Notes on Contributors xvii Preface xxi Acknowledgements xxv Part I Clinical Leaders: Role Models for Values Based Leadership 1 1 Clinical Leadership Explored 5 David Stanley Introduction 5 Clinical Leadership: What Do We Know? 6 Attributes Less Likely to Be Seen in Clinical Leaders 8 Clinical Leaders Are Not Seen as Controlling 8 Clinical Leaders Are Not Seen as Visionary 8 Clinical Leaders Are Not Seen as ''Shapers'' 10 Attributes More Likely to Be Seen in Clinical Leaders 11 Clinical Competence/Clinical Knowledge 11 Approachability 13 Empowered/Motivator or Motivated 13 Supportive 13 Inspires Confidence 14 Integrity/Honesty 14 Role Model 14 Effective Communicator 15 Visible in Practice 15 Copes Well with Change 16 Other Attributes 16 Values: The Glue that Binds 17 Who Are the Clinical Leaders? 18 Clinical Leadership Defined 21 Why Clinical Leadership Now? 21 A New Agenda 22 Changing Care Contexts 22 Change Equates to More Leadership 22 More Emphasis on Quality 23 Summary 25 Mind Press Ups 25 References 26 2 Leadership Theories and Styles 31 David Stanley Introduction: Leadership - What Does It All Mean? 31 Leadership Defined: The Blind Man''s Elephant 33 No One Way 36 Leadership Theories and Styles 36 The Great Man Theory: Born to Lead? 36 The Heroic Leader: Great People Lead 37 The Big Bang Theory: From Great Events, Great People Come 37 Trait Theory: The Man, Not the Game 38 Style Theory: It''s How You Play the Game 40 Situational or Contingency Theory: It''s about Relationships 42 Transformational Theory: Making Change Happen 44 Transactional Theory: Running a Tight Ship 46 Authentic/Breakthrough Leadership: True to Your Values 47 Servant Leadership: A Follower at the Front 48 Other Perspectives 50 Shared Leadership/Collaborative Leadership 50 Compassionate Leadership 50 The Right Leader at the Right Time 51 Summary 54 Mind Press Ups 54 References 55 3 Values Based Leadership: Congruent Leadership 61 David Stanley Introduction: A New Theory 61 Values Based Leadership 62 Values Based Leadership Theories Applied in Healthcare 62 Congruent Leadership: Another View 66 It All Started with Clinical Leadership 66 Congruent Leadership Theory Explored 79 A Solid Foundation 80 The Strengths of Congruent Leadership 82 Grassroots Leaders 83 Foundation for Other Theories 83 Strong Link between Values and Actions 84 Supports Further Understanding of Clinical Leadership 85 Anyone Can Be a Congruent Leader 85 The Limitations of Congruent Leadership 85 New Theory 85 Similar to Other Values Based Leadership Theories 86 Not Driven by a Focus on Change 86 Not Suitable for Leaders with ''Control'' as an Objective 86 Congruent Leadership, Change and Innovation 87 Congruent Leadership and Power 88 Congruent Leadership and Quality 91 Summary 96 Mind Press Ups 97 References 97 4 Followership 105 David Stanley Introduction: From behind They Lead 105 Defining Followership 106 Followers'' Responsibilities 106 The Good Follower 110 The Not So Good Follower 113 Summary 116 Mind Press Ups 117 References 117 5 Leadership and Management 119 Clare L. Bennett and Alison H. James Introduction: Why Delineate? 119 Who Should Take Centre Stage? 120 Skills 123 The Need for Education 125 Toxic or Misunderstood? 127 The Future 128 A Culture Shift 129 Summary 131 Mind Press Ups 132 References 133 Part II Clinical Leadership Tools: How to Influence Quality, Innovation and Change 137 6 Organisational Culture and Clinical Leadership 139 Sally Carvalho and David Stanley Introduction: Values First 139 What Is Organisational Culture? 139 A Culture of Care and Compassion 142 Culture and Leadership 144 How Congruent Leaders Shape Culture 146 Clinical Leadership, Education and Training 150 Summary 152 Mind Press Ups 153 References 153 7 Leading Change 157 Clare L. Bennett and Alison H. James Introduction: Tools for Change 157 All Change 158 Transformational Change 159 Approaches to Change 160 SWOT Analysis 161 Stakeholder Analysis 162 Pettigrew''s Model 163 The Change Management Iceberg 164 PEST or STEP 165 Kotter''s Eight Stage Change Process 166 Nominal Group Technique 166 Process Re Engineering 167 Force Field Analysis 168 Restraining Forces 169 Driving or Facilitating Forces 169 How Do You Find Either Restraining or Facilitating Forces? 