Team Climate in Healthcare Management Decision Simulation Leadership Masterclass Series
Intro

The case

Webber Health · Manager, Ambulatory Operations

You finished your administrative residency and took this job eight months ago. It is your first permanent leadership role. You run operations for one large multispecialty ambulatory clinic — about forty-five people across patient access, scheduling and referrals, day clinic and late clinic. Two supervisors report to you directly; two team leads coordinate the floor through them. One of the supervisors has been here since before you finished high school.

You report to the Director of Ambulatory Operations. Many of the problems you will need to solve extend beyond your own span of control: provider-template changes require Medical and Nursing leadership, enterprise referral rules depend on Patient Access partners, reporting infrastructure depends on Analytics, and additional resources require Finance and senior approval. You also share an operations analyst who supports access, workflow and performance analysis.

What happens next

You will walk back through the eight months you have already had — month by month, then how you spent the time nobody assigned you.

Answer as you would actually have played it, not as you think a good administrator should.

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

Your performance

    Your performance

    What else did you do?

    Beyond the day-to-day work

      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.
      04

      Your gut impression of the environment

      Based only on what you currently know, where do you think psychological safety sits in this team? Look back at the items you marked as most strongly associated with it and weigh them together — do they point toward a favorable environment or an unfavorable one?

      This is your managerial read — not a measured psychological-safety score.

      65
      High

      Reassuring — most people would speak up about most things

      0255075100
      Very lowSerious concern LowConcerning ModerateNeeds attention HighReassuring Very highStrong

      Simulation interpretation scale; not validated cut points.

      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?

      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

      Your organizational capacity to get things approved outside your own span of control. It reflects the working relationships you built over your first eight months.

      You can carry forward at most four actions. No manager can attend to everything at once, so you are choosing under bounded rationality as well as limited capital.

      CYCLE 2 

      Now go ask for it

      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?

        Where you are

        You have diagnosed the area and taken a treatment forward. Nothing will tell you whether it worked, or whether it holds, unless you decide to watch for it.

        4
        Monitoring bandwidth remaining
        0 chosen

        For this round, your constraint is management attention. Every method below is available for you to consider, and your political capital is not being spent or measured here. In practice, some approaches would also require organizational support or resources.

        Cycle 3 · Director check-in

        Your Director stops you

          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.