Management Issues and Practices
James Strong, the former CEO and managing director of Qantas Airlines, twice sat on the panel convened at the Sydney office of CPA Australia to select those who would be recognized for the annual 40 Young Business Leaders list. Strong believed in the importance of nurturing young talent and threw himself wholeheartedly into leading much of the discussion among prominent leaders from all over the globe. Criteria for entrants included "the ability to land a top job, develop others and get the most from a team, and leading by example was also a must-have attribute" ("CPA Australia," 2014). To provide the scope and depth of the list-building endeavor, it is informative to explore the names of other participants on the panel, and to match them to the criteria they articulated for entrant evaluation. Here is a quick run down: James Strong looked for entrants who had "done well from a tough start" ("CPA Australia," 2014). CPA Australia's president, John Cahill, emphasized "a sense of integrity," while the company's CEO stressed the importance of "having passion and the courage to fail. The executive chair of Women on Boards, Ruth Medd, was on the lookout for "professionally well-rounded" entrants ("CPA Australia," 2014). Chris Cuffe, philanthropist and financier considered entrants who demonstrated early that they "have the get up and go to experiment" evidenced emerging leadership traits. In concert with Cuffe's criteria, public practitioner Jason Cunningham was watchful for "young leaders who were likely to be ahead in sports, volunteering and other activities" ("CPA Australia," 2014). From these proven leaders and their insights on leadership, it is possible to distill the attributes and propensities that are essential for strong leadership and good management practices ("CPA Australia," 2014). A discussion of these dynamics follows.
Leadership, Management, and Teams
The business management literature is replete with studies intended to discover and articulate the differences between leaders and managers (Cummings, et al., 2010). Operating a business is a like a sojourn on unmapped territory, fraught with known hazards and unknown risks, and a destination that seems continually just out of reach on an indistinct horizon. Leaders tend to set the company compass, determining what direction to travel, how fast to travel, and what to jettison when the load has grown too heavy, and create the necessary overlap to get the whole caravan moving in yet another direction. Managers are more typically engrossed by activities such as what to do when a wheel comes off, or the river can't be forded, or which short cut to recommend when another caravan threatens to overtake the travelers. Leaving this simile, a more formal definition of leadership is getting people to work efficiently and effectively toward a common goal, such that the work is accomplished through the agency of people other than oneself. W hat, then is management? In 1997, a book written by leadership guru Warren Bennis, was titled, "Managing People Is Like Herding Cats." The origin of the phrase "herding cats" has not definitively been established, but Bennis (1997) wrote, "Cats, of course, won't be herded. And the most successful organizations in the 21st Century won't be managed!" This phrase doesn't stand well on its own, and though Bennis wore out his own simile, he does clarify elsewhere in his book, adding: "Management is getting people to do what needs to be done. Leadership is getting people to want to do what needs to be done. Managers push. Leaders pull. Managers command. Leaders communicate."
Retaining some of the most talented people in an organization is not an easy feat. Highly intelligent and highly creatively people synthesize information in a way that can produce insights that are difficult to wrap oneself around. Add to this: highly capable people may find it difficult to be patient while others catch up. They want to take action and are often compelled by a sense of urgency. So these capable "cats" don't take being herded, nor do they herd others well. Highly talented people may find the constellation of skills that enable one to maintain long-term relationships or productively coach others a mystifying conundrum. If enough disgruntled people register complaints, the organization may find it easier to push out the rare talent than try to figure out how keep the wheels turning smoothly…without overly squeaking.
From this, one is reminded that diversity is more than ethnicity, race, gender, age, and primary language. Diversity also includes a rather large spectrum of talent, education, and areas of specialty -- any one of which can function to undermine or support to teamwork.
Team members and teamwork. The team members include...
The role of the senior manager is a combination of oversight and troubleshooting, which is done in conjunction with the middle managers. In a company of any large size -- with multiple facilities -- communication is one of the primary concerns: the more layers a message needs to travel, the more opportunity that the meaning will be misconstrued. Even when communications are written, there will be times when the rationale behind a decision or the participation of the parties engaged in deliberation will not be clear to those who receive only the written message. The chaos, conflict, and confusion that can ensure ensured from a reduction in force are a perfect example of the importance of inclusive communication, in which critical information is shared across stakeholders.
The role of leadership and management is crucial to ensuring good stewardship of scarce resources. Absent informed and timely leadership there is a danger of the following scenarios occurring in the healthcare setting:
The continued growth of healthcare expenditures will reach such high levels that they are not sustainable;
Care that should be provided and is justified from every consideration will not be provided;
Care that is not of certain value will be funded.
One of the primary roles of healthcare leadership in the company has been to facilitate the contemporary shift away from providers and toward patients and their families (Graetz, et al., 2011). The important changes that managers have had to address deal primarily with alterations in the Australian system of healthcare financing so that it does not subsidize the health inputs, so to speak (Graetz, et al., 2011). This radical change has helped to focus system resources on outputs -- that is to say, on measuring and monitoring patient outcomes as they reflect quality healthcare (Graetz, et al., 2011).
Some of the roles of the people in the company could be improved by using action research as a format to address the changes of practice that are required in order to be an agile organization (Graetz, et al., 2011). The company is organizing its effort to improve team building around the theory of caring. The transformation of the healthcare sector from a provider focus to patient-centered healthcare providers is mirrored in the company's initiative to demonstrate that through their clinical activities and professional transactions, nurses care about patients as well as care for them -- and that both of these are important to the well-being of their patients (Tonges & Ray, 2011). The plan is to use action research to study how caring theory can be manifested by integrating routine interventions to connect healthcare processes, care expectations, and nursing actions (Tonges & Ray, 2011).
The team building initiative and the action research are modeled after the Carolina Care Model that was developed at the University of North Caroline Hospitals (Tonges & Ray, 2011). The Carolina Care Model includes a performance framework for ways to actualize the caring theory and to support nursing practices that promote patient satisfaction (Tonges & Ray, 2011). Embedded in this initiative and essential to the Caroline Care Model are efforts to transform cultural norms in order to sustain the model implementation (Tonges & Ray, 2011).
The Carolina Care Model has enabled the Swanson Caring Theory to be operationalized and fostered change of practice that enhances the hospital experiences of patients and their families (Tonges & Ray, 2011). The Carolina Care Model also demonstrates the linkages between caring theories and the development and implementation of evidence-based methodologies (Tonges & Ray, 2011).
The tasks and protocols that comprise nursing rounds practice are designed to analyze patient needs, anticipate those needs as much as possible, and ensure regular, personalized contact between the patients and the nursing staff (Tonges & Ray, 2011). In the process of anticipating and meeting those needs, patients increase their trust in the nurses and in the hospital procedures and policies that influence the quality of care that they receive (Tonges & Ray, 2011). These actions, taken together, foster trust in the patients, which is closely linked to patient satisfaction, assuming that patient needs are adequately or superbly met (Tonges & Ray, 2011). In addition to patient satisfaction, there are benefits to nursing staff of conducting practice in a manner that reflects the influence of caring theory (Tonges & Ray, 2011). Nurses gain professional satisfaction from…
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