The clinical informatics core content is organized into four fundamental elements. Unlike many other subspecialties where technical topics rule, clinical informatics places a strong emphasis on leadership and managing change. Why leadership? Because tackling many of the issues within clinical informatics such as new IT system implementations and completely re-engineering workflows requires not only technical skills, but the skills to get others to follow your lead and want to make the change.
These are some pretty critical skills, so let’s get started with the basics. Here’s how leadership fits into the overall topic of clinical informatics:
Four Fundamental Elements of Clinical Informatics
- Informatics Fundamentals
- Clinical Decision Making and Care Process Improvements
- Health Information Systems
- Leading and Managing Change
Within leading and managing change, the core content includes:
- Leadership Models, Processes, and Practices
- Effective Interdisciplinary Teams
- Effective Communications
- Project Management
- Strategic and Financial Planning for Clinical Information Systems
- Change Management
We’ll be primarily discussing the first sub-topic – leadership models, processes and practices.
Within leadership models, processes and practices, the following topics are covered:
- Dimensions of effective leadership
- Conflict Management
- Decision Making
What is Leadership?
We can’t just jump right into the dimensions of leadership without discussing what leadership is and is not…so without further ado…
Leadership is using social influence to enlist the help of others to accomplish a mutual task or goal. Notice that the definition of leadership does not include things such as managing or directing. In fact, there are many things that leadership is not, including some of the following:
- 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
The influence that leaders have on our workplaces, industries, and daily lives is so great and so fascinating, its no wonder that hordes of research has been done on what makes leaders effective. Multiple theories that have emerged from leadership research. Some of the more popular include:
- 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
Good leadership motivates people to action, provides guidance and direction, builds a positive work environment, and promotes collaboration within and across organizations. Good leaders not only know, but do. They also can change their style based on the maturity of the group and understand when a change in style is needed.
The 8 Dimensions of Leadership
Because leaders lead people, they need to be flexible in the way they organize others towards their goals. Determining the right actions, traits, behaviors, attitudes, and priorities needed for the situation is what makes a leader effective. These beliefs, attitudes, and priorities can be grouped into various styles, or dimensions, or leadership. Sugerman, Scullard, and Wilhelm define the eight dimensions for leadership as:
The pioneering leader is unafraid to move into uncharted territory. They are bold, but can be overconfident and impulsive.
The energizing leader is energetic and excited to go after new ideas. However, their high levels of activity can cause them to be inconsistent and unpredictable.
The affirming leader supports others and creates an open and positive environment. However, they may fail to keep others accountable or address problems indirectly so as not to cause conflict.
The inclusive leader promotes collaboration and accommodates all within the team. However, their inclusiveness and gentleness can be taken advantage of by others who are more cutthroat.
The humble leader is modest, reliable and consistent. However, their need for consistent can make them risk-averse and unlikely to make bold decisions.
The deliberate leader is intentional and purposeful in their actions. They’re careful planners and deliver high quality results. However, their need for analysis can cause them to overlook the human dimension of leadership.
The resolute leader is independent and unafraid to challenge the status quo. However, their disdain for the status quo can make them appear pessimistic and cynical.
The commanding leader is decisive and uses delegation to effectively reach goals. However, the commanding leader can be seen as too push or forceful.
You may find yourself drawn to one particular style of leadership on this list and that’s OK. You can be a good leader if you’re very good at your style of leadership. However, to become a great leader, you may want to work on developing the competencies and skills of some other dimensions so you can become a flexible, multi-dimensional leader.
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 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 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.
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 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:
- Maslow’s Hierarchy of Needs
- Herzberg’s Two-Factor Theory
- Self-Determination Theory
- Goal-Setting Theory
- Intrinsic/Extrinsic Motivation
We’ll cover more detail in…you guessed it…the book…
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.
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
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