mch working conference: the future of maternal and child health leadership dominick p. depaola,...

MCH Working Conference:MCH Working Conference:The Future of Maternal and Child Health LeadershipThe Future of Maternal and Child Health Leadership

Dominick P. DePaola, D.D.S., Ph.D.Dominick P. DePaola, D.D.S., Ph.D.The Forsyth InstituteThe Forsyth InstituteApril 19, 2004April 19, 2004

LEADERSHIP LEADERSHIP

AND AND

THE PUBLIC GOODTHE PUBLIC GOOD

SUMMARY THOUGHTSSUMMARY THOUGHTS

• The true test of leadership is to ask: “Are those who would participate in leadership equipped to serve the common good?”

• Leadership is the practice of helping people envision and then participate in creating a better world

• Leadership is about creating a caring culture: People Come First!

• Leadership is about exceeding expectations (Disney)

• Influencing change is the business of leadership!

““A leader is one who mobilizes others A leader is one who mobilizes others toward a goal shared by leader and toward a goal shared by leader and

follower”follower”

Willis, G., Certain Trumpets – The Call of Leaders, NY, Simon and Shuster, 1994

LEADERSHIP WORKING DEFINTION ILEADERSHIP WORKING DEFINTION I

““Leadership is a Leadership is a dynamic relationshipdynamic relationship based on mutual influence and common based on mutual influence and common

purpose between leaders and purpose between leaders and collaboratorscollaborators in which both are moved in which both are moved to higher levels of motivation and moral to higher levels of motivation and moral

development as they effect development as they effect realreal, , intended changeintended change.”.”

LEADERSHIP WORKING DEFINTION IILEADERSHIP WORKING DEFINTION II

Roast, J, Leadership for the 21st Century

New York, Praeger, 1991

INGREDIENTS FOR SUCCESSFUL AND INGREDIENTS FOR SUCCESSFUL AND EFFECTIVE LEADERSHIPEFFECTIVE LEADERSHIP

LEADERSHIP FOLLOWERSHIP

• Agreement on process of establishing common goal

• Agreement on common good (goal)

• Context

• Environment

• Agreement on outcomes (success) measures/intended change

COMMON COMMON GOOD GOOD

(GOAL)(GOAL)

ATTRIBUTES OF THE EFFECTIVE LEADERATTRIBUTES OF THE EFFECTIVE LEADER

The ABILITYABILITY to

move multiple constituencies

be flexible and tolerant of disparate positions

be “savvy” about the political/social landscape

create coalitions, partnerships and collaborations

nurture interdisciplinary and cross-cultural approaches

The WILLINGNESSWILLINGNESS to

take risks and push the envelope

challenge traditional values and the status quo

exhibit sustained resolve

In order to achieve the common good, leadership must have definitive characteristics:In order to achieve the common good, leadership must have definitive characteristics:

LEADERSHIP STYLES ARE JUDGED ON GOALS LEADERSHIP STYLES ARE JUDGED ON GOALS AND THEIR PURSUIT:AND THEIR PURSUIT:

+ Arrogant - “our” goals are best

+ Confrontational - conflicting goals

+ Plodding - meeting perceived needs

+ Regressive - low level goals

+ Status quo - goals may be good but implementation is slow

+ Visionary - pushing the “envelope” – true shared vision

Leadership: Eight Steps to Rapid ChangeLeadership: Eight Steps to Rapid ChangeEquipped with the necessary attributes and passion, leaders spring into action:Equipped with the necessary attributes and passion, leaders spring into action:

1. Sound a Bugle

2. Give Them a Compass

3. Unleash Your Change Ninjas

4. Shake Up the Status Quo

5. Sing from the Same Songbook

6. Focus Your Workforce

7. Ignite Unbeatable Performance

8. Let Go of the PresentMcPherson, C., Wittemann, K., Inspiration or Desperation: Companies Change When People Care, Summerville, 2004

If Benjamin Franklin had If Benjamin Franklin had tried to be a General and tried to be a General and George Washington had George Washington had

tried to be an Inventor, we tried to be an Inventor, we would probably be living in would probably be living in

a British Colony without a British Colony without electricity!electricity!

Do Thine Own ThingDo Thine Own Thing

Questions To Ponder I:Questions To Ponder I:

1. What kind of leadership do you practice?

• Simple

• Transformational

2. Does the leadership you exhibit move both leader and collaborators to a higher level of moral development?

3. Do you take public need and social responsibility seriously?

4. Who is on the leadership team?

• Does the team have the appropriate mix of qualities?

• Is there attention paid to cross-sector partnering?

