Leadership

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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]

Selection of leaders

Narcissism may be selected for.[2]

Leadership styles related to worksite climate

Early categorization of leadership styles was by Lewin in 1938 who labeled styles as autocratic, democratic.[3]

The terms transactional and transformation were introduced by Weber in 1947.[4] 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[5]. 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.[6]

Measurement of transactional versus transformation leadership using the was first proposed by Bass in 1985.[7]

Bass added the concept of laissez-faire leadership in 1997.[8][9]

Leadership styles may effect employee burnout.[10][11][12]

Laissez-faire

Among physicians, management by passive exception and laissez-faire and may overlap.[13]

Laissez-faire, in health care, is associated with low subordinate job satisfaction and effort.[14]

Transactional

When converting from transactional to empowering leadership, teams may transiently function more slowly.[15]

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.[13]

Transformational

This style may be the most effective in healthcare on employee responses and clinical outcomes.[16]

Transformational leadership may increase employee thriving and decrease burnout.[17]

Transformational style may better promote team learning behaviors than a transactional style.[18]

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."[14]

Empowering leadership

Defined variably.[19][20]

Compared to transformational leadership, in servant leadership, the leader's focus is on the employees rather than the organization.[21]

Similar concepts are:

  • Servant leadership[22]
  • Gardener leadership[23]

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 Empowering Leadership Questionnaire (ELQ) has been proposed to measure this style.[24] 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[25]
  • Increased productivity by implementing Strategic Human Resource Management (SHRM) as compared to initiating operational improvements[26]
  • Increased knowledge sharing and team efficacy.[27]
  • Increases work engagement via work meaningfulness[28]

Servant or empowering leadership has been proposed for healthcare.[29][30][31]

Leadership tactics related to worksite innovation

Complexity science has been proposed as a framework for health care organization since early this century.[32][33] Anderson and McDaniel proposed in 2000 that key leadership tasks are:

  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.[34]

Complexity Leadership Theory, also called Complex systems leadership theory, was proposed in 2006.[35][36][37] Based on this theory, Hazy has proposed leadership skills similar to Anderson and McDaniel:[38]

  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. ↑ Mayo. If humble people make better leaders, why do we fall for charismatic narcissists. Harvard Business Review. 2017
  3. ↑ 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.
  4. ↑ Weber, Max, Alexander Morell Henderson, and Talcott Parsons. "The theory of social and economic organization, 1st Amer." (1947). ISBN 0684836408
  5. ↑ McGregor D. The Human Side of Enterprise. 1st edition. New York: McGraw-Hill; 1960. 256 p. ISBN 978-0-07-045092-9
  6. ↑ Burns, J. M. G. (1978). Leadership. New York: Harper & Row.
  7. ↑ Bass, MB (1985). Leadership and performance beyond expectations. New York: Free Press.
  8. ↑ Bass MB. The Future of Leadership in Learning Organizations. J of Leadership & Organizational Studies 2000 doi:10.1177%2F107179190000700302
  9. ↑ 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
  10. ↑ 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.
  11. ↑ 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.
  12. ↑ 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.
  13. ↑ 13.0 13.1 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.
  14. ↑ 14.0 14.1 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.
  15. ↑ 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.
  16. ↑ 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.
  17. ↑ 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.
  18. ↑ Raes, Elisabeth, et al. "Facilitating team learning through transformational leadership." Instructional Science 41.2 (2013): 287-305. doi:10.1007/s11251-012-9228-3
  19. ↑ 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.
  20. ↑ 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
  21. ↑ 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
  22. ↑ Greenleaf, Robert K. "Servant leadership." (1977). Mahwah, NJ: Paulist Press
  23. ↑ 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
  24. ↑ 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
  25. ↑ 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
  26. ↑ 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
  27. ↑ 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
  28. ↑ 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
  29. ↑ 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.
  30. ↑ 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.
  31. ↑ 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.
  32. ↑ Anderson RA, McDaniel RR (2000). "Managing health care organizations: where professionalism meets complexity science". Health Care Manage Rev. 25 (1): 83–92. PMID 10710732.
  33. ↑ 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.
  34. ↑ 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
  35. ↑ Lichtenstein, Benyamin B., et al. "Complexity leadership theory: An interactive perspective on leading in complex adaptive systems." (2006)
  36. ↑ 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
  37. ↑ 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
  38. ↑ 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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