Good managers should strive to be good leaders and good leaders, need management skills to be effective. Leaders will have a vision of what can be achieved. provides a basic introduction to management theory and prob- Introduction to Management and Leadership Concepts, Principles, and Practices ing. Little that. Management and Leadership. Learning Objectives. 1) Identify the four interrelated functions of management: planning, organizing, leading, and controlling.
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𝗣𝗗𝗙 | Some are born great, some achieve greatness, and some have greatness thrust understand why organizations invest in leadership and management. Keywords: Leadership, Business Excellence, Performance Management, Leadership and management are often considered practically overlapping concepts. Leadership and management must go hand in hand. They are not the same thing . But they are necessarily linked, and complementary. Any effort to separate the.
Leadership has been defined in many ways and the elitist implications of traditional notions of leadership sit uncomfortably with modern healthcare organisations. The concept of distributed leadership incorporates inclusivity, collectiveness and collaboration, with the result that, to some extent, all staff, not just those in senior management roles, are viewed as leaders. Leadership development programmes are intended to equip individuals to improve leadership skills, but we know little about their effectiveness. Furthermore, the content of these programmes varies widely and the fact that many lack a sense of how they fit with individual or organisational goals raises questions about how they are intended to achieve their aims. It is important to avoid simplistic assumptions about the ability of improved leadership to solve complex problems. It is also important to evaluate leadership development programmes in ways that go beyond descriptive accounts Highlights Commentaries Published on this Paper Responsibilising Managers and Clinicians, Neglecting System Health?
Leaders, in contrast, tolerate chaos and lack of structure and are willing to delay closure in order to understand the issues more fully.
In this way, Zaleznik argued, business leaders have much more in common with artists, scientists, and other creative thinkers than they do with managers. Organizations need both managers and leaders to succeed, but developing both requires a reduced focus on logic and strategic exercises in favor of an environment where creativity and imagination are permitted to flourish.
What is the ideal way to develop leadership? Every society provides its own answer to this question, and each, in groping for answers, defines its deepest concerns about the purposes, distributions, and uses of power. Business has contributed its answer to the leadership question by evolving a new breed called the manager. Simultaneously, business has established a new power ethic that favors collective over individual leadership, the cult of the group over that of personality.
While ensuring the competence, control, and the balance of power among groups with the potential for rivalry, managerial leadership unfortunately does not necessarily ensure imagination, creativity, or ethical behavior in guiding the destinies of corporate enterprises. Leadership inevitably requires using power to influence the thoughts and actions of other people.
Power in the hands of an individual entails human risks: first, the risk of equating power with the ability to get immediate results; second, the risk of ignoring the many different ways people can legitimately accumulate power; and third, the risk of losing self-control in the desire for power. The need to hedge these risks accounts in part for the development of collective leadership and the managerial ethic. Consequently, an inherent conservatism dominates the culture of large organizations.
The deck is stacked in favor of the tried and proven way of doing things and against the taking of risks and striking out in new directions. Ironically, this ethic fosters a bureaucratic culture in business, supposedly the last bastion protecting us from the encroachments and controls of bureaucracy in government and education. Manager vs.
Leader Personality A managerial culture emphasizes rationality and control. Whether his or her energies are directed toward goals, resources, organization structures, or people, a manager is a problem solver. It takes neither genius nor heroism to be a manager, but rather persistence, tough-mindedness, hard work, intelligence, analytical ability, and perhaps most important, tolerance and goodwill.
Another conception of leadership, however, attaches almost mystical beliefs to what a leader is and assumes that only great people are worthy of the drama of power and politics. Here leadership is a psychodrama in which a brilliant, lonely person must gain control of himself or herself as a precondition for controlling others. Such an expectation of leadership contrasts sharply with the mundane, practical, and yet important conception that leadership is really managing work that other people do.
Three questions come to mind. Is this leadership mystique merely a holdover from our childhood—from a sense of dependency and a longing for good and heroic parents? Or is it true that no matter how competent managers are, their leadership stagnates because of their limitations in visualizing purposes and generating value in work?
Driven by narrow purposes, without an imaginative capacity and the ability to communicate, do managers then perpetuate group conflicts instead of reforming them into broader desires and goals? If indeed problems demand greatness, then judging by past performance, the selection and development of leaders leave a great deal to chance.
Further, beyond what we leave to chance, there is a deeper issue in the relationship between the need for competent managers and the longing for great leaders. What it takes to ensure a supply of people who will assume practical responsibility may inhibit the development of great leaders. On the other hand, the presence of great leaders may undermine the development of managers who typically become very anxious in the relative disorder that leaders seem to generate.
