Special leadership & management challenges in the 21st century


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Special leadership & management challenges in the 21st century

  1. 1. Special Leadership & Management Challenges in the 21st Century<br />Rami N. Abdel Rahman<br />Oncology Nursing Master Student<br />2010 – 2011<br />Supervised and directed By:<br />Dr. Nejmeh Al Attyat.<br />10/10/10<br />1<br />
  2. 2. Questions to Consider!!<br />Why is it important for you to understand the mission &values of the organization to provide direct patient care?<br />What leadership and management skills will assist you as beginingnew role as Nursing leader?<br />What type of team-building skills will help you leading a multidisciplinary team and coordinate patient care?<br />10/10/10<br />2<br />
  3. 3. Learning Outcomes<br />Relate leadership and managementtheory to nursing leadership and management activities.<br />Differentiate among the five functions of management essential activities related to each function<br />10/10/10<br />3<br />
  4. 4. Learning Outcomes<br />Integrate principles of the customer service role in professional nursing practice.<br />Implement effective team-buildingskills as an essential component of nursing practice.<br />10/10/10<br />4<br />
  5. 5. Learning Outcomes<br />Implement the concept of transformational leadership in nursing directed institutions.<br />Discuss the implications Magnet Hospitals on the leadership & management.<br />10/10/10<br />5<br />
  6. 6. Key Terms<br />Authority<br />Healthcare Organizations<br />Leadership<br />Management<br />Organizational Chart<br />Resources<br />Productivity<br />Safety<br />Quality<br />Service excellence<br />Point of care<br />Stakeholders<br />Transactional vs.<br />Transformational<br />Customers<br />10/10/10<br />6<br />
  7. 7. During Nursing School<br />More concerned with developing clinical knowledge and skills.<br />But immediately after graduation, you may placed in many situations that require leadership and management skills<br /><ul><li>Less concerned with management and leadership .</li></ul>10/10/10<br />7<br />
  8. 8. After Graduation<br />Managing group of assigned patients<br />Serving on a taskforce or a committee<br />Acting as team leader or charge nurse<br />And, and, and ,….. ….. etc. <br /><ul><li>Providing safe, evidenced – based, high quality clinical care. This also require these skills</li></ul>Also..!<br />10/10/10<br />8<br />
  9. 9. 21st century demands<br />Higher – acuity patients.<br />Diverse health professionals and nonprofessionals.<br />Work environment .<br />Reimbursements, health insurance.<br />Constant admitting and discharging units.<br />Shrinking budgets.<br />Limited resources.<br />10/10/10<br />9<br />
  10. 10. Health care providers and Nursing Turnover.<br />Nurse : Patient (ratio).<br />Standardization (JCI, CCHSA..etc)<br />Cultural and societal development and changes.<br />Traditional  Evidence-based Nursing<br />21st century demands and challenges<br />10/10/10<br />10<br />
  11. 11. What is expected!<br />Regardless of which position or area the nurse is employed, the health care organization will expect the professional nurse to have leadership and management skills<br />10/10/10<br />11<br />
  12. 12. What is leadership?<br />Leadershipoccurs any time a person attempts to influence the beliefs, opinions, or behaviors of a person or group (Hersey and Blanchard, 1988)<br />Situational Leadership Model<br />10/10/10<br />12<br />
  13. 13. So… what is leadership?<br />It is a combination of:<br /> intrinsic personality traits.<br />Learned leadership skills.<br />and characteristics of the situation.<br />It is to guide people or groups to accomplish common goals.<br />May not have formal authority.<br />10/10/10<br />13<br />
  14. 14. Leadership defined!<br />“a job title alone does not make a person a leader. Only a person’s behavior determines if he or she occupies a leadership position” (Marquis and Huston, 2006)<br /><ul><li>Leadership ability may be related to qualities, such as:
  15. 15. Unique characteristics.
  16. 16. Exceptional clinical expertise.
