Article / Reflective Article

Healthcare Leader, Scientist, International Author, Educator, and Consultant. Los Angeles, California.

Dr. Glenn D. Pascual, DHSc, DNP, MSN, RN, eMHL, MBA, FACHE, CPXP, OCN
Healthcare Leader, Scientist, International Author, Educator, and Consultant. Los Angeles, California.

Submitted :28 March 2022 ; Published : 12 April 2022

Beneath the cloak of formal and informal relationships in every healthcare organization, a more complex system of social, economic, professional, and political relationships has a correlational effect on work productivity, system efficiency, and job satisfaction among stakeholders. Today’s workforce is changing, notwithstanding the impact of the environment, regulations, and resources to practice. Conflict, change, chaos, and complexity (4Cs) are unavoidable components of human relationships, it is always found in every work environment. Complex organizational structures require healthcare leaders to assume numerous roles, leading to conflict. Although usually viewed as unfavorable, 4C’s can be beneficial to organizations and in every leadership journey. It can be a powerful motivator for positive and innovative change. The key to successfully managing 4C’s is to analyze the value given to the situation and the experience derived from it. I have been in the health care practice, academia, and leadership for over 25 years. Much has been seen to write an article that highlights the experience. Here are the alphabets of healthcare that, when put together, describe the complex and dynamic system-ness (or lack thereof) of the environment/practice.

Conceptualizing a concept outside its stereotypical paradigm will facilitate the explanation of effective leadership. To understand the true context of leadership, it is necessary to consider the myriad of conceptual correlations in which they are embedded, including factors within and outside a particular group or organization. A leader with conceptual skills can understand how various organization functions complement one another, how the organization relates to its environment, and how changes in one part of the organization affect the rest of the organization. Accountability is the glue that holds the best-laid plans together. Healthcare leaders should lead in creating accountable cultures. They need to approach accountability by setting specific and concise goals, strategically measuring data, screening variances, and keeping others responsible for outcomes. Accountability equates to responsibility, thus leading to ownership. A culture without accountability is like a person seeing a glass half empty. Modeling and enforcing accountability is the greatest challenge one leader will ever have. It is the most incredible value of all, yet the sore point of every high-performing leader. It all starts from the leader; then it cascades to a myriad of factors as quality of recruitment, an environment of practice, condition of work, and value-based leadership. Asking potential leaders why they dismiss the idea of being a health care leader, the majority would rationalize, “I do not want to deal with people, especially the staff.” This archetypal and prototypical response ensemble the importance of my 5A’s of Leadership-Accountability, Alignment, Action, Appraisal, and Appreciation.

Alignment is the failure to align an organization in its responses to changes in the external environment that can create an ineffective ‘Because I said so’ mentality. Senior leaders will become frustrated that managers and employees aren’t implementing changes with the sense of urgency they feel.” Aligning goals is a crucial impetus in the conceptual framework as it ensures that all people from the organizational hierarchy are working to achieve similar goals. A true leader wants people to be pulling in the same direction to achieve better productivity. Action describes leaders needing great agility to see changes coming and adapt accordingly. And they must also have a suitable skill set. This skill set might depend on the organization’s circumstances, but leaders must keep the organization healthy and performing well. Leadership is like a body. Each interdependent system contributes to the success or failure of the entire organization. All parts of the organization should be interrelated and change in one area will affect the whole organization in one way or another. The appraisal is vital to employees’ professional development, to meet the organizational goals and objectives, and to adapt to change in the internal and external environment. When employees are given feedback about their performance, they feel appreciated, thus improving morale and are motivated to work harder. I emphasized the importance of appraisal to improve the present performance of the employees and draw on the future potential. Appraisal also gauges and helps leverage performance in comparison to set standards. Appreciation is vital to employee retention and continued productivity. It boosts self-worth, thus improving self-esteem. It also contributes to a lower turnover rate, decreased stress level, and better intra/inter-departmental collaboration.

Organizational behavior dictates the tone of the performance. Organizational behavior starts and ends from the top. Leaders in high performing organizations enables people to speak up, creates a psychologically safe environment, openly fosters an environment of employee engagement, and creates and maintains an inclusive culture where people feel comfortable expressing their ideas, points of view, and concerns. Leaders need to listen and stop leading from the C-suite actively. Listen for content. Separate the content from the person. Try to ferret out some value from everyone. Listening will help you execute appropriately and treat people with kindness and empathy. The behavior of the C-suite/executive leaders transcend performance. Executives need to demonstrate lateral thinking skills. They need to break down obstacles into their parts and address problem issues head-on proactively. The “power of the pen” mentality (metonymic adage) should not focus on destructive authority instead writing on improvement that spells quality, safety, experience, and satisfaction. Leaders should overtake the power of the sword somewhat objectively see ways to discover, empathize, and innovate. A leader speaks in a manner that only your heart can hear. When you manage to find this paragon of virtue, model the behavior as it never comes easy with every leader. Adversely other leader contrives shameless falsehoods to take advantage of others. Rumor can frequently be a great hardship to endure. Being a leader is not an easy mantle to take off. Set an illustrious example of integrity, honesty, and a steadfast guide for others to follow. Many envious people will be trying to break it apart for their ends. When those ill-mannered people inevitably reveal themselves and their sly intentions, stay focused, and avoid being misled. Your vision should become your voice, your course of action, and your way to systematic leadership.
Communication