It is easy enough to dismiss the dilemma of training managers, though we may need new leaders or leaders at the expense of managers, by saying that the need is for people who can be both.
But just as a managerial culture differs from the entrepreneurial culture that develops when leaders appear in organizations, managers and leaders are very different kinds of people. They differ in motivation, personal history, and in how they think and act. Attitudes Toward Goals Managers tend to adopt impersonal, if not passive, attitudes toward goals. Frederic G. We must design not just the cars we would like to build but, more important, the cars that our customers want to download.
In reality, through product design, advertising, and promotion, consumers learn to like what they then say they need. Few would argue that people who enjoy taking snapshots need a camera that also develops pictures. But in response to a need for novelty, convenience, and a shorter interval between acting snapping the picture and gaining pleasure seeing the shot , the Polaroid camera succeeded in the marketplace.
It is inconceivable that Edwin Land responded to impressions of consumer need. The example of Polaroid and Land suggests how leaders think about goals. They are active instead of reactive, shaping ideas instead of responding to them. Leaders adopt a personal and active attitude toward goals. The influence a leader exerts in altering moods, evoking images and expectations, and in establishing specific desires and objectives determines the direction a business takes.
The net result of this influence changes the way people think about what is desirable, possible, and necessary. Conceptions of Work Managers tend to view work as an enabling process involving some combination of people and ideas interacting to establish strategies and make decisions. They help the process along by calculating the interests in opposition, planning when controversial issues should surface, and reducing tensions. Alfred P. The time was the early s when Ford Motor Company still dominated the automobile industry using, as did General Motors, the conventional water-cooled engine.
With the full backing of Pierre du Pont, Charles Kettering dedicated himself to the design of an air-cooled copper engine, which, if successful, would be a great technical and marketing coup for GM.
Kettering believed in his product, but the manufacturing division heads opposed the new design on two grounds: first, it was technically unreliable, and second, the corporation was putting all its eggs in one basket by investing in a new product instead of attending to the current marketing situation.
In the summer of , after a series of false starts and after its decision to recall the copper engine Chevrolets from dealers and customers, GM management scrapped the project. Alfred Sloan was all too aware that Kettering was unhappy and indeed intended to leave General Motors. Sloan was also aware that, while the manufacturing divisions strongly opposed the new engine, Pierre du Pont supported Kettering.
Further, Sloan had himself gone on record in a letter to Kettering less than two years earlier expressing full confidence in him. The problem Sloan had was how to make his decision stick, keep Kettering in the organization he was much too valuable to lose , avoid alienating du Pont, and encourage the division heads to continue developing product lines using conventional water-cooled engines. First, he tried to reassure Kettering by presenting the problem in a very ambiguous fashion, suggesting that he and the executive committee sided with Kettering, but that it would not be practical to force the divisions to do what they were opposed to.
He presented the problem as being a question of the people, not the product. Second, he proposed to reorganize around the problem by consolidating all functions in a new division that would be responsible for the design, production, and marketing of the new engine.
This solution appeared as ambiguous as his efforts to placate Kettering. Kettering, a kind of copper-cooled car division. Kettering would designate his own chief engineer and his production staff to solve the technical problems of manufacture.
Essentially, the managerial solution that Sloan arranged limited the options available to others. The structural solution narrowed choices, even limiting emotional reactions to the point where the key people could do nothing but go along.
Kettering at some length this morning, and he agrees with us absolutely on every point we made.
He appears to receive the suggestion enthusiastically and has every confidence that it can be put across along these lines. Interestingly enough, this type of work has much in common with what diplomats and mediators do, with Henry Kissinger apparently an outstanding practitioner.
Managers aim to shift balances of power toward solutions acceptable as compromises among conflicting values. Leaders work in the opposite direction. Where managers act to limit choices, leaders develop fresh approaches to long-standing problems and open issues to new options.
To be effective, leaders must project their ideas onto images that excite people and only then develop choices that give those images substance. John F. This much-quoted statement forced people to react beyond immediate concerns and to identify with Kennedy and with important shared ideals. On closer scrutiny, however, the statement is absurd because it promises a position, which, if adopted, as in the Vietnam War, could produce disastrous results.
Yet unless expectations are aroused and mobilized, with all the dangers of frustration inherent in heightened desire, new thinking and new choice can never come to light.
Leaders work from high-risk positions; indeed, they are often temperamentally disposed to seek out risk and danger, especially where the chance of opportunity and reward appears promising. From my observations, the reason one individual seeks risks while another approaches problems conservatively depends more on his or her personality and less on conscious choice. For those who become managers, a survival instinct dominates the need for risk, and with that instinct comes an ability to tolerate mundane, practical work.
