By Bruce Anderson To grow an organisation, you need to grow its people.
These changes require leadership capable of transforming not just a physical environment, but also the beliefs and practices of nurses and other health care workers providing care in that environment and those in the HCO who establish the policies and practices that shape the environment—the individuals who constitute the management of the organization.
Behavioral and organizational research on work and workforce effectiveness, health services research, studies of organizational disasters and their evolution, and studies of high-reliability organizations see Chapter 1 have identified management practices that are consistently associated with successful implementation of change initiatives and achievement of safety in spite of high risk for error.
Because HCOs vary in the extent to which they currently employ these practices, as well as in their available resources, collaborations with other HCOs can facilitate more widespread adoption of these practices.
We first discuss transformational leadership as the essential precursor to any change initiative. Finally, we examine how evidence-based management collaboratives can be used to stimulate the uptake of health care quality improvement practices. Not surprisingly, leadership has been observed to be the essential precursor to achieving safety in a variety of industries Carnino, undateda critical factor in the success of major change initiatives Baldridge National Quality Program, ; Davenport et al.
In a study of hospital reengineering initiatives in U. The exercise of leadership has also been associated with increased job satisfaction, productivity, and organizational commitment among nurses and other workers in HCOs Fox et al. He stresses that leadership, like the exercise of power, is based foremost on a relationship between the leader and follower s.
In contrast to power, however, leadership identifies and responds to—in fact, is inseparable from—the needs and goals of followers as well as those of the leader. Leadership therefore can be either transaction-based or transformational. Transactional leadership typifies most leader—follower relationships.
Each party to the bargain is conscious of the power and attitudes of the other.
Their purposes are related and advanced only as long as both parties perceive their individual interests to be furthered by the relationship. The bargainers have no enduring relationship that holds them together; as soon as an item of value is perceived to be at risk, the relationship may break apart Burns, This point is illustrated by labor strikes resulting from a change in the terms of work.
The compliance of labor with management is based on an acceptable set of transactions; when the transactions are changed, the relationship may not have much to hold it together.
In contrast, transformational leadership occurs when leaders engage with their followers in pursuit of jointly held goals. Their purposes, which may have started out as separate but related as in the case of transactional leadershipbecome fused.
Transformational leadership is in essence a relationship of mutual stimulation and elevation that raises the level of human conduct as well as the aspirations of both the leader and those led, and thereby has a transforming effect on both Burns, Transformational leadership is achieved by the specific actions of leaders.
First, leaders take the initiative in establishing and making a commitment to relationships with followers. This effort includes the creation of formal, ongoing mechanisms that promote two-way communication and the exchange of information and ideas. On an ongoing basis, leaders play the major role in maintaining and nurturing the relationship with their followers.
Although a transforming leader plays the major role in achieving the combined purpose of leader and followers, transformational leadership recognizes that leaders and followers are engaged in a common enterprise and thus are dependent on each other. The premise of transformational leadership is that, regardless of the separate interests people may hold, they are presently or potentially united in the pursuit of higher goals.
|Author Credits||Almost everything that affects an organization's ability to compete and respond successfully to changes in the external environment — ultimately, the organization's success or failure — is an aspect of that culture.|
This point is evidenced by the achievement of significant change through the collective or pooled interests of leaders and followers. The effectiveness of leaders and leadership is measured by the extent to which intended change is actually accomplished and human needs and expectations are satisfied Burns, Burns offers reassurance that transformational leadership is far more common than might be thought, given the above discussion.
He notes that acts of transformational leadership are not restricted to and often are not found in governmental organizations, but are widespread in day-to-day events, such as whenever parents, teachers, politicians, or managers tap into the motivations of children, students, the electorate, or employees in the achievement of a needed change.
In acute care hospitals, individuals in potential transformational leadership roles range from board-level chairmen and directors; to chief executive, operating, nursing, and medical officers; through the hierarchy to unit managers.
Leadership by these senior organization managers and oversight boards is essential to accomplishing the breadth of organizational change needed to achieve higher levels of patient safety—changes in management practices, workforce deployment, work design and flow, and the safety culture of the organization see Chapter 1.
However, if these individuals rely solely on a traditional, transactional approach to leadership, such substantive changes are likely to be difficult to achieve and sustain, as leaders will need to conduct frequent, ongoing, possibly contradictory renegotiations with workers in response to rapidly changing external forces.
In contrast, transformational leadership seeks to engage individuals in the recognition and pursuit of a commonly held goal—in this case, patient safety. For example, individual nurses may desire wide variation in the number of hours they would like to work on a hour or weekly basis.
Attempting to secure their commitment to the organization by accommodating all such requests transactional leadership despite evidence that extended work hours may be detrimental to patient safety would likely be both time-intensive and unsuccessful.
Instead, transformational leadership would engage nursing staff in a discussion of patient safety and worker fatigue and seek to develop work hour policies and scheduling that would put patient safety first and respond to individual scheduling needs within that construct.
Such a discussion could have a transforming effect on both staff and management as knowledge was shared.
A leadership approach that aims to achieve a collective goal rather than a multitude of individual goals and aims to transform all workers—both managers and staff—in pursuit of the higher collective purpose can be the most efficient and effective means of achieving widespread and fundamental organizational change.
In practicing transformational leadership, leaders need to engage managers and staff in an ongoing relationship based on the commonly held goal of patient safety, and communicate with and teach managers and staff about this higher collective purpose.
When teaching managers about the actions they can take to minimize threats to patient safety, HCO leaders should underscore the five management practices enumerated earlier that have been found to be consistently associated with successful implementation of change initiatives and with the achievement of safety in organizations with high risk for errors.
These management practices also underlie all of the worker deployment, work design, and safety culture practices that are addressed in the remaining chapters of this report.The company's mission statement, organizational culture, and style of leadership are factors that are typically associated with the internal environment of an organization.
The external environment are those factors that occur outside of the company that cause change in organizations and are, for the most part, beyond the control of the company.
The company's mission statement, organizational culture, and style of leadership are factors that are typically associated with the internal environment of an organization. The internal factors determine how the organization moves forward, both as a self-contained organizational entity and in response to its external environment.
Internal Factors: Mission. Why does an organization exist? What is its purpose? Answering these fundamental questions describes an organization's mission. How to Break the 7 Barriers of Leadership December 26, Tags: Leadership, Leadership Development, organizational success.
The counterpoint to #7 is #8, having the vision (internal and external) to see it is the challenge. That definition of insanity keep on doing what you have been and expecting different results, may come into.
Internal and External Barriers by Pamper Your Mind / Monday, 07 April / Published in Uncategorized Last week, I encouraged you to identify your goals.
Organizational Communications (Internal and External) Much of the information in this topic is adapted from the books Field Guide to Leadership and Supervision in Business and Field Guide to Leadership and Supervision for Nonprofit Staff.