The science of communication is the predictor of quality, safety, and experience. To be successful, communication and interaction requires authentic presence-ways of being reflective, sensitive, and present to every patient encounter every moment every time. Townsend-Gervis et al. (2014) suggested the importance of consistency, structure, standard, process, and repeatability of communication in a shared understanding of the patient and plan of care, resulted in improved patient satisfaction and clinical outcomes. Most agreed the greatest influence that sparked behavioral change in every team dynamic is leadership’s recognition of the barriers in communication. Communication should be transparent, open, sincere, purposeful, and systematic. Overall, the art and science of communication dictates outcomes.

• Commitment with a purpose
• Observe meaningful cues
• Managing patient-centered interaction
• Model the behavior
• Understanding preferences and values
• Need to listen and explain things clearly
• Integrating human design
• Connecting using caring behaviors
• Accountability and ownership in action
• Treat with courtesy and respect
• Identify with the patient
• Outline structured evidence-based intervention
• Nurture relationships as every moment matters every patient every time

I was a hospital department director at age 21 in another continent. It was a struggle, but I studied their culture and embraced diversity with an open mind and heart to be successful. However, I had setbacks because of employees’ resistance due to some leadership and working styles changes. Individual and group reactions to change range from enthusiastic support to deliberate sabotage. Leadership can attain their objective of minimizing resistance most effectively if they first focus their attention on trying to anticipate the reasons for and the intensity of resistant feelings and attitudes. Assessing the following assists the manager in gaining an understanding of the dynamics of the situation. Diversity is an overused word but has never been the foundation of every leadership. I have been discriminated against in executive positions I deserved regardless of my education, relationships, and the plethora of outcomes established. This is one thing that, if I focused immensely, could paralyze my being. One should not ignore this daunting experience but an opportunity to build one’s priorities upon. Self-esteem, ultimately your self-actualization, trumps biases and discrimination. As a leader, find avenues to maximize your talents. Avoid succumbing to being a victim. Your race, color, gender, and sexual preference are given, yet your future is one you can manage. Achievers have well-developed self-projection, positioning, risk-taking, and situational and behavioral awareness. Being different should not be seen as a liability, instead change of perspectives in looking indifference as a way to make a difference creates more value.

Over the course of writing this reflective article, I have had difficulty choosing a word that fits this letter. Ultimately, I chose Education- without education a leader will not be able to optimize evidence-based practice (EBP) and without EBP a leader will not fully engage staff. A man with good education will always be the envy of this C-suite leaders that garnered a position out of Peter Principle- people in hierarchy tend to rise to a level of respective incompetence. Believe me, no one will take those doctoral and master’s degree behind your name in a lifetime (they never expire, and you don’t need to renew them so often) but those executive positions can be taken in wink of an eye. Innovation and change stems from proper education. The extent to which transformation will move from the margin of organizational practice to the mainstream of organizational strategy will depend upon the ability of a leader to create value, which can be achieved through education, networking, and connectivity. Education builds values that support ethical professional practice and compromised decision making with a clear-headed acknowledgment of the diversity of philosophy at stake and an attempt to answer indifferences.
In using evidence-based practice as the foci of advanced education, the leader would grow along with a body of research to address and assess the emerging field of policies/regulations and discover practice foundations that emphasize the need for inter-professional involvement.

As a leader or a person when you fail do not see it as something negative rather never give up because FAIL means First Attempt In Learning. You will get a lot of “NO” as an answer, yet do not think less of yourself-see it as an opportunity that will lead you to the “Next Opportunity” pointing you to the next direction. Aside from change, another important thing that is constant in life is a failure. If you view life as a series of moving targets, you will find that some targets move fast, requiring you to lead the target before you fire, and others require you to shoot straight ahead. You score more points for those fast-moving, hard-to-shoot targets, so you must try more formidable challenges to be successful in life. And in every encounter with tougher challenges, you will fail. Life is really a series of targets. But in life, they may not look like targets, nor do you shoot at them. Life in leadership is full of failures, whether with people, processes, or careers. The most complex losses are those caused by your peers. Crab mentality often happens. Some leaders want others to fail to take advantage of the situation. Do not destruct by the gestalt of posturing others will showcase. Do not let ego distort good leadership sense. You can admire others but do not get jealous. Be the leader of your own. There are no failures, only outcomes.

