Principles of Health Management & Midwifery Leadership PDF

Principles of Health Management & Midwifery Leadership Dr. Gina Afoakwah Welcome to Health Management and leadership Class: Before we begin, you need to understand that nurses and midwives regardless of your position, must develop leadership skills. This is because nurs...

Principles of Health Management & Midwifery Leadership Dr. Gina Afoakwah Welcome to Health Management and leadership Class: Before we begin, you need to understand that nurses and midwives regardless of your position, must develop leadership skills. This is because nurses and midwives embody leadership qualities through their advocacy, expertise, communication, collaboration, critical thinking, patient education, resource management, role modeling, adaptability, and contributions to the advancement of healthcare professions. These multifaceted roles make a nurse or a midwife essential leader in the healthcare ecosystem.  Every NURSE/MIDWIFE a leader It is important therefore to develop essential skills such as effective decision making, initiating and maintaining effective working relationships, using respectful communication, collaborating with interprofessional and intraprofessional teams, coordinating care effectively, and developing delegation skills and conflict resolution strategies Every nurse or midwife is in a position to perform some leadership roles whether formal or informal. This is due to several reasons: 1. Patient Advocacy: Nurses and midwives often serve as advocates for their patients, ensuring that they receive the best possible care. Advocacy requires leadership skills to effectively communicate and negotiate on behalf of patients. 2. Clinical Expertise: Nurses and midwives possess specialized knowledge and skills in healthcare. Their expertise allows them to lead in clinical settings, making decisions, and guiding other healthcare professionals in delivering patient care. 3. Communication Skills: Effective communication is a key leadership skill. Nurses and midwives regularly communicate with patients, families, and other healthcare team members, demonstrating leadership through clear and empathetic communication. 4. Collaboration: In healthcare settings, collaboration is crucial. Nurses and midwives work closely with diverse teams, including physicians, therapists, and administrative staff. Leadership is required to facilitate effective teamwork and coordination. 5. Critical Thinking: Nurses and midwives are often faced with complex and dynamic situations. Their ability to think critically and make informed decisions contributes to their role as leaders in ensuring patient safety and well-being. 6. Patient Education: Educating patients about their health conditions and treatment plans is a leadership role. Nurses and midwives empower patients by providing information and guidance, fostering a sense of responsibility and self- care. 7. Resource Management: Nurses and midwives are responsible for managing resources efficiently, including time, medications, and medical equipment. Leadership in resource management is essential for providing quality care within the constraints of the healthcare environment. 8. R ole M odeling: Nurses and midwives serve as role models for other healthcare professionals. Their behavior, work ethic, and commitment to patient-centered care set the standard for others to follow, demonstrating leadership through example. 9. Adaptability: Healthcare is ever-evolving, and nurses and midwives must adapt to new technologies, treatments, and protocols. Leadership is demonstrated through the ability to embrace change, innovate, and guide others through transitions. 10. A dvancing the P r ofession: Nurses and midwives contribute to the advancement of their professions by participating in research, continuing education, and professional development. Leadership is evident in their commitment to enhancing the quality of care and promoting best practices.  QUESTION OF THE DAY Your ward in-charge has been called to attend a one month workshop and the Director of Nursing Service has appointed you to act as a ward manager, to be a ward leader and manage the maternity ward affairs until when your ward In- charge returns back. a) Define the following terms i. Leadership ii. Management b) Outline three ways through which people become leaders a) Discuss any four (4) leadership styles you are going to use b) Describe any five (5) functions of management that you are going to perform as a ward manager c) Outline five (5) principles of management according to Henry Fayol  UNIT I: Introduction to Management and Leadership in Nursing Learning Objectives After studying this session, you should be able to: 1.Define the following terms: 5. Explain why it is important to Management, study Management and Leadership Leadership, as midwives Administration, Nursing Management, 6. Understand theories of Subordinate, management and their application Follower, Health System Governance, in nursing practice Health system management. 