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Chapter 3 Developing Effective Leaders to Meet 21st-Century Health Care Challenges

Today’s Health Care

System in critical condition

Half of hospitals functioning in deficits

Care received: only 55% of what should be given

Severe shortage of health professionals

Changing morbidities

Up to 400,000 patient deaths every year

Medical errors are the third leading cause of death in America

21st-Century Leadership Challenges #1

Expectations for increased productivity within budget constraints

Resource stewardship + nursing product of safe, evidence-based quality care

Challenge for nurse leaders: advocating, attaining, and maintaining balance

Connectedness of nurse engagement, productivity, and retention with caring and quality outcomes

Evidence-based practice in institutions

Creation of EBP cultures; spirit of inquiry

EBP role models

21st-Century Leadership Challenges #2

Leadership succession and mentoring

Creation of internal leadership pipeline for promotion of internal candidates

Organizational result: effective resource stewardship; ongoing focus on strategic mission achievement

Mentoring and empowering of young nurse leaders (intentional and informal)

Question #1

Is the following statement true or false?

The majority of hospitals today have appropriate budgets to provide the necessary care.

Answer to Question #1

False

Approximately, half of the hospitals in the United States are functioning in deficits.

21st-Century Leadership Challenges #3

Teamwork and effective communication

Effective communication: a marker of safe and highly reliable care

Use of effective communication by leaders; role model skills; administrative structures that assure effective communication and teamwork

Ability to manage/confront conflicts arising out of poor communication

21st-Century Leadership Challenges #4

Transdisciplinary health care

Interprofessional decision making and trust; interprofessional collaboration

Nursing influencing decision making

Active contributors to key discussions and decision making influencing science and delivery of health care

Proactive positioning of nurses at organizational and health policy tables

Workplace wellness

21st-Century Leadership Challenges #5

Balance of technology and interpersonal relationships

Importance of role and place of technology as integrated component of health care in the future

Nonlinear and team-based nature of health care work, complexity of life, and requirement of safe, timely, efficient, effective, equitable patient-centered care via human interactions and relationships

Innovation and change

Incorporation into own leadership practices

Active participation, role modeling, mentorship

Characteristics of Effective Leaders #1

Vision and ability to inspire a team vision/dream

Passion for patient care and making a difference

Transparency, honesty, integrity, trust

Effective communication skills

Ability to lead/not micromanage

Team, not “I,” oriented

Risk taking

Characteristics of Effective Leaders #2

High level of execution

Positive future orientation

Innovative and entrepreneurial spirit

Dedication to coaching/mentoring

Commitment to motivating and empowering others to act/encouraging the heart

Passion and persistence through “character building” experiences

Question #2

Is the following statement true or false?

An effective leader must be focused on self-empowerment.

Answer to Question #2

False

An effective leader seeks to motivate and empower others to act.

Models of Leadership for the 21st Century #1

First step in determining optimal leadership model: understanding the dynamics of changes in work processes; relationships between and among employees, patients, and community; speed of information processing

Four areas of change from electronic world:

Media: how information is documented, shared, transmitted

Time: open access, day or night

Space: locations for work

Structure: free-flowing and open

Models of Leadership in the 21st Century #2

Transactional (instrumental leadership): most common and well-known style

Focus on task orientation, leader direction, follower participation with expectation of rewards, threats, or disciplinary action (see Table 3.1)

Expectation that followers will support leader’s goals

Reliance on traits to support or facilitate role of leader

No creativity, self-actualization, or empowerment of followers

Models of Leadership in the 21st Century #3

Inspirational (transformational) model: emphasis on emotional and ideological appeals with exemplary behavior, confidence, symbolism, and intrinsic motivation

Formation of relationship of mutual stimulation and elevation, converting followers into leaders

Processes of empowerment for leader and followers

Personal growth for followers

Self-actualization and contribution to the organization

Locus of power: still with the leader

Models of Leadership in the 21st Century #4

Complexity leadership model

Positional and informal leaders fulfilling diverse functions

Control difficult/impossible; uncertainty = norm

System boundaries not defined; all interactions interconnected

Leadership = accountability of every person

Power not with one individual; distributed among members

High degree of individual interactions = norm

Question #3

Which of the following has not been affected by the electronic world?

Time

Media

Staffing

Space

Answer to Question #3

The electronic world has affected time, media, space, and structure. Staffing is unrelated to these changes.

Models of Leadership in the 21st Century #5

Complexity leadership model (cont.)

3 types of leadership functions

Administrative: coordinating, planning

Adaptive: outcomes from collaboration

Enabling: mediation between administration and adaptive

Models of Leadership in the 21st Century #6

Trimodal model: focus on evidence-driven processes

3 vital work processes

Operation

Innovation

Transformation

End of Presentation