Post 4.1-LDRS 501

“Crafting a realistic vision and gaining employee-buy in is just a first step “(Lepsinger, 2010, p.6)

Background

An organization that understands customer value and focuses on its purpose and the process works towards achieving those values as “an organization’s cultural commitment to applying the scientific method to designing, performing, and continuously improving the work delivered by teams of people, leading to a measurably better value for patients and other stakeholders” (Toussaint and Berry (2013). The importance of evidence-based medicine (EBM) (Price, 2012) and point-of-care testing is to improve the safety, quality, and efficiency of care. The principal objective of EBM as suggested by Glasziou and colleagues was trying to improve the quality of the information on which decisions are based and outcomes. Point of Care Testing (POCT) (Leeds pathology, 2014) is clinical laboratory testing conducted close to the site of patient care, typically by patients or clinical personnel whose primary training is not in the clinical laboratory sciences. POCT refers to any testing performed outside of the traditional, core or central laboratory. While POCT represents an important advance in patient care and providing decision support interventions; thereby, healthcare providers must use it discerningly and back up its use with evidence-based data through electronic health record as a tool to achieve a learning health system. Therefore, affords the opportunity to build decision support within the workflow of the nurses, physician and laboratory staff.

Switching from conventional laboratory testing to POCT shortens the time to decision-making about further testing (Junker, Schlebusch, Luppa, 2010) and treatment, therefore, delays are no longer caused by specimen transport and preparation, and the results are rapidly available at the point of care as better medical outcomes and lower costs may ensue. The POCT is a patient-centric strategy when implemented successfully; it is essential that there should be suitable management structures (Galbraith; Hughes, Beatty, Dinwoodie, 2014) with clearly defined areas of responsibilities. Managing all the POCT activities through a computer network of the instrument in the decentralized use with a central information system (laboratory information system) allow reliable documentation of the results, optimizing the quality assurance and service performance, and provide a proper calculation of cost-effectiveness. “Systems cannot be fully perceived with one set of eyes,”(Senge’s law, 2006) and visioning the benefits of POCT require the clinicians, laboratorians and healthcare administrators to have guidance in the effective utilization of POCT, exploit the therapeutic potential and avoid waste. Hospitals systems, wanting faster turnaround time of laboratory results to move patients faster through the system, and POCT as rapid clinical decision-making can provide faster results[outcomes] and earlier therapeutic interventions. There is also a tendency for physicians to equate new technology with better patient care. Thus, it is essential that each laboratory or testing site research new test requests to determine clinical utility and cost-effectiveness, as well as management and reimbursement issues. The implication of implementing the POCT systems into medical practice is patients’ satisfaction, quality assurance, and compliance.

Lean Thinking and implementing the change                                                                       

Based on the background, some area in an organization needs improvements. Strategic renewal is “the process of change and the outcome of adjustment in a strategic direction that has the potential to determine the long-term competitiveness of a firm” (Bonnici & McGee, 2015). Using lean thinking principles by Toussaint and Berry (2013) to determine actions would make the better change.

Areas to focus on

Considering the objective of the strategic renewal is to provide “a strategic fit between a firm’s internal capabilities and shifts in the external environment involving technology, markets, industries, and the economy that require a change in the status quo of conducting business” (Bonnici & McGee, 2015)

• Considering the available analytical spectrum without facilitating the networking of POCT system made it difficult to develop the new approaches of using POCT into clinical decision-making. Therefore, lack of communication and transferring the laboratory service, regarding POCT, to the providers to shorten the turn around time. Which means, the computer- networking of the instruments in decentralized use with a central information system [Hospital or Laboratory information system].
• Lacking reliable documentation of the results may affect the optimization of quality assurance and accreditation, patient care and safety. When considering the errors as most commonly due to a) operator incompetence [nonlaboratorian clinical staff, whose primary job is the delivery of patient care rather than the analysis of fluid body samples];  b)nonadherence to test procedures due to the pressure of a busy clinical environment might result in a violation of the performance of POCT; c) and the use of uncontrolled reagents and testing equipment as necessary in POCT. It is easy to speculate that such errors may be symptomatic of a lack of accountability of the individuals performing POCT. Therefore, “lack of accountability creates and reinforces a culture of blame” which, in turns, generates other problems (Lepsinger, 2010). Given that, POCT is often carried out by individuals not previously accustomed to POCT; these individuals may often view the need for performing instrument maintenance, instrument calibration, or external quality assurance (EQA) testing as being the responsibility of someone else.
• Suitable management structure to defined areas of responsibilities (Galbraith, 2014). Thus, Insufficient information on cost-effectiveness hinders the successful implementation of POCT instruments when screened with the fixed costs in the laboratory. Junker et al., 2010. Additionally, overuse or incorrect utilization of POCT could potentially increase the cost of care or delay treatment. 

