basic concepts of leadership & health system management
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Basic Concepts of Leadership &Health Services Management:
An Overview
Dr Aderonke Manuwa-Olumide
WACP/CM Update Course on Leadership & Management, December 14th-18th,2009
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ManagementSome Definitions
Taking Responsibility for :
Getting things done through people
-concern for achievement of results
-concern for people
The efficient use of resources to achieveobjectives effectively
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Elements of the Managerial
Process Continuous decision-making Continuous problem-solving (after problem identification &
analysis)
Sequentialprocesses of
PlanningOrganising )Staffing ) ImplementationLeading(directing) )Controlling )
Evaluation
Continuous Communication
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Basic Management Functions (1)
Planning: setting objectives & choosingalternative courses of action towardstheir attainment.
Organising: ensuring order in thedeployment of resources.
Staffing: ensuring that positions on the
organisational chart are filled withadequate no. of staff,with appropriateskills & attitudes.
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Basic Management Functions (2)
Leading : motivating personnel to work withsustained zeal towards organisationalobjectives.
Controlling : surveillance to ensure that thework is done according to plan.
Evaluating : assessing progress towards pre-determined objectives.
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Basic Management Functions (3)
Management of human resources
Management of material resources,drugs& supplies
Management of financial resources
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Health Services Management
The process of mobilising and deployinghuman,material & financial resources forthe efficient provision of effective healthservices. It involves the planning,implementation & evaluation of healthprogrammes.
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The Continuous Cycle of Management
Planning ( P )
Implementation (I )
Evaluaion ( E )
Slice 4
P
I
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A Simplified Open Systems
Approach to Management
Inputs
ManpowerMaterialsMoney
(3 Ms)
Outputs Outcomes
ExternalEnvironment (Opportunities &Political Constraints)
EconomicSocialCulturalLegal / RegulatoryTechnological, etc.
ManagerialTransformationProcess(Planning,organising,etc)
Re-energising the System
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Levels of Management (1)
Top / Strategic Level
Middle / Tactical / Administrative Level
Lower / Operational / Supervisory Level
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Levels of Management (2)
A
B C
D E F G H
StrategicLevel
TacticalLevel
OperationalLevel
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Major Functions at the StrategicLevel of Management
Formulation of corporate vision,mission,
goals & objectives
Corporate policy formulation
Strategic planning
Resource mobilisation
Corporate evaluation
Etc
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Major Functions at the Tactical
Level of Management Corp. policy translation,regional pol. formn
Regional planning & definition of tactics
Structuring of authority
Structuring of responsibility
Coordination of activities
Control & supervision of activities
Regional evaluation Etc
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Major Functions at the OperationalLevel of Management
Policy implementation
Operational planning
Implementation of service operations & deliveryof service outputs
Utilisation of resources
Activity scheduling
Inventory control
Monitoring of performance
Etc
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Summary of Skills of the
Effective Manager Human skills : the ability to work effectively with people,tobuild cooperative effort & stimulate teamwork.Requires a deepperceptionof self,peers, subordinates & superiors as well associological, psychological & anthropological knowledge &intelligence.
Technical skills : knowledge,understanding & practicalprofeciency in the technical aspects of management.
Conceptual skills : ability to visualise the organisation as awhole,the interaction between its constituent parts as well as theimpact & the relationship of the organisation with its external
environment against the background of the organisations mission &vision.
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DEFINITIONS OFLEADERSHIP (1)
The process by which an agent induces a subordinate tobehave in a desired manner
The presence of a particular influencerelationship between two or more persons
Directing and coordinating the work of a group of
members
An interpersonal relationship in which others complybecause they want to, not because they have to.
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DEFINITIONS (2)
Transforming followers, creating visions of goalsthat may be attained, and articulating for thefollowers the ways to attain those goals
The process of influencing an organisedgroup towards accomplishing its goals
Actions that focus resources to create desirable
opportunities
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Leadership
The essence of leadership is the exercise of
influence for a common cause Leadership
includes the capacity to scan, focus, influence,
inspire, rally, direct, encourage, motivate,induce, move, mobilize, and activate others to
pursue a common goal or purpose while
maintaining focus, commitment, momentum,
confidence, and courage (Myles Munroe)
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SIGNIFICANCE OF THE
DEFINITIONS Complexity of leadership Multitudes of factors involved
Different perspectives of leadership
Leadership is a social influence process sharedamong all members of a group.
Leadership is not restricted to the influenceexerted by someone in a particular position orrole
Followers are part of the leadership process
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NATURE OF LEADERSHIP
Lacks a universal meaning; is multifaceted& multidimensional
Complex phenomenon involving the
Leader, the Followers, and the Situation orEnvironment
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THE LEADERSHIP TRINITY
Leader
CContext
BFollowers
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A
D
E
F
G
G = LeadershipEffectiveness
LEADERSHIP FRAMEWORK
Leader
Personality, Position, Expertise, Attitude
Followers
Values, Norms, Cohesiveness, Motivation,
Satisfaction
Situation Climate, Tasks, Stress, Resources,Environment, Culture, Personalities,
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EFFECTIVE LEADERSHIP
Leaders, followers, and the situationinteractively determine leadershipeffectiveness
Effective leadership is based on theeffectiveness of a leaders attitude andbehaviour in a particular context withparticular followers.
