HCA 301 Leadership and Management in Healthcare Setting PDF

HCA 301 Leadership and management in healthcare setting CHAPTER 4 UNDERSTANDING POWER AND POLICY Resource: Sullivan, E.J. & Garland, G. (2013), 2nd Edition. Practical Leadership & Management in Healthcare for Nurses and Allied Health Professionals. UK: Pearson HCA 301, CHSS, AHD, SEMESTER II-2023- 2...

HCA 301 Leadership and management in healthcare setting CHAPTER 4 UNDERSTANDING POWER AND POLICY Resource: Sullivan, E.J. & Garland, G. (2013), 2nd Edition. Practical Leadership & Management in Healthcare for Nurses and Allied Health Professionals. UK: Pearson HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 1 Learning Outcomes 1. Differentiate between power and leadership. 2. Describe how to use power appropriately. 3. Explore the relationships among power, politics and policy. 4. Summarize ways healthcare professionals can influence healthcare future. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 2 Introduction Power is a force for good in many cases. Patients have gained power through access to information formerly available only to health professionals. Information power allows patients to be more involved in their treatment and to make informed choices Understanding and use of power are essential skills for effective leadership HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 3 Introduction Power is the potential ability to influence others Symmetrical power ◦ Two parties have equal and reciprocal power. Asymmetrical power ◦ One person or group has more control than another. Power can be exclusive to one party or may be shared among many people or groups. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 4 Introduction Policy is a statement of decisions taken by those with authority. Some people see policy as a restriction of professional autonomy, whereas others see that policies guide actions and help people to make decisions. Organizations also have many policies on practically every aspect of our work. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 5 Power and Leadership Real power — principle-centred power — is based on honour, respect, loyalty and commitment. Principle-centred power is not forced; it is invited (Covey, 1990). ▪It is defined by the capacity to act and to make choices and decisions. ▪Leadership power then becomes the capacity to create order from conflict, contradictions and chaos. ▪ Leadership power comes from the ability to influence because followers trust and respect the leader to do the right thing for the right reason. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 6 Power and Leadership Healthcare professionals must understand and select behaviors that activate principle-centered leadership ◦ ◦ ◦ ◦ ◦ ◦ Get to know people. Be open. Know your values and visions. Sharpen your interpersonal competence. Use your power to enable others. Enlarge your sphere of influence and connectedness. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 7 Power and Leadership Power: How Managers and Leaders Get Things Done ◦ Leader’s use of power alters attitudes and behavior by addressing individual needs and motivations. ◦ Seven generally accepted types of interpersonal power used in organizations to influence others: 1. Reward ◦ Based on the inducements the manager can offer in exchange for cooperation and contributions 2. Coercive (punishment) ◦ Based on the penalties a manager might impose on an individual or a group ◦ Punishments are often subtle. For example, a manager/leader might give a disruptive staff member an undesirable job assignment or deny requests for leave or educational opportunities. ◦ Coercion is a bit different. Coercive power entails the ability to compel someone to do things they don't want to do by use of implied threats or manipulation. This type of behaviour is often called bullying. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 8 Power and Leadership Power: How Managers and Leaders Get Things Done 3. Legitimate ◦ Stems from manager’s right to make a request because of authority associated with job and rank 4. Expert ◦ Based on possession of unique skills, knowledge, and competence ◦ Senior staff members, by virtue of experience and advanced education, are often the best qualified to determine what to do in a given situation. Others follow their advice because they respect the colleague's expertise. Expert power relates to the development of personal abilities through education and experience. 5. Referent ◦ Based on admiration and respect ◦ For example, a staff member may want to be on a project group to develop care pathways because the project leader is a nationally respected expert on pathway development HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 9 Power and Leadership Power: How Managers and Leaders Get Things Done 6. Information ◦ Based on access to valued data ◦ depends on a person's position, connections and communication skills 7. Connection ◦ Based on an individual’s formal and informal links to influential or prestigious persons inside and outside an area or organization HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 10 Power and Leadership Position power determined by: ◦ ◦ ◦ ◦ ◦ ◦ ◦ Job description Assigned responsibilities Recognition Advancement Authority Ability to withhold money Decision making ◦ Legitimate, coercive, and reward power are positional. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 11 Power and Leadership Personal Power Refers to: ◦ Credibility ◦ Reputation ◦ Expertise ◦ Experience ◦ Control of resources or information ◦ Ability to build trust ◦ Expert, referent, information, and connection power are based, for the most part, on personal traits. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 12 Using Power HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 13 Using Power Some healthcare professionals still consider power unattractive. Negative association of power with aggression and coercion remains strong ◦ Power grabbing ◦ Traditionally accepted means of relating to power for one’s own self-interests and use Healthcare professionals tend to be more comfortable with power sharing and empowerment. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 14 Using Power Image as Power Comes from portraying themselves as confident and competent ◦ A powerful image enhances the ability to achieve goals. ◦ Images emerge from interactions and communications with others. ◦ Positive interactions create a strong, favorable image for the individual and the profession. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 15 Using Power Image as Power ◦ Individual healthcare professionals can promote an image of power by a variety of means. 1. Introduce yourself by saying your name, using eye contact, and shaking hands. (establish you as a powerful person). 2. Dress appropriately. Attire can symbolize power and success. (Although many health professionals may believe that they are limited by the need to wear a particular uniform, it is the presentation of the uniform that can hold the key to power) 3. Convey a positive and energetic attitude. (Chronic complaining conveys a powerlessness, whereas solving problems and being optimistic promotes a 'can do' attitude that suggests power and instils confidence in others) 4. Pay attention to how you speak and how you act when you speak. (Nonverbal signs and signals say more about you than words Stand erect and move energetically. Use only body movements and gestures necessary to make your point) HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 16 Using Power Image as Power 5. Use facts and figures when you need to demonstrate your point. ◦ Patient acuity, daily census, length of stay, and overtime budgets ◦ Data that reflect nursing's overall contribution 6. Become visible, be available, and offer assistance. ('If I don't see you, I can't ask you for needed information, analysis, and alternative recommendations.’) ◦ Knowing when to be at the right place at the right time is crucial for gaining access to key personnel in the organization. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 17 Using Power Image as Power 7. When dealing with people outside your profession, it is important to develop powerful partnerships. (Learn how to share both credit and blame, When working on collaborative projects, be clear about what is needed) 8. Make it a point to get to know the people who matter in your sphere of influence. (Any strategy will involve a good deal of energy and effort. Direct influence and efforts towards issues of highest priority) 9. Powerful people have a keen sense of timing. (Be sure to position yourself to be at the right place at the right time) 10. Use power appropriately to promote consensus in organizational goals. (By capitalizing on the special relationship that nurses have with patients, they can enhance their position and image as professional caregivers) HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 18 Using Power Using Power Appropriately ◦ The way power is used has a lasting effect on relationships. ◦ Best to use least amount of power necessary. ◦ Use power appropriate to the situation. ◦ Improper use of power can destroy a manager's effectiveness. ◦ Power can be overused or underused. ◦ Overusing power occurs when you use excessive power relative to the situation; if you fail to use power when it is needed, you are underusing your power. In addition to the immediate loss of influence, you may lose credibility for the future. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 19 Using Power Using Power Appropriately ◦ Power plays ◦ Attempts to diminish or demolish one’s opponents. Healthcare professionals must perceive power for what it really is. ◦ The ability to mobilize and focus energy and resources Power is the means, not the end, to seek new ways of doing things in this uncertain and unsettling time in healthcare. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 20 Using Power Rules for Using Power 1. 2. 3. 4. 5. 6. 7. 8. Use the least amount of power you can to be effective in your interactions with others. Use power appropriate to the situation. Learn when not to use power. Focus on the problem, not the person. Make polite requests, never arrogant demands. Use coercion only when other methods do not work. Keep informed to retain your credibility when using your expert power. Understand you may owe a return favor when you use your connection power. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 21 Policy and Politics Policy ▪can be defined as the decisions that govern action. ▪determine an organization's relationships, activities and goals, and result from political action on either a national or a local level. ▪set by the government include those that determine how the MOH will operate: for example, how the service is structured, the lines of responsibility and accountability within and across organizations, and how funding is allocated and accounted for. Also a number of policies that affect how the organization functions as a workplace. Relate to human resource matters, health and safety, and employment regulation. The ban on smoking in enclosed public spaces is one example of a workplace policy in that the primary reason for implementing the ban was for the protection of workers. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 22 Policy and Politics Politics ▪Is the art of influencing the allocation of scarce resources, which includes money, time, personnel and materials (Mason, Leavitt and Chaffee, 2002). ▪Is a means for influencing events and the decisions of others. ▪Important to develop relationships with people close to the patient interface because these people are the ones who can bring the knowledge of practical solutions. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 23 Policy and Politics Politics ▪Is an interpersonal endeavour. Uses the skills of communication and persuasion to create meaningful connections with people ▪It is a collective activity. requires the support and action of many people to bring effective politics to bear on a situation or issue The politically astute health professional develops and carefully uses a support base that crosses the boundaries created by differences in discipline, position, role and organisation. In the workplace, this means developing connections to other healthcare professionals, support staff such as housekeepers, cleaners and porters, and other related disciplines such as social services. Effectiveness in politics arises from a careful and insightful political analysis of the situation, issue or problem. A political analysis includes assessing the structure and functioning of the area in which you are operating HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 24 Policy and Politics Politics ▪It requires analysis and planning. Effective political action involves planning. A group trying to influence an issue or situation would brainstorm about alternative solutions and evaluate their risks and benefits. ▪It involves image and perception Do people think you can make the change? Do people think the change will be harmful to them? Do people trust you? HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 25 How You Can Influence the Future Convert policy ideas into political realities using the following power points: ◦ Use persuasion over coercion. ◦ Persuasion is the ability to share reasons and rationale when making a strong case for your position while maintaining a genuine respect for another’s perspective. ◦ Use patience over impatience. ◦ Impatience in the nursing community can be detrimental. ◦ Be open-minded rather than closed-minded. ◦ Use compassion over confrontation. ◦ It takes genuine care and concern to change course and make corrections. ◦ Use integrity over dishonesty. ◦ Control, manipulation, and malice must be pushed aside for change to occur. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 26 Ponder points ◦ Power enables individuals and organisations to accomplish their goals. ◦ Exercise of power is an essential aspect of leadership. Power is positional or personal and is based on several different sources, including control over rewards, punishment, information, institutional authority, expertise, personal likeability and connections. ◦ Healthcare professionals must perceive power for what it really is — the ability to mobilise and focus energy and resources. ◦ Effective use of power is using it appropriately. ◦ Image is a source of power. ◦ Politics is the ability to influence the allocation of scarce resources and events in our everyday world. ◦ Health professionals can use political action to influence policies in a variety of areas HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 27 Useful links French and Raven's Bases of Power https://www.youtube.com/watch?v=S4V2FlNR_h4 HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 28