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PubMedDate not supplied

National leadership in healthcare: the role of the hospital CEO.

For CEOs, leadership may be exercised in three contexts. However, only two avenues to practice leadership are open to most CEOs: leadership in the CEO's organization and participation as a member of a leadership group. Managers who are successful while functioning as a part of the leadership group generally are those who perform as "transforming" leaders in their own organizations. Transforming leaders hold to strong values and set about to practice them. They do it best when they do for others before doing for themselves. Such behavior draws followers, which in turn confers leadership status on a manager.

Culture↗
PubMed1999

Challenges in developing physician leadership and management.

Many of the issues confronting healthcare organizations require physician involvement and understanding, and the physician executive is a tool to achieving physician participation. Physician leaders can become the mediators between physicians and organizational management, minimizing miscommunication and maximizing agreement and understanding. Yet few doctors seem willing to stand up and speak positively for the plans and proposals that will move the institution forward, and healthcare executives are often frustrated by physician leadership that fails to articulate and implement the vision and objectives of the organization. Understanding physician leadership and exploring the challenges in managing and leading physicians require an understanding of the physician mindset--a completely different mindset than that of the typical healthcare executive. Beginning with a discussion of the unique situation faced by physicians in leadership positions, this article attempts to define the obstacles faced by both the physician and the executive in developing the role of physician executive. After reviewing the opportunities open to physician executives for improving leadership ability, the author presents the essential characteristics and core skills for effective leadership. The second half of the article suggests ways in which an organization can reemphasize physician leadership development within an organization from selection of potential candidates to creating training and networking opportunities and offering appropriate incentives.

Communication↗
PubMed2000

Leadership skills help financial managers achieve career success.

Financial managers who want to distinguish themselves in their organizations need to demonstrate their leadership ability. Because financial managers sometimes overlook the need for leadership skills, cultivating mentors who can teach them specific leadership skills, such as improved communications and entrepreneurship, may be necessary. Healthcare financial managers can sharpen their leadership skills by distinguishing between leadership and management, adopting a new mentoring model, evaluating the usefulness of new management techniques, understanding the connection between technology and leadership, looking for the solution beyond the problem, and being seen and heard within the organization.

Career Mobility↗
PubMed1998

Leadership development in a nursing service. A South African ethnographic perspective.

Leadership development at operational level in a nursing service is important to cope with all the transformation required. The purpose with this study is to explore and describe the views of black professional nurses on leadership behaviour, within the context of an operating theatre department, and to determine the influence of their occupational history on these views. An exploratory and descriptive research design, with an ethnographic perspective, was employed by means of semi-structured interviews (views on leadership) and questionnaires (occupational history). The results compare positively with the theoretical description of leadership behaviour. Guidelines for leadership development of these nurses were formulated, and should be followed by the necessary capacity building regarding leadership practice by professional nurses.

Black or African American↗
PubMed2005

Planting the seeds of leadership.

The college of New Caledonia (CNC) in Prince George, British Columbia, believes in creating an environment where students can learn leadership skills from the beginning of their professional education. To that end, students, faculty members and administrators of CNC's health sciences and social services division worked together to engage in a campaign called "Expect a Leader." The intention of this campaign was to strengthen interdisciplinary awareness between programs and to introduce leadership qualities to future healthcare professionals. This article demonstrates how this initiative created change within six health science programs and across an entire division. The authors represent a cross-disciplinary team of health professionals: former CNC students, faculty members and the administrator. This team came together to discuss leadership strategies and activities that occurred within the educational setting and in the community during the Expect a Leader campaign. The authors anticipate that the campaign will foster students' involvement in interdisciplinary leadership activities within practice settings. Readers of this article will learn about the positive effects of promoting interdisciplinary leadership campaigns across healthcare disciplines, and will gain an understanding of reasons for nurturing leadership from the beginning of the students' education.

Canada↗
PubMed1977

Sharing leadership influence: a life-cycle model.

We have described the effective leader in terms of several concepts: (1) leadership style as a means of sharing the influence of leadership with a ready group; (2) the readiness of a group to successfully exert influence on the practice; (3) the matching of leadership styles with group readiness; and (4) the impact of the environment on the readiness of a group. We have described how all of these elements combine to determine a leader's effectiveness. All elements interact and present the leader with a situation for which he must adopt an appropriate leadership style (Table 1). Several elements combine to change the readiness of a group through four phases - unready, ready, mature, and professional. The leader then matches leadership styles I through IV to these levels of readiness. We believe a dentist will be effective as a leader in proportion to his success in matching an appropriate leadership style to the readiness of his group to perform in its particular environment.