Challenge and new direction

Three steps necessary to shift to a new direction; lean thinking presents six principles that constitute the essential dynamic of Lean management: the attitude of continuous improvement, value creation, the unity of purpose, respect for front-line workers, visual tracking, and flexible regimentation.  Based on the background provided above;

–    I would suggest embracing a new economy of productivity, quality and continuous improvement (Ungerer, Ungerer & Herlodt, 2016). Identifying the organizational performance standards and expectations and focus greater attention on patient safety; whereby, implementing the meaningful of patient safety programs with defined executive responsibility (Kohan, Corrigan, Donaldson, 2000). The public and private purchaser should provide incentives to healthcare organizations for continuous improvements in patient safety. (Kohan, Corrigan, Donaldson, 2000).

–    I would advocate commitments and hold myself and others accountable. Adding more emphasis on accountability, Blagescu & de Las Casas (2005), Bovens, (2007), and O’Dwyer & Unerman (2007), they referred as” relationship based on commitments of some people to demonstrate, review, and take responsibility for performance, both the results achieved in light of agreed expectations and the means used”(as cited in Abd Aziza, Ab Rahman, Alam, Said, J., 2015, p.164). It includes moral and rights as well.  Through a collaborative process with others in collective efforts and responsibilities (Hughes et al., 2014); Implement periodic examinations, relicensing, accreditation and training sessions to doctors, nurses and key providers to improve performance and reduce errors (national academic press, 2000). Training and education are the principal mechanisms for cultural change with relationship to quality improvements. The need for interdisciplinary training since there is a team involvement with different backgrounds.

–    The importance to set up a POCT coordination office managed by the central laboratory. The role of this office is fulfilling the requirements of quality management. Another condition for successful [fruitful] POCT system is the computer networking[connectivity] of the instruments in decentralized use with the central information system [Hospital or Laboratory information system]. The reliable documentation of the results, optimization of the quality assurance, in regard, providing proper control of cost-effectiveness.

Promoting the threes

The positive renewal (Create-continue-promote)

1. Create the supportive environment and encourage healthcare providers in an organization and make them comfortable with trying a new approach when taking on challenges (Lepsinger, 2010), which in regard, increase chances of innovation, quality improvement, and safe patient care.
2. Continue to follow the organization’ mission, vision, and values. Hughes, Beatty, and Dinwoodie, (2014) noted MVV helps employees understand and make sense of the organization’s purpose, goals and culture, that, promote patient safety.
3. Promote and welcome innovation and acknowledge “the systems can’t perceive with one set of eyes” (Senge’s law, 2006). Therefore, a new connection leading to new insights (Ungere et al., 2016) and create a visible value to support evidence-based medicine and therapeutic intervention, which in regard, support patient safety.

The contrary practice [Three negatives]

1. Ignoring the negative pressure that may affect the networking of the POCT system, then, developing the new approach of using it. Hindering the communication and transferring the laboratory service, regarding POCT, may affect the practice and patient safety.
2. Ignoring the cultural norm and the possibility of making errors (Hughes et al., 2014) and learn from these errors and contribute to success as opposed to apportioning blame.
3. Ignoring the use of suitable management structure (Galbraith, 2014) in defining the areas of responsibilities, which in regards, affect the performers. Not changing that sap energy will cumulatively and negatively reflect on developing capabilities and values (Hughes et al., 2014), that is, crucial to any healthcare organization.

