Post on 20-Jan-2015
description
transcript
1
Special Leadership & Management Challenges in the 21st Century
Rami N. Abdel Rahman
Oncology Nursing Master Student
2010 – 2011
Supervised and directed By:
Dr. Nejmeh Al Attyat.10/10/10
2
Questions to Consider!!
What type of team-building skills will help you leading a
multidisciplinary team and coordinate patient care?
Why is it important for you to understand the mission &values of the organization to provide direct
patient care?
What leadership and management skills will assist you as begining
new role as Nursing leader?
10/10/10
3
Learning Outcomes
1. Relate leadership and management theory to nursing leadership and management activities.
2. Differentiate among the five functions of management essential activities related to each function
10/10/10
4
Learning Outcomes
3. Integrate principles of the customer service role in professional nursing practice.
4. Implement effective team-building skills as an essential component of nursing practice.
10/10/10
5
Learning Outcomes
5. Implement the concept of transformational leadership in nursing directed institutions.
6. Discuss the implications Magnet Hospitals on the leadership & management.
10/10/10
6
Key Terms
• Authority• Healthcare Organizations• Leadership• Management• Organizational Chart• Resources• Productivity
Safety
Quality
Service excellence
Customers
Point of care
Stakeholders
Transactional vs.Transformational
10/10/10
7
During Nursing School
• More concerned with developing clinical knowledge and skills.
• But immediately after graduation, you may placed in many situations that require leadership and management skills
• Less concerned with management and leadership .
10/10/10
8
After Graduation
• Managing group of assigned patients• Serving on a taskforce or a committee• Acting as team leader or charge nurse• And, and, and ,….. ….. etc.
• Providing safe, evidenced – based, high quality clinical care. This also require these skills
Also..!
10/10/10
9
21st century demands
• Higher – acuity patients.• Diverse health professionals and
nonprofessionals.• Work environment .• Reimbursements, health insurance.• Constant admitting and discharging units.• Shrinking budgets.• Limited resources.
10/10/10
10
• Health care providers and Nursing Turnover.• Nurse : Patient (ratio).• Standardization (JCI, CCHSA..etc)• Cultural and societal development and
changes.
• Traditional Evidence-based Nursing
21st century demands and challenges
10/10/10
11
What is expected!
• Regardless of which position or area the nurse is employed, the health care organization will expect the professional nurse to have leadership and management skills
10/10/10
12
What is leadership?
• Leadership occurs any time a person attempts to influence the beliefs, opinions, or behaviors of a person or group (Hersey and Blanchard, 1988)
Situational Leadership Model
10/10/10
13
So… what is leadership?
• It is a combination of:– intrinsic personality traits.– Learned leadership skills.– and characteristics of the situation.
• It is to guide people or groups to accomplish common goals.
• May not have formal authority.
10/10/10
14
Leadership defined!
• “a job title alone does not make a person a leader. Only a person’s behavior determines if he or she occupies a leadership position” (Marquis and Huston, 2006)
• Leadership ability may be related to qualities, such as:• Unique characteristics.• Exceptional clinical expertise.• Relationships with other
organizations.10/10/10
15
What is Management?
• Management refers to the activities involved in coordinating people, time, supplies to achieve desired outcomes and involves problem-solving and decision making processes.
10/10/10
16
So.. What is Management?
• Control of day-to-day operations of a defined area or responsibility.
• Plan and organize:– What is to be done.– Who is to do it.– When is to be done.
10/10/10
17
Nurse Manager.. e.g…
• An appointed management position within an organization:
• Planning staffing.• Employee performance reviews.• Controlling use of supplies.• Meeting, budgeting, productivity goals… etc
• A formal line of authority and accountability to ensure:
• Safe and effective patient care along with organization’s goals and standards.
10/10/10
18
Leadership versus management
• Leadership and management are intertwined.
• Its difficult to discuss one without the other.• Though… they are different concepts.
10/10/10
19
Leadership versus management
Leadership• The ability to guide or
influence others.
• People are led.
• Leaders are able to motivate and inspire others.
Management• The coordination of
resources (time, people, supplies)
• Activities and things are managed.
• Managers have the assigned responsibility to accomplish organization’s goals.
10/10/10
20
Leadership versus management
Leadership• A person with good management skills may not have
leadership ability. Same the way around.• Leadership and management skills are complementary
• Both can be learned and developed through experience.• Improving skills in one area will enhance abilities in the other.
Management
10/10/10
21
Power and Authority
• Authority: is the legitimate right to direct others and is given to a person by the organization through an authorized person (e.g. Nurse Manager)
10/10/10
22
Power and Authority
• Power: is the ability to motivate people to get things done with or without the formal right granted by the organization.
• Sources of Power are identified
10/10/10
23
The primary sources of power
1. Reward Power: to reward others (e.g. money, acknowledgment, desired assignment… etc.)
2. Coercive Power: based of fear of punishment (opposite of reward)
10/10/10
24
The primary sources of power
3. Legitimate Power: based on an official position in the organization (granted right to influence)
4. Referent Power: comes from the followers to the leader (admiration, respect… etc)
10/10/10
25
The primary sources of power
5. Expert Power: based on knowledge, skills and information
6. Information Power: information that is needed by others.
7. Connection Power: relationship or affiliation with powerful people.
10/10/10
26
Chain of Authority (e.g.)
