Leadership: All Members as Leaders – Leaderful Teams Working in Teams, Unit 7b Leadership: All Members as Leaders – Leaderful Teams Welcome to Working in Teams, Unit 7b, Leadership: All Members as Leaders – Leaderful Teams This material was developed by Johns Hopkins University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC000013.

Leadership is Collective The view is that many people within the group might be operating as leaders. The group is not solely dependent on one individual to mobilize action or make decisions. Decisions are made by whoever has the relevant responsibility. Leadership may emerge from multiple leaders of the team. Someone may initiate an activity, but others become involved and share leadership. “Leaderful leadership is not only concurrent, but is also collective. Since the assumption that there be only one leader in a group can be dispelled, we can entertain the view that many people within the group might be operating as leaders. The group is not solely dependent on one individual to mobilize action or make decisions on behalf of others. Decisions are made by whoever has the relevant responsibility. Leadership may thus emerge from multiple members of the team especially when important needs arise, they may be preparing for a strategic mission, creating meaning for the group, or proposing a change in direction. Although someone may initiate an activity, others may become involved and share leadership with the initiator.” (Boston Consortium. What is the ‘Leaderful’ Concept? Available from: http://www.leaderful.org/leaderful.html) Component 17/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011

Leadership is Collaborative All members of the team, not just the designated leader, are in control of and may speak for the entire organization. All members may advocate a point of view and they believe they can contribute to the common good of the community. The group seeks to engage in public dialogue in which they open their beliefs and values to the scrutiny of others. Leaderful leadership is also collaborative. All team members contribute to and manage the direction of the group. If they represent and advocate for a specific point of view in the community, they may actively seek an opportunity to communicate their opinions and ideas. (Boston Consortium. What is the ‘Leaderful’ Concept? Available from: http://www.leaderful.org/leaderful.html)   Component 17/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011

Leadership is Compassionate The compassionate leader extends uncompromising commitment to preserving the dignity of others. Team members’ views are considered before making a decision. Each member of the organization is to be valued regardless of background or social standing. Leaders recognize that values are interconnected with leadership – no higher value than democratic participation. Finally, leaderful managers are compassionate. By demonstrating compassion, managers promise to protect the dignity of others. They listen and value the opinions of team members' views before making a decision on behalf of the group. They value each member of the organization, regardless of his or her background or social standing, and they respect all perspectives, whether or not they line up with current opinion. In practicing compassion, leaders view the success of the organization as dependent upon the contributions of all. Compassionate leaders also recognize that values inform leadership, and respect the practice of democracy. When leaders invite people with a stake in a venture to participate, they ensure the stakeholders' commitment to the project. (Boston Consortium. What is the ‘Leaderful’ Concept? Available from: http://www.leaderful.org/leaderful.html) Component 17/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011

Tenets of Leaderful Practice Traditional Leaderful Serial Individual Controlling Dispassionate Concurrent Collective Collaborative Compassionate To summarize, let’s take a look at each of the leaderful leadership roles we’ve just discussed and how each one compares with more traditional leadership roles: Serial vs. Concurrent; Individual vs. Collective; Controlling vs. Collaborative; and Dispassionate vs. Compassionate. Component 17/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011

Health IT Workforce Curriculum Version 2.0/Spring 2011 Changing Face of Teams Change is occurring in how people think about who in the organization has credible and valuable knowledge. Shift is movement away from the idea that knowledge is found only in a select group of experts or best practitioners. The notion is toward the idea that useful knowledge is distributed throughout the whole of the organization. People are beginning to think differently about the way knowledge is valued in a company. They are questioning the idea that knowledge is held only by a select group of experts , as they realize that useful information is distributed throughout the organization. Knowledge-sharing systems at such companies as Ford and Lockheed-Martin reflect this new, broad understanding of who holds credible knowledge in the organization.   For example, if we were to ask former top management to identify those employees in their organization with key knowledge, would likely point to experts in the organization's competitive areas. In an oil company, those people might know the most about horizontal drilling or refinery maintenance. If the organization encountered a problem in those areas, they would assemble a task force of such experts to identify a solution. This solution would then be communicated to those less familiar with this area. (Dixon N. The Changing Face of Knowledge. The Learning Organization; 6(5): p212-216. MCB University Press. 1999) Component 17/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011

