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9 LEADING OTHERS Calling Others to Action
Starting Point
Go to www.wiley.com/college/Lombardi to assess your knowledge of the basics of leadership. Determine where you need to concentrate your effort.
What You’ll Learn in This Chapter ▲ Common definitions of leadership and five models of leadership ▲ Relationship between vision and leadership ▲ Three types of position power and two types of personal power ▲ Techniques for developing leadership skills ▲ Transformational leadership characteristics ▲ The role of morals and ethics in leadership
After Studying This Chapter, You’ll Be Able To ▲ Demonstrate characteristics of strong leadership ▲ Distinguish ways to establish, share, and maintain vision ▲ Compare position power and personal power ▲ Examine appropriate ways to empower others while leading ▲ Differentiate between leadership models and types ▲ Employ the continuous leadership development process ▲ Interpret possible roles of gender, morals, and ethics in strong leadership
Goals and Outcomes ▲ Master the terminology and tools related to leadership ▲ Describe characteristics of strong leadership ▲ Compare leadership models ▲ Employ traditional leadership development models ▲ Choose appropriate leadership styles and techniques ▲ Model strong leadership characteristics within work teams ▲ Perform leadership duties and responsibilities within a team setting ▲ Evaluate leadership styles and effectiveness
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9.1 DEFINING LEADERSHIP 245
INTRODUCTION Leadership is the catalyst of action in any group. Although various definitions of leadership exist, one of a leader’s central responsibilities is establishing and sharing his or her vision. Leaders have various types of power and must use this power wisely. Additionally, a leader can empower others. Leadership models are useful tools for describing different styles of leading others. In general, leaders are made not born—managers can and should work to develop leadership skills over the course of their careers. Superior leadership requires a manager to also be aware of the moral and ethical implications of their activities as leader.
9.1 Defining Leadership
What is great leadership? Perhaps at its most simple, great leaders are individu- als who are able to bring out the best in other people.
In the words of management consultant Tom Peters, “Leaders get their kicks from orchestrating the work of others—not from doing it themselves.”1 He goes on to say that the leader is “rarely—possibly never?—the best performer.” They don’t have to be; they thrive through and by the successes of others.
Leadership—the process of inspiring others to work hard to accomplish important tasks—is one of the most popular management topics.2
As Figure 9-1 shows, leadership is also critical to the management process. Planning sets the direction and objectives; organizing brings the resources together to turn plans into action; leading builds the commitments and enthu- siasm needed for people to apply their talents fully to help accomplish plans; and controlling makes sure things turn out right.
Leading– to inspire effort
Planning– to set the direction
Controlling– to ensure results
Organizing– to create structures
• Build enthusiasm • Communicate the vision • Maintain positive momentum
Leading viewed in relationship to the other management functions.
Figure 9-1
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9.1.1 Understanding Leadership and Vision
“Great leaders,” it is said, “get extraordinary things done in organizations by inspiring and motivating others toward a common purpose.”3 More and more frequently, great leadership is associated with vision. This term is generally used to describe someone who has a clear sense of the future and an understanding of the actions needed to get there successfully. But there is more. Leading requires turning vision into results. Five core principles for meeting the challenges of visionary leadership are:4
▲ challenge the process: Be a pioneer—encourage innovation and support people who have ideas;
▲ be enthusiastic: Inspire others through personal enthusiasm to share in a common vision;
▲ help others to act: Be a team player and support the efforts and talents of others;
▲ set the example: Provide a consistent role model of how others can and should act;
▲ celebrate achievements: Bring emotion into the workplace and rally “hearts” as well as “minds.”
9.1.2 Maintaining a Clear Vision for Leadership
A strong leader must maintain a clear vision of what he or she wants to accom- plish with a work group. The adage “If you can dream it, if you can conceive it, then you can achieve it,” captures the essence of visionary leadership.
Leaders who do not have a vision are not true leaders. People need to share a vision to get meaning from and excited about their daily responsibilities and individual work. A tremendous motivator for health care professionals—one that unfortunately is often overlooked—is the feeling that one is making a contribu- tion to “the big picture.” Health care professionals like to know that their efforts contribute to a greater, larger good. If a leader fails to provide a vision—a goal that provides patients with solid health care, for example—the work group has nothing to get excited about and little inspiration during difficult professional times. To work through adversity—and everyone experiences adversity at some time in his or her work life—you must have a sense of moving toward accom- plishment of an important, even if difficult, goal.
9.1.3 Establishing and Sharing Vision
To establish a vision, managers consider what they want to see happen within their work groups. To begin the process, list five or six major goals you want your work group to accomplish in the next year. Base these goals on interaction and com- munication with peers and supervisors, as well as your entire frame of reference.
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9.1.3 ESTABLISHING AND SHARING VISION 247
Write these goals on an index card or a word-processing file; keep the list easily accessible in your briefcase, PDA, or computer. Every few weeks, review this list. Make sure that you present the elements of your vision to staff members on a reg- ular basis, beginning with the start of your management activities. Staff should feel that the vision is achievable, viable, and important to their professional aspirations.
A shared vision is a terrific motivator. Individuals who feel that the vision represents something that can provide them with a great deal of satisfaction and opportunity for career growth are more likely dedicated to helping make the vision a reality.
The vision does not necessarily have to be measured quantitatively, as long as its content and achievement are positive and worthy of team effort. For exam- ple, a vision statement for a director of rehabilitation services at a small com- munity hospital may include the following:
Make every patient feel as though he or she is the most important per- son in the building.
Provide the opportunity for the entire staff to grow and develop every day.
Provide the best rehabilitation services possible at all times.
Support each other fully and give each other the benefit of the staff’s tal- ents and personal attributes.
Be totally uncompromising in pursuing the goal of making patients feel as though the organization does everything possible to assist them in enhancing their life and health.
Savvy managers involve their work group in creating and defining vision state- ments. For example, after establishing the basic framework of your vision, involve your team in the vision process simply by asking them to list criteria that ascertains whether the department is maintaining its vision.
F O R E X A M P L E
Visionary Leadership at Dosher Memorial Hospital Although small in size and remotely located, Dosher Memorial Hospital (www.dosher.org) is still a health care and community leader in Southport, North Carolina, a small historic town about a mile from Cape Fear. Through its comprehensive vision statement (visit www.dosher.org/vision.htm), the 100-bed hospital clearly articulates its vision to both employees and patients. For example, the hospital realizes that due to its size, it cannot offer every type of medical service. Therefore, the hospital pursues a policy of “network development with other providers to establish a continuum of quality yet efficient healthcare.”
