Leadership in Health SystemLeadership in Health System

Shahid Beheshti University of Medical SciencesSchool of Medical EducationStrategic Policy Sessions: 24

Dr. Shahram Yazdani

Defining leadership

Leadership is the process through which an individual attempts to intentionally influence another individual or group in order to accomplish a predetermined set of goals

Characteristics of leadership

Leadership is a process. It is a verb, an action word, not a noun.

Leadership manifests itself in doing; it is a performing art.

Characteristics of leadership

Only individuals lead. The locus of leadership is in a

person. Inanimate objects do not lead, groups do not lead, only people do.

Characteristics of leadership

The focus of leadership is other individuals and groups.

A leader cannot exist without followers.

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Characteristics of leadership

Leadership entails influencing followers, their thoughts (the cognitive target of influence), feelings (the affective target), and their actions (the behavioral target).

Influence is leadership’s center of gravity and most critical element.

Characteristics of leadership

The objective of leadership is goal accomplishment .

Leadership is instrumental; it is done for a purpose.

Characteristics of leadership

Leadership is intentional, not accidental.

All of us unknowingly influence others hundreds of times each day, but those are not acts of leadership.

What is leaders main tasks?

Leaders have two main tasks: To set a path, goal, or vision for the people

who are being led. To motivate people to pursue and eventually

achieve the goal.

Leadership Versus Management

A manager have different roles such as formulating goals, developing strategies, communicating, making decisions, collecting information, planning, organizing, monitoring, and resolving conflicts;

But without leadership or with poor leadership the organization is impaired.

Multidirectionality

Leadership is multidirectional. A person can lead not only subordinates

in his organization but also peers, superiors, and individuals and groups outside the organization.

Leadership and Power

The more power a person possess, the greater the potential that he or she will be able to influence other individuals and groups.

The key concept here is potential; one can have power and not use it.

Sources of power

Office power: power associated with a particular managerial office

Expert power: information, knowledge, skill, abilities, and experience

Referent power: connection with other individuals and groups who possess influence

Reward / Coercive power: control of incentives

Charismatic power: one’s own persona

Characteristics of Good Leadership

Characteristics of Good Leadership

What influences leadership effectiveness?

NatureNurtureSituational factor

The nature argument

TraitLeadership

EffectivenessAnd Success

The Nurture Argument

TraitLeadership

EffectivenessAnd Success

Abilities &Behaviors

The Situational Argument

TraitLeadership

EffectivenessAnd Success

Abilities &Behaviors

Situation

Stogdill - 1948 Research Factors Affecting Leadership

Capacity Intelligence Alertness Verbal facility Originality Judgement

Achievement Scholarship Knowledge Athletic

accomplishments

Stogdill - continued

Responsibility Dependability Initiative Persistance Aggressiveness Self-confidence Desire to excell

Participation Activity Sociability Cooperation Adaptability Humor

Stogdill - continued

Status Socioeconomic

position Popularity

Situation Task to be

accomplished Followers to be led

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Kurt Lewin

o Kurt Lewin(1930): three type of leadership 1.Autocratic Leadership (direction)

2.Democratic Leadership (facilitation)

3.Laissez-faire Leadership

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Leadership Behavior Continuum

Manager centered Follower centered

Use of authority by

ManagerFreedom for subordinates

Tell Sell Participate DelegateTell & Ask Ask & Tell

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Path-Goal ModelEvans - 1970 & House & Dressler -1974

Effort Performance Reward Motivation

InstrumentalityExpectancy Valence

Subordinate Perceptions

WorkEnvironment

Characteristics

SubordinateCharacteristics

LeaderBehavior

(style)

Path Goal Model

Expectancy is the relation between effort and performance

Instrumentality is the degree to which a person perceives that performance will lead to reward

Valence is the strength of a person’s preference for different types of reward

Path Goal Model

According to expectancy theory a person will be highly motivated when effort results in performance (high expectancy) and when performance leads to rewards (high instrumentality) that are valued (high valence)

Implications of Path Goal Model

The path between effort, performance, and reward is difficult. The leader must do everything possible to turn what is often a cow path into a well designed, high-speed freeway

Individuals’ valences are heterogenous

Implications of Path Goal Model

The contingency most under a manager’s control is his own leadership style: Instrumental behavior (defining objectives

and specifying the task to be performed) Participatory behavior (seeking follower

input on decisions that affect them Achievement-oriented behavior

(establishing goals and setting expectations that challenge followers)

Factors affecting effectiveness of leadership

Characteristics of the manager:• Traits / dispositions• Skills• Values

Characteristics of followers:• Skills• Knowledge• Experience• Responsibility• Understanding of goals and tasks

Characteristics of situation:• Time availability• Nature of problem

Educating for Leadership (FP Program in Iran)

Individual CoachingTeam Building and TeamworkMeeting ManagementEmpowering and DelegationConflict NegotiationPositional Bargaining Interest Based BargainingThird Party Alternative Dispute

ResolutionConsensus BuildingStakeholder AnalysisAdvocacyCollaboration and Partnership Building

Any Question ?