Health IT Workforce Curriculum Version 2.0/Spring 2011 Changing Face of Teams Expert Model Shared Model Leader (Expert) Team Member Leader Team Member One example of shared knowledge is the Best Practice Replication system that facilitates the transfer of knowledge among Ford's vehicle assembly plants. Each plant contributes practices that have benefited its productivity or cost effectiveness. Each week, an intranet distributes a few of these practices to all of the plants. Ford does not require the plants to implement these practices, because they understand that each plant may have its preferred practices; however, it the information is helpful, the plants have it at hand. The system assumes that each plant makes a valuable contribution to the body of knowledge held by the organization. Component 17/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011

Summary Points for the Changing Face of Teams 1. Each team is both giver and receiver. 2. Existing knowledge is transferred. 3. New knowledge is developed through the transfer process. A summary of the points describing the changing face of a team is as follows: each team both contributes and receives knowledge existing knowledge is shared among all teams, and this process develops new knowledge. (Dixon N. The Changing Face of Knowledge. The Learning Organization; 6(5): p212-216. MCB University Press. 1999) Component 17/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011

Changing Face Activity: Activity: Provide different examples of HIT teams and let the learner decide if they are traditional or leaderful teams. Scenario #1: Telehealth A remote physician’s office is in need to monitor 20 diabetic patients in various parts of the county. The physician is certain that if he could identify declining health trends in the patients and have a nurse visit the patient it will prevent the patient from having to enter the hospital or at the very least have the patient seen by a physician. The physician has assembled a team consisting of the following members: 1 physician 1 nurse 1 office manager 1 receptionist The physician is requiring that the team research and present a system that will enable the patients to enter their vital signs into a telephone after dialing a toll free number. The system will then send the information to a database that will sort the data and notify the physician if any patient is beginning to have declining health. During several meetings the physician monopolized the conversation and voiced his opinions frequently. The other team members were not able to state their opinions about any system that was demonstrated. Scenario #2: Free Standing Surgery Center A free standing surgery center has been tasked with investigating several vendor options for new digital radiology equipment that will be used across multiple offices. The regional director has assembled a team of the following employees: 2 Radiologists 2 Radiology Techs 2 Office Managers 2 Receptionists The team has had the initial meeting to lay the ground rules and action plan for the work ahead. One of the Radiologists has stated that she will not be able to attend the meetings on a regular basis but her associate will cover for her when she is not available. One of the office managers has offered to research from a business standpoint which system will best suit the needs of the business. One of the receptionists has offered to be part of that search. After discussion it was determined to have one of the radiology techs be part of that team as well. This information will be brought back to the entire team for discussion and decision making to take place. Component 17/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011

Real Teams Team: A small group with complementary skills committed to a common purpose, performance goals, and working approach. All members of the real team need to apply the essential discipline. Groups become teams through disciplined action, and they sustain team performance only as long as the discipline prevails. Teams are becoming more central to high performing organizations. A real team consists of people in a small group with complementary skills focused on a shared vision, performance goals, and working philosophy. Real teams require dedication and discipline from each member. Groups become teams through disciplined action which, in turn, sustains team performance. Team performance is characterized by discipline and hard work, as well as by empowerment and camaraderie. Unfortunately, leaders who support teams grapple with the market's increasing demand for immediate responsiveness and flexibility. In the face of such pressure, it is easier to thus rely on individual accountability rather than dedicate the resources that enhance team performance.   However, teams are gaining ground in high performing organizations. Basic industries feature front-line workforce teams, cross-functional teams help manage complex organizational issues, and efforts to balance team leadership are producing added leadership capacity, as well as increased team performance. All of these developments suggest that future team leaders will need to enhance their leadership approaches. (Katzenbach J, Palestrant S. Team Leadership: Emerging Challenges, Innovative Leader. 482(9);8. 2000. Available from: http://www.winstonbrill.com/bril001/html/article_index/articles/451-500/article482_body.html) Consider the following scenario – In a Visiting Nurse company it has been determined to incorporate remote devices placed in patient’s homes to capture various health information in between visits by the nurses. For example – a patient has been diagnosed with Congestive Heart Failure while hospitalized and it is critical that the patient follow strict water and diet restrictions in order to not be hospitalized again. Each Visiting Nurse office has a group of nurses that are working on the project. The Director of the company has decided to have a nurse from each site join a “team” that will work together to make sure that the best possible equipment/system is chosen and the same policies and procedures are created and followed in each office. Component 17/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011

