Developing integrity in facilities leadership

Health care facilities managers should use team meetings to explain their decisions and the values behind them.

Image by Getty Images

Although leadership qualities may be inherent, the so-called “born leaders” are really those who spent their lives as works in progress, wrote Robert L. Danzig in the e-book, The Leader Within You: Master 9 Powers to Be the Leader You Always Wanted to Be. These leaders are constantly developing skill sets to be great, and a critical skill set in health care facilities management is integrity.

Integrity is the foundation of leadership and trust. At its core, integrity means consistency. It is aligning actions with words, policies and the ethical standards of the health care field and the facilities management profession.

Following through on commitments, reporting issues accurately and maintaining transparency with leadership, staff and vendors aren’t optional. They are essential, even for small things like properly logging a repair request, double-checking inspection documentation or treating vendor bids with fairness. Without integrity, technical skill and vision lose credibility. And without credibility, facilities leaders and their teams will fail.

In his 2003 American Society for Health Care Engineering (ASHE) monograph on “Developing Effective Facilities Management Leaders” (see resource box on page 56), ASHE Past President Phil Stephens wrote, “In order to accomplish this process, it is first necessary to build trust. The foundation of this trust is the belief that the leader has integrity. Meeting commitments and keeping promises best demonstrate this.”

This is a timeless statement that still resonates as facilities managers have inherited the even greater pressures of post-COVID-19 operations, aging infrastructure and workforce shortages.

Culture of integrity

Integrity shows up in the day-to-day decisions. When critical equipment fails or deadlines loom, a health care facilities manager with integrity ensures that proper safety checks, accurate documentation and critical communications are completed — even if it results in a slowdown in operations or creates pushback from staff, other departments or senior leadership.

These daily choices will build a culture of integrity and lack thereof will erode it. And these are not hypothetical situations — every health care facilities manager knows what it feels like to weigh whether to push a contractor, delay a shutdown or sign off quickly under pressure despite concerns.

Practicing integrity reduces risk, fosters collaboration and creates a workplace in which people feel empowered to act ethically regardless of the circumstances. Without it, even small lapses can escalate into major failures and compromise the safety and trust everyone relies on.

A facilities manager’s integrity is challenged daily. There are time pressures, culture pressures and leadership pressures. It often is tempting to take shortcuts or cut corners just to survive the day or eliminate pressure in a situation. In some situations, facilities managers may even be tempted to let a systems outage or other emergency pull attention away from compliance checks or preventive maintenance routines.

Facilities managers often are faced with conflicting priorities while trying to balance cost, safety, deadlines and relationships. Moreover, a manager may find themselves in a situation in which a superior pressures them to delay repairs or skip compliance to save money.

Maintaining integrity can feel risky but is essential. Modeling integrity sets the tone for everyone under a health care facilities manager’s leadership. As Colin Powell, former general and secretary of state, once said, “Remember: Your first name doesn’t have to be president or CEO in order for you to be a leader.”

There also are cultural and interpersonal pressures. Often, new facilities managers inherit cultures that tolerate shortcuts. It takes courage to reset those expectations. There is the influence of “this is how we’ve always done it.” There also is pressure to conform to the existing team dynamics, and in those times, the fear of standing out can cloud judgment.

Even when facilities policies are clear, fear can freeze action. Raising concerns about safety, budget mismanagement or equipment issues can trigger concern in the facilities manager over retaliation or strained relationships with other departments or senior leadership. Mid-level managers feel this keenly because they often feel caught between executive demands and staff realities.

Giving in to this fear suppresses behaviors that protect everyone in the building. Health care facilities managers must balance transparency with diplomacy to overcome it. The truth is that integrity often requires courage, which means taking the right action even when it is uncomfortable or unpopular.

Policies can be complex or open to interpretation. Making decisions about vendor negotiations, resource allocation or reporting incidents without clear consequences can test a health care facilities manager’s judgment. For example, should a facilities manager report the near-miss of a safety issue that technically caused no harm but exposed a real vulnerability? Integrity says so. It demands consistently applying principles, rather than convenient rules. It is a choice that requires discipline and foresight.

Facilities managers must plan to do something beforehand and then measure every decision by the standards of integrity they have established during decision-making and afterward upon reflection.

Issues and examples

Health care facilities managers have a responsibility for the safety of their facilities. Integrity is tied directly to effectively protecting everyone in the building, including staff, visitors, patients and vendors. Safety should never be sacrificed for convenience, and integrity helps ensure it isn’t. That means a facilities manager must resist the temptation to skip steps, such as overlooking personal protective equipment compliance, to speed things up and get things back online quickly.

A project manager once halted a major project with a tight deadline until a safety step was corrected. It was an unpopular decision that delayed work but earned them lasting respect for protecting people over deadlines. This project manager showed integrity in action.

On the other hand, another facilities manager had more than 150 invoices to review and approve. He took time to go through each one and review them to make sure they were legitimate, but he still had to sign off on each one individually in the system. It was an easy but very time-consuming task, and he was under a deadline for another project, so he took a shortcut by asking his assistant to sign off on them for him.

