Intro

The case

Webber Health · Manager, Ambulatory Operations

Your roleManager, Ambulatory OperationsEight months in · your first permanent leadership role

Your clinicAbout 45 peoplePatient access · Scheduling & referrals · Day clinic · Late clinic

Your leaders2 supervisors, 2 team leadsThe team leads coordinate the floor through the supervisors

You report toDirector of Ambulatory Operations

You depend onDepartments you don’t controlMedical & Nursing leadership · Patient Access · Analytics · Finance

You finished your administrative residency and took this job eight months ago. One of your supervisors has been here since before you finished high school.

Many of the problems you will need to solve sit outside your span of control. Provider templates need Medical and Nursing leadership. Referral rules depend on Patient Access. Reports depend on Analytics. New resources need Finance and senior approval.

You share one operations analyst who supports access, workflow and performance analysis.

Webber Health, its leadership and all characters in this simulation are fictional. Any resemblance to real organizations or individuals is coincidental.

Your performance · Month 1 of 8

—

Your taskPick the one closest to what you would actually do.

Your performance

What else did you do?

Your taskYou had 14 units of time beyond the day-to-day work. Spend them the way you actually would have.

14

units of time left

0 chosen

Nobody assigned any of this. You had limited bandwidth and you spent it somewhere.

Baseline result

What your first eight months produced

Your performance review, from your Director

How the same eight months appear in the formal record.

Overall rating Meets Expectations

Operational metricsExceedson target

BudgetFavorable−1.8% to plan

Patient accessImproved+4 pts

GrievancesLow2 year to date

Recommended for continued development in role. — Director of Ambulatory Operations

Facilitator pause

Stop here

Review your results, then return to the main session with Dr. Webb.

Review completed choices. Decisions cannot be changed.

Stay on this screen until you are instructed to continue.

Cycle 1

Your analysis: What do you make of the climate?

01

The formal picture

Your quarterly scorecard for Ambulatory Operations

02

The informal picture

What you have heard, noticed and been handed — none of it is on the scorecard

Your Director's read

“This is one of the stronger areas in my portfolio. Access is up, complaints are down, patient safety is moving in the right direction, accountability is improving, and leadership activity is exactly where we want it. Whatever you're doing, keep doing it.”

In your one-on-one last week

“And people stay. Turnover ticked up a little this year, but my long-tenured staff are still here — some of them fifteen, twenty years. People don't stay that long somewhere they don't feel safe.”

Same conversation, on retention

What you notice day to day

Staff meetings run according to schedule. Agenda items pass without conflict and decisions get made on time.
People linger in the break room afterward and the conversation keeps going. The mood is warm and everyone seems glad to be there.
Your supervisors speak confidently for their teams, so you rarely have to fill in gaps in a meeting.
You hear very few complaints. When something does come up it usually reaches you through a supervisor, already handled.

Your own observations across the clinic.

Other signals on your desk

03

How the clinic operates

The routines and processes employees work within every day

Survey participation

Annual employee survey completion is tracked by department. Managers receive completion updates throughout the survey window, and departments are expected to reach 100% participation.

Shift huddles

Each operating area holds a required start-of-shift huddle led by the team lead or supervisor using a standard operational agenda.

How concerns reach you

Most employee concerns that reach you come through a team lead or supervisor. Employees are not formally required to use that route.

Performance and error follow-up

Supervisors may use coaching, written counseling, formal corrective action, or a performance improvement plan under existing HR policy. Formal actions are documented by the supervisor.

Management meetings

Meetings follow a standing agenda. Unresolved items may be carried forward to a subsequent meeting.

Executive walkrounds

Executive walkrounds are scheduled in advance. Managers receive the planned route and timing before the visit.

Step 1

What matters most?

Select up to six pieces of information most strongly associated with psychological safety here.

Choose on relevance, not on whether the information is favorable or unfavorable. Strongly relevant evidence can point either way.

0 of up to 6 selected You can change your selections until you lock your assessment.

Step 2 · Your gut instinct

Look back at the pieces of information you selected as most strongly associated with psychological safety. Taken together, do they point toward a favorable or an unfavorable environment? Use the slider to set your gut instinct.

65

High

Reassuring — most people would speak up about most things

0255075100

Diagnostic result

Your gut impression

Here’s what informed your diagnosis.

Facilitator pause

Stop here

Review your results, then return to the main session with Dr. Webb.

Review completed choices. Decisions cannot be changed.

Stay on this screen until you are instructed to continue.

Cycle 2

What will you do?

Your taskChoose up to four actions. Look at all four tabs before you commit.

Within your authority No approval requirement shown. You can act on it yourself.

Requires approval Marked with the department that has to agree. Costs political capital.

6

Political Capital Available

0 chosen

Political capital is your capacity to get approval outside your own span of control. It reflects the relationships you built in your first eight months.

CYCLE 2

Now go ask for it

Your taskAnswer all four questions.

One approach, for every request.

Treatment result

What did your treatment change about the climate?

Facilitator pause

Stop here

Review your results, then return to the main session with Dr. Webb.

Review completed choices. Decisions cannot be changed.

Stay on this screen until you are instructed to continue.

Cycle 3

How will you know whether the climate is changing?

Your taskChoose how you will keep watching. You have 5 units of attention.

4

Monitoring bandwidth remaining

0 chosen

Political capital is not spent here. Your only limit is attention. In practice, some of these methods would also need organizational support.

Cycle 3 · Director check-in

Your Director stops you

Your taskChoose your response.

She's waiting.

Monitoring result

What did the signals tell you?

After your monitoring period

Facilitator pause

Stop here

Review your results, then return to the main session with Dr. Webb.

Review completed choices. Decisions cannot be changed.

Stay on this screen until you are instructed to continue.

Debrief

Your leadership footprint

What you changed inside the team, what you built outside it, and what that allowed you to do.

01 · Your impact on psychological safety within your team

Everyone in this room inherited the same team.

02 · How you operated across the organization — political skill

Four facets, inferred from your choices in this run. Tap any facet to see which decisions contributed.

03 · Who you built relationships with — political capital

04 · Mobilizing the organization

05 · Managing the climate

Your decision history

Every choice you made, in order, with the situation you were in and the evidence you had.

Keep your results

Before you leave

Please take a short 3-minute survey about your experience with the simulation.

Take the 3-minute survey