Clinical Leadership in Nursing and Healthcare: Values into Action

373 Pages·2017·2.94 MB·English

by  David Stanley

Clinical Leadership in Nursing and Healthcare
Clinical Leadership in Nursing and Healthcare
Values into Action
Edited by David Stanley
Second Edition
This edition first published 2017 © 2017 by John Wiley & Sons, Ltd
The first edition was published by Macmillan Education Australia in 2011
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Set in 10/12pt Warnock by SPi Global, Pondicherry, India
1 2017
To my mum,
Marj Stanley (1926–)
vii
Contents
Notes on Contributors xix
Foreword xxiii
Preface xxv
Acknowledgements xxvii
Part I Clinical Leaders: Role Models for Values into Action 1
1 Clinical Leadership Explored 5
David Stanley
Introduction 5
Clinical Leadership: What Do We Know? 5
Attributes Less Likely to be Seen in Clinical Leaders 7
Not Controlling 7
Not Visionary 8
Not Shapers 9
Attributes More Likely to be Seen in Clinical Leaders 10
Clinical Competence/Clinical Knowledge 11
Approachability 11
Empowered/Motivator or Motivated 11
Supportiveness 12
Inspires Confidence 12
Integrity/Honesty 12
Role Model 12
Effective Communicator 12
Visible in Practice 13
Copes Well with Change 14
Other Attributes 14
Values: The Glue that Binds 14
Who are the Clinical Leaders? 15
Clinical Leadership Defined 17
Why Clinical Leadership Now? 18
A New Agenda 18
Changing Care Contexts 18
Change Equates to more Leadership 18
More Emphasis on Quality 19
viii Contents
Summary 20
Mind Press‐ups 21
References 21
2 Leadership theories and styles 25
David Stanley
Introduction: Leadership – What Does It All Mean? 25
Leadership Defined: The Blind Man’s Elephant 27
No One Way 29
Leadership Theories and Styles 29
The Great Man Theory: Born to Lead? 29
The Big Bang Theory: From Great Events, Great People Come 30
Trait Theory: The Man, not the Game 30
Style Theory: It’s How You Play the Game 32
Situational or Contingency Theory: It’s about Relationships 34
Transformational Theory: Making Change Happen 35
Transactional Theory: Running a Tight Ship 37
Authentic/Breakthrough Leadership: True to Your Values 37
Servant Leadership: A Follower at the Front 38
The Right Leader at the Right Time 39
Summary 41
Mind Press‐ups 42
References 42
3 Followership 47
David Stanley
Introduction: From Behind They Lead 47
Defining Followership 47
Followers’ Responsibilities 48
The Good Follower 52
The Not‐So‐Good Follower 53
Summary 56
Mind Press‐ups 56
References 57
4 Congruent Leadership 59
David Stanley
Introduction: A New Theory 59
Congruent Leadership: A Beginning 60
It all Started with Clinical Leadership 60
Congruent Leadership Theory Explored 69
A Solid Foundation 71
The Strengths of Congruent Leadership 74
Grassroots Leaders 74
Foundation for Other Theories 75
Strong Link between Values and Actions 75
Supports Further Understanding of Clinical Leadership 76
Anyone can be a Congruent Leader 77
Contents ix
The Limitations of Congruent Leadership 77
New Theory 77
Similar to Authentic Leadership and Breakthrough Leadership 77
Not Driven by a Focus on Change 77
Not Suitable for Leaders with ‘Control’ as an Objective 78
Congruent Leadership, Change and Innovation 78
Congruent Leadership and Power 79
Congruent Leadership and Quality 81
Summary 85
Mind Press‐ups 86
References 86
5 Leadership and Management 91
David Stanley
Introduction: Necessary and Essential 91
Misunderstood 92
A House Divided Cannot Stand 93
Leadership and Management: Apples and Pears? 95
Leadership and Management: Snakes and Ladders? 96
Leadership and Management: Heart and Head? 98
A Culture Shift 100
Summary 102
Mind Press‐ups 102
References 103
Part II Clinical Leadership tools: How to Influence Quality, Innovation and Change 107
6 Organisational Culture, Clinical Leadership and Congruent Leadership 109
David Stanley and Sally Carvalho
Introduction: Values First 109
What is Organisational Culture? 109
A Culture of Care and Compassion 111
Culture and Leadership 113
How Congruent Leaders Shape Culture 114
Clinical Leadership, Education and Training 118
Summary 120
Mind Press‐ups 121
References 121
7 Managing Change 125
