What does the literature indicate leaders are required to do? From extensive and repeated reviews of the research, Yukl (2013) argues for an integrative hierarchical framework of leader behaviors subsuming four broad categories: Task oriented: clarifying, planning, monitoring operations, problem solving y Relations oriented: supporting, developing, recognising, empowering Change oriented: advocating change, envisioning change, encouraging innovation, facilitating collective learning External networking: external monitoring, representing.
The following statement of what constitutes the essence of effective leadership:
1. Helping to interpret the meaning of events. Effective leaders help their followers make sense of change, catastrophes, successes and the future. They provide a narrative which both makes sense to people and inspires them to give of their best and make a positive difference. Martin Luther King’s ‘dream’ speech is an example.
2. Creating direction and alignment around strategies and objectives. Effective leaders clarify direction, strategy and the priorities for people’s efforts. They help to create shared understanding and agreement about direction. They define the key priorities (few in number) and make clear what the team is not going to do rather than overwhelming people with inspirational priorities. They help to define clear, challenging, measurable objectives for all.
3. Nurture commitment and optimism. They encourage belief in the team or organization about likely efficacy and a sense of the value of the work. They encourage positive attitudes and experiences rather than cynicism or defeatism and they do so with humour, belief and a sense of purpose which inspires others to be committed.
4. Encourage trust and cooperation. They emphasise the importance of people supporting each other, backing each other up and valuing each other’s contributions to build trust and cohesion. They work to continually develop mutual respect trust and cooperation among followers. They help to resolve conflicts quickly and fairly. They continuously build a strong sense of community and supportiveness that ensures people act cooperatively and supportively with colleagues.
5. Create a sense of collective identity. They encourage a strong and positive vision of the value of the team’s/organization’s work and a sense of pride in the efficacy of the group. They encourage a sense of identity for the group or organization, such that people derive value from being part of that collective. They enable the group/organization to see how their work makes a positive difference and they nurture a sense of the group’s character, uniqueness and identity through rituals, celebrations, humour and narrative.
6. Organize and coordinate work efforts. They ensure people are clear about their roles and contributions and help them work together in a coordinated way towards success. They are practical and timely in dealing with systems difficulties and coordination problems so that the group/organization can be successful.
7. Enable collective learning. They ensure followers engage in collective learning about errors, successes and means of ensuring continually improving quality. They ensure the group regularly takes time out to review objectives, strategies and processes so they collectively learn and improve.
8.Ensure necessary resources are available. They ensure the group or organisation has the resources (money, staff, IT support, time) necessary for them to get the job done and work actively and tirelessly to be certain these resources are in place. This may involve political acumen and risks in dealing with the wider organisation, customers and other stakeholders but they are consistent in working tirelessly to get the necessary resources for the group/organisation to be effective.
9. Develop and empower people. They focus on ensuring the continued growth and development of their followers; they provide high levels of autonomy and development opportunities to empower those they work with and ensure they continue to develop efficacy and confidence. They encourage followers to believe in their ability to respond successfully to greater challenges and responsibility while providing the necessary supports and resources to achieve this.
10.Promote social justice and morality. They emphasise fairness and honesty in their dealings with all, challenging unethical practices or social injustices on behalf of all, not just their followers. They set an outstanding example of ethical/moral behaviour, especially when it requires them to sacrifice their personal interests. From this brief review of the wider literature on leadership, we now turn to examine the research on leadership in health care specifically.