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Defined variably<ref>Seibert, Scott E., Gang Wang, and Stephen H. Courtright. "Antecedents and consequences of psychological and team empowerment in organizations: a meta-analytic review." (2011): 981. {{doi|10.1037/a0022676}}</ref><ref>Drasgow, 1994 ('Empowered work groups: conceptual and empirical assessment of empowering processes and outcomes in organization': Paper presented as part of a annual meetings of the Society of the Industrial and Organizational Psychologists, TN, U.S.A.</ref><ref>Manz, C. C. and Sims, H. P. Jr. (1987). 'Leading workers to lead themselves: the external leadership of self- managed work teams', Administrative Science Quarterly, 32, 106-128 [http://www.jstor.org/stable/2392745 JSTOR]</ref> but includes:
Defined variably<ref>Seibert, Scott E., Gang Wang, and Stephen H. Courtright. "Antecedents and consequences of psychological and team empowerment in organizations: a meta-analytic review." (2011): 981. {{doi|10.1037/a0022676}}</ref><ref>Drasgow, 1994 ('Empowered work groups: conceptual and empirical assessment of empowering processes and outcomes in organization': Paper presented as part of a annual meetings of the Society of the Industrial and Organizational Psychologists, TN, U.S.A.</ref><ref>Manz, C. C. and Sims, H. P. Jr. (1987). 'Leading workers to lead themselves: the external leadership of self- managed work teams', Administrative Science Quarterly, 32, 106-128 [http://www.jstor.org/stable/2392745 JSTOR]</ref> but includes:
* Autonomy support<ref name="Nix2000">Nix, Glen A., et al. "Revitalization through self-regulation: The effects of autonomous and controlled motivation on happiness and vitality." Journal of Experimental Social Psychology 35.3 (1999): 266-284. {{doi|10.1006/jesp.1999.1382}}</ref>. Autonomy adds to mastery.<ref name="Nix2000"/> Perceived autonomy is associated with less [[Burnout (psychology)|burnout]].<ref>Fernet, Claude, et al. "How do job characteristics contribute to burnout? Exploring the distinct mediating roles of perceived autonomy, competence, and relatedness." European Journal of Work and Organizational Psychology 22.2 (2013): 123-137. {{doi|10.1080/1359432X.2011.632161}}</ref>
* Autonomy support<ref name="Nix2000">Nix, Glen A., et al. "Revitalization through self-regulation: The effects of autonomous and controlled motivation on happiness and vitality." Journal of Experimental Social Psychology 35.3 (1999): 266-284. {{doi|10.1006/jesp.1999.1382}}</ref>. Autonomy adds to mastery.<ref name="Nix2000"/> Perceived autonomy is associated with less [[Burnout (psychology)|burnout]].<ref>Fernet, Claude, et al. "How do job characteristics contribute to burnout? Exploring the distinct mediating roles of perceived autonomy, competence, and relatedness." European Journal of Work and Organizational Psychology 22.2 (2013): 123-137. {{doi|10.1080/1359432X.2011.632161}}</ref>
At a minimum, it means giving employees decision making; however, some definitions include giving employees information to guide their decision making.


Compared to transformational leadership, in servant leadership the leader's focus is on the employees rather than the organization.<ref>Gregory Stone, A., Robert F. Russell, and Kathleen Patterson. "Transformational versus servant leadership: A difference in leader focus." Leadership & Organization Development Journal 25.4 (2004): 349-361. {{doi|10.1108/01437730410538671}}</ref>
Compared to transformational leadership, in servant leadership the leader's focus is on the employees rather than the organization.<ref>Gregory Stone, A., Robert F. Russell, and Kathleen Patterson. "Transformational versus servant leadership: A difference in leader focus." Leadership & Organization Development Journal 25.4 (2004): 349-361. {{doi|10.1108/01437730410538671}}</ref>
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* Gardener leadership<ref>McChrystal GS, Collins T, Silverman D, Fussell C. Team of Teams: New Rules of Engagement for a Complex World. 1 edition. Portfolio; 2015. 289 p. {{ISBN|1591847486}}</ref>
* Gardener leadership<ref>McChrystal GS, Collins T, Silverman D, Fussell C. Team of Teams: New Rules of Engagement for a Complex World. 1 edition. Portfolio; 2015. 289 p. {{ISBN|1591847486}}</ref>