170 Initiating, Envisioning, Playing, Sustaining: A Theoretical Synthesis for Change 171 Beckhard and Harris''s Change Equation 172 People Mover Change Model: Effectively Transforming an Organisation 172 Instituting Organisational Change: An Examination of Environmental Influences 172 Change Is Never Simple, Even with a Model 172 Resistance to Change 173 Self Interest and Conflicting Agendas 173 Increased Stress 173 Uncertainty 174 Diverging Points of View 174 Ownership 174 Recognising the Drivers 175 Some People Just Do Not Like Change 175 Recognising Denial and Allowing Time for Reflection 175 Successfully Dealing with Change 176 Summary 179 Mind Press Ups 180 References 180 8 Patient Safety and Clinical Decision Making 183 Clare L. Bennett and Alison H. James Introduction: A Choice 183 Patient Harm 183 What Is Patient Safety? 184 Leadership and Patient Safety 185 Clinical Decision Making and Patient Safety 186 Terminology 188 Decision Making Approaches 188 Theories of Clinical Decision Making 190 Knowledge and Information 191 Intuitive Humanistic Model 191 Systematic Positivist, Hypothetico Deductive and Technical Rational Models 192 Integrated Patient Centred Model 192 IDEALS Model 193 Managerial Decision Making Process 193 Clinical Leadership and Decisions 194 Why Decisions Go Wrong 195 Not Using the Decision Making Framework 195 Flawed Data 195 Bias 195 Seeking to Avoid Conflict or Change 196 Ignorance 196 Hindsight Bias 196 Availability Heuristics 196 Over Confidence in Knowledge 196 Haste 196 How about Emotion? 197 Group Decision Making 197 Advantages of Group Decisions 198 Disadvantages of Group Decisions 198 Challenges 198 Summary 200 Mind Press Ups 201 References 201 9 Creativity 205 David Stanley Introduction: A New Way Forward 205 What Is Creativity? 206 Building Creative Capacity 209 Techniques for Developing Creativity 210 Relax 211 Keep a Notebook or Journal 211 Journaling 211 Record Your Ideas 211 Do or Learn Something New Each Day 211 Learn to Draw 211 Become a Cartoonist 212 Learn to Map Your Mind 212 Try Associational Thinking 212 Go for a Walk 212 Adopt a Genius 212 Open a Dictionary 213 Study Books about Creative Thinking 213 Flood Yourself with Information 213 Attend Courses 213 Listen to Baroque Music 213 Face a New Fear Every Day 213 Develop Your Imagination 213 Leave Things Alone for a While 214 Find a Creative Space 214 Develop Your Sense of Humour 214 Define Your Problem 215 Know Yourself Well 215 Use Guided Reflection 215 Be Mindful 215 Focus 215 Do Not Be Afraid to Fail 215 Develop Some Techniques for Creative Thinking 215 Barriers to Creativity 216 Organisational Barriers 217 Competition 217 Organisational Structure 217 Being Too Busy to Address a Problem 217 Too Hectic an Environment 217 A Sterile Environment 217 Poor or Harsh Feedback 218 Rules 218 Unrealistic Production Demands 218 The Boss Is Always Right 218 Poor Communication 218 Personal Barriers 219 Fear of Criticism/Fear of Failure 219 Our Belief that We Are Not Creative 219 Fear of Change 219 Ego 219 Beliefs and Values 219 Lack of Confidence 219 Stress 220 Previous Negative Experiences with Risk 220 Negative Self Talk 220 Routines 220 Other Barriers 220 Daily Distractions 220 Not Having a Place to Go or Time to Get There 220 Drugs 220 Leadership and Creativity 221 Summary 224 Mind Press Ups 224 References 225 10 Leading Teams 227 Alison H. James and Clare L.

Bennett Introduction: Identifying Dynamics and Self Role within Teams 227 Do We Really Need Teams? 228 Are We a Team or a Group? 229 Established Teams 230 High Performance Teams 230 OK or Functional Teams 232 Struggling Teams 232 ''Teaming'' for Healthcare 233 Creating Powerful and Positive Teams 234