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9.2 Leadership and Power
Leadership involves influencing the behavior of other people. Power, in this sense, is the ability to get someone else to do something you want done. Power is also the ability to make things happen for the good of the group or organi- zation as a whole.5 This positive aspect of power is the foundation of effective leadership.6
Figure 9-2 divides possible sources of power into those that trace to one’s posi- tion in an organization and those that come from personal qualities.7
9.2.1 Position Power
A manager’s official status, or position, in the organization’s hierarchy of author- ity provides access to position power. Position power includes the power of rewards, punishments, and legitimacy.
Reward power is the ability to influence through rewards. It is the capabil- ity to offer something of value—a positive outcome—as a means of influencing
• Identify and define vision, leadership, and visionary leadership.
• Describe how leading fits with other responsibilities of the manage- ment process.
• Explain the role of vision in effective leadership.
• List the five core principles for meeting challenges of visionary leadership.
• Discuss ways a manager can share vision with teams or departments.
S E L F - C H E C K
Sources of power...
Rewards: "If you do what I ask, I'll give you a reward." Coercion: "If you don't do what I ask, I'll punish you." Legitimacy: "Because I am the boss; you must do as I ask."
Expertise: as a source of special knowledge and information. Reference: as a person with whom others like to identify.
Power of the POSITION: based on things managers can offer to others.
Power of the PERSON: based on the ways managers are viewed by others.
Sources of position power and personal power used by leaders.
Figure 9-2
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9.2.3 USING POWER WISELY 249
the behavior of other people. This involves the control of rewards or resources such as pay raises, bonuses, promotions, special assignments, and verbal or writ- ten compliments. To mobilize reward power, a manager says, in effect, “If you do what I ask, I’ll give you a reward.”
Coercive power is the ability to influence through punishment. It is the capacity to punish or withhold positive outcomes as a way to influence the behav- ior of other people. A manager may attempt to coerce someone by threatening him or her with verbal reprimands, pay penalties, and even termination. To mobi- lize coercive power, a manager says, in effect, “If you don’t do what I want, I’ll punish you.”
Legitimate power is the ability to influence through formal authority—the right by virtue of one’s organizational position or status to exercise control over people in subordinate positions. It is the capacity to influence the behavior of other people by virtue of the rights of office. To mobilize legitimate power, a manager says, in effect, “I am the boss and therefore you are supposed to do as I ask.”
9.2.2 Personal Power
Power can also derive from a manager’s or leader’s unique personal qualities. Two bases of personal power are expert power and referent power.
Expert power is the ability to influence through special expertise. It is the capacity to influence the behavior of other people because of one’s knowledge, understanding, and skills. Expertise derives from the possession of technical know- how or information pertinent to the issue at hand.8
Expert power is developed by acquiring relevant skills or competencies or by gaining a central position in relevant information networks. It is maintained by protecting one’s credibility and not overstepping the boundaries of true under- standing. When a manager uses expert power, the implied message is, “You should do what I want because of my special expertise or information.”
Referent power is the ability to influence through identification. It is the capacity to influence the behavior of other people because they admire you and want to identify positively with you. Reference is a power derived from charisma or interpersonal attractiveness. It is developed and maintained through good interpersonal relations that encourage the admiration and respect of others. When a manager uses referent power, the implied message is, “You should do what I want in order to maintain a positive self-defined relationship with me.”
9.2.3 Using Power Wisely
Good leaders appreciate the ramifications of power and know how to use it effec- tively. Most organizations give health care managers a significant scope of author- ity in formatting policy, executing decisions, and establishing plans for progres- sive performance. With this trust comes power.
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On the management power continuum, two extremes are possible: At one end is the manager who is reluctant to use power; at the other is the autocrat. A reluctant manager does not want to exert authority over staff activities, holds back from making decisions, or perhaps tries to be one of the group. In a sense, the reluctant manager does not want to accept the responsibilities of manage- ment and would rather maintain a low profile by being part of the work group. This stance causes problems because these managers cannot garner the respect necessary to have their plans and initiatives followed and carried through. Fur- thermore, they are in effect abandoning their responsibility to the organization and belying the organization’s trust.
Successful health care leadership includes the proper use of power by exert- ing appropriate pressure when necessary to help realize the department’s vision. The following four basic strategies suggest ways to properly utilize your power base:
▲ Let people know you are in charge. From your first day as manager, emphasize in appropriate words that you are indeed the manager and will make decisions. Of course, new managers need to take time to learn about their department and get to know each staff member, but you can still emphasize your intent to take appropriate action when necessary in the interest of achieving top performance.
▲ Let people know where you stand. From the outset, communicate feedback to all members of your staff. Let them know when they are doing a good job in moving toward top performance and, conversely, when their performance is less than satisfactory. In this way you commu- nicate to your staff that you are interested in their activities and are set- ting high standards for performance.
▲ Be forceful when necessary. Someone in the department—usually a poor performer—is sure to challenge your authority early on. When this happens, meet with the person privately in your office and tact- fully provide specific evidence of their poor performance and contrast it to the high performance standards you have delineated. You must take an immediate stand with subversive or poor performers. (See section 5.5.6 for more information about dealing with problem employees.)
▲ Be action-oriented. From the first day, never hesitate to make decisions (after you gather enough information) or to take appropriate action to enhance departmental performance. New health care managers often take too much time to make decisions or fail to empower staff with the resources necessary to take action. Procrastination causes departmental stagnation and can cripple performance. (Sections 6.3, 8.2, and 8.3 offer decision-making strategies.)
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9.3 LEADERSHIP AND EMPOWERMENT 251
9.3 Leadership and Empowerment
Health care management today is rich with the processes of empowerment, the process through which managers enable and help others to gain power and achieve influence within the organization. Effective leaders know that when peo- ple feel powerful, they are more willing to make the decisions and take the actions needed to get their jobs done.9
Savvy managers realize that power in organizations is not a “zerosum” quantity—that is, in order for someone to gain power, it isn’t necessary for some- one else to give it up. Indeed, to master the complexity and pace of challenges
F O R E X A M P L E
Position Power at National Health Information Network In May 2004, President George W. Bush created the position of national coordinator for Health Information Technology within the Health & Human Services Department (www.hhs.gov) in an effort to promote a National Health Information Network. The department’s goal of giving every Ameri- can an electronic record of their health care by 2014 is aggressive, but the National Coordinator position has been given with considerable position power, including a close relationship with the White House and a substan- tial PR and marketing budget. To learn more about the national coordina- tor position and the U.S. Department of Health Information Technology, visit www.hhs.gov/healthit.
• Identify and define power, personal power, and position power.
• Compare position power and personal power.
• Describe and contrast the three types of position power: reward power, coercive power, and legitimate power.
• Describe and contrast the two types of personal power: expert power and referent power.
• Discuss four strategies for using power wisely.
S E L F - C H E C K
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faced in today’s environments, an organization’s success may well depend on how much power can be mobilized throughout an organization’s workforce.
