Given the new Ontario Health Teams (OHTs) that are the entire buzz today in healthcare, I was searching for some research and data specific to the healthcare workforce on successful large transformations.

I found a lot of academic papers and researched studies on what large transformations look like and how success can be accomplished. One particular read of close to 150 pages, I felt, was one of the better written and researched ones; however, this is clearly too much to share in this column from start to finish. For the purpose of the new OHTs coming into formation, I felt one element was always noted in each section of the paper, regardless of where the transformation process was at, and that was leadership!

What does it take to be successful in such changing times, particularly with no structure or governance in place, and new partners coming to the table to become part of these new entities that now must work together to improve patient care? Always remember that what looks good on paper does not necessarily translate into success, in reality. The implementation of any project, be it small or a large new strategic plan, takes good leadership to be successful. Being a visionary is all about ideas and talking about potentials, being the person who takes that vision and implements it successfully.  That, to me, is a true leader and a success story.

Healthcare is still based on people. We continue to remain one of the sectors in the workforce that needs people to care for other people, despite technological advances or the number of additional computers, new x-ray machines, or surgical robots produced…healthcare is a business of caring. Technological growth is fine, as we must continue to move forward with advancement and research to improve diagnosis and find cures…however, caring for patients remains the same as it was a hundred years ago – hands on assistance from caring people.  In healthcare-based organizations – whether it’s EMS, hospitals, primary care offices, surgical suites, home care services, or long-term care homes – good leadership is a necessity.

The question now is, can you tell when someone has bad or good leadership skills? 

Good or Bad Leadership?

I know when it comes to the topic of leadership, one can find a lot of information, academic papers and books, research based conclusions, and companies that actually help people to self-improve on all things leadership. So this isn’t really a bite-by-bite explanation of leadership and the differences between bad and good, rather I’ve written a more condensed version of some of the traits that I’ve read about from multiple sources.

I believe each and every person reading this column can remember the one boss (or more in some cases!) that left a terrible impression on them and their co-workers, and actually did more damage to the department than any mistake an honest hard working RT could ever do. The practice of promoting only friends of the senior team continues even today in many facilities (let’s not kid ourselves); however, more and more, Human Resources are now seeking to promote people that have specific skills.  The main one is that they are people-centered individuals and they have a specific style of leadership. The two that are highly sought after in the non-profit sector are Servant Leadership and Values-Based Leadership. In simple terms, these styles of leadership are about serving the needs of people, so that staff can reach their fullest potential, and these leaders set the example for all to witness in day to day activities, such as dealing with issues or how they treat staff and the team around them.

One point found in the research of leadership is that high performing individuals may not necessarily be good managers. In other words, it is assumed that because someone is a high performer in their role at work that this somehow translates into being a good manager, but often other skills they bring to the table may be overlooked. For example, being a good performer in workload is very important, but without the right people leadership competencies (ie. a good mentor and leader that truly cares for their staff), a high performer will likely end up treating staff poorly, may abuse the power of their role, and ultimately bring down the department.  This may become evident with high staff turn-over, poor staff morale, or other similar indicators.

Some traits of leadership that have the potential to disengage employees and tear down departments:

Micromanager: A manager that micromanages is, plain and simple, a control freak! It makes the work environment stifling, because staff are afraid to make any decisions on their own, they have absolutely no say in anything, thus they don’t exist in the eyes of the manager as anything better than a worker bee that should be seen but not heard. In this case the leader/manager distrusts the team, asks for no feedback, and the style is autocratic. Loyal workers trying to find meaning and purpose in their jobs are left with nothing but orders to follow, and say nothing as no one will hear them anywOff balance: Although the following affects shift workers more, the issues found with this can also occur with those who work straight days… managers that don’t care at all about the work/life balance of their staff.  It can show up in scheduling, through a lack of input into the schedule prior to it being developed, disregarding requests for days off or specific weekends off, whether for medical visits or family events. As a result, people’s personal lives are negatively affected.  They become resentful of working shift work and ultimately of the organization. A good leader will think about work/life balance of their team. That does not mean giving in to every whim, but there should be a process in place so that each member affected by a set schedule is given equal asks and input regarding the schedule, making it fair and equitable.

Toxic: The toxic leader can do a lot of damage by the processes they put in place. These managers don’t trust anyone and even for a staff member to order something as simple as a box of pens, it becomes this lengthy overdrawn process of paperwork, asks and confirmations before being approved with the signature of the manager. This type of leader knocks the motivation out of the staff, making staff feel that they are not capable or trusted, and as a result the staff stop caring about their surroundings, given they have no input into anything.

Bad: When someone works for a bad leader that is rude and treats people like crap, destroys staff morale and strips them of any confidence, quite frankly, this is nothing but harassment.  Staff often put up with this, obligated to keep their job until they find another, or they may feel stuck financially.  This can negatively affect their health.  This actually happened to me, waking up with very real stomach aches prior to going to work every morning; I had not yet found another job, thus had no choice but to stay where I was and take the abuse of that manager I had. Having had this experience with this type of bad leader, I vowed back then as a front liner that should I ever get into management, I would never treat people the way I was being treated. A good leader shares information and is transparent with the team, communicating things openly and asking for feedback, too. As well, a good leader, when it permits, will ask for staff input before a decision is made, whereas the bad leader will keep information to themselves, making all the decisions without any staff input,  and they love to wield their power and control over the staff. They share nothing except when they absolutely must, and give out as little information as possible to their team. This behavior is the one that quickly shows in high staff turnover… staff leave, as this manager loves to show others the control they have over others. This is demeaning to the staff.

“If your actions inspire others to dream more, learn more, do more, and become more, you are an excellent leader.”

– John Quincy Adams

“The greatest leader is the one that gets the people to do the greatest things.”

– Ronald Reagan

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