Thank You is an expression that when meaningfully uttered creates a ripple effect. It needs to be sincere and should be purposeful- and not merely a note in an email or a card. Gratitude is a benchmark of a confidently behavior smart leader with a heart. Practice awareness that everything is a gift and if this practice is graciously assimilated in our daily lives, gratefulness comes back as a habit. Why focus on what you lack when you can focus on all that you have. Gratitude is an element of contentment, confidence, and self-awareness. See good in everything and everybody. There is nothing wrong with this technique of seeing that which is good in people, situation, or things. In fact, there is no better technique if you are truly invested in leading meaningfully, influencing people, and making a mark in healthcare. When you see good, make your voice reflect your interest through a word of gratitude. Your method of thanksgiving does not have to be extraordinary, but it does have to pack the sales punch of genuine interest and transparency. It must pack the vitality of a good leader who sees good in everything. Fill the professional lives of others only with that which is good and wholesome. Bear only good tidings and people will see you only in the image of positivity rather than disaster and grief. Gratitude begins with the attitude you portray. It begins with the demonstration of giving part of yourself to someone you lead every day.

If your employees cannot satisfy their lower level of needs, they’re unable to focus on the higher level of growth and progress. Define, discover, and provide what is essential to them. Your people are the most remarkable creation the world has ever given you. They are the technological pinnacle of every leadership. Objectively, hire someone that fills up what is missing in your team. Do not be afraid of being overshadowed by a talent. Let every member of your team shines. Remember, as a leader, you are the reflection of their performance. Your outcomes speak volumes of your tenacity, agility, and prowess. As a leader, search for what you can give and not for what you can take. No one lasts long in any responsible job if they do not have adequate basic needs. But it is equally essential that no one can make a success of such a job, even if he has knowledge and skills unless they likewise have direction. Only by ever meeting the needs of your team is when your performance can maximize to greater heights. Leaders’ ability to understand and manage the changing needs of their followers and their own would serve to motivate them to perform and increase satisfaction. Leader’s emotional intelligence is a unique predictor of follower’s performance and organizational behavior. Respect to uniqueness is transformational juxtaposed, leaders may be highly competent and functional, but without respect, the followers will not achieve all that they can attain.

Future leadership development in the new global economy must consider the national culture and background of potential leaders as significant variables in training techniques, methods, and philosophies. Nationality affects one’s cognitive maps, values, behavior, and language. It also affects leadership development and selection by determining the basic assumptions about what leaders look like, how they behave, what their style is, and so one.” Diversity and respect to cultural identity can help leaders promote effective collaboration through integration management. Integration management can be accomplished by successful managing rather than diminishing the diversity related conflicts, using corporate culture as a glue to help hold together diverse parties, using various management systems to help integrate efforts, and selecting and developing leaders who understand both to encourage diversity for improved performance and require collaboration for a more integrative and synergistic effort. A cohesive team is a blend of effective leadership, individual background, past experiences, relationships, and role definition. The formulation of a high performing team starts with the integration of every member and how a particular member gels into the agreed upon direction. Integration is the building block of team culture and dynamics.

Enjoy the colorful journey while it last. Create memories of your great leadership. Nothing is more important than taking up space and cement yourself. Create your own journey as you go along. To meet the competitive demands in the current challenging healthcare environments, purposeful leaders mobilize teams in many capacities in the quest to reach their full potential as high performing systems. True (transformational, reliable, ubiquitous, & empowering) leadership is a special case of interpersonal influence that gets an individual or team to accomplish and reach the unimaginable. Leaders need to be energetic and to operate on an even keel (working or progressing smoothly and steadily, without any sudden changes. They crave authority not as an end itself but to achieving a vision or desired goal. A lot of times, life throws curveballs. However, leaders should not be discouraged. They need to stick to a chosen course of action and push toward goal accomplishment. At the same time, they must be cognitively sharp enough to deal with information overload. Unfortunately, current healthcare’s nature is whereby goals are cascaded simultaneously and unilaterally. The expectation is excellence in performance and confidence in the team’s ability to achieve high standards. The role of leadership is to promote adaptive change. My well-defined leadership journey starts with embracing every moment and opportunity while I can. Do not get tied down to personal edifications or commitments while you can expand, grow, and travel. Learn things outside your scope. The more you engage with people of various leadership experiences, the more you broaden your spectrum of understanding. Along the way, define the meaning of your happiness. Your value preference precedes any norms or rules. Each day is a one moment of experience that you can only seize once. And finally, find a blend!