Behavior↗
PubMed1988

Relationship between leadership styles of hospital pharmacists and perceptions of work-unit effectiveness.

Relationships between hospital pharmacists' perceptions of their own and their immediate supervisors' leadership styles and their perceptions of the effectiveness of their work units were examined. Pharmacists practicing in 12 large Chicago-area hospitals were asked to complete a four-part questionnaire that consisted of demographic questions, the LEADSelf instrument, the LEADOther instrument, and a measure of perceived work unit effectiveness. Respondents' primary, secondary, and combination leadership styles and their degree of style adaptability were determined and compared with the primary, secondary, and combination leadership styles and style adaptability of their immediate supervisors and with their perceptions of the effectiveness of their work units. Pharmacists involved in providing clinical or drug information services and pharmacists responsible for purchasing activities perceived their work units to be most and least effective, respectively. Most respondents perceived their primary leadership style to be high task-high relationship, but only 32% perceived their immediate supervisors to exhibit this style. Pharmacists who perceived their immediate supervisors to have high relationship leadership styles (based on primary and combination style classifications) had significantly more favorable perceptions of the effectiveness of their work units than did pharmacists who perceived their supervisors to exhibit low relationship styles. Respondents' perceptions of their supervisors' style adaptability were positively and significantly correlated with their perceptions of work-unit effectiveness. Respondents who thought their supervisors' leadership styles were more adaptable than their own had the most favorable perceptions of work-unit effectiveness.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude of Health Personnel↗
PubMed1985

Leadership styles of hospital pharmacy directors.

The leadership styles of hospital pharmacy directors and the association between leadership style, participative management, and innovative pharmaceutical services were studied using a mail questionnaire. The questionnaire was sent to 570 randomly selected hospital pharmacy directors. Included were a validated instrument that measures task-oriented versus relationship-oriented leadership behavior and other questions about participation of staff members, innovative services, and respondents' personal characteristics. The response rate was 69%. The majority of respondents perceived their leadership as highly relationship-oriented as well as highly task-oriented. Respondents with the "high relationship-high task" leadership style had the highest scores for subordinate participation. There were no significant differences in scores for innovative services by leadership style. A positive correlation between scores for subordinate participation and scores for innovative services was demonstrated. Most hospital pharmacy directors used a management style in which relationships and staff participation were important.

Leadership↗
PubMed1996

Quality leadership: involving staff in continuous quality improvement.

Helen and I hope that you have gained a deeper insight into what it means to be a dynamic leader. We are convinced that leadership skills can be learned. Once learned, they must be operationalized in practice. Practice makes perfect, and the more you use leadership skills the more you master the art of leadership and become more of a craftsman reaping the benefits of intense learning and work. Leadership is a journey. It is a long and often painful one. But, it is the only safe road to travel in this turbulent time. You can become a dynamic leader. The articles in this issue are just an initial step to help you realize your leadership potential and direct you on the right road to fast becoming an effective leader. Helen and I, and her staff thank you for allowing us to share the dynamics of leadership. Hopefully, one day soon I can write a commentary on your success story. Please contact me with your stories so that we can learn through your particular experiences. I invite those interested in contributing to this column to contact me directly. Thank you, and may the road you travel always be the long hard road to success.

Decision Making, Organizational↗
PubMed1996

[Dimensions of leadership practice by nursing service managers].

Leadership development is an important component of the nursing service manager's personal and professional development. Competent leadership is required to lead the nursing service in the right direction within the context of dynamic political and social changes. Various internal and external environmental variables have a significant influence on leadership behaviour and practice. The purpose with this study is to explore and describe the characteristics or dimensions of leadership excellence by the nursing service manager. An exploratory and descriptive research design was followed and data collection was done by means of focus group interviews. The results do not show a significant difference between the knowledge already generated by research, or described in the literature, but is utilised as the basis of leadership development of nursing service managers. A leadership development programme for nursing service managers, based on the results of this study, is recommended.

Focus Groups↗
PubMed1997

Promoting clinical involvement in hospital quality improvement efforts: the effects of top management, board, and physician leadership.

