Becoming the
Transformational Leader for
the Future of Health Care
Elaine S. Marshall, PhD, RN, FAAN
October 25, 2013
Transformational Leadership
Our Objective tonight:
To explore system, institutional, and
personal perspectives related to the
critical need for transformational leaders
in
health care and nursing education.
Transformational Leadership
What is it?
Why do we need it?
Leadership
“The art of mobilizing others to want
to struggle for shared aspirations.”
Management – “The use of authority
to obtain compliance from
members of the organization.”
Donald E. Gibson, AACN, 2010.
Transformational Leadership
Leaving a legacy for good by creating a
vision, inspiring others, and using power
and influence to effectively guide ordinary
people to produce extraordinary results.
Marshall – stolen definition from several others.
Transformational Leadership
The New Normal
What is it?
Things will never be the same.
Think differently about how we lead.
1000
1000
30
40
1000
10
1000
20
= 4100
What is Transformational
Leadership?
•
•
•
•
Leader identifies change needs
Leader creates a vision
Leader works through inspiration
Leader exhibits idealized influence
What is Transformational
Leadership?
• Leader provides intellectual
stimulation
• Leader maximizes human potential
by individual consideration
• Leader is role model for trust
• Ordinary people produce
extraordinary results
Transformational leaders
leave legacies.
What is a legacy?
What is a legacy?
•
•
•
•
•
Heritage
Bequest
Endowment
Enduring gift given freely
Change for good into the future
What is a legacy?
Legacy :
• Personal – Everything is personal
• Given freely - with no thought of
recompense
• Left by apparently “ordinary” people
• Makes a difference in extraordinary
ways
• Contributes to the whole of
organization, society, universe
George Eliot:
“If we had a keen vision of all that is
ordinary in human life, it would be like
hearing the grass grow or the squirrel’s
heart beat, and we should die of that
roar which is the other side of silence.”
Eliot G. Middlemarch: A Study of Provincial Life. Edinburgh: W. Blackwood & Sons, 1847.
Who leaves the legacy?
Who leaves the legacy?
Lillian Wald
Who leaves the legacy?
Who leaves the legacy?
Lavinia Dock
Who leaves the legacy?
Who leaves the legacy?
Susan B. Anthony
Who leaves the legacy?
Who leaves the legacy?
Margaret Shanks
Who leaves the legacy?
Who leaves the legacy?
Em Olivia Bevis
Who leaves the legacy?
Who leaves the legacy?
Margretta Styles
Who leaves the legacy?
Dorothy Mereness
Ages of Culture/Civilization
Wisdom
Information/Knowledge
Industrial
Agricultural
Hunter/Gatherer
“The greatest obstacle to discovery is not
ignorance—it is the illusion of knowledge.”
Daniel J. Boorstin
“The important thing in science is not so much
to obtain new facts as to discover new ways
of thinking about them.”
William Bragg
“Where is the knowledge we have lost in
information?”
Where is the wisdom we have lost in
knowledge?
T. S. Eliot
Shifting Conditions in Health Care
Longer life span and more chronic illness
New diseases: infectious diseases, metabolic
syndrome, etc.
Increased care needs of youngest and oldest
Increased global perspective
Increased technology
Greater disparities between rich and poor
2003 Institute of Medicine:
Health Professions Education
5 Competencies for All Health
Professions:
1.
2.
3.
4.
5.
Patient-centered care
Interdisciplinary teams
Evidence-based practice
Quality Improvement
Informatics/Technology
2004 Institute of Medicine:
Eliminating Health Disparities
1.
2.
3.
Health Literacy: A Prescription to End
Confusion
Patient Safety: Achieving a New Standard
for Care
Environmental Health: Bridging the Chasm
of Public Health and the Environment
2007 Institute of Medicine:
Preventing Medication Errors
Quality Chasm Series:
Errors and Safety
2011 Institute of Medicine:
Health Information
Technology
and Patient Safety
2011 Institute of Medicine:
The Future of Nursing:
Leading Change, Advancing
Health
2011 - The Future of Nursing
1.
2.
3.
4.
Nurses should practice to the full extent of
their education and training.
Nurses should achieve higher levels of
education and training through an
improved education system . . .
Nurses should be full partners . . . In
redesigning health care . . .
Effective workforce planning and policy . . .
Require better . . . Information
infrastructure.
