Developing Effective Leaders to Meet 21Stcentury Health Care Challenges

Developing Effective Leaders to Meet 21Stcentury Health Care Challenges

Chapter 3

Developing Effective Leaders to Meet 21stCentury Health Care Challenges


The learner will be able to:

1.Describe factors that are driving the need for innovative and transformational leaders in healthcare for the 21st century.

2.List five healthcare leadership challenges of the 21st century.

3.Delineate three effective strategies to promote and sustain an evidence-based practice organizational culture.

4.Explain why effective leaders in the 21st century must engage in mentoring of young leaders and succession planning today.

5.Describe the characteristics required of leaders in order to effectively promote innovation and change.

6.Discuss the importance of teamwork, effective communication, and transdisciplinary/de-siloed work as they relate to healthcare outcomes.

7.List 13 essential characteristics of effective leaders.

8.Recognize the areas of change that have occurred as a result of the “electronic world.”

9.Discuss the strengths and weaknesses of three leaderships models; transactional, transformational, and complexity.

10.Distinguish the unique leadership components required in the complexity leadership model.




Evidence-based practice

Succession planning


Transdisciplinary health care

Workplace wellness

Transactional/instrumental leadership

Inspirational/transformational leadership

Complexity leadership model

Trimodal model

Culture of innovation and change

Team vision

Risk taker






Key Concepts

1.Leadership is imbedded in relationships, effective communication, shared ownership, and the coaching and motivation of others.

2.In order to be successful, leaders must possess important characteristics to overcome the major challenges that plague healthcare in the 21st century including dwindling resources, organizations and practices steeped in tradition, and intense pressures to achieve high-value, high-reliability organizations.

3.Leaders must have the knowledge and skills to create cultures of evidence-based practice that ignite a spirit of inquiry throughout organizations and cultivate an environment where outcomes management flourishes.

4.Continuity is a vital aspect of effective organizations and is critical to strategic and operational goals. Succession planning is the cure for disruption in an organization’s continuity. It is a process of creating an internal leadership pipeline that delivers internal candidates for promotion. As a result, less time and effort is needed to orient them and they are more likely to be successful in their new positions. In turn, organizations can accomplish effective resource stewardship and continued focus on the strategic mission.

5.Transdisciplinary care is emerging as an essential requirement for health care, focusing on true interprofessional decision making and trust among a variety of healthcare providers. This merging of specialized knowledge to act on the same situation results in better and faster results for the recipient of care.

6.Nurses need to be active contributors to key discussions and decision-making forums that influence the science and delivery of health care and need to be proactive such that the right nurses are positioned at the right organizational and health policy tables.

7.Workplace wellness is critical not only for the health of nurses directly but also to enhance productivity and decrease absences and high turnover rates.

8.To create a culture of innovation and change, leaders must acknowledge, embrace, and demonstrate engagement in innovation and change in their own leadership practices first. Only then are leaders able to help others to learn, embrace, and imbed the requirements of innovation and change into their individual practices. Creating a culture of innovation and change is not a passive process; it requires active participation, role-modeling, and mentorship by the leaders involved.

9.Leaders must possess numerous essential characteristics, such as an ability to inspire a team vision, effective communication skills, integrity, and an ability to mentor and encourage their team to excel among others, in order to be effective.

10.Technology has led to four areas of change: media, time, space, and structure.

11.Transactional or instrumental leadership is the most common and well-known leadership style employed in healthcare. In this model, the focus is on task orientation, leader direction, and follower participation with the expectation of rewards, threats, or disciplinary action from the leader.

12.Inspirational or transformational leadership is the second most common leadership model; it emphasizes the emotional and ideological appeals using exemplary behavior, confidence, symbolism, and intrinsic motivation. The work of managing meaning, infusing ideological values, and co-creation of goals is recognized as processes of empowerment for both the leader and the follower. The exchange between leader and follower is elevated to include the value of personal growth for the followers.

13.The complexity leadership model is based on complexity leadership theory (CLT) and provides a new lens for leadership to increase effectiveness and efficiency.This model recognizes healthcare organizations as networks of people, resources, knowledge, and other entities composed of overlapping, informal boundaries; leadership is both positional and informal, incorporating the full potential of human and social capital.

14.The trimodal model reframes and identifies three vital work processes for leaders:operational stability, innovative leadership, and transformation from innovation to operations. These three categories are designed to manage the present, look to the future, and support the processes in between.

Teaching/Learning Activities

1.Have the students interview a nurse whom they consider is a leader. Inform them that as they interview this person, they should keep in mind the 13 essential characteristics of a leader. Have the students identify which characteristics their interviewer demonstrated and share their findings with the class. Review the list of characteristics for those that were identified most often. This discussion could occur in a traditional classroom or online in chat rooms or on discussion boards.

2.Using the same nurse leader interviewed in activity 1, have the students identify the type of leadership model used. Then prepare an oral presentation of 3 to 5 minutes that describes specific examples from the nurse interview that support the model chosen. This oral presentation could occur in a traditional classroom or online in chat rooms or on discussion boards.

3.Ask students to review the healthcare leadership challenges of the 21stcentury (Box 3.1). Have each student select one of the challenges and write a two-page essay, proposing ways that they would address the challenge.