Lessons in
Central
Service
Leadership
Part I
CHL Self-Study Lesson Plan
Lesson No. CHL 336 (Supervisory Continuing Education - SCE)
by Jack D Ninemeier, Ph.D.
Sponsored by:
Learning Objectives
1. Define the terms “leadership” and
“management”
2. Explain how leaders differ from
traditional managers
3. Discuss the role of power in leadership
Supervisory Continuing Education (SCE) lessons
provide members with ongoing education focusing
R
eaders of the lessons in this Certification in Healthcare
Leadership (CHL) series know there is a continuing emphasis on the universal process of management: basic principles apply regardless of an organization’s non-profit or for-profit status or the industry in which it operates. The
previous two lessons in this series paved a management foundation for Central Service
(CS) leaders.1
This lesson is the first in a three-part series that will focus more specifically on
leadership principles. CS leaders who understand and consistently apply these principles will likely be more effective and successful than their counterparts who do not.
This lesson will specifically address differences between “leadership” and management,”
and will explain several types of power and how leaders use power as they interact with
their teams.
on supervisory or management issues. These
lessons are designed for CHL re-certification, but
can be of value to any CRCST in a management or
supervisory role.
You can use these lessons as an in-service with
your staff, or visit www.iahcsmm.org for online
grading at a nominal fee.
Each lesson plan graded online with a passing
score of 70% or higher is worth two points (2
contact hours). You can use these points toward
either your re-certification of CRCST (12 points) or
CHL (6 points).
Mailed submissions to IAHCSMM will not be
graded and will not be granted a point value
(paper/pencil grading of the SCE Lesson Plans is
not available through IAHCSMM or Purdue University; IAHCSMM accepts only online subscriptions).
What is Leadership?
The term “leadership” is not easy to
define. CS personnel can sense when
leadership is present (and when it is not
present), but they often find the concept
difficult to explain precisely. Numerous
definitions have been offered, and here
are some examples:
• Directing an individual’s or group’s
activities towards goals.
• Developing common values and sharing
a vision to create an environment that
others can support and work to improve.
• Providing helpful direction to a common
effort.
• Delegating, influencing, and motivating
others to contribute to an organization’s
goals.
The terms “management” and “leadership” are often used interchangeably. This
is especially true in many CS departments
because those responsible for this function
should have numerous qualities that apply
to management and leadership activities.
However, good managers are not always
good leaders, and good leaders are not
always good managers. Generally, managers
are thought of as individuals who
emphasize stable environments, orderly
work methods, and employee efficiency.
In contrast, leaders are flexible individuals
who encourage innovation, effectively
adapt to changing situations, and
facilitate the work of their staff members.
www.iahcsmm.org
Another way to explain the difference
between managers and leaders can be
expressed as managers do things right,
while leaders do the right things.” CS
leaders are able to do the right things
because they have positive attributes, such
as relatively predictable personalities,
self-confidence, emotional maturity,
good social skills, a desire to achieve, and
strong personal values.
A “skill” is the ability to effectively do
something, and leaders possess strong
technical, interpersonal, and conceptual
skills. Technical skills are those needed
to perform a job, including supervising
employees. Interpersonal skills relate
to the “art” of interacting with people
(employees, bosses, other department
heads, and external stakeholders such as
vendors and representatives of regulatory
and advisory organizations). Conceptual skills are those that allow leaders to
correctly analyze problems and make
decisions. Other examples include the
ability to consider how one’s experience
does – or does not – relate to a present situation and the ability to be creative when
analyzing dynamic situations.
The leadership dimension is difficult to
define because it involves many disciplines and concepts. One definition, while
less specific than some readers might like,
can at least point us in the right direction:
“leadership is the process by which ordinary people lead others in accomplishing
march / april 2013
Communiqué
CHL Self-Study Lesson Plan
extraordinary things.”
Two popular myths should be dispelled
about leadership:
1. People are born with innate leadership
qualities
2. Only a few can be successful leaders.
In fact, leadership involves a set of skills
and abilities that we can all learn with
feedback and practice. There are some
essential leadership elements, and they
interact in some ways to yield effective
leadership.
Emphasis of Leaders
and Managers
Figure 1 highlights the broader and
longer-term focus of leaders compared
to the more focused, task-related, and
shorter-term priorities of traditional
managers. While management activities
serve a purpose in the daily work of the
CS department, there is also a need for
leadership skills if a department is to
excel in the long-term.
organizational policy, the existence of an
organization chart showing reporting
relationships, and the willingness of
employees to recognize and accept it. Position power is formal authority delegated
to the holder of the position. In contrast,
leadership power is derived from followers’ willingness to be led by someone.
Persons in administrative positions do
have power, but this does not automatically make them leaders. Position power
is derived from vested authority and
responsibilities, and it is different from
the leadership power that is bestowed by
those who are willing to follow someone.
A person who has both position and
leadership power may maximize his or
her influence over a group.
Position power is limited by the
boundaries of the position’s authority,
while leadership power is given by the
group because it believes the leader will
use it to move the group in a mutually
desired direction. Sometimes a person
with position and leadership power may
be allowed to go beyond his or her position’s bounds because leadership power
expands the leader’s influence.
A person with position power is
accepted by followers because of the
authority an organization invests in the
position. A person with leadership power
Figure 1: Priorities Leaders and Managers
Factor
Leader Focus
Traditional
Management Focus
The number one concern
Stakeholders and quality
Money (“the numbers”)
Goal
Long-term success
Current financial status and
productivity
Power and Leadership
Power is not synonymous with leadership; it is a tool applied by leaders. One
dictionary definition of power states it
is the possession of control, authority, or
influence over others. Leadership power
is based on the followers’ willingness to
be influenced and guided by a leader. It
is not necessarily true that the leader is
the person who holds the highest degree
of authority. Position ranks or titles do
not possess leadership characteristics;
only people do. While one may expect
certain leadership characteristics to be
exhibited by people in certain positions,
those positions alone do not guarantee
leadership.