Emerging Challenges of Team Leadership Situational Opportunities Self Discipline Shifting Leadership Roles Virtual Teams Team leadership has been described in various ways. Here are a few examples of emerging challenges of team leadership. As a leader, you would need to be aware of these challenges and how to facilitate them to ensure you have an effective team built. Component 17/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011

Situational Opportunities Capable leaders instinctively pursue team behavior in all situations. The more varied and complex team purposes and goals become, the more important it will be for every member to step up to leadership challenges that fit his/her skills and experience. Capitalizing on differing leadership will become a key characteristic of the best team leaders in the future. Effective teams can no longer depend upon individual leaders to identify opportunities and energize members. Many leaders automatically facilitate team behavior in all situations, whereas others do not. Neither approach results in “real teams in the right places at the right times,” which is what balanced leadership provides. A team effort that relies on a single leader wastes time and frustrates members. And a single leader in a situation that warrants a combined leadership approach hinders effective management, which results in a less-than-stellar team performance.   It is difficult to find real teams in situations requiring fast and proactive behaviors. New groups need time to establish roles and working practices. While a single leader can help new teams become functional, once the group is up and running, the single-leader approach is no longer the most effective. Marketplace demands, however, will require that future team efforts have the flexibility to switch between leadership styles as appropriate. Thus, it will be critical to be able to identify the appropriate conditions for each, and adapt the group's approach accordingly. (Katzenbach J, Palestrant S. Team Leadership: Emerging Challenges, Innovative Leader. 482(9);8. 2000. Available from: http://www.winstonbrill.com/bril001/html/article_index/articles/451-500/article482_body.html) Component 17/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011

Health IT Workforce Curriculum Version 2.0/Spring 2011 Self Discipline The collective performance results of any small working group are more about discipline than “togetherness,” empowerment or individual accountability. The group leader may initiate the necessary discipline, but as group capabilities emerge, peer and self-discipline come into play. Example: a sports team that moves from pre-season practice to regular season competition. The performance results of any team reflect discipline rather than sense of team spirit. But real teams require both peer- and self- discipline to sustain their performance. As an example, the U.S. Marine Corps cultivates a respect for authority balanced with the kind of self-control and peer-approval that bolsters performance. Many team leaders foster the wrong kind of discipline, or not enough discipline. The group loses commitment and direction, eventually affecting its performance. Leaders need to learn to identify appropriate discipline needs. (Katzenbach J, Palestrant S. Team Leadership: Emerging Challenges, Innovative Leader. 482(9);8. 2000. Available from: http://www.winstonbrill.com/bril001/html/article_index/articles/451-500/article482_body.html) Component 17/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011

Shifting Leadership Roles A real team is never leaderless. Leadership is drawn of each member at different times and in different ways. Real teams boost their leadership capacity by shifting the leader’s role back and forth among members, depending on the task. The leader’s responsibility falls naturally on the shoulders of whichever member has the knowledge or experience most relevant to the particular issue at hand. A real team is never leaderless. It draws on the leadership ability of each member as appropriate. Real teams shift the leadership responsibilities among members, depending on the skills required to complete the task. (Katzenbach J, Palestrant S. Team Leadership: Emerging Challenges, Innovative Leader. 482(9);8. 2000. Available from: http://www.winstonbrill.com/bril001/html/article_index/articles/451-500/article482_body.html)   Component 17/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011