Treasure your loyal followers- you don’t get them a lot. Trust but verify not once but multiple times. Always speak with transparency; bureaucratic and tyrant leaders will not like you but never worry about who you will be offended or who will be deceived, misled, and destroyed if you don’t speak up. Never let your voice be silent because the beauty of leading lies in the ability to be themselves and have the courage to take the higher road elaborately. Do not let others overshadow your light; if other leaders are trying to bring your down, it only means that you already are above them—keepsake the trustworthiness and the memories you make along the journey. Try to be the leader of value-positions are only titles that often do not denote efficiency, intelligence, and substance. Most importantly, do not interchange boldness with humility. The leaders mentioned above will derail you from your journey; hence, assimilate into the value of kindness, positivity, and humility. The current work environment is not kind to those who want to prove worth. But unfortunately, the instinct of competitiveness marginalized and antagonized track records of outcomes and rewarded those who didn’t speak and projected a brotherhood smile. The work environment is bewildered by gamers of injustice, incompetence, and superficiality. Nonetheless, stick to the basics- the nature and the foundation of why you decide to lead. Then you will find your strength beneath the struggling flaws of our current healthcare environment. Do not allow others to have power over you- the power of mind control and prevails. Keepsake of your team-they will define your end results.

Effective listening skills may be one of the most challenging leadership skills to master. Like other behaviors, it can improve with practice and constant behaviors. An essential component of leadership using the techniques of effective communication and rapport building is the art of effective listening. Poor listening habits on the part of the leader can cause conflicts, misunderstandings, and decreased effectiveness. Often some leaders do not listen to their subordinates because they think they’re better and they know everything (superiority complex) but remember your position does not determine superiority; instead, opportunities must have knocked on your door timely that plunge you to where you are. And all you sometimes need in life is LUCK, ALIGNMENT, and OPPORTUNITY. Never assume you are bigger and better- remember the cliché “Too Big to Fail” mentality is dangerous. Active listening builds a strong relationship. Building a relationship does not merely entail repeating a series of techniques; it requires the strategic application of the proper approach to the appropriate situation to accomplish the goal. Another central area of focus in active listening is maintaining communication awareness. It consists simply of being aware of the emotions based on voice tone, speech rate, and content, to name a few. The most crucial intake of my leadership journey is listening to ideas you may not want to hear. Try not to unconsciously tune out ideas that you perceive as anxiety-provoking or threatening. Selective hearing/listening helps protect us from ideas, which is disagreeable, but it becomes a negative mechanism when it interferes with effective communication. Effective listening helps crystallize the meaning of ideas productively. Finally, consider how of the message was garbled by the listener’s interpretation, thus validation and teachback is essential in communication.

<span class=”correspondence-author”>Process:</span> the analysis, streamlining, and reconfiguration of actions and tasks required to reach a goal. The process re-engineering looks at every step in the process to crash unnecessary time to improve outcomes (Lutfiyya et al., 2016).

<span class=”correspondence-author”>Resources:</span> Many strategies may center on altering the organization’s degree of resource dependence (Evans et al., 2016). Leaders should craft strategies that respond differently to various external stakeholders. The role of senior leaders is to develop workable compromises among the competing resources dependencies facing the organization – compromises that enhance the high performing organization’s power (Haverkamp et al., 2016).

<span class=”correspondence-author”>Organizational Elements:</span> this system establishes what is important, how issues will be defined, who should and should not be involved in key choices, and the boundaries of acceptable implementation (Skylar, 2016). Incongruence relies on the ability of the leaders to actualize identified strategies and implement them as planned. Leaders know the right steps to implement the change, yet the degree of strategic implementation often showcases unsavory side of the organizational politics and bureaucracy.

<span class=”correspondence-author”>Strategy:</span> is the process of knowledge acquisition, information distribution, information interpretation, and organization planning used to adapt successfully to changing circumstances (Roberts et al., 2019).

Looking at the potpourri of leadership theories, several theories appear to be the best, most potent theoretical perspectives to use in leadership. Applying these theories encourage administrators/executives to practice more holistic and comprehensive leadership. Knowledge of these theories helps leaders assess the organizational philosophy, structures, functions, and values; develop a basis for more effective management and leadership; view the ‘big picture and, thus, contribute to well-rounded decision-making; improve morale and productivity through staff participation/buy-in in decision-making and planning; improve our communication effectiveness and role flexibility; communicate to society about healthcare leaders -who we are, what we do, why customers need our services, and why our costs are justified; and understand the business of health care delivery. Finally, evidence-based research foundations are essential because they guide leaders in asking the right questions, obtaining the right information to deal systematically with problems and issues, and can help influence health care policies. Research can influence leadership and management by providing evidence or an impetus for change, offering a model for behavior, or serving as a catalyst for evaluating current practices. These influences on leadership and management reflect instrumental, conceptual, and symbolic utilization of research findings—integrity and credibility in administration spring from using evidence-based practice as the backbone of one’s leadership.

