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PubMed2003

A different age for leadership, part 1: new context, new content.

This is Part 1 of a 2-part article on the new and emerging characteristics and elements of leadership for changing, fast-paced organizations. As we leave the 20th century workplace and are increasingly driven by innovation and technological transformation, new roles are demanded from everyone. Leadership expression now calls for a different emphasis and skill set from those that predominated in the past century. The first article focuses on the context of leadership affecting what leaders do and how they must now behave. Part 2 will center on the activities of leadership and the new learning and skill set development that will increasingly be required of leaders in a fundamentally altered work environment.

Delivery of Health Care↗
PubMed2003

A different age for leadership, part 2: new rules, new roles.

This is Part 2 of a 2-part article on the new and emerging characteristics and elements of leadership for changing, fast-paced organizations. As we leave the 20th century workplace and are increasingly driven by innovation and technological transformation, new roles are demanded from everyone. Leadership expression now calls for a different emphasis and skill-set from those that predominated in the past. The first article (February 2003) focused on the context of leadership affecting what leaders do and how they must now behave. This article centers on the activities of leadership and the new learning and skill-set development that will increasingly be required of leaders in a fundamentally altered work environment.

Attitude of Health Personnel↗
PubMed2005

Promoting nurses' self-efficacy: a leadership strategy to improve practice.

OBJECTIVE: The purpose of this study was to investigate the interaction between structural empowerment, nursing leadership, and self-efficacy for nursing practice, to determine if self-efficacy could contribute to more professional nursing behaviors. BACKGROUND: Increasing self-efficacy for nursing practice may improve nurses' professional practice behaviors because individuals not only react to environmental influences, but also have the ability to exercise self-influence to shape their social systems. A new theory was developed that suggests the interaction between structural empowerment, nursing leadership, and self-efficacy may determine whether a nurse's practice behavior is either professional or more task-focused. METHODS: The study used a nonexperimental survey design. Path analysis was used to demonstrate both direct and indirect relationships. Mediation was also tested through Sobel's tests. RESULTS: Self-efficacy partially mediated the relationship between structural empowerment and professional practice behaviors. Sobel's tests were significant when self-efficacy mediated the relationship between structural empowerment and professional practice behaviors in the group who perceived strong nursing leadership, as well as in the model where nursing leadership was not included. CONCLUSIONS: Nurse managers may want to provide opportunities for enhancing self-efficacy, such as role modeling and verbal persuasion, recognizing that through improved self-efficacy, practice behaviors may improve.

Adult↗
PubMed2005

The RWJ Executive Nurse Fellows Program, Part 2: Mentoring for leadership success.

This article is the second in a 3-part series describing the RWJ Executive Nurse Fellows Program, an advanced leadership program for nurses in senior executive roles who aspire to help lead and shape the US healthcare system of the future. Part 1 (October 2005) described the program, its core leadership competencies, and the primary components. This article discusses the mentor experience that is a cornerstone of the 3-year fellowship program. Fellows are encouraged to have this experience with senior-level executives outside of healthcare in order to broaden their leadership perspectives. Examples of these mentor experiences are described from the viewpoints of both fellows and mentors, including successes, challenges, and lessons learned. Part 3 (February 2006) will explain how fellows are required to create a business plan for their leadership project because it is so important for nurse leaders to offer a strong business case for proceeding with anew initiative, service, or program.

Data Collection↗
PubMed2006

Using an executive coach to increase leadership effectiveness.

Senior executive nursing roles demand excellence and rigor in both the technical and interpersonal domains of leadership. Many nurse leaders have begun seeking innovative self-development programs and practices to assist them as they strive to improve their effectiveness as leaders in complex organizations. One practice that has gained in popularity is that of engaging a leadership "coach." To understand this relatively new trend in healthcare leadership, the authors interviewed 4 coaches and 4 nurse leaders who had been coached. In this article, they present their overall findings about the effectiveness of coaching as a leadership development tool and offer recommendations for leaders who are interested in engaging a coach.

Assertiveness↗
PubMed1998

Shared leadership in a newly merged medical center.

Mergers of new health care entities require visionary leadership in forming effective partnerships. Shared leadership was one key ingredient in blending two major health care competitors in the Northwest. Building a successful foundation for shared leadership required formation of a common vision, definition of core values, and establishment of guiding principles. Honoring respective cultures, recognizing achievements, and inviting participation led to the design of the shared leadership model focused on the primary objective for the merger: Enhancing health care services to the community.

Decision Making, Organizational↗
PubMedDate not supplied

Perceptions of leadership competence between interns and mentors in a cooperative nurse internship.

