Chapter 16

Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins
Chapter 16Chapter 16
Theories, Models, andTheories, Models, and
Frameworks From LeadershipFrameworks From Leadership
and Managementand Management

Leadership Theories
• Leaders empower others and lead others.
• Leadership involves one individual trying to influence the
behavior of others.
• All nurses in management or advanced practice should
know prevailing theories of leadership and management.

Leadership Theories—(cont.)
• Trait approach
• Style approach
– Managerial grid
• Transformational leadership

Trait Approach
• Objective is to identify personality characteristics that
can be used to define a leader.

Trait Theory
• Related to the Great Man Theory
• Leadership exists as an attribute of a personality; if
certain traits are exhibited, the individual is a leader.
• Successful leaders have certain inborn traits or
qualities that help them stand out.
• Traits of one leader may not be the same as other
leaders.
• Traits valued in one situation may not be valued in
other situations.

Trait Theory—Leadership Traits
• Intelligence
• Social sensitivity and participation
• Honesty and integrity
• Communication skills
• Persuasive powers
• Tireless energy
• Uncanny foresight and intuition

Trait Theory: Research-Identified
Leadership Traits
• Leaders need to be more intelligent than the group
they lead.
• Leaders must possess initiative (the ability to perceive
and start courses of action not considered by others).
• Creativity is an asset.
• Communication skills are important.
• Leaders have emotional maturity and integrity (a
sense of purpose and direction, persistence,
dependability, and objectivity).
• Persuasion often is used by leaders to gain the consent
of followers.

Trait Theory: Researcher-Identified
Leadership Traits—(cont.)
• Leaders participate in social activities.
• Leaders need to be perceptive enough to distinguish
their allies from their opponents and to place their
subordinates in suitable positions.

Trait Theory—Main Points
• Focuses exclusively on the leader
• Does not relate the leader to the situation or
circumstances
• Emphasizes having a leader with a certain set of traits is
crucial having effective leadership
• It is the leader and his/her personality that is central to
the leadership process.
• Organizations will work better if people in management
have leadership traits.

Trait Theory—Issues
• Not clear which traits are essential to acquire and/or
maintain leadership
• Does not perceive personality as an integrated whole
• Does not deal with followers
• Omits environmental and situation factors

Trait Theory—Application
• Having a person with a specific set of traits is
important for effective leadership.
• Awareness of own traits can be useful in self-
development.
• Awareness of traits can be helpful when seeing a
career or employment.

Leadership Style Theories
• Objective—to integrate the two major behavioral aspects
of the leader—task and relationship—in order to
influence subordinates to reach a predefined goal

Leadership Style Theories—(cont.)
• Behavior pattern of an individual who attempts to
influence others
• Includes
– Directive (task) behaviors
– Supportive (relationship) behaviors
• Give directions, establish goals, set timelines, define
roles

Leadership Style Theories—(cont.)
• Point is to motivate behavior to maximize the
impact on the satisfaction and performance of
followers.
• Behavior-based theories assume that effective
leaders acquire a pattern of learned behaviors.

Leadership Styles
• Three distinct leadership styles along a continuum
– Authoritarian
– Democratic
– Laissez-faire

Leadership Styles—Authoritarian
Leader
• Dictatorial
• Leader makes all decisions and allows
subordinates no influence in the decision-
making process.
• Emphasis on concern for the task

Leadership Styles—Authoritarian
Leader—(cont.)
• Motivated by external forces, power, authority,
need for approval
• Uses coercion, punishment to change followers
behavior, and achieve results

Leadership Styles—Democratic
Leader
• Relationship/person orientation
• Participative
• Consults with subordinates
• Gives subordinates some influence in decision
making

Leadership Styles—Democratic
Leader—(cont.)
• Majority rule
• Treats subordinates with fairness and dignity

Leadership Styles—Laissez-Faire
Leader
• Free reign
• Allow group to have complete autonomy

Leadership Styles—Laissez-Faire
Leader—(cont.)
• Rarely supervise directly
• No direction or facilitation
• Group makes own decisions.

Question
The style of leadership that gives subordinates free reign
with minimal supervision is:
A.Authoritarian
B.Democratic
C.Dictatorial
D.Laissez-faire

Answer
D. Laissez-faire
• Rationale: Laissez-faire leaders provide little direction or
facilitation and allow the group to make decisions. They
are often ineffective.

