The Clinical Informatics Board Exam: What You Need to Know About Leadership

Four Fundamental Elements of Clinical Informatics

1. Informatics Fundamentals
2. Clinical Decision Making and Care Process Improvements
3. Health Information Systems
4. Leading and Managing Change

Withinleading and managing change, the core content includes:

1. Leadership Models, Processes, and Practices
2. Effective Interdisciplinary Teams
3. Effective Communications
4. Project Management
5. Strategic and Financial Planning for Clinical Information Systems
6. Change Management

Within

1. Dimensions of effective leadership
2. Governance
3. Negotiation
4. Conflict Management
5. Collaboration
6. Motivation
7. Decision Making

What is Leadership?

• Leadership is not something that requires a role with manager, director, or VP in its title. Even those seemingly low on the corporate totem pole can be leaders.
• Leadership does not require that power be assigned. It can be commanded via respect or acquired over time.
• Leadership does not prefer extraversion over introversion or nature over nurture. There are many styles of leadership and types of people who succeed as leaders.
• Leadership is not always synonymous with management
• Trait Theory- Leadership is based on individual attributes
• Behavioral Theory - Evaluating leadership based on behaviors and broad leadership styles
• Situational and Contingency Theories - Different situations call for different leadership characteristics
• Functional Theory - The leader needs to be aware of and provide what the team needs at the correct moment

The 8 Dimensions of Leadership

1. Pioneering
2. Energizing
3. Affirming
4. Inclusive
5. Humble
6. Deliberate
7. Resolute
8. Commanding

energizing

affirming

inclusive

humble

deliberate

resolute

commanding

Governance

Governance relates to processes and decisions that seek to define actions, grant power, and verify performance. It is the rules and actions used to produce, sustain, and regulate an organization or group.

In healthcare, governance creates a leadership and decision making framework for IT, operational, financial, risk, reporting, regulatory, and other organizational management processes. Without governance, various arms of the organization can operate in complete opacity. Without it, large or small decisions that affect the organization can be made without input from stakeholders in the organization and without regard to its affect on others.

The benefits of implementing a governance operating model include:

• Increased transparency and consistency across the organization
• Decisions that are better aligned with the goals and strategic plan of the organization
• Better risk mitigation
• Increased collaboration
• Decreased duplication of work
• Better stakeholder involvement

Well implemented governance models help personnel better answer the questions of “why are we doing this?”, “who needs to know about this?”, and “how are we going to do this?”. They also serve as an entry point for new ideas, new business, new regulations, and other new needs that must be addressed and provided feedback on.

In the book, we also cover the four elements needed to implement a foundation for a governance structure into an organization plus why the word "committee" shouldn't always send shudders down your spine. 

Negotiation

Negotiation is reaching an agreement via discussion(s). Negotiations typically take place when two parties have a conflict of interest, a new partnership is to be formed, or two parties want to come to a compromise rather than arguing, conceding, or giving up.

Contrary to some beliefs, negotiation is not something you should go in to trying to “win” at the expense of the loss of the other party. Instead, a negotiation should result in a compromise between parties where both feel like they come out better off. If someone feels shortchanged once negotiations are over, then that party may be bitter and result in a poor working relationship.

In the book, we'll also cover tips to improve your negotiation skills and work out the best deal for you and your future partner. 

Conflict Management

Conflict is a serious disagreement or argument. While we’re quick to identify conflict with negative feelings and emotions, conflict itself can be good, bad, or neither depending on how it is dealt with. We’ll discuss different conflict styles and strategies to turn conflict into a positive situation. 

As you can see in the graphic below, a group is interrupted by an initial conflict, follows with an escalation of the conflict, and peaks with a resolution of the conflict that allows the group to fall back into their routine interactions.

Initial negative conflicts are typically spurred from one of three things: relationships, tasks, and processes. In addition to relationship, task, or process conflicts, conflicts may also stem from differences in superiority, vulnerability, distrust, helplessness, and injustice.

In the book we'll also cover constructive conflict, conflict management and conflict resolution techniques.  

Collaboration

As we discussed above, collaboration is the best “conflict” style to have. Collaboration is working with other individuals, groups, and organizations to find solutions that meet the goals of all parties involved. Collaborators have a high concern for group and individual outcomes. Because of this, those that collaborate with others can achieve greater access to resources, recognition, and rewards.

To use collaboration effectively, everyone must be on board – especially leadership since collaboration requires time and energy from all team members.

Motivation

Motivation is the inspiration and incentive to move toward a goal. Something is motivating you to study for this exam. What it is may be personal, professional, or something else entirely. It could be extrinsic such as a promotion at work or a pay raise, or intrinsic such as the successful completion of a challenge completed. It could also be that it gives you a sense of meaningfulness, a sense of choice, a sense of competence, and/or a sense of progress. All are feelings that may motivate you towards your goal.

Motives are the hypothetical constructs as to why someone does what they do. Some are simple and natural (hunger) while others are complex and involve rationality (running an ultra marathon to test one’s limits). Some of the prominent theories in motivation include:

• Drive
• Maslow's Hierarchy of Needs
• Herzberg's Two-Factor Theory
• Self-Determination Theory
• Goal-Setting Theory
• Intrinsic/Extrinsic Motivation

the book...

Decision Making

As a leader it may be your responsibility to make the decisions. You may already know that you can’t make decisions that everyone will always like and you can’t always make decisions that are correct, but you do have to make decisions. Indecisiveness is bad. So, how can you make the best decisions? We’ve provided a few guidelines below to help:

• Gather only the required information needed to make the decision
• Use questions to clarify your problem or decision. Is it based on fact or conjecture? Will it provide value? Or does it have to meet a policy or regulation?
• Discuss your potential decision with others and receive feedback if appropriate for the situation
• Listen to arguments, opinions, and suggestions, and be open to new ones you had not yet considered
• Explain your proposed decision and your rational for that decision

Decisions can be made in various ways such as voting, consensus, or authority, and vary depending on an individual’s decision making styles. Some styles include using rational and logical thinking, intuition, dependence on others, avoidance of making a decision, and those who make decisions spontaneously.

Just remember, decision-making is not problem solving. Decision-making requires coming to a conclusion, judgment, deciding on a particular option, or something otherwise concrete. Problem solving asks why and how or develops a plan for solving a problem – the two are not the same thing.

We get into more detail on each subject in our clinical informatics study guide. You can pre-order it now for its release in November.

Recommended Reading:

The 8 Dimensions of Leadership: DiSC Strategies for Becoming a Better Leader (Bk Business)

Getting to Yes: Negotiating Agreement Without Giving In

Drive: The Surprising Truth About What Motivates Us

Decisive: How to Make Better Choices in Life and Work