Effectively synthesizing concepts is an attribute of effective leadership. Synthesizing and operationalizing concepts involve clarifying and establishing the topic’s significance, pointing out gaps in current knowledge about a problem area, and providing a context and a basis of comparison for interpreting information. I believe that operationalizing concepts is a combination of talent and technique. Talent is what we call creativity (although we say it’s a bit more than that). Talent is undoubtedly your ideas, imagination, situation, plot ideas, and everything that makes your story/writing. The technique is the frame for your picture – the knowledge that helps you tell your story to its best advantage. Technique makes sure that you don’t try to put the roof on until the walls are ready to take the weight, and it makes sure that the main feature window is facing towards the sun, not from it. Blending/combining/meshing talent and technique is essential in leading. Explaining the “what” and the “why” helps leaders connect the heart and mind. A leader should be relevant and highly educated. An effective leader can obtain followers if they have credibility- not only in action but also in education. Leaders need some boundary-spanning activities and a highly connected approach to articulate the blend of theories, practice, and research – this I refer to as the integrated knowledge (practice knowledge, knowledge based in research and science, and knowledge based on art). The highly connected approach to research would put to rest the problem of separated areas of knowledge and operationalization (application).

I became the Department Administrator for a Telemetry (cardiac) unit at age 28. Before that, my experience as a hospital administrator started when I was 21 back. It is hard to command respect from seasoned colleagues who have been in the organization for more than 30-40 years. Their bigoted and illiberal thinking coined me as a neophyte and did not know anything about their “world.” I felt left alone and disregarded on most occasions. A quarter passed by, and just by surprise, I received state recognition. Despite the award, I didn’t get any acknowledgment from the team. After two-three years of winning at least ten state and national awards in patient care and satisfaction, the hospital executives decided to promote me as the Director of Hospital Service. I have reservations because subconsciously, I can work parallel to them by running my department. But working for and with them operationally, under my management, is considerable uncertainty, doubt, and puzzle. Nevertheless, I accepted the job and started my first day with a director and hospital administrator’s meeting. I read what Michael Hyatt mentioned about accountable leadership, and all of them were fascinated with that statement. Most of our leaders think and behave negatively because they live in a bubble of security and self-preservations. Traditional work ethics (autocracy, bureaucracy) may have been productive for some, but they exacted high human costs. Productivity was emphasized; status symbols became measures of success, and front-line workers were driven to produce in the name of profit. The paycheck became a regular supply for non-productive hours spent in a spiraling health care organization. Leaders stay because of the economic pressure despite their poor performance. These are the current issues we have in every organization. Can change be implemented through force resignation? How can change management work when the bureaucracy (friendship, loyalty, etc.) system works? What can I do as a leader to change a culture and work design if I’m the only eye visualizing the orbital defects in management? For once, I made a change using the virtue of servant leadership. I walked every step to gain their support and made a stride in increasing their productivity. It’s been almost two years since then, and I have moved mountains – not at the pace I want but something that I can live with.

Faced with growing expectations of quality, staff members were being asked to be more accountable for the costs and outcomes of service delivery. Predominantly, managing service delivery across highly divergent and fast-moving healthcare system requires a laser-like focus on execution and operational excellence. Commitment to quality care entailed accountability in putting the systems and processes in place to measure standards through performance measures and service behavior indicators. Despite the push to build better outcomes, leaders often get trapped with a lack of competencies and skillsets to lead in the changing demand of society. Quality leaders bring quality people thus, bring quality outcomes. It all starts and ends with you being the leader. Political forces shape how tyrant, traditional, and toxic leaders recruit, retain, reward, and retreat their managers and staff. Unfortunately, that political force is often used to poison productivity and morale. Understand what your people do and reward those who truly produce/deliver. This rule is about getting a true understanding of performance—what people do and why they do it—and avoiding the smokescreen of the hard and soft approaches. Leadership should focus in improving relationship between all the stakeholders and avoid a one-sided siloed, myopic view of the healthcare environment. Encourage teams how their work impacted others and what they do brings meaning to the future landscape of health care. Most importantly, add the element of quality to your leadership. No one engages in healthcare leadership for money-leaders often do it as a passion. Working in healthcare can give stability, but it is not a guarantee for one to be at the upper echelon of society.

Instill fun as a strategy in your leadership. Fun is the balancing element of longevity in leadership. So, like in any other relationship, invigorate it with activities that promote togetherness and bond your team more formidably. Yet within the frolic of these activities comes the boundaries of respect and collegiality. Devising activities that illicit the personal side of your team helps develop a more effective working system, improves communications, lightens the workload for management, enhances cooperation between workgroups, provisions of a safety valve for staff’ emotions, and assistance with providing stability and satisfaction for the team members. Working effectively with teams takes practice and experience. Team productivity increases when staff are motivated and driven. Team productivity is directly related to the ability of its members to cooperatively focus their efforts, talents, time, and energies to meet a shared goal. Teams vary in effectiveness just as individuals do. As a leader, you need the right ampule of formula to sustain a high performing team. I had a wonderful experience leading a high-performing team in my organization. We had the best outcomes to qualify us in winning 31 state and national awards. But, as a leader, things got shaky on the 6th-7th year of my stint in the department. Then I suddenly realized what my mentors had told me, “Influential leaders should only stay at least two years in one unit/department to be efficient.” Two years is the period you should implement the changes needed for improvement. If you want to increase your tenure, find ways to reinvent, re-energies, and excite the team. Make an extra effort to sustain gains and relationships; ultimately, the foundation you created impacts your sustainability. Lastly, savor every moment while you are with such high-performing teams. One of the most complex challenges of a leader is making a well-put-together (highly reliable) team- it is indeed a blessing.