Corrective Action

1. Strategic influence in gendering Commitments to on continuing improving resulting in improved performance; the powerful dynamic starts when your expectation translated into behaviors” (Lepsinger, 2010).
2. Continue to develop the best performance and transform perspectives that encompasses many facets and dimensions of the leadership process (Northhouse, 2013) When all conditions come together we can create a team of high performers; a team can execute care effectively than ever before. (Lepsinger, 2010)
3. Challenge the process (Northhouse, 2013) and willingness to challenge the status quo and to be willing to innovate, grow and improve. Building trust with others and promote collaboration. Encourages the heart and support others attentively, take an active and keen interest in providing quality service to patients; therefore, they resonate with their surroundings (Mukonoweshuro & Sanangura, 2016) toward success.

Conclusion

The underlying goal of Lean is to improve the quality and efficiency of patient care while controlling the cost in the provision of the best ideal patient care. Successful lean transition requires a systematic and systemic change, leaders at all levels and servant leaders to engage their staff in identifying and solving problems based on continuous improvement attitude; therefore, change the culture.  The medical or organizational advantages of POCT is to provide the preliminary screening of patient results; thus, leverage a clinically significant strength in decision-making.

References

Abd Aziza, M., Ab Rahman, H., Alam, M., Said, J.(2015). Enhancement of the Accountability of Public Sectors through Integrity System, Internal Control System, and Leadership Practices: A Review Study. Procedia Economics and Finance,28, 163-169. doi.org/10.1016/S2212-5671(15)01096-5

Bonnici, S., T., & McGee, J. (2015, January). Strategic renewal. Wiley Encyclopedia of Management, (12). Retrieved from: https://www.researchgate.net/publication/280248400_Strategic_Renewal

Christopher, P., Price (2012). Evidence-based laboratory medicine: is it working in practice?. The Clinical biochemist. Reviews, 33(1), 13-19. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3284339/#b13-cbr_33_1_13

Galbraith, J. R. (2014). Designing Organization: strategy, structure, and process at the business unit and enterprise level. San Francisco: Jossey-Bass. ISBN:978-1-118-40995-4

Glasziou P, Del Mar C, Salisbury J. Evidence-Based Practice Workbook. 2nd ed. Oxford, UK: Blackwell Publishing, BMJ Books; 2007. pp. 1–202. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3284339/#b13-cbr_33_1_13

Hughes, R. L., Beatty, Collarelli-Beatty, K., & Dinwoodie, D. L. (2014). Becoming a strategic leader: Your role in your organization’s enduring success. San Francisco, CA: Jossey-Bass

John S. Toussaint, Leonard L. Berry (2013). The Promise of Lean in Health Care. Mayo Clinic Proceeding, 88 (1), 74 – 82. doi.org/10.1016/j.mayocp.2012.07.025

Junker, R., Schlebusch, H., & Luppa, P. B. (2010). Point-of-care testing in hospitals and primary care. Deutsches Arzteblatt international, 107(33), 561-7.

Kohan, L., T., Corrigan, J., M., Donaldson, M., S. (2000). To Err is Human: Building a safer Health System. Institute of Medicine (US) Committee on Quality of Health Care in America; Washington (DC): National Academies Press (US). Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK225181/

Leeds Pathology. (20104, November). Introduction to Point of Care. Retrieved from: http://www.pathology.leedsth.nhs.uk/pathology/Departments/BloodSciences/ClinicalBiochemistry/PointofCareTesting.aspx

Lepsinger, R. (2010). Closing the execution gap: How great leaders and their companies get results. San Francisco, CA: Jossey-Bass

Mukonoweshuro, Jeskinus & Sanangura, Cleopas. (2016). The role of servant leadership and emotional intelligence in managerial performance in a commercial banking sector in Zimbabwe. Banks and Bank Systems. 11. 94-108. doi10.21511/bbs.11(3).2016.10. Retrieved from https://www.researchgate.net/publication/309141829_The_role_of_servant_leadership_and_emotional_intelligence_in_managerial_performance_in_a_commercial_banking_sector_in_Zimbabwe

Northouse, P. G. (2016). Leadership: Theory and practice, Seventh Edition. Thousand Oaks, CA: Sage Publications. ISBN 971452203409

Senge, P. (2006). The fifth discipline. New York: Doubleday. Retrieved from: https://create.twu.ca/ldrs501/unit-3-learning-activities/

