Jack: Hi everyone, and welcome to this week's module,
in which we're going to be discussing principles
of effective leadership.
So in this module, we're first going to understand concepts
and theories about leadership.
Then we'll use those concepts and theories
to analyze approaches to managing people, resources
and organizational change.
From there, we're gonna use different models
to identify leadership behaviors,
knowledge and skills,
then build partnerships and networks
to provide healthcare services.
And finally, we'll apply this knowledge
to look at healthcare issues affecting low income countries.
And I also wanna point out that throughout this chapter,
there's this number of vignettes I'd encourage you to read
detailing the application of different leadership principles
in different settings around the world.
So those are very helpful. Definitely look into those.
So to begin with, the book posits that there's a crisis
in leadership today.
Or rather, there's numerous crises
facing health leaders today.
Some of these crises include constant changes
in health system reform.
Emergencies, disasters and conflicts,
which concern global leaders.
Inadequate preparation
of organizations providing healthcare.
A lack of expertise in planning and implementing change
and deficiencies in strategy to sustain the change.
Some of these crises that we think about
include climate change, migration, displacement,
political changes, et cetera.
So now we look at the power of motivation.
And this is so central to this chapter
because the fundamental job of a leader
is to motivate team members.
Motivation leads to accomplishing organizational goals
and brings positive outcomes,
and it's important to consider individual needs
and make staff feel appreciated.
There's three main kinds of motivation.
The first, achievement motivation,
is driven by accomplishment of goals.
The second, authority or power motivation
is driven by the desire for power and influence.
And affiliation motivation describes motivation
that's driven by interpersonal relationships.
People that have theorized
about different kinds of motivation
have found or believe that achievement motivated leaders
are the ones who produce the best results.
And they do so by setting goals that are achievable
through their own efforts
and the efforts of others in the organization.
The work of these thinkers suggests
that achievement is more important than material
or financial reward.
And there have been numerous studies
that support this suggestion.
While financial report may be...
Financial rewards and payment may be important
in attracting high performers,
recognition,
job satisfaction,
and the presence of a clear career path
and promotional chain
are key elements of organizational retention strategies.
(paper rustles)
So now we'll turn
to the dimensions of Healthcare Leadership Model.
And this is a model that describes key aspects
of healthcare leadership.
This was developed
by the United Kingdom's National Health Service or NHS,
and this was published in 2016.
The dimensions of this model include leading with care,
sharing the vision, engaging the team, influencing results,
evaluating information, inspiring shared purpose,
holding to account and developing capability.
And you'll note that a number of these
really involve interdisciplinary teams.
You know, they don't rely exclusively on the leader, they...
It's a combination of the leader, the members of the team,
and the population they're serving.
So next, how does one develop these leadership competencies?
There's no one, single path for developing competencies.
Rather, there's a number of different ways to do so.
And it's important to use these different skills
or these different tools in conjunction with each other.
For example, after assessing your strengths and weaknesses,
you might want to obtain formal training
to make up for some of your weaknesses.
Or you find a mentor or a coach who can help you
to work on some of those weaknesses
and turn them into strengths.
It's also important to be an active networker
and see what other leaders are doing in the field,
and to use those other leaders as best examples
to guide your own leadership style.
We all...
And it's also important to remember
to participate continuously
in professional development opportunities,
both within your organization and in other settings.
So next, we turn to this Change Management Model.
It's highly useful for healthcare leaders
and it consists of eight steps.
These steps can be used to respond quickly to change
whether in terms of unexpected emergencies,
reorganize systems of care,
the adoption of new technology
or implementation of quality improvement initiatives.
With the steps here listed on the slide,
it outlines a way to turn negative events
into a positive force for change.
Next, I really like this figure
because it identifies some of the key stakeholders
who contribute to organizational change,
and with whom senior healthcare leaders
continually interact.
For example, and as we mentioned before,
it's very important to build teams of different stakeholders
and communicate a vision
to encourage buy-in from various groups.
These groups, like I mentioned before,
can be the audience or the community who you're serving,
or the staff members of your organization.
So now we turn to the Millennium Development Goals.
And while the Millennium Development Goals
are mentioned in the book,
and they were published in 2018,
they have since been replaced
by the Sustainable Development Goals,
also from the United Nations.
That being said, the Millennium Development Goals
or the MDGs,
and the Sustainable Development Goals, the SDGs,
are similar and there are numerous overlaps.
Though the SDGs are more numerous
and get into more detail about the dates and the years
by which they hope to be accomplished.
This is an example of a list of global efforts
to improve health,
particularly for vulnerable populations.
These are all given time-bound targets
to ensure that they have a set timeline for being met.
UNICEF related to the development of these goals
has estimated that 80% of all newborn deaths are preventable
with the right interventions,
in the right place at the right time.
And you'll read more about these interventions
in your readings this week.
Next we turn to the distinction between leadership traits
and leadership styles.
It's important to note that leadership traits
and leadership styles are not the same.
The leadership styles describe more encompassing
portfolios of leadership.
For example, situational leadership,
transformational leadership,
and servant leadership.
Where leadership traits are just aspects or components
of these styles,
like self understanding,
performances and effectiveness and management by objectives.