7. Discuss the functions and Styles 2. Differentiate between leadership and of Leadership management 8. Discuss the functions/principles 3. Explain why organizations need manager’s of mananagement - Outline Factors that affect a manager’s 4. List the attributes/qualities of a manager /leader  Historical Perspective of leadership in Nursing Management and leadership theories were first established in fields such as business, psychology, sociology, and anthropology Nursing and Midwifery has traditionally borrowed various theoretical ideas from these fields, where management and leadership theories were first developed from their various contributions. These theories were developed as a means to enhance productivity in business Similarly in the healthcare profession such as nursing and midwifery effective leadership and management are critical in providing patients with safe, effective and quality care E.g.,modern theories of leadership incorporate some of the ideas that were first introduced almost a century ago…E.g., Trait and Great Man Theories  DEFINITIONS: The term management comes from the Italian word maneggiare which means to (handle, especially tools) which in turn was derived from a Latin word “Manus” meaning “hand”. The concept of management is very difficult to define as it does not lend itself to a simple/single definition. So we start by defining management as: Management is the systematic coordination and control of tasks within an organization or sector Management is the process of leading and directing all or part of an organization through deployment and manipulation of resources. Management involves handling the day-to-day operations of a work group to achieve a desired outcome. Management also refers to the activities involved in coordinating people, time, and supplies to achieve desired outcomes. This involves problem-solving and decision- making processes. The essence of management is getting work done through others.  Defn. of Management Cont’d Overall, the classic definition of management by Henri Fayol’s 1916, he listed managerial tasks to include: planning, organizing, commanding, coordinating, and controlling the work of a group of employees. However, Mintzberg (1989) argued that managers really do whatever is needed to make sure that employees do their work and do it well. Also, Lombardi (2001) points out that two-thirds of a manager’s time is spent on people’s problems. The rest is taken up by budget work, going to meetings, preparing reports, and other administrative tasks The term management is simply ‘ MANAGE MEN ’ (men here refers to the people in the organisation …i.e., getting things done through them ), including the material and financial resources. Management is what a manager does (action or activities). Example: A head nurse/midwife organizing and delegating tasks for a busy weekend shift to ensure efficient patient care.  other definitions of management According to Mary Parker Follet () - “it is the art of getting things done through people” “The art of management has been defined, ’as knowing exactly what you want men to do, and then seeing that they do it in the best and cheapest way.’” (Taylor, 1911, p. 7) “Management is working with and through other people to accomplish the objectives of both the organization and its members.” (Montana & Charnov 2008, p. 2) “Management, then, is the planning, organising, leading, and controlling of human and other resources to achieve organisational goals efficiently and effectively.” (Jones & George 2018, p. 5) “[...] management is defined as (1) the pursuit of organisational goals efficiently and effectively by (2) integrating the work of people through (3) planning, organising, leading, and controlling the organisation’s resources.” (Kinicki & Williams 2018, p. 5) Peter Drucker stated that the job of Managers is to give direction to their resources to achieve or accomplish goals. THE NATURE OF MANAGMENT We must understand that management combines features of both science as well as art. a) a science because it has an organised body of knowledge which contains certain universal truth. b)It is called an art because managing requires certain skills which are personal possessions of managers.  DEFINITION OF LEADERSHIP Leadership is the ability to influence a group towards the achievement of goals Leadership can also be defined as the process by which an individual (the leader) influences others in a group to accomplish key goals, while directing that group in ways that make it function more cohesively. In management terms, it is the use of authority which is inherent in the designated formal rank to obtain complaince from organisational members. The nature of leadership, lies in one’s ability to motivate, direct, and otherwise influence people to work hard to achieve the organisational goals It is a relationship of influence that is practiced by both leaders and followers A leader is a person who demonstrates and exercises influence over others to guide direction over a decision or within an organization (Nagelkerk, 2006)  Leadership role maybe formal or informal: Formal: Appointed to a position and given a leadership role in their JOB POSITION Informal: Based on PERSONAL CHARACTERISTICS (experience, knowledge, etc.); i.e. maybe someone who steps up in a situation, someone who helps less experienced nurses, someone who mentors others, someone who specialises in an area to help a certain population of characteristics, people who form a committee to make changes on a unit Defn. of terms cont’d C. NURSING MANAGEMENT: Nursing management is the process of working through staff members to be able to provide comprehensive care to the patient. D. SUBORDINATE: A subordinate is someone who works for someone else. As a verb, to subordinate means to place or rank one thing below another. A subordinate role in a workplace means that the person reports to someone else. E. FOLLOWER: A follower is someone who accepts guidance, command or leadership to assist in achieving goals and accomplishing tasks. Followership is a reciprocal process of leadership that refers to the willingness to follow within a team or organization. F. HEALTH SYSTEM GOVERNANCE: Health system governance refers to the rules and norms that shape roles and responsibilities, incentives and interactions in the health sector. It is concerned with structure and processes for decision making, accountability, control and behaviour Who is a manager A manager is an individual within an organization who is in charge of coordinating the efforts of individuals or the allocation of resources. As such, a manager is one who undertakes management activities. A nurse or midwife managers embody nurse and executive roles Typically report to a superior in nursing: director, chief nursing officer, or vice president of nursing The manager’s job is to accomplish the work of the organization, to this end managers perform roles and functions that vary with the type of organization and the level of management. Who is a leader A leader is the one who inspires others to dream more, to learn more, to do more, for changing the world around. a leader is a person who influences a group of people towards the achievement of a goal Similarities and Differences between Management and Leadership in Nursing Similarities between Management and Leadership in Nursing In terms of similarities, they play Complementary Roles: 1. Both management and leadership are essential for a well-functioning healthcare system. 