Knowing Who You Are as a Leader

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Del curso dictado por The George Washington University

Leading Healthcare Quality and Safety

185 calificaciones

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The George Washington University

Leading Healthcare Quality and Safety

185 calificaciones

Ensuring patient safety and healthcare quality is critical and should be a key focus of everyone in healthcare practice. This course provides healthcare practitioners and others with an introduction to the knowledge and skills needed to lead patient safety and quality improvement initiatives at the micro and macro levels. Participants will explore the foundations of health care quality and the science underlying patient safety and quality improvement, design and select effective health care measures, analyze patient safety problems and processes using tools such as human factors analysis, apply systematic approaches including the Plan-Do-Study-Act (PDSA) model to address quality improvement challenges, and learn strategies to lead a culture of change. The course takes a world view of patient safety and quality, linking participants to research and resources from the World Health Organization (WHO), the US Agency for Healthcare Research and Quality (AHRQ), the Joint Commission and other international organizations. Course highlights include personal stories, lessons learned from other industries and interviews with the President of the National Committee for Quality Assurance (NCQA) and other leaders in quality movement. About The George Washington University School of Nursing Ranked among the top nursing schools by U.S. News & World Report, the George Washington University School of Nursing educates and inspires nurses to provide high-quality, compassionate person-centered health care. The school develops leaders actively engaged in health promotion, patient advocacy and healthcare innovation, and prepares exceptional nurse educators who pursue quality and advance the profession. The School of Nursing is committed to improving the health and wellbeing of people and communities locally, nationally and globally. The school values lifelong learning and its students advance nursing practice, leadership and education as they make a difference in the world.

De la lección

Leadership for Quality & Safety

Welcome to Module 5! This week we explore the importance of leadership in supporting and advancing quality and safety at all levels of the healthcare organization. We'll discuss strategies that contribute to a quality culture in health care, and examine different models of organizational change that you can apply as you lead your own quality and safety initiatives.

Introduction6:19

Culture of Improvement and Safety: Models for Creating More Effective Organizations10:52

Leadership and Followership in a Culture of Quality12:44

Knowing Who You Are as a Leader8:35

Overcoming Resistance to Change6:12

Conoce a los instructores

Jean Johnson

Professor, GW School of Nursing and Executive Coach
Gregory Pawlson

Clinical Professor of Medicine and Adjunct Professor, GW School of Nursing and Executive Coach

Episode 4, Knowing Who You Are as a Leader.

One of the primary motivations for those of us in healthcare,

is that we want to add something positive to the world by helping others.

I know that my image of myself as a physician,

was that I would be taking care of individuals.

And my learning was all about that, learning about diseases, their treatment

and how to assess a patient and how to learn to deliver both good and bad news.

What I had not thought about is how to be a leader, and yet

I was frequently cast in a role of a leader in both large and small ways.

What I learned since through both formal course work in my own life experiences is

the most important element of leadership is to truly know yourself.

Leaders have been described in many ways having many different attributes.

Among these attributes are having a vision, communicating the vision,

caring about people, honesty, delegating effectively,

having confidence, commitment,

a positive attitude, and a kitchen sink full of other characteristics.

However, at the deepest level, leaders, and especially leaders of change,

must understand themselves and how they function in their role as a leader.

Another key attribute of effective leaders is their ability to listen.

And to recognize ideas and

critical skills of others at all levels of the organization.

I've seen many situations where ideas to improve care generated by

hands on staff have been ignored to the peril of patients.

This frequently manifests itself as nursing and

medical staff during work arounds within a broken system because they can't get

the attention of the leaders of the organization to fix a systemic problem.

Many organization groups feel that there's far too much focus put into the leader,

the President, or the CEO and far too little attention given to the importance

of other levels of both formal and informal leaders within an organization.

Healthcare organizations that are too hierarchical tend to stamp out the ability

of people to be curious and to engage in systems thinking.

In addition, often little attention is paid to the teams that

are the real unit of work in the organization.

People are sort of thrown together whit the expectation

that they'll be productive.

But with little support for knowing how those teams should function and having

a limited idea of how the work of the team fits into the whole of the organization.

Kegan and Lahey have done a lot of work around mental complexity and

the fit between the complexity of an organization and the capacity for

the complexity of leaders.

This fit depends on the leader.

While organizational complexity can change,

it's the leader who needs to adjust.

Kegan and Lahey identified three plateaus for adult mental complexity.

The first plateau is the socialized mind, where the person is a team player and

a faithful follower and seeks direction and is reliant.

The second plateau is the self-authoring mind,

with the individual driving an agenda,

learning to lead and being a problem solver with a great deal of independence.

The self-transforming mind is the third plateau.

At this level the leader leads to learn and can reflect on the limits

of their own authority or ideology and can live with those contradictions.

This type of leader can be effectively messaging

that all communication is welcomed, both formal and informal.

In this model of mental complexity and

performance, each level builds on the previous level, with a self-transforming

mind being the highest level of mental complexity and therefore performance.

Work done by Eigel supports, higher level of mental complexity

is related to a more effective leader and a more effective organization.

So, what do Kegan and

Lahey suggest that can help leaders move to this higher plateau?

The challenge is to have leaders learn how to step outside their values and

beliefs and to look at issues and themselves through a new lens.

Only by stepping outside their usual way looking at things can the potential for

change happen.

Based on much research of the decades, as well as on their own work, Kegan and Lahey

suggest what they call optimal conflict, that helps move to a higher plateau.

Optimal conflict includes the persistent experience of some frustration,

dilemma, life puzzle, quandary, or personal problem that is

perfectly designed to cause us to feel the limits of our current way of knowing.

In some sphere of our living that we care about and

with sufficient supports, so that we are neither overwhelmed by the conflict nor

able to escape and diffuse it.

Knowing where you are at as a leader is critically important.

Having greater mental complexity will help in leading change.

Establishing a culture of quality and safety in today's healthcare environment

means doing this within very complicated situations.

Think about the changes in the health systems that you work in.

In a few short years, the US has been through health maintenance organizations

that kind of a procure organizations integrating technology for patient care,

integrating electronic health records.

And in addition, we've had to deal with new diseases that have emerged,

including HIV/AIDS, Ebola and the Zika virus.

The challenge to leaders is not just to create the quality culture but

to do this as the business of healthcare changes.

Argyris and Schon propose that organizations engage in single-loop or

double-loop learning to solve problems and describe these processes as follows.

When an error is detected and can be corrected in a way that allows

the organization to just carry on its present policies or achieve its current

objectives, this error in correction process is single-loop learning.

Double-loop learning occurs when the error is detected and

the correction requires changes and

modifications of an organization's underlying norms, policies and objectives.

While single-loop problem solving is efficient and usually sufficient,

healthcare organizations that stay within single-loop thinking often fail to

recognize situations that require double-loop learning and will fall behind

those who can seize on those opportunities to change their underlying norms,

policies and beliefs.

Thus building a deep culture of quality and safety.

It takes double-loop learning to challenge assumptions and

ways of doing business to build a true culture of safety.

One example of single-loop learning, for example,

would be recruiting a new director of quality insurance when the department

of quality insurance is not improving some key measures that are important.

Double-loop thinking would look deeper and

might include an analysis of what staff believes about quality.

And how quality improvement is supported or not throughout the organization.

Developing leadership capacity is not easy work.

However, there are ways of continuing to develop leadership capacity including

working with a coach, using leadership assessment instruments for feedback and

recognizing that leadership is not only about knowledge but also about heart.

To seek knowledge without the passion to apply that knowledge is useless,

it does not improve anything.

Self reflection is an important aspect of leadership, of leadership at every level.

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