You can read more about all of these traits and styles
in the textbook chapter this week.
Next, we turn to this figure, which I like a lot,
as it lays out a Professional Development Model
for healthcare leaders.
This pyramid provides a way of conceptualizing
the relationships between the necessary body of knowledge,
skills and competencies
as individuals take on leadership responsibility.
In this particular model,
people are drawn to management and leadership positions
because they have a certain level of interest,
desire or motivation
at the bottom level of the pyramid,
which is rooted in their personal background.
To reach the higher levels of the pyramid,
they must acquire a body of knowledge
through formal education,
and they must develop through training and work experience
the set of skills necessary
for specific leadership positions
within a particular organization and healthcare setting.
(paper rustles)
Another kind, another model of learning,
which is not depicted here,
describes the process of learning from awareness
to understanding,
to finally action on that understanding.
Related to these models of learning,
this diagram is the International Hospital Federation
Competency Domains.
This is a platform of key competencies
for healthcare leaders and managers,
which was derived
from the Healthcare Leadership Alliance model.
There are five specific domains
across which specific competencies can be categorized.
Leadership, health and healthcare environment,
business skills, communications and relationship management,
and professional and social responsibility.
These are interconnected domains
depicted in the figure on this slide.
Next, the Cascading Competency Model shown here
considers competencies on a continuum,
with individuals progressing from minimal competencies
to maximum competencies.
The model assumes that people over time
will acquire the body of knowledge,
the skills and the attitudes needed
to demonstrate effective and efficient leadership behavior.
They develop basic competencies
upon entering an entry-level position,
and then proceed to acquire intermediate competencies
and eventually advanced competencies.
These competencies can correspond
with the stages for early career,
mid-career and late career.
And this type of thinking is embedded
in the competency assessment
used by the American College of Healthcare Executives
or ACHE,
which assumes that individuals develop in their careers
and embark on a process of lifelong learning
to enhance their professional competencies
and qualify for future leadership positions.
Next, this figure expands on the Cascading Competency Model
to more clearly represent the levels of competency training
and the growing intensity from one level to the next.
As competency development matures,
base competency serve as the foundation
for the development of intermediate
and more advanced competencies.
Training and experience enable individuals
to move from entry-level positions to middle management,
and ultimately to senior management.
Next, we turn to evidence-based management.
And evidence-based management takes a similar approach
to management practices and has led to protocols
that are now being applied globally.
These principles apply the principles
that management should be based on evidence,
and in a similar way
that medicine is based on evidence-based interventions.
This Eight-Step Model
published by Robbins and DeCenzo in 2004,
lays out steps by which one becomes an effective manager
or one makes an effective management decision.
Next, we'll turn to the BRIDGE Model
for successful partnerships.
This came out of a collaboration in the 1990s
between the University of Scranton in Pennsylvania
and three Slovakian partners.
Again, the importance of teams
to create effective leadership strategies.
This partnership framework was developed
to assist with the restructuring of health services
and systems in central and eastern Europe.
Here BRIDGE stands for Building Relationships
in Developing and Growing Economies.
And it stresses the importance of collaboration
and cooperation,
sustainability and financial solvency.
It also focused on replication.
The ability of partnership projects to repeat it
in other settings.
Key features are shown on the slide.
The model used university-based partnerships
with religious affiliations
while drawing upon
and recognizing local community healthcare providers
as key stakeholders and partners.
Another key theme
when dealing with effective leadership development
and principles of effective leadership
are adult learning principles and methods.
As we discussed in the beginning of this lecture,
one key way that leaders develop
or leaders develop their leadership styles
is that they participate in continuing education workshops
and other methods by which to increase their skills.
In these workshops,
it's important to take note of adult learning principles
and methods.
Which are different from child and youth principles
and methods.
So here are some examples,
adult learners looking for competent teachers,
using life experiences, working in teams, group discussion,
et cetera.
And adult methods of learning,
while similar to elementary, middle and high school levels
of learning,
emphasize group interaction, simulation, case analysis,
and real projects that can really, clearly be applied
to the workplace.
So here are some examples of education and training,
residency training, career planning, shadowing,
self-study courses, coaching, field work, fellowships.
Some of these types of education and training
might be more relevant for certain careers
in certain physicians than others.
And this list is certainly not exhaustive.
Next, we'll discuss a little bit
about the Jesuit Paradigm for learning.
And here the Jesuit Paradigm describes growth,
development and change.
And it includes reflection as a key stage.
Reflection can add meaning to the work environment
and provide valuable new perspectives
about existing conditions,
and ways to bring about change.
Finally, when we turn to the importance of leadership
in healthcare performance,
we see that clinical outcomes,
patient safety and patient satisfaction
are all key outcomes related
to the skill of the CEO and executive staff,
the medical staff,
and the governing board of a healthcare organization.
So in summary,
it's important that leaders can navigate change
and motivate others to reach organizational goals.
That leaders are prepared to deal
with a wide range of obstacles,
and that leaders are continuously
developing their leadership skills
based on the best available evidence,
and that they're self-aware
and self-understanding throughout the process.