Health Management

IV study year

Medicine

Leadership
"Cautious, careful people who always try to preserve their reputation and
social position, can never bring about reform." Those who are truly serious
must be prepared to be anything or nothing."

Susan B. Anthony
Introduction
• Today's climate demands individuals who are flexible, creative and able to
empower others to be flexible and creative.
• Due to a shortage of doctors, nurses and technicians, increased patient
acuity, fewer resources, diverse demographics and external influences,
doctors and nurses/techs must be more effective leaders than ever as
they manage patients in diverse settings.
• This is also a time when doctors need to be effective followers, knowing
who to follow, who to follow, how to follow, and how to use that role of
follower.
• Some see leadership as a discipline that sheds light on some of the most
difficult problems of human need and social change.
• Others believe that leadership means having a vision and getting people
to follow it using the art of persuasion.
Introduction
• There are also those who equate leadership with management.
• Some say that leadership is a crucial factor that affects people's lives and
the success of organizations.
• Experts agree that leadership can be learned.
• Knowing that leaders are not necessarily born as leaders, but are made, is
an important concept when considering that all nurses/techs must be
viewed as leaders in the profession.
• Today, nursing is focused on providing quality and cost-effective patient
care, not on completing a list of doctor's and nursing tasks.
Leadership theories - past and present
• In order to understand the phenomenon of leadership and how
contemporary perspectives shape leadership behaviors, it is useful to know
how attitudes about leaders and leadership have changed over time.
• The theory of the great man. This is how the world imagined leaders for
many years, but today this theory is not widely accepted. This theory
assumes that all the leaders were men and that they were all great (eg the
noble class). It was not conceivable that those from the "working class"
could be leaders, that leadership could be learned, or that women could be
leaders.
• Trait theories. During the early 20th century, several researchers studied
the behavior and traits of individuals who were considered to be effective
leaders. Studies have found that these leaders had multiple characteristics,
although there were commonalities among them. There was no standard
one-size-fits-all list of traits that could be used to predict or determine who
Leadership theories - past and present
• Contingency or situational theory. These theories advocate the idea that
leadership depends on the situation in which the leader finds himself.
• Transformation theory. A new way of thinking emerged in the mid-1970s
when James McGregor Burns determined that the true nature of
leadership is not the ability to motivate people to work hard for their pay,
but the ability to transform followers to become more self-directed in
all they do. Barker determined that transformational leaders must have
heightened self-awareness and a self-development plan.
• New scientific guidance. Leadership is a method of thinking in a different
way that is not standard. Leadership involves natural events in which
leaders have knowledge and use their leadership only when necessary. So
there is no need for others to manage and control what we do.
Contemporary models of leadership
• Today's healthcare industry does not prescribe any leadership model.
• Many leaders use various combinations of traditional and contemporary
models.
• Emotional intelligence (EI). It suggests the existence of certain abilities
(intrapersonal and interpersonal) that a person should have in today's
world. These abilities include self-awareness (deeper understanding of
emotions, strengths, weaknesses, needs), self-regulation (tendency to
think, ability to adapt to changes, power to say no to impulsive urges),
motivation (enjoying challenges, being passionate about the profession),
empathy (considering the feelings of others when interaction) and social
skills (leading people in the direction you want through your ability to
interact effectively).
• EI when applied to leadership suggests a caring, reliable and enthusiastic
leadership style that establishes good relations with workers.
Contemporary models of leadership
• Authentic leadership. Leaders who follow this model are those who know
their authentic selves, define their values ​and leadership principles,
understand what motivates them, build a strong support team, and stay
grounded by integrating all aspects of their lives.
• Diversity leadership. Leaders who recognize the importance of diversity and
project acceptance of diversity into the organizational culture will be highly
successful.
• Servant leadership. This concept applies to a care leader who is largely
motivated by a desire to serve others. This leader is sensitive to what
motivates others. This model operates in a non-profit setting and continues
the mission of meeting the needs of the community more than the needs of
the organization.
Contemporary models of leadership
• Spiritual leadership. This spiritual focus does not imply a specific set of
religious beliefs, but emphasizes ethics, values, relationship skills, and the
promotion of balance between work and self. These leaders have a positive
influence on their employees and create a work atmosphere that supports
all individuals in finding meaning in what they do.
• Endurance leadership. There is a lot of emphasis on the executive and the
organization needs a strong and resilient leader to overcome all the
pressures and keep the organization moving forward.
• An emerging leader. Medical students cannot become successful leaders
overnight. It takes years of study and experience to become proficient in
that role. The best leaders are those who continuously learn and use new
knowledge for their further development as leaders in today's applied
world of healthcare.
Leadership vs. Management
• In any business environment there must be both leaders and managers.
• Are they the same people? Not really.
• There are managers who are good leaders, as well as leaders who are
good managers, but there is no norm that one conditions the other.
• In care, both are necessary.
• Whatever setting you are in, hospital, ambulatory center, clinic, polyclinic,
leaders as well as managers are needed to keep the organization moving
forward while maintaining existing operations.
Leadership vs. Management
• Leaders have a more
external focus in the
organization compared to
managers who are more
internally oriented.
• Leaders often spend time
communicating and
connecting with various
external groups that their
organization can benefit
from (partners, community,
suppliers) or influence
(government, government
agencies, media).
Leadership vs. Management
• Every doctor is a leader and manager at some level, and the duty requires both
leadership and management skills.
• As changes are expected to continue in the future in healthcare, it is becoming
increasingly important for doctors to develop leadership and managerial skills.
• Gardner (1990) claims that integrated leaders/managers possess 6 different
characteristics:
1. They think long term. They are visionaries and futurists.
2. They are not narrowly focused, they look and move towards a larger organization.
3. They influence others outside their group. They rise above bureaucratization.
4. They emphasize diversity, values, motivation.
5. Politicians are wise. They are able to cope with the conflicting demands and
expectations of their numerous supporters.
6. They think about change and renewal in order to keep pace with the
environment and the world.
Leadership vs. Managerial competencies