A supportive learning environment, both personal and professional, is a top requirement for a robust culture of engagement and transformation. A unique learning environment with a framework that consists of tools to collect, curate, and construct knowledge customized to an individual’s learning goals and interests is essential in a high-reliable/performing organizations. It is a professional learning environment where the individual has a group of people within their A climate of open communication must be encouraged to support a free exchange of ideas and attributes. With leadership setting the example, this provides an impetus of growth and a channel for change. It can help individuals understand one another’s responsibilities and accountabilities, opens new avenues of communication, energizes people, and may result in a more equitable distribution of learning resources within an organization. Learning does not merely entail repeating a series of techniques; it requires the strategic application of the proper method to the appropriate situation to accomplish the goal. A learning environment with a collective prioritization of learning opportunities and the creation of structure facilitates sharing, supported through strategic planning and training. This is an opportunity whereby organizational members become more proficient learners due to their own and their co-worker’s insights, perspectives, ideas, trials, observations, and reactions. Engage the minds and hearts of the front-line staff by stoking their passion through workforce engagement and informal knowledge-sharing initiatives. The team is motivated to do what they’re passionate about; it makes them accept possible outcomes of decisions and learn from the experience of execution. Integration and engagement mean bringing people together, meeting the organizational goals, and promoting group cohesiveness to achieve productive outcomes.

Elevate standards of practice
Develop standardize skillsets
Understand foundational needs
Communicate areas of improvement
Appraise performance
Teach relentlessly and follow-through
Enroll in reputable schools to advance formal education

Most times where you secure your education dictates your characteristics and outcomes as a leader. Lastly, the goal is not only to educate others but also to formally educate yourself as a leader. You cannot teach others if you, as the leader, are not well taught. Education is a performance equalizer.

A transformational leader promotes a culture of diversity, partnership, integrity, quality, service, and collaboration. The organization realized the necessity of partnership in participative decision-making and strategic planning for growth and advancement. Decisions are better coordinated. Organizational goals are emphasized. Change is a universal fact. Seasons change; relationship change; people change; and leadership change. No one escapes it. The topic of change is important to leaders who must keep pace with constant change in the healthcare industry. Effective leaders possess the ability to anticipate positive outcomes and any difficulties that may be present along the way. Accept possible outcomes of decisions and learn from the experience of execution. Integration means the ability to bring people together, meet the organizational goals, and promote group cohesiveness to achieve productive outcomes.

Leaders should realize that keeping a dynamic, change-oriented, and supportive culture is a mix of managerial actions, decisions about innovation, technological venture, and initiatives from all employees. Second, it is also a mistake for leaders to attempt to revitalize an organization by dictating major changes and ignoring actual implementation stage. With our scare resources and recessionary economic conditions, tactical, short/long-term, and sound business-function specific decisions are of greater demand for adoption and implementation. Organizations should reinvent the way business is delivered to reconfigure the chiastic structure of the spiraling healthcare system.

Critical to the success of any organization is the ability of its leaders to inspire visionary thinking by transferring knowledge throughout the organization to develop future leaders. A Leader- as the Transformational model illustrates how it has been able to effect knowledge transfer, increase cross-functional and divisional collaboration, inspire succession management, energize the leadership team, and provide quality time in a learning environment. As leaders, we demonstrate the ethical fiber of the organization by our behaviors. We earn respect from others by holding ourselves accountable for what we do. We can practice acting with integrity by being an example of action, recognizing areas that need improving, and choosing a more ethical way of working and operating with consistency, honesty, and openness. Some of the qualities and undertakings of a transformational leader written include building and maintaining successful teams, planning, and conducting results-oriented gatherings, communicating effectively with others in dealing with disagreements, and turning resistance into cooperation, energizing colleagues, and strengthening morale, observing, and coaching others, and implementing reforms that lead to higher achievements. More so, visionary thinking leaders have a high regard for the
importance of care (experience), health (quality), cost, and meaning in work in their underlying patters of values, attitudes, and strategies (Sikka et al., 2015).

Be where your feet are. Your team sees within your heart. Display kind gestures but stay close-grained with adversities. Along with caring, sensitivity to people is an essential skill for the leader. Sensitivity to people/or subordinates is the ability to sense what others think and feel accurate. Many studies have been done to identify the traits or characteristics of a sensitive leader. Because this is a complex area to study, some results are conflicting. However, when compared, a clear pattern of traits emerges sensitive leaders are more tolerant, highly motivated, independent, responsible, and considerate. Leaders that are motivated learn what they want to know. Motivated leaders approach learning with eagerness and are open to new experiences. They actively participate in the learning process. As leaders, we bear an important responsibility-one that cannot deny that the old ways and standards just aren’t good enough anymore. We live, work, and learn in a society that expects high performance and high quality-of-work life to blend hand in hand; that considers ethics and social responsibility paramount measures of individual and organizational performance; that respects the talents and uniqueness of workforces increasingly in demographic and cultural diversity; and that knows the imprint of globalization. Abuse comes along with the territory of being kind. We can show our heart, but our team should not know every muscle fiber in our musculoskeletal system.