Ungerer, M., Ungerer, G., & Herholdt, J. (2016). Navigate strategic possibilities: strategy formulation and execution practices to flourish. Randburg: KR Publishing. ISBN 978-1-869-22623-7. Retrieved from http://ezproxy.student.twu.ca:2956/eds/ebookviewer/ebook/ZTAwMHhuYV9fMTQyNzAyOF9fQU41?sid=978ecd5d-68db-489c-9ecb-1f013269a988@sessionmgr4010&vid=2&hid=/&format=EB

 

 

 

 

 

 

 

 

 

A Strategic Dimension of Transformational Servant Leadership || HC1-post 2.1

Leadership as defined by Northouse (2013), Is a process whereby an individual influence a group of individuals to achieve a common goal” (p.5). The definition focused on the “influence” and “the common goal,” whereby, strategic leadership defined as “Individuals and teams enact strategic leadership when they create the direction, alignment, and commitment needed to achieve the enduring performance potential of the organization” (Hughes, Beatty, and Dinwoodie, 2014, p.11). The focus of TS strategy is “the enduring performance potential of the organization” (Hughes et al., 2014, p.11). TS leader wants to achieve the potential of the organization and flourish it in the long term. TSL focus on the capability and commitment of the employees to compete in a dynamic environment.

Transformational Servant leadership Strategic Direction

TSL is engaging others in creating shared direction, alignments, commitment, and demonstrate as much by collectives. Furthermore, it can be exercised by engaging and stimulating employees to act to further specific goals and purposes, which represents the needs and wants, values and motivations, aspirations and high performance of both strategic leaders and employees.

Regarding, bringing more focus to Al Stubblefield observation regarding the turn-around of the Baptist Healthcare organization as noted in the Leadership Integration Project Manual (2018, p.13)

“How did we achieve such a tremendous turnaround so quickly? We discovered that the key to patient satisfaction is to focus not on patients first, but on your employees. We quickly realized that the satisfaction of our patients was directly related to the satisfaction of our employees; only happy, fulfilled employees will provide the highest level of healthcare to our patients. Therefore, we reasoned, “all” we had to do was find a way to satisfy every employee, who would then, in turn, create happy customers. With that determination, we faced an even harder question: How do we fill our organization with satisfied employees? (2005, p.5) Stubblefield’s experience extensively chronicled in The Baptist Healthcare Journey to Excellence.

Conceiving leadership as outcomes of (DAC) needs “strategic leadership approach that allows the flexibility that, how those outcomes achieved, are varied and context-dependent” (Van Velsor, McCauley, & Ruderman, 2010; as cited in Hughes et al., 2014, p. 41-42). Thereby, the success is too dependent on the blending of the capabilities and have the strategic leader engendering strategic leadership in others by diffusing the power and the potential of the entire organization to serve its performance potential.  As a result, shared direction with each person in the organization towards the attainable goal, when prioritized and planned successfully, will help members to stay focused and engaged. Nevertheless, TSL influences the commitments to the organization’s strategic direction through learning and engagement (Hughes et al., 2014, p. 145).

It is essential to “sustain competitive advantage in contemporary organizations” (Hughes et al., 2014, p. 145), and have people on the same page regarding strategic direction. Additionally, “when strategy lacks meaning for people, it is highly unlikely that they will assimilate the strategic directives and perform to their highest potential. Gaining commitment and aligning individuals with the overarching organizational aim require investing time and energy into crafting people-oriented strategies that bring the business model to life (Hughes et al., 2014, p.230-231). In health care and according to Hughes et al. (2014), the focus on the employee’s satisfaction will serve patient satisfaction the most. It is the indirect relationship that achieves the most desired outcome. Three conditions that are important for the performance of individuals that has positive impacts on the performance outcomes of the organization at large: “the motivation to perform, the ability to perform, and a work context that provides an opportunity to perform” (Blumberg & Pringle, 1982; Dinwoodie, 2011; as cited in Hughes, et al., 2014, p. 232).

