International Hospital Federation (IHF): Which of Its 32 Competencies Are People Skills?

Why does the IHF model focus on what leaders do, not who they are?

During a team briefing, a junior doctor raises a concern about a new patient handover procedure. The department head could cut her off and repeat the instruction. Or they could ask what worries her, hear her out and then explain the decision. That seemingly small choice says a great deal about how someone leads. In 2023, the International Hospital Federation (IHF) introduced a model of 32 leadership competencies across six domains, developed with input from 45 experts in 30 countries and regions. It is not a personality profile of the ideal hospital executive. It describes capabilities that healthcare leaders need in their work. Instead of asking only, “Am I a good manager?”, a more useful question is, “What did I actually do when someone challenged my decision?”

Which IHF competencies matter most in conversations with staff?

Not all 32 competencies concern interpersonal relationships. The model also covers planning, financial management and understanding healthcare systems. But in everyday work with staff, several areas come to the fore: emotional intelligence and self-awareness (2.A), continuous improvement (2.B), communicating leadership decisions and the four competencies in the Relations domain. Those four concern developing and supporting employees, compassionate leadership, interpersonal relationships, and problem-solving and negotiation. In practice, these abilities often work together. A manager notices their own irritation, makes room for another point of view, explains what is expected, agrees on the next step and follows up. This is not a prescribed order of development or a ranking of personal qualities. It is a set of behaviours that become useful in specific workplace situations.

A natural tendency can explain a reaction, but it is not a skill

Personality can help explain why certain behaviours feel effortless while others take conscious work. It does not, by itself, show that someone leads people well. A medical director who makes decisions quickly and values directness may genuinely believe they welcome debate. Yet in meetings they may interrupt colleagues or dismiss concerns before hearing the full argument. The answer is not to change their personality. It may be to practise three observable habits: holding back an immediate reply, asking a follow-up question and checking that they have understood the risk. Research on hospital managers’ competencies also shows that performance depends on responsibilities, organisational support and working conditions. A psychometric profile can offer insight into preferences, motivations and values, but that insight needs to be tested against what happens in conversations and how colleagues experience them.

Time pressure is the real test of communication skills

Communication is hardest when people are exhausted, time is short and colleagues disagree. Suppose a hospital introduces a new approach to shift handovers. A senior clinician objects, junior colleagues fall silent and the manager wants to finish the briefing quickly. It would be easy to see the objection as defiance. A more skilful response is to distinguish the non-negotiable standard from the details that the team can help refine. The manager explains the purpose of the change, asks what might make it difficult and agrees who will do what next. This combines listening, communicating decisions and negotiating workable solutions. Reviews of nursing leadership communication emphasise clarity, active listening, trust and checking for a shared understanding. These are not abstract qualities: they are behaviours that colleagues can see, discuss and practise.

Different hospital managers need different development priorities

A newly appointed department head may need to work first on giving feedback. A chief medical officer may spend more time explaining organisational change, while an emergency department manager needs to issue clear instructions under intense pressure. The core interpersonal skills overlap, but the situations in which they are used differ. That is why the same generic training programme will not always meet everyone’s needs. A better starting point may be one or two behaviours that can be tried during the next shift: “When someone reports a problem, I will ask for the details before responding,” or “After giving feedback, I will agree on a specific next step.” The IHF model provides a framework; the person’s responsibilities and the department’s needs determine the priorities. A competency matters because it improves how people work together, not because it has an impressive label.

How do you know whether a manager’s people skills are improving?

After a month, a manager says they are listening better. How could anyone tell? Look for observable changes: do they ask more questions during briefings, return to concerns that staff have raised and leave employees clear about what is expected after feedback? It is better to examine a series of conversations than to celebrate one successful meeting. In its continuous improvement competency, the IHF stresses ongoing learning and development. A practical cycle is simple: notice what happened, reflect, choose one change, try it again and discuss the outcome. Completing a questionnaire or receiving a positive course evaluation does not prove that a new habit has taken hold. Progress becomes more credible when a manager starts responding differently even when time is short and the conversation is uncomfortable.

The IHF model brings structure to the competencies hospital leaders need. People skills, however, develop through small, visible changes: a more useful question, a willingness to hear concerns or feedback that clearly describes what needs to change. The priorities should come from the team’s real difficulties, with progress checked through everyday interactions.

How Empatyzer helps put the IHF’s interpersonal competencies into practice

A department head notices that staff have largely stopped raising concerns during briefings, even though those concerns still surface in private conversations. In Empatyzer, they start by reviewing their own profile, including a preference for decisive action that may shape how meetings unfold. They then tell Em about a recent briefing: what they said, how the team responded and the moment someone tried to speak up. They ask for two questions that would invite discussion, along with a way to close the meeting without putting unnecessary pressure on people. Before the next briefing, they choose one goal: listen to the concerns before offering a response. If colleagues’ profiles are available, they can also account for different communication preferences. Afterwards, they return to Em to reflect on what worked and what still discouraged discussion. Micro-lessons provide opportunities to revisit similar situations. In this way, the IHF’s competencies become practical behaviours a manager can work on throughout the working day.