CHAPTER 9
LEADING:
THEORIES AND MODELS
Management of Healthcare Organizations: An Introduction
Third Edition
Peter C. Olden
Copyright © 2019 Foundation of the American Coll
ege of Healthcare Executives. Not for sale.
Learning Objectives
Studying this chapter will help you to
define and explain leading;
examine, compare, and contrast leadership
theories and models;
identify practical tools and approaches for leading
workers in organizations; and
describe ideas for leading physicians.
Copyright © 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
What Is Leading?
Leading: A process by which a person
tries to influence someone else to
voluntarily accomplish a task, goal, or vision
Leading is part of managing
All managers lead (so do some other people)
Many theories and models explain leading
Copyright © 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
Traits and Skills Theories
Examined traits and characteristics of leaders
• Early studies emphasized intelligence, extraversion,
confidence, initiative
• Later research focused on being ambitious, adaptable,
persistent, cooperative, assertive, decisive, energetic,
social, responsible
• Effective leaders did not have all of these traits
Traits led to studying skills: technical, conceptual,
and human skills
Recent trait studies
• Focus on emotional intelligence, self-confidence, integrity,
other traits
Copyright © 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
Behavior Theory
Focuses on leaders’ behavior (also called leadership
styles)
Examines what leaders do
• How they behave and conduct themselves
Leaders rate low to high for two dimensions of
leadership:
• Job-centered behavior (concern for production and work)
• Employee-centered behavior (concern for people)
Copyright © 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
The
Managerial
Grid
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College of Healthcare Executives. Not for sale.
Situational Theory
There is no universal one best way to lead
Best way to lead is contingent—depends on the
situation and people
Effective leadership depends on characteristics of:
• Leader
• Followers
• Situation
One size does not fit all.
Copyright © 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
Hersey Blanchard Situational Model
As worker’s readiness for task increases, manager
adjusts leadership style
• Task-oriented behavior (i.e., production orientation)
• Relationship behavior (i.e., people orientation)
Low readiness, manager leads with high task and low
relationship emphasis
Low to moderate readiness, manager leads with high task
and high relationship emphasis
Moderate to high readiness, manager leads with low task
and high relationship emphasis
High readiness, manager leads with low task and low
relationship emphasis
Copyright © 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
Theory X and Theory Y
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College of Healthcare Executives. Not for sale.
Theory Z
Assumes workers want close, supportive working
relationships
Leader. . .
• Emphasizes concern for workers
• Develops long-term cooperative relationships
• Provides workers slow, steady, long-term growth
opportunities
• Promotes individual and collective responsibility
Supervisors influence workers using trust and
teamwork while avoiding fear and reprisal
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College of Healthcare Executives. Not for sale.
Transactional and
Transformational Leadership
Transactional leader transacts a deal with the followers
Followers: provide work, complete tasks, obey rules
Leader: gives followers pay and rewards
The deal tends to maintain the status quo
Transformational leader uses compelling vision, inspiration,
charisma, intelligence, and individual attention to employees
to revitalize organization with change for greater good of all
Inspire and empower others
Appeal to greater good for everyone
Help employees and organization grow, develop, innovate
Copyright © 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
Servant Leading
Servant leadership: A leader serves followers
to support them and help them succeed
Leader serves followers by respecting, empowering, hearing,
teaching, mentoring, understanding, helping
Leader serves followers by:
• Providing them resources
• Meeting their needs
• Helping them grow
Bottom-up approach with more power and control to
followers than top-down leaders would allow
Servant leading expected to:
• Improve workers’ goal achievement
• Develop future managers
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College of Healthcare Executives. Not for sale.
Collaborative Leading
Collaborative leading: used to form and lead
interorganization relationships
Useful to form networks, integrated systems, accountable
care organizations, alliances, other collaborative
structures
Leading people from multiple organizations toward a
common purpose
• Leader lacks direct control or authority over followers
Collaborative leading uses collaborative skills
• Conflict resolution, teamwork, create trust, share power, share
credit, influence without authority, political skills
Copyright © 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
Leadership Competency Models
Leadership competencies: skills, knowledge, values,
and traits that guide leader’s performance,
behavior, interaction, decisions
Recall early leadership studies and theories for
traits, skills, behaviors
In 21st century, healthcare management profession
developed leadership competency models
• Healthcare Leadership Alliance model
• Dye–Garman model
• National Center for Healthcare Leadership model
• Used to guide leadership education and practice for HCOs
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College of Healthcare Executives. Not for sale.
Leading Physicians
Understand physicians. . .
• In general
• Individually
Contingency theory: best style for leading depends
on the followers
When followers are physicians, adjust style of
leading to what works with physicians
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College of Healthcare Executives. Not for sale.
Understand
Physicians to
Lead Them
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College of Healthcare Executives. Not for sale.
Lead with Various Leadership Styles
A manager should:
1. Develop a mix of leadership styles to use
2. Continually assess oneself, followers, situations
3. Continually decide which leadership style to use
4. Correctly apply chosen leadership style
Copyright © 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
For Your Toolbox
Trait theory Theory Z
Skills theory Transactional and
Behavior theory transformational
leadership
Managerial Servant leadership
(leadership) grid
Collaborative leadership
Situational leadership Leadership competency
Hersey Blanchard models
model Differences between
Theory X , Theory Y managers and physicians
Copyright © 2019 Foundation of the American Coll
ege of Healthcare Executives. Not for sale.
One More Time
Leading is a process by which a person tries to influence
someone to accomplish task or goal.
Leading is performed by managers at all levels in an HCO.
Many leadership theories, models, styles exist.
• No single leadership style is always best.
Best way to lead is contingent (depends) on the leader,
followers, and situation.
Managers should
• develop a mix of leadership styles;
• assess contingencies (leader, followers, situation); and
• correctly use leadership style that fits the contingencies.
Copyright © 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