  17. 17. Relationships with other organizations.</li></ul>10/10/10<br />14<br />
  18. 18. What is Management?<br />Management refers to the activities involved in coordinatingpeople, time, supplies to achieve desired outcomes and involves problem-solving and decision making processes.<br />10/10/10<br />15<br />
  19. 19. So.. What is Management?<br />Control of day-to-day operations of a defined area or responsibility.<br />Plan and organize:<br />What is to be done.<br />Who is to do it.<br />When is to be done.<br />10/10/10<br />16<br />
  20. 20. Nurse Manager.. e.g…<br />An appointed management position within an organization:<br />Planning staffing.<br />Employee performance reviews.<br />Controlling use of supplies.<br />Meeting, budgeting, productivity goals… etc<br />A formal line of authority and accountability to ensure:<br />Safe and effective patient care along with organization’s goals and standards.<br />10/10/10<br />17<br />
  21. 21. Leadership versus management<br />Leadership and management are intertwined.<br />Its difficult to discuss one without the other.<br />Though… they are different concepts.<br />10/10/10<br />18<br />
  22. 22. Leadership versus management<br />Leadership<br />The ability to guide or influence others.<br />People are led.<br />Leaders are able to motivate and inspire others.<br />Management<br />The coordination of resources (time, people, supplies)<br />Activities and things are managed.<br />Managers have the assigned responsibility to accomplish organization’s goals.<br />10/10/10<br />19<br />
  23. 23. Leadership versus management<br />Leadership<br />A person with good management skills may not have leadership ability. Same the way around.<br />Leadership and management skills are complementary <br />Both can be learned and developed through experience.<br />Improving skills in one area will enhance abilities in the other.<br />Management<br />10/10/10<br />20<br />
  24. 24. Power and Authority<br />Authority: is the legitimate right to direct others and is given to a person by the organization through an authorized person (e.g. Nurse Manager)<br />10/10/10<br />21<br />
  25. 25. Power and Authority<br />Power: is the ability to motivate people to get things done with or without the formal right granted by the organization.<br />Sources of Power are identified<br />10/10/10<br />22<br />
  26. 26. The primary sources of power<br />Reward Power: to reward others (e.g. money, acknowledgment, desired assignment… etc.)<br />Coercive Power: based of fear of punishment (opposite of reward)<br />10/10/10<br />23<br />
  27. 27. The primary sources of power<br />Legitimate Power: based on an official position in the organization (granted right to influence)<br />Referent Power: comes from the followers to the leader (admiration, respect… etc)<br />10/10/10<br />24<br />
  28. 28. The primary sources of power<br />Expert Power: based on knowledge, skills and information<br />Information Power: information that is needed by others.<br />Connection Power: relationship or affiliation with powerful people.<br />10/10/10<br />25<br />
  29. 29. Chain of Authority (e.g.)<br />10/10/10<br />26<br />
  30. 30. Organizational Chart and Chain of Authority<br />10/10/10<br />27<br />
  31. 31. 10/10/10<br />28<br />
  32. 32. Leadership Theories<br />10/10/10<br />29<br />
  33. 33. Sir Francis Galton<br />One of the earliest leadership theorists<br />Wrote “Hereditary Genius” pub. 1869<br />Believed leadership qualities were genetic<br />This theory assumes physical and psychological characteristics (traits) account for effective leadership<br />Basic intelligence<br />Clear and strong values<br />High personal energy<br />Leadership Trait Theory<br />Leaders were born with such traits<br />10/10/10<br />30<br />
  34. 34. Leadership Trait Theory<br />Edwin Gheselli identified six traits for effective leadership:<br />Need for achievement<br />Intelligence<br />Decisiveness<br />Self-confidence<br />Initiative<br />Supervisory ability<br />10/10/10<br />31<br />
  35. 35. Leadership Trait Theory<br />Borrow Ideas<br />Leading by example<br />Accountable<br />Fairness<br />Virtue<br />Respect<br />Listening<br />Involving<br />Planner<br />Dreamer<br />Integrity<br />Sense of Humor<br />Humble<br />Simplifier<br />Serve<br />10/10/10<br />32<br />
  36. 36. Leadership Behavior Theory <br />In the 1930s, emphasis on behaviorism moved researchers in the direction of leadership behavior<br />Kurt Lewin trained assistants in behaviors indicative of three leadership styles: <br />Autocratic: tight control of group activities, decisions made by the leader<br />Democratic: group participation, majority rule<br />Laissez-faire: little activity of any type by the leader.<br />10/10/10<br />33<br />
  37. 37. Leadership Behavior Theory <br />In the 1940s, research focused on leader behaviors<br />Assumed that leaders take distinct actions<br />Ralph Stogdill at Ohio State University<br />Helped develop the Leader Behavior Description Questionnaire (LBDQ)<br />Respondents described leaders’ behavior in two dimensions:<br />Initiating structure<br />Showing consideration<br />10/10/10<br />34<br />
  38. 38. Leadership Behavior Theory <br />3D Behavioral Scale<br />10/10/10<br />35<br />
