Jessie Michaelson Our organization has grown from 25 employees to over 70 in less than four years. Originally, I was responsible for supervising all of our support staff, which was less than 20 people. As the organization grew, so did the need for additional management support. I was unable to give each staff person the level of support that they needed. Initially we created Lead positions for each of our three main support staff areas, Front Office, Medical Assistants, and Care Coordination. We selected the leader for each area from the current staff that worked in these roles and who demonstrated an interest and ability to lead their respective teams. We have since added additional lead roles for other support areas. I have worked very closely with this entire group to help them become what we call our Middle Mangers. They are the liaisons between the entire support staff and the Executive Team. Challenges – 1)staff found it difficult to change who they reported to; 2) selecting a manager from the department, who was technically skilled in the position, but didn’t have any management experience; 3) added one more layer between the Executive Team and the support staff; 4) as our organization continues to grow we need additional management support. Overcoming the Challenges – 1) continue to work with the Middle Managers to help them gain the trust and respect of their staff 2) continue to coach the Middle Managers as we work to develop a strong workforce 3) work to make sure that the Executive Team is available and visible to all staff and try to make sure that the Executive Team is not making decisions without the input of the staff that are affected by the decisions; 4) we are currently developing assistant manager positions and working to figure out how to incorporate these staff into the leadership role. Results – The creation of the Middle Manager positions have allowed us to grow employees who have an interest in leadership who we might have lost to other employers if we weren’t able to give them growth opportunities. We have also been able to hire staff for entry level positions who have very little professional experience and help them be successful because they have more support from their manager. We were also able to create Standards of Behavior and as a group we work to help hold all staff accountable to these standards. Successful Outcome – I act as the liaison between the Middle Managers and the Executive Team. I am responsible for bringing information back and forth between the two teams. I get to spend lots of time working the the Middle Managers as a group and individually as they face new and/or challenging management situations. We talk through the conversations that they need to have with their staff. We are currently working on a team building project to help the Middle Managers and the Executive Team work together better. We are all learning/relearning Lean practices and working on projects to improve efficiencies within our organization.