Public Health Systems Leadershipand Core CompetencyMaster of Public Health Capstone ClassMPH 641University of San FranciscoSummer 2014Alane CruzKathleen GillisJoan HauserHannah Wikkeling

MPH 631 Course Description: “This core course will focus on preparing students to develop entry-level competencies in public health management, leadership and administration. Topics will include leadership, mission and vision definition, quality improvement, strategic planning and marketing, and other emerging topics necessary for the effective delivery and administration of public health services.”

(MPH 631 Course Syllabus via Blackboard)

SixLeadership Objectives#1 and #5 Identify the main components and issues of

organizations, financing and delivery of health services, and public health systems in the US.

Explain methods of ensuring community health safety and preparedness.

Apply principles of strategic planning and marketing to public health.

Apply quality and performance improvement concepts to address organizational performance issues.

Apply systems thinking principles for resolving organizational problems.

Demonstrate leadership skills for building collaborative partnerships.

Components and Issues of Organizations Entities with deliberate goals, activities,

structure, relationships, environments. Chicken or the egg?

Organizations and Leadership exist symbiotically

Trajectory of organizational leadership theories followed growth of nations

Issues may include machine vs. organism Control and organizational behavior Or, adaptation, creativity, evolution

Organizational TheoriesClassical Theory

Division and specialization of labor Chain of Authority Organizational structure Span of control

Neoclassical Theory/Human Relations Approach People desire social relationships, respond to group pressures, and search

for personal fulfillmentSystems Theory

Input-throughput-output, classified open/closed by how much/how little they interact with their environments.

Contingency Theory Match organization’s structure to environment

Chaos/Complexity Science Theory Organizations are living, self-organizing systems that are complex and self-

adaptive

Public Health Organization Components and Issues Focus on emerging patterns effecting health outcomes Health of individuals is influenced by complex social

and environmental interactions PH has a relationship with local, state and federal

policy that is unpredictable PH is effected by healthcare as an industry: programs,

insurance, pharm PH can be limited by workforce, regional needs (rural

vs urban), community size Funding for programs is linked to need, region,

economy, health determinants

PH Organizations are Complex SystemsFrom Rowitz, chapter 4, Public Health is about the system.

Medical care is more about management than leadership. Public health is a clear example of complex adaptive system.

Chaos theory Every complex system has a life of its own, with

its own rule book. Learning Theory

Adaptive and Generative

Complexity and PH Organizations

structure

systems processes

identity

information

meaning

action trustrelationships

The phenomena of organization, emerge from the dynamics of organizing,

which create the capacity for change and organization

PH System Levels

Mesosystem

Microsystem

Macrosystem

Local PH clinics/agencies/orgs

County/City PH agencies

USPHS/State PH Agencies

How PH Programs get funded Federal sources

CDC, per capita range $41-$47, by state. CA per capita is 181 (about the national avg)

Health Resources and Services Administration (HRSA), per capita $13-$45, by state. CA per capita is $20.

Federal health plan reimbursements (Medicare) State Investment from all sources

Range is $55-$155 CA per capita is $64

Local Funding Grants Endowments Corporate and private donors

http://www.healthyamericans.org/

Applying Systems Thinking to Solve PH Organizational Issues Recall systems thinking is dynamic,

evolving, adaptive. The organization is an organism not a machine.

Solutions Create, engage, promote learning,

teamwork, know yourself/your competencies, have a vision

Competencies in PH Leadership: Reflection and Self-Awareness Emotional intelligence Cultural competency Conflict resolution and negotiation Decision making and planning Leadership and followership Share your vision, diverse perspectives

enhance the talent pool, grow from change

SixLeadership Objectives#2 Identify the main components and issues of organizations,

financing and delivery of health services, and public health systems in the US.

Explain methods of ensuring community health safety and preparedness.

Apply principles of strategic planning and marketing to public health.

Apply quality and performance improvement concepts to address organizational performance issues.

Apply systems thinking principles for resolving organizational problems.

Demonstrate leadership skills for building collaborative partnerships.

Public Health Threats Epidemics or Pandemics

Need for vaccination, medical resources, etc

Natural disasters Need for shelter, food, water, etc.

International local terrorists Medical aid, hospital availability, coping

management, etc.

Who are Leaders in Crisis Management? We expect the following people to avert

the threat

Leadership Competencies Decision making Communication Creating organizational competencies Sustaining an organizational culture Managing multiple constituencies Developing human capital

Community Health Preparedness

Six Leadership Objectives#3 and #4 Identify the main components and issues of organizations,

financing and delivery of health services, and public health systems in the US.

Explain methods of ensuring community health safety and preparedness.

Apply principles of strategic planning and marketing to public health.

Apply quality and performance improvement concepts to address organizational performance issues.

Apply systems thinking principles for resolving organizational problems.

Demonstrate leadership skills for building collaborative partnerships.

Apply principles of strategic planning and marketing to public health.

