How Inova Taught 2,000 Managers To Lead Using ‘Four Key Moments’


“Inova is in the midst of a very large transformation, both structurally and culturally. And a big part of that transformation is to a people-centered system of care. We started to think about what that actually means for our two-thousand frontline leaders. How should their behavior change to support this shift?”

—Sharon Blackborow, Assistant Vice President Learning & Development at Inova

How do you design and scale a leadership development program that will help shift your culture?

sustain-leadership-habits-previewThis was exactly the challenge faced by the leadership development team at Inova, a system of five hospitals in Northern Virginia. Scaling leadership development to 2,000 people managers as a five-person team is challenging enough. Tack on the fact that Inova is in a pivotal moment of cultural transformation, and you start to get a sense for how much Sharon Blackborow—Assistant Vice President Learning & Development—and Julie McKee—Director of Learning & Development—have on their plate.

Blackborow and McKee took a unique and highly impactful approach: They honed in on and trained “four critical moments in a frontline leader’s day-to-day work.” They called the program Leadership Moments.

Sharon Blackborow, Assistant Vice President Learning & Development & Julie McKee, Director of Learning & Development

Inova Shifted their Culture to Be More People Focused by Honing on “Four Key Moments” in a Leader’s Day-to-Day Work

How did Blackborow and McKee help frontline leaders make the shift from a financial focus to a people-centered focus? “What we realized,” Blackborow said, “is that we needed a way to help our frontline leaders harness a healthy tension between empathy and accountability. That’s what being people-centered means to us.”

To achieve that balance, Blackborow and McKee built a framework with the explicit goal of maximizing tactical, applicable learning. Inspired by Shane Green’s Forbes article, “Employee Experience Strategy: Seven Key Moments When It Comes To Performance,” and Dan and Chip Heath's book, The Power of Moments, they began to design their program around the concept of “critical moments in a leader’s day.” Blackborow and McKee then distilled Green’s seven moments down into four moments. McKee said, “The idea was to get really intentional about creating key moments that are memorable and positive in relationship building. The result was our Four Leadership Moments.”

The Four Leadership Moments they landed on were: 

  1. Starting the day well. 
  • Did I start the day well? 
  • Did I help my team members start their day well? 
  1. Being present and listening. 
  • Am I present and fully listening when my team members share? 
  1. Caring for self and others. 
  • Did I take a break? 
  • Did I help others take a break? 
  • Did I help support my team members?
  1. Ending the day well. 
  • Did I end my day well? 
  • Did I help my team members end their day well?

Within each of these four moments, they also train foundational skills like Recognition, Psychological Safety, Coaching, Empathy, Compassion, and Feedback. 

The Coach Approach: “Doing A Little, Often.” 

“Focus on behaviors, and the results will come.”
—Julie McKee, Director of L&D at Inova

One of the main reasons that Blackborow and McKee chose to focus on four core moments was that they wanted to focus the program on specific actions and tactics that were simple to apply. 

“Many of our participants,” Blackborow emphasized, “have strengths that fall more on the task side of things than the relationship side. So if we focus the program on behaviors, the end result will follow. We stay keenly tuned in to motivation and behavior. We show leaders exactly how to behave and let those behaviors lead to the end result of ‘empathy.’”

Both Blackborow and McKee are coaches and have an extensive background in coaching. So, they took a coach approach to develop their program. “This program was built through a coaching lens,” Blackborow explained, “not so much a learning lens. With that comes experimentation. We help learners determine what they want to practice and apply, and then we build enablement tools.”

McKee added, “Our modules all have items and tools that leaders can pick up and experiment with. We encourage leaders to modify these tools to make them authentic to their approach and style. For example, we have a ‘how to coach’ document with questions pre-listed. We provide that document in Word because we want leaders to edit it and make it their own.”

Inova Leveraged Micro-Learning, Nudges, and Peer Learning to Engage Busy Hospital Staff

All 1968 frontline leaders at Inova were automatically enrolled in Leadership Moments. 