Top employee-related
concern
Help employees to feel
pride and joy in the
workplace
Keep positions filled with
qualified employees
How employees can help
Provide creative input for
decisions
Perform the physical
work well
Valued contribution
Added by all staff members
Added by top-level
managers
Position Power and
Leadership Power
Also known as legitimate power, position
power is conferred on someone by virtue
of his or her position and responsibilities
within an organization. It is enforced by
Communiqué
march / april 2013
Organizational effectiveness Lateral processes
(dependence)
Hierarchical processes
(independence)
Organizational design
Around patients and facility/department associates
Around functions
Key to organizational
efficiency
Leading people
Managing functions and
processes
Planning and
implementation activities
Interrelated
Separate activities
Quality emphasis
The entire organization and
its “brand”
Physical functions,
processes and products
Perception of manager’s
(leader’s) role
To facilitate operations
To manage operations
Interactions with employees Treat people with respect
and dignity
“Follow the rules”
How to improve
Cut costs and reduce
defects
Increase quality and employee engagement
www.iahcsmm.org
CHL Self-Study Lesson Plan
is accepted because followers perceive
that the leader will use it to promote
the group’s goals and purposes. There
is a willingness on the part of followers
to submit to leadership power because
of an overriding commitment to group
values. In a sense, then, position power
is imposed on followers while leadership
power is bestowed by followers.
Other Types of Power
There are other types of power applied by
leaders in some circumstances. These include:
• Representation power. A person is given
the power to represent a group internally
and/or externally. This person will likely
value the values, mission, and goals of
the group and may be empowered to
communicate the purpose and intent of
group actions to external entities. Within
the group, this person may occupy any
position; the consistent factor is that
group members look to him or her to
represent their interests to others.
• Purpose power. This type of power
applies when the group’s mission or
purpose takes priority over the desires
of any one person or set of persons
within the group. Therefore, actions that
are viewed to further a group’s goals
and purposes are considered more
important than any special interests that
might arise within the group. The group
leader enjoys purpose power when group
members know the leader is pursuing the
group’s purpose and intent, and group
members then accept the leader’s actions.
• Reward power. Influencing the behavior
of others by giving them some type of
reward can result in power for the person
giving it. The rewards must be perceived
to be of value to recipients if they are to
successfully alter their behavior or per formance. In addition to pay, promotion,
and prestige, rewards may include praise,
publicity, respect, favorable working
conditions, and scheduling preferences.
• Coercive power. This is the opposite of
reward power. It results from a person’s
ability to punish others or withhold
www.iahcsmm.org
rewards to impact behavior. Examples
include denial of raises, demotions,
unfavorable job transfers, or similar
actions. Coercive power is often inef fective because it tends to build resistance
and resentment from those who expe rience it. However, staff members
should perceive that their supervisors
have the capability and authority to use
coercive power, if necessary.
• Personal (charismatic) power. This arises
from personal characteristics such
someone’s appearance, personality, and
interpersonal skills that can impact the
responses of others. A leader with
personal power enhances the effectiveness
of other types of power that he or she
possesses. Some people have magnetic
personalities that lead people to be
naturally and positively drawn to them.
Alternatively, some leaders with personal
power may not be liked but are still
perceived as having personal qualities
worth emulating. Leaders can use this
personality attraction to influence others.
Minimally, a leader with personal power
is generally perceived as one with the
qualities needed to attain the group’s
goals. The group’s collective feelings
concerning the leader’s positive quali ties give the leader personal power.
• Influence power. If a group perceives a
person as leader, this person has inherent
influence within the group. The leader
usually has the power to influence policy
and the general group attitude. The
leader is usually a key person in
establishing important work relation ships and influencing how people
interact to accomplish group missions.
• Expert power. If someone is judged to
possess superior knowledge or skill, he
or she may influence others with less
knowledge or skill. The importance of
expert power is often seen in a superior- subordinate relationship. Unlike other
types of power, expert power is usually
specific and limited to the particular area in which the expert is trained and qualified.
• Referent power. Referent power may
exist when a person is liked, admired, or
respected because of personality traits or
skills that others find desirable. Referent
power is based on the individual’s
charisma and interpersonal skills. A
leader with this type of power may or
may not be conscious of it.
In Conclusion
There are numerous ways to influence
and lead a team of workers. If the goal
of a CS manager is to create the best
team possible and get the best results
for the department and its clients, it is
important for him or her to function as
a leader, rather than as only a manager.
The roles and work-related philosophies
of leaders allow them to engage their
employees and empower them to be part
of the solution. Leaders can also broaden
their scope beyond current department
functions and focus on long-term success
and their contributions to the greater
hospital system. In the end, this allows
them to earn much more respect for their
department and achieve optimal results
for the hospital’s staff and patients.
The second lesson in this three-part
series will discuss several elements of
successful leadership. It will also address
the question, “Is leadership an art or a
science?” and explain the importance of
using SMART goals.
References
1.Ninemeier, Jack. A Management Foundation
for CSSD Leaders: Parts I and Parts II. Chicago,
IL. International Association of Healthcare Central Service Materiel Management. Communiqué,
November-December, 2012 and January-February, 2013.
Additional Reading
Kouzes, James and Posner, Barry. Leadership
Practices Inventory. San Francisco, Ca. Pfeiffer. 2003.
march / april 2013
Communiqué