THE COMMON GOODTHE COMMON GOOD

What is the “Common Good”?What is the “Common Good”?• Increase access to care and effective use of access

• Eliminate oral health disparities

• Engage the community in expanding the community capacity for enhancing the wellness of its pediatric population

• Expand community-based education and clinical care

• Improve public schools

• Improve science education and functional literacy

• Engage in health care reform debate, including appropriate reimbursement models

• Work toward a unified health system

•Scientific and technological advancements are at all time high

•Pediatric oral health care is in a crisis

high prevalence of disease

limited access to care

limited use of access

•Perceived value of oral health is still problematic

Public Paradox Relative to Children’s Oral HealthPublic Paradox Relative to Children’s Oral Health

A NATIONAL CALL TO ACTION TO PROMOTE A NATIONAL CALL TO ACTION TO PROMOTE ORAL HEALTHORAL HEALTH

ACTIONS:ACTIONS:

Change Perceptions of Oral Health

Overcome Barriers by Replicating Effective Programs and Proven Efforts

Build the Science Base and Accelerate Science Transfer

Increase Oral Health Workforce Diversity, Capacity, and Flexibility

Increase Collaborations

SG, Call to Action 2003

TO ADDRESS THE PARADOX, AN TO ADDRESS THE PARADOX, AN EFFECTIVE LEADER NEEDS:EFFECTIVE LEADER NEEDS:

•Legitimacy

•Public Trust

•360 degree view

•Communication and engagement skills

•Flexibility

•Courage

•Unwavering commitment to realizing a vision

OBSTACLESOBSTACLES are those frightful are those frightful things you see when you take your things you see when you take your

eyes off youreyes off your GOAL.GOAL.Henry Ford

These are some clips from real responses of These are some clips from real responses of students to exam questions (Jay Leno):students to exam questions (Jay Leno):

• H2O is hot water; and Co2 is cold water

• Water is composed of two gins, Oxygin and Hydrogin. Oxygin is pure gin and Hydrogin is water and gin

• Vacuum: a large empty space where the Pope lives

• The place where people speak Gaelic is San Francisco

• For a nosebleed; put the nose much lower than the heart until the heart stops

• Pyramids were built for shade

Gaining support and excitement from the community, Gaining support and excitement from the community, the effective leader must:the effective leader must:

• Exhibit caring, passion and compassion about the common good

• Communicate a shared vision for the common good

• Engage the consumer in an advocacy role

• This is where the rubber meets the sky!This is where the rubber meets the sky!

EFFECTIVE EFFECTIVE LEADERSHIP UNFOLDS LEADERSHIP UNFOLDS

FROM THE COMMON FROM THE COMMON GOOD!GOOD!

Questions To Ponder II:Questions To Ponder II:

1. Who should define our priorities?

2. Are your priorities connected to perceived and/or real public values and need?

3. Is the apparent public paradox related to oral health a failure of leadership?

4. Are health disparities in general a leadership failure per se or a failure to create leadership in the public good?

5. Is partnering with the community a critical approach to improve health outcomes?

LEADERSHIP AND THE PUBLIC GOODLEADERSHIP AND THE PUBLIC GOOD

A COMMUNITY-ORIENTED A COMMUNITY-ORIENTED HEALTH MODELHEALTH MODEL

Individual Patient Care

Access to Care

Direct Socioeconomic Influences

Broad Socioeconomic Influences

Global Health Influences

Domains of Professional Obligation Domains of Professional Aspiration

Model of Physician Responsibility in Relation to Influences on Health

JAMA, January 7, 2004, Vol. 292, No.1, Pg. 95

Community-Oriented Health ModelCommunity-Oriented Health Model

Communications

Community NeedsCommunity Capacity

Partnership(s) Contracts

Educators Practitioners Caregivers Citizens

Health Professions

Schools

Community Empowerment

HEALTH OUTCOMES

Determinants of Health

Outcomes

Higher Health Level• Safer environment• Decreased communicable diseases• Decrease chronic diseases• Improve immunization• Improve access to care• Decrease prevalence of oral disease

• Higher level of self-care• Improved nutrition/food supply• Improved literacy• Reduced poverty• Improve specific health status measures• Improve utilization of health services

Based on an understanding that a public good is worth Based on an understanding that a public good is worth pursuing, leadership must:pursuing, leadership must:

+ Understand community need

+ Understand community capacity

+ Be willing to engage societal issues consonant with academic or public health mission

+ Be willing to establish shared goals and implementation strategies

+ Be willing to understand community expectations

+ Be willing to measure success outcomes

+ Be willing to be both flexible and persistent!

PRACTICAL LEADERSHIP:PRACTICAL LEADERSHIP:+ Make work fun!

+ Use celebrations to create relationships

+ Equip people to make decisions

+ Become a “risk doctor” – help people recover from mistakes

+ Make your organization and personal mission, vision and values clear – then hold the reins loosely

+ Stamp out bureaucracy – make rules your servants

+ Deal with people, not positions

+ Train for skill – Hire for spirit, spunk and enthusiasm

+ Look for creative, unconventional ways to tell your story

+ When serving others (the community), make sure that “good enough” is never good enough Freiberg, K, Freiberg, J, Nuts,

New York, Broadway Books, 1996

Questions To Ponder III:Questions To Ponder III:

1. Can you define your customers?

2. Do you perceive leadership as a position of power?

3. Do you believe the “Lone Ranger” is an appropriate leadership metaphor?

4. Do you believe that leaders are servants by nature?

5. Do you believe people are born leaders?

MAKE VISION THE BOSS!MAKE VISION THE BOSS!

LEADERSHIP IS ALL ABOUT LEADERSHIP IS ALL ABOUT PEOPLE AND MAKING PEOPLE AND MAKING

THINGS HAPPENTHINGS HAPPEN

There is a Special Place in Hell Reserved for the Morally

Indifferent and Safely Neutral.

- Dante