Managers have numerous ways of empowering others:10
▲ Get others involved in selecting their work assignments and the methods for accomplishing tasks.
▲ Create an environment of cooperation, information sharing, discussion, and shared ownership of goals.
▲ Encourage others to take initiative, make decisions, and use their knowledge.
▲ When problems arise, find out what others think and let them help design the solutions.
▲ Stay out of the way; give others the freedom to put their ideas and solutions into practice.
Leadership through empowerment is helping others use their knowledge and judgment to make a real difference in daily workplace affairs. This occurs as peo- ple work in responsible jobs, as they participate in cross-functional task forces and teams, and as they function in work environments that respect them as capa- ble and creative human beings.
F O R E X A M P L E
Open Doors at Baptist Hospital In the mid-1990s, low satisfaction surveys from patients, families, and staff led Baptist Hospital Inc. (www.ebaptisthealthcare.org) of Florida to radically restructure nearly every aspect of its business, including leadership policies. One of the hospital’s first restructuring actions (based on feedback from lis- tening events and surveys) was to create a flat, fluid, and open leadership system designed to facilitate easier communication. Under the new system, staff is not just encouraged, they are expected, to contact anyone in the orga- nization, including the hospital’s president, at any time to discuss work issues and improvement opportunities. To symbolize management’s com- mitment to “open-door” communication policies, a large glass window that faces into a busy area of the hospital was installed in the president’s office. Additionally, senior leaders are charged with creating a “no secrets” envi- ronment by facilitating short informational meetings during which manage- ment and employees gather together and review the hospital’s daily staff newsletter.
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9.4.1 LEADERSHIP BASED ON BEHAVIORS 253
9.4 Exploring Leadership Models
For centuries, people have recognized that some persons perform very well as leaders, whereas others do not. The questions still debated are, Why? and What determines leadership success?
Several models for leadership have emerged over the years. Five of the most common models for leadership include leading based on
▲ behaviors; ▲ contingencies; ▲ situation; ▲ paths and goals; ▲ participation.
9.4.1 Leadership Based on Behaviors
The behavioral theories of leadership sought to determine which leadership style—the recurring pattern of behaviors exhibited by a leader—worked best.13
Given a preferred style, the goal was to be able to train leaders to become skilled at using a certain style to best advantage.
Most research in the leader behavior tradition has focused on the degree to which a leader’s style displays concern for the task to be accomplished and/or concern for the people doing the work. The behavioral characteristics of each dimension are quite clear:
▲ A leader high in concern for task plans defines work to be done, assigns task responsibilities, sets clear work standards, urges task completion, and monitors performance results.
▲ A leader high in concern for people acts warm and supportive toward followers, develops social rapport with them, respects their feelings, is sensitive to their needs, and shows trust in them.
• Identify and define empowerment and leadership through empowerment.
• Explain how empowering others is a form of leadership.
• Describe methods for empowering others.
S E L F - C H E C K
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The results of leader behavior research at first suggested that followers of people- oriented leaders would be more productive and satisfied than those working for more task-oriented leaders. Later results, however, suggested that truly effective leaders were high in both concern for people and concern for task.14
As shown in Figure 9-3, the preferred style of leadership involves sharing decisions with subordinates, encouraging participation, and supporting the team- work needed for high levels of task accomplishment.
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Preferred style
Team or participative leadership
Human relations
leadership
C on
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P eo
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Concern for Task
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Automatic leadership
Implications of leader behavior research.
Figure 9-3
F O R E X A M P L E
Common Leadership Traits? An early tradition in leadership research involved a search for universal traits that separate effective and ineffective leaders. The results of many years of research on leadership traits can be summarized as follows:11
Physical traits such as a person’s height, weight, and physique make no dif- ference in determining leadership success. On the other hand, followers do appear to admire certain things about leaders. One study of more than 3,400 managers, for example, found the most respected leaders were described as honest, competent, forward-looking, inspiring, and credible. Such positive feelings may enhance a leader’s effectiveness, particularly with respect to creating vision and a sense of empowerment. Among the per- sonal traits now considered most important as personal foundations for leadership success are drive, desire to lead, motivation, honesty, integrity, self-confidence, intelligence, knowledge, and flexibility.12
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9.4.2 LEADERSHIP BASED ON CONTINGENCIES 255
9.4.2 Leadership Based on Contingencies
Instead of searching for the one best style, contingency leadership theory (developed by Fred Fiedler) suggests that leadership success depends on a match between leadership style and situational demands.15 The theory suggests that leadership style is part of one’s personality and is therefore relatively enduring and difficult to change. Rather than trying to train leaders to adopt new styles, the theory recommends matching leaders’ existing styles with situations for which they are the best fit.
According to the theory, people’s leadership styles tend to be either task moti- vated or relationship motivated. Extensive research suggests that neither style is effective all the time. Instead, each works best when used in the right situation.
To diagnose leadership, you must understand and evaluate three contingency variables:
▲ The quality of leader-member relations (good or poor) measures the degree to which the group supports the leader.
▲ The degree of task structure (high or low) measures the extent to which task goals, procedures, and guidelines are clearly spelled out.
▲ The amount of position power (strong or weak) measures the degree to which the position gives the leader power to reward and punish subordinates.
Figure 9-4 shows eight possible combinations that range from the most favor- able situation for a leader (good leader-member relations, high task structure,
Combinations of situational characteristics
Good
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T = Task-oriented style R = Relationship-oriented style
T T R R R T T
Very low
Matching leadership style and situations based on contingency leadership theory.
Figure 9-4
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strong position power) to the least favorable situation (poor leader-member rela- tions, low task structure, weak position power).
Two significant implications of Figure 9-4 and the contingency theory are
▲ a task-oriented leader is more successful in either very favorable (high- control) or very unfavorable (low-control) situations;
▲ a relationship-oriented leader is more successful in situations of moderate control.
9.4.3 Leadership Based on Situation
Hersey-Blanchard’s situational leadership model suggests that successful lead- ers adjust their styles depending on the readiness of followers to perform in a given situation.16 Readiness, in this sense, is based on how able, willing, and confident followers are to perform required tasks.
As Figure 9-5 shows, the possible leadership styles that result from different combinations of task-oriented and relationship-oriented behaviors are as follows:
▲ Delegating: Allowing the group to make and take responsibility for task decisions; a low-task, low-relationship style.
▲ Participating: Emphasizing shared ideas and participative decisions on task directions; a low-task, high-relationship style.
▲ Selling: Explaining task directions in a supportive and persuasive way; a high-task, high-relationship style.
▲ Telling: Giving specific task directions and closely supervising work; a high-task, low-relationship style.
R el
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Participating Share ideas
Followers able & unwilling, insecure
Selling Explain decisions
Followers unable & willing, confident
Delegating Turn over decisions
Followers able & willing, confident
Telling Give instructions
Followers unable & unwilling, insecure
Low High
Leadership implications of the situational leadership model.