Leaders sometimes react to mundane work as to an affliction. Relations with Others Managers prefer to work with people; they avoid solitary activity because it makes them anxious. Several years ago, I directed studies on the psychological aspects of careers. The need to seek out others with whom to work and collaborate seemed to stand out as an important characteristic of managers.
When asked, for example, to write imaginative stories in response to a picture showing a single figure a boy contemplating a violin or a man silhouetted in a state of reflection , managers populated their stories with people. His instrument was ordered and had just arrived. The boy is weighing the alternatives of playing football with the other kids or playing with the squeak box. Football season is now over, but a good third baseman will take the field next spring.
The first, as I have suggested, is to seek out activity with other people that is, the football team , and the second is to maintain a low level of emotional involvement in those relationships. In this case, the boy, Mom, and Dad agree to give up the violin for sports.
These two themes may seem paradoxical, but their coexistence supports what a manager does, including reconciling differences, seeking compromises, and establishing a balance of power.
The story further demonstrates that managers may lack empathy, or the capacity to sense intuitively the thoughts and feelings of others. It is also the capacity to take in emotional signals and make them meaningful in a relationship. Managers relate to people according to the role they play in a sequence of events or in a decision-making process, while leaders, who are concerned with ideas, relate in more intuitive and empathetic ways.
In recent years, managers have adopted from game theory the notion that decision-making events can be one of two types: the win-lose situation or zero-sum game or the win-win situation in which everybody in the action comes out ahead.
Managers strive to convert win-lose into win-win situations as part of the process of reconciling differences among people and maintaining balances of power. As an illustration, take the decision of how to allocate capital resources among operating divisions in a large, decentralized organization. On the surface, the dollars available for distribution are limited at any given time.
Presumably, therefore, the more one division gets, the less is available for other divisions. Managers tend to view this situation as it affects human relations as a conversion issue: how to make what seems like a win-lose problem into a win-win problem. From that perspective, several solutions come to mind.
Here the players become engrossed in the bigger problem of how to make decisions, not what decisions to make.
Once committed to the bigger problem, these people have to support the outcome since they were involved in formulating the decision-making rules.
Because they believe in the rules they formulated, they will accept present losses, believing that next time they will win. Signals are inconclusive and subject to reinterpretation should people become upset and angry; messages involve the direct consequence that some people will indeed not like what they hear.
The nature of messages heightens emotional response and makes managers anxious. With signals, the question of who wins and who loses often becomes obscured. Third, the manager plays for time. Compromises mean that one may win and lose simultaneously, depending on which of the games one evaluates.
There are undoubtedly many other tactical moves managers use to change human situations from win-lose to win-win. But the point is that such tactics focus on the decision-making process itself, and that process interests managers rather than leaders. Tactical interests involve costs as well as benefits; they make organizations fatter in bureaucratic and political intrigue and leaner in direct, hard activity and warm human relationships. Consequently, one often hears subordinates characterize managers as inscrutable, detached, and manipulative.
In contrast, one often hears leaders referred to with adjectives rich in emotional content. Leaders attract strong feelings of identity and difference or of love and hate. Human relations in leader-dominated structures often appear turbulent, intense, and at times even disorganized.
Such an atmosphere intensifies individual motivation and often produces unanticipated outcomes. Twice-borns, on the other hand, have not had an easy time of it.
Their lives are marked by a continual struggle to attain some sense of order. Unlike once-borns, they cannot take things for granted. According to James, these personalities have equally different worldviews. For a twice-born, the sense of self derives from a feeling of profound separateness. A sense of belonging or of being separate has a practical significance for the kinds of investments managers and leaders make in their careers. Managers see themselves as conservators and regulators of an existing order of affairs with which they personally identify and from which they gain rewards.
William James had this harmony in mind—this sense of self as flowing easily to and from the outer world—in defining a once-born personality. Leaders tend to be twice-born personalities, people who feel separate from their environment. In addition to challenges associated with resources and demand, episodes of poor patient outcomes, cultures of poor care, and a range of workplace difficulties have been associated with poor clinical leadership, 8 , 9 , 14 and these concerns have provided the impetus to examine clinical leadership more closely.
Definitional issues in clinical leadership Within the health care system, it has been acknowledged that clinical leadership is not the exclusive domain of any particular professional group. While effective clinical leadership has been offered up as a way of ensuring optimal care and overcoming the problems of the clinical workplace, a standard definition of what defines effective clinical leadership remains elusive.