Empowering leadership is variably defined. At a minimum, it means giving employees decision making; however, some definitions include giving employees information to guide their decision making.
The World Health Organization recommends as one of 4 reforms needed for primary health care, “leadership reforms need to steer away from either ‘command and control’ or ‘laissez-faire disengagement’ towards a participatory style”<ref name="pmid23372580">{{cite journal| author=Gauld R, Blank R, Burgers J, Cohen AB, Dobrow M, Ikegami N et al.| title=The World Health Report 2008 - Primary Healthcare: How Wide Is the Gap between Its Agenda and Implementation in 12 High-Income Health Systems? | journal=Healthc Policy | year= 2012 | volume= 7 | issue= 3 | pages= 38-58 | pmid=23372580 | doi= | pmc=3298021 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23372580  }} </ref>
 
..


The Empowering Leadership Questionnaire (ELQ) has been proposed to measure this style.<ref>Arnold, Josh A., et al. "The empowering leadership questionnaire: The construction and validation of a new scale for measuring leader behaviors." Journal of Organizational Behavior (2000): 249-269. [http://www.jstor.org/stable/3100332 JSTOR]</ref> The ELQ measures either categories:
The Empowering Leadership Questionnaire (ELQ) has been proposed to measure this style.<ref>Arnold, Josh A., et al. "The empowering leadership questionnaire: The construction and validation of a new scale for measuring leader behaviors." Journal of Organizational Behavior (2000): 249-269. [http://www.jstor.org/stable/3100332 JSTOR]</ref> The ELQ measures either categories:

Revision as of 02:56, 19 September 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Robert G. Badgett, M.D.[2]

Leadership is "the function of directing or controlling the actions or attitudes of an individual or group with more or less willing acquiescence of the followers".[1]

Leadership development in health care is perceived as being many years behind that of other industries.[2]

Selection of leaders

Narcissism may be selected for.[3][4]

The selection for narcissism may be related to the Dunning-Kruger effect which has been noted to occur in the self-assessment of leadership skills.[5][6][7][8]

Leadership styles related to worksite climate

Leadership style affects work climate.

Leadership styles in health care may affect institutional finances, specifically operating margins.[9]

Early categorization of leadership styles was by Lewin in 1938 who labeled styles as autocratic, democratic.[10]

The terms transactional and transformation were introduced by Weber in 1947.[11] Weber said the charismatic leader was a transformer and the bureaucratic leader was transactional.

Similar concepts are Theory X and Theory Y management by Douglas McGregor in 1960[12]. Theory X is transactional and Theory Y is transformational.

The concept of transactional versus transformation leadership was using the Multifactor Leadership Questionnaire (MLQ) first proposed by Bass in 1978.[13]

Measurement of transactional versus transformation leadership using the was first proposed by Bass in 1985.[14]

Bass added the concept of laissez-faire leadership in 1997.[15][16]

Leadership styles may effect burnout of employees burnout[17] and leaders themselves.[18][19].

Laissez-faire

Among physicians, management by passive exception and laissez-faire and may overlap.[20]

Laissez-faire, in health care, is associated with low subordinate job satisfaction and effort.[21]

Transactional

When converting from transactional to empowering leadership, teams may transiently function more slowly.[22]

Management by exception: active

Management by exception: passive

Among physicians, management by passive exception and laissez-faire and may overlap and management by passive exception may be within laissez-faire.[20]

Transformational

This style may be the most effective in healthcare on employee responses and clinical outcomes.[23]

Transformational leadership may increase employee thriving and decrease burnout.[24]

Transformational style may better promote team learning behaviors than a transactional style.[25]

Transformational leadership may build on transactional leadership, "for transformational leadership to be effective,the leader must first build trust and follower responsiveness on the basis of tangible, transactional processes perceived as fair."[21]

Empowering leadership

Defined variably[26][27][28] but includes:

  • Autonomy support[29]. Autonomy adds to mastery.[29] Perceived autonomy is associated with less burnout.[30]

At a minimum, it means giving employees decision making; however, some definitions include giving employees information to guide their decision making.

Compared to transformational leadership, in servant leadership the leader's focus is on the employees rather than the organization.[31]

Similar concepts are[32]:

  • Servant leadership[33]
  • Shared Leadership
  • Participative Leadership
  • Gardener leadership[34]

The World Health Organization recommends as one of 4 reforms needed for primary health care, “leadership reforms need to steer away from either ‘command and control’ or ‘laissez-faire disengagement’ towards a participatory style”[35]

..

