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Principles of Leading an Empowered OrganizationMarky Medeiros MSN RN
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Objectives
At the end of the presentation, participants will be able to:
• Describe the conceptual framework of Leading an Empowered Organization (LEO)
• Discuss the need for leaders to build relationships, build capacity, and lead change in an empowered organization
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History of Leading an Empowered Organization (LEO)
• 1982, Marie Manthey as “Leading an Empowered Staff”
• Dynamic leadership development program for leaders at any level
• Fosters creation of environments for high performing individuals and teams
• Adopted in the United Kingdom in the late 1990’s to support modernization of the National Health Service
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Inside = key competencies
Middle = vulnerabilities or challenges
Outside = empowerment
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Articulated Expectations
• Effective leaders create an environment for success by stating expectations that inspire, guide and direct.
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Articulated Expectations
• A leader must be clear with expectations in three directions:
• Immediate Supervisor
• Peers
• Staff members
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Guidelines for Articulated Outcomes
• Connect to M/V/V
• Focus on behaviors (short list)
• Use SMART format
• Assertive language and positive tone
• Negotiate expectations
• Affirm success and OFIs
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Language for Articulated Expectations
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Responsibility Authority Accountability
• Common understanding is the essential foundation for empowerment.
• Necessary for role clarity and organizational effectiveness
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Responsibility • Duties and obligations
• Found in
• job descriptions
• standards of performance
• state practice acts for clinical professions
• Two-way process
• must be both allocated and accepted
• Should be negotiated before finalized
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Potential Barriers
Limited Resources
• time
• money
• people
Lack of:
• support
• trust
• competence
• confidence
• “Just culture”
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Responsibility Just because you have given responsibility do not assume it has been accepted
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Authority
• Right to act
• Right to make decisions
• Given
• Responsibility has been accepted
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Levels of Authority
• Level 1:
• Data/Information/Idea Gathering
• Level 2:
• Data/Information/Idea Gathering + Recommendations
• Level 3:
• Data/Information/Idea Gathering + Recommendations [Pause to communicate, clarify or negotiate] + Act
• Level 4:
• Act and inform others after taking action – ‘Do as I would do’ or ‘Act in my absence’
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Accountability
• Reviewing decisions
• Evaluating effectiveness
• Directing future efforts
• Feeling a sense of ownership
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Building Relationships
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Building Relationships
• Relationship with self
• Relationship with colleagues
• Relationship with patients and families
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Building Relationships –
Four elements of healthy
interpersonal relationships
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Two Potential Ways of Being
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Unhealthy Behaviors
• “Learned behaviors that contribute to self-neglect, intrapersonal distress and interpersonal conflict and disharmony.” (Beattie, 1987)
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We are all Susceptible to Unhealthy Behaviors
• Healthcare employees are especially vulnerable to unhealthy behaviors
• Types of unhealthy behaviors explored:
• Caretaking
• Control issues
• External referencing
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Replacements for Unhealthy Behaviors
• Let go of past and focus on what you can influence in the present
• Practice healthy sense of detachment
• Listen with respect to others/seek to understand
• Take responsibility for actions
• Respect and honor yourself
• Care for mind, body, spirit
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Replacements for Unhealthy Behaviors
Meditation
Exercise
Spiritual exercise
Eating right
Reading
Spending time with family & friends
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Ultimately Getting to Interdependence
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Working interdependently, in the true spirit of collaboration,
represents the highest level of maturity as individuals and groups.
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Developing Capacity
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Developing Capacity
• Creating an environment of safety
• Developing competent people who are committed to the vision
• All staff members must feel safe I trying new things and making decisions independently
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Developing Capacity
• Enhancing competence and confidence of followers so they realize potential beyond their expectations• Leaders
• Learn their needs
• Provide necessary resources and encouragement
• Stand by them when things don’t go well
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Mistakes
Human Error
Behavior/AttitudeSkill/Knowledge Deficit
System Issues
• Acknowledge no deficiency• Forgive
• Create needed system• Improve system• Reinforce correct use
• Set objectives• Follow up
• Teach• Train
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Determining the Appropriate Response to Mistakes
Punitive Practices & Just Culture
• Creating an open and fair culture
• Creating a proactive learning culture
• Designing safe systems
• Managing behavioral choices (management and staff)
• Seeing events as OFIs to improve the understanding of risk
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Cultures of Learning
• Willing to risk:
• Being vulnerable
• Make mistakes
• Try something new
• Inquire (ask the question)
• Express opinions
• Disagree
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Leading Change
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Leading Change
Leaders must be skilled in leading change,
solving problems by engaging others,
and inspiring ownership and commitment.
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Clarity of Vision and Purpose
Leaders create a
shared vision and
engage others at every
step of the way.
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I2E2 Formula for Leading Change
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Problem Processing
• Processing the same problems over and over
• Take inordinate amounts of time to make changes
• This can slow down improvements –get in the way of efficiency
• Affect staff satisfaction and customer satisfaction
• Leads to gaps in quality
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Problem Solving/Process Improvement
• Step 1: Defining the problem
• Step 2: Analysis
• Step 3: Options
• Step 4: Action Plan
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Commitment
• Individual ownership and commitment emerges as leaders develop a culture of empowerment.
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Ownership and Commitment
• Leaders creating the vision
• Articulating expectations
• Competencies: skills, knowledge, attitude
• Individuals confidence/awareness
• Collaboration
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Ownership
• Sustainable outcomes depend on the ownership of the work designed to produce them. the higher the level of ownership of the work, the more sustainable the outcomes. Although this is a simple truth, it is counter to the design of most organizations.
Tim Porter-O’Grady, 2009
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References
• Arbinger Institute. (2006). The anatomy of peace: resolving the heart of conflict. San Francisco, CA: Berret-Koehler Publishers, Inc.
• Creative Health Care Management (2015).Leading an Empowered Organization Facilitator Guide. Minneapolis, MN: CHCM
• Hancock, H. & Campbell, S. (2006) Impact of the Leading an Empowered Organisation programme. Nursing Standard. 20, 19, 41-48.
• Porter-O’Grady, T. (2009). Interdisciplinary Shared Governance (2nd Ed). Sudbury, MA: Jones & Bartlett
• Woolnough, H. & Faugier, J. (2002). An evaluative study assessing the impact of the Leading an Empowered Organisation programme. N T Research, 7(6), 412-427.
• Wright, D. (2007). Establishing a System of Accountability, In Koloroutis, M, Felgen, J., Person, C. and Wessel, S. (Eds.) Relationship-based care field guide. Minneapolis, MN: Creative Health Care Management.
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