The competency game: my take on what it really takes to lead.

Beaufort Longest, PhD, University of Pittsburgh, articulated core managerial competencies in his article, "Managerial Competence at Senior Levels of Integrated Delivery Systems." Longest was referring to the six core competencies necessary to manage an integrated health system--conceptual, technical managerial/clinical, interpersonal/collaborative, political, commercial, and governance competencies. In this article, I add some practical advice to Longest's concepts in three of the competencies--conceptual, technical managerial/clinical, and interpersonal/collaborative. This advice is based on lessons learned during a career path that began as a bedside nurse, moved through each level of nursing management, and then broadened into hospital administration and health system management.