They followed a monthly cadence for each of the four moments. With “busy staff” being a chief concern in healthcare, Blackborow and McKee leaned on bite-size eLearning videos to deliver the initial learning moment. Then, true to the “coach approach,” the majority of training happens as leaders leverage new tools to apply what they learned on the job.

Participants received two nudges per week with a “deep link” that enabled them to log in seamlessly without having to find and enter any credentials. The nudges led them to various “tools” related to that month’s topic. Tools ranged from videos to word docs and self-ranking scales. For example: 

  • A “Leader Discussion Guide” helps participants talk to their boss about applying what they learned.
  • A “Pay it Forward” Guide helps participants share and teach what they learned to their employees.
The “Pay it Forward” Guide helps participants share and teach what they learned to their employees.

Each month, participants also have the option to join peer learning groups. Peer learning sessions are about an hour and, again, focused on application.  Here’s a brief, high-level look at the agenda of these instructor-led peer sessions:

  • Opening
  • Review of the tool
  • 2-3 questions (Poll QR Code)
  • Breakout
  • Review 2nd tool
  • Breakout: How did you use it; impact
  • Tips to use in a remote environment
  • Download tools and documents and recap

Results: Impressive Participation, Adoption and Application Of Tools, and Self-Perceived Improvement

I speak with leadership development professionals every day, and participation rate is a constant thorn in the side for many. Recently, the head of leadership development at one of the biggest tech companies broke down how they made it their sole mission for a year to get their participation rate up to 20%. With that 10-20% benchmark rate of participation in mind, Inova achieved an impressive 53.5% participation rate in their first year of rolling it out. 

Since it’s their first-year pilot, Blackbarow and McKee looked at metrics like “use of tools” and areas where leaders most want to impact their behavior. Some key early results include:

  • 53.5% participation rate (compared to the industry eLearning average of 10-20%)
  • 95% of participants said that this micro-learning format was an effective way for them to learn.
  • 88% said they'd used that first tool, 86% the second, and 92% the third.
  • “Stronger relationships with team members” is the number one impact observed after using the Moment 1 tool. 
  • 30% of leaders who practiced the leader tools found improvement in stronger relationships with team members, 19% saw an increase in coaching conversations, and 19% saw an increase in morale.
This dashboard shows an example breakdown of the observed impact of the Moment 1 tool (left) and the desired impact of the Moment 2 tool (right).

Of course, Blackborow and McKee learned a lot through the pilot and are confident they will see strong improvements across the board as they continue to refine the program and its delivery. 

3 Pieces of Advice For Leadership Development Professionals

  1. Expect resistance to new learning initiatives, but push ahead. Blackborow said, “Expect resistance from senior leadership and don't let it stop you. Anytime you're trying to communicate something new like this, it looks like so much on paper. To an extent, you have to help your senior leaders learn your vision as you execute.”
  2. Put together diverse, cross-functional focus groups and listen. McKee said, “We are a small, in-house team. The bottom line is when working with a small team, involving our clinical and operational front-line leaders and asking them to test the content was imperative! Through involvement with our focus group, we were also able to identify frontline leaders who were willing to be featured within the program and offer ideas about how they help care for their teams. Their presence and examples resonated with our participants.”
  3. Micro-learning is not one-size-fits-all. McKee said, “When we launched our primarily micro-learning-based program, we received a lot of requests to help implement other content in the same framework. Be prepared to have conversations about your team’s intake process and how you determine what modality will be most effective, dependent on desired learning outcomes, desired learner actions, and learning barriers. Also, be prepared to articulate a realistic timeline for program development and time investments for stakeholders and subject matter experts. It’s okay to share that a two-minute animated video could take approximately eight to sixteen hours to develop, script, test, iterate, and launch.” 


CEO of LEADx, and NY Times bestselling author, of Great Leaders Have No Rules and Employee Engagement 2.0. Get a FREE demo of the LEADx platform at