Health IT Workforce Curriculum Version 2.0/Spring 2011 Virtual Teams Virtual teams are being fueled by fundamental forces of globalization, merger, “scaling” and speed as well as advances in technology that allow real work to take place. Team performance still relies on the application of discipline. A variety of different tools and approaches will be required for team leaders to ensure real team efforts at the right time in the right place. Virtual teams are supported by globalization, merger “scaling,” and rapid response, as well as technological advances facilitate work online. Nonetheless, team performance still requires the discipline and attention of its leaders and members. Leaders will need to evaluate and choose among a variety of different tools and approaches ensure effective teamwork at the right time and in the right place.   Therefore, we must develop better methods to evaluate the requirements of a group task in the context of group behaviors, and adapt those behaviors accordingly. Ideally, future teams would be able to make these evaluations and change behaviors in quick response to changing needs. (Katzenbach J, Palestrant S. Team Leadership: Emerging Challenges, Innovative Leader. 482(9);8. 2000. Available from: http://www.winstonbrill.com/bril001/html/article_index/articles/451-500/article482_body.html) Component 17/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011

Challenges of Team Leadership Activity Based on the previous slides/instruction material, you are to create an HIT team to perform the following: Choose a system that will enable the hospital to track the location of every piece of equipment that is used to transport patients. For example – wheelchairs and stretchers. Based on the previous slides/instruction materials, you are to create an HIT team to perform the following: Choose a system that will enable the hospital to track the location of every piece of equipment that is used to transport patients. For example – wheelchairs and stretchers. Component 17/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011

Challenges of Team Leadership Activity Answer the following: Is there a situation that could be seen as an opportunity for the hospital to take maximum advantage of this type of project? If so, what? Could shifting leadership roles be detrimental to the success of the project? What kind of self discipline would be needed to see this project to a successful ending? Would this project be able to use virtual teaming? If so, in what instances? Answer the following – Is there a situation that could be seen as an opportunity for the hospital to take maximum advantage of this type of project? If so, what? Could shifting leadership roles be detrimental to the success of the project? What kind of self discipline would be needed to see this project to a successful ending? Would this project be able to use virtual teaming? If so, in what instances? Component 17/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011

Health IT Workforce Curriculum Version 2.0/Spring 2011 Summary Different types of leaders, traits, styles, and emerging challenges have been discussed in this unit. When being a team leader, you will need to decide what type of leader you want to be and strive for that type and trait. Leadership is learned; model your performance on a leader you want to be like. To summarize this unit, let’s review the following: Different types of leaders, traits, styles, and emerging challenges have been discussed in this unit. When being a team leader, you will need to decide what type of leader you want to be and strive for that type and trait. Leadership is learned; model your performance on a leader you want to be like. Component 17/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011

Health IT Workforce Curriculum Version 2.0/Spring 2011 References Boston Consortium. What is the ‘Leaderful’ Concept? Available from: http://www.leaderful.org/leaderful.html Clark DR. Character and Traits in Leadership. c2010. Available from: http://www.nwlink.com/~donclark/leader/leadchr.html Clark D. Leadership. Scribd. 2001. Available from: http://www.scribd.com/doc/9191/Leadership Community Foundation for Jackson Hhole. Building Sustainability for Nonprofit Organizations. 2008. Available from: http://www.cfjacksonhole.org/documents/CFJHLeadershipSkills-ParticipantWorkbook.pdf Component 17/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011

Health IT Workforce Curriculum Version 2.0/Spring 2011 References Dixon N. The Changing Face of Knowledge. The Learning Organization; 6(5): p212-216. MCB University Press. 1999 Graff D. Core Leadership Traits Found. Available: http://www.dcma.mil/communicator/summer09/2_features/DCMA_Communicator_v09n02_pp12-pp15.pdf Katzenbach J, Palestrant S. Team Leadership: Emerging Challenges, Innovative Leader. 482(9);8. 2000. Available from: http://www.winstonbrill.com/bril001/html/article_index/articles/451-500/article482_body.html Taffinder P. Leadership Crash Course. C2007. Available from: http://www.leadershipcrashcourse.com/cc_seventypes.html Component 17/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011