In chapter $1,$ the author discusses six obstacles that healthcare leaders face $($beginning on page $7).$ Select one of the obstacles that relates to your experience or interests you.$$ Is this a major obstacle, yes or no$?$ DO you agree with the imperative action provided? DO you have an alternative action?

Short Answer Assignments.$$ These assignments will require you to analyze a situation, scenario, or leadership concept and provide a brief opinion.$$ In some assignments, questions will be listed that need to be addressed, in other assignments you will be asked to consider or reflect or evaluate. The expected length should be approximately one page, sometimes a$$ little shorter and sometimes a little longer. It is important that your response be based on your opinion, personal perspective and experience, and be supported. Obstacle $2$: Employee Engagement and Loyalty Are Low

Opinion surveys continue to reveal that employee commitment and engagement are decreasing. According to Gallup $(2016),$ "A staggering $\backslash (87\backslash \%\backslash )$ of employees worldwide are not engaged at work. The world has a crisis of engagement$-$one with serious and potentially long$-$lasting repercussions for the global economy."

Job security is one of the most important elements of a highperformance work environment. For a long time, healthcare offered just that: job security. Employees, in turn, showed their appreciation for this security by being loyal to the organization. Employees stayed at their jobs longer, performed harder and better, recommended family members and friends to apply for open positions, missed fewer workdays, and participated more in the activities of the organization. Gallup has developed a well$-$known employee engagement tool and has shown that engaged employees are more productive $($Adkins $2016).$

Today, even the hardiest healthcare systems cannot ensure jobs for their employees. One CEO suggests that the high levels of trust between management and staff that once existed in the healthcare field may never return: "I remember the first time I faced a room full of hospital employees who were to be laid off. That was is years ago, and I personally talked to all of them. However, the last three

$8$ Leadership in Healthcare