The purpose of this study was to explore senior leaders integration of the National Center for Healthcare Leadership (NCHL) competency model within their employee evaluation system. This case study was conducted to explore how the NCHL leadership competency model is used within their organization's employee evaluation system. The NCHL leadership competency model guided this study. The research was an exploration of themes in leadership competencies used in the healthcare organization. Data collection included in-depth interviews with 10 healthcare junior leaders in a single healthcare organization in the Midwestern United States who had at least 1 year of experience as a leader and a review of secondary data related to their job skills and annual evaluations. Using Saldana's method of data analysis, 4 primary themes emerged: leaders are transformed by vision and focus, leaders need continuous training, leaders like accountability, and leaders like influence goal creation. The 4 themes indicated that participants perceived NCHL leadership competencies integrated in their performance evaluation system to be of benefit. The findings revealed senior leaders might benefit from integrating the NCHL competency model in new leader orientation competencies, leadership training, and performance assessment tools. Positive social change may result by successful implementation of the NCHL leadership competency model strategies from this study, improving societal healthcare through efficient healthcare delivery.

Effective leadership in healthcare improves the patient experience. Self-awareness drives leadership development, competence, and, in turn, leader effectiveness. The problem addressed by this study was the absence of knowledge regarding how healthcare leaders develop awareness of their leadership strengths and weaknesses: their competence. The purpose of this postintentional phenomenological study was to explore how healthcare leaders develop this awareness. Twelve midlevel nonclinical healthcare leaders from 3 hospitals in the Pacific Northwest region of the United States shared their experiences during semistructured interviews. Participants and their organizations contributed supporting documentation of competence and performance expectations. Following Vagle's postintentional process, data were reviewed holistically and then in detail in multiple iterations. A reflective plan, including a postreflective statement, created prior to data collection and reviewed throughout the study, elevated and abated researcher bias and potential for influence. This plan also served to question the emerging themes and contributed to the trustworthiness of the study. In response to the research question, the necessity of honest and constructive feedback and use of self-reflection to elevate understanding of leadership competence emerged. The shared participant experiences elevated five feedback mechanisms of greatest value: quantifiable results, person-person, recognized capabilities, environmental/relational, and self. Adoption of recommendations for practice, such as an improvement of performance-evaluation processes or the development of a feedback culture, could contribute to social change through the development of effective healthcare leaders. Honest and constructive feedback, with reflection, contributes to gained awareness and identification of developmental needs.

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