  39. 39. Take a Break<br />10/10/10<br />36<br />
  40. 40. Do you know them..?<br />10/10/10<br />37<br />
  41. 41. Do you know them..?<br />10/10/10<br />38<br />
  42. 42. Do you know them..?<br />10/10/10<br />39<br />
  43. 43. Do you know them..?<br />10/10/10<br />40<br />
  44. 44. Nursing Leaders<br />10/10/10<br />41<br />
  45. 45. Do you know them..?<br />If you know 30 names… You are genius!!<br />10/10/10<br />42<br />
  46. 46. Other Leadership Theories<br />Situational Leadership Theory.<br />Interactional Leadership Theory.<br />Leadership Contingency Theory.<br />10/10/10<br />43<br />
  47. 47. Transformational Leadership<br />Leadership theory is an evolving field; while these highlight the most common theories of the last century, more theories continue to be researched in the elusive search for a definitive understanding of leadership. More recent leadership theories are discussed on the following slides.<br />10/10/10<br />44<br />
  48. 48. Transformational Leadership<br />Burns (1978) identified and defined transformational leadership.<br />Tow types of leaders:<br />The transactional leader; concerned with day-to-day operation of the facility.<br />The transformational leader; committed to organizational goals, has vision and is able to empower others<br />10/10/10<br />45<br />
  49. 49. Transactional Vs. Transformational<br />Transformational<br />Identify and clearly communicate vision and direction.<br />Empower the work group to achieve goals and vision.<br />Are admired and emulated.<br />Provide mentoring based on needs.<br />Transactional<br />Focus on day–to–day operation.<br />Reward staff for desired work (I’ll do x for you doing y).<br />Monitor work performance.<br />Wait until problems occur and deal with it.<br />10/10/10<br />46<br />
  50. 50. Anderson, S. & Miller, A. (2007). Implementing Transformational Leadership as a Model for Service Learning Activities in an Online RN to BSN Leadership Course. Online Journal of Nursing Informatics (OJNI), 11, (1).<br />Transformational Leadership<br />Transformational Leadership means collective empowerment:<br /><ul><li>All parties work together to achieve a shared goal.
  51. 51. Focus is innovation and change.
  52. 52. Followers have a sense of mission.
  53. 53. Leaders inspire followers beyond interpersonal relationships and extrinsic rewards for a job well done.
  54. 54. People have a purpose: worthwhile, meaningful and important.</li></ul>10/10/10<br />47<br />
  55. 55. Transformational Leadership<br />Anderson, S. & Miller, A. (2007). <br />Nurses are responsible for providing high quality patient care in a culture of safety.<br />Transformational leaders help achieve this goal …<br /><ul><li>Make the experience meaningful, inspiring, exciting…
  56. 56. Appeal to our sense of mission and purpose of making a difference in people’s lives</li></ul>Manage well in an environment <br />of constant change<br />10/10/10<br />48<br />
  57. 57. Who are the Transformational Leaders?<br /><ul><li>Clinical Nurse Specialists
  58. 58. Nurse and Patient Educators
  59. 59. Nurse Managers
  60. 60. Directors, Vice-Presidents, the CNO
  61. 61. Patient Safety and Quality
  62. 62. Nurses in non-traditional, non-direct care roles</li></ul>WE ALL ARE!<br />WE ARE COLLECTIVELY EMPOWERED TO BE LEADERS WHEREVER WE PRACTICE<br />10/10/10<br />49<br />
  63. 63. The New Magnet Model<br />Evidence Based Leadership<br />10/10/10<br />50<br />
  64. 64. Magnet Recognition Program<br />10/10/10<br />51<br />
  65. 65. Transforming Our Practice<br />Building a culture of change<br />Transformational leaders will help to build exemplary professional practice at the unit level<br />Our Transformational Leadership Council’s role will evolve to reflect the roles defined by the New Magnet Model<br />Initially, the Council will provide the foundational structure needed to build all other councils<br />10/10/10<br />52<br />
  66. 66. Transformational Leadership Council Roles<br />Advocacy and Influence<br />Visibility, Accessibility and Communication<br />Strategic Planning<br />10/10/10<br />53<br />
  67. 67. Application:Nursing Process<br />Assess.<br />Plan.<br />Intervene.<br />Evaluate<br />10/10/10<br />54<br />
  68. 68. Nursing Assessment – Evaluation Cycle <br />Leadership.<br />Management<br />Power<br />Authority<br />Transformational<br />10/10/10<br />55<br />
  69. 69. Evidence – Based Leadership in Nursing Process<br />10/10/10<br />56<br />“ … in any moment of decision, the best thing you can do is the right thing,<br />the next best thing to do is the wrong thing, <br />and the worst things you can do is nothing.”<br />Theodore Roosevelt<br />
  70. 70. Pathway for Patient Safety;Working as a Team<br />10/10/10<br />57<br />
  71. 71. Effective Team Work and Communication<br />10/10/10<br />58<br />
  72. 72. Effective Team Work<br />10/10/10<br />59<br />
  73. 73. Questions, Ideas, Suggestions!!<br />10/10/10<br />60<br />
  74. 74. References<br />www.nursingcredintialing.org<br />www.ihi.org<br />www.ahqr.org<br />www.nursingquality.org<br />Cherry, Barbara; Jacob, Suzan R.; Contemporary Nursing Issues, Trends and Management, Chapter 15, 2008.<br />10/10/10<br />61<br />