The Empowering Leadership Questionnaire (ELQ) has been proposed to measure this style.[36] The ELQ measures either categories:

  1. Coaching
  2. Informing. Examination of the 6 questions in this scale suggest informing here does not fit with information sharing as proposed by complexity science.
  3. Leading By Example
  4. Showing Concern/Interacting with the Team
  5. Participative Decision-Making

Empowering leadership is associated with:

  • Increased employee intrinsic motivation and creativity[37]
  • Increased productivity by implementing Strategic Human Resource Management (SHRM) as compared to initiating operational improvements[38]
  • Increased knowledge sharing and team efficacy.[39]
  • Increases work engagement via work meaningfulness[40]

Servant or empowering leadership has been proposed for healthcare.[41][42][43]

Leadership tactics related to worksite innovation

Complexity science has been proposed as a framework for health care organization since early this century.[44][45] Anderson and McDaniel proposed in 2000 that key leadership tasks are[44]:

  1. Relationship building
  2. Loose coupling
  3. Complicating
  4. Diversifying
  5. Sense making
  6. Learning
  7. Improvising
  8. Thinking about the future

A model of of learning based on complexity science has been developed.[46]

Complexity Leadership Theory, also called Complex systems leadership theory, was proposed in 2006.[47][48][49] Based on this theory, Hazy has proposed leadership skills similar to Anderson and McDaniel:[50]

