EFFECTIVE LEADERSHIP IN HEALTHCARE ORGANIZATIONS

BY

Dr. Naila H. Amer

Professor of Health Administration and Planning

LEARNING OBJECTIVES
1. Define leadership.
2. Describe leadership approaches. 3. Discuss the most important leadership traits and skills as well as functions of effective leadership.

4. Determine sources of leaders power & importance of influence.

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5. Explain leadership development. 6. Differentiate between transactional transformational leadership. &

7. Discuss the role of emotional intelligence in relation to successful leadership. 8. Describe the different leadership styles.

Introduction:
Effective leadership is essential if a health services organization (HSO) is to provide high-quality care and succeed financially. All managers at all levels of the organization, who depend on other people for efficient and effective work performance, require leadership ability. The quality of leadership is crucial to how work gets done.
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Definition:
Leadership is a very complex multidimensional concept and has been defined in a number of different ways. A common definition is: The process by which one person designates what is to be done and influences the efforts of others in order to accomplish specific purposes.
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Another important definition is that: Leaders are agents of change, persons whose acts affect other people more than other peoples acts affect them.

Leadership Approach:
Leaders following the proactive approach take responsible initiatives to change situations and attitudes through people. This approach is the essence of modern leadership,it contrasts with the : Reactive approach where a leader responds only to events and instructions from outside.
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EXERCISE (1)

From your experience, try to describe a leader you worked with or had contact with; whom you consider a role model of a successful leader & why. What in your opinion are the main traits ,skills & behaviours of a successful leader?
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Leader Traits, Skills and Behaviour:

Although none of the hundreds of studies conducted in search of universal leader traits were successful yet, certain traits are known to be associated with leader effectiveness. Table 1 is a list of traits and skills that most frequently characterise successful leaders.
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Table1: Traits and skills found most frequently to be characteristic of successful leaders
Traits

Skills

Adaptable to situations Alert to social environment Ambitious and achievementoriented. Assertive Cooperative Decisive Dependable Dominant(desire to influence others) Energetic (high activity level) Persistent Self-confident Tolerant of stress Willing to assume responsibility

Clever(intelligent) Conceptually skilled Creative Diplomatic and tactful Fluent in speaking Knowledgeable about group task Organized (administrative ability) Persuasive Socially skilled
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Leaders Power and Influence

Influence is important to the leadership process because it is the means by which leaders successfully persuade others to follow their advice, suggestion or order. The essence of leadership is the ability to influence others. To have influence, however, one also must have power.
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Sources of Power: 1.Legitimate Power :This is the power a leader has as a result of his / her position in the organization.

2. Coercive Power : Is the power to punish or control. 3. Reward Power : Is the power of giving positive benefits or rewards whether financial or otherwise.
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4. Expert Power : Influence thats based on expertise, special skills or knowledge. 5. Referent Power : Arises because of a persons personal traits or desirable resources, e.g. admiration of another & a desire to be like that person, in this case that person has referent power over you.

Most effective leaders rely on several different forms of power e.g. giving orders (legitimate), praising (reward), & disciplining (coercive).

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Also power must be used wisely to influence people e.g. abuse of coercive power may lead to weakening or loss of referent power. Effective leaders understand the costs, risks, and benefits of using each kind of power and are able to recognize which to draw on in different situations and with different people.
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Leadership Behaviour
In the 1950s, the study of leadership and leaders shifted from traits to behaviour. This raised the exciting possibility that if leader behaviour explained leadership effectiveness, then leadership could be taught since behaviour can be learned and programs can be designed to develop effective leaders. The trait theories maintained that leaders are born : Either you have it or you dont. The behaviour theories believed that leaders are made!
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Leadership Development
Leadership development means the improvement and strengthening of abilities and effectiveness of both current and prospective leaders. Some of the functions to be developed for effective leadership are demonstrated in table 2:
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Table 2: Functions of Effective Leadership:

The provision of a vision that influences all who work in the organization.

Confidence in ones vision and oneself.

Projecting / communicating the vision. Initiating / guiding change. Mobilizing commitment and support for change. Resolving conflict. Building of trust. Building sustainability Developing others.
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Transformational And Transactional Leadership

Among the contemporary approaches to leadership is that leadership in organizations is of two types: transformational and transactional. Transactional leaders are those who guide & motivate their followers towards established goals & clarify role & task requirements.
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Transformational leaders on the

other hand, are mainly concerned with change, the needs of followers, and helping followers look at old problems in new ways. They are able to excite ,arouse and inspire followers to put an extra effort and transcend their own self interest to achieve group goals.