The ongoing nature of leadership development and a marketplace that requires strong clinical competence call for programs that enhance leadership and clinical skills for new nurses. The author describes an internship designed and implemented by baccalaureate and associate degree faculty and nurse administrators at a local community hospital. Ten new graduates, employed full time, were mentored by nurse managers and taught leadership and clinical skills by nursing faculty during the one-year program. Perceptions of leadership competence between interns and mentors improved in the six categories measured.

Acute Disease↗
PubMed2000

Leadership: a skill, not a role.

The ever-changing healthcare landscape demands leaders who can help navigate through the turbulence. At a time when the demand for leaders in healthcare continues to grow, many wonder whether there is a pending leadership shortage. This perception is fostered by the confusion about how leaders are defined. For many the definition of a leader is synonymous with a job title or role, such as a Manager or Director. Leadership, however, is not a job description; rather, it is influencing others to contribute to a positive outcome. All clinicians, particularly advanced practice nurses, must take the responsibility of finding solutions to the current challenges in healthcare and work through others to achieve a better outcome. In this article leadership is defined by skill sets, not job title, and offers specific strategies to enhance advanced practice nurses' leadership skills.

Humans↗
PubMed2001

A conceptual model for leadership development.

Collaboration among schools of public health and national, state, and local health agencies has resulted in creation of comprehensive public health workforce education and training initiatives that offer integrated, sequential, and accessible professional development programs, including a nation-wide network of public health leadership institutes. A conceptual model for leadership development is presented. It contains seven elements considered critical for design of leadership programs in public health: capacity/competence needs; program target; area served; program content; training level; learning approach; and implementation methods. This model can be used to design leadership as well as public health workforce education and training programs.

Cooperative Behavior↗
PubMed2000

Gender differences in leadership in the health professions.

The leadership characteristics and behaviors of men and women differ. As increasing numbers of women enter positions of leadership, understanding of these differences can increase the quality and productiveness of relationships in the workplace. This article describes the evolution of women in leadership, gender differences in leadership style, and the way gender may affect behaviors in the workplace.

Communication↗
PubMed2006

Clinical leadership in contemporary clinical practice: implications for nursing in Australia.

BACKGROUND: Leadership in the clinical practice environment is important to ensure both optimal patient outcomes and successive generations of motivated and enthusiastic clinicians. AIM: The present paper seeks to define and describe clinical leadership and identify the facilitators and barriers to clinical leadership. We also describe strategies to develop clinical leaders in Australia. Key drivers to the development of nursing leaders are strategies that recognize and value clinical expertise. These include models of care that highlight the importance of the nursing role; evidence-based practice and measurement of clinical outcomes; strategies to empower clinicians and mechanisms to ensure participation in clinical decision-making. KEY ISSUES: Significant barriers to clinical leadership are organizational structures that preclude nurses from clinical decision making; the national shortage of nurses; fiscal constraints; absence of well evaluated models of care and trends towards less skilled clinicians. CONCLUSIONS: Systematic, strategic initiatives are required to nurture and develop clinical leaders. These strategies need to be collegial collaborations between the academic and health care sectors in order to provide a united voice for advancing the nursing profession.

Australia↗
PubMed2004

Personality traits in leadership behavior.

Correlational analyses of the personality traits measured by the Revised NEO Personality Inventory (NEO PI-R; Costa & McCrae, 1992) and three leadership styles, that is, Change, Production, and Employee (CPE) measured by Ekvall and Arvonen's (1991) CPE questionnaire, were performed. The sample was 106 Norwegian leaders. Three common factors comprising leadership styles and personality domains were interpreted as "looking for new possibilities,""hard working," and "dealing with people." Considering personality traits as behavior tendencies in unspecified situational contexts and leadership styles as behavioral tendencies in the leadership context, and due to the self-report nature of the data, it is argued that the factors show consistency in self-perceptions independent of context. The strongest predictors of the CPE total score were Conscientiousness and Extraversion; Openness and Agreeableness were specific predictors of Change and Employee, respectively.

Adult↗
PubMed1995

Leadership development: educating nurse practitioners for the future.

The development of leadership potential is recognized to be an essential component of nurse practitioner education to prepare graduates for a dynamic health care system. Leadership potential refers to those skills that enable a nurse practitioner to function as a change agent and to effectively resolve conflict. The purpose of the study was to examine personal variables (personality type, self-esteem, and learning style) with respect to the leadership potential of pediatric nurse practitioner graduates over a 3-year period. The research study was descriptive, and data were analyzed using descriptive statistics. The subjects consisted of 21 female students who completed five instruments used to measure the relationships between variables and leadership potential. Significant results were found between those students who learned abstractly and the ability to function effectively as a change agent post-program.