Figure 9-5
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9.4.4 LEADERSHIP BASED ON PATHS AND GOALS 257
Anyone using the situational model must be able to implement the alterna- tive leadership styles as needed. For example, a delegating style works best in high-readiness situations of able, willing, and confident followers; the telling style works best at the other extreme of low readiness. In between, the participating style is recommended for low to moderate readiness and the selling style for moderate to high readiness.
Hersey and Blanchard further believe that leadership styles can and should be adjusted as followers in a given situation change over time. The model also implies that if the correct styles are used in lower readiness situations, followers can grow in ability, willingness, and confidence. Not only is this a positive result in itself, but it also allows the leader to become less directive.
9.4.4 Leadership Based on Paths and Goals
The path-goal theory, as advanced by Robert House,17 suggests that an effective leader is one who clarifies paths through which followers can achieve both task- related and personal goals. A good leader helps people progress along these paths, removes any barriers, and provides appropriate rewards for task accomplishment. Four leadership styles exemplify a path-goal model of leadership:
▲ Directive leadership: Letting subordinates know what is expected; giving directions on what to do and how; scheduling work to be done; maintaining definite standards of performance; clarifying the leader’s role in the group.
▲ Supportive leadership: Doing things to make work more pleasant; treat- ing group members as equals; being friendly and approachable; showing concern for the well-being of subordinates.
▲ Achievement-oriented leadership: Setting challenging goals; expecting the highest levels of performance; emphasizing continuous improvement in performance; displaying confidence in meeting high standards.
▲ Participative leadership: Involving subordinates in decision making; consulting with subordinates; asking for suggestions from subordinates; using these suggestions when making a decision.
The path-goal leadership theory advises a manager always to use leadership styles that complement the needs of situations. This means that the leader “adds value” by contributing things that are missing from the situation or that need strengthening. She or he specifically avoids redundant behaviors. The important contingencies for making good path-goal leadership choices include the work environment (tasks, authority, and group) and subordinate personal characteris- tics (ability, experience, and locus of control). For example,
▲ when job assignments are unclear, an effective manager provides directive leadership to clarify task objectives and expected rewards;
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▲ when worker self-confidence is low, the effective manager provides sup- portive leadership to clarify individual abilities and offers needed task assistance;
▲ when performance incentives are poor, the effective manager provides participative leadership to identify individual needs and appropriate rewards;
▲ when task challenge is insufficient, the effective manager provides achievement oriented leadership to raise performance aspirations.
Path-goal theory has led some to identify substitutes for leadership.18 Sub- stitutes for leadership are aspects of the work setting and the people involved that can reduce the need for a leader’s personal involvement. In effect, these sub- stitutes make outside leadership unnecessary because leadership is already built into the situation. Possible substitutes for leadership include staff characteristics such as ability, experience, and independence; task characteristics such as rou- tineness and availability of feedback; and organizational characteristics such as clarity of plans and formalization of rules and procedures.
9.4.5 Leadership Based on Participation
The Vroom-Jago leader-participation model is designed to help a leader choose the method of decision making that best fits the nature of the problem being faced. In this approach, an effective leader is someone able to consistently choose and implement from the following alternatives the most appropriate decision models:19
▲ Authority decisions are made by the leader and then communicated to the group. Participation is minimized. No input is asked of group mem- bers other than to provide specific information on request.
▲ Consultative decisions are made by the leader after asking group mem- bers for information, advice, or opinions. In some cases, group members are consulted individually; in others, the consultation occurs during a meeting of the group as a whole.
▲ Group decisions require all members to participate in making a decision and working together to achieve a consensus regarding the preferred course of action. This approach to decision making is a form of empowerment, and it is successful to the extent that each member is ultimately able to accept the logic and feasibility of the final group decision.20
For a manager who wants to be successful at leading through participation, the challenge in effectively managing the decision process is twofold. First, the
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9.4.5 LEADERSHIP BASED ON PARTICIPATION 259
leader must know when each decision method is the preferred approach. Second, the leader must be able to properly implement decision-making methods when needed.
No decision-making method is considered universally superior to any oth- ers. Rather, leadership success results when the decision method used correctly matches the characteristics of the problem to be solved.
Figure 9-6 shows when to choose among authority, consultative, and group decisions.
Using participative decision-making methods offers important benefits to the leader.21 Participative decisions help improve decision quality by bring- ing more information to bear on the problem. They help improve decision acceptance as participants gain understanding and become committed to the process. And they contribute to the development of leadership potential in oth- ers through the experience of active participation in the problem-solving process.
However, a cost must also be considered: The greater the participation, the more time required for the decision process. Leaders do not always have suffi- cient time available; some problems must be resolved immediately. In such cases, the authority decision may be the only option. The more authority-ori- ented decisions work best when leaders personally have the expertise needed to solve the problem, they are confident and capable of acting alone, others are likely to accept the decision they make, and little or no time is available for discussion.
Authority decision Consultative decision Group decision
Leader FollowersWho has information/expertise?
No YesAcceptance critical for implementation?
High LowTime pressure for decision making?
Recommended Decision Methods
Implications of participatory styles of leadership.
Figure 9-6
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9.5 Developing Leadership Skills
A magic formula for great leadership does not exist. Often, the circumstances and types of individuals in your department have much to do with the type of leadership style that’s most effective.
However, a second part of the equation—your own preferences, personality, and predilections—is equally important. Personal characteristics dictate the type of leadership style you use, as they define what you feel comfortable with and find to be effective in daily activities. Accordingly, first examine the influences that played most prominently in developing your leadership style. Then ascertain which ones were most influential in the development of your innate leadership identity.
In addition to the leadership models covered in section 9.4, the best health care managers continuously seek new applications of leadership, learn about the latest insights into leadership styles, and attempt to upgrade their leadership effectiveness.
9.5.1 Continuous Leadership Development
To ensure that your leadership style develops progressively and your effective- ness grows over time, remember the following strategies:
▲ Get as diverse and as much feedback as possible on leadership effec- tiveness. Influences on your leadership style can be numerous and diverse; have family, peers, and trusted subordinates give you feedback
• Identify and define leadership style, contingency leadership theory, situational leadership model, path-goal theory, substitutes for leadership, leader-participation model, and strategic management process.
• Contrast the characteristics and relative strengths of the five lead- ership models.
• Explain the importance of tasks and people in behavioral leadership models.
• Discuss task motivation and relationship motivation in contingency leadership theory.
• Define the role of readiness in the situational leadership model.
• Define the four path-goal leadership styles.
• Compare decision models in leader-participation theory, including authority decisions, consultative decisions, and group decisions.
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on your leadership effectiveness. Get suggestions from all these individu- als and try to incorporate any good ideas into your future efforts.
