Every five years or so, health care CEOs rediscover an employee-engagement strategy known as management by walking around. Also known in some Big Business circles as management by "wandering" around, which, personally, I think sounds like more fun.

The idea, of course, is that the CEO gets together with front-line employees and managers on their turf and meets them personally, hears their concerns and delivers some kind of reassuring, grateful message. He then would, well, wander off—in many cases, never to be seen again in that neck of the woods.

The last time walking about was in vogue was as a well-meaning attempt to build a culture of safety. It intended to send a top-level message of commitment, openness and communication about tough patient-safety issues. As an opening salvo in the never-ending culture-of-safety battle that we continue to wage today, it probably did much more good than harm. But then for the devil to be in the details, we actually need some, well, follow-up details.

In fact, most of these "impromptu" events were planned in detail, escorted and scripted, with 24-hour notice so that people in the visited area could "prepare" for the unexpected. (Not sure if photos were distributed in advance to staff.)

Perhaps the next time we go for employee engagement we should try for a more authentic, radical experience, say something similar to the reality-television show Undercover Boss.

Each episode features a CEO who leaves the cozy, comfortable corporate digs to work undercover as an entry-level employee. For about a week, they work in different parts of the company with varying degrees of success. Joe DePinto, CEO of 7-Eleven, donned an orange smock and served coffee while spilling somewhat less than he delivered, and failed to keep up with the conveyor belt in the doughnut bakery. Larry O'Donnell, former president and COO of Waste Management, picked up garbage cans, cleaned portable toilets and came very close to being fired the first day for his fumbling inability to bag litter.

The CEOs featured all had differing types of strong personalities, but they all seemed to learn some humbling universal truths:

  • Front-line work is exhausting and takes a heavy toll on the body by the end of each day.
  • You are dependent on these employees. They are the direct link between the consumer, public perception and the ultimate success of your organization. Yet, these are the same employees you know and understand the least.
  • They are not likely to be consistently rewarded or signaled out for outstanding performance.
  • Decisions made in the C-suite may make it more difficult for them to perform their jobs because no one checks up on the outcome of those decisions, and no one solicits their ideas.

I know we feel we are living in a time of uncertainty, big ideas and transformational change. But who is going to execute those big ideas—day in, day out?