The healthcare sector is a complex, fast-moving and profoundly human world in its own right. Managing in this field is not something you can improvise: it requires a leadership posture capable of combining rigour, adaptability, humanity and operational efficiency. Between institutional requirements, budget constraints, a shortage of qualified professionals and growing patient expectations, the challenges are numerous. How do you manage successfully in this sector? What are the strategies and best practices to adopt? Sandrine Pierrat, health executive and trainer, specialising in management, quality and risk management, provides the answers.
The role of the manager, whether health executive, senior health executive or director of care, goes far beyond administrative or organisational management. It's about uniting teams around common objectives, guaranteeing the quality and safety of care while maintaining a healthy, respectful and motivating working environment.
Key figures
62 % of healthcare managers say they do not have enough time to support their teams (FHF, Hospital Management Barometer, 2024)
1 in 3 carers wants more recognition on a daily basis (HAS, Enquête sur la qualité de vie au travail, 2024)
70 % of teams that have benefited from a continuous improvement project report better cohesion (DREES, Report on team dynamics in health establishments, 2024)
Creating a positive and collaborative working environment
A healthy, cooperative and stimulating working environment is the basis of any effective team dynamic. This is particularly the case in healthcare establishments, where tensions can be frequent and the emotional load high.
Transparent and open communication
The quality of internal communication is a determining factor in collective cohesion and performance. Transparency, active listening and mutual respect are the pillars of this communication.
Marie-Hélène, healthcare executive in medical and rehabilitation care (SMR) :
"Introducing weekly meetings where everyone can express themselves freely has transformed relations within the team. Caregivers now feel listened to and considered.
Team meetings should not simply be downward transmissions, but a forum for exchange, regulation and co-construction.
Example of a team meeting
Duration: 30 minutes
Frequency: every Thursday at 1.30pm
Participants: managers, state-registered nurses, nursing auxiliaries, rehabilitation specialists, social workers, psychologists, hospital service agents, etc.
Objectives: circulate information, regulate tensions, coordinate actions, suggest improvements, etc.
Welcome by the manager: reminder of the rules (active listening, no interruptions, respect for opinions)
Positive points from the past week
Follow-up on actions decided the previous week
Reviewing the problems raised previously and checking that they have been resolved: for example, improving the management of care trolleys, updating physiotherapy schedules.
Examples of topics discussed among those on the agenda: organisation (for example, difficulties in coordinating rehabilitation schedules with hygiene care).
Recognition
Valuing effort and success is a powerful source of motivation and loyalty. A simple thank you, some well-formulated positive feedback or a written note of recognition can have a far more profound impact than you might think.
Lionel, Director of Care:
"Congratulating an agent on his or her involvement in a complex situation boosts the agent's self-esteem and creates a collective dynamic".
Example of positive feedback
During a particularly busy week (2 absences that could not be replaced, several emergency admissions), the afternoon nurse spontaneously reorganised the care planning with the HA present to ensure that care was provided on time, while maintaining the quality of communications.
Positive feedback from the manager
"I'd like to congratulate you on the way you handled the situation on Friday. As soon as you heard about the absences, you quickly reviewed the priorities, organised the distribution of tasks with your partner and informed the night team of the changes. Thanks to your organisation, all the care was delivered on time, and communications were clear and precise. This kind of responsiveness and coordination is invaluable for the quality of care and the well-being of the team. Keep up the good work!
What the manager did in concrete terms :
Direct observation: he took the time to observe the behaviour and its effects.
Immediate feedback: feedback given the following Monday morning, so that the action is still fresh.
Clear structure: facts observed → positive impact → encouragement to continue.
Get trained!
Would you like to strengthen your managerial posture and communication skills to instil a positive team dynamic and successfully achieve your objectives? Discover the training programme Team management: best practice.
Key points:
- Identify the management style best suited to your employees
- Activating the levers of motivation
- Adapting your communication to situations and people
- Supporting your team on a daily basis
Examples of practical exercises :
- Giving feedback, adapting your management style to a given situation
- Self-diagnosis to discover your own management style
Read also : Feedback: a lever for successful management
Managing conflict
Tensions are part and parcel of team life, especially in high-pressure organisations. The role of the manager is therefore to prevent, identify and defuse conflicts, without ducking the issue.
The aim is not to "police" the situation, but to establish a clear framework and support the parties involved towards a constructive resolution. Managers can draw on tools such as mediation, systemic analysis and sympathetic reframing interviews.
Some useful tools
Mediation
Two care assistants have not been talking to each other for several weeks, following a dispute over the allocation of toilets. The atmosphere in the team is tense, and other colleagues are starting to take sides.