▲ Give clear direction at all times to all staff members. Try to specify exactly what is expected and provide as much insight as appropriate on why something should be done. Sharing this information with employees can build trust and allow you to have two-way communication, which is impor- tant for a successful leader. Use appropriate follow-up methods to ensure that progress is being made and provide as much additional instruction as possible as employees strive to achieve their goals. Doing so enhances com- munication and trust, two commodities that are always helpful.
▲ Give staff an appropriate amount of freedom. Assume that staff mem- bers know what they are doing until they prove otherwise. Providing too much direction or constraining performance can create the perception that you are unnecessarily overbearing or not trusting of your staff. Closely monitor performance, provide inspiration, and measure goal attainment of all staff members.
▲ Balance positive and negative information realistically. You must occa- sionally give your staff bad news. Provide this information on a timely basis, try to identify an upside (if possible), and deal with problems real- istically. On these occasions, verbally stress your confidence that the group can handle adversity and rebound from negative circumstances. Strong leaders participate in adversity as much as in prosperity.
▲ Try to keep perspectives on all issues. The true measure of leaders, in the opinion of many, is their reaction to things that are above and beyond the call of duty or beyond the norm. Try to maintain a balanced view of things, and exhibit the courage and strength necessary to handle tough situations.
▲ Learn from every situation. Health care offers learning opportunities every day. Collect as much information as possible, process that informa- tion, and incorporate it into your leadership efforts. Remember that one of the best ways to learn things is to ask appropriate questions. These may be questions that you ask yourself about what you have learned from a situation or questions you ask your peers and your supervisor about their insights and experiences. The more you learn, the greater your frame of reference becomes and the better leader you become.
▲ In all cases, be yourself. Whatever makes sense to you should inspire the judgments you make. Whatever you are comfortable communicating or exhibiting in your words and actions should rule the way you communi- cate ideas, thoughts, and objectives. Your actions and words are being closely examined by your staff because they provide the impetus and inspi- ration for staff’s activities. Therefore, in the long run, whatever is most natural and comfortable is likely the most progressive precedent to set.
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▲ Pace your activities both inside and outside the workplace. Do not try to accomplish everything at once, and make time to enjoy your responsibilities rather than unnecessarily allowing them to be burden- some. Strike a balance between the things that you like to do and the things that you have to do.
▲ Trust your instincts. Your instincts and intelligence are what got you the management job to begin with. As a leader, your good intentions, frame of reference, and basic values are the greatest strengths you have to offer those who want you to succeed.
Perhaps the most important point to remember is that the health care organiza- tion wants you to succeed, your staff wants you to succeed (if for no other rea- son than it makes their lives easier), and of course you want to succeed. This innate desire, coupled with all the factors discussed throughout this chapter, can allow you to become a strong, positive leader.
9.5.2 Becoming a Transformational Leader
The term transformational leadership is often used to describe someone who uses charisma and related qualities to raise aspirations and shift people and orga- nizational systems into new high-performance patterns. This contrasts with transactional leadership in which a leader adjusts tasks, rewards, and struc- tures to help followers meet their needs while working to accomplish organiza- tional objectives.22
Transactional leadership meets only part of an organization’s requirements in today’s dynamic environment. A manager must also lead in an inspirational way and with a compelling personality. The transformational leader provides a strong aura of vision and contagious enthusiasm that substantially raises the confidence, aspirations, and commitments of followers. The transformational leader arouses followers to be more highly dedicated, more satisfied with their work, and more willing to put forth extra effort to achieve success in challenging times.
The special qualities that are often characteristic of transformational leaders include
▲ vision: Having ideas and a clear sense of direction; communicating them to others; developing excitement about accomplishing shared dreams;
▲ charisma: Arousing others’ enthusiasm, faith, loyalty, pride, and trust in themselves through the power of personal reference and appeals to emotion;
▲ symbolism: Identifying leadership heroes, offering special rewards, and holding spontaneous and planned ceremonies to celebrate excellence and high achievement;
▲ empowerment: Helping others develop, removing performance obstacles, sharing responsibilities, and delegating truly challenging work;
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▲ intellectual stimulation: Gaining the involvement of others by creating awareness of problems and stirring their imagination to create high-qual- ity solutions;
▲ integrity: Being honest and credible, acting consistently out of personal conviction, and by following through on commitments.23
9.5.3 Embracing Emotional Intelligence
Over the last decade, the concept of emotional intelligence—the ability to understand emotions in one’s self and others and the ability to use that under- standing to guide behavior—has caught the attention of leadership scholars and consultants.24
Emotional intelligence is now recognized as an important contributor to leadership success. Research indicates that emotional intelligence may even be more important than technical and cognitive skills in creating performance excel- lence. Emotional intelligence becomes increasingly important as you move into higher levels of management responsibility. Technical or knowledge-based skills and cognitive or analytical skills are “threshold capabilities” for leadership.25
They are baseline or entry-level requirements for performing in a leadership capacity. The achievement of true excellence in leadership, however, depends on the presence of emotional intelligence.
In this sense, emotional intelligence is not an option or a “nice to have” lead- ership component; it is a necessity. Someone low in emotional intelligence, for example, may fail to spot signs of excessive stress or burnout in members of a work team. Without this awareness and the ability to act on it, the team leader may push too hard to meet performance expectations and find members responding with anger, job avoidance, and/or poor performance. By contrast, a leader high in emotional intelligence has the interpersonal insight and sensitiv- ity to recognize that emotions are running high. He or she also has the confi- dence and expertise to take actions that help team members balance work demands and find relief from stressful conditions.
One of the important implications of research on emotional intelligence is the notion managers can make the improvement of emotional intelligence an important component in any leadership development agenda. For example, the following five components can be enhanced in the modern health care work- place:
▲ Self-awareness: The ability to understand one’s moods, emotions, drives, and how they affect others.
▲ Self-regulation: The ability to think before acting and to control disrup- tive impulses or moods.
▲ Motivation: The ability to work for more than money or status, and to work with perseverance and high energy.
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▲ Empathy: The ability to understand emotions of others and deal with them according to their emotional states.
▲ Social skill: The ability to manage relationships, build interpersonal net- works, and establish social rapport.
By consciously and persistently seeking to acquire and develop these skills, any- one can improve upon his or her leadership effectiveness.
9.5.4 Gender and Leadership
One leadership theme of continuing interest is the question of whether gender influences leadership styles or effectiveness. Overall, evidence clearly supports the belief that both women and men can be effective leaders.26
However, men and women do tend to exhibit somewhat different styles.27
Research regarding gender differences in respect to the leaderparticipation model discussed in section 9.4.528 indicates that female managers are significantly more participative than their male counterparts. Although followers in these research studies value participation by all leaders, they tended to value participation by female leaders more highly than by men.