Problem solving

implementation

Decision making

Shared decision making promotes teamwork, increases

participation and involvement allows for more input and new

information from different individuals increases possibility of consensus

Decision making models

The 4 P’s Relative to Public Health

Product: Behavior, Service Price: Monetary Cost, Time,

Efficiency Place: Where services are provided,

Where information is received Promotion: Appeal, Tone

Leadership Challenge: 5 Practices Model the Way Inspire a Shared Vision Challenge the Process Enable Others to Act Encourage the Heart

Followership Styles – Followership Styles Quiz Pragmatic followers Conformist followers Alienated followers Effective or exemplary followers

Important to understand how and when to be a follower vs. a leader in certain situations- Being a good follower will help teach us how to be more effective leaders

Leadership Styles – StrengthsFinder Being aware of our own leadership strengths will help make us more effective at working and communicating with others

 Personality Styles – Gregorc Mindstyles Knowing how we each take in and process

information helps us identify what types of learning and working environments are best for us, which in turn will help lead to increased productivity

Personality Styles Meyers-Briggs Understanding our personality type gives us a

better sense of self, and also helps us communicate ourselves better to other people

Emotional Intelligence – Intrapersonal

Self-Awareness Self-Regulation Self-Motivation

Interpersonal Empathy Effective Relationships

Emotional intelligence is essential in the professional workplace Helps improve social dynamics and harmony within a teamIncreases overall self and social awareness within individuals

Conflict Resolution/Management Styles –

Important to address how we respond to conflict in order to improve communication, increase productivity, and prevent future interpersonal issues

Cultural Competence – Critical to reducing health disparities Improves access to high-quality health care and

accuracy in health research Enables systems, organizations, and groups to

function together effectively

Visioning and Creativity – Vision Vision = Mission, Purpose, Goals Extremely important to have a shared

vision

Creativity Open to change, experimentation Creativity = Hope

Summary of Objectives 4 & 5 By addressing the strengths and

weaknesses at the individual level, effective system-level improvements can be made to address conflicts that affect overall organizational performance issues.

Understanding oneself makes us a better leader, follower, team member, communicator, and a more honest version of ourselves.

SixLeadership Objectives#6 Identify the main components and issues of

organizations, financing and delivery of health services, and public health systems in the US.

Explain methods of ensuring community health safety and preparedness.

Apply principles of strategic planning and marketing to public health.

Apply quality and performance improvement concepts to address organizational performance issues.

Apply systems thinking principles for resolving organizational problems.

Demonstrate leadership skills for building collaborative partnerships.

Personal Example – A Rap song (or a poem) by Kate (in absentia) To be a leader and have team

collaboration You have to have tons of imagination The key to success is to set up the buy-

in And make everyone feel like kin. This will for sure set up the win And the project will not fall like the wall

in Berlin. If you spell out your goals You will have no lost souls.  You MUST develop trust Or the whole thing will go a-bust  You have to know when to lead and to

follow Then the team will be as a strong as

the mighty dollar. You, the leader, will have to always

listen

So the team members will glisten The leader makes everyone feel

enlighten And no one will get brow-beaten. If the leader can expel motivation The whole team gets a standing

ovation. Even though power is a great sensation Shared power is a better foundation. I could give you more But don't want to be a bore. You all know how to lead a team All the luck in fulfilling your dream.  There is going to be conflicts and

troubles But nothing in life is a perfect bubble So the good leader will face this fact Displaying  at all times polish and tact. 

Final Questions Final Questions: - What was the standout concept or

lesson you learned from this class? - Is there any important concept you can

think of that we may have forgotten to cover?

References Rowitz, L. (2013). Public health leadership (3rd ed.) Sudbury, MA: Jones and Bartlett Publishers.

(2014.). Retrieved June 3, 2014, from http://healthyamericans.org/assets/files/TFAH2014-InvestInAmericaRpt08.pdf

Wooten, L. P., & James, E. H. (2008). Linking Crisis Management and Leadership Competencies: The Role of Human Resource Development. Retrieved May 30, 2014, from http://webuser.bus.umich.edu/lpwooten/PDF/ADHR316450.pdf

Centers for Disease Control and Prevention: Office of Public Health Preparedness and Response (2011). Public Health Preparedness Capabilities: National Standards for State and Local Planning. Retrieved May 30, 2014, from http://www.cdc.gov/phpr/capabilities/dslr_capabilities_july.pdf

James, K. (2014). Followership [PowerPoint slides]. Retrieved from https://blackboard.usfca.edu/bbcswebdav/pid-527473-dt-content-rid-1995568_1/xid-1995568_1

  James, K. (2014). Knowledge workers and emotional intelligence [PowerPoint slides]. Retrieved from

https://blackboard.usfca.edu/bbcswebdav/pid-532195-dt-content-rid-2012449_1/xid-2012449_1   James, K. (2014). Leadership and decision-making. [PowerPoint slides]. Retrieved from https://blackboard.usfca.edu/bbcswebdav/pid-

533960-dt-content-rid-2019490_1/xid-2019490_1   James, K. (2014). The leadership challenge [PowerPoint slides]. Retrieved from https://blackboard.usfca.edu/bbcswebdav/pid-532193-dt-

content-rid-2012459_1/xid-2012459_1   James, K. (2014). Vision and…creativity [PowerPoint slides]. Retrieved from https://blackboard.usfca.edu/bbcswebdav/pid-532194-dt-

content-rid-2012450_1/xid-2012450_1   National Institutes of Health. (2013). Cultural competency. Retrieved from http://www.nih.gov/clearcommunication/culturalcompetency.htm   Shaikh, B. (n.d.). Social marketing applications in public health [PowerPoint slides]. Retrieved from

http://www.bibalex.org/supercourses/supercourseppt/9011-10001/9271.ppt