Executive action :
- Organise a meeting with the two carers in a neutral setting
- Establish rules: listen without interruption, respect, no personal accusations
- Invites everyone to explain their feelings and their perception of the facts
- Rephrase to clarify and identify common ground
- Concludes with a written agreement: clear division of tasks and commitment to exchange information directly in the event of a problem
Result:
The two professionals start communicating again. The latent conflict is defused, avoiding a lasting deterioration in team cohesion.
Systemic analysis
There are recurring tensions between nurses and physiotherapists over patient mobilisation times. Each profession accuses the other of not respecting the organisation.
Executive action :
- Does not try to point the finger of blame, but observes the whole operation
- Identifies that schedules are drawn up separately, with no interdepartmental coordination
- Brings together the stakeholders to visualise the distribution of interventions around the patient on a chart
- Set up a joint schedule
Result:
The structural source of the conflict (partitioned schedules) is eliminated. The IDE-physiotherapist relationship improves because the root cause is tackled.
Caring reframing interview
A member of the hotel staff regularly speaks abruptly to patients, leading to complaints.
Executive action :
- Convene the employee promptly for a one-to-one meeting, in a calm atmosphere
- Gives a precise description of what was observed ("Three patients have reported to me that they were very terse when meals were being served").
- Listen to the agent's version (stress, overload, lack of communication training)
- Rephrase to confirm understanding, then reiterate professional expectations
- Provides support (patient reception training + field observation)
- Set a follow-up period of 1 month
Result:
Behaviour changes for the better, the agent feels supported rather than judged, and the complaints stop.
Training
Managing conflicts in the health and medico-social sector
Many healthcare establishments are regularly faced with conflicts that disrupt their operations. This training course aims to equip managers to prevent and manage such situations more effectively, in order to maintain the efficiency of their teams and the quality of their working lives.
Supporting team skills development
Care professionals are constantly learning, because the sector is evolving at a rapid pace. Managers must be the driving force behind this dynamic of continuous development, both individually and collectively.
Continuing training linked to needs in the field
Offering training that is relevant and adapted to identified needs helps to maintain a high level of quality in practice and to reinforce professionalism.
Themes :
- Geriatrics : bientraitance, Alzheimer and related dementias, palliative care and end of life
- Emergencies : violencecommunication
- Surgery: wounds and healing, mobilisation equipment, pain
- Paediatrics: care through play, relationships with families
- Medicine : targeted transmissions, home
Organising regular professional interviews, identifying employee expectations and co-constructing training plans are all ways of making the approach lively and effective.
Case study: needs assessment and training proposals
Stage 1: Preparing for the interview
The manager prepares for the interview by reviewing the healthcare professional's current performance, training history and the objectives of the unit or department. They also prepare a list of open questions to guide the discussion.
Stage 2: carrying out the interview
During the interview, the manager and the healthcare professional discuss the following points:
- Current skills assessment: what are the professional's current skills and how are they used in their day-to-day work?
- Expectations and aspirations: what are the professional's career objectives? What new skills would they like to acquire?
- Identifying needs: are there areas in which the professional feels less competent or would like to improve?
Example: healthcare professionals may need to improve their skills in interpreting complex ECGs in an emergency. This need arises from stress or a lack of fluency and has a direct impact on the safety and quality of care.
Stage 3: Co-construction of the training plan
Once the need or needs have been identified, the manager and the employee work together to explore possible development solutions. This collaborative phase ensures the support of the professional and the relevance of the actions.
The plan can mobilise various levers:
- external training leading to certification: enrolment in specialised courses offered by recognised training organisations (e.g. training in advanced ECG reading, training in therapeutic patient education)
- in-house training, participation in workshops
- tutoring and mentoring: organisation of support by a more experienced peer or a mentor in a specific field to transfer practical skills
- other methods: participation in conferences, professional congresses or enrolment in a university diploma (DU).
The choice of actions depends on the nature of the need, the agent's profile, the department's timetable and the resources available.
Stage 4: Planning and monitoring
The manager and the healthcare professional agree on a training plan, including dates and participation arrangements. They also set follow-up points to assess progress and adjust the plan if necessary.
Stage 5: Post-training evaluation
After the training, the manager and the healthcare professional meet again to assess the effectiveness of the training and discuss the next steps. This may include identifying further training needs or adjusting career objectives.
By following these steps, the professional interview process becomes a dynamic tool for the ongoing development of skills and the satisfaction of healthcare professionals.
Mentoring new professionals, the key to integration and transmission
The arrival of a new agent is a delicate stage. Structured support, provided by a trained and willing tutor, makes for a smoother integration, reduces initial stress and encourages loyalty.