Leadership competencies Managerial competencies

Establishing a mission, purpose of existence Personnel affairs

Setting the vision/directions for the organization Ensuring patient-centred practice

Motivating employees Resource control

To be an effective spokesperson for the organization Monitoring of services provided

Defining strategies for the future Compliance monitoring

Defining strategies for the future Counseling/employee development

Networking Management of work operations

Types of leaders

• Strategic leader - defines the purpose and vision of the organization,

aligns people, processes and values ​(internal and external focus).

• Network leader - connects people from different disciplines,

organizational departments and regions (more external focus).

• Operational leader - has functional responsibilities that are internally

oriented.
Leadership styles
• Different authors list different leadership styles.
• Some styles are appropriate for use with a particular group of health
professionals, depending on their education, training, competencies,
motivation, experience and personal needs.
• The environment must also be considered when deciding which style is
most acceptable.
• In a forced leadership style, power is used inappropriately to get a
desired follower. This type of style should not be used unless the leader is
dealing with a very problematic subordinate or is in an emergency
situation and needs immediate action.
Leadership styles
• A participative leadership style assumes the participation of lower-level
managers who answer to or report to the leader, where they are included
in the decision-making vote and their contribution to the progress of the
organization is valued.
• The speed-matching style sets high standards for followers. This style is
effective when employees are self-motivated and highly competent, e.g.
researchers or intensive care unit nurses.
• The mentoring style is recommended and applies to staff who need to
develop more than to fulfill work tasks. This style is reserved for followers
whom the leader can trust and who have proven competence.
Characteristics and success of leadership
• Characteristics of leadership styles:
1. A leader must be human-oriented, but he must also have the ability to
say NO in certain situations,
2. He cannot be successful if he is too sensitive to human problems,
3. The democratic way does not imply forgiving omissions in work.

• The success of leadership in a given situation may depend on:

1. Situations,
2. Types of work organization,
3. From those who are guided.
Leadership competencies
• Leaders need certain skills, knowledge and abilities to be successful.
These are competencies.
• Leadership competencies can be grouped into 4 domains:
1. Functional and technical domain,
2. Self-development domain,
3. interpersonal domain,
4. Organizational domain.
• Competencies from the functional and technical domain are: business
knowledge, strategic vision, decision making and quality, managerial
ethics and values, problem solving, change management, systemic
thinking.
Leadership competencies
• Competencies in the field of self-development are: self-awareness, self-
confidence, personal responsibility, honesty and integrity, continuous
learning, motivation, empathy, flexibility.
• Competencies from the interpersonal domain are: communication,
motivation, empowerment of subordinates, management of group
processes, conflict management, negotiation, formal presentation, social
interaction.
• Competencies in the domain of organization: organizational design, team
building, alignment of priorities, political understanding, management
and performance measurement, development of others, human
resources, community and external resources, culture and diversity
management.