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TEN MOST COMMON CAUSES OFLEADERSHIP DERAILMENT
An insensitive, abrasive, or bullying style
Aloofness or arrogance
Betrayal of personal trust
Self-centered ambition
Failure to constructively face an obviousproblem
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TEN MOST COMMON CAUSES OFLEADERSHIP DERAILMENT
Micro-management
Inability to select good subordinates
Inability to take a long-term perspective -narrow vision
Inability to adapt to a boss with a differentstyle
Over-dependence on a sponsor ormentor
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LEADERS VERSUSMANAGERS
Managers do things right; leaders do theright things
Managers maintain; leaders develop
Managers control; leaders inspire and
empower Managers have a short-term view; leaders
have long-term visionary view
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LEADERS VERSUS
MANAGERS (2)
Managers ask how and when; leadersask what and why
Managers imitate; leaders originate
Managers accept and defend the statusquo; leaders challenge, destroy, refine,
and transform the status quo
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MANAGEMENT
Management involves keeping the currentsystem operating efficiently throughplanning, budgeting, organising, staffing,controlling, and problem solving (Kotter)
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LEADERSHIP
Leadership is scanning and focusing; thedevelopment of vision, systems, andstrategies; the passionate alignment ofrelevant people behind these systems andstrategies; the empowerment of individualsto be strategically divergent thinkers,creative and innovative; and inspiring or
influencing teams of followers to make thevision happen, despite all obstacles
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LEADING AND MANAGING FRAMEWORK (1)
LEADING
SCANNING
Identify client and stakeholderneeds and priorities
Recognize trends, opportunities,and risks that affect theorganization
Look for best practices
Identify staff capacities andconstraints
Know yourself, your staff, andyour organization values,
strengths, and weaknesses
Organizational Outcome
Managers have up-to-date valid knowledge
of their clients, the organization, admitscontext, they know how their behaviouraffects others
MANAGING
PLANNING
Set short-term organizationalgoals and performance objectives
Develop multi-year and annualplans
Allocate adequate resources(money, people, and materials)
Anticipate and reduce risks
Organizational Outcome
Organizational has definedobjectives, assigned resources,and an operational plan
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LEADING MANAGING
FOCUSSING
Articulate the organizationsmission and strategy
Identify critical challenges
Link goals with the overallorganizational strategy
Determine key priorities ofaction
Create a common picture ofdesired results
Organizational Outcome
Organizations work is directedby well-defined missionstrategy, and priorities
ORGANISING
Ensure a structure that providesaccountability and delineatesauthority
Ensure that systems for humanresource management, finance,logistics, quality assurance,operations, information, andmarketing effectively support theplan
Strengthen work processes toimplement plan
Align staff capacities with plannedactivities
Organizational Outcome
Organization has functional structures,
systems, and processes for efficientoperations: staff are organized and aware ofjob responsibilities and expectations.
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LEADING MANAGING
ALIGN/MOBILIZING
Ensure congruence of values,mission strategy, structure,systems, and daily actions
Facilitate teamwork
Unite key stakeholders around aninspiring vision
Link goals with rewards andrecognition
Enlist stakeholders to commitresources
Organizational Outcome
Internal and external stakeholders
understand and support theorganization goals and have mobilizedresources to reach these goals
IMPLEMENTING
Integrate systems and coordinatework flow
Balance competing demands
Routinely use data for decision-making
Coordinate activities with otherprogrammes and sectors
Adjust plans and resources ascircumstances change
Organizational Outcome
Activities carried out efficiently,and responsively
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LEADING MANAGING
INSPIRING
Match deeds to words
Demonstrate honesty ininteractions
Show trust and confidence instaff: acknowledge thecontribution of others
Provide staff with challenges,feedback, and support
Be a model of creativity,innovation, and learning
Organizational Outcome
Organization displays aclimate of continuous learningand staff show commitmenteven when setbacks occur.
MONITORING AND EVALUATING
Monitor and reflect on progressagainst plans
Provide feedback
Identify needed changes
Improve work processes,procedures, and tools
Organizational Outcome
Organization continuously updatesinformation about the status of
achievements and results andapplies on-going learning andknowledge
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LEADERSHIP AND MANAGEMENT
The point is not that leadership is good andmanagement is bad. They are simply different,serve different purposes, form parts of acontinuum, and are complementary.
The strategic needs of our health services are:
Visionary and credible leadership
Competent management
Effective management-leadership continuum
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WHAT DO LEADERS REALLY DO?
Challenge the Process and Status Quo Search, Experiment, Take Risks, Pay the Price
Inspire a Shared Vision Envision and Enlist Others
Enable Others to Act and Shine Foster and Strengthen Followers
Model and Mentor the Way Exemplary Behaviour, Commitment, Consistency
Encourage the Hearts to Perform Recognise, Reward, and Celebrate Outstanding
Contributions12/18/2009 copyright 35
ENVIRONMENT FOR BREEDINGLEADERS AND STRATEGIC MANAGERS
Leadership Style That Empowers
Mentoring, Delegating, and Team Building
Organising to Facilitate Empowerment
Incentive Systems
Succession Planning Transformation
Creativity and Innovation
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