Julie, health executive in orthopaedic surgery:
"Having a mentor during my first days as a nurse enabled me to adapt quickly and was decisive in my staying on the ward. I now do the same with new arrivals.
Tutoring also helps to develop andragogical skills and to pass on knowledge to new colleagues, students and pupils, which reinforces the feeling of recognition.
Definition of andragogy
It is the art and science of teaching adults, as opposed to pedagogy, which is more concerned with teaching children and adolescents.
In the context of healthcare tutoring, andragogy is based on a key principle: adults learn differently from children. They come with experience, knowledge and perceptions of the profession, and they expect the training to be directly useful to their professional practice.
In a hospital department, a tutor who applies andragogy :
- Involves the newcomer or student in care as soon as possible
- Relate the explanations to real-life situations in the unit
- Builds on the knowledge that the individual already possesses
- Uses constructive feedback to reinforce autonomy and confidence
- Gives meaning to procedures by explaining their practical impact on the patient and the team
Constructive delegation: empowerment without offloading
Delegating is not just about allocating tasks, it's about helping people to grow. It's not about disengaging, but about supporting, guiding and valuing initiatives.
Agnès, manager in a long-term care unit (USLD) :
"When I give an assignment, I remain available, clarify the objectives and provide support. This empowers and energises the team.
Read also : Delegating and empowering: best practices
Optimising the organisation and management of resources
The manager is a key player in organisational performance. They must be able to juggle limited resources while guaranteeing the quality of their services.
Managing time and priorities
In a sector where unforeseen events are frequent, planning and prioritising are crucial skills. Using project management, collaborative planning and visualisation tools helps to structure your activity.
Anne, health executive in home hospital care (HAD) :
"Thanks to a shared planner, we've reduced the number of oversights, duplications and tensions linked to unforeseen events".
Ensuring budget transparency
Transparency about available resources, costs and trade-offs creates a dynamic of collective responsibility. Too often perceived as taboo, the budget issue can become a lever for mobilisation.
Aurélie, dialysis manager:
"By explaining the budget constraints, I was able to involve the nurses in optimising the use of consumables. The result: a reduction in waste.
Examples of optimisation :
Dialysis filters: use them to their maximum capacity
Dialysis solutions: prepare the quantity required for each session
Dialysis solution bags: using distribution systems
Sterile gloves: training with an operational hygiene team (EOH) to ensure correct use
Disinfectants: use appropriate dispensers
Bandages: use appropriate sizes to reduce falls and waste
Compresses: calculate the number needed before treatment
Encouraging innovation and continuous improvement
Healthcare establishments need to innovate in order to adapt to changing needs, regulatory requirements and technological developments. The manager is the catalyst for this dynamic.
Encouraging creativity and initiative
Fostering a climate where new ideas are positively received stimulates motivation and involvement. These ideas can range from simple day-to-day improvements to more ambitious projects.
Emma, paediatric executive :
"We have set up a 'success wall' featuring testimonials from families and positive care outcomes. This initiative has boosted staff morale and created a real team spirit."
An environment where ideas are welcome, even the most audacious ones, nurtures creativity and develops autonomy.
Using data and performance indicators
Data-driven management enables fact-based management. Quality, satisfaction, absenteeism and incident indicators are invaluable tools for objectifying findings and guiding action.
Michel, Quality Manager:
"Complaints rates and satisfaction indicators enable us to identify areas for attention and to make continuous improvements.
Supporting change
Any change (new tool, reorganisation, new protocol) must be supported if it is to be accepted. This requires information, training, dialogue and the appointment of liaison officers.
The manager must become a facilitator of change rather than an authoritarian agent.
Towards inspiring, embodied and sustainable leadership
Managing in the healthcare sector is not just about managing teams and schedules. It also means embodying a vision, creating links, supporting the quality of care and the well-being of professionals. Managers need to know how to listen, arbitrate, unite and protect. They must also know how to say no, set a framework and assert a clear guideline.
Effective leadership in this sector is based on 4 fundamental pillars:
1. Setting an example not demanding what you don't embody
2. Professional empathy understanding the emotions and needs of teams without getting emotional
3. Communication developing active and sympathetic listening skills
4. Clarity setting clear objectives
Keep in mind that your impact is not measured by figures alone, but by the confident looks in people's eyes, the close-knit teams, and the care delivered with dignity and kindness.
Would you like to learn more about managerial communication? Discover the training programme Managing in the health and medico-social sector.
Key points:
Communicating in difficult situations
Developing your posture as a communicative manager
Optimising communication with employees
Mastering the emotional dimension of managerial communication
