Leadership Carol Alexander, RN, MS Director of Emergency & Education Depts. Porter Adventist Hospital Denver, Colorado

LeadershipLeadershipCarol Alexander, RN, MSDirector of Emergency & Education

Depts.

Porter Adventist Hospital

Denver, Colorado

One of the most universal One of the most universal cravings of our time is a cravings of our time is a

hunger for compelling and hunger for compelling and creative leadershipcreative leadership..

James BurnsJames Burns

CourageCourageStrength to venture into Strength to venture into

uncharted territory, persevere uncharted territory, persevere in the wilderness, and in the wilderness, and

withstand danger, fear or withstand danger, fear or difficulty associated with difficulty associated with

becoming architects of the becoming architects of the future.future.

Leadership is...Leadership is...courage to adjust mistakes,courage to adjust mistakes,vision to welcome chance,vision to welcome chance,

and confidence to and confidence to stay out of stepstay out of step

when everyone else when everyone else is marchingis marching

to the wrong tune!to the wrong tune!

According to ancient Indian According to ancient Indian folklore, we need the vision of folklore, we need the vision of the eagle and the view of the the eagle and the view of the

mousemouse

What We Want from WorkWhat We Want from Work

Is my work significant in terms of achieving critical outcomes and a meaningful cause?

Does my work enable me to use my creative talents?

Will my work make a difference to the world? Is this how I want to be in the universe?

Does my work meet my spiritual needs?

Inspirational LeadershipInspirational Leadership

Define your causeEnable followers to

find their callingAlign the calling

with the causeServe the followers

Vision without action is a daydream

Action without vision is a nightmare

Inspirational LeadershipInspirational Leadership

Guide the contribution of brilliance

Create the environment that encourages followers to inspire their leader

If you can dream it, If you can dream it, you can do it.you can do it.

HIGHER GROUND LEADERHIGHER GROUND LEADER

C – COURAGE

A – AUTHENTICITY

S – SERVICE

T – TRUTHFULNESS

L – LOVE

E - EFFECTIVENESS

The Greatest of These is LoveThe Greatest of These is Love

If I have not understanding that touches the heartbeat of my patients, I

only chatter.

If I have not mastered the gift of compassion, my endeavors are hollow.

If I do not notice wounded hearts and broken dreams, my mission is not

fulfilled.

LeadershipLeadershipSource of vision and inspirationCreator of options-capitalize on

possibilitiesCapacity to influence othersAbility to achieve priority resultsProducer of actions that make a

difference

LEADERSHIP PARADOXESLEADERSHIP PARADOXES

PROACTIVE PREFERRED FUTURE VERSUS CRISIS MANAGEMENT

COMMITMENT VERSUS OBEDIENCE

PROFIT WITHOUT GREEDQUALITY OUTCOMES NOT

ILLUSIONSCOACHING NOT ABANDONMENT

LEADERSHIP PARADOXESLEADERSHIP PARADOXES

LEARNING ORGANIZATION VERSUS COMPETENCY SKILL CHECKLISTS

TRUTH NOT UNDISCUSSABLESINTEGRATION NOT TURF BATTLESREENGINEERING BEFORE

DOWNSIZINGHUMANISM NOT SUFFERING

The Virtuous Cycle of Attributes and Results

So that

ATTRIBUTES

HOW IT HAPPENS

XRESULTS

WHAT HAPPENS

because of

From, D. Ulrich, J. Zenger, and N. Smallwood, “Results Based Leadership,” (Boston, MA: Harvard Business School Press, 1999)

Implementation

-Feedback loops & strategic planning corrections in place

Evaluation:

Final results match

intended outcome?

Environmental

Assessment

-Demographic Trends

-Industry Trends

-Competitor Activity

-Strategic Initiatives

Identify Desired

Outcomes

-Through Vision

-Through Analysis

Desired Outcomes clear?

Focus is on results – not assorted symptoms?

Diverse views/stakeholders included?

Clear plan to engage others?

Measurement and feedback plan in place?

Time frames reasonable?

Accountability

-individual

-collective

RESULTS

ORIENTED

LEADERSHIP

GAP ANALYSIS

What supports

Achieving

Outcomes?

What obstructs Achieving Outcomes?