David Stanley
Introduction: Tools for Change 125
All Change 126
Approaches to Change 128
SWOT Analysis 128
Stakeholder Analysis 129
Pettigrew’s Model 130
x Contents
The Change Management Iceberg 131
PEST or STEP 132
Kotter’s Eight‐stage Change Process 132
Nominal Group Technique 133
Process Re‐Engineering 134
Force‐Field Analysis 134
Restraining Forces 135
Driving or Facilitating Forces 135
How Do You Find Either Restraining or Facilitating Forces? 135
Other Approaches 137
Initiating, Envisioning, Playing, Sustaining: A Theoretical Synthesis for Change 137
Seven S‐Action Words Model for Organisational Change 137
Beckhard and Harris’s Change Equation 138
People‐Mover Change Model: Effectively Transforming an Organisation 138
Instituting Organisational Change: An Examination of Environmental Influences 138
Change is Never Simple, Even with a Model 138
Resistance to Change 139
Self‐Interest and Conflicting Agendas 139
Increased Stress 139
Uncertainty 140
Diverging Points of View 140
Ownership 140
Recognising the Drivers 141
Some People Just do not Like Change 141
Recognising Denial and Allowing Time for Reflection 141
Successfully Dealing with Change 141
Summary 145
Mind Press‐ups 145
References 146
8 Clinical Decision Making 149
Veronica Swallow, Joanna Smith and Trish Smith
Introduction: A Choice 149
Why do We have to make Decisions? 149
What is a Decision? 150
Accountability 150
Terms 151
Decision‐Making Approaches 151
Theories of Clinical Decision Making 155
Intuitive‐Humanistic Model 156
Systematic‐Positivist, Hypothetico‐Deductive and Technical Rational Models 157
Integrated Patient‐Centred Model 157
IDEALS Model 157
Managerial Decision‐Making Process 158
Clinical Leadership and Decisions 158
Why Decisions Go Wrong 159
Not Using the Decision‐Making Framework 159
Contents xi
Flawed Data 159
Bias 159
Seeking to Avoid Conflict or Change 159
Ignorance 159
Hindsight Bias 160
Availability Heuristics 160
Over‐Confidence in Knowledge 160
Haste 160
Group Decision Making 160
Advantages of Group Decisions 161
Disadvantages of Group Decisions 161
Characteristics of Effective Decision Makers 161
Summary 163
Mind Press‐ups 164
References 164
9 Creativity 167
David Stanley
Introduction: A New Way Forward 167
What is Creativity? 167
Building Creative Capacity 170
Techniques for Developing Creativity 170
Relax 170
Keep a Notebook or Journal 171
Journaling 171
Record Your Ideas 171
Do or Learn Something New Each Day 171
Learn to Draw 171
Become a Cartoonist 171
Learn to Map Your Mind 171
Try Associational Thinking 172
Go for a Walk 172
Adopt a Genius 172
Open a Dictionary 172
Study Books About Creative Thinking 172
Flood Yourself with Information 172
Attend Courses 172
Listen to Baroque Music 172
Face a New Fear Every Day 172
Develop Your Imagination 173
Leave Things Alone for a While 173
Find a Creative Space 173
Develop Your Sense of Humour 174
Define Your Problem 174
Know Yourself Well 174
Use Guided Reflection 174
Be Mindful 174
xii Contents
Focus 174
Do not be Afraid to Fail 174
Develop Some Techniques for Creative Thinking 174
Barriers to Creativity 175
Organisational Barriers 175
Competition 175
Organisational Structure 176
Being Too Busy to Address a Problem 176
Too Hectic an Environment 176
A Sterile Environment 176
Poor or Harsh Feedback 176
Rules 176
Unrealistic Production Demands 177
The Boss is Always Right 177
Poor Communication 177
Personal Barriers 177
Fear of Criticism 177
Our Belief that we are Not Creative 177
Fear of Change 177
Ego 177
Beliefs 178
Lack of Confidence 178
Stress 178
Previous Negative Experiences with Risk 178
Negative Self‐Talk 178
Routines 178
Other Barriers 178
Daily Distractions 178
Not Having a Place to go or Time to Get There 179
Drugs 179
Leadership and Creativity 179
Summary 182
Mind Press‐ups 182
References 182
10 team Working 185
David Stanley
Introduction: Effective Teams 185
Healthcare Teams 186
Do We Really Need Teams? 187
Teams and Groups 188
Established Teams 189
High‐Performance Teams 189
Ok or Functional Teams 190
Struggling Teams 190
Creating Powerful Teams 191
Support and Challenge 192
Team Building 193