 The behavioral component of TSL

Respecting, strategic leadership context, Transformational leadership has conceptualized as containing four behavioral elements (Bass & Avolio, 1993 (as cited in Northouse, 2016); Smith, Montagno & Kuzmenko, 2004):

a) Idealized influence ( It’s the emotional component of the leaders and followers want to emulate and follow the vision of the leader),

b) Inspirational motivation ( leaders communicate high expectations to the team to become committed to, and part of the shared vision in the organization ad mobilized commitment to a higher level for the sake of group development),

c) Intellectual stimulation ( stimulate followers creativity and Innovative thinking to challenge their own beliefs and values, they are tolerant of followers mistakes, involve them in problem-solving and new ideas),

d) Individualized consideration (followers’ achievement and growth well supported

The transformational leader serves as a role model and supports the group development by creating two-way personalized communication with followers (Smith et al., 2004), in other words, this strategy incorporates both followers’ and leaders’ needs (Northouse, 2016). Therefore, TL becomes motivated to transcend their self-interest for the good of the group or organization towards the shared vision and provide the necessary resources for developing their potential.

 Transformational servant leadership decisions

“high change environment requires empowered dynamic culture of transformational leadership” (Smith, 2004, p.80). Assessing follower’s motives and satisfy their needs, require having an evidence-based decision-making strategy in their leadership context (Northhouse, 2013).  Decision makers cannot assume that followers will be committed to a decision without being part of the process. Evidence-based decision -making helps a transformational leader in making well-informed choices by having the best available evidence and managed outcome. Transformational leadership is a relationship when mutual stimulation raises the level of human conduct as well as the aspirations of both the leader and members, resulting in a transformational that affect both to serve.

 Transformational Servant Leadership focus

Servant leadership is a unique leadership philosophy that defined by Greenleaf (1971) as “begins with a natural feeling that one wants to serve, to serve first. Then conscious choice brings one to aspire to lead” (as cited in Northouse, 2018, p. 220). The three main components of servant leadership model noted from Liden, Wayne, Zhao, and Henderson (2008) and Liden, Panaccio, Hu, and Meuser (2014) are antecedent conditions, servant leader behaviors, and leadership outcomes (as cited in Northouse, 2016, p.225); thereby, facilitate the shared vision and trust that are necessary for the organization (Van Dierndoneck, 2011). This approach emerged from the previous focus of the transformational leadership approach. The conditions that influenced the leader to become a servant leader are Organizational culture and context, leader’s attributes, follower’s receptivity (Northouse, 2016). The Internalized values of SL explained by Van Dierndoneck, (2011) such as honesty, fairness, integrity, and justice are rooted to have a significant impact on followers. SL behaviors viewed as a multidimensional, that, included conceptualizing, emotional healing, putting followers first, helping followers grow and succeed, behaving ethically, empowering, and creating value for the community (Linden, Wayne et al., 2008; as cited in Northouse, 2016).

Leader-member exchange (LMX) quality in a dyadic relationship with Servant Leader, produce multiple positive outcomes on the follower’s performance and growth. Therefore, they influence organizational performance through organizational citizenship behavior (OCB) and have a positive impact on society (Van Dierndoneck, 2011; Northouse, 2016, p.182).

Self- awareness considered as a foundation for emotional intelligence (Goleman, 2017) needed by servant leaders to manage emotions. The servant with high EI, understand the emotional state and the needs of others, share leadership with followers, take an active and keen interest in providing quality service to customers; therefore, they resonate with their surroundings (Mukonoweshuro & Sanangura, 2016). Bringing the self-awareness of the servant leaders into the center of the strategy is preferred approach when needed to change, leads, to insight about when, how, and where you see things differently (Hughes, 2014, p.83). Dealing with the complexity of the shared vision of TL and SL, regards, ensure shared understanding within their organizations and teams by thinking systemically to uncover the answers to complex problems. The mindset of strategic thinking, in a similar manner of strategic acting and influencing, are rooted in TSL.

Listening, is an inclination in servant leadership approach; it’s a mindset of strategic thinking that help in understanding the situation and make sense only in the  context of a particular point (Hughes, 2014, p.54), collectively, considering the present and future as well as the rigorous and analytical side, and the challenges in such environment; whereby, “embraced more collective leadership” (Hughes, 2014, p.56).