Adult↗
PubMed1999

Female medical leadership: cross sectional study.

OBJECTIVE: To assess the relation between male and female medical leadership. DESIGN: Cross sectional study on predictive factors for female medical leadership with data on sex, age, specialty, and occupational status of Norwegian physicians. SETTING: Oslo, Norway. SUBJECTS: 13 844 non-retired Norwegian physicians. MAIN OUTCOME MEASURE: Medical leaders, defined as physicians holding a leading position in hospital medicine, public health, academic medicine, or private health care. RESULTS: 14.6% (95% confidence interval 14.0% to 15.4%) of the men were leaders compared with 5.1% (4.4% to 5.9%) of the women. Adjusted for age men had a higher estimated probability of leadership in all categories of age and job, the highest being in academic medicine with 0.57 (0.42 to 0.72) for men aged over 54 years compared with 0.39 (0.21 to 0.63) for women in the same category. Among female hospital physicians there was a positive relation between the proportion of women in their specialty and the probability of leadership. CONCLUSION: Women do not reach senior positions as easily as men. Medical specialties with high proportions of women have more female leaders.

Adult↗
PubMedDate not supplied

Consultation-liaison psychiatrists on bioethics committees: opportunities for academic leadership.

OBJECTIVE: This article briefly reviews the history of the relationship between psychiatry and the leadership of ethics committees as a background for examining appropriate educational initiatives to adequately prepare residents and early career psychiatrists to serve as leaders of ethics committees. METHOD: A Medline review of literature on psychiatry and ethics committees and consultation as well as recent survey data from the Academy of Psychosomatic Medicine indicate that psychosomatic medicine psychiatrists are particularly qualified and interested in serving as chairs of ethics committees. The authors compare knowledge and skills obtained in psychiatric training with the Society for Heath and Human Values and the Society for Bioethics Consultation Task Force on standards for ethics consultation proposed as core competencies for ethics committee leadership. RESULTS: Psychiatric residency and fellowship training in psychosomatic medicine can provide the knowledge and skill sets to meet the standards for ethics consultation. Further professional development through pursuit of formal ethics training, advance degrees in bioethics, mentoring, and residency and felloships focus on ethics and enhance competency, confidence, and the skills required for ethics committee leadership. CONCLUSIONS: Academic psychiatrists, particularly those in psychosomatic medicine, have historically made a significant contribution as chairs of ethics committees. Continuation and expansion of this leadership may require interested psychiatrists to obtain additional training in bioethics.

Bioethics↗
PubMed1985

Alternative professional roles in health care delivery: leadership patterns in self-help groups.

The increasing professionalization of health care delivery systems, improved client awareness, funding cutbacks, and an emphasis on voluntarism have led recipients of health services to turn increasingly to self-help groups. This article examines the leadership and organizational pattern of such groups, using a study of 43 self-help groups from around the U.S. whose members are parents of children with cancer. Three leadership patterns emerged: groups were independent and parent-led, were led by professionals, or had a shared leadership of parents and professionals. Data indicate that the professionally led groups were the smallest, least formal, and had the narrowest range of activities. The groups with shared leadership had the greatest longevity, tended most often to retain as members parents of deceased children. The authors conclude that such coalitions of clients and professionals are vital for ensuring proper service delivery at a time when health care systems will likely remain bureaucratic and public resources for professional care are being reduced.

Adult↗
PubMed2000

Leadership-scholarship integration: using the Neuman systems model for 21st-century professional nursing practice.

This article describes leadership and scholarship from the Neuman systems model as requisite for a true practice model necessary for 21st-century scientific professional nursing. A rationale for the integration of leadership and scholarship is provided along with markers to guide the leadership-scholarship protocol, which can be viewed as a scholarly research process. An example from a community nursing center demonstrating the application of the integration of leadership-scholarship is presented to support the proposed integration.

Aged↗
PubMed2002

Nursing leadership in Chile: a concept in transition.

The purposes of this two-year research study were to uncover Chilean nurses' perspectives of the elements that comprise leadership, and to identify challenges faced by nurse leaders in modern health administration. The research question is, What are the structural components that define and characterize nursing leadership in Chile? Nine nurses from different professional backgrounds volunteered to take part in audiorecorded successive interviews. The research methodology was a kind of grounded theory. Findings suggest that leadership is characterized mainly by exerting a positive influence on others based on good communication, knowledge of management, and a futurist vision of the nursing profession. Crisis and transition in nursing leadership were associated with external and internal forces, such as reforms in healthcare organizations and changes in the nursing conceptual framework.

Chile↗