Women may tend toward a style sometimes referred to as interactive lead- ership.29 This style focuses on the building of consensus and good interpersonal relations through communication and involvement. Interactive leaders display behaviors typically considered democratic and participative—such as showing respect for others, caring for others, and sharing power and information with others. This interactive style also has qualities in common with transformational leadership discussed earlier in this section.30
Men, by contrast, may tend to utilize transactional leadership, relying more on directive and assertive behaviors and using authority in a traditional “com-
F O R E X A M P L E
Advice on Leadership Skills from the Academy of Achievement Established in 1961, the not-for-profit Academy of Achievement (www. achievement.org) has sponsored awards for leaders “who represent the pin- nacle of achievement in their respective fields.” Each year, new inductees participate in public forums in which high school and college students can ask questions about each leader’s style, skills, accomplishments, and per- sonal development. More than 30 leaders have been honored in the areas of science and medicine, including Jonas Salk, David Ho, and Andrew Weil. Transcripts and audio recordings of the forums are free and downloadable from the Academy’s Web site, along with detailed biographies and profiles.
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mand and control” sense. Given the emphasis on shared power, communication, cooperation, and participation in health care organizations today, these results are provocative.
Gender issues aside, interactive leadership styles seem to be an excellent fit with the demands of a diverse and evolving health care workplace. Regardless of whether the relevant behaviors are displayed by women or men, future lead- ership success rests more often on one’s capacity to lead through positive rela- tionships and empowerment than through aloofness and formal authority.
9.6 Moral and Ethical Leadership
Regardless of the leadership model a health care manager or a health care orga- nization ascribes to, integrity—a leader’s honesty, credibility, and consistency in putting his or her values into action—is a critical management trait.
As section 2.3 explains, health care leaders have an undeniable responsibil- ity to set high ethical standards to guide the behavior of followers. For man- agers, the ethical aspects of leadership are important and everyday responsibili- ties. They are central to the notion of moral leadership—that is, leadership that by actions and personal example sets high ethical standards for others to follow. Most health care organizations and professional groups have codes of ethics that offer managers guidance for appropriate behavior.
Concerned about what he perceives as a lack of momentum in organiza- tional life, author and consultant John W. Gardner suggests that managers have a moral obligation to supply the necessary spark to awaken the potential of each individual, to urge each person “to take the initiative in performing leader-like
• Identify and define transformational leadership, transactional lead- ership, emotional intelligence, and interactive leadership.
• Describe strategies for continuous leadership development.
• Compare transformational leadership with transactional leadership.
• List six characteristics of transformational leaders.
• Explain the importance of emotional intelligence in today’s health care workplace.
• List five common components of emotional intelligence.
• Discuss the role of gender in leadership.
• Contrast interactive leadership with transactional leadership.
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acts.”31 Gardner points out that high expectations tend to generate high per- formance. Gardner’s premise is that people with a sense of ownership of their jobs naturally outperform those who feel they are outsiders. Moral leaders instill ownership by truly respecting others and helping them to do their best. By doing so, they build organizations that consistently perform to society’s expec- tations.32 Moral leadership, therefore, must be clearly and strongly anchored in a true commitment to people.
9.6.1 Forging a Value-Driven Orientation
Leaders incorporate certain values and ethical principles into the work environ- ment at the outset. Many health care teams fail because they lack a proper eth- ical orientation. Volumes of books and a score of management development pro- grams focus on medical ethics, but this concept of value-driven leadership is relatively new to—though gaining wide acceptance in—modern health care lead- ership. Many strong health care organizations have very sound value-driven lead- ership at all organizational levels and enjoy a solid record of health care provi- sions and organizational growth.
The lack of value-driven leadership in a health care environment presents a number of problems. First, animosity can invade a work group in which ethical values are not an important or integral part of the everyday work process. The major catalyst in establishing a value-driven environment is the leader. If the leader fails to demonstrate value-driven action—actions that demonstrate decency and compassion, for instance—these qualities may not be valued and demonstrated by subordinates, and eventually this can have a detrimental effect on the department’s performance.
9.6.2 Identifying Appropriate Values
As a health care manager, you need to determine which values are important for a health care department to maintain and enhance. A logical starting point is to examine the larger organization’s values as they are expressed in the mission statement or in other organizational literature.
In general, the following value-based elements should be part of any value- driven health care leadership strategy:
▲ Care mandates the provision of health services to patients with the added “human touch” that all staff members should demonstrate when dealing with each patient.
▲ Concern should be shown by the staff not only to patients, but also to each other. Staff should be concerned about the welfare and development of fellow employees, helping each other through crises, as well as sharing the joy of daily victories.
▲ Compassion is a cornerstone of successful health care organizations and must be present at all levels of a facility—including your department.
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Sensitivity and perceptiveness should be demonstrated by all team mem- bers toward the professional needs and desires of fellow team members and certainly toward the patient.
▲ Community, the sense that “we are in this together,” should be promoted throughout the work group.
Initially, you may simply want to list the preceding four value-based elements on a chalkboard or flip chart and encourage discussion among team members about the importance of each one. Discussion may center on the definition of each element, the importance that you as leader place on each one, and how team members per- ceive them to help contribute to success of the larger health care organization.
You may want to enhance the list with your own short list of five or six addi- tional value-based elements, perhaps including allegiance, dignity, optimization of resources, quality, societal awareness, and commitment (just to mention a few).
• Identify and define integrity, moral leadership, and value-driven leadership.
• Discuss the place of morals, ethics, and values in leadership today.
• List the four common values in today’s health care organizations.
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F O R E X A M P L E
“Good Old-Fashioned” Leadership Noted management scholar and consultant Peter Drucker (www.peter- drucker.com) takes a practical approach to workplace leadership by focus- ing on what he calls the “good old-fashioned” view of the leadership as hard work. Specifically, the work of a leader is threefold: First, good leaders define and establish a sense of mission by setting clear goals, priorities, and stan- dards. Second, good leaders accept their roles as responsibility rather than rank; hence, good leaders aren’t afraid to develop strong and capable sub- ordinates. Third, great leaders understand the importance of earning and keeping the trust of others. The followers trust good leaders and believe their leaders mean what they say and act in ways consistent with what is said. “Effective leadership . . . is not based on being clever,” says Drucker, “it is based primarily on being consistent.”
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SUMMARY In addition to planning, organizing, and controlling, health care managers must devote time to leading their staffs, teams, and departments. Leadership can be defined in numerous ways, but establishing and sharing vision is a key trait of any successful leader. Leaders are aware of their power, in all its many forms, and use these powers appropriately. Managers who empower their teams can improve the effectiveness of individuals as well as entire departments. Models are useful tools for identifying proven methods of leadership success. Developing leadership skills can and should be a continuous process for managers. In health care work- places, in particular, managers must also consider aspects of moral and value- driven leadership.