Visioning is one of the strategic thinking skills in the inclination of the TSL approach, which in regards, used to express the ideal and values and affirm the human dimension and have a meaning to the context that connect the members to its core values and clarify the expectation about the desired growth (Hughes, 2011, p.77). Using the idea of the inverted pyramid organization as a metaphor (Hughes, et al., 2014, p.81-82):  “instead of thinking of the senior leaders at the top of the pyramid and being “served by” everyone else in the organization, think about senior leaders at the bottom of the pyramid and serving everyone else. Developing vision to where the organization needs to be in the future and have a broader perspective on the competitive landscape require scanning, visioning, reframing, making common sense (Hughes, 2014). Considering the TL approach with SL approach as a central focus of strategic leaders will create an environment that has its unique movement towards the goals when prioritized and identified.

What kind of relationship is needed to transform? And What makes strategic leadership different?

A person who further the decision-making process of a group demonstrates effective leadership. The critical thinking principles rooted in TSL and performed, are implicated in the understanding of the situation as a strategy of a learning process. In this learning process, TSL requires to engage others in the form of curiosity, humility, and collaboration. “… critical thinking is about taking a step back and thinking logically and carefully about the information and evidence you have, rather than believing and acting on everything you read, see and hear. (Aveyard, Woolliams, & Sharp, p. 7; as cited on LDRS 501-Strategic Leadership, 2018). Regarding this excerpt, the principles of critical thinking begins with an initial discovering the new opportunity, defining of the situation according to leadership context, followed by exploration of the leadership context, generating possibilities through brainstorming, building a prototypes that can be tested, often a number of times, and the findings used to refine the resolution associated with the context.

Furthermore, endeavouring the practical process that can engage the divergent mindset to explore and develop the full range of potential solutions; thus, can deliver value to the members and organization. “leader is how to make changes that progressively build on each other and represent an evolving enhancement of the organization’s well-being” (Hughes, 2014, p.21). The critical thinking process in any organization wants to achieve long-term performance, ties with a strategy as a learning process. Hughes, et al., (2014) imperative work in explaining critical thinking strategy as a learning process, starts with assessing the internal and external environment (p.23-25), clarifying mission, vision, and values (p.25-26), discover and prioritize drivers (p.26), create business strategy in a pattern of choices to position itself for superior performance over time (p.30), develop leadership strategy that involve human emotions, needs, beliefs, and desire as part of the change (p. 32), execute, perform and learn what need to happen within the organization to maximize those drivers(p.33-35). The functionality of the learning process occurs through the movement and iteration of all the elements in a circle; therefore, there is a potential for emerged direction to the desired outcome to benefit the leadership context. Regarding, TSL traits are critical thinkers, intellectually humble, and intellectually empathic. They have confidence in reason and intellectual integrity; they provide support, intellectual courage; hence, become autonomous.  I agree with John Maxwell (2013) statement about different leadership levels; it’s a learning growing process. People follow you because of who you are and what you have done. Bringing TSL capabilities and paradox thinking to any organization will benefit any strategic context. TSL will keep the premises of critical thinking principles as a rooted strategy to navigate purposes and strategic directions to furthermore potential growth and superior organizational performance.

It’s a call for all leaders in the leadership context to respond with a positive, substantive response. Looking forward to welcoming a new opportunity for sharing and learning!

References

Goleman, D. (2017, Jan 12). Self- Awareness: The foundation of Emotional Intelligence [web blog post]. Retrieved from ttps://www.linkedin.com/pulse/self-awareness-foundation-emotional-intelligence-daniel-goleman

Hughes, R. L., Beatty, Collarelli-Beatty, K., & Dinwoodie, D. L. (2014). Becoming a strategic leader: Your role in your organization’s enduring success. San Francisco, CA: Jossey-Bass.

Imbenzi, G., Williaume, D. & Page, D. (2013). Transformational servant leadership.

JohnMaxwellCo (2013, Sep 10). John Maxwell The 5 levels of leadership [Video file]. Retrieved from https://www.youtube.com/watch?v=aPwXeg8ThWI

Leadership Integration Project Manual 2018. (2018). Unpublished manuscript, Master of Arts in Leadership, Trinity Western University, Langley, Canada.