It may seem like a small thing, but technically, he would be breaking two rules: he would have had to share his login and password to do it, and he wouldn’t be signing off on them himself. It wasn’t just simply that it broke the rules. It was that he was asking his assistant to break the rules and setting an example and a precedent of taking shortcuts for convenience. It would have prevented him from ever having a conversation with her or anyone else who knew about what had occurred regarding doing the right thing no matter what.

Thankfully, he owned up to giving in to the pressure of the moment and being tempted to do the wrong thing. He accepted the corrective action that came with owning it and went to his administrative assistant and apologized for putting her in that situation. Ultimately, owning up to it and making things right actually helped build credibility with his superior and his assistant.

In a similar example, a facilities manager admitted to using the hospital copier for his side business. When confronted, he acknowledged his wrongdoing, confessed it to his crew and made sure they knew it was wrong. His honesty and willingness to make things right strengthened their respect for him.

Integrity is not about achieving perfection but maintaining accountability regardless of the cost.

Practical steps

What are some practical steps that can help health care facilities managers lead with integrity?

First, facilities managers should always define clear standards for their staff and fellow leaders. They must take the time to clarify values and expectations and then model them. And they must be crystal clear. Facilities managers must be careful not to let ambiguity weaken accountability. To help, they can hold daily safety huddles or monthly integrity spot checks, where staff can share concerns and the manager can reinforce standards.

Next, health care facilities managers must be transparent in their decision-making. It is critical that they explain the “why” behind choices and avoid secrecy or favoritism. They should use team meetings to explain their decisions and the values behind them. This builds trust and support for the decisions and respect for the manager’s leadership.

Health care facilities managers must model consistency in the standards they have set and how they are upheld. Integrity is measured when choices are difficult and not when they are easy.

Facilities managers must hold themselves accountable for mistakes. This means not shifting blame to others or deflecting but owning them and making the tough choices that are necessary to correct their own decisions and behavior. People are always watching, and the truth of a facilities manager’s character is revealed in these crucial moments.

“When it comes to honesty and integrity, followers wait to be shown,” Stephens wrote in his monograph. “They observe behavior and wait to see if the leader is as good as their word. Consistency between word and deed is the true measure.”

Another practical step is to recognize contributors to any project. When receiving praise, health care facilities managers must give credit to team members, mentors or tools (including artificial intelligence) that help shape a successful report or project. By being transparent and giving credit where it is due, a facilities manager builds trust and reinforces humility and respect for others.

As Marshall Loeb and Stephen Kindel wrote in Leadership for Dummies, “Leadership begins with a willingness to accept responsibility.”

Some self-check questions for leaders to ask themselves when faced with pressure to make a decision that is uncomfortable or gives them pause include:

• Am I making this decision for the right reasons or the easy reasons?
• If this choice was made public, would I be proud of it?
• Does this action promote safety and trust for everyone involved?
• Am I being consistent, even in the details no one else sees?
• Would I feel confident explaining this choice to a new employee learning what integrity looks like?
• Have I given proper recognition to those who contributed?

“Harry Truman was right,” Stephens wrote in his monograph. “Whether you are a CEO or a facilities manager, the buck stops here. The essence of leadership is the willingness to make the tough decisions that will have an impact on the fate of the organization.”

Embracing integrity

Health care facilities managers must resist shortcuts despite the pressures of the moment, embrace accountability and protect the people under their care regardless of the difficulty.

They must embrace integrity and lead with courage, transparency and consistency. Not only for their own benefit but because the people they lead will model what they see.

Integrity demands that facilities managers always hold themselves accountable, model ethical behavior and create a culture in which doing the right thing is non-negotiable and routine.

Ultimately, it is about building a workplace where trust, fairness and safety are foundational to everything the health care facilities department does.

Related article // Practicing integrity every day

Integrity isn’t usually tested in the big moments of drama but in the ordinary moments when no one else may be aware or notice.

Integrity is tested when a health care facilities manager must decide whether to review each invoice line by line when the stack is high, it’s the end of the month and they have already worked too many hours that day. Or when they are faced with the decision to stop a contractor mid-job when they see a safety shortcut, even though it will delay progress on a project with a tight deadline. Or when they have to decide to admit an oversight in front of their team, even if it hurts their pride.

These seemingly small, daily decisions either build or erode a culture of trust. These decisions may not be newsworthy, but each decision defines how a health care facilities manager’s staff, vendors and leadership view them. And they can shape just how safe a building really is for patients, visitors and employees.

Integrity means doing the right thing even when no one is watching. This means documenting thoroughly, enforcing fairly and communicating honestly, not just when inspectors are on-site or executive leadership is listening but every day with every decision. The facilities manager’s reward for choosing integrity is creating teams that trust one another, vendors who want to partner with them and leaders who know their word can be trusted.

Health care facilities managers also should remember that integrity is never about perfection. It’s about a goal — a steady, consistent choice to do the right thing even when it’s hard. Repeating that choice over time is what turns a facilities manager into the type of leader people will follow. 

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Shadie (Shay) R. Rankhorn Jr., CHFM, CHC, CxA, FASHE, is a partner at Facility Diagnostics LLC in Nashville, Tenn. He can be reached at srankhorn@FDllc-cx.com.