2. Effective nurse leaders often exhibit strong management skills and vice versa. The table below will explain on the similarities and differences between a leader and a manager to give a clear picture: Differences between Leadership and Management Leadership is a substantially different role from management. From the ancient Greek: Leadership meaning pathmaker Management meaning pathfollower The implication of the pathmaker/pathfollower distinction is that - managers have to be concerned with organising stable systems, ensuring quality, and identifying and implementing best practice. - whereas leaders need to be concerned about creativity and innovation, making positive changes and seeking to challenge and push bound identify the differences that exist between Management and leadership  Management vs Leadership Roles 1. Management: - Goal Achievement: Managers are responsible for setting goals, creating action plans, and coordinating resources to achieve organizational objectives. They ensure that tasks are assigned, deadlines are met, and progress is monitored. - Efficiency and Effectiveness: Managers focus on optimizing processes, streamlining operations, and maximizing resource utilization. They ensure that tasks are performed efficiently to minimize waste and achieve desired outcomes effectively. - Decision Making: Managers make informed decisions based on data, analysis, and their expertise. They assess risks, evaluate alternatives, and choose the best course of action to address challenges and seize opportunities. - Organizational Stability: Managers establish structures, policies, and systems to maintain stability and order within the organization. They provide guidelines, enforce rules, and ensure compliance with regulations. - Resource Allocation: Managers allocate resources, including finances, personnel, and materials, to different projects and departments. They balance competing needs and make decisions that optimize resource utilization.  - Operational Oversight: Managers oversee day-to-day operations, coordinate activities, and resolve issues that arise. They monitor performance, provide feedback, and take corrective measures when necessary. 2. Leadership: - Vision and Direction: Leaders provide a compelling vision and set a clear direction for the organization. They communicate goals, values, and the desired future state, inspiring others to align their efforts towards a common purpose. - Inspiration and Motivation: Leaders inspire and motivate individuals and teams to achieve their full potential. They foster a positive work environment, encourage innovation, recognize achievements, and provide support and guidance. - Relationship Building: Leaders build strong relationships with employees, fostering trust, open communication, and collaboration. They create a sense of belonging, encourage teamwork, and promote a positive organizational culture.  - Change Management: Leaders navigate and facilitate change within the organization. They anticipate and adapt to changing market conditions, technological advancements, and societal trends. They guide employees through transitions and help them embrace new ways of working. - Talent Development: Leaders identify and develop talent within the organization. They mentor and coach individuals, provide growth opportunities, and support professional development. They create a talent pipeline for future leadership roles. - External Representation: Leaders represent the organization to external stakeholders such as clients, partners, and the community. They build relationships, negotiate partnerships, and promote the organization's values and reputation. Integration in Nursing Practice: it is important to note that both roles are necessary in nursing practice for delivering high-quality patient care and fostering a positive work environment. 1. Balancing the operational aspects (management) with the visionary aspects (leadership) is crucial. 2. Successful nursing leaders adapt their approach based on the situation and organizational needs. TYPES/CLASSIFICATION OF MANAGERS Managers can be classified in two ways: 1) By their level in the organization (management levels) 2) By the scope of activities they manage (so-called Functional and General Manager) functions of middle level managers 1. Interpret & explain the policies framed by top management 2. Compile & issue detailed instructions regarding operations. 3. Maintain close contacts with operating results so as to evaluate performance. 5. Cooperate among themselves so as to integrate or coordinate various parts of a division or a department HOW TO BE AN EFFECTIVE MANAGER  Management/Managerial Skills Management skills are the abillities that a Manager or Leader should have Management skills can be defined as certain attributes or abilities that a manager should possess in order to fulfill specific tasks in an organization. They include the capacity to perform executive duties in an organization while avoiding crisis situations and promptly solving problems when they occur. Managerial skills are very important in order to be an effective manager.  