Work economically and
Efficiently
Avoid waste to achieve the
Necessary change

Offset
Unnecessary steps
To succeed

Lean healthcare decision-making in organizations is directly coupled with objectives in one of two ways: decision processes are triggered by an effort to search/discover new objectives and decision processes are triggered by a search for better ways to achieve established goals. The American healthcare industry is struggling with spiraling healthcare costs, poor standard of care, scarcity of resources, and low staff morale – all symptoms of deeper issues inherent in the system itself. Strategic leaders with business acumen realized the imperative of improving quality and eliminating waste as strategies for responding to the challenges faced currently by healthcare organizations. How well leaders run their organizations depend heavily on how well they create and respond to changes. First, organizations must be designed so that they can innovate. Second, leaders must realize that the bases of power in organizations are changing. Third, organizations must recognize that the global village is a reality. Lastly, organizations must find ways to allow individuals and teams to develop their inner potentials to create improvement. Bureaucratic leaders will not serve this purpose. The top-down approach type of organizations should stop keeping traditional leaders before retiring. It is not about how long one serves a company; instead, their contributions in building a long-lasting change and innovation are a productive approach in the fast-changing dynamics of healthcare.

The radical restructuring of the healthcare system required to reduce spiraling healthcare costs and make healthcare accessible to all citizens will necessitate ongoing changes in healthcare organizations. The challenge for all healthcare leaders is improving quality and service delivery through an ongoing process of innovation, restructuring of systems and processes, and implementing aligned behaviors to improve and enhance clinical outcomes. Unfortunately, leaders succumb to meeting targets, goals, and other metrics as it ties to performance. You need to ask yourself before venturing into this field: Am I ready to have this life? The balance of cost and effectiveness under stringent government regulation is a growing issue in health care. In addition, there are increasingly strict reimbursement policies and rising concerns over hospital organizations’ perceived loss of control over their economic environment, which adds pressure to leadership. The landmark law/regulation precipitates a daunting challenge that forces the entire value chain to innovate, restructure, and change to achieve a market-clearing reimbursement suitable to maintain economic stability and sustainability for most thriving hospital organizations. In this environment, we lose sight of the true value of choosing to be leaders. Numbers do not lie but remember there’s always a story behind those numbers. Do not deviate from the foundation of leadership, which is to serve with integrity, transparency, and value. Above all, we need a laser focus on the story- the quality of care we provide our patients. Continuously assess your staff’s skillsets, including the care providers, because their hands, heart, and mind will dictate your future.

A leader should have a yearning desire to improve and succeed. I can share that if it does not work, do not push it. If your sets of leaders do not get it, do not waste time as healthcare is moving exponentially. You have the apply the theory of CHANGE MANAGEMENT. But if you decide to do it- do it fast. The logic that flows from this premise leads to an important conclusion for leaders; if your team members are going to play a significant role in the improvement process, they need to assume responsibility for shaping and directing the forces driving the system. In other words, you need the right people at the table. It all starts from you as the leader setting the example and modeling the desired behavior. Then you need the right sets of leaders underneath you to move the dial. It all starts and ends with the leaders. They should own it and examine their engagement and commitment in this practice and, ultimately, their impact on the organization’s health and their people. The ability of leaders to have positive impact on outcomes is primarily determined by the capabilities of the individual leader and the level of contribution and competence of his subordinates. Leadership, as with all that is health care today, is also being shaped by the societal forces found in the marketplace and the public policy arena. If leadership is to be all that it claims-the firestarter and a profession with a commitment to achieving, protecting, and sustaining outcomes-it must strive to direct those forces that are shaping the system of healthcare delivery. In other words, the practice of leadership at all levels should include courage and skillsets to deliver the best outcome at the right moment and space.

Approach others and the tasks with enthusiasm, excitement, and energy. Today, we need vibrant, upbeat, and charismatic leaders. We need personality and spright. Zestful behavior to pursue organizational activities with energy and not halfhearted. The leader does not and should not be friends with other team members, but a concerned and friendly approach to interactions makes a difference in the general climate. Some leaders create an atmosphere of suspicion and fear through their criticism and unwillingness to tolerate less than perfection. Organizational climates are not static; they change. Although most changes in organizational climate occur gradually as the people in the organization change and each brings a different approach to the work environment, a leader can change an organizational environment through deliberate action. Remember, the structure of the working environment affects the way it functions. Based on the belief that the highest quality of leadership will be provided by the individuals who feel empowered, the leader develops a core set values that emphasize the importance of contributions of the individual, that support positive behaviors, and that expect and recognize excellence and expertise. Leaders that support empowerment must allow for risk taking and potential failure as team members attempt new ways of meeting the challenges facing them. As team members feel free to attempt, experiment, and to achieve they will be more involved and more committed to the leader/organization. Finally, you are the ship’s skipper. Your tone, attitude, and entity dictate your outcome. Toe the line of excellence, and others will follow.

