Clinical Leadership - what is it and how do I do it? Ian Govier

opportunitynowhere

Health Scare Headlines!

Since the inception of the NHS, more than 50 NHS public inquiries have been conducted to address catastrophic failures in patient care. The same 5 common themes emerge from each inquiry. Walshe & Higgins (2002) Disempowerment of staff and patients IsolationIsolation Poor communication Inadequate leadership / management Failure of systems and processes

“More than one in ten people admitted to hospital are harmed unintentionally by its care. It is believed there is a one in 300 chance of accidental death through errors in care.”

Effective clinical leadership improves patient care

When I was a child I wanted to….When I was a child I wanted to…. I came into the health service because:I came into the health service because: If I wasn’t working in my current position, I’d like to:If I wasn’t working in my current position, I’d like to: I‘d like to achieve ……. this afternoon:I‘d like to achieve ……. this afternoon:

Let’s look at Leadership!

Leadership: The Myths It’s rare It’s found mainly at the top It’s about being superhuman

John Harvey-Jones (2002) “Leaders in the NHS need imagination, vision & charisma, allied with outstanding communication skills & the ability to fire their staff with enthusiasm”

“Lots of ordinary health care staff are leaders – it is in the very nature of the job. Good care involves winning your patient’s confidence, convincing them to keep to their treatment regimes and inspiring them to battle their way back to health” (Crouch, 2002) Who are the leaders?

The Leadership / Management Dilemma!

Managers maintain paths Managers maintain paths Administrators tidy paths Administrators tidy paths LEADERS MAKE PATHS!

Management is efficiency in climbing the ladder… …leadership determines whether the ladder is leaning against the right wall.

Transformational Leadership An approach to leadership which seeks to bring about success and sustainable growth within groups through a change within the consciousness of participants

Leadership and Performance Outcomes Transformational Leadership has a significantly greater impact than Transactional Leadership on: Staff StaffTeamsOrganisations Source: Bass, B.M. (1998) Transformational Leadership: Military, Industrial & Educational Impact. London:Lawrence Erlbaum

Transformational Leaders have: Transformational Leaders have: Staff who: have higher levels of satisfaction, motivation, and performancehave higher levels of satisfaction, motivation, and performance have lower levels of stress & burnouthave lower levels of stress & burnout Teams that…. are more innovative, collaborative and effective are more innovative, collaborative and effective Organisations which… respond more quickly and productively to changerespond more quickly and productively to change are more effectiveare more effective have healthier, more humane cultureshave healthier, more humane cultures (Bass,1998)

What do you consider to be the characteristics of effective Leaders?

Clinical Leadership The Challenges! Clinical Leadership The Challenges!

Permanent White Water (Vaill, 1996)

Exemplary Clinical Leaders (Kouzes and Posner, 2002) Challenge Inspire ModelEnable Encourage

Exemplary Clinical Leaders Challenge

“The one indisputable fact that characterises organisational life, is that CHANGE is inevitable.” (Beverley Alimo-Metcalfe, 2005)

Two choices regarding CHANGE: GET ORGANIZED or ‘go with the flow’ (Yoder-Wise, 1999)

Challenges to Developing Practice “The greatest difficulty in the world is not for people to accept new ideas, but to make them forget their old ideas!” John Maynard Keynes ‘ Are you kidding? I like it here!’

The truth is that our finest moments are most likely to occur when we are feeling deeply uncomfortable, unhappy, or unfulfilled. For it is only in such moments, propelled by our discomfort, that we are likely to step out of our ruts and start searching for different ways or truer answers. M.Scott Peck

What would you like to challenge / change in your clinical area?

Beware of Change Saboteurs!!

Time for a Break

Exemplary Clinical Leaders Inspire a shared VISION

The most important task of leadership is to define and nurture a shared VISION that energises and brings out the best in people James A. Vaughan

is almost a contradiction in terms! is almost a contradiction in terms! A VISION -less leader (lacking in vision or inspiration) (John Adair, 2002)

Let’s look at some VISIONS !

To make people happy To enable people & businesses throughout the world to realize their full potential To experience the emotion of competition, winning & crushing competitors To be the world’s favourite airline & the undisputed leader in world travel for the millennium

By 2015, through the efforts of the Assembly Government, the NHS, local authorities, their partners, the community and individuals, Wales will have minimised avoidable death, pain, delays, helplessness and waste.

We need World Class Leaders to deliver World Class Healthcare

Delivering this challenging strategy will require the full engagement of clinicians and other professionals… …leading and shaping services, ensuring that high standards of care will be the key driver for change.

Visions without actions are merely hallucinations!

The vision must be followed by the venture It is not enough to stare up the steps

What is my VISION for my clinical / work area?

Welsh Regional Burns Unit

So many of our dreams at first seem impossible, then they seem improbable, but when we summon the will, they soon become inevitable.

Exemplary Clinical Leaders Enable

To become a leader one must believe in one’s own ability to achieve results for one’s self, but the real job of the leader is not doing it but ENABLING others to do it. Saskin & Rosenbach 1993

Where once leaders were aloof decision-makers, today they are dedicated collaborators & networkers whose role is to ENABLE & give power to their team rather than wield power to their own ends. Leaders on Leadership – an intimate view of life at the top of Europe plc Development Dimensions International (DDI), Research Report, January 2006

How can I more effectively enable others?

Exemplary Clinical Leaders Model

The biggest disease today is not leprosy or tuberculosis but rather the feeling of being unwanted, uncared for and deserted by everybody Compassion and Care

Everyone thinks of changing the world, but no one thinks of changing themselves. Leo Tolstoy Leo Tolstoy

“If you want to see change, be the change you want to see”

A patient is the most important person in our Hospital. They are not an interruption to our work. They are the purpose of it. They are not an outsider in our Hospital. They are part of it. We are not doing them a favour by serving them. They are doing us a favour by giving us the opportunity to do so.

To be a more effective role model, what would colleagues ask me to: stop doing; stop doing; do more of; do more of; do differently? do differently?

Exemplary Clinical Leaders Encourage

...is about the principles & practices that support the basic human need to be appreciated for what we do & who we are. (Kouzes & Posner, 1997) Encouraging

How can we promote ‘excellence in practice’ unless we first acknowledge, and then PRAISE ?

Really believe in your heart of hearts that your fundamental purpose, the reason for being, is to enlarge the lives of others.

Your life will be enlarged also, and all of the other things we have been taught to concentrate on, will take care of themselves.

Who am I going to encourage / praise within the next 24 hours?

Exemplary Clinical Leaders Challenge Inspire ModelEnable Encourage

Final Thoughts Final Thoughts

If we always do what we’ve always done… …we’ll always get what we’ve always got!

What am I going to do differently after today?

…I’ll probably do nothing about it! If I do nothing about it in 24 hours…

The ‘Star Fish’ Principle

and finally…

We do not lead by being corporate, professional or institutional… …we lead by being human

Thank You Diolch