Leadership, Teamwork, and Engagement

1. Leadership, Teamwork, and Engagement Michael A. Rosen, PhD Armstrong Institute for Patient Safety and Quality Johns Hopkins University School of Medicine

2. Agenda • Why talk about leadership, teamwork, and engagement? • What do effective leaders do? • Use power wisely. • Lead with vision and values. • Build trust. Armstrong Institute for Patient Safety and Quality

3. Why talk about leadership, teamwork, and engagement? • It matters for managing patient care. • It matters for safety and quality improvement teams. • It matters at the organizational level. Armstrong Institute for Patient Safety and Quality

4. Trust in Leadership and Patient Safety Vogus, T.J., & Sutcliffe, K.M. Medical Care, Vol. 45, No. 10 (Oct., 2007), pp. 997-1002 Armstrong Institute for Patient Safety and Quality

5. Perceptions of leadership and mortality Huang et al., 2010 Armstrong Institute for Patient Safety and Quality

6. Leadership matters at the organizational level • Hospital scores on the PSOA Leadership Domain are meaningfully related to Core Measure Performance Weaver, Rosen, Goeschel, et al., in progress

7. What is leadership? • “…the only thing of real importance that leaders do is to create and manage culture… the unique talent of leaders is their ability to understand and work with culture… it is an ultimate act of leadership to destroy culture when it is viewed as dysfunctional.” • Schein, E. H. (2006, p. 11).Organizational culture and leadership. Jossey-bass.

8. Five conditions leaders can put in place to facilitate teamwork • Ensure the team is a ‘real’ team • Compelling direction • Enabling structure • Supportive organizational context • Expert coaching Hackman, 2002

9. What do effective leaders do? • Use power wisely. • Lead with vision and values. • Build trust. Armstrong Institute for Patient Safety and Quality

10. 1. Effective leaders use power wisely. • What is power? • How do leaders exercise power? • Which strategies are effective under what conditions? Armstrong Institute for Patient Safety and Quality

11. We talk about empowerment, but what is power? Armstrong Institute for Patient Safety and Quality

12. How do leaders exercise power? • Rational persuasion • Apprising • Inspirational appeals • Consultation • Exchange tactics • Collaboration • Personal appeals • Ingratiation tactics • Legitimating tactics • Pressure tactics • Coalition tactics Armstrong Institute for Patient Safety and Quality

13. What strategies work best? Yukl, 2009 Armstrong Institute for Patient Safety and Quality

14. 2. Lead with vision and values • Vision is a leader’s statement of a desired, long-term future state. • The quality of a vision statement has been shown to impact individual, group / team, and organizational outcomes (e.g., performance, attitudes, capacity to manage change). Armstrong Institute for Patient Safety and Quality

15. What does an effective vision statement look like? Kirkpatrick, 2009 Armstrong Institute for Patient Safety and Quality

16. Leading with vision and values • State the desired values. • Model the desired values. • Integrate the values into the organizational systems. Armstrong Institute for Patient Safety and Quality

17. 3. Build trust. • Trust is the estimated probability that someone will do something: • That will affect our own actions, workload, emotions, or other outcomes • Without our being able to monitor and double check they’ve done it • Do you feel comfortable putting something you value in the hands of someone else? Armstrong Institute for Patient Safety and Quality

18. Components of trust Mayer & Davis (1999); Colquitt et al., (2007)

19. Components of Trust • My perception that another… • Is capable of performing task at hand • Is known to be successful at things they try • Has necessary knowledge • Is well qualified • Has skills that increase our performance Mayer & Davis (1999); Colquitt et al., (2007)

20. Components of Trust • My perception that another… • Cares about my welfare • Would not knowingly do anything to hurt me • Looks out for me • Will go out of their way to help me Mayer & Davis (1999); Colquitt et al., (2007)

21. Components of Trust • My perception that another… • Will stick to their word • Tries to be fair in dealing with others • Shows consistency between their words & actions • Uses sound principles or values to guide their behavior Mayer & Davis (1999); Colquitt et al., (2007)

22. How can leaders build trust? • Build a culture of trustworthiness. • Increase leader ability. • Build leader benevolence. • Demonstrate leader integrity. Armstrong Institute for Patient Safety and Quality

23. Action items • Self-assess (as a team)… • Who uses what type of power through which means in your projects? • Are there better approaches? • Do you have a vision statement for your organization? For your CUSP team? • Does it meet the criteria of effectiveness? • How is it implemented? • Where are our opportunities to build trust? • Increase ability? Build benevolence? Demonstrate integrity? Armstrong Institute for Patient Safety and Quality