KEY TERMS Authority decision Decision made by the leader and then communi-
cated to the group.
Coercive power The ability to influence through punishment, a type of position power.
Consultative decision Decision made by the leader after asking group members for information, advice, or opinions.
Contingency leadership Leadership theory in which a leader’s success de- theory pends on a match between leadership style and
situational demands.
Emotional intelligence The ability to understand emotions in one’s self and others and then use this understanding to guide behavior.
Empowerment The process through which managers enable and help others to gain power and achieve influence within the organization.
Expert power The ability to influence through special expertise; a type of personal power.
Group decision All members to participate in making a decision and working together to achieve a consensus re- garding the preferred course of action.
Integrity Honesty, credibility, and consistency in putting one’s values into action.
Interactive leadership A leader focuses on building consensus and good interpersonal relations through communication and involvement.
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Leader-participation model Leadership model in a leader chooses the method of decision making that best fits the nature of the problem being faced.
Leadership The process of inspiring others to work hard to accomplish important tasks.
Leadership style The recurring pattern of behaviors exhibited by a leader.
Leadership through Helping others use their knowledge and judg- empowerment ment to make a real difference in daily workplace
affairs.
Legitimate power The ability to influence through formal authority, a type of position power.
Moral leadership Leadership that by actions and personal example sets high ethical standards for others to follow.
Path-goal theory Leadership theory that suggests an effective leader is one who clarifies paths through which followers can achieve both task-related and per- sonal goals.
Personal power Power derived from a leader’s unique personal qualities.
Position power Power from a manager’s official status in the orga- nization’s hierarchy of authority.
Power The ability to get someone else to do something you want done; the ability to make things happen for the good of the group or organization as a whole.
Referent power The ability to influence the behaviors of other people because they admire you and want to identify positively with you; a type of personal power.
Reward power The ability to influence through rewards; a type of position power.
Situational leadership Successful leaders adjust their styles depending model on the readiness of followers to perform in a
given situation.
Substitutes for leadership Aspects of a work setting and the people involved that can reduce the need for a leader’s personal involvement.
Transactional leadership A leader adjusts tasks, rewards, and structures to help followers meet their needs while working to accomplish organizational objectives.
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Transformational A leader uses charisma and related qualities to leadership raise aspirations and shift people and organiza-
tional systems into new high-performance pat- terns.
Value-driven leadership Leaders incorporate certain values and ethical principles into the work environment.
Vision An overarching goal that manager/leader has for his or her department or team.
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SUMMARY QUESTIONS 271
ASSESS YOUR UNDERSTANDING Go to www.wiley.com/college/Lombardi to evaluate your knowledge of the basics of leadership. Measure your learning by comparing pretest and post-test results.
Summary Questions
1. Managers who lead with vision (a) celebrate differences. (b) challenge processes. (c) help others do their jobs. (d) set budgets and schedules.
2. A manager without vision can still be a leader. True or false? 3. To establish a vision, a manager can
(a) present your departmental goals to your staff on a regular basis. (b) list five major goals you want the department to accomplish in the
next year. (c) base goals on your interaction and communication with peers and
supervisors. (d) All of the above
4. The two main types of power are position power and personal power. Position power is derived from staff respect for a leader’s accomplish- ments, while personal power is derived from the leader’s status. True or false?
5. When a manager offers staff gift certificates for taking on additional shift work, what type of power is he or she exercising? (a) Expert power (b) Coercive power (c) Reward power (d) Legitimate power
6. Letting your staff know where you stand on issues and being action- oriented are two appropriate manners of utilizing managerial power. True or false?
7. Power is essentially a “zero-sum” proposition: If someone gains power, someone else must lose power. True or false?
8. Leadership through empowerment happens when (a) staff has opportunities to participate in cross-functional teams. (b) managers trust staff enough to eliminate status reports.
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(c) staff can provide critical feedback to management. (d) managers require two signatures for a purchase request.
9. Emotional intelligence, although a natural skill for some managers, can be learned or enhanced in managers who have limited relational or social-interaction skills. True or false?
10. Leader behavior research shows that task-oriented leaders generally out- perform people-oriented leaders. True or false?
11. In contingency leadership theory, the degree of task structure measures the extent to which (a) schedules and budgets are determined by upper management. (b) task goals, procedures, and guidelines are clearly spelled out. (c) job descriptions are made available to all employees. (d) None of the above
12. In the situational leadership model, delegating works best in (a) high-readiness situations of confident followers. (b) low-readiness situations of confident followers. (c) high-readiness situations of reliant followers. (d) low-readiness situations of reliant followers.
13. Leading through participation offers the benefit of (a) improving decision quality. (b) bringing more information to bear on the problem. (c) developing leadership potential in others. (d) all of the above.
14. Which of the following is NOT an appropriate strategy for continuous leadership development? (a) Give staff an appropriate level of freedom (b) Learn from every situation (c) Refer to organizational procedures to solve problems (d) Balance positive and negative information realistically
15. Transactional leaders adjust tasks and rewards to help staff meet their needs while accomplishing organizational objectives; transformational leaders use personal quality to raise staff aspirations and encourage high- performance patterns from people and organizations. True or false?
16. Emotional intelligence includes five main components: (a) Self-awareness, self-regulation, motivation, empathy, and social skills (b) Self-direction, self-sacrifice, empowerment, sympathy, and analytical
skills (c) Self-regulation, self-analysis, intuition, integrity, and interpersonal
skills
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REVIEW QUESTIONS 273
(d) Self-motivation, self-starting, honesty, empathy, and problem-solving skills
17. In moral leadership, a leader’s actions and personal examples (a) override the policies and procedures in company manuals. (b) set high ethical standards for others to follow. (c) are more important than the staff’s actions and examples. (d) are open to critical feedback from the team.
18. Although value-driven health care leadership differs, most approaches include care, concern, compassion, and (a) charisma. (b) continuity. (c) civility. (d) community.
Review Questions
1. A manager’s vision does not have to be measurable in a quantitative sense. What characteristics does the vision need to have?
2. A leader with vision has a clear sense of the future, as well as what other characteristics?
3. If you tell a staff member that he must work 4 hours of overtime this week because you’re the manager and you set the schedule, you are exercising what type of power?
4. What sort of power is the shift manager at a nursing care facility using when he tries to persuade his staff to alter a procedure based on his 10 years of hands-on elderly care?
5. Some managers are reluctant to utilize power, while others focus solely on maintaining and using their power. Why is either extreme undesirable?
6. What is a manager doing when she takes time to find out what her staff thinks may be causing an accounting problem for the department, rather than assuming she already knows the answer?
7. Based on the contingency leadership model, a relationship-oriented manager is likely to be more successful in what types of management situations?