Note that one can develop management skills through: 1. working experience as a manager, and/or by 2. learning 1. Developing managerial skills help the nurse manager to relate with his/her fellow co- workers and know how to deal well with subordinates, which allows for the easy flow of activities in the organisation  Managerial Skills by Robert L. Katz According to Robert L. Katz, “if managers have the necessary management skills then they will probably perform well and be relatively successful. On the other hand, if managers do not have the necessary management skills, they will probably perform poorly and be relatively unsuccessful in their careers. There are three types of primary skills that are important for successful management performance. a) Conceptual Skills b) Human Relations Skills c) Technical Skills Level of Management vs Skills  Conceptual Skills The ability to coordinate and integrate ideas, concepts, and practices conceptual skills are manager’s ability to work with ideas and concepts. These skills enable executives to understand and better decide the actions that have to be taken in a particular field of work or the organization as a whole. For example, managers use conceptual skills to take decisions and formulate strategies. most important for top-level managers, e.g., nurse executives Human Relations Skills (also known as interpersonal skills) it is the ability to work with poeple it helps the manager to understand, communicate and work with others. it also helps the manager to lead, motivate and develop team spirit it is required or important by all managers at all levels of management, especially the middle-level managers/middle nurse managers Technical Skills The skills of working with the resources and having knowledge in a specific area. ability to use principles, tools, techniques, procedures his/her specialised area most important to first-level managers (nurse managers, nurse supervisors) top managers require least technical skills other skills required by nurses Leadership skills Teamwork skills Problem solving skills Decision making skills Emotional intelligence  The top-level managers should know how to make plans and policies. Administrative Skills They should also know how to get the work done. They should be able to co-ordinate different activities of the organisation. They should also be able to control the full organisation The manager must be able to convey ideas and Leadership Skills information to motivate the workers. These skills help the manager to get the work done through the workers  ROLES AND RESPONSIBILITIES OF A NURSE MANAGER Nurse managers maintain two roles within the unit: They deliver clinical care and serve as administrative leaders on their unit. THE TRADITIONAL ROLES OF THE NURSE MANAGER Obtaining the resource necessary to do the work Assigning the work to individuals Telling the workers how it is to be done Supervising the actual process of work Evaluating the outcome Rewarding or punishing the workers Management Roles by Henry Mintzberg Regarding the roles of managers stated above, Mintzberg classified manager’s role in three major categories with specific sub-roles and tasks linked to them. Interpersonal: Roles that involve coordination and interaction with employees Informational: Roles that involve handling, sharing, and analyzing information Decisional: Roles that require decision-making 1. Interpersonal Roles These roles revolve around a manager’s interactions and relationships, both within and beyond the organization. Within this category, managers undertake three primary roles: Figurehead: Managers serve as symbolic leaders, representing their organization through ceremonial duties and the embodiment of its values. Leader: Managers assume the vital responsibility of guiding and motivating their teams, making pivotal decisions, and providing support to their staff. Liaison: Managers establish and nurture networks and relationships, fostering connections within and outside their organization to gather crucial information and access valuable resources.  2. Informational Roles Within this sphere, managers act as conduits of information, adept at collecting, processing, and disseminating vital data that facilitates informed decision-making. This category encompasses three primary informational roles: Monitor: Managers diligently observe their environment, staying attuned to internal and external developments that may impact their organization. Disseminator: Managers share pertinent information with their teams and other stakeholders, ensuring that everyone possesses the essential knowledge required for their roles. Spokesperson: Managers represent their organization by communicating its goals, policies, and actions to external parties, such as the media, government entities, and the public. 3. Decisional Roles In this domain, managers engage in the critical process of making choices and resolving issues within the organization. Four primary decisional roles encompass this dimension: Entrepreneur: Managers identify opportunities and champion innovative projects or improvements within their organization. Disturbance Handler: When conflicts or crises emerge, managers skillfully address them to maintain organizational stability and harmony. Resource Allocator: Managers allocate resources, including budgets, time, and personnel, strategically to various projects and initiatives, aligning them with organizational objectives. Negotiator: Managers skillfully navigate negotiations, whether internally, with employees or departments, or externally, with other organizations or stakeholders, to secure agreements and resolve conflicts. Management Theories and Application