  1. Generative
  2. Administrative
  3. Community-building
  4. Information gathering
  5. Information using

References

  1. ↑ Anonymous (2024), Leadership (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. ↑ McAlearney, Ann Scheck. "Leadership development in healthcare: a qualitative study." Journal of Organizational Behavior 27.7 (2006): 967-982. doi:10.1002/job.417
  3. ↑ Mayo. If humble people make better leaders, why do we fall for charismatic narcissists. Harvard Business Review. 2017
  4. ↑ Brunell AB, Gentry WA, Campbell WK, Hoffman BJ, Kuhnert KW, Demarree KG (2008). "Leader emergence: the case of the narcissistic leader". Pers Soc Psychol Bull. 34 (12): 1663–76. doi:10.1177/0146167208324101. PMID 18794326.
  5. ↑ Giambatista, Robert C., and J. Duane Hoover. "An Exploration of Overconfidence in Experiential Learning of Behavioral Skills among MBA Students." Developments in Business Simulation and Experiential Learning 41 (2014).
  6. ↑ Bass, Bernard M.; Yammarino, Francis J. (1991). "Congruence of Self and Others' Leadership Ratings of Naval Officers for Understanding Successful Performance". Applied Psychology. Wiley-Blackwell. 40 (4): 437–454. doi:10.1111/j.1464-0597.1991.tb01002.x. ISSN 0269-994X.
  7. ↑ Atwater, Leanne E., and Francis J. Yammarino. "Does self‐other agreement on leadership perceptions moderate the validity of leadership and performance predictions?." Personnel Psychology 45.1 (1992): 141-164. doi:10.1111/j.1744-6570.1992.tb00848.x
  8. ↑ Sheldon, Oliver J., David Dunning, and Daniel R. Ames. "Emotionally unskilled, unaware, and uninterested in learning more: Reactions to feedback about deficits in emotional intelligence." Journal of Applied Psychology 99.1 (2014): 125. doi:10.1037/a0034138
  9. ↑ Crowe D, Garman AN, Li CC, Helton J, Anderson MM, Butler P (2017). "Leadership development practices and hospital financial outcomes". Health Serv Manage Res. 30 (3): 140–147. doi:10.1177/0951484817702564. PMID 28391712.
  10. ↑ Lewin, Kurt, and Ronald Lippitt. “An Experimental Approach to the Study of Autocracy and Democracy: A Preliminary Note.” Sociometry, vol. 1, no. 3/4, 1938, pp. 292–300. JSTOR, http://www.jstor.org/stable/2785585.
  11. ↑ Weber, Max, Alexander Morell Henderson, and Talcott Parsons. "The theory of social and economic organization, 1st Amer." (1947). ISBN 0684836408
  12. ↑ McGregor D. The Human Side of Enterprise. 1st edition. New York: McGraw-Hill; 1960. 256 p. ISBN 978-0-07-045092-9
  13. ↑ Burns, J. M. G. (1978). Leadership. New York: Harper & Row.
  14. ↑ Bass, MB (1985). Leadership and performance beyond expectations. New York: Free Press.
  15. ↑ Bass MB. The Future of Leadership in Learning Organizations. J of Leadership & Organizational Studies 2000 doi:10.1177%2F107179190000700302
  16. ↑ Bass, Bernard M. "Does the transactional–transformational leadership paradigm transcend organizational and national boundaries?." American psychologist 52.2 (1997): 130. doi:10.1037/0003-066X.52.2.130
  17. ↑ Shanafelt TD, Gorringe G, Menaker R, Storz KA, Reeves D, Buskirk SJ; et al. (2015). "Impact of organizational leadership on physician burnout and satisfaction". Mayo Clin Proc. 90 (4): 432–40. doi:10.1016/j.mayocp.2015.01.012. PMID 25796117.
  18. ↑ Courtright SH, Colbert AE, Choi D (2014). "Fired up or burned out? How developmental challenge differentially impacts leader behavior". J Appl Psychol. 99 (4): 681–96. doi:10.1037/a0035790. PMID 24490967.
  19. ↑ Arnold KA, Connelly CE, Walsh MM, Ginis KA (2015). "Leadership styles, emotion regulation, and burnout". J Occup Health Psychol. 20 (4): 481–90. doi:10.1037/a0039045. PMID 25844908.
  20. ↑ 20.0 20.1 Xirasagar S (2008). "Transformational, transactional among physician and laissez-faire leadership among physician executives". J Health Organ Manag. 22 (6): 599–613. doi:10.1108/14777260810916579. PMID 19579573.
  21. ↑ 21.0 21.1 Xirasagar S, Samuels ME, Stoskopf CH (2005). "Physician leadership styles and effectiveness: an empirical study". Med Care Res Rev. 62 (6): 720–40. doi:10.1177/1077558705281063. PMID 16330822.
  22. ↑ Lorinkova NM, Pearsall MJ, Sims HP. Examining the Differential Longitudinal Performance of Directive versus Empowering Leadership in Teams. ACAD MANAGE J. 2013 Apr 1;56(2):573–96.
  23. ↑ Spinelli RJ (2006). "The applicability of Bass's model of transformational, transactional, and laissez-faire leadership in the hospital administrative environment". Hosp Top. 84 (2): 11–8. doi:10.3200/HTPS.84.2.11-19. PMID 16708688.
  24. ↑ Hildenbrand K, Sacramento CA, Binnewies C (2016). "Transformational Leadership and Burnout: The Role of Thriving and Followers' Openness to Experience". J Occup Health Psychol. doi:10.1037/ocp0000051. PMID 27631555.
  25. ↑ Raes, Elisabeth, et al. "Facilitating team learning through transformational leadership." Instructional Science 41.2 (2013): 287-305. doi:10.1007/s11251-012-9228-3
  26. ↑ Seibert, Scott E., Gang Wang, and Stephen H. Courtright. "Antecedents and consequences of psychological and team empowerment in organizations: a meta-analytic review." (2011): 981. doi:10.1037/a0022676