STUDY QUESTION: An examination of the effects of top management, board, and physician leadership for quality on the extent of clinical involvement in hospital CQI/TQM efforts. DATA SOURCES: A sample of 2,193 acute care community hospitals, created by merging data from a 1989 national survey on hospital governance and a 1993 national survey on hospital quality improvement efforts. STUDY DESIGN: Hypotheses were tested using Heckman's two-stage modeling approach. Four dimensions of clinical involvement in CQI/TQM were examined: physician participation in formal QI training, physician participation in QI teams, clinical departments with formally organized QA/QI project teams, and clinical conditions and procedures for which quality of care data are used by formally organized QA/QI project teams. Leadership measures included CEO involvement in CQI/TQM, board quality monitoring, board activity in quality improvement, active-staff physician involvement in governance, and physician-at-large involvement in governance. Relevant control variables were included in the analysis. PRINCIPAL FINDINGS: Measures of top management leadership for quality and board leadership for quality showed significant, positive relationships with measures of clinical involvement in CQI/TQM. Active-staff physician involvement in governance showed positive, significant relationships with clinical involvement measures, while physician-at-large involvement in governance showed significant, negative relationships. CONCLUSIONS: Study results suggest that leadership from the top promotes clinical involvement in CQI/TQM. Further, results indicate that leadership for quality in healthcare settings may issue from several sources, including managers, boards, and physician leaders.

Chief Executive Officers, Hospital↗
PubMed2003

Transformational, transactional, and laissez-faire leadership styles: a meta-analysis comparing women and men.

A meta-analysis of 45 studies of transformational, transactional, and laissez-faire leadership styles found that female leaders were more transformational than male leaders and also engaged in more of the contingent reward behaviors that are a component of transactional leadership. Male leaders were generally more likely to manifest the other aspects of transactional leadership (active and passive management by exception) and laissez-faire leadership. Although these differences between male and female leaders were small, the implications of these findings are encouraging for female leadership because other research has established that all of the aspects of leadership style on which women exceeded men relate positively to leaders' effectiveness whereas all of the aspects on which men exceeded women have negative or null relations to effectiveness.

Administrative Personnel↗
PubMed2005

Management and leadership: analysis of nurse manager's knowledge.

Nurses have assumed management positions in many health institutions. To properly accomplish the demands of this role, it is important that they be competent in both management and leadership. For appropriate performance, knowledge of management and supervision styles is a priority. Therefore, the goal of this investigation is to identify the nurse manager's knowledge regarding management and leadership. A structured questionnaire containing twenty-seven questions was applied to twelve Brazilian nurse managers of primary care center called "Family Basic Health Units". Data analysis suggested that the nurse manager lower knowledge in management and leadership is related to visionary leadership, management and leadership conceptual differences, leader's behavior, and situational leadership. And, nurse manager greater knowledge is related to power; team work, and coherence between values and attitudes.

Adult↗
PubMed1999

Nursing leadership in the US 1950s-1970s: a discourse analysis.

This paper proposes that the development of nursing leadership and the struggle for professionalisation from the time of the early nineteenth century to the late twentieth century may be conceived as a series of products of constituent discourses. However, particular attention is focused on the concept of leadership as it pertains to the nursing profession in the US between the 1950s-1970s. This time-frame is an important period in the discursive formation of the idea of leadership and professionalisation as the US literature on these subjects in the areas of sociology, psychology, education and business administration exercised a strong influence on the microsocial world of professional nursing practice in the US and, indeed elsewhere, for example, Australia and the UK. The sociological complexity of the concept of leadership ultimately meant that it came to be regarded as a dynamic process pervading the existence of all people; their interrelationships, their morale, their confidence and their capacity to achieve. These features are reflected through the perceptions, beliefs and experiences of the American nursing profession as its constituent discourse appeared during the 1950s-1970s. Thus the paper is a discourse analysis on leadership in nursing with particular attention given to the bureaucratic authority of the hospital, the drive for the creation of a profession and the idea of leadership itself.

History, 20th Century↗
PubMed2006

Leadership characteristics and business management in modern academic surgery.

