation,” he assured.

According to Dr. Lombardi, the first thing on the agenda should be the department-wide “win” of the month that everyone can celebrate. The second important topic is the “number of the month,” a positive or negative number value that reflects well on the department (i.e., a decrease in delinquent records).

The manager also should recognize an “employee of the month” and cover the “organizational issue of the month,” describing its potential impact on the HIM department. Last, the manager should ask employees for the “rumor of the month” and frankly discuss this topic with staff members.

To positively reinforce the attitude of superstars and steadies, Dr. Lombardi advised allowing them to lead the action in the department. “Inform them of what might be coming down the road, and solicit their ideas and feedback,” he said. “Whenever it is possible and appropriate, get these staff members involved in the decision-making process.”

Another way to reward superstars and steadies is to give them preference on a variety of important workplace issues, such as picking job duties or new equipment, off-site travel and education opportunities and vacation preferences. “This isn’t a democracy here; it’s a business,” reminded Dr. Lombardi. “If the non-player whines, ‘That’s not fair,’ the manager can tell them, ‘Maybe not, but so-and-so earned this.'”

And the trick to managing non-players? There isn’t one. According to Dr. Lombardi, the sad reality is that often, the best solution for the team is to have the non-player leave. For this reason, managers dealing with non-players must be prepared to fire them if necessary.

“Zero tolerance,” Dr. Lombardi reiterated. “Document in writing every task you expect them to accomplish during a given period. Make sure you give them either point-specific or quantitative goals. When they don’t perform up to your expectations, document it. Do not be afraid to hold these employees accountable.”

Dr. Lombardi also recommended using the power of pronouns (we, us, etc.) when speaking with non-players. “Make it clear to them that they are part of a team, and their teammates expect them to perform up to par,” he advised. “This will make non-players very uncomfortable.”

A non-player who is forced to perform, however, is almost certain to end up hating the boss, Dr. Lombardi warned. How should a manager handle this?

“BEWARE,” HE said. “The more these employees are put to the task, the more they will act out—with hostility, tears, erratic behavior. As their boss, you cannot get emotional when dealing with them. Keep calm and stay very professional—you don’t want to play their game.”

As difficult as it is to lead diverse staff members through a period of change, it teaches most managers valuable lessons about themselves as professionals and individuals. “You learn to truly cultivate your staff members, not just for the short-term, but for the duration,” Dr. Lombardi commented. “And you realize that if you can make it through this, you can make it through anything.”

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