TRENDS IN NURSING MANAGEMENT AND
LEADERSHIP
Key Concepts
 Trends- direction
 Nursing Management- act or manner of
managing/controlling; skillful use of means to
accomplish a purpose
 Leadership- ability to persuade other to seek
defined objectives enthusiastically
LEADERSHIP
- Considered a necessary quality of a
manager; manager must have leadership
because he deals with people, and gets
results thru people
“Leadership as a personal quality” (combination
of personal characteristics)
“Leadership as an organization function”
(distribution throughout an organization of decision-
making processes)
WHAT IS LEADERSHIP?
- Often associated with people who could
dominate and command; those who bore
titles of authority
- Ability to persuade other to seek defined
objectives enthusiastically
- Working relationship; process used to
inspire others to accomplishment by
working with him
- Essence of leadership: “interpersonal
influence”; the leader is attempting to
influence the behavior of other people
through the communication process
- Qualities possessed by leaders:
a. Energy
b. Moderate level of intelligence
c. Some sociability
d. Some degree of self-confidence
- Types of Leadership (Behavioral Theory)
a. Instrumental and great men
leadership- effective leader is
characterized by the performance of
instrumental functions in the
achievement of group goals. These
instrumental functions consist of
planning, organizing, coordinating,
directing and controlling the work of
subordinates
b. Supportive or democratic leader- one
who endeavors to create a social
climate in which each person will want to
do his best and will not use compulsion
c. Autocratic leader- very conscious of
his own position and has little trust or
faith in his subordinates
“According to the great men theory, anyone
exhibiting both instrumental and supportive
leadership behavior will be an effective leader in
any situation.”
SKILLS OF A LEADER
 Technical Skills- a person’s knowledge of, and
proficiency in, any type of process or
technique; learned in the practice of an
employee on the operating level
 Human Skills- ability to interact effectively with
people and to build team work.
 Conceptual Skills- skills that deal with the idea,
goals, and plans of the organization; top
management deals with long-range plans,
broad relationships and other observations
THE ‘ACE’ PARADIGM
3 Elements:
 Align- today’s leader needs to align
resources, particularly human resources,
creating a sense of shared objectives
worthy of people’s support and even
dedication.
 Create- must create where ideas come
through unhampered by people who are
fearful.; committed to problem-finding not
just problem-solving; they embrace error,
even failure, because they know it will teach
them more than success
 Empower- involves the sense people have
that they are at the center of things, rather
than the periphery
LEADERSHIP CONCEPTS AND TRENDS
APPLIED TO NURSING
Teams need to be led by effective leaders in any
area of the nursing profession, be it in nursing
education or practice. Effective leaders need to
drive the whole quality improvement process. To
put into practice the leadership process is also to
maintain the continued growth and well-being of
each of the members of the organization.
Customers here means the students in an
academic community and the patients or clients in
any setting, or in the tertiary or curative setting or in
the communities.
QUALITY- satisfying the need and reasonable
expectation of the customer
HOW?
Total Quality Management (TQM)- a management
philosophy that centers on external customer
satisfaction as the key success; focuses on the
internal customers of the organization; and harness
the power, spirit, and creativity of its employees
  Clarify individual contributions toward
achieving customer satisfaction
Commitment to Quality
 Improve daily operations (continuous
Improve quality -> Cost by: -> Productivity improvement)
(Customer -less network improves  Maintain the gains achieved through
satisfaction) - fewer mistakes improvement projects
-fewer days
- better use of resources
FOUR PRINCIPLES OF TOTAL QUALITY
MANAGEMENT
1. Customer Satisfaction: Student/Employee
Provide jobs Stay in business Capture  the primary purpose of the TQM process
& more jobs market share is to ensure that the needs and
w/ better reasonable expectations of the external
quality and customer are satisfied
lower price  identify the customer: student nurse in
the college of nursing
 Communicate with the customer
(student/faculty) to establish agreed-upon
set of needs and reasonable
expectations (translated into valid
requirements) that are both desirable and
possible
 Sit down with the student/faculty to
discuss vision, mission, philosophy,
objectives, rules and regulations of the
organization to identify needs and
reasonable expectations
 Design the work process to ensure that
these valid requirements are met.