A secondary analysis of studies exploring organizational wrongdoing in hospitals highlighted the nature of ineffectual leadership in the clinical environment. The focus of the analysis was on clinical nurse leader responses to nurses raising concerns.
Three forms of avoidant leadership were identified: placating avoidance, where leaders affirmed concerns but abstained from action; equivocal avoidance, where leaders were ambivalent in their response; and hostile avoidance, where the failure of leaders to address concerns escalated hostility towards the complainant.
Similarly, McKee et al employed interviews, surveys, and ethnographic case studies to assess the state of quality practice in the National Health Service NHS ; they report that one of the most important insurances against failures such as those seen in the Mid-Staffordshire NHS Trust Foundation is active and engaged leaders at all levels in the system.
Synthesis of the literature suggests clinical leadership may be framed variously — as situational, as skill driven, as value driven, as vision driven, as collective, co-produced, involving exchange relationships, and as boundary spanning see Table 1.
Effective clinical leaders have been characterized as having advocacy skills and the ability to affect change. Table 1 The characteristics of clinical leadership and the attributes of clinical leaders Notes: Table distilled from: Clark ; 31 De Casterle et al ; 47 Edmonton ; 11 McKeon et al ; 73 Stanley ; 32 Patrick et al ; 34 McKee et al While transformational leadership positions the leader as a charismatic shaper of followers, 33 clinical leadership is more patient centered and emphasizes collective and collaborative behaviors.
Edmonstone notes following the implementation of numerous clinical leadership programs in the UK the little research undertaken has largely focused on program evaluation, rather than the nature or outcomes of clinical leadership. Role of hospitals in contemporary health care Globally, hospitals are under increased strain and scrutiny. Increased demands and fiscal pressures have increased the pressures on all health professionals as well as clinical and non-clinical staff. A number of nationally and internationally influential reports 6 — 8 have resulted in changes in visibility, scrutiny, and accountability in relation to hospital care.
This scrutiny has increased the emphasis on the role of health professionals, including nurses, in monitoring standards, developing and evaluating better ways of working as well as advocating for patients and their families; and led to a substantial momentum in the quality and safety agenda, including the promotion of various strategies such as promoting evidence-based practice.
In the hospital sector, the demands placed upon leaders have become more complex, and the need for different forms of leadership is increasingly evident. To derive cost efficiency and improve productivity, there has been intense reorganization. Coupled with these reforms has been increasing attention upon improving safety and quality, with programs instituted to move attention beyond singular patient—clinician interpretations of safety toward addressing organizational systems and issues of culture.
In part, this shift has been in response to growing recognition that while designated leaders in positions of formal authority within hospitals play a key role in administration and espousing values and mission, such leaders are limited in their capacity to reshape fundamental features of clinical practice or ensure change at the frontline. This type of work engagement requires forms of citizenship behaviors that are focused upon improving clinical systems and practices.
Hospitals are complex socio-political entities, and the ability for engagement and leadership among clinicians can be hampered by power dynamics, disciplinary boundaries, and competing discourses within the organization.
The tension inherent between clinical and administrative discourses is evidenced in the findings from the evaluation of clinical directorate structures in Australian hospitals, with close to two thirds of medical and nursing staff surveyed reporting the primary outcome of such structures was increased organizational politics. Edmonstone 11 cautions that without structural and cultural change within institutions, the move toward clinical leadership can result in devolution of responsibility to clinicians who are unprepared and under resourced for these roles.
Evidence emerging from the NHS suggests particular value in leadership coalitions between managers and clinicians. As Gagliano et al comment, there is some evidence that health service provider groups are attempting to address issues pertaining to leadership issues through design and implementation of leadership development programs.
Other countries have developed education and professional development programs in clinical leadership for doctors, nurses, and allied health professionals working in their respective health systems. Some of these programs have similar features to UK NHS leadership frameworks and associated strategies. For example, in New Zealand medical schools are working to provide leadership training in their undergraduate medical curriculum.
Much has been written in the organizational and health care literature about employee work engagement and the benefits derived through promoting work engagement.
Considerable evidence confirms positive associations between constructs such as job satisfaction, work performance, improved productivity, and engaged employees. Although considerable discussion has occurred on the need for clinical leadership, and large scale pubic inquiries evidence the considerable patient harm that has occurred in the absence of such leadership, 7 , 8 there continues to be a major disconnect between clinicians and managers, and clinical and bureaucratic imperatives.
The debate over who is best positioned to lead service delivery and the place of clinicians in governance continues.