10/10/10
27
Organizational Chart and Chain of Authority
10/10/10
2810/10/10
29
Leadership Theories
10/10/10
30
• Sir Francis Galton– One of the earliest leadership theorists– Wrote “Hereditary Genius” pub. 1869– Believed leadership qualities were genetic
• This theory assumes physical and psychological characteristics (traits) account for effective leadership– Basic intelligence– Clear and strong values– High personal energy
Leadership Trait Theory
Leaders were born with such traits10/10/10
31
Leadership Trait Theory
• Edwin Gheselli identified six traits for effective leadership:– Need for achievement– Intelligence– Decisiveness– Self-confidence– Initiative– Supervisory ability
10/10/10
32
Leadership Trait Theory
Dreamer
Borrow Ideas
Sense of Humor
SimplifierServe
Accountable
Respect
Listening
Leading by example
Involving
VirtueFairness
PlannerIntegrity
Humble10/10/10
33
Leadership Behavior Theory
• In the 1930s, emphasis on behaviorism moved researchers in the direction of leadership behavior– Kurt Lewin trained assistants in behaviors
indicative of three leadership styles: • Autocratic: tight control of group activities, decisions
made by the leader• Democratic: group participation, majority rule• Laissez-faire: little activity of any type by the leader.
10/10/10
34
Leadership Behavior Theory
• In the 1940s, research focused on leader behaviors– Assumed that leaders take distinct actions
• Ralph Stogdill at Ohio State University– Helped develop the Leader Behavior
Description Questionnaire (LBDQ)– Respondents described leaders’ behavior in two
dimensions:• Initiating structure• Showing consideration
10/10/10
35
Leadership Behavior Theory
3D Behavioral Scale
10/10/10
36
Take a Break
10/10/10
37
Do you know them..?
10/10/10
38
Do you know them..?
10/10/10
39
Do you know them..?
10/10/10
40
Do you know them..?
10/10/10
41
Nursing Leaders
10/10/10
42
Do you know them..?
If you know 30 names… You are genius!!10/10/10
43
Other Leadership Theories
• Situational Leadership Theory.• Interactional Leadership Theory.• Leadership Contingency Theory.
10/10/10
44
Transformational Leadership
Leadership theory is an evolving field; while these highlight the most common theories of the last century, more theories continue to be researched in the elusive search for a definitive understanding of leadership. More recent leadership theories are discussed on the following slides.
10/10/10
45
Transformational Leadership
• Burns (1978) identified and defined transformational leadership.
• Tow types of leaders:– The transactional leader; concerned with day-
to-day operation of the facility.– The transformational leader; committed to
organizational goals, has vision and is able to empower others
10/10/10
46
Transactional Vs. Transformational
Transformational• Identify and clearly
communicate vision and direction.
• Empower the work group to achieve goals and vision.
• Are admired and emulated.• Provide mentoring based on
needs.
Transactional• Focus on day–to–day
operation.
• Reward staff for desired work (I’ll do x for you doing y).
• Monitor work performance.• Wait until problems occur
and deal with it.
10/10/10
47
Anderson, S. & Miller, A. (2007). Implementing Transformational Leadership as a Model for Service Learning Activities in an Online RN to BSN
Leadership Course. Online Journal of Nursing Informatics (OJNI), 11, (1).
Transformational Leadership
• Transformational Leadership means collective empowerment:– All parties work together to achieve a shared goal.– Focus is innovation and change.– Followers have a sense of mission.– Leaders inspire followers beyond interpersonal
relationships and extrinsic rewards for a job well done.– People have a purpose: worthwhile, meaningful and
important.
10/10/10
48
Transformational Leadership
• Nurses are responsible for providing high quality patient care in a culture of safety.
• Transformational leaders help achieve this goal …– Make the experience
meaningful, inspiring, exciting…
– Appeal to our sense of mission and purpose of making a difference in people’s lives
Anderson, S. & Miller, A. (2007).
Manage well in an environment of constant change10/10/10
49
Who are the Transformational Leaders?
– Clinical Nurse Specialists– Nurse and Patient
Educators– Nurse Managers– Directors, Vice-
Presidents, the CNO– Patient Safety and
Quality– Nurses in non-traditional,
non-direct care roles
• WE ALL ARE!
WE ARE COLLECTIVELY EMPOWERED TO BE LEADERS WHEREVER WE PRACTICE10/10/10
50
The New Magnet Model
Evidence Based Leadership
10/10/10
51
Magnet Recognition Program
10/10/10
52
Transforming Our Practice
• Building a culture of change• Transformational leaders will help to build
exemplary professional practice at the unit level• Our Transformational Leadership Council’s role will
evolve to reflect the roles defined by the New Magnet Model
• Initially, the Council will provide the foundational structure needed to build all other councils
10/10/10
53
Transformational Leadership Council Roles
• Advocacy and Influence• Visibility, Accessibility and Communication• Strategic Planning
10/10/10
54
Application:Nursing Process
• Assess.
• Plan.
• Intervene.
• Evaluate
10/10/10
55
Nursing Assessment – Evaluation Cycle
• Leadership.
• Management
• Power
• Authority
• Transformational
10/10/10
56
Evidence – Based Leadership in Nursing Process
10/10/10
“ … in any moment of decision, the best thing you can do is the right thing,
the next best thing to do is the wrong thing,
and the worst things you can do is nothing.”
– Theodore Roosevelt
57
Pathway for Patient Safety;Working as a Team
10/10/10
58
Effective Team Work and Communication
10/10/10
59
Effective Team Work
10/10/10
60
Questions, Ideas, Suggestions!!
10/10/10
61
References
• www.nursingcredintialing.org• www.ihi.org• www.ahqr.org• www.nursingquality.org• Cherry, Barbara; Jacob, Suzan R.;
Contemporary Nursing Issues, Trends and Management, Chapter 15, 2008.
10/10/10