How to Maximize

How to Minimize

PLAN

GOALS

Job SpecificFocus

Business Focus

Customer/Guest Focus

EmployeeFocus

Team/Communication

Focus

Personal Focus

Staf

fing

Service SkillsReceptive to Feedback

Performance Profile Core Competencies

15 Competencies of High-Performance Nurse Managers15 Competencies of High-Performance Nurse Managers

2002 The Advisory Board Company

Leading

Dev

elop

ing

Peo

ple

Showing Support

Teambuilding

Conflict P

revention

& M

anagement M

otiv

atin

g &

In

flue

ncin

g

Man

agin

g V

isio

n

& P

urpo

se

Clinica

l Quality

Managem

ent

& Service

Orie

ntation

Accountability

Developing & Recruiting Top Talent

Identifying & Recruiting

Top Talent

Building R

elatio

nships

Planning, Prioritization,

& Time ManagementProblem Solving

and Innovation

Initiative

Financial Savvy

Comm

unica

ting

Clearly

(v

erba

l & w

ritte

n)

Standards &

Accountability

Communication Planning &

Act

ive

Lea

rnin

g

Decisi

on M

akin

g

LEADERInspire vision& optimism

Exemplify ourvalues Inspire trust

Nurture &develop talent

Talented, motivated empowered ASSOCIATES

Resulting in thedelivery of ourrevenue andmarginFINANCIALcommitment

CASTLE

Constantly, creatively

finding betterOPERATIONAL

ways to improveperformance

And becomePartners for Lifeto allure service

So we meetand exceed

CUSTOMERexpectations

ACCOUNTABILITYACCOUNTABILITY

The act of accepting ownership of the results

or lack thereof.

Ham & Eggs $1.98Ham & Eggs $1.98

Levels of AccountabilityLevels of Accountability Below the Line Below the Line

Ignore/DenyIt’s Not My JobFinger-PointingConfusion/Tell Me What To DoCover Your TailWait and See

Levels of Accountability Levels of Accountability Above the LineAbove the Line

Muster the Courage to See ItFine the Heart to Own ItObtain the Wisdom to Solve ItExercise the Means to Do It

Enhancing Personal Enhancing Personal AccountabilityAccountability

What clinical outcomes do I actively strive to achieve on a daily basis?

Do I do the right things for patients/families?

Do I advocate for high standards despite unpredictable consequences?


How can I intentionally discover innovative solutions to identified problems?

How can I collaborate with others to overcome system barriers?

If I really “owned it,” what would I do differently?


Am I comfortable engaging in risk-taking behaviors that produce results?

What do I pretend to not know about my personal accountability in a given situation?

Do I use excuses that sabotage my ownership of the consequences of my actions or non-actions?


Can I learn from errors and/or mistakes?Can I avoid blaming myself and/or others

if the outcomes are acceptable but not ideal?

Can I overcome feelings of hopelessness, powerlessness, and despair so I am proactively responsive to needs of others?


How do I let others know that I support joint accountability?

Do I have a role in holding colleagues accountable or is that just the manager’s responsibility?

Can I confront colleagues when they fail to hold themselves accountable?


When should I give direct feedback to others in order to create a culture that values stellar clinical outcomes?

Do I support disciplinary corrective action when I or others fail to be accountable?


How can I focus on what I can control in a given situation?

Do I embrace coaching and “grace,” thus avoiding judgment while refining my own accountability?

JOINT JOINT ACCOUNTABILITYACCOUNTABILITY

People share ownership

for organizational results that come from collective,

not individual activity.


Everyone works together so the “ball” is not dropped.

Should it be dropped, everyone dives for the

“ball” to pick it up.


Because staff assume joint accountability for all aspects of a project, boundaries disappear

and the group is collectively responsible for outcomes.

Holding Others AccountableHolding Others Accountable

Collaborate to determine desired outcomes

Clarify expected results

Coach for successful performance

Monitor performance for compliance

Provide feedback regarding acceptable and unacceptable behavior

Institute corrective action if necessary

Reward action-oriented behavior that produces results

Priorities for Action by Priorities for Action by Exceptional LeadersExceptional Leaders

Forecast the futureDistinguish trends from fadsArticulate vision for preferred

future—shape course of healthcare


Find new directions amid waves of turmoil—heal wounds if necessary

Define overarching goals that unify constituencies and focus energies

Revitalize shared beliefs and values—align individual and group goals


Create loyalty to the larger ventureConduct an environmental

assessment—critique current systemIdentify desired outcomes—

challenge sacred assumptions


Design organizational transformational models

Prioritize work processes requiring reengineering

Foster renewal to enhance the vitality of the system—avoid stagnation


Build a learning organization—generate the optimum learning structure

Promote wisdom—set strategic targets for learning

Exhibit transformational leadership competencies


Engender hope in turbulent timesImplement a bias for action that

produces desired outcomesBe accountable for both actions and

outcomes

Leadership is action, Leadership is action, not position.not position.

One who fears failureOne who fears failurelimits his worth.limits his worth.

Failure is the opportunityFailure is the opportunityto begin again more to begin again more

intelligently.intelligently.

When you’re fallingWhen you’re fallingon your face, on your face,

you’re actuallyyou’re actuallymoving forward.moving forward.

Documents

Leadership Carol Alexander, RN, MS Director of Emergency & Education Depts. Porter Adventist Hospital Denver, Colorado