Mukonoweshuro, Jeskinus & Sanangura, Cleopas. (2016). The role of servant leadership and emotional intelligence in managerial performance in a commercial banking sector in Zimbabwe. Banks and Bank Systems. 11. 94-108. doi10.21511/bbs.11(3).2016.10. Retrieved from https://www.researchgate.net/publication/309141829_The_role_of_servant_leadership_and_emotional_intelligence_in_managerial_performance_in_a_commercial_banking_sector_in_Zimbabwe

Northouse, P. G. (2016). Leadership: Theory and practice, Seventh Edition. Thousand Oaks, CA: Sage Publications. ISBN 971452203409

Unpublished manuscript, Master of Arts in Leadership, Trinity Western University, Langley, Canada.

Van Dierendonck, D. (2011). Servant leadership: A review and synthesis. Journal of Management 37(4), 1228-1261.

 

 

 

Thank you, Badesha & Kunal for the insight

Response to Kamal Badesha response to H21

Vision may begin with one person, but its accomplished only through the efforts of many people. Taking the leader’s vision and work it to fulfill it should be the response of 360 – Degree leaders, they should strive to take the vision from “me” to “we” (Maxwell, 2011, p. 70). Vision it needs to be communicated clearly, creatively, and continuously. One of the Senge’s law is “System cannot be fully perceived with one set of eyes.” Considering the environment and the culture are crucial when deciding on how to influence the change. and those who championed the vision as stated in Maxwell’s book (2011, p.70) “The 360 Leader” are

-Placed the organization’s needs first

-Kept the vision before the people

-Represented me well to others

-Understood their roles.

In the sense of organization, it’s the involvement of everyone in the decision making rather than waiting to be told what to do. To close the gap is seeking out the perspectives of a wide range of people (Lepsinger, 2010), to obtain insight into a different way of thinking rather than one in isolation.

Let think about it this way; if I have to believe, the frontline employees being responsible for bringing more insight into the process of change, decision making and helping the organization vision. Therefore, in my opinion, I believe, the leaders have to be there in engaging the frontline in sharing the vision, responsibility with their employees about the influence and the right direction.

“If you go out of your way to care about others and help them, then they will go out of their way to help you when you ask them to” (Maxwell, 2011, p.75).

Thank you for Badesha’s post and Kunal’s response!

Reference

Lepsinger, R. (2010). Closing the execution gap: How great leaders and their companies get results. San Francisco, CA: Jossey-Bass

Maxwell, J. (2011). The 360 Leader: Developing your influence from anywhere in the organization. USA: Thomas Nelson

Senge, P. (2006). The fifth discipline. New York: Doubleday. Retrieved from: https://create.twu.ca/ldrs501/unit-3-learning-activities/

 

Response to Pierre’s response to HC 1, post 2.1

It’s the need for a team that enables the visioning and thinking when considering leading lean initiatives in any organization in health care. “Crafting a realistic vision and gaining employee-buy in is just a first step “(Lepsinger, 2010, p.6). It seems crafting any applicable vision for any organization in the healthcare sector is to understand the diverse perspectives of the organization in their systems and the individuals who use that system.

Regarding, its essential to the strategic leadership team (Hughes, Beatty, Dinwoodie, 2014) to understand the diverse culture and the team members who represent the confluence of the information in such an organization.   Visioning the benefits vs. burdens conceptualization of value requires to include medical outcomes, financial costs and extends beyond these constructs to also include patients’ perceptions of the overall healthcare experience.  It is a people-centric strategy, when, a clinician’s sensitivity in answering patients’ questions, and operation that starts on time, and a quiet, calming medical facility may be ancillary to the medical outcome, and in regard, they can still be important to patients’ assessment of value. Additionally, It is essential to distinguish between discrete steps in a process that does or not contribute to the value. For instance, the team can ask “why we do this step? Is it needed, and would the patient be willing to pay for this part of the process if he/she had the choice? What steps in the process are vulnerable to error? Or try to improve workflow itself on one side of (discharging patient), thus, will help to reduce the turnaround time for the patient stay. Providing results to the physician on time will facilitate reducing the turnaround time as well. Another way to think about it is to list the ideal states that you wish to have and implement the successful solution.

Let think this way!

Thank you for sharing in the learning process.