BACKGROUND: Management skills are necessary to successfully lead a surgical department in future. OBJECTIVE: This article focuses on practical aspects of surgical management, leadership and training. It demonstrates how the implementation of business management concepts changes workflow management and surgical training. METHODS: A systematic Medline search was performed and business management publications were analysed. RESULTS: Neither management nor leadership skills are inborn but acquired. Management is about planning, controlling and putting appropriate structures in place. Leadership is anticipating and coping with change and people, and adopting a visionary stance. More change requires more leadership. Changes in surgery occur with unprecedented speed because of a growing demand for surgical procedures with limited financial resources. Modern leadership and management theories have to be tailored to surgery. It is clear that not all of them are applicable but some of them are essential for surgeons. In business management, common traits of successful leaders include team orientation and communication skills. As the most important character, however, appears to be the emotional intelligence. Novel training concepts for surgeons include on-the-job training and introduction of improved workflow management systems, e.g. the central case management. CONCLUSION: The need for surgeons with advanced skills in business, finance and organisational management is evident and will require systematic and tailored training.

Entrepreneurship↗
PubMedDate not supplied

Role-taking abilities of nursing education administrators and their perceived leadership effectiveness.

This article examines the relationship between role-taking abilities of nursing education administrators and their perceived leadership effectiveness as rated by their faculty. Thirty nursing education administrators and their respective faculty members (n = 176) participated in this cross-sectional survey study. All participants filled out a demographic questionnaire, nursing education administrators also filled out the Davis Interpersonal Reactivity Index, which measured their role-taking abilities, and faculty also filled out selected subscales of the Leadership Behavior Description Questionnaire-XII (LBDQ-XII), which measured their perception of their nursing education administrators' leadership effectiveness. Correlation coefficients were calculated for these data, and they were also subjected to multiple regression analysis. Initial analysis of the data indicated that 26 of the 30 administrators were perceived to be effective leaders. Statistical analysis determined that there was a significant positive relationship between the role-taking abilities of the nursing education administrators and the consideration subscale of the LBDQ-XII. Multiple regression analysis found that certain organizational variables--formalization, centralization, and job satisfaction--affected the perception of leadership effectiveness. Further analysis of these three organizational characteristics according to large and small organizations found inverse relationships between job satisfaction and the faculty's perception of formalization and centralization. The results of this study support role-taking abilities among nursing education administrators as a way of enhancing their leadership effectiveness.

Cross-Sectional Studies↗
PubMed2006

A leadership programme for critical care.

This paper describes the genesis, design and implementation of a leadership programme for critical care. This was an initiative funded by the National Health Service (NHS) Nursing Leadership Project and had at the core of its design flexibility to meet the needs of the individual hospitals, which took part in it. Participation was from the multi-disciplinary critical care team. Six NHS hospitals took part in the programme which was of 20 days duration and took place on hospital sites. The programme used the leadership model of as its template and had a number of distinct components; a baseline assessment, personal development, principles of leadership and critical case reviews. The programme was underpinned by three themes; working effectively in multi-professional teams to provide patient focussed care, managing change through effective leadership and developing the virtual critical care service. Each group set objectives pertinent to their own organisation's needs. The programme was evaluated by a self-reporting questionnaire; group feedback and feedback from stakeholders. Programme evaluation was positive from all the hospitals but it was clear that the impact of the programme varied considerably between the groups who took part. It was noted that there was some correlation between the success of the programme and organisational 'buy in' as well as the organisational culture within which the participants operated. A key feature of the programme success was the critical case reviews, which were considered to be a powerful learning tool and medium for group learning and change management.

Attitude of Health Personnel↗
PubMed2004

Introducing and developing nurse leadership through a learning set approach.

This study is an evaluation of how far the use of co-operative learning has helped six 'new' Directorate Senior Nurses (DSNs) at Salisbury District Hospital NHS Trust in the UK to develop their roles, and reflects on their acquisition of leadership skills and capability. The project has two elements: co-operative learning and evaluation research of both learning methods and leadership development. The six DSNs--five nurses and one midwife--agreed to take part in both aspects, with the research aspect consisting of tape-recorded, qualitative interview questions based on the leadership characteristics given by Krause [The Way of the Leader, Nicholas Brealey, London, 1997]. The research showed that co-operative learning was an effective way of learning leadership and role acquisition. The DSNs identified gaps in their knowledge and understanding of leadership. However, they found that, by exploring their life experiences through reflection and developing knowledge from theory as part of co-operative learning, they were able to construct strategies to help them manage their role in new and creative ways.

Educational Measurement↗