Leadership Styles—Comparison
AutocraticAutocratic DemocraticDemocratic Laissez-faireLaissez-faire
Strong controlStrong control Less controlLess control No controlNo control
Gives ordersGives orders Offers suggestionsOffers suggestions NondirectiveNondirective
Does decisionDoes decision
planningplanning
Makes suggestionsMakes suggestions AbdicatesAbdicates
decision makingdecision making
Leader plansLeader plans Group plansGroup plans No planningNo planning
DirectiveDirective ParticipativeParticipative UninvolvedUninvolved
FostersFosters
dependencydependency
FostersFosters
independenceindependence
Fosters chaosFosters chaos

Leadership Style Theories
• Focus is on what leaders do in relational and contextual
terms.
• Leaders must pursue effective relationships with
subordinate while considering factors in the environment
that might influence outcomes.
• Note: Employee satisfaction is not always the best
measure of leadership.

Leadership Style Theories—Application
• Leaders should modify behavioral style to
increase their effectiveness.
• Employee-centered leaders tend to be most able
to achieve effective work environments and
productivity.

Transformational Leadership
• Objective—to show how the leader can transform
subordinates and motivate them to achieve their
fullest potential and at the same time link their
identities to the collective identity of the
organization

Transformational Leadership—(cont.)
• Involves assessing the motives of followers and
satisfying their needs
• Understands the motives of followers and helps
them attain their fullest potential
• Raises the level of motivation by being attentive to
the needs and motives of followers

• Leadership concerned with values, ethical standards, and
long-term goals
• Process in which leaders and followers raise one another
to higher levels of motivation

• Commits people to action, converts followers
into leaders, converts leaders into agents of
change
• Focuses on merging motives, desires, values,
and goals of leaders and followers

• Assumes three types of leaders
– Transformational leaders
– Transactional leaders
– Laissez-faire leaders

Transformational Leaders
• Characteristics
– Aware of importance of change and innovation
– Seek to empower others
– Serve as change agents and role models
– Able to interpret and shape new meaning

Transactional Leadership
• Characteristics
– Contingent reward—Efforts by subordinates
are exchanged for specified rewards.
– Management by exception—Corrective
criticism, negative feedback, and negative
reinforcement are applied as needed.

Laissez-Faire Leadership
• Characteristics
– Hands-off approach
– There is no exchange with followers or any
attempt to help them achieve goals.
– Considered to be “nonleaderhip” approach

Comparison of Transactional and
Transformational Leadership
TransactionalTransactional TransformationalTransformational
HierarchyHierarchy NetworkingNetworking
CompetitiveCompetitive CooperativeCooperative
Task focusTask focus Process focusProcess focus
Identify needs of followersIdentify needs of followers Attend to needs and motives ofAttend to needs and motives of
followersfollowers
Provide rewards to meet needsProvide rewards to meet needs Inspire through optimismInspire through optimism
Set goals for employeesSet goals for employees Individualized considerationIndividualized consideration
Focus on day-to-day operationsFocus on day-to-day operations Provide sense of directionProvide sense of direction
Management by exceptionManagement by exception Encouragement of self managementEncouragement of self management
CaretakerCaretaker Role modelRole model

Transformational Leadership—
Characteristics: The 4 Is
• Idealized influence—Followers want to emulate
leaders as role models.
• Inspirational motivation—Followers are motivated
to achieve more than they would on their own.
• Intellectual stimulation—Followers are
intellectually encouraged to be creative and
innovative.
• Individualized consideration—Followers perform
best when leaders work with them one-on-one.

• Leader is a role model.
• Leader uses individualized consideration.
• Leader provides a sense of direction.
• Leader encourages self management.
• Leader is consistent.

• Strategies
– Attention through vision
– Meaning through communication
– Trust through positioning
– Deployment of self through positive self-
regard and optimism about a desired
outcome

• Five types of knowledge
– Knowing oneself
– Knowing the job
– Knowing the organization
– Knowing the business
– Knowing the world

• Six core functions of leaders
– Valuing
– Visioning
– Coaching
– Empowering
– Team building
– Promoting quality

Transformational Theories
• Application
– Useful in all levels of an organization
– Useful in team development
– Helps to define and build a vision

Management Theories
• Taylor’s Principles of “Scientific” Management
– Using scientific methods, work can be organized to
produce maximum efficiency and productivity.
– Workers with specific attributes and qualifications
should be hired and trained to match the job that
makes best use of their capabilities.