Reference

Hughes, R. L., Beatty, Collarelli-Beatty, K., & Dinwoodie, D. L. (2014). Becoming a strategic leader: Your role in your organization’s enduring success. San Francisco, CA: Jossey-Bass

Lepsinger, R. (2010). Closing the execution gap: How great leaders and their companies get results. San Francisco, CA: Jossey-Bass

 

Response to Servant and Strategic Leadership Tools –HC 2-post 2.1

ttps://create.twu.ca/chiefanalyzerofthings/2018/10/09/servant-and-strategic-leadership-tools-hc2/

Thank you for sharing the valuable information, and I would like to add a new thought to strategic leadership.

Lean Thinking Strategy

The implication of “learning process” (Hughes, 2014, p.21) on a strategic leadership approach is

“Making a change that progressively builds on each other,” Enhancement of well-being, Visioning, Service, and Cultural change. The implementation of these transformational strategies, in my opinion, requires a lean strategy. An organization that understands customer value and focuses on its purpose and the process works towards achieving those values. Lean in healthcare defined by Toussaint and Berry (2013) as “an organization’s cultural commitment to applying the scientific method to designing, performing, and continuously improving the work delivered by teams of people, leading to a measurably better value for patients and other stakeholders.” Lean thinking is the key to having a lean organization. It starts where you are; it is a top down and bottoms up strategy. The Lean strategy is a quality improvement philosophy and set of principles. Using the idea of the inverted pyramid organization as a metaphor (Hughes, et al., 2014, p.81-82): “instead of thinking of the senior leaders at the top of the pyramid and being “served by” everyone else in the organization, think about senior leaders at the bottom of the pyramid and serving everyone else”. It is a “people-centric” strategy which recognizes that the people are doing the work, they understand their problems best and have good ideas of how to solve those problems. Now everyone in a position to find problems that are standing in the way of providing patients with the best quality faster at an acceptable cost.  Now, they face the reality of the situation and create meaningful operation to capture the current state and improvement as they happen. Framing the issues regarding improvement directions needs executives to stretch goals that everyone understands and able to vision.

Principles of lean as noted in Toussaint, et al., (2013) studies are:

Principle 1: Lean is an attitude of continuous improvement

Principle 2: Lean is value-creating

Principle 3: Lean is unity of purpose

Principle 4: Lean is respect for the people who do the work

Principle 5: Lean is visual

Principle 6: Lean is fixable regimentation

In a study of Lean implementation in four emergency departments as noted in Dickson, Anguelov, Vetterick, Eller, and Singh (2009) studies, they found that “successful Lean implementation depended on both leaders’ and followers’ degree of adherence to Lean principles and willingness to change the culture. They described the following three key factors for successful Lean implementation: 1) engaged frontline workers who come to “own” Lean, 2) long-term leadership commitment, and 3) a flexible workforce that is open to change”( as cited in Aij & Rapsaniotis, 2017)

The positive indicators in Mann (2009) study referred to the ability of servant leadership and lean leadership strategy when considering reported results; both tangible and intangible outcome. “The most frequently noted tangible outputs were reduced error rates, shorter waiting times, and increased productivity. Decreases in waiting time and errors led to reduced costs; fewer errors resulted in reduced morbidity and mortality and thus improved patient safety. Intangible outputs included increased employee motivation and satisfaction and increased patient satisfaction”(as cited in Aij et al., 2017). Abuhejleh and Dulaim (2016) found that “Lean markedly and sustainably increased patient access, improved safety, and patient satisfaction, and increased employee empowerment” (as cited in Aij et al., 2017).

The underlying goal of Lean is to improve the quality and efficiency of patient care while controlling the cost in the provision of the best ideal patient care. Successful lean transition requires a systematic and systemic change, leaders at all levels and Servant leaders to engage their staff in identifying and solving problems based on continuous improvement attitude; therefore, change the culture.  The composition of lean strategy and Transformational servant leadership have a positive outcome to achieve patient-centered, high-quality, employee empowerment and contribute to the attainable sustainability of healthcare organization.

 

References:

Aij Kh, Rapsaniotis S. (2017). Leadership requirements for Lean versus servant leadership in health care: a systematic review of the literature. Journal of Healthcare Leadership. 9,.1-14. doi.org/10.2147/JHL.S120166

John S. Toussaint, Leonard L. Berry (2013). The Promise of Lean in Health Care. Mayo Clinic Proceeding, 88 (1), 74 – 82. doi.org/10.1016/j.mayocp.2012.07.025