The Future of Nursing
Leader or Leadership =
640 times
2012 Affordable Care Act
2013 – Government Shut Down
What next?
Unprecedented Use of Health
Care in Polarized Political
Ideology
Sea change?
What next?
Sea Change in “Leadership”
Those who get the pulpit, attract the camera,
set their hair on fire, stand the most impassible,
or talk the longest:
Grab the illusion of leadership when what the
world needs most is transformative leadership
with a foundation in wisdom.
Where are the leaders?
Where are the
transformational leaders?
Need Leaders with
1.
2.
3.
4.
Curiosity
Daring
Imagination
Wisdom
The Need For Leaders
“Your work is to discover your work
and then with all your heart
to give yourself up to it.”
Gautama Buddha
The Need For Leaders
“Being excellent is hard. So when
you have something hard to do,
remember you are being
excellent. Do you want to be
remembered for being good or
great?”
Cockerell, L. (2008). Creating magic: 10 common sense
leadership strategies from a life at Disney.
Leaving a Legacy as a Leader
It is all personal.
Becoming the
Transformational Leader Who
Leaves a Legacy
QKS
What do I want to QUIT doing?
What do I want to KEEP doing?
What do I want to START doing?
Sustaining Transformation
QKS
What do I want to QUIT doing?
Sustaining Transformation
Q KS
What do I want to KEEP doing?
Sustaining Transformation
QKS
What do I want to START doing?
First step: “Know Thyself” to
Know Others
Knowing Self and Others
Tell a story: Fairy Tale
Characteristics of Leaders
Who Leave Legacies
Tell a story about your most admired
leader.
Describe Characteristics:
1.
2.
3.
4.
5.
Top 7 Characteristics of
Admired Leaders
1.
2.
3.
4.
5.
6.
7.
Honest
Forward looking
Competent
Inspiring
Intelligent
Fair minded
Broad minded
Kouzes, J. M., & Posner, B. Z. (2007). The leadership challenge. SF: Jossey-Bass.
Characteristics of Nursing
Leaders Who Leave Legacies
1.
2.
3.
4.
5.
6.
7.
8.
Commitment to excellence
Passion about your work
Clear vision and strategic focus
Trustworthiness
Respectfulness
Accessibility
Empathy and caring
Commitment to coach and develop others
Sherman, R. O. (2012). What followers want in their nurse leaders. American Nurse
Today.
Characteristics of Leaders
Who Leave Legacies
1.
2.
3.
4.
5.
6.
7.
8.
Reflection and Personal Mission
Goal Direction
Presence and Emotional Intelligence
Accountability and Authenticity
Vulnerability, Risk Taking, and Fearlessness
Inspired Creativity and Innovation
Building on Strengths
Moral Sensitivity and Reasoning
Characteristics of Leaders
Who Leave Legacies
1. Reflection and Personal Mission
– Be willing to be “alone”
– Reflect on your practice of leadership
– Make a study of leaders and your
leadership
– Develop a personal mission statement
Characteristics of Leaders
Who Leave Legacies
2. Goal Direction
– What are your top 3 personal goals
as a leader?
1.
2.
3.
Characteristics of Leaders
Who Leave Legacies
2. Goal Direction
– What are your top 3 goals for your
organization?
1.
2.
3.
Characteristics of Leaders
Who Leave Legacies
2. Goal Direction
– What are your goals for the future of
your leadership career?
1.
2.
3.
Characteristics of Leaders
Who Leave Legacies
3. Presence
and Emotional Intelligence
– “All fear (and hope) arises from looking
backward to forward. The present moment
is the only place of clear seeing unclouded
by hope or fear.” – Margaret Wheatley
Characteristics of Leaders
Who Leave Legacies
Presence and Emotional Intelligence
4 simple rules:
• Be present, not pretentious
• Reach out, not looking down
• Be expressive, not impressive
• Be self-knowing, not self-absorbed
“Let your values, confidence, and authenticity
precede you. Then get over yourself, let go,
and be there.”
Characteristics of Leaders
Who Leave Legacies
Emotional Intelligence
1. Identify “ideal self”
2. Identify “real self” as appear to others
3. Create a plan that builds on strengths to
closes gap between ideal and real self
4. Develop trust and encourage others
Goleman, D. (2008).