  27. ↑ Drasgow, 1994 ('Empowered work groups: conceptual and empirical assessment of empowering processes and outcomes in organization': Paper presented as part of a annual meetings of the Society of the Industrial and Organizational Psychologists, TN, U.S.A.
  28. ↑ Manz, C. C. and Sims, H. P. Jr. (1987). 'Leading workers to lead themselves: the external leadership of self- managed work teams', Administrative Science Quarterly, 32, 106-128 JSTOR
  29. ↑ 29.0 29.1 Nix, Glen A., et al. "Revitalization through self-regulation: The effects of autonomous and controlled motivation on happiness and vitality." Journal of Experimental Social Psychology 35.3 (1999): 266-284. doi:10.1006/jesp.1999.1382
  30. ↑ Fernet, Claude, et al. "How do job characteristics contribute to burnout? Exploring the distinct mediating roles of perceived autonomy, competence, and relatedness." European Journal of Work and Organizational Psychology 22.2 (2013): 123-137. doi:10.1080/1359432X.2011.632161
  31. ↑ Gregory Stone, A., Robert F. Russell, and Kathleen Patterson. "Transformational versus servant leadership: A difference in leader focus." Leadership & Organization Development Journal 25.4 (2004): 349-361. doi:10.1108/01437730410538671
  32. ↑ Meuser, Jeremy D., et al. "A network analysis of leadership theory: The infancy of integration." Journal of Management 42.5 (2016): 1374-1403. doi:10.1177/0149206316647099
  33. ↑ Greenleaf, Robert K. "Servant leadership." (1977). Mahwah, NJ: Paulist Press
  34. ↑ McChrystal GS, Collins T, Silverman D, Fussell C. Team of Teams: New Rules of Engagement for a Complex World. 1 edition. Portfolio; 2015. 289 p. ISBN 1591847486
  35. ↑ Gauld R, Blank R, Burgers J, Cohen AB, Dobrow M, Ikegami N; et al. (2012). "The World Health Report 2008 - Primary Healthcare: How Wide Is the Gap between Its Agenda and Implementation in 12 High-Income Health Systems?". Healthc Policy. 7 (3): 38–58. PMC 3298021. PMID 23372580.
  36. ↑ Arnold, Josh A., et al. "The empowering leadership questionnaire: The construction and validation of a new scale for measuring leader behaviors." Journal of Organizational Behavior (2000): 249-269. JSTOR
  37. ↑ Zhang, Xiaomeng, and Kathryn M. Bartol. "Linking empowering leadership and employee creativity: The influence of psychological empowerment, intrinsic motivation, and creative process engagement." Academy of management journal 53.1 (2010): 107-128. doi:10.5465/AMJ.2010.48037118
  38. ↑ Birdi, Kamal, et al. "The impact of human resource and operational management practices on company productivity: A longitudinal study." Personnel Psychology 61.3 (2008): 467-501. doi:10.1111/j.1744-6570.2008.00136.x
  39. ↑ Srivastava, Abhishek, Kathryn M. Bartol, and Edwin A. Locke. "Empowering leadership in management teams: Effects on knowledge sharing, efficacy, and performance." Academy of management journal 49.6 (2006): 1239-1251. doi:10.5465/AMJ.2006.23478718
  40. ↑ Lee, Michelle Chin Chin, Mohd Awang Idris, and Paul H. Delfabbro. "The Linkages Between Hierarchical Culture and Empowering Leadership and Their Effects on Employees’ Work Engagement: Work Meaningfulness as a Mediator." (2016) doi:10.1037/str0000043
  41. ↑ Trastek VF, Hamilton NW, Niles EE (2014). "Leadership models in health care - a case for servant leadership". Mayo Clin Proc. 89 (3): 374–81. doi:10.1016/j.mayocp.2013.10.012. PMID 24486078.
  42. ↑ Schwartz RW, Tumblin TF (2002). "The power of servant leadership to transform health care organizations for the 21st-century economy". Arch Surg. 137 (12): 1419–27, discussion 1427. PMID 12470112.
  43. ↑ Feussner JR, Landefeld CS, Weinberger SE (2016). "Change, Challenge and Opportunity: Departments of Medicine and Their Leaders". Am J Med Sci. 351 (1): 3–10. doi:10.1016/j.amjms.2015.10.008. PMID 26802752.
  44. ↑ 44.0 44.1 Anderson RA, McDaniel RR (2000). "Managing health care organizations: where professionalism meets complexity science". Health Care Manage Rev. 25 (1): 83–92. PMID 10710732.
  45. ↑ Plsek, Paul. "Redesigning health care with insights from the science of complex adaptive systems." Crossing the quality chasm: A new health system for the 21st century (2001): 309-322.
  46. ↑ Lanham, Holly Jordan, et al. "Trust and reflection in primary care practice redesign." Health services research 51.4 (2016): 1489-1514. doi:10.1111/1475-6773.12415
  47. ↑ Lichtenstein, Benyamin B., et al. "Complexity leadership theory: An interactive perspective on leading in complex adaptive systems." (2006)
  48. ↑ Uhl-Bien, Mary, Russ Marion, and Bill McKelvey. "Complexity leadership theory: Shifting leadership from the industrial age to the knowledge era." The leadership quarterly 18.4 (2007): 298-318. doi:10.1016/j.leaqua.2007.04.002
  49. ↑ Hazy, James K., and Mary Uhl-Bien. "Changing the rules: The implications of complexity science for leadership research and practice." Oxford handbook of leadership and organizations (2013) doi:10.1093/oxfordhb/9780199755615.013.033
  50. ↑ Hazy, James K., and Mary Uhl-Bien. "Towards operationalizing complexity leadership: How generative, administrative and community-building leadership practices enact organizational outcomes." Leadership 11.1 (2015): 79-104. doi:10.1177/1742715013511483


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