8. Based on the situational leadership model, what leadership style best describes a manager who hosts bimonthly brainstorming sessions to problem-solve issues facing his department?
9. In path-goal theory, substitutes for leadership are aspects of the work setting and people involved that can reduce the need for the leader’s per- sonal involvement. What are some common substitutes?
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10. To respond to recent budget cuts, a shift manager asks individual team members for opinions on how to deal with the situation. The manager then presents her plan for saving money within the department based on this feedback. Within the leader-participation model, which type of deci- sion does this represent?
11. Participative decision making offers many benefits; however, what is the drawback of this model of decision making?
12. A manager decides to look at every situation she encounters during her day as an opportunity to collect new information and reevaluate her leadership style. Which strategy for continuous leadership development is the manager utilizing?
13. Being honest and credible, acting consistently out of personal conviction, and following through on commitments are all examples of which aspect of transformational leadership?
14. Moral leaders instill their teams with a sense of ownership of their jobs. How do moral leaders go about doing this?
15. Where should a leader look first when determining appropriate values to include in a value-driven leadership approach?
16. What four values are an appropriate part of most any value-driven lead- ership approach in today’s health care workplace?
Applying This Chapter
1. The new shift manager at large nursing care facility presents her vision for her team as follows: Each patient is a “unit of care,” which includes the patient, as well as the patient’s families. Staff must do everything possible to satisfy medical and housing needs of this unit of care and avoid legal action. Is this an appropriate vision for leading a team or department?
2. How might the office manager of a multidoctor family medicine practice utilize reward power and coercive power to improve the efficiency of a new billing/claims representative in his department?
3. The team you manage at a student health center at a small liberal arts college looks to you to make all treatment decisions, solve day-to-day problems, sign off on all paperwork, and set their daily schedule and priorities. What are some things you can do as a manager to empower your staff?
4. For a nursing team leader to effectively utilize contingency leadership, what three variables must the leader understand and evaluate on an ongoing basis?
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APPLYING THIS CHAPTER 275
5. Jan has managed the record-keeping staff in an inner-city clinic for 5 years. Although her department generally runs smoothly, she has been chal- lenged to think strategically about the hospital’s record-keeping policies and improve the effectiveness and performance of her department. Jan decides to focus first on her style of leadership, which has been very by- the-book since she became a manager. What skills and abilities should Jan develop if she wants to grow from being a transactional leader to a transformational leader?
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YOU TRY IT
Building a Leadership Matrix Many health care managers look to history books to help define the characteristics of great leadership. Cre- ate your own leadership matrix to help identify leader- ship examples that you consider important and mean- ingful. Along one side of a piece of paper, list figures from U.S. and world history (as well as current figures) who impress you because of their notable actions and achievements. In a second column, list next to each leader the characteristic (or two characteristics) that you believe the individual represents. After identifying 10 or so leaders, share your list with someone else and add to your list as you learn about additional impres- sive individuals. Consider reading online and print bi- ographies about individuals who most intrigue you, noting inspirational quotes or anecdotes along the way. Some noteworthy individuals (along with outstanding characteristics they exemplify) can include Abraham Lincoln (honesty, integrity); Franklin D. Roosevelt (courage to implement innovative programs); Mother Theresa (compassion, human spirit); Benjamin Franklin (imagination, innovation); John F. Kennedy (charisma, vision); Dr. Martin Luther King Jr. (recognized that little things launch big things); Winston Churchill (ability to get the job done); Mohandas Gandhi (regard for others interests and needs); Eleanor Roosevelt (compassion- ate communication).
How You Use Power Consider a recent event in which you used power to make a decision or get something done. The event doesn’t have to be major; it could be that you made the decision of which movie to see or that you changed someone’s mind while shopping. Maybe you assigned a task to someone in a study group or in a workplace setting. Maybe you disciplined a young child or suc- cessfully debated a topic with a parent or elder. What- ever the case, which of the two main types of power did you use: personal or position? Did you use both types of power? If you used personal power, was it
reward, coercive, or legitimate? If you used position power, was it expert or referent?
Using Nominal Group Process Developed in the 1970s, nominal group process is a popular approach for leading and empowering groups. During nominal group process, the goal is to select one solution based on group consensus (rather than total agreement). Research suggests that in many situa- tions, nominal process produces better results than un- structured group interactions. To facilitate nominal process on group decision (perhaps determining the topic for a group project/presentation, or selecting a movie for you and your friends to see), guide your group through the following series of specific interac- tive steps. First, have everyone generate ideas individ- ually and silently. Share ideas in round-robin fashion, encouraging feedback from the group only after all ideas have been presented. Ask each group member to establish their final recommendation and record this decision. Finally, mathematically combine all recom- mendations and produce a ranked list of final ideas.
Role Model Roundup Role models are sources of inspiration for your leader- ship style. The ways in which your role models ap- proach their responsibilities and conduct their activities shows you how you might lead and what choices you might make as a leader. Consider the success stories behind one of your role models—perhaps a family member, a favorite teacher, a youth group leader, a successful co-worker, or an inspiring religious or com- munity leader. On three index cards, list the role model’s name and position or title. On each card, list a brief “success story” associated with the role model. (For example, “hired an entirely new nursing staff in one month’s time” or “empowers staff to present one new idea at each monthly staff meeting” are briefly stated success stories.) Read over the three success stories and consider the challenges or negative aspects the
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role model may have encountered prior to the success story; list one or two challenges on each card. Finally, read through the cards one last time. This time con- sider why the role model may have been successful (despite the challenges); list one or two reasons for success on each card. Clip the three cards together and keep them in your purse, briefcase, or backpack. During free moments over the next month, take out the cards, shuffle through the success stories, and the les- son each story offers to you and your career as a health care manager.
Your Continuous Leadership Development Leaders aren’t born, they’re made. Developing leader- ship skills is a daily activity that you can engage in to- day, even if you’re not yet working in your chosen ca- reer field. Review the nine strategies for continuous leadership development in section 9.5.1 and select one aspect that you can begin working on in little ways to- day. For example, if you choose to develop your ability to “balance positive and negative information realisti-
cally,” how might this play out in your daily life? How might you interact differently with your friends, family, partner or spouse, and classmates? How might you act/react differently to horrible news story or a day when nothing seems to be going your way?
Your Health Care Values Value-driven leadership continues to be an important topic in today’s health care workplace. If you apply for or work as a manager within an organization, you will, most likely, be asked to discuss some of your values as they relate to patient care and your leadership style. Al- though every manager’s values are different, the four basic values outlined in section 9.6.2—care, concern, compassion, and community—are all strong values for today’s health care manager. Review these four values and formulate a specific example of a time each value played a significant role in your education, work life, or personal life. Consider incorporating an outstanding example of one or more of these values into your re- sume or cover letter.
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