Leadership in Health System Dr Shahram Yazdani Shahid

Leadership in Health System Dr. Shahram Yazdani Shahid Beheshti University of Medical Sciences School of Medical Education Strategic Policy Sessions: 24

Defining leadership v Leadership is the process through which an individual attempts to intentionally influence another individual or group in order to accomplish a predetermined set of goals

Characteristics of leadership v. Leadership is a process. It is a verb, an action word, not a noun. v. Leadership manifests itself in doing; it is a performing art.

Characteristics of leadership v. Only individuals lead. v. The locus of leadership is in a person. Inanimate objects do not lead, groups do not lead, only people do.

Characteristics of leadership v. The focus of leadership is other individuals and groups. v. A leader cannot exist without followers.

Characteristics of leadership v. Leadership entails influencing followers, their thoughts (the cognitive target of influence), feelings (the affective target), and their actions (the behavioral target). v. Influence is leadership’s center of gravity and most critical element. Dr. Shahram Yazdani 6

Characteristics of leadership v. The objective of leadership is goal accomplishment. v. Leadership is instrumental; it is done for a purpose.

Characteristics of leadership v. Leadership is intentional, not accidental. v. All of us unknowingly influence others hundreds of times each day, but those are not acts of leadership.

What is leaders main tasks? v. Leaders have two main tasks: § To set a path, goal, or vision for the people who are being led. § To motivate people to pursue and eventually achieve the goal.

Leadership Versus Management v A manager have different roles such as formulating goals, developing strategies, communicating, making decisions, collecting information, planning, organizing, monitoring, and resolving conflicts; v But without leadership or with poor leadership the organization is impaired.

Multidirectionality v Leadership is multidirectional. v A person can lead not only subordinates in his organization but also peers, superiors, and individuals and groups outside the organization.

Leadership and Power v The more power a person possess, the greater the potential that he or she will be able to influence other individuals and groups. v The key concept here is potential; one can have power and not use it.

Sources of power v Office power: power associated with a particular managerial office v Expert power: information, knowledge, skill, abilities, and experience v Referent power: connection with other individuals and groups who possess influence v Reward / Coercive power: control of incentives v Charismatic power: one’s own persona

Characteristics of Good Leadership

What influences leadership effectiveness? v. Nature v. Nurture v. Situational factor

The nature argument Trait Leadership Effectiveness And Success

The Nurture Argument Trait Abilities & Behaviors Leadership Effectiveness And Success

The Situational Argument Situation Trait Abilities & Behaviors Leadership Effectiveness And Success

Stogdill - 1948 Research Factors Affecting Leadership v Capacity § § § Intelligence Alertness Verbal facility Originality Judgement v Achievement § Scholarship § Knowledge § Athletic accomplishments

Stogdill - continued v Responsibility § § § Dependability Initiative Persistance Aggressiveness Self-confidence Desire to excell v Participation § § § Activity Sociability Cooperation Adaptability Humor

Stogdill - continued v Status § Socioeconomic position § Popularity v Situation § Task to be accomplished § Followers to be led

Kurt Lewin o Kurt Lewin(1930): three type of leadership 1. Autocratic Leadership (direction) 2. Democratic Leadership (facilitation) 3. Laissez-faire Leadership Dr. Shahram Yazdani 22

Leadership Behavior Continuum Manager centered Follower centered Use of authority by Manager Tell Sell Tell & Ask Freedom for subordinates Ask & Tell Participate Dr. Shahram Yazdani Delegate 23

Path-Goal Model Evans - 1970 Leader Behavior (style) & House & Dressler -1974 Subordinate Characteristics Work Environment Characteristics Subordinate Perceptions Expectancy Effort Instrumentality Performance Reward Dr. Shahram Yazdani Valence Motivation 24

Path Goal Model v Expectancy is the relation between effort and performance v Instrumentality is the degree to which a person perceives that performance will lead to reward v Valence is the strength of a person’s preference for different types of reward

Path Goal Model v According to expectancy theory a person will be highly motivated when effort results in performance (high expectancy) and when performance leads to rewards (high instrumentality) that are valued (high valence)

Implications of Path Goal Model v The path between effort, performance, and reward is difficult. The leader must do everything possible to turn what is often a cow path into a well designed, highspeed freeway v Individuals’ valences are heterogenous

Implications of Path Goal Model v The contingency most under a manager’s control is his own leadership style: § Instrumental behavior (defining objectives and specifying the task to be performed) § Participatory behavior (seeking follower input on decisions that affect them § Achievement-oriented behavior (establishing goals and setting expectations that challenge followers)

Factors affecting effectiveness of leadership § Characteristics of the manager: • Traits / dispositions • Skills • Values § Characteristics of followers: • • • Skills Knowledge Experience Responsibility Understanding of goals and tasks § Characteristics of situation: • Time availability • Nature of problem

Educating for Leadership (FP Program in Iran) v Individual Coaching v Team Building and Teamwork v Meeting Management v Empowering and Delegation v Conflict Negotiation v Positional Bargaining v Interest Based Bargaining v Third Party Alternative Dispute Resolution v Consensus Building v Stakeholder Analysis v Advocacy v Collaboration and Partnership Building

Any Question ?