To end my leadership journal, I wanted to highlight the top ten tidbits of knowledge I learned in my last 25 years in healthcare leadership. First, you can serve two masters at the same time. What I mean by this is never give your all to one organization-one day, when you wake up, their attention shifted to another person. Instead, enrich other interests such as publishing, consulting, teaching, mentoring, etc. You need a fallback if things don’t serve your way. In addition, you might not have the title. Still, if you excel or are professionally recognized by a well-renowned institution for your work, the feeling of satisfaction is far greater achieved. I have won 62 state, regional, national, and international awards in healthcare. I might not be the president of a healthcare system, yet my value preference was appreciated by healthcare in general. Second, a top-down, bureaucratic healthcare leader will only see your value when they need you. Reserve something for yourself and develop markets and avenues to excel outside your formal employment. Third, you can’t show people where they need to go if you don’t step out in front. Fourth, values form the bedrock of culture. Avoid leaders who possess obfuscated values and actions. Fifth, do not let your senior leaders use your talents for their benefit.

As a purposeful leader, you are not a product of circumstance, but you are a product of choice. We can’t just stay who we were rather keeping marching forward. Sixth, once you become a leader, you stop being the picture and start being the frame. The actions of your subordinates are the reflection of your quality as a leader. Leaders pass a very long shadow in organizational culture. Seventh, in leadership, as in art, the beautiful moves are in the curves. Value every experience. You may not get the ultimate reward you envisioned yet focus on other things you are passionate about. Eight, take up space in healthcare and cement yourself. Overlook what you are not superficially; instead, maximize the God-given talents bestowed upon His image of likeness. Ninth, leaders do not decide their future; they decide their attitudes and behaviors, and their attitudes and behaviors decide their futures. Tenth, put your patients and staff at the core of all you do- you will always find your value. It is easier how to be a leader when one sees someone you want to be but do not wait for the person; instead, be that person. Lastly, do not stay in an organization for the benefit of the money. You are worth more than what you think you are. Stand up for yourself. If your back is bent, only then will somebody climb it. Stand up straight, and nobody will ever attempt to climb it.

To lose a balance for exemplary leadership means living a balance of professionalism, accountability, compassion, and kindness There’s a certain simplicity to leading. How disciplined you are, how disciplined you are willing to become, and how hard you are willing to work is everything. I do not want to meet anyone with an excuse for anything. And people who drift and people who make excuses and are passive are the biggest turnoffs in healthcare leadership. I want to be in an organization with the kind of people who obsess over their passions in leading and want to be the best. And more to the point, they’re happy working to be better, because we can always be the best.

1. Evans, S., Shaw, N., Ward, C., & Hayley, A. (2016). “Refreshed…reinforced…reflective”: A qualitative exploration of interprofessional education facilitators’ own interprofessional learning and collaborative practice.Journal of Interprofessional Care, 30(6), 702-709. https://doi.org/10.1080/13561820.2016.1223025
2. Haverkamp, J., Chovan, J. D., Justice, S., Ball, K., Ballard, K. C., Batross, D., Zamaripa, C. (2020). Transforming nursing education through interprofessional collaborative innovation: A project story.Computers, Informatics, Nursing, 38(4), 176-182. https://doi.org/10.1097/CIN.0000000000000587
3. Lutfiyya, M. N., Brandt, B. F., & Cerra, F. (2016). Reflections from the intersection of health professions education and clinical practice: The state of the science of interprofessional education and collaborative practice.Academic Medicine, 91(6), 766-771. https://doi.org/10.1097/ACM.0000000000001139
4. Roberts, S. D., Lindsey, P., & Limon, J. (2019). Assessing students’ and health professionals’ competency learning from interprofessional education collaborative workshops.Journal of Interprofessional Care, 33(1), 38-46. https://doi.org/10.1080/13561820.2018.1513915
5. Sikka, R., Morath, J. M., & Leape, L. (2015). The quadruple aim: Care, health, cost and meaning in work.British Medical Journal Quality & Safety, 24(10), 608-610. https://doi.org/10.1136/bmjqs-2015-004160
6. Sklar, D. P. (2016). Interprofessional education and collaborative Practice—If not now, when?Academic Medicine, 91(6), 747-749. https://doi.org/10.1097/ACM.0000000000001179
7. Townsend-Gervis, M., Cornell, P., & Vardaman, J. M. (2014). Interdisciplinary rounds and structured communication reduce re-admissions and improve some patient outcomes. Western Journal of Nursing Research,36(7), 917-928. https://doi.org/10.1177/0193945914527521