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Creating Leaders Around You

Creating Leaders Around You. International Collaboration for Excellence in Critical Care Medicine. “ The acute care hospital is the most complex organization to lead and manage.”

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Creating Leaders Around You

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  1. Creating Leaders Around You International Collaboration for Excellence in Critical Care Medicine

  2. “ The acute care hospital is the most complex organization to lead and manage.” “This complexity is compounded by academic missions and by an increasingly broad range of single and multi-site organizations, public/private mix of providers and a highly professional and autonomous cadre of knowledge workers.” Peter Drucker

  3. Objectives • What is leadership? • Why is leadership [v. management] needed in critical care? • What are key attributes of a leader?

  4. Integrating Definition Leadership involves a social influence process whereby intentional influence is exerted by one person over other people to structure the activities and relationships in the group organization.

  5. Managers: • Are oriented toward stability • Get people to do things more efficiently • Leaders: • Are oriented toward innovation • Get people to agree about what things should be done

  6. Can You Think of Some Leadership Examples? Patton and Caesar.

  7. Can You Think of Some Leadership Examples? Lincoln and Socrates

  8. Can You Think of Some Leadership Examples in Healthcare? Albert Schweitzer James Burke?

  9. Case Study • Mr. B, was a 75 year-old male referred for pre-op assessment before surgery for liver resection: • He WAS “high-risk” for peri-operative cardiovascular events  prescribed a beta-blocker. • He WAS badly nourished.

  10. Case Study • Mr. B did not fill his prescription. • Neither family doctor or surgeon received pre-op consultation note until after surgery. • CCAC not aware so nutritional supplementation at home not begun. • Long case – surgical team “forget” to put in a feeding tube.

  11. Case Study • ICU not aware bed required; unable to accommodate  agency nurse contracted to monitor Mr. B overnight in PARU • Admitted to ICU 24 h later, hypotensive. • No DVT prophylaxis for 34 h. • ICU course complicated by MI & prolonged weaning.

  12. What “Evidence” Says…Should Happen • -blockers before high risk surgery • DVT prophylaxis • Feeding (enteral; parenteral), • Skin management, • Antibiotic impregnated CV catheters, • Consent and procedures      

  13. An Issue of SAFETY:What Should The Critical Care Leader Do?

  14. Congress grills Ford, Firestone, NHTSA Execs say they acted quickly on tire failures By Thomas A. Fogarty, USA TODAY Safety in the Auto Industry

  15. Design Delivery Assembly Sales Supplier Managing Cars

  16. Safety in the Auto Industry GM Announces Safer Airbags Execs say they acted quickly to install on new cars By Thomas A. Fogarty, USA TODAY

  17. “Good To Great” Level 5 leadership: self-effacing, quiet, reserved, even shy - a paradoxical blend of personal humility and professional will. First who... then what: People are not your most important aspect - the right people are. Confront the brutal facts – maintain faith that you can and will prevail in the end, regardless of difficulties AND at the same time have the discipline to confront the most brutal facts of your current reality.

  18. What You Can Be Deeply passionate About What Drives Your Economic Engine What Can You Be The Best In the World At? The Hedgehog Concept

  19. Good To Great A culture of discipline: When you combine a culture of discipline with an ethic of entrepreneurship, you get the magical alchemy of great performance Technology accelerators: never used technology as the primary means of igniting a transformation. The flywheel and the doom loop: transformations never happen in one fell swoop…build momentum until a point of breakthrough, and beyond

  20. Another Problem • You are the ICU Director. You are approached by the CEO who asks that the CC Service develop an “outreach” program • He just returned from an international meeting on “redesigning” health care and he heard an Australian speaker talk about this.

  21. Good things to be doing

  22. Does Your Unit Have a Vision? • Leaders provide a clear vision & direction. • Achieving a vision implies change. Leaders must understand the nuances and best practices of the change process. They must know how to build consensus.

  23. Pointing the Direction • If we understand our reality, we can see where we need to go. • Confidence and authenticity come from demonstrated knowledge.

  24. Have You Set “Stretch” Goals? • Leaders set and celebrate goals • Goals should make people stretch, but they must also be achievable. …when the goal is reached, celebrate!

  25. Do You Identify problems? • Leaders openly identify problems. • Anticipate and acknowledge issues … and then effectively deal with needed change. • They build trust by openly admitting mistakes rather than assigning blame. • “Developing an ability to predict, embrace and better manage change are absolutely imperative.” — Web source.

  26. Do You Help Others as Leaders? • Leaders cultivate leadership by empowering others. • Your job is to set clear goals, • If you pick the right team, you don’t need to tell them what to do. Build self-directed teams of responsive and thoughtful colleagues.

  27. Leaders Communicate • They increase communication and encourage others to do likewise, all day, every day. • People hardly ever complain of “over-communication.” • See things from others` points of view and say so. • Speak to be understood, and not misunderstood. Listen. Wait. Listen. Question for clarity and understanding.

  28. Leadership and learning are indispensable to each other. John F. Kennedy(1917 - 1963), speech prepared for delivery in Dallas the day of his assassination, November 22, 1963 Leaders Learn

  29. Why Do We Resist Change?Why Do We Resist Showing Leadership?

  30. Healthcare CEOs Admit They Miss/Ignore Opportunities to Mentor Effectively • CEOs miss mentoring opportunities, create short-term leadership roles and fail to evaluate future leaders. • HCOs have financial constraints and short-term focus – and they lack leadership commitment and identification/development of future leaders. Witt/Kieffer Survey

  31. More Work Needed to Improve Overall Future Leader Development in Health Care • Healthcare CEOs believe graduate education plays the most effective mentoring role. • Purposeful one-on-one mentoring and assuming personal responsibilities for mentoring can help future executives – including women and minority leaders - grow. Witt/Kieffer Survey

  32. What Would They have Done? • Albert Schweitzer • James Burke

  33. INPUT #2 Conversion OUTPUT #2 Processes OUTPUT #1 INPUT #1 The ICU “Business” Care Integration???

  34. Management is doing things right; leadership is doing the right things. Peter Drucker

  35. Start with the premise that the function of leadership is to produce more leaders, not more followers. Ralph Nader

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