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Transforming Health Care Leadership
A Systems Guide to Improve Patient Care, Decrease Costs, and Improve Population Health519
Health care organizations are challenged to improve care at the bedside for patients, learn from individual patients to improve population health, and reduce per capita costs. To achieve these aims, leaders are needed in all parts of the organization need positive solutions. Transforming Health Care Leadership provides healthcare leaders with the knowledge and tools to master the unprecedented level of change that health care organizations and their leaders now face. It also challenges management myths that served in bureaucracies but mislead in learning organizations.
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Michael Maccoby, PhD, is president of The Maccoby Group in Washington, DC and an associate fellow at the Said Business School, Oxford University. Clifford L. Norman, MA, ASQ Certified Quality Engineer, is a consultant with Associates in Process Improvement (API) and co-owner of Profound Knowledge Products, Inc. He is a member of the American Society for Quality (ASQ).. C. Jane Norman, BS, MBA, ASQ Certified Quality Engineer, is a consultant and president of Austin API, Inc. and Profound Knowledge Products, Inc. Richard Margolies, PhD, is a psychologist and vice president of the Maccoby Group who assists leaders in developing their leadership and strategy.
Figures, Tables, Exhibits xiii Preface xxi The Authors xxix Part 1: The Challenge to Health Care Organizations and Creating the Leadership Team 1 1 Introduction: From Management Myths to Strategic Intelligence 3 Plan of the Book 8 Part 1: The Challenge to Health Care Organizations and Creating the Leadership Team 8 Part 2: Strategic Intelligence and Profound Knowledge for Leading 9 Part 3: Learning from Other Leaders and Creating a Path Forward 11 Key Terms 11 2 Why and How Health Care Organizations Need to Change 13 The Purpose of the Preliminary Research 18 The Model of Change 18 Changing Modes of Production in Health Care 20 Health Care in Learning Organizations 20 Leadership for Learning 23 The Human Side of Change 24 Approach to Service 25 The Role of Culture 26 The Mayo Model 27 Summary 29 Key Terms 31 Exercises 31 3 Leading Health Care Change 35 Summary 43 Key Terms 43 Exercises 43 4 Developing a Leadership Philosophy 45 How to Develop a Philosophy 46 Purpose 46 Ethical and Moral Reasoning 46 Levels of Moral Reasoning 47 Practical Values 48 Gap Analysis 50 Defi nition of Results 51 Using the Purpose to Defi ne Results: Cherokee Nation Health Services 52 The Mayo Clinic Organization Philosophy 53 Summary 56 Key Terms 56 Exercises 56 Part 2: Strategic Intelligence and Profound Knowledge for Leading 59 5 Leading with Strategic Intelligence and Profound Knowledge 61 Foresight 63 Visioning as Designing the Idealized Organization 64 Partnering 65 Motivating 68 Profound Knowledge 68 Understanding Systems 69 Understanding Variation 71 Understanding Psychology 72 Understanding Theory of Knowledge 73 Employing Strategic Intelligence and Profound Knowledge 74 Summary 75 Key Terms 75 Exercises 76 6 Changing Health Care Systems with Systems Thinking 77 Interdependence 84 What Do We Mean by Process? 85 Two Kinds of Complexity 87 Classifi cations of Processes 89 Defi ning the System 93 Why Systems Thinking Is Difficult 96 Changing a System 97 Leverage, Constraints, and Bottlenecks 98 Systems and People: Improving Behavior 100 Summary 102 Key Terms 103 Exercises 103 7 Statistical Thinking for Health Care Leaders: Knowledge About Variation 107 Interpretation of a Control Chart 110 Avoiding the Two Kinds of Mistakes in Reacting to Variation 114 Graphical Display Using Statistical Thinking 115 Power of Simple Run Charts for Data Display 120 Leadership to Improve Population Health 127 Summary 131 Key Terms 131 Exercises 132 8 Understanding the Psychology of Collaborators 137 Personality Intelligence 139 Talents and Temperament 139 Social Character 140 Drives 141 Motivational Types 144 Identities and Philosophy 148 Bureaucratic and Interactive Values 149 Bureaucratic and Interactive 149 Motivation: Popular Ideas to Unlearn 151 Maslow s Hierarchy of Needs Theory 151 Maccoby s Critique of Maslow s Theory 152 Hawthorne Experiments: Maccoby Critique 152 Using Personality Intelligence 155 Creating the Environment for Intrinsic Motivation: The Five Rs of Motivation and the Seven Value-Drives 155 Leading with the Heart 160 Disciplines of the Heart 163 Seeing Things as They Are Deep Listening 163 Listening and Responding to Others 164 Summary 165 Key Terms 166 Exercises 167 9 A Health Care Leader s Role in Building Knowledge 169 How Do Theories Evolve? 170 Learning and Continuous Improvement 174 Shared Meaning and Operational Defi nitions 176 Utilizing a Standard Methodology for Learning in the Organization 177 Using Multiple PDSA Cycles to Build Knowledge 184 The Leader as Learner and Teacher 186 Summary 188 Key T