Description
Book SynopsisHealth care organizations are challenged to improve care at the bedside for patients, learn from individual patients to improve population health, and reduce per capita costs. To achieve these aims, leaders are needed in all parts of the organization need positive solutions.
Transforming Health Care Leadership provides healthcare leaders with the knowledge and tools to master the unprecedented level of change that health care organizations and their leaders now face. It also challenges management myths that served in bureaucracies but mislead in learning organizations.
Table of ContentsFigures, Tables, Exhibits xiii
Preface xxi
The Authors xxix
Part 1: The Challenge to Health Care Organizations and Creating the Leadership Team 1
1 Introduction: From Management Myths to Strategic Intelligence 3
Plan of the Book 8
Part 1: The Challenge to Health Care Organizations and Creating the Leadership Team 8
Part 2: Strategic Intelligence and Profound Knowledge for Leading 9
Part 3: Learning from Other Leaders and Creating a Path Forward 11
Key Terms 11
2 Why and How Health Care Organizations Need to Change 13
The Purpose of the Preliminary Research 18
The Model of Change 18
Changing Modes of Production in Health Care 20
Health Care in Learning Organizations 20
Leadership for Learning 23
The Human Side of Change 24
Approach to Service 25
The Role of Culture 26
The Mayo Model 27
Summary 29
Key Terms 31
Exercises 31
3 Leading Health Care Change 35
Summary 43
Key Terms 43
Exercises 43
4 Developing a Leadership Philosophy 45
How to Develop a Philosophy 46
Purpose 46
Ethical and Moral Reasoning 46
Levels of Moral Reasoning 47
Practical Values 48
Gap Analysis 50
Definition of Results 51
Using the Purpose to Define Results: Cherokee Nation Health Services 52
The Mayo Clinic Organization Philosophy 53
Summary 56
Key Terms 56
Exercises 56
Part 2: Strategic Intelligence and Profound Knowledge for Leading 59
5 Leading with Strategic Intelligence and Profound Knowledge 61
Foresight 63
Visioning as Designing the Idealized Organization 64
Partnering 65
Motivating 68
Profound Knowledge 68
Understanding Systems 69
Understanding Variation 71
Understanding Psychology 72
Understanding Theory of Knowledge 73
Employing Strategic Intelligence and Profound Knowledge 74
Summary 75
Key Terms 75
Exercises 76
6 Changing Health Care Systems with Systems Thinking 77
Interdependence 84
What Do We Mean by Process? 85
Two Kinds of Complexity 87
Classifications of Processes 89
Defining the System 93
Why Systems Thinking Is Difficult 96
Changing a System 97
Leverage, Constraints, and Bottlenecks 98
Systems and People: Improving Behavior 100
Summary 102
Key Terms 103
Exercises 103
7 Statistical Thinking for Health Care Leaders: Knowledge About Variation 107
Interpretation of a Control Chart 110
Avoiding the Two Kinds of Mistakes in Reacting to Variation 114
Graphical Display Using Statistical Thinking 115
Power of Simple Run Charts for Data Display 120
Leadership to Improve Population Health 127
Summary 131
Key Terms 131
Exercises 132
8 Understanding the Psychology of Collaborators 137
Personality Intelligence 139
Talents and Temperament 139
Social Character 140
Drives 141
Motivational Types 144
Identities and Philosophy 148
Bureaucratic and Interactive Values 149
Bureaucratic and Interactive 149
Motivation: Popular Ideas to Unlearn 151
Maslow’s Hierarchy of Needs Theory 151
Maccoby’s Critique of Maslow’s Theory 152
Hawthorne Experiments: Maccoby Critique 152
Using Personality Intelligence 155
Creating the Environment for Intrinsic Motivation: The Five Rs of Motivation and the Seven Value-Drives 155
Leading with the Heart 160
Disciplines of the Heart 163
Seeing Things as They Are—Deep Listening 163
Listening and Responding to Others 164
Summary 165
Key Terms 166
Exercises 167
9 A Health Care Leader’s Role in Building Knowledge 169
How Do Theories Evolve? 170
Learning and Continuous Improvement 174
Shared Meaning and Operational Definitions 176
Utilizing a Standard Methodology for Learning in the Organization 177
Using Multiple PDSA Cycles to Build Knowledge 184
The Leader as Learner and Teacher 186
Summary 188
Key Terms 188
Exercises 189
Part 3: Learning from Other Leaders and Creating a Path Forward 191
10 Three Case Studies: Mastering Change 193
Case Study A: System for Mastering Change in Jönköping County Council, Sweden 197
Case Study B: A Medical Director-Leader Improves Care in Dialysis Clinics 219
Case Study C: Building a Learning Organization at OCHIN, Portland, Oregon, United States 232
Key Terms 256
11 Leading Change: First Steps in Employing Strategic Intelligence to Get Results 259
Assessing and Defining Purpose for the Organization 260
Assessing the Learning Organization 263
Aligning Roles to Support the Organization’s Purpose 264
Leading Health Care 269
Developing a Leadership Philosophy and Practical Values 270
Summarizing and Interpreting Results from the Practical Values Gap Survey for Leadership Team Learning 272
Strategic Intelligence and Profound Knowledge for Changing Systems 274
Summarizing and Interpreting Results from the Strategic Intelligence Inventory for Leadership Team Learning 277
Developing Personality Intelligence 281
Systems Thinking: Creating a System Map of Your Organization 283
Process of Change: Idealized Design 288
Understanding the Psychology of Partners and Collaborators 290
Translating the Vision and Strategy to Actionable Approaches 291
Leading Individual and Team Improvement Efforts to Achieve the Vision 294
The Sponsor Report: Keeping Leaders in the Communication Loop 296
Learning from Improvement Efforts 299
Redeployment of Resources 301
Removing Barriers and Obstacles 302
Summary 309
Key Terms 310
Appendix 311
Leadership Personality Survey 311
Social Character Questionnaire 318
Scoring of Social Character Questionnaire 319
Understanding Leadership Personality 320
The Caring (Freud’s Erotic) Leadership Personality 322
The Visionary (Freud’s Narcissistic) Leadership Personality 324
The Exacting (Freud’s Obsessive) Leadership Personality 326
The Adaptive (Fromm’s Marketing) Leadership Personality 328
Leadership Personality Examples 330
Combinations of Types 332
Caring-Dominant Mixed Leadership Types 332
Visionary-Dominant Mixed Leadership Types 335
Exacting-Dominant Mixed Leadership Types 337
Adaptive-Dominant Mixed Leadership Types 339
Mixed Type and Social Character 342
Farming-Craft Social Character 342
Bureaucratic Social Character 343
Interactive Social Character 344
Glossary 345
Index 367