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Transformational and transactional leadership should not be viewed as opposing approaches. Transformational leadership is built on top of transactional leadership producing performance that goes beyond what would occur with transactional approach alone. There is evidence that transformational leadership is more strongly correlated with lower turnover rates, higher productivity, & higher employee satisfaction.
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Some authors state that transformational leadership is more likely to be practiced by senior managers who focus on creating system - wide change in relation to organizations missions, values, culture, strategiesetc. This group maintains that transactional leaders are those who usually have a direct supervisorsubordinate relationship with their followers.
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Emotional Intelligence:
As a result of many researches, Goleman (1998) concluded that although successful leaders vary in many ways, yet the most effective ones are alike in one crucial way:

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They all have a high degree of what has come to be known as emotional intelligence. Its not that IQ and technical skills are irrelevant. They do matter, but mainly as threshold capabilities or entry-level requirements for executive positions.

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Recent studies clearly show that without emotional intelligence a person can have the best training and a brilliant analytical mind but still wont make a great leader.

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Table 3: The Five Components Of Emotional Intelligence At Work

Component

Definition

Hallmarks

The ability to recognize Self-awareness and understand your moods, emotions, and drives, as well as their effect on others.

self-confidence Realistic selfassessment Self-deprecating sense of humor

The ability to control or redirect disruptive Self-regulation impulses and moods. The propensity to suspend judgment.

Trustworthiness and integrity Comfort with ambiguity. Openness to change. 25

Table 3: (continued)
Motivation
A passion to work for reasons that go beyond money or status. A propensity to pursue goals with energy and persistence. The ability to understand the emotional makeup of other people. Skill in treating people according to their emotional reactions. Strong drive to achieve. Optimism, even in the face of failure. Organizational commitment.

Empathy

Expertise in building and retaining talent. Cross-cultural sensitivity. Service to clients and customers..

Social skills

Proficiency in managing relationships and building networks. An ability to find common ground and build rapport.

Effectiveness in leading change. Persuasiveness. Expertise in building and leading teams. 26

I suppose that leadership at one time meant muscle but today it means getting along with people.
Indira Ghandi

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)2( EXERCISE

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Styles of Leadership:
Leadership style is how you behave when you are trying to influence the performance of others. (A) Tannenbaum and Schmids Continuum of Leader Behaviour: This relates to the decision making authority dimension of leader behaviour, and can be displayed on a continuum from autocratic to laissez-faire as shown in figure 1. 29

Continuum of leader decision-making authority

Use of authority by the manager

Area of freedom for subordinates

Manager makes decision and announces it

Manager Manager sells presents decision. ideas and invites questions

Manager presents tentative decisions subject to change

Manager presents problem, gets suggestions, makes decisions

Manager defines limits, asks group to make decisions.

Manager permits subordinates to function within limits defined by superior.

(1)
AUTOCRATIC

(2)

(3)

(4)

(5)

(6)
DEMOCRATIC

(7)
LAISSEZ-FAIRE 30

CONSULTATIVE

PARTICIPATIVE

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NO ONE STYLE IS APPROPRIATE AT ALL TIMES

CONTINGENCY THEORY
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Factors affecting styles :

1234-

Urgency and time factor The type of work Subordinates characteristics Personal characteristics of the leader

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(B) Situational Leadership Model:

In this model leadership style is a combination of task and relationship behaviours.

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TASK BEHAVIOUR
Involves: Extent to which leaders organize and define roles of followers through clearly telling them what to do, how to do it, where to do it, and when to do it, and then closely supervising their performance.

RELATIONSHIP BEHAVIOUR
Involves: Maintaining personal relations with followers, listening to them, providing support and encouragement for their efforts, and then facilitating their involvement and sharing in problem-solving and decision-making.
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There are four leadership styles: Telling, Selling, Participating and Delegating

BUT
THERE IS NO ONE BEST LEADERSHIP STYLE.

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According to Hersey and Blanchard (1996), effective leadership is an interplay among: 1)The leaders task behaviour 2)The leaders relationship behaviour 3)The followers readiness level to take responsibility to perform a task or function.
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Situational Leadership

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SITUATIONAL LEADERSHIP IS NOT

SOMETHING YOU DO TO PEOPLE BUT SOMETHING YOU DO WITH PEOPLE

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Thank You