Characteristics of Leaders
Who Leave Legacies
4 Domains of Emotional Intelligence :
1. Self-awareness
2. Self-management
3. Social awareness
4. Relationship management
Keys: Empathy & Listening – To self & others
Goleman, D. (2006). Emotional intelligence. NY: Bantam
Characteristics of Leaders
Who Leave Legacies
Emotional Intelligence and Communication:
Johari Window
Open
What others know
about me & what I
know about myself
Blind
What others know
about me but what I
don’t know about
myself
Hidden
What I know about
myself but others do
not know about me
Unknown
What no one knows
about me
Characteristics of Leaders
Who Leave Legacies
4. Accountability
See it.
Own it.
Solve it.
Do it.
and Authenticity
Characteristics of Leaders
Who Leave Legacies
4. Accountability
and Authenticity
“Integrity, intelligence, and energy—Hire someone
without the first, and the other two will kill you.”
Warren Buffett
“Integrity is the beginning of wisdom.”
Elaine Marshall
Characteristics of Leaders
Who Leave Legacies
4. Accountability
and Authenticity
Consistently doing the right thing
Levels:
Obligation- duty with consequences
Willingness – accepted by choice
Ownership – take power or control
Commitment – emotionally compelled to principle
Increased accountability = Increased Satisfaction
Characteristics of Leaders
Who Leave Legacies
4. Accountability
and Authenticity
Critical Elements:
Clarity – Goals are clear & specific
Commitment – Have to ask to get it
Do not accept, “I’ll try . . .” Must listen, understand,
agree, and commit
Consequences
Rachel, M. M. (2012). Accountability: A concept worth revisiting. American
Nurse Today, 7(3).
Characteristics of Leaders
Who Leave Legacies
Accountability & Satisfaction Model
1.
2.
3.
4.
5.
Introduce self
Get to eye level
Call the person by name
Non-treatment touch
Carry mission/values in pocket
Dingman, Williams, Fosbinder, & Warnick (1999). Implementing a caring
model to improve patient satisfaction. J Nurs Adm, 29(12), 30-37.
Characteristics of Leaders
Who Leave Legacies
5. Vulnerability,
Risk Taking, and
Fearlessness
“What would you do
if you knew you could not fail?”
Characteristics of Leaders
Who Leave Legacies
5. Vulnerability,
Risk Taking, and
Fearlessness
Collins – Good to Great leaders & humility
Recognize and value uncertainty
Choose to take risks that challenge the quick
sand
Involve others in new ideas
Characteristics of Leaders
Who Leave Legacies
6. Inspired
Creativity and Innovation
Critical to compete
Don’t alienate people from their own talents
New ideas :
Make sure everyone knows
Persuasion – sell it
Decision – bring in informal leaders
Implement , confirm, and start over
Characteristics of Leaders
Who Leave Legacies
7. Build on strengths
Appreciative Inquiry:
Discover
Dream
Design
Deliver
Characteristics of Leaders
Who Leave Legacies
7. Build on strengths
Appreciative Inquiry
What IS working?
How can we build on it?
Characteristics of Leaders
Who Leave Legacies
When you are not in your strength zone:
1. Dread going to work.
2. Notice more negative relationships.
3. Treat others poorly.
4. Achieve less.
5. Enjoy fewer positive moments.
6. Burdened with more fatigue.
Rath, R. (2007). Strength Finders 2.0. NY: Gallup Press.
Characteristics of Leaders
Who Leave Legacies
Strength: “The ability to consistently provide
near-perfect performance.”
Strength = Talent X Investment
Talent
= “Natural best self”
Investment = Practice, study, building – 10,000
hour rule (Malcolm Gladwell)
Rath, T. (2007). Strength Finders 2.0. NY: Gallup Press.
Characteristics of Leaders
Who Leave Legacies
8. Moral Sensitivity and Reasoning
It’s all about values:
•
Why are we here?
•
How will we be?
•
What will we stand for?
•
How will we use our gifts and talents to
serve?
Secretan, L. (1999). Inspirational leadership: Destiny, cause, & calling.
Caledon, CA: The Secretan Cr.
---------------- (2009). The Secretan center.
Knowing Yourself and Others
Who am I as a leader?
What will be my transformation:
How will I sustain it?
How will I spread or share it?
What will be my legacy?
Homework: Due Tomorrow
Morning
1. Take a test – type preference
http://www.keirsey.com/sorter/register.aspx
Becoming the
Transformational Leader who
Leaves a Legacy
QKS
What do I want to QUIT doing?
What do I want to KEEP doing?
What do I want to START doing?