In the context of accelerated change in the Indian health system, Ayushman Bharat and the post-COVID-19 scenario emphasize that strong leadership and team management are essential for the successful implementation of health programs, particularly at the state level.

Health Systems Transformation Platform (HSTP) recognized the need and proposed a groundbreaking Leadership Development program tailored to district-level managers in Odisha. By equipping primary healthcare facility managers with management training and supportive supervision, the program seeks to enhance skills and decision-making autonomy, ultimately improving health outcomes. Leveraging the expertise of Athulya Performance CIP, renowned for implementing their leadership program 'Causing Incredible Performance' (CIP) across various non-government and government departments other than health, HSTP collaborated with Athulya to adapt CIP to the health context for implementation in Odisha.

The program focuses on nurturing management leadership skills among in-service public sector physicians and empowering managers to achieve unprecedented performance levels. The program underscores the crucial role of decentralized leadership in driving impactful change and efficiently attaining healthcare objectives. Developed collaboratively with Athulya Performance Facilitators and anchored at the State Institute for Health and Family Welfare, this Leadership Development program based on the 'Causing Incredible Performance' (CIP) Framework, signifies an important step forward in transforming healthcare management in Odisha.

The first cohort of the Leadership Development program in Odisha took place in 2022. The intervention aims to develop leadership competencies among the in-service medical officers holding management positions in Odisha.  The leadership development journey encompasses the following steps:

• Identifying potential participants and collaboratively developing Key Result Areas and other progress parameters within the purview of the CIP Framework.
•  Implementing the CIP framework for the selected participants through designated methods (workshops and individual coaching sessions).
• Monitoring the progress of participants and providing necessary support throughout their learning journey.
• Documenting the intervention to disseminate insights and learning to a wider audience.

Causing Incredible Performance Intervention is a results-based program that focuses on individual and organizational goals, indicating performance. Organizations categorize these goals/ performances into four types:

 1. Business-as-usual goals/ performance, 2. Stretch goals/performance 3. Impossible goals/performance and 4. Incredible goals/performance.

A business-as-usual (BAU) goal represents achievements participants are highly confident in attaining. ‘Incredible performance’ is indicative of any performance between “stretch performance” and ‘impossible performance’.  Participants are instructed in the application of action principles to accomplish their self-set goals, facilitated through real-life coaching scenarios to yield organizationally significant outcomes. Participants establish a deeper connection with the framework by implementing these Action Principles beyond the classroom, producing unprecedented results.

Cohort 2 – Nov 2023 to March 2024

The second cohort of this four-month intervention program was carried out between 7th November 2023 to March 2024.

Module 1: Spanning from 7th Nov to 10th Nov 2024, Module 1 entailed a four-day residential workshop. This session featured face-to-face training, encompassing the selection of topics and goal-setting activities.

Module 2: Following Module 1, Module 2 comprised a three-month online weekly individual coaching/ mentoring sessions. Assigned coaches conducted these sessions to monitor progress and assist participants in overcoming challenges faced while achieving their goals, applying the Action Principles of CIP.

Midterm review workshop

A three-day Mid-term review workshop was conducted in Shillong, Meghalaya in February—the workshop aimed to review the participants’   progress and handhold the participants. Additionally, the workshop provided an opportunity for the visiting cohort from Odisha to gain insights into the healthcare systems of Meghalaya through an exposure visit to Tirot Singh Memorial Hospital in Mairang.

Areas of Interventions and Magnitude of Goals Taken

The participating physicians in the program tackled a broad spectrum of objectives, spanning the general management of hospital facilities such as the number of patients coming for OPD, number of telemedicine consultations, number of deliveries/surgeries performed, maintaining online records, and organizing the physical space within the health centers. Additionally, objectives related to addressing diseases and interventions/Government projects like Leprosy, Anaemia among pregnant women, HIV testing, facilitating blood donation, and providing care for hypertension patients were also pursued.

Remarkably, participants undertook incredible goals surpassing their usual performance benchmarks (BAU goals) by 1.2 to 7 times. This exemplifies the profound impact of the CIP program, which inspired them to take on goals of significant magnitude that may have seemed implausible and unattainable.

Among the twenty-two participants in the introductory workshop, eighteen declared their goals. Out of those who set their goals, fourteen participants achieved their incredible goals, with 78% of the participants successfully achieving their incredible goals.  Of the remaining four, two crossed their Stretch goals and the remaining two achieved their business-as-usual goals. Seven out of these fourteen participants also surpassed seemingly their impossible goals. One participant notably accomplished both of his incredible goals, one lasting for a month and the other for two months, demonstrating exceptional commitment and achievement.

Quantum Jump in Results

On average, the Incredible Goals undertaken were 1.94 times higher than the Business-as-Usual Goals, indicating ambitious targets set by participants. Furthermore, when comparing the average results achieved to the Business-as-Usual Goals, the magnitude was 8.82 times higher, underscoring the substantial performance enhancements. Notably, the most significant leap in performance was observed at 12.7 times the BAU goal, showcasing remarkable achievements within the program.

To summarize, the Leadership Development Program for district and block-level Medical Officers and Program Managers of Odisha, initiated in 2022, aims to enhance leadership competencies among in-service medical officers. It acknowledges the vital role of strong leadership in driving health program implementation. Through workshops, coaching sessions, and a midterm review workshop, participants enhance their skills and achieve remarkable goals, often surpassing their usual benchmarks. The program's success is evident in the significant performance jump observed, highlighting its transformative impact on healthcare management in Odisha.