Management Theories—(cont.)
• Taylor’s Principles of “Scientific” Management—(cont.)
– Workers should be rewarded monetarily if
production exceeds goals.
– Workers should know where and how they fit into
the organization and should know the mission and
how to accomplish it.
– Managers and workers should work cooperatively
(managers should plan and supervise; workers
should implement).

Management Theories—(cont.)
• Fayol’s Principles of Management
– To ensure maximum efficiency and effectiveness,
there should be specialization (both technical work
and administrative work).
– Managers must have the right and power to give
orders—but with authority comes responsibility.
– When sanctions are necessary, they should be fair
and appropriate.
– Employees should have only one supervisor.

Motivational Theories
• Vroom’s Expectancy Theory
– Looked at the effects of ability and motivation on
performance
Performance = Ability × Motivation
– Managers should attempt to develop and motivate
employees simultaneously.
– Motivation of employees depends on aptitude as well
as ability.

Motivational Theories—(cont.)
• Vroom’s Expectancy Theory—(cont.)
– Later work added concepts of expectancy,
instrumentality, and valence.
Motivation = Expectancy × Instrumentality × Valence
– Expectancy is the association between the action
and the outcome of the action.
– Instrumentality is the type of outcome derived
from an action.
– Valence is value on the desirability of the outcome.

Power and Authority
• Power—influence wielded by an individual or group of
individuals to change behaviors and attitudes and to
sway decisions
• Implies a dependence relationship
– The more dependent one individual is on another,
the more power is generated.
• May be positive or negative

Power and Authority—(cont.)
• Types of power
– Reward
– Coercive
– Legitimate
– Referent
– Expert

Power and Authority—(cont.)
• Authority—a formal right based on position in an
organization
– Authority is derived from power.

Planned Change—Lewin
• Planned change occurs by design.
• Main concepts are “field” and “force.”
– Field—a system
– Force—directed entity that has focus and strength
• Change is a move from the status quo that results in a
disruption in the balance of forces or disequilibrium
between opposing forces.

Planned Change—Lewin—(cont.)
• Two main forces involved in change
– Driving forces
– Restraining forces
• Driving forces encourage or facilitate movement in a new
direction.
• Restraining forces block or impede progress.
• Driving forces should exceed restraining forces during
movement.

Question
Tell whether the following statement is true or false:
For planned change to be successful, restraining forces
should exceed driving forces during movement.

Answer
False
Rationale: Driving forces should exceed restraining forces
for “movement” or positive change to occur.

Conflict Management
• Conflict may be positive or negative.
• Conflict may be functional or dysfunctional.
• People tent to move away from situations in which there
may be conflict.

Conflict Management—(cont.)
• Conflict situations
– At least two parties
– Strong emotions and behavior directed at defeating
or suppressing the opponent
– Mutually exclusive needs or values exist (or are
perceived to exist)
– Opposing parties attempt to gain power over each
other.

Conflict Management—(cont.)
• When conflict occurs—strategies
– Competing
– Accommodating
– Avoiding
– Collaborating
– Compromising

Quality Improvement
“In God we trust. All others bring data.”
—W. Edwards Deming
• QI is the commitment and approach used to scrupulously
examine and continuously improve every process in
every part of an organization.
• The intent of QI is meeting and exceeding customer
expectations.

Quality Improvement—(cont.)
• In health care, QI began with creation of Joint
Commission on Accreditation of Hospitals (JCAH) (1951)
– Published standards for hospital accreditation
• Donebedian proposed framework for measuring quality
– Structure, process, outcomes

Quality Improvement—(cont.)
• Forces of Magnetism set by AACN (1983)
• Institute of Medicine released report: To Err is Human:
Building a Safer Health System (1999)
• Institute of Medicine released report: Crossing the
Quality Chasm: A New Health System for the 21st
Century (2001)

Quality Improvement—Deming
• Create constancy of purpose for improvement.
• Adopt a the new philosophy.
• Cease dependence on mass inspections.
• End the practice of awarding business on the basis of
price alone.
• Institute on-the-job training and research.
• Adopt and institute leadership.
• Drive out fear among employees.

Quality Improvement—Deming—(cont.)
• Improve constantly every process for planning,
production, and service.
• Dismantle barriers between departments.
• Eliminate slogans, exhortations, and production
targets.
• Eliminate numerical quotas.

Quality Improvement—Deming—(cont.)
• Remove barriers to pride of workmanship.
• Institute a vigorous program of education and self-
improvement.
• Put everyone in the organization to work to accomplish
the transformation.

Quality Improvement—Juran
• Quality planning
• Quality control
• Quality improvement

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