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How Can We Become Better Leaders? By Becoming Better Followers…

January 23, 2014

MeganSchrammI’d like to introduce you to our guest blogger Megan Schramm BBA, RN, CNOR, RNFA.

Like many of us, I have worked at the staff as well as the managerial level at various points throughout my clinical career.  Before getting into those leadership roles, there were many times that I felt that I was simply “following orders”.  Another rule, mandate or policy that I never realized was being considered, let alone have the opportunity to voice an opinion about, would be communicated to me by my superiors and my job was to simply carry it out.  As a staff nurse, how do you think that made me feel?  It made me feel exactly like that- staff.  That was how I was seen by management- someone who followed orders.  I often did not feel I was seen as the educated and knowledgeable professional I truly was- with the potential to offer valuable insight to my organization’s leaders.  With this in mind, it is important to note that people are also less likely to support something if they do not have a say about it.  How often have you heard grumblings and complaints after setting new policy?  Well, maybe it is more than “change management” issues…. Maybe we as leaders need to make some changes as well….

Speaking of change, how many of you are feeling the effects of the recent healthcare reforms and federal legislation?  As Meaningful Use, the ACA, updated CMS standards and other mandates become more a part of everyday life, those of us in healthcare leadership will have (and already have!) many new challenges to face.   Now more than ever, we  need to look at the care our organizations provide in terms of quality rather than quantity as well as re-examine available resources and find ways to utilize them in the most productive, yet cost effective manner possible. All of this will mean thinking out side of the box in order to define new and innovative methods of care provision.  Part of this organizational assessment includes analyzing our current methods of leadership and decision making.  Are they the most effective practices for the healthcare environment of today?

What is YOUR leadership style?  Are you autocratic, democratic or laissez- faire?  Do you consider yourself a visionary, coach, pacesetter or commander to those who report to you?  Are you the primary decision maker for your organization or do you consider this process to be more of a group effort?  If so, who is included in the decision making process?

Tell me if this sounds familiar…. Historically, healthcare management has been based on methods that worked in the past (“This is what we’ve always done!”), intuition and educated guesses.  The decisions of the organization’s knowledgeable superiors were rarely questioned publically by those under them.

As time went on, the 20th century saw hospital-based care become the primary mode of healthcare delivery as well as an increased need for specialization of disciplines and skills.  In order to keep track of everyone, what did we do?  Most hospitals followed a centralized leadership design- each different department was run by a manager, who reported to a higher manager and so on until finally reaching the organizations CEO.  Is this how it is at your facility?

Now is this type of leadership effective?  Sure!  Everyone knows who they are accountable to and information from the lower rungs of management is funneled up to the top… eventually.  However, this vertical management structure IS a bit one sided… information is reported UP and decisions are sent DOWN.  What about direct input from your frontline care givers?  What about supporting the development of innovation or quality improvement right at the level of service?  How can different departments integrate functions or share ideas if communication only happens vertically and not horizontally as well?

So is there a need for leadership style change in your institution?  Is it time for you to look at your current leadership style and maybe have a little personal change management occur? How can you better leverage one of your most valuable resources- your staff?  Tune in next time when we continue our discussion on how to be better leaders by being better followers….

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