2. P-D-C-A- plan, do, check and act
TEAMS- provide a structured environment for
 Simple and corresponds to the way
employees to work together to:
people cooperate
 Improve quality of products and services  Provides a common language and a
through problem solving clear model
 Develop skills and attitudes This cycle is the heart of the TQM process:
 Promote communication and teamwork check the results, and act further improve or
 Enhance quality of worklife standardize. PDCA help us to keep on track
as well as to solve problems and make
continuous improvement/
3. Management by Fact- it is a two-step
POLICY MANAGEMENT- targets the achievement
process;
of breakthrough by concentrating institutional
a. 1st step- collect objective data so that
efforts and priority resources on a few issues.
information is valid
 Increase performance levels b. 2nd step- manage based on this
 Improve communication of institution/s information rather than according to
systems and department direction instinct, preconceptions, or other non-
 Attain participation in the development and objective input
achievement of long term and short-term 4. Respect for People- trying to the best of
goals our ability to create meaningful and
satisfying lives for ourselves.
Respect for people is manifested in such
Quality in Daily Work- requires application in the simple things as:
development of the Plan-Do-Check-Act (P-D-C-A)  Keeping informed and involved; showing
philosophy to activities necessary to meet the them how they are part of the bigger
needs and expectations of the customer. The goals picture.
are to:  Training people so that every individual is
the best that he or she can be at the job.
 Achieve consistency in daily work and  Helping people communicate well so they
improve results can do their jobs with peak effectiveness.
  Delegating responsibility and authority
downward so that people are not just
doing what I’m told (even it is wrong), but
are trying to make things work better.
 Creating a sense of purpose in the
workplace to motivate people do their
best.
TOOLS USED IN TEAM BUILDING
1. Team members’ needs and expectations
 Must know what they are.
 Successful at working together
(dynamics) and also successful in
achieving their goal (task).
 Certain basic needs of an effective team
members, interact productively.
(Physical, safety, psychological, security,
shared responsibility, respect, and the
chance to exercise initiative.)
2. The QI Story- quality improvement problem
solving process systemic data-based
approach to problem solving. It is a
structure that helps illustrate the steps to be
taken by a team in the improvement
process. It also provides a standard way of
communicating team progress.
 Reason for improvement
 Current situation
 Analysis
 Countermeasures
 Results
 Standardization
 Future plans
TECHNIQUES USED IN GENERATING IDEAS
ON A PROBLEM
1. Brainstorming- using group of people to
quickly generate, clarify, and evaluate a
sizeable list of ideas, problems, issues, etc;
the emphasis is on quantity of ideas, not
quality. 3 phases are:
a. Generation phase
b. Clarification phase
c. Evaluation phase
2. The Role of the Team Leader- leading the
team, teaching, communicating,
coordinating, sharing experience and
knowledge, and fulfilling administrative
duties. TEAM which means together
everyone achieves more. Shared leader
results from balancing concerns for task and
concerns for people.
Task People
Team Leader
“The team leader is also a team member.”
3. Consensus- implies the voluntary giving of
consent. It requires all decision makers to
discuss the issue until everyone can agree
on a solution. It is a win/win method. It
guarantees that nobody will lose because it
requires that the decision not be made until
everyone can live with it. Consensus is an
extremely useful technique for making sure
that everyone feels ownership of the action
which is finally taken.
SEVEN BASIC QUALITY CONTROL (QC)
TOOLS
1. Checklist/Checksheet- form on which data
may be collected systematically and
recorded in a uniform manner by means of
check marks or simple symbols.
2. Graphs- (pie chart, line graph, and or bar
chart); visual displays of quantitative data;
layout, describe or summarize a set of
number or statistics.
3. Pie Chart- graphically compares relative
magnitudes or frequencies of things through
slices of pie
4. Line graph- displays data, usually over time
to show trends.
5. Bar Chart- compares quantities
represented by rectangles (bars) of
uniforms widths, but of heights proportional
to the quantities represented.
6. Pareto Chart- organizes data to show the
major factor/s that make up the subject
being analyzed. It is search for significance.
The bars in pareto chart are arranged side
by side (touching) in descending order from
left. The basis for pareto analysis is the 80-
20 rule percent of the problems result from
20 percent of the causes.
7. Cause-and-effect analysis- help the team
solve a problem by identifying the root
cause so that corrective action can be take;
the diagrams is a picture composed of lines
and words designed to represent a meaning
relationship between an effect and its
causes. This tool is called the ‘fishbone’ or
‘Ishikawa diagram’.
8. Group Dynamics- Five stages:
 Form
 Storm
 Norm
 Perform
 Adjourn
Meeting guidelines:
1. Unite the group
2. Focus the group
3. Mobilize the group