Leadership: An Analysis
David M. Franklin, MSA, President, Advanced Care Consulting Services
There is no single, standardized definition of what a “leader” is. If you look it up in the dictionary, it says that a leader is someone that goes first. That’s fair enough, but that’s not quite the context that we’re dealing with. While, again, there is no standard definition, one that I’ve always been fond of is “The ability to influence others.” I think that definition describes a leader in the context that we’re examining the issue as well as anything. If you can influence others and convince them that your path and your methods are the most sound and get them to go along with you, then they are following, which by definition would make you a leader.
“The ability to manage change” is another one I like. The word ‘technology’ defines our total storehouse of knowledge. It didn’t change much for centuries. Then in the late 1820’s we invented locomotion, which greatly affected our ability to travel. This started a period of a little over 100 years – up to about 1945 – when technology increased about five times over. That’s a lot, considering that it hadn’t moved much for thousands of years. Within a few years we split the atom, invented vaccines, the transistor, and the computer chip. Since 1945 technology has actually ‘turned over’ thousands of times. Recent estimates point to a doubling about every 18 months right now, although most experts seem to agree that nothing really stands still long enough to even be measured. And healthcare moves faster than most other industries, so in discussing leadership in healthcare, we are often discussing change management. People react differently to change. Some actually embrace it, others fight all aspects of it tooth and nail; some come along rather slowly.
Maybe the first casualty of change is priorities. Habit becomes your enemy. What was the most important thing yesterday all of the sudden doesn’t matter. New problems compete for our attention. That’s not necessarily a bad thing, unless we don’t communicate with each other and end up working on differing or even competing agendas. A good leader will ensure that everyone has the same understanding of where we are at and where we are trying to go. It can create distrust as well. Staff will have expectations as to how things will be, and change alters how things are. This can create suspicion if all elements are not communicated. “Hey – I thought I was supposed to be doing this, but this person has me doing that. I don’t trust this person.” This can have a corresponding effect on loyalty. We hope that our people will be loyal to us and to the organization, but when we change things quickly loyalty can take a beating. “I used to like it her, but now things are different.” Some people just get angry. They want things the old way, and you are changing them to a new way, so now they are angry at you. Probably the saddest response is those that just give up. They don’t fight the change, they don’t embrace it… they just phone in their performance. Like they are beaten down, like a scolded puppy. They won’t jump to the other side of the cage anymore.
Despite all of these potentially negative outcomes, change is going to happen. We can’t prevent it, and in fact we often have an obligation to implement it. So all we can do it try to manage it and blunt some of the negative effects. How? As a leader, you might start by embracing change. Not only should you adapt to changes forced upon you, you should actually anticipate what needs to be changed and change it yourself. Don’t wait for it to be imposed – go out and find a better way yourself! Maintaining a high degree of integrity at all times is another necessary coping mechanism. Integrity is a general word that has many meanings, but we all know what it is: Don’t lie, cheat, or be disrespectful. Think to yourself: “If I did that would my mom be proud of me?” If you can’t answer yes then don’t do it. Stand up and be counted. When things are going poorly, step directly into the fire and fix whatever is broken. And fix the problem, not the blame. Then make sure and implement whatever steps are necessary to make sure that whatever circumstances arose to cause the problem are never allowed to arise again. Think of your department not as a wheel, but as a spoke of a wheel. Always consider how what your department does effects others, and how all of the departments must function as one entity. Give your people whatever they need to do their jobs, including training, assets, access to advice, and anything else – and then get the heck out of their way. Other than an initial training period, if you are peering over the shoulder of an employee you have failed to: 1) Recruit a dependable person; 2) Train that person adequately; 3) Communicate your expectations to that person; 4) Motivate that person; or 5) Inspire that person. In other words, if you can’t depend upon that person working autonomously you have not done your job as a leader. Motivate and inspire your staff. Lead by example, and show them why something is important. Find out what is important to them and then make sure that they have it. Make them want to walk through the very gates of hell for you. And, perhaps most importantly, allow them to fail. Mistakes are made only by people that try things, and the only way to never